Author: Marie Benz MD FAAD
25 Feb Common Measurement of Kidney Function Altered by Poor Glycemic Control
MedicalResearch.com Interview with: Eiji Ishimura, MD, PhD, FASN, FACP Osaka City University Hospital Professor,Department of Nephrology Osaka, JAPAN MedicalResearch.com: What are the main findings of the study? Dr. Ishimura: Poor glycemic control is a major factor in the overestimation of glomerular filtration rate (GFR) in diabetic patients. We found this simple conclusion by directly measuring GFR by use of inulin clearance. We have created new formulae to accurately assess the GFR in diabetic patients, with the correction of hemoglobin A1C (HbA1C) or glycated albumin (GA) as followings; 1) eGFRcr corrected by HbA1c=eGFRcr / (0.428 + 0.085 × HbA1c) 2) eGFRcr corrected by GA=eGFRcr / (0.525 + 0.028 × GA)25 Feb ADHD and Acetaminophen During Pregnancy
MedicalResearch.com Interview with:
Jørn Olsen, M.D., Ph.D.
Professor Institute of Public Health, Department of Epidemiology UCLA
Aarhus University
Aarhus,Denmark
MedicalResearch.com: What are the main findings of the study?
Dr. Olsen: Acetaminophen (paracetamol) is drug being used by many, including pregnant women. In our data about half of all pregnant women in 1995 to 2002 had used the drug all least once during their pregnancy. The drug has shown hormonal disruptor properties in animal studies.
We found that women who used this drug during pregnancy gave birth to children who 5 – 10 years later slightly more often had behavioral problems or were treated for ADHD. The risk was highest for those who took the medication late in pregnancy and/or had taken the drug several times. The increased risk was about 10-30%.
25 Feb Programs That Protect Drug-Users from HIV Also Help General Population
MedicalResearch.com Interview with:
Samuel R. Friedman PhD
Institute of Infectious Disease Research
National Development and Research Institutes, Inc. Ny, NY
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD
MedicalResearch.com: What are the main findings of the study?
Dr. Friedman: The main finding is that programs that helped protect people who inject drugs from HIV and those that helped them to get medical care seem to be associated with less HIV disease and less death related to HIV disease among the heterosexual population of large United States metropolitan areas.
This is important. Drug users in the US are widely despised, and their has been a lot of political opposition to programs like syringe exchange and drug abuse treatment. Our findings show that these programs are associated with better health and less death in the broader population. It makes more sense to help people--even those you despise--stay uninfected, and to get medical care, than to restrict or attack programs for them.
25 Feb Body Shape Index and Death Rates
MedicalResearch.com Interview with:
Nir Y. Krakauer Ph.D
Assistant Professor Department of Civil Engineering
The City College of New York
New York, New York
MedicalResearch.com: What are the main findings of the study?
Dr. Krakauer: We studied the association between the recently proposed body shape index (ABSI) -- which combines waist circumference, height and weight measurements -- and risk of death in a United Kingdom population sample. We found that high ABSI predicted greater mortality hazard, with death rates increasing by about 13% per standard deviation increase in ABSI. Further, ABSI was a stronger predictor of early death than BMI, waist circumference, or other indices based on waist circumference such as waist to height ratio and waist to hip ratio. For a given starting ABSI value, reducing A Body Shape Index over a 7-year period was associated with lowered mortality risk, .
25 Feb Acute Coronary Syndrome: Genotyping Guided Antiplatelet Therapy After Stent Surgery
Posted at 03:23h
in Annals Internal Medicine, Author Interviews, Cost of Health Care, Heart Disease, UCSF
MedicalResearch.com Interview with:
Dhruv S. Kazi, MD, MSc, MS
Assistant Adjunct Professor
Division of Cardiology San Francisco General Hospital
Department of Medicine, and
Department of Epidemiology and Biostatistics
University of California San Francisco
MedicalResearch.com: What is the background of your study?
Dr. Kazi: When we first asked the research question -what is the role of genotyping among patients receiving a stent for ACS, we quickly realized that there were no RCTs that had directly compared ticagrelor with prasugrel. But in our opinion, that was precisely the reason to build a model and systematically synthesize the available literature. There are nearly half a million PCIs for ACS in the US each year, and each time, the physician and patients have to examine the trade-offs between the various alternatives. What our model does is that it explicates the trade-offs - makes them transparent, and quantifies them. So patients and physicians can make an informed decision on what is the optimal therapy for them.
24 Feb Vegetarian Diet and Blood Pressure Lowering Effect
MedicalResearch.com Interview with: Yoko Yokoyama, Ph.D., M.P.H. National Cerebral and Cardiovascular Center, Osaka, Japan, MedicalResearch.com: What are the main findings of the study? Dr. Yokoyama: We found consistent evidence that a vegetarian diet has a significant blood-pressure-lowering effect, and this was clear both in observational studies of individuals who had chosen vegetarian diets on their own and in intervention trials in which people were asked to make diet changes. Our meta-analysis included 32 observational studies and 7 controlled clinical trials. In the observational studies, vegetarian diets were associated with blood pressures that were about 7 mmHg lower systolic and 5 mmHg lower diastolic. In the clinical trials, the reductions were about 5 mmHg systolic and 2 mmHg diastolic. These are pooled averages, so for some individuals, particularly those with higher body weights or higher blood pressures at the beginning, the blood-pressure-lowering effects could be much greater.24 Feb Powerpoint of Recent Medical Research Interviews
Posted at 12:42h
in Author Interviews
MedicalResearch.com - Medical Research Interviews Week in Review from Marie Benz , MD FAAD ...
23 Feb Maternal Influenza and Offspring Bipolar Disorder
MedicalResearch.com Interview with:
Alan S. Brown, M.D., M.P.H.
Professor of Clinical Psychiatry and Clinical Epidemiology College of Physicians and Surgeons of Columbia University Director
Unit in Birth Cohort Studies Division of Epidemiology New York State Psychiatric Institute
New York, NY
MedicalResearch.com: What are the main findings of the study?
Dr. Brown: We found that a mother's exposure to influenza during pregnancy, documented by antibodies in her serum, increased the risk of bipolar disorder with psychotic symptoms in her offspring. We did not show a relationship between influenza and bipolar disorder not accompanied by psychosis.
23 Feb COPD: Risk from Chinese WaterPipe Smoking
MedicalResearch.com Interview with:
Chunxue Bai, MD & PhD
Director, Shanghai Respiratory Research Institute
Professor of Medicine, Chairman, Shanghai Leading academic discipline
Chair, Chinese Alliance against Lung Cancer
MedicalResearch.com: What are the main findings of the study?
Dr. Bai: Recently, we found a dilemma phenomenon that the incidence of chronic obstructive pulmonary disease (COPD) and lung cancer has remained high in southwest China despite the 1976 National Stove Improvement Program for indoor air quality.
However, little information is known to the public about a regional endemic related to Chinese waterpipe smoking, which is different from the Arabic waterpipe. The Chinese waterpipe has been traditionally misconceived as less harmful for three reasons:
- (1) no charcoal was used in contrast to the Arabic waterpipe,
- (2) tobacco smoke passed through the water as opposed to cigarette smoking and
- (3) smoking through a large volume waterpipe could “improve lung function.”
23 Feb After Ear Tubes: Eardrops Found Superior to Oral Antibiotics for Ear Discharge
MedicalResearch.com Interview with:
Dr. T. M. A van Dongen, MD
Univ Med Ctr Utrecht
Julius Ctr Hlth Sci & Primary Care, Dept Epidemiol
Utrecht, Netherlands.
MedicalResearch.com: What are the main findings of the study?
Answer: We performed a pragmatic trial, in which we randomly assigned 230 children who had acute tympanostomy-tube otorrhea to receive antibiotic-glucocorticoid eardrops, oral antibiotics or to undergo initial observation. The primary outcome of our study was the presence of ear discharge, 2 weeks after study-group assignment. We also looked at, among others, the duration of the initial otorrhea episode and the total number of days of otorrhea and the number of otorrhea recurrences during 6 months of follow-up. We found that antibiotic–glucocorticoid eardrops were superior to oral antibiotics and initial observation for all outcomes.
22 Feb Glioblastoma: Avastin Did Not Improve Survival or Symptoms
MedicalResearch.com Interview with:
Minesh P. Mehta, M.B., Ch.B. F.A.S.T.R.O.
Professor of Radiation Oncology,
University of Maryland School of Medicine
Radiation oncologist, University of Maryland Marlene and Stewart Greenebaum Cancer Center
MedicalResearch.com: What are the main findings of the study?
Dr. Mehta: RTOG 0825 was a clinical trial evaluating whether the addition of a novel drug that inhibits tumor vascular growth, bevacizumab, to the standard of care for glioblastoma, an aggressive brain tumor, would prolong survival. Patients were allocated randomly to one of two different treatment regimens – the standard of care, which includes radiotherapy and a drug known as temozolomide, or another regimen of radiation, temozolomide and bevacizumab. The trial design was double-blinded, and therefore, on one arm patients received the bevacizumab, whereas on the other arm they received a placebo. The survival on both arms was equivalent, and therefore it was fairly concluded that bevacizumab failed to prolong survival when given initially as part of treatment for glioblastoma.
Freedom from progression, referred to as progression-free survival was also measured on this trial, and although bevacizumab appeared to lengthen progression-free survival, this level of benefit did not meet the pre-defined goals, and is therefore regarded as statistically not demonstrating an improvement.
Additional endpoints included outcomes reported by the patient, including the burden of symptoms, and the impact of these on the quality of life, as well as effects on the brain, known as neurocognitive changes. Bevacizumab did not improve these endpoints either.
22 Feb Breast Cancer Brain Metastasis: Genomic and Epigenomic Analysis
MedicalResearch.com Interview with:
Bodour Salhia, PhD
Assistant Professor
Integrated Cancer Genomics Division
Translational Genomics Research Institute
Phoenix, Arizona, 85004
MedicalResearch.com: What are the main findings of the study?
Dr. Salhia: Our study identified novel rare genomic and epigenomic events underlying breast cancer metastasis to brain. We demonstrated that we could molecularly subtype breast cancer brain metastasis the same way we can subtype primary breast cancer. From this analysis we found that the Luminal B subtype was the most common subtype in our cohort, followed by Her2+/ER- enriched tumors and Basal-like tumors. Each of these subtypes displayed genetic and epigenetic features reminiscent of primary breast cancer. We demonstrated that these tumors have a strong predilection to grow by activating pathways involved in G2/M cell cycle progression, whereas, many genes involved in cell migration were epigenetically silenced. Broad amplification of chromosome 8q was common, which resulted in the upregulation of important genes.
22 Feb Colon Cancer Patients Have Less Diverse Gut Bacteria
MedicalResearch.com Interview with:
Jiyoung Ahn, PhD
Assistant Professor of Epidemiology
Department of Population Health
NYU School of Medicine
New York, NY 10016
MedicalResearch.com: What are the main findings of the study?
Dr. Ahn: Before we did our research, it was suspected that gut bacteria were related to colorectal cancer. We, for the first time, found colorectal cancer patients have a different gut bacteria composition than healthy subjects.
22 Feb Atrial Fibrillation: Ablation Found Superior to Conventional Drug Therapy
MedicalResearch.com Interview with:
Carlos A. Morillo, MD, FRCPC, FACC, FHRS, FESC
Professor Department of Medicine, Cardiology Division
Program Director Cardiac Electrophysiology and Autonomic Physiology Fellowship
,Hamilton, ON, Canada
MedicalResearch.com: What are the main findings of the study?
Dr. Morillo: The main findings were that Ablation of atrial fibrillation was superior to conventional antiarrythmic drug therapy in patients with Paroxysmal atrial fibrillation that had not been treated with Antiarrhythmic medications. Ablation extended the time to first recurrence of atrial fibrillation within the 2 year follow-up of the study and significantly reduced the recurrence of repeated episodes of AF.
21 Feb Promising Approach to Treat Non-Alcoholic Fatty Liver Disease and Visceral Obesity
MedicalResearch.com Interview with:
Norbert Stefan, MD
Heisenberg Professorship for Clinical and Experimental Diabetology
Department of Internal Medicine IV
University Hospital Tübingen
Tübingen, Germany
MedicalResearch.com: What are the main findings of the study?
Dr. Stefan: Currently there is little evidence for an effective and safe pharmacological treatment of nonalcoholic fatty liver disease (NAFLD). Based on the fact that inhibition of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), the enzyme, that converts inactive cortisone into active cortisol in metabolic tissues such as liver and adipose, was found to be effective to improve lipid metabolism in animals, we hypothesized that inhibition of 11β-HSD1 may also prove to be effective to decrease liver fat content in patients with NAFLD. In our 12 week trial in 82 patients with NAFLD, inhibition of 11β-HSD1 with RO5093151 resulted in a 14 % decrease of liver fat content and in a resolution of NAFLD in 20 % of the patients. This was accompanied by a decrease of liver enzymes. Furthermore, inhibition of 11β-HSD1 brought about a reduction of body weight and total body- and visceral adipose tissue mass, while insulin sensitivity did not change. In agreement with findings from other trials, also in our study 11β-HSD1 inhibition was well tolerated and safe.
21 Feb Many Pregnant Women Have Not Taken Folic Acid to Reduce Neural Tube Defects
MedicalResearch.com Interview with:
Prof. Nicholas J. Wald
Wolfson Institute of Preventive Medicine
Barts and the London School of Medicine and Dentistry
Queen Mary University of London
London, United Kingdom
MedicalResearch.com: What are the main findings of the study?
Prof Wald: The percentage of women who become pregnant without having taken folic acid supplements to reduce the risk of a neural tube defect declined from a relatively low proportion (35%) to an even lower one (31%) between 1999 and 2012.
Moreover such use of folic acid in some groups of the population is much lower for example 17% in Afro-Caribbean women and 6% in women aged under 20.
21 Feb Sitting Time Linked to Increased Disability
MedicalResearch.com Interview with:
Dorothy D Dunlop, PhD
Professor, Medicine-Rheumatology
Center for Healthcare Studies - Institute for Public Health and Medicine and Preventive Medicine
Northwestern University Feinberg School of Medicine
MedicalResearch.com: What are the main findings of the study?
Dr. Dunlop: We know being active, especially doing moderate activity like taking a brisk walk, is good for health. We know a sedentary lifestyle leads to health problems. What we do not know is whether or not those are two ways of looking at the same question. Does being sedentary like sitting just reflect insufficient activity OR is sedentary time is a separate and distinct risk factor for health problems. Our physical activity research group looked at national US data from the National Health and Nutrition Examination Survey. This is an important study because they monitored physical activity using an accelerometer. We found sedentary behavior such as sitting was its own separate risk factor for disability.
20 Feb Blood Clot Risk Elevated for 12 Weeks After Childbirth
MedicalResearch.com Interview with:
Dr.Hooman Kamel MD
Department of Neurology and the Brain and Mind Research Institute
Weill Cornell Medical College in New York City.
MedicalResearch.com: What are the main findings of the study?
Dr. Kamel: The risk of thrombotic events remains higher than normal for twice as long after childbirth as previously thought. However, the absolute risk in any given patient is low, especially after the first 6 weeks.
20 Feb Advanced Cervical Cancer: Adding Avastin to Chemotherapy Prolonged Survival
MedicalResearch.com Interview with:
Krishnansu S. Tewari, MD, FACOG, FACS| Professor & Director of Research
Principal Investigator - The Gynecologic Oncology Group at UC Irvine, Division of Gynecologic Oncology
University of California, Irvine Medical Center
Orange, CA 92868
MedicalResearch.com: What are the main findings of the study?
Dr. Tewari: The main findings of this study were that the addition of bevacizumab to chemotherapy resulted in a significantly improved survival of 3.7 months in a population of patients that have very limited options. This improvement in overall survival was not accompanied by any significant deterioration in quality of life and serious side effects were limited to 3% to 8% of the study population.
20 Feb Good Sleep Habits for Children: Early Consistent Bedtime, No Evening TV
MedicalResearch.com Interview with:
Dr Abi Fisher PhD
Senior Researcher, Cancer Research UK
Health Behaviour Research Centre
University College London
MedicalResearch.com: What are the main findings of the study?
20 Feb Pediatric Oncology: Radiation Free Imaging Test as Alternative to PET/CT Scans
Posted at 05:32h
in Author Interviews, CT Scanning, Lancet, Medical Imaging, MRI, Pediatrics, Stanford
MedicalResearch.com: Interview with:
Dr Heike Daldrup-Link
Associate Professor of Radiology
Stanford University School of Medicine, Palo Alto
MedicalResearch.com: What are the main findings of the study?
Answer: We use magnetic resonance imaging, a technology based on magnetic fields rather than radiotracers or x-rays. The underlying technology is not new – it has been used for tumor staging for many years. This is an advantage as MR scanners are available in nearly every major Children’s Hospital where children with cancer are treated. What is new about our approach is that we combined anatomical and functional images, similar to current approaches that use radiotracers and CT (PET/CT): We first acquired scans that showed the anatomy of the patient very well and we then acquired scans that depict tumors as bright spots with little or no background information. We did that by using an iron supplement as a contrast agent: The iron supplement can be detected by the MRI magnet and improved tumor detection and vessel delineation MR scans. We then fused the anatomical scans with the tumor scans.
20 Feb Mesh Hernia Repairs Associated with Fewer Recurrences
MedicalResearch.com Interview with: Mike K.Liang, MD, Department of Surgery, The University of Texas Health Sciences Center, Lyndon B. Johnson Hospital,Houston, TX 7702 MedicalResearch.com: What are the main findings of the study? Dr. Liang: Compared to suture repair, mesh repair of primary ventral hernias (umbilical, epigastric, spigelian, lumbar), the most common type of ventral hernias, is associated with fewer hernia recurrence but slightly more seromas and surgical site infections.19 Feb Carcinogens in Food Packaging
MedicalResearch.com Interview with:
Dr. Jane Muncke PhD
Managing Director
Food Packaging Forum Foundation
Zurich, Switzerland
MedicalResearch.com: What are the main conclusions from your work?
Answer: Food packaging is a relevant, but still under-recognized source of chemical contamination in foods. Everybody is exposed to these chemicals on a daily basis, but we have very little understanding of the actual health effects caused by this chronic exposure source. We propose that epidemiological research tackles chemical exposures from food packaging as a new and highly relevant exposure source. Epidemiologist have played crucial roles in advancing understanding of health issues, for example cardiovascular disease caused by fine particulate air pollution. Through their work they have encouraged toxicologists to ask different questions, thereby supporting the generation of critical knowledge and, essentially, enabling prevention.
19 Feb Online Physician Rating Sites: Public Awareness and Participation Increasing
MedicalResearch.com Interview with:
Dr. David Hanauer, MD
Associate Professor, University of Michigan Medical School
1500 East Medical Center Drive
Ann Arbor, MI 48109-5940
MedicalResearch.com: What are the main findings of the study
Dr. Hanauer: From my perspective, the primary findings were that 65% of the general public is now aware of physician rating web sites and among those who are aware, about 36% had used them in the prior year. Awareness and usage seems to be rapidly increasing compared to what has been reported in prior studies from just a few years ago. We also found that patients consider word of mouth recommendations (from family/friends) to be almost twice as important as ratings sites are.
19 Feb Pulmonary Fibrosis: High Resolution CT Diagnosis
MedicalResearch.com Interview with:
Ganesh Raghu, M.D.,FCCP, FACP
Professor of Medicine & Lab Medicine (Adjunct)
Division of Pulmonary & Critical Care Medicine
University of Washington(UW)
Director,CENTER for Interstitial Lung Disease (ILD),UW Medicine,
ILD, Sarcoid and Pulmonary Fibrosis Program
Co-Director, Scleroderma Clinic, UW Medical center(UWMC)
Seattle, WA 98195
MedicalResearch.com: What are the main findings of the study?
Dr. Raghu: In a subgroup of patients with typical clinical features of Idiopathic pulmonary fibrosis ( IPF) , further evaluation by a thorough evlauation by regional experts experienced in management of idiopathic pulmonary fibrosis and related diseases may lead to a diagnosis of idiopathic pulmonary fibrosis without the need for surgical lung biopsy if the HRCT features have a Possible-UIP pattern AND if there are no suspicion for environmental factors or collagen vascular diseases to explain the pulmonary fibrosis .
19 Feb TAVR vs Surgical Aortic Valve Replacement for Aortic Stenosis with LV Dysfunction
MedicalResearch.com Interview with:
Sammy Elmariah, MD, MPH
Massachusetts General Hospital
Boston, MA
MedicalResearch.com: What are the main findings of the study?
Dr. Elmariah: Within the randomized PARTNER I trial, we evaluated the effect of left ventricular (LV) dysfunction on clinical outcomes after transcatheter and surgical aortic valve replacement (TAVR and SAVR, respectively) and the impact of valve replacement technique on recovery of LV function. We found that LV dysfunction, defined as an LV ejection fraction < 50%, had no impact on 30-day and 1-year mortality after either TAVR or SAVR. In those with baseline LV dysfunction, marked improvement in LV ejection fraction was observed within 30-days of valve replacement in approximately half of patients, with an equivalent degree of improvement observed after TAVR and SAVR. Permanent pacemaker at study entry, low mean aortic valve gradient, and high LV ejection fraction were associated with reduced odds of LV functional recovery after valve replacement.
19 Feb Pre-Op Vitamin D and Infection Risk Following Gastric Bypass Surgery
MedicalResearch.com Interview with:
Sadeq A. Quraishi, MD, MHA
Massachusetts General Hospital, Harvard Medical School
Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study?
Dr. Quraishi: Our retrospective study suggests that there is an association between pre-operative 25-hydroxyvitamin D [25(OH)D] levels and the risk of hospital-acquired infections after gastric bypass surgery. In particular, patients with 25(OH)D levels <30 ng/ml before surgery were almost 4 times more likely to develop a surgical site infection within 30 days of surgery than patients with pre-operative 25(OH)D levels at 30 ng/ml or higher.
19 Feb Alzheimer’s: Celexa Reduced Agitation, Has Modest Cognitive, Cardiac Side Effects
MedicalResearch.com Interview with:
Anton P. Porsteinsson M.D.
William B. and Sheila Konar Professor of Psychiatry
Director, Alzheimer's Disease Care, Research and Education Program (AD-CARE)
University of Rochester School of Medicine and Dentistry
Rochester, N.Y. 14620
MedicalResearch.com: What are the main findings of the study?
Dr. Porsteinsson: Identifying drugs outside the antipsychotic class with targeted anti-agitation effects that provide greater benefit or lower risk among patients with Alzheimer’s disease is a research priority. Citalopram, a selective serotonin reuptake inhibitor (SSRI), is frequently used in older individualsand has been suggested as an alternative to antipsychotic drugs for agitation and aggression in dementia. Among 186 patients with probable Alzheimer’s disease and agitation receiving psychosocial intervention, the addition of citalopram compared with placebo robustly and significantly reduced agitation and caregiver distress, but modest cognitive and cardiac adverse effects of citalopram may limit its practical application at the 30 mg/d dose studied in this trial. There are insufficient data on efficacy for agitation at lower doses of citalopram.
18 Feb Expanded Health Insurance: Hospital Services Use by Young Adults with Behavioral Diagnoses
Posted at 21:53h
in Cost of Health Care, Dartmouth, Health Care Systems, Mental Health Research, Yale
MedicalResearch.com Interview with:
Ellen R. Meara
Associate Professor of The Dartmouth Institute
Adjunct Associate Professor in Economics & Nelson A. Rockefeller Center for Public Policy, Dartmouth College
MedicalResearch.com: What are the main findings of this study?
Answer: When insurance coverage for young adults rose by over 15 percentage points following Massachusetts' 2006 health reform, use of inpatient care for mental illness and substance use disorders fell and emergency department visits for these conditions grew more slowly for 19 to 25 year olds in Massachusetts relative to other states. Also, their care was much more likely to be paid for by private or public insurance insurers.