Author: Marie Benz MD FAAD
12 Mar Low Birth Weight Babies at Higher Risk of Infertility Later in Life
MedicalResearch.com Interview with: Dr Josefin Vikström Division of Obstetrics and Gynecology Department of Clinical and Experimental Medicine Faculty of Health Sciences Linköping University, Linköping, Sweden MedicalResearch.com: What are the main findings of the study? Dr. Vikström: Our study showed that women with a female infertility factor were more than two times more likely to have been born with a low birth weight (less than 2500g) or small for gestational age compared to women where the cause of infertility was unknown and/or male.12 Mar Randomized Controlled Trials: 25% Discontinued, Mostly in Patient Studies
MedicalResearch.com Interview with:
Matthias Briel, MD, MSc
Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital of Basel, Basel, Switzerland
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
MedicalResearch.com: What are the main findings of the study?
Dr. Briel: Using a retrospective cohort of 1017 randomized controlled trials (RCTs) based on archived protocols approved by six research ethics committees in Switzerland, Germany, and Canada between 2000 and 2003, we found that 25% of initiated RCTs were discontinued. While discontinuation was common with RCTs involving patients (28%), it was rare in RCTs with healthy volunteers (3%). The most commonly reported reason for RCT discontinuation was poor recruitment (10% of included RCTs). We found that trials with investigator sponsor (versus industry) and those with smaller planned sample sizes were at higher risk of discontinuation due to poor recruitment. Of discontinued RCTs, up to 60% remained unpublished. Trial investigators rarely informed research ethics committees about trial discontinuation and publication.
12 Mar E-Cigarettes Use By Adolescents May Lead to Heavier Smoking
MedicalResearch.com Interview with:
Lauren Dutra, ScD
Postdoctoral Scholar, UCSF School of Medicine
Cardiovascular Research Institute
San Francisco, CA 94143
MedicalResearch.com: What are the main findings of the study?
Answer: Middle and high school students who used e-cigarettes were more likely to smoke tobacco cigarettes. They were also more likely to progress from experimenting with tobacco cigarettes to becoming regular smokers.
Teen smokers who used e-cigarettes were more likely to be planning to quit in the next year and less likely to have abstained from smoking recently, compared to smokers who had never used e-cigarettes. They were also more likely to be heavier smokers (smoke more cigarettes per day) than those who had never tried e-cigarettes, that being said there are eliquids available that have no nicotine content whatsoever and these are therefore a much healthier option, you can see a wide variety of these at Gourmet E-Liquid.
12 Mar Massachusetts Health Care Reform and the Working Poor
MedicalResearch.com Interview with: Liane J. Tinsley, MPH Associate Research Scientist Department of Epidemiology New England Research Institutes, Inc. Watertown, MA 02472 MedicalResearch.com: What are the main findings of the study? Answer: For this study, we analyzed health insurance data from a cohort of community-dwelling individuals between the ages of 30-79 at baseline, in Boston, MA. Massachusetts health care reform legislation, including the expansion of Medicaid, resulted in substantial overall gains in coverage in our study population. Despite being targeted by the law, the working poor (those currently working for pay, either part- or full-time and earning less than 200% of the US federal poverty threshold for household size) continued to report lower rates of insurance coverage following reform (13.3% without insurance), compared to the both non-working poor (4.7% without insurance) and the not poor (5.0% without insurance).12 Mar PTSD and Plasma Marker of Inflammation CRP
MedicalResearch.com Interview with:
Dr. Dewleen Baker MD
Veterans Affairs (VA) San Diego Healthcare System, San Diego, California
MedicalResearch.com: What are the main findings of the study?
Dr. Baker: The main finding of this study is that a marker of peripheral inflammation, plasma CRP may be prospectively associated with PTSD symptom emergence, suggesting that inflammation may predispose to PTSD.
12 Mar Depression and Hearing Impairment in Adults
MedicalResearch.com Interview with:
Dr. Chuan-Ming Li MD, PhD
Statistician (Health/Medicine)
Division of Scientific Programs
The National Institute on Deafness and Other Communication Disorders
MedicalResearch.com: What are the main findings of the study?
Dr. Chuan-Ming Li: We used data on adults 18 years or older from the National Health and Nutrition Examination Survey for the study and found that prevalence of moderate to severe depression was 4.9 percent for individuals who reported excellent hearing, 7.1 percent for those with good hearing and 11.4 percent for participants who reported having a little hearing trouble or greater hearing impairment (HI). Depression rates were higher in women than in men. The prevalence of depression increased as hearing impairment became worse, except among participants who were deaf. There was no association between self-reported HI and depression among people ages 70 years and older; however, an association between moderate HI measured by pure-tone threshold hearing exams and depression was found in women aged 70 years and older but not in men.
12 Mar Alcohol in Early Pregnancy Associated with Preterm, Small Babies
MedicalResearch.com Interview with:
Camilla Nykjaer, PhD Student
School of Food Science and Nutrition
University of Leeds, Leeds, UK
MedicalResearch.com: What are the main findings of the study?
Answer: In our study, there was an association between the mother drinking alcohol during early pregnancy and being born preterm or small for gestational age. Babies of women who drank more than 2 units of alcohol per week in the first trimester were more likely to be born preterm, small for gestational age and with lower birth weight compared to non-drinkers, even after adjusting for a range of confounders including cotinine levels as a biomarker for smoking status. The association with preterm birth was present even in those mothers who reported drinking less than 2 units/week.
12 Mar ALS Amyotrophic Lateral Sclerosis: FDG-PET as Marker of Cerebral Involvement
MedicalResearch.com Interview with:
Prof. Dr. Philip Van Damme, MD, PhD
Neuromuscular Reference Center, Neurology Department, University Hospitals Leuven
Vesalius Research Center, VIB, Leuven
Leuven Institute of Neurodegenerative Disorders (LIND)
KU Leuven, Belgium
MedicalResearch.com: What are the main findings of the study?
Prof: Van Damme: Earlier FDG-PET studies carried out in the 80’ties already pointed out that patients with ALS had decrease glucose uptake in the brain that is more extended than the motor cortex, at least at the group level. Of course, this imaging technique has been improved since then.
We prospectively assessed the diagnostic and prognostic value of FDG-PET in patients that were referred to us because a diagnosis of ALS was suspected.
The most important finding of our study probably is that FDG-PET shows perirolandic and variable frontotemporal hypometabolism in most patients with ALS at the first presentation in our clinic. It suggests that FDG-PET is a very sensitive marker of cerebral involvement in ALS, which has a high sensitivity at the single patient level.
In addition our study revealed that the co-occurrence of extensive prefrontal or anterior temporal hypometabolism was present in about 10% of patients and had a negative effect on survival after disease onset.
11 Mar Orthopedic Trauma Patients: ‘Doctor Shopping’ and Increased Narcotics Use
MedicalResearch.com Interview with:
Brent J. Morris, M.D.
Shoulder and Elbow Surgery Fellowship
Texas Orthopaedic Hospital in affiliation with the University of Texas Houston Health Science Center, Houston, Texas
MedicalResearch.com: What are the main findings of the study?
Dr. Morris: There are concerns that an increasing percentage of patients are receiving narcotics by “doctor shopping” or seeking narcotics from multiple providers. One in five of our postoperative orthopedic trauma patients received narcotics from one or more additional providers other than the treating surgeon.
Patients that doctor-shopped postoperatively had a significant increase in narcotic prescriptions, duration of narcotics, and morphine equivalent dose per day.
11 Mar Emergency Room Visits for Insulin-Related Hypoglycemia
MedicalResearch.com Interview with:
Andrew I. Geller, MD
Medical Officer in the Division of Healthcare Quality Promotion at CDC.
MedicalResearch.com: What are the main findings of the study?
Dr. Geller: Using CDC’s national medication safety monitoring system, we estimated that, each year, there were about 100,000 visits made to U.S. emergency departments (EDs) for insulin-related hypoglycemia and errors during 2007-2011, or about half a million ED visits over the 5-year study period. This is important because many of these ED visits for insulin-related hypoglycemia may be preventable.
We also found these ED visits were more common with increasing age: every year, 1 in 49 insulin-treated seniors (aged 65 years or older) visited the ED because of hypoglycemia while on insulin or because of a medication error related to insulin. Among the very elderly (aged 80 years or older), this number was 1 in 8 annually.
11 Mar Suicide in Children and Adolescents: Relationship Between Peer Victimization, Cyberbullying
Posted at 02:14h
in Author Interviews, BMJ, Mental Health Research, Pediatrics, Psychological Science
MedicalResearch.com Interview with:
Mitch van Geel, PhD
Institute of Education and Child Studies, Leiden University
Leiden, the Netherlands
MedicalResearch.com: What are the main findings of the study?
Dr.van Geel: We performed a meta-analysis, which is a way to statistically summarize effect sizes from earlier studies. Individual studies often provide varying effect sizes, which makes it difficult to judge whether and how strong variables are related. Furthermore, study characteristics (sampling methods, response rates, controlling for certain confounders) might influence study results. By using a meta-analysis it can be analyzed to what extent study characteristics are related to results; if a particular result only tends to be established in studies with certain designs (for example a convenience sample), we might wonder whether such an effect really exists; but if we find that a particular outcome is unrelated to study characteristics or found in studies with relatively stronger designs, we might feel more certain in concluding that a relation between variables (bullying-suicide thoughts or attempts) exists.
By using a meta-analysis we established a significant relation between bullying and thoughts about suicide, and bullying and suicide attempts, and we found that these results were unrelated to study characteristics.
11 Mar Excessive Substance Use: Training Family Physicians to Deliver Brief Intervention
MedicalResearch.com Interview with: Dr. Dagmar Haller, MD, PhD Médecin adjointe agrégée Unité Santé Jeunes Hôpitaux Universitaires de Genève Suisse MedicalResearch.com: What are the main findings of the study? Dr. Haller: One year after a consultation with a family doctor there was a 28% reduction in the proportion of excessive substance users among those who had reported excessive use at the start of the study but there was no significant difference between the group that received counseling and the one that did not.09 Mar COPD: Using FEV6 to Identify More Affected Patients
MedicalResearch.com Interview with:
Surya P Bhatt MD
Assistant Professor
Division of Pulmonary and Critical Care Medicine
University of Alabama at Birmingham
MedicalResearch.com: What are the main findings of the study?
Dr. Bhatt: The forced vital capacity (FVC) maneuver is a difficult maneuver for many patients and the forced expiratory volume in the first 6 seconds (FEV6) has been shown to be a reliable substitute. We used imaging findings on computed tomography, COPD questionnaires and tests of exercise capacity to compare these two spirometric measures (FEV1/FVC and FEV/FEV6) in the diagnosis of airflow obstruction, and showed that FEV6 can be reliably substituted for FVC. Our findings suggest that using FEV6 may in fact identify more patients with disease than by using FVC.
09 Mar Decreasing Bacterial Contamination from Surgical Gloves, Gowns
Posted at 02:14h
in Author Interviews, Hospital Acquired, Infections, NIH, Surgical Research, University of Pennsylvania, Wake Forest
MedicalResearch.com Interview with:
William G Ward, Sr. MD
Chair of Orthopaedic Surgery, Chief of Musculoskeletal Service Line - Guthrie Clinic
Sayre, Pennsylvania 18840
(Professor Emeritus - Wake Forest University Dept of Orthopaedic Surgery)
MedicalResearch.com: What are the main findings of this study?
Dr. Ward: The main findings of the study include:
- The use of disposable spun-lace “paper” gowns was associated with a dramatic decrease in the likelihood of culture-detected bacterial contamination on the surgeon’s gloved hand and gown sleeve.
- For a double-gloved surgeon, changing the outer glove just prior to implant handling should decrease bacterial contamination from the surgeon by about 50%.
- Bacteria suspended in saline solution transgressed the material of standard reusable scrub attire in 96% (26/27) of tested gowns and in 0% (0/27) of spun-lace disposable “paper” gowns.
07 Mar Electronic Medical Records: Decreased Face-to-Face Communication Between Physicians and Nurses
MedicalResearch.com Interview with: Stephanie Parks Taylor MD MS Associate Professor Director of Clinical Research Associate Division Director, Hospital Medicine USF Department of Internal Medicine MedicalResearch.com: What are the main findings of your study? Dr. Parks Taylor: The integration of electronic medical records has been proposed to have many benefits for the healthcare system. We investigated the effect of EMR implementation on communication between physicians and nurses in a hospital setting. The primary finding was that overall agreement about a patient's plan of care actually worsened after the implementation of EMR. This seemed to be related to a decrease in face-to-face communication between physicians and nurses.06 Mar Online Access to Dietitian Improved Weight Loss
MedicalResearch.com Interview with:
Beverly B. Green, MD, MPH
GroupHealth Research Institute
Seattle WA
MedicalResearch.com: What are the main findings of the study?
Dr. Green: We found that Group Health patients who were overweight and had hypertension were more likely to have lost 10 pounds in six months if they had secure online access to a dietitian than if they received only information and usual care. The patients really loved this intervention—and having access to a dietitian to work with them toward a healthier lifestyle. Although blood pressure and heart risk trended lower in the intervention group, the differences weren’t significant—unlike their weight.
06 Mar Early Prostate Cancer: Watchful Waiting or Radical Prostatectomy?
MedicalResearch.com Interview with: Anna Bill-Axelson MD, PhD Department of Urology Uppsala University Hospital Uppsala, Sweden MedicalResearch.com: What are the main findings of this study? Dr. Bill-Axelson: The main finding is that surgery reduces prostate cancer mortality but not all men need curative treatment. After up to 23 years of follow up we found that men with low-risk tumors did not...
06 Mar Low-Fat Diet: No Proof Of Positive Health Effects
MedicalResearch.com Interview with:
Dr James J DiNicolantonio PharmD
Ithaca, New York
MedicalResearch.com: What are the main findings of the study?
Dr. DiNicolantonio: The increase in the prevalence of diabetes and obesity in the United States occurred with an increase in the consumption of carbohydrate not saturated fat. There is no conclusive proof that a low-fat diet has any positive effects on health (good or bad). The public fear that saturated fat raises cholesterol is completely unfounded as the low-density lipoprotein (LDL) particle size distribution is worsened when fat is replaced with carbohydrate. A public health campaign is drastically needed to educate on the harms of a diet high in carbohydrate/sugar.
06 Mar No Increase in Complications from Surgery on Weekends
MedicalResearch.com Interview with: Mr. Aneel Bhangu West Midlands Research Collaborative, Academic Department of Surgery Queen Elizabeth Hospital Birmingham UK MedicalResearch.com: What are the main findings of the study? Mr. Bhangu: Out study was based on a novel collaborative approach, spanning 95 centres in the UK. It was led by surgical trainees, who form a natural network and work in a rotational pattern. These networks will mature to allow a future of clinical research to be embedded into routine NHS care. Our study found no increase in complications based on weekend operating. It’s possible that patients present differently at weekends, or that surgeons select less complex patients to operate upon. A key secondary finding is that patients operated on at weekends were less likely to undergo laparoscopy. This means that they are exposed to different processes of care, which may introduce risk. This may be a surrogate marker for other differences in weekend care that require exploration.06 Mar HealthCare Quality: Should “Willful Neglect” Be a Criminal Offense?
MedicalResearch.com Interview with:
Karen Yeung
Professor of Law
Centre for Technology, Ethics Law & Society
King's College London
London WC2R 2LS
MedicalResearch.com: What are the main findings of the study?
Professor Yeung: This study found a gap in existing legal regulation of healthcare quality in the UK. While patients receiving treatment under mental health legislation are protected by the criminal law against wilful neglect or ill treatment, other patients are not subject to the same level of protection, although many such patients are just as vulnerable as those who are mentally incapacitated. Hence we argue that a new criminal offence of 'wilful neglect or ill treatment' of patients in the healthcare sector is needed.
05 Mar Genetically Elevated BMI Raises Risks of Hypertension and Diabetes
Posted at 21:44h
in Author Interviews, Blood Pressure - Hypertension, Diabetes, Genetic Research, University of Pennsylvania
MedicalResearch.com Interview with:
Brendan Keating D.Phil
Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania
Lead Clinical Data Analyst, Center for Applied Genomics
Children's Hospital of Philadelphia
Michael V. Holmes, MD, PhD, MSc, BSc, MRCP
Transplant Surgery
Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
MedicalResearch.com: What are the main findings of the study?
Answer: We found that individuals with a genetically-elevated BMI had higher
blood pressure, inflammatory markers, metabolic markers and a higher
risk of type 2 diabetes, although there was little correlation with
coronary heart disease in this study population of over 34,500
European-descent individuals of whom over 6,000 had coronary heart
disease.
05 Mar Mother’s Diet and Preterm Delivery
MedicalResearch.com Interview with:
Dr Linda Englund-Ögge
Department of Obstetrics and Gynaecology, Institute of Clinical Sciences
Sahlgrenska Academy, Sahlgrenska University Hospital
Gothenburg, Sweden
MedicalResearch.com: What are the main findings of the study?
Answer: Women adhering to a prudent* or a traditional** dietary pattern during pregnancy had a significantly reduced risk of preterm delivery, even after adjusting for a range of confounders. The prudent pattern was also significantly associated to lower risk in the nulliparous, in spontaneous and in late preterm delivery.
*, characterized by high intake of e.g. vegetables, fruit, whole grains and water to drink.
**, characterized by high intake of e.g. boiled potatoes, fish and cooked vegetables.
05 Mar Adult Cancer End of Life Care: Palliative Chemotherapy and Place of Death
MedicalResearch.com Interview with:
Holly G. Prigerson, Ph.D.
Irving Sherwood Wright Professor in Geriatrics
Professor of Sociology in Medicine
Co-Director, Center for End-of-Life Research
Weill Cornell Medical College
New York Presbyterian Hospital
New York City, New York 10065
MedicalResearch.com: What are the main findings of the study?
Dr. Prigerson: The main outcome of the research was end-of-life treatment and location of death with secondary outcomes being length of survival, late hospice referrals and attainment of preferred place of death. We found that 56 percent of patients receiving palliative chemotherapy in their final months. Patients treated with palliative chemotherapy were five to 10 times more likely to receive intensive medical care and to die in an intensive care unit (ICU). Fewer than half died at home as compared with two-thirds of patients with metastatic cancer not treated with palliative chemotherapy.
More specifically, we found that palliative chemotherapy was associated with:
- Increased use of CPR and mechanical ventilation: 14% versus 2%
- Late hospice referral: 54% versus 37%
- Death in an ICU: 11% versus 2%
- Death away from home: 47% versus 66%
- Death away from their preferred place: 65% versus 80%
05 Mar HPV Vaccination and Prevention of Cervical Abnormalities
MedicalResearch.com Interview with: Dr Julia Brotherton Victorian Cytology Service, Melbourne, Victoria, Australia Dr Elizabeth Crowe The University of Queensland, School of Population Health, Brisbane, Australia NHS Borders, Department of Public Health, Melrose, Scotland, UK Prof. David Whiteman Group Leader / Department Coordinator QIMR Berghofer Medical Research Institute Royal Brisbane Hospital, QLD 4029 MedicalResearch.com: What are the main findings of the study? 1. We conducted a case-control study in which we retrieved the HPV vaccination histories of young Australian women who were notified to the Pap smear registry with high-grade cervical lesions or with other types of cervical lesions, and compared them with the vaccination histories of women whose Pap smears showed only normal cytology. 2. We found that women with high grade cervical lesions were significantly less likely than women with normal cytology to have received 3 doses of the quadrivalent HPV vaccine, equivalent to a vaccine effectiveness of 46%. 3. The vaccine effectiveness among 15-19 year old women was even higher at 57%. We believe this reflects the fact that HPV16 causes an even higher proportion of high grade disease in young women due to its higher oncogenicity and shorter latent period. 4. The HPV vaccine had 34% effectiveness against other cervical lesions (i.e. those not proven to be high grade lesions on histology). 5. We also observed that 2 doses of the vaccine were 21% effective in preventing both high grade lesions and other grade lesions.04 Mar Atrial Fibrillation, Warfarin and Kidney Function after Heart Attack
MedicalResearch.com Interview with:
Juan Jesus Carrero PhD (Pharm and Med)
Associate Professor in Renal Medicine
Karolinska Institutet, Sweden.
MedicalResearch.com: Why did you choose to study this particular question?
Answer: We chose this question because there is currently an important knowledge gap regarding safety and effectiveness of common drugs in individuals with chronic kidney disease. Because kidney dysfunction interferes with drug metabolism and drug elimination, patients with kidney dysfunction have traditionally been excluded from randomized controlled trials. Yet, practice guidelines are afterwards extrapolated to those in the absence of formal evaluation.
04 Mar Hepatitis C: About 1% US Population Infected
MedicalResearch.com Interview with:
Scott D. Holmberg, MD, MPH
Chief, Epidemiology and Surveillance Branch
Division of Viral Hepatitis.
MedicalResearch.com: What are the main findings of the study?
Dr. Holmberg: Based on interview and testing of over 30, 000 National Health and Nutrition and Examination Survey (NHANES) participants from 2003 to 2010, 273 US residents or about 1%, are chronically (actively) infected with hepatitis C virus (HCV). This translates to about 2.7 million chronic HCV-infected persons in the non-institutionalized population.
04 Mar Herbal Cannabis Not Proven Effective For Rheumatic Diseases
MedicalResearch.com Interview with:
Mary-Ann Fitzcharles, MB, ChB, MRCP(UK), FRCP(C)
McGill University Health Centre
Division of Rheumatology and Alan Edwards Pain Management Unit
MedicalResearch.com: What are the highlights of your review?
Dr. Fitzcharles: Thank you for your interest in the review article which will shortly be published in Arthritis Care & Research. This was not a research study but rather a review focused towards the use of herbal cannabis for patients with rheumatic diseases.
The essence of our message after a thorough review of the literature is that there is not a single study published regarding efficacy or side effects of herbal cannabis in the rheumatic diseases. It is notable that almost 2 thirds of persons using herbal cannabis for therapeutic reasons report use for musculoskeletal complaints. In the 21st century, we cannot rely upon heresay or anecdote to justify use of a treatment intervention. It is unacceptable to recommend use of a substance without knowledge of concentration of molecules in the product, any knowledge of blood concentrations that might have a positive or negative effect, and formal study in defined patient populations with acceptable endpoint criteria and evidence for short and long term risks.
04 Mar Colon Cancer: Improving Determinants of Who Should Be Screened
MedicalResearch.com Interview with:
Sameer Saini MD
Veterans Affairs Center for Clinical Management Research,
VA Ann Arbor Healthcare System
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
MedicalResearch.com: What are the main findings of the study?
Dr. Saini: The way that quality measures are defined can have important implications for how care is actually delivered. Current colorectal cancer screening quality measures use age to identify screen-eligible patients, encouraging screening in patients between 50 and 75 years of age. But they do not explicitly incorporate health status. In this context, our study had two main findings.
- First, by focusing on age alone, we are not screening everyone who is likely to benefit. Specifically, many healthy people over 75 years of age (who are outside the target age range of the quality measure) may benefit from screening, but the current measure does not encourage screening in this population, leading to low screening use.
- Second, some people who are NOT likely to benefit are being screened unnecessarily, like those with serious health problems. For example, people between ages 70-75 with serious health problems (who have limited life expectancy) are unlikely to benefit from screening, and may even be harmed by it. But the current quality measure encourages screening in such individuals due to their age, yielding relatively high screening rates. If the system focused on age and health status (rather than age alone), screening use would be more aligned with screening benefit, and we would have better health outcomes.
04 Mar Obesity Rates Triple in Canada Over 25 Years
MedicalResearch.com Interview with:
Dr. Laurie K. Twells, PhD
School of Pharmacy, Memorial University, St. John’s
Faculty of Medicine, Memorial University
St. John’s Newfoundland and Labrador
MedicalResearch.com: What are the main findings of the study?
Dr. Twells: Obesity rates in Canada tripled between 1985 and 2011. Although class I obesity (BMI ≥ 30) appears to have increased at a slower rate, obese classes II (BMI ≥ 35) and III (BMI ≥40) continued to increase disproportionately. Over the last decade, every province in Canada experienced increases in obesity rates. Overall obesity rates were lower in the west and higher in the eastern provinces and people over age 40 years were more likely to be overweight/obese than younger people. By 2019 it is projected that twenty-one per cent of Canadians will be obese but this will vary by province from 15.7% in British Columbia to 34.6% in Newfoundland and Labrador.