Author Interviews, BMJ, Outcomes & Safety / 16.01.2014

Sunita Vohra MD MSc FRCPC FCAHS Director, CARE Program Director, PedCAM Network, AIHS Health Scholar Professor, Dept of Pediatrics Faculty of Medicine & Dentistry University of Alberta Edmonton Continuing Care Centre, Edmonton, Alberta CanadaMedicalResearch.com Interview with: Sunita Vohra MD MSc FRCPC FCAHS Director, CARE Program Director, PedCAM Network, AIHS Health Scholar Professor, Dept of Pediatrics Faculty of Medicine & Dentistry University of Alberta Edmonton Continuing Care Centre, Edmonton, Alberta Canada MedicalResearch.com: What are the main findings of the study? Dr. Vohra: Our main findings were: (i) relative to how often systematic reviews evaluate the effectiveness of health interventions, the systematic review of harms is quite neglected; and (ii) even when systematic reviews do aim to evaluate harms, there is considerable room for improvement in reporting.
Alcohol, Author Interviews / 16.01.2014

Professor Karen Hughes Professor in Behavioural Epidemiology Centre for Public Health Liverpool John Moores University Liverpool L3 2ETMedicalResearch.com Interview with: Professor Karen Hughes Professor in Behavioural Epidemiology Centre for Public Health Liverpool John Moores University Liverpool L3 2ET MedicalResearch.com: What are the main findings of the study? Answer: We used trained actors to test whether servers in pubs, bars and nightclubs would sell alcohol to people showing signs of extreme intoxication, despite this being illegal in the UK. In over four fifths (83.6%) of purchase attempts, bar servers sold alcohol to the pseudo-drunk actors – even though many clearly identified the actors as being drunk. We also collected data on bar environments, looking specifically at ten factors that have been associated with alcohol-related harm in previous studies: low levels of seating, loud noise, crowding, poor lighting, dirtiness, cheap drink promotions, young bar staff, young customers, rowdiness, and customer drunkenness. We found that the more of these characteristics bars had, the more likely they were to sell alcohol to drunks, with 100% of bars with 8 or more of these characteristics serving the pseudo-drunk actors. However, even in bars with none of these characteristics, two thirds of purchase attempts resulted in an alcohol sale. Having security staff managing entrance to the premises was also associated with alcohol service; possibly suggesting that bar servers in premises with door staff believe responsibility for vetting customers lies with such staff.
General Medicine / 16.01.2014

MedicalResearch.com Interview with: Weiya Zhang, BPH, MEpi, PhD Associate Professor & Reader Division of Rheumatology, Orthopaedics and Dermatology The University of Nottingham Clinical Sciences Building City Hospital Nottingham NG5 1PB MedicalResearch.com: What are the main findings of the study? Dr. Zhang: We found the prevalence and incidence of gout keep rising from 1997 to 2012, but the management (percentage of patients treated with the recommended effective drugs) remains poor.
Allergies, Asthma, Author Interviews, Lancet / 15.01.2014

Mariona Pinart, PhD CREAL-Centre for Research in Environmental Epidemiology ISGlobal alliance Parc de Recerca Biomèdica de Barcelona Doctor Aiguader, 88 | 08003 BarcelonaMedicalResearch.com Interveiw with: Mariona Pinart, PhD CREAL-Centre for Research in Environmental Epidemiology ISGlobal alliance Doctor Aiguader, 88 | 08003 Barcelona MedicalResearch.com: What are the main findings of the study? Answer: The study examined 23.434 children at 4 and 8 years from 12 ongoing European population-based birth cohort studies that recorded information on current eczema, rhinitis, and asthma from questionnaires and serum-specific IgE to six allergens. We wanted to assess how often eczema, rhinitis and asthma coexist in the same children (comorbidity) and whether the occurrence of comorbidities was due to causality or casualty and finally we wanted to examine whether the occurrence of comorbidity was modified by IgE sensitization. We found that comorbidity affects about 4% of children aged 4–8 years and that about 50% of this comorbidity is due to causality, suggesting that these diseases share common pathophysiological mechanisms. In addition, we found that children comorbidity at age 4 are 30 to 60 times more likely to have comorbidity at age 8 years, suggesting that the presence of comorbidity at age 4 years is a strong determinant of comorbidity at age 8 years. Even children with one single disease are also at high risk of developing comorbidity by age 8 years. Interestingly, we found that not only comorbidity is present in children both sensitized and not sensitized to IgE but also that only 38% of incident comorbidity at age 8 years is explained by the presence of IgE sensitization at age 4 years.
Author Interviews, Diabetes, Diabetes Care, Ophthalmology / 15.01.2014

MedicalResearch.com Interview with: Dr. Eelco van Duinkerken Vrije Universiteit Medical Center, Amsterdama MedicalResearch.com: What are the main findings of the study? Answer: In our study we assessed the relationship between cerebral small vessel disease and peripheral microvascular function in type 1 diabetes patients. By MRI cerebral small vessel disease was assessed as white matter hyperintensities and lacunar infarcts (markers of ischemia) and cerebral microbleeds (expression of vascular leakage). We hypothesized that subgroups, i.e. those with (proliferative) retinopathy, are more at risk to develop cerebral small vessels disease. To this end, we selected type 1 diabetes patients with proliferative retinopathy, type 1 diabetes patients without microvascular complications and healthy controls. The main finding of our study was that only cerebral microbleeds, but not ischemic markers of cerebral small vessel disease were more prevalent in type 1 diabetes patients with proliferative retinopathy relative to the other groups. Cerebral microbleeds were also related to microvascular function in skin. This suggest that cerebral microbleeds are part of generalized microangiopathy in patients with type 1 diabetes.
Author Interviews, BMJ, Heart Disease, Nutrition / 15.01.2014

Dr Victoria J Burley Senior Lecturer in Nutritional Epidemiology School of Food Science and Nutrition University of Leeds Biostatistics, University of Leeds, UKMedicalResearch.com Interview with: Prof. Victoria J Burley Senior Lecturer in Nutritional Epidemiology School of Food Science and Nutrition University of Leeds Biostatistics, University of Leeds, UK MedicalResearch.com: What are the main findings of the study? Prof. Burley: Although it’s been suggested for a long time that foods rich in dietary fiber may protect individuals from having a heart attack or stroke because they lower some of the risk factors for these diseases, trying to determine how much dietary fibre might be beneficial and whether these benefits are apparent in all populations around the world has been less easy to research. Our research at the University of Leeds has pooled the results of published large-scale follow-up studies and has demonstrated a consistent lowering of risk of cardiovascular and coronary heart disease with increasing dietary fiber intake. This dose-response trend suggests that even small additional increments in intake may be beneficial in the long term.
Author Interviews, Gastrointestinal Disease, NEJM, Pediatrics, Vaccine Studies / 15.01.2014

W. Katherine Yih Ph.D., M.P.H Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care InstituteMedicalResearch.com Interview with: W. Katherine Yih Ph.D., M.P.H Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute MedicalResearch.com:  What are the main findings of the study? Dr. Yih: The main findings are that vaccination with the first dose of RotaTeq is associated with a small increase in the risk of intussusception, which is concentrated in the first week after vaccination.  The estimated risk is about 1.5 excess cases per 100,000 first doses administered.  This risk is fairly small, amounting to roughly 1/10 of the risk seen after the original rotavirus vaccine (called Rotashield) that was used in 1998-1999, before it was withdrawn from the market. We also found evidence that Rotarix increases the risk of intussusception.  However, the number of infants receiving Rotarix and the number getting intussusception after Rotarix were too small to allow us to estimate the risk after Rotarix with any precision.
Author Interviews, Diabetes, Diabetes Care, Fish / 15.01.2014

Jyrki Virtanen, PhD Adjunct Professor of Nutritional Epidemiology University of Eastern Finland Institute of Public Health and Clinical Nutrition Kuopio, FinlandMedicalResearch.com Interview with: Jyrki Virtanen, PhD Adjunct Professor of Nutritional Epidemiology University of Eastern Finland Institute of Public Health and Clinical Nutrition Kuopio, Finland MedicalResearch.com: What are the main findings of the study? Dr. Virtanen: The main finding was that serum long-chain omega-3 polyunsaturated fatty acid (PUFA) concentration, an objective biomarker of fish and long-chain omega-3 PUFA intake, was associated with a lower risk of incident type 2 diabetes during the average follow-up of 19.3 years in middle-aged and older men from Eastern Finland. The risk was 33% lower in the highest vs. the lowest quartile after adjustment for potential confounders. In contrast, hair mercury, a marker for long-term exposure to mercury, was not associated with the risk. Previously in this study population, high hair mercury content has been associated with higher risk of cardiovascular diseases and attenuation of the beneficial impact of long-chain omega-3 PUFA on the risk. Also, we did not find associations with the intermediate-chain length omega-3 PUFA alpha-linolenic acid, either, which is a plant-based omega-3 PUFA. This suggests that the findings were specific to the long-chain omega-3 PUFAs from fish.
Author Interviews, Gastrointestinal Disease, Infections, NEJM, Vaccine Studies / 15.01.2014

MedicalResearch.com Interview with Eric S. Weintraub, M.P.H. Epidemiologist at Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? Mr. Weintraub: While current rotavirus vaccines were not associated with intussusception in large pre-licensure trials, recent post-licensure data (from international settings) suggest the possibility of a low risk of intussusception occurrence after receipt of monovalent rotavirus vaccination (RV1).  We examined the risk of intussusception following RV1 vaccination in a U.S. population.  In this study of more than 200,000 doses of RV1, a slight increased risk of intussusception was observed after vaccination, which should be considered in light of the benefits of preventing rotavirus associated illness.
Author Interviews, Gastrointestinal Disease, JAMA, Nutrition, Pediatrics / 14.01.2014

Flavia Indrio, MD Department of Pediatrics Aldo Moro University of Bari Bari, ItalyMedicalResearch.com Interview with: Flavia Indrio, MD Department of Pediatrics Aldo Moro University of Bari Bari, Italy MedicalResearch.com: What are the main findings of the study? Answer: The main finding is that for the first time the use in prevention instead of treatment with a probiotic for the colic regurgitation and constipation.
Author Interviews, Emergency Care / 14.01.2014

Dr. Michael A. LaMantia Regenstrief Institute, Inc. Investigator and Assistant Professor of Medicine Indiana University School of MedicineMedicalResearch.com Interview with: Dr. Michael A. LaMantia Regenstrief Institute, Inc. Investigator and Assistant Professor of Medicine Indiana University School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. LaMantia: We conducted a systematic review of existing studies on delirium in emergency departments and found that neither completely validated delirium screening instruments nor an ideal schedule to perform delirium assessments exist there.
Author Interviews, JAMA, Ophthalmology, Smoking / 14.01.2014

MedicalResearch.com Interview with: Birgitta Ejdervik Lindblad, MD PhD Department of Ophthalmology Örebro University Hospital Örebro, Sweden MedicalResearch.com: What are the main findings of the study? Answer: We have investigated the association between smoking cessation and risk of having a cataract extraction among 44 371 Swedish men aged 45-79 years. During 12 years of follow up we identified 5713 incident cases of cataract extraction. Smoking cessation significantly decreased the risk with time. Men who currently smoked more than 15 cigarettes per day had a 42 % increased risk of cataract extraction compared with men who had never smoked. More than 20 years since quitting smoking, men who had smoked more than 15 cigarettes per day had a 21% increased risk of  having a cataract extraction compared with men who had never smoked. The effect of smoking cessation was observed earlier among men who smoked less than 15 cigarettes per day but more than 2 decades since smoking cessation the risk had not decreased to the level of never smokers.
Author Interviews, JAMA, Nutrition, Pediatrics, University of Michigan / 14.01.2014

Yvonne M. Terry-McElrath, MSA Institute for Social Research, University of Michigan, Ann ArborMedicalResearch.com Interview with: Yvonne M. Terry-McElrath, MSA Institute for Social Research, University of Michigan, Ann Arbor MedicalResearch.com: What are the main findings of the study? Answer: This study examined 2007-2012 commercialism trends in schools attended by nationally representative samples of US elementary and secondary students. While some measures showed significant decreases over time (especially beverage vending measures), most students at both elementary and secondary school levels continued to be exposed to school-based commercialism. Commercialism increased significantly with grade level. The most frequent type of commercialism varied by school level:  food coupons used as incentives was most common at the elementary school level, while exclusive beverage contracts were the most prevalent type of commercialism for middle and high school students.
Author Interviews, Prostate Cancer, Race/Ethnic Diversity / 14.01.2014

David M. Albala, MD Associated Medical Professionals of NY, PLLC Syracuse, NY 13210MedicalResearch.com Interview with: David M. Albala, MD Associated Medical Professionals of NY, PLLC Syracuse, NY 13210 MedicalResearch.com: What are the main findings of the study? Dr. Albala: Prostate cancer is the second leading cause of cancer death and American man. Prostate cancer diagnosis and mortality differences between African American and Caucasian populations have been highlighted in the literature. Research has shown that African American males are at a biological predisposition for prostate cancer and that additional socioeconomic and physician-patient educational factors may contribute to a higher mortality rate among this group - over two times greater than that of Caucasian American males. At present the most commonly used to detection tools for prostate cancer are the serum prostatic specific antigen test (PSA) and a digital rectal examination (DRE). These complementary tests provide physicians with an indication of whether to proceed with biopsy for a definitive pathological diagnosis. Despite ongoing disputes regarding the effectiveness of PSA screening as an indicator for prostate cancer, a superior alternative test as yet to become available for men at risk. The American Urological Association (AUA) emphasizes the value of early detection and that sheared decision-making should not be overlooked and that shared decision making should be integral to screening decisions. The AUA urges individuals to personally assess, with their physicians, whether a PSA screen is necessary. Emphasis should be placed on the proper education of African American men who are at increased risk for the disease, as well as on their participation in repeated screening practices for the earliest possible detection of prostate cancer.
Author Interviews, Cancer Research, Lancet / 14.01.2014

MedicalResearch.com Interview with: Dr Jonathan Banks Programme Manager: The Discovery Research Programme Centre for Academic Primary Care NIHR School for Primary Care Research School of Social and Community Medicine University of Bristol Bristol BS8 2PSDr Jonathan Banks Programme Manager: The Discovery Research Programme Centre for Academic Primary Care NIHR School for Primary Care Research School of Social and Community Medicine University of Bristol  Bristol BS8 2PS MedicalResearch.com: What are the main findings of the study? Dr. Banks: We asked members of the public attending their local general practice or primary care centre to consider a series of hypothetical scenarios or vignettes which depicted cancer symptoms, their risk of cancer and the investigative processes involved in testing for cancer. We wanted to measure the point at which the risk of cancer outweighed the burden and inconvenience of testing in relation to lung, colorectal and pancreas cancers. Most people, around 88%, opted for testing even at the lowest risk of cancer which in our vignettes was 1%. Further analyses showed variation between cancers with fewer people opting for testing for colorectal cancer at a low (1%) risk and more people choosing to be tested for all cancers in the 60-69 age group.
Author Interviews, Geriatrics, MRSA / 11.01.2014

Courtney Reynolds, PhD Medical Scientist Training Program University of California Irvine, School of MedicineMedicalResearch.com Interview with: Courtney Reynolds, PhD Medical Scientist Training Program University of California Irvine, School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Reynolds: Our survey of factors influencing admission to 13 nursing homes in Orange County, California showed that MRSA carriers are denied admission more often than non-carriers, even after accounting for other important factors such as insurance status, required level of care and previous experience at the facility. In 80% of cases where MRSA carriage was responsible for denial of admission, nursing home administrators cited a lack of available single or cohort (MRSA only) rooms to accommodate these potential residents.
Author Interviews, Education, Exercise - Fitness, Infections / 11.01.2014

MedicalResearch.com Interview with: Anna-Christina Lauer, MD Department of Audiology and Phoniatrics Charité-University Medicine Berlin Berlin, Germany MedicalResearch.com: What are the main findings of the study? Dr. Gross: We could show that the injury rates depend on the undergraduate medical training the students attended. This demonstrates that medical undergraduatue education, especially a hands-on training, is critical in the prevention of needlestick- and sharps injuries. Also the use of safety devices has proven to reduce injury rates significantly. Given the large size of our study we could not only comfirm that needlestick and sharps injuries are still a common problem, looking at an injury rate of about 20% per year, we also learned a lot about the accident circumstances: Most accidents occur at bedside during venepuncture and intravenous cannulation. The second most common setting is the operating room, where suturing and instrument transfers can lead to injuries. Since we analyzed official reports and the anonymous surveys at the same time we could affirm an underreporting rate of more than 50%.
Author Interviews, Diabetes, Diabetes Care, Pediatrics, Stanford / 11.01.2014

Naama Barnea-Goraly M.D. Center for Interdisciplinary Brain Sciences Research Stanford UniversityMedicalResearch.com Interview with: Naama Barnea-Goraly M.D. Center for Interdisciplinary Brain Sciences Research Stanford University MedicalResearch.com: What are the main findings of the study? Answer: Our main findings showed that compared with age and sex matched controls, children with type 1 diabetes have significant differences in white matter structure in widespread brain regions. Within the type 1 diabetes group, earlier onset of diabetes and longer duration were associated with greater alterations in white matter structure. In addition, measures of hyperglycemia and glucose variability, but not hypoglycemia were associated with white matter structure; however, hypoglycemia exposure and the number of severe hypoglycemia events in our sample were too small to identify statistically meaningful differences. Finally, we observed a significant association between white matter structure and cognitive ability in children with type 1 diabetes, but not in controls.
Annals Internal Medicine, Author Interviews, Electronic Records / 10.01.2014

Robert S. Rudin, Ph.D. Associate Policy Researcher RAND Corporation 20 Park Plaza, Suite 920 Boston, MA 02116MedicalResearch.com Interview with: Robert S. Rudin, Ph.D. Associate Policy Researcher RAND Corporation Boston, MA 02116 MedicalResearch.com: What are the main findings of the study? Dr. Rudin: We found that most published health IT implementation studies report positive effects on quality, safety, and efficiency. Most evaluations focus on clinical decision support and computerized provider order entry. However, not all studies report equally positive results, and differences in context and implementation are one likely reason for these varying results, yet details of context and implementation are rarely reported in these studies.
Alzheimer's - Dementia, Author Interviews, JAMA / 10.01.2014

Maurice Dysken, MD Professor, School of Medicine Department of Psychiatry Minneapolis VA Health Care System, Minneapolis, MinnesotaMedicalResearch.com Interview Invitation Maurice Dysken, MD Professor, School of Medicine Department of Psychiatry Minneapolis VA Health Care System, Minneapolis, Minnesota MedicalResearch.com: What are the main findings of the study? Dr. Dysken: In patients with mild-to-moderate Alzheimer’s disease who were taking an acetylcholinesterase inhibitor, a dosage of 2000 IU/d of vitamin E significantly slowed functional decline compared to placebo by 6.2 months over the mean follow-up period of 2.27 years.  Over this period of time caregiver time increased least in the vitamin E group compared to the other three groups (memantine alone, vitamin E plus memantine, and placebo) although the only statistically significant difference was between vitamin E alone and memantine alone.  There were no significant safety concerns for vitamin E compared to placebo and mortality was lowest in the vitamin E alone group.  It should be noted that patients who were on warfarin were excluded from the study because of a possible interaction with vitamin E that could have possibly increased bleeding events.
Annals Internal Medicine, Author Interviews, Diabetes, Mediterranean Diet / 10.01.2014

Jordi Salas-Salvadó, MD, PhD Human Nutrition Unit, Faculty of Medicine and Healthy Sciences Universitat Rovira i Virgili, C/ Sant Llorenç, 21, 43201 Reus, SpainMedicalResearch.com Interview with: Jordi Salas-Salvadó, MD, PhD Human Nutrition Unit, Faculty of Medicine and Healthy Sciences Universitat Rovira i Virgili, C/ Sant Llorenç, 21, 43201 Reus, Spain MedicalResearch.com: What are the main findings of the study? Answer: Randomized trials have shown that lifestyle interventions promoting weight loss can reduce the incidence of type-2diabetes, however, whether dietary changes without calorie restriction or increased physical activity also protect from diabetes development has not been evaluated in the past. In our study, we found that a long-term adherence to a high-quality dietary pattern akin to the traditional MedDiet and rich in extra-virgin olive oil was able to reduce the incidence of new cases of diabetes in older individuals at high cardiovascular risk. We have demonstrated for the first time that a beneficial effect on diabetes prevention could be obtained witha healthy dietary pattern (without calorie restriction, increased physical activity or weight loss). These benefits have been observed in participants between 55 to 80 years-old at high cardiovascular risk; therefore,the message is that it is never too late to switch to a healthy diet like the Mediterranean.
Addiction, Author Interviews, JAMA, Mental Health Research / 10.01.2014

Sarah M. Hartz, MD, PhD Assistant Professor of Psychiatry Washington University in St. Louis, MissouriMedicalResearch.com Interview with: Sarah M. Hartz, MD, PhD Assistant Professor of Psychiatry Washington University in St. Louis, Missouri MedicalResearch.com: What are the main findings of this study? Dr. Hartz: This is the first large-scale study to comprehensively evaluate substance use in people with schizophrenia, bipolar disorder, and other severe mental illness.We found that people with severe mental illness have rates of smoking, alcohol use, and other substance use that are 3 to 5 times higher than people in the general population.
Author Interviews, Endocrinology, Testosterone / 10.01.2014

J. Bradley Layton, PhD Postdoctoral Research Associate University of North Carolina at Chapel HillMedicalResearch.com Interview with: J. Bradley Layton, PhD Postdoctoral Research Associate University of North Carolina at Chapel Hill MedicalResearch.com: What are the main findings of the study? Dr. Layton: Use of testosterone testing and treatment had greatly increased over the past decade, with more pronounced increases seen in the United States than in the United Kingdom. The increases in testing in the UK seem to be targeted, identifying more men with reduced testosterone levels, but the increases in the US seem to be identifying more and more men with normal levels. Many of the men who begin testosterone treatment in the US appear to have normal testosterone levels to begin with.
Author Interviews, General Medicine, Hand Washing / 10.01.2014

Caroline Landelle, PharmD, PhD Infection Control Unit, Centre Hospitalier Universitaire (CHU) Albert Chenevier–Henri Mondor, Assistance Publique–Hôpitaux de Paris, Université Paris–Est Créteil, FranceMedicalResearch.com Interview with: Caroline Landelle, PharmD, PhD Infection Control Unit, Centre Hospitalier Universitaire (CHU) Albert Chenevier–Henri Mondor, Assistance Publique–Hôpitaux de Paris, Université Paris–Est Créteil, France MedicalResearch.com: What are the main findings of the study? Dr. Landelle: The main findings point to the fact that nearly one in four healthcare workers’ hands are contaminated with Clostridium difficile spores after routine care of patients infected with the bacteria, before performing hand hygiene. This is the first study focusing upon the carriage of viable C. difficile spores on healthcare workers’ hands. C. difficile exist in 2 possible forms: vegetative and spore. Vegetative forms of C. difficile are killed when exposed to air, whereas their spores are resistant to oxygen, desiccation, and most disinfectants, and may persist in the hospital environment for long periods of time; thus, bacterial spores could be the principal form of transmission. Furthermore, contamination of exposed healthcare workers’ hands is statistically associated with direct exposure to fecal soiling and contact without the use of gloves.
Asthma, Author Interviews, Biomarkers, CHEST / 10.01.2014

Dr. Lawrence M. Lewis, MD Professor, Emergency Medicine and Medicine Washington University School of Medicine in St. LouisMedicalResearch.com Interview with: Dr. Lawrence M. Lewis, MD Professor, Emergency Medicine and Medicine Washington University School of Medicine in St. Louis MedicalResearch.com: What are the main findings of the study? Dr. Lewis: The main finding of the study is that there is a dose-dependent increase in serum lactate concentration with increasing amounts of nebulized albuterol administered. This hyperlactatemia did not portend a worse prognosis, and was not associated with worse FEV1 or dyspnea scores.
Author Interviews, MRSA, OBGYNE / 10.01.2014

MedicalResearch.com Interview with: Dr. Andrea Parriott MPH, PhD Department of Epidemiology Fielding School of Public Health University of California Los Angeles

MedicalResearch.com: What are the main findings of the study? Dr. Parriott:  We wanted to know whether hospital and provider volume (i.e. the number of deliveries performed by each hospital and provider per quarter) and cesarean section rates were predictors of the risk of methicillin-resistant Staphylococcus aureus (MRSA) infection before discharge from the hospital (after delivering a baby). We did not find an association between any of these variables and risk of MRSA infection.
AHA Journals, Author Interviews, Cost of Health Care, Stroke / 08.01.2014

Dr. James Sheppard MRC Research Fellow Department of Primary Care Health Sciences University of OxfordMedicalResearch.com Interview with Dr. James Sheppard MRC Research Fellow Department of Primary Care Health Sciences University of Oxford MedicalResearch.com: What are the main findings of the study? Dr. Sheppard: The aim of our study was to develop a decision-tree model which estimates the cost-effectiveness and potential implementation costs of a series of interventions which increase thrombolysis rates in acute stroke. The model examined all possible acute stroke patient pathways and was based on real life patient data. We found all proposed interventions to be cost saving whilst increasing patient quality of life after stroke. We estimate that, assuming a "willingness-to-pay"  of USD $30,000 per quality adjusted life year gained, the potential budget available to deliver interventions which improve acute stroke care range from USD $50,000 to USD $144,000.
Author Interviews, Depression, JAMA, Johns Hopkins, Mental Health Research, Pain Research / 07.01.2014

Madhav Goyal MD, MPH Assistant Professor General Internal Medicine Johns Hopkins School of MedicineMedicalResearch.com Interview with: Madhav Goyal MD, MPH  Assistant Professor General Internal Medicine Johns Hopkins School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Goyal:
  • The evidence is moderately strong that there is a small but consistent benefit for mindfulness meditation programs to improve 3 symptoms: anxiety, depression, and pain.  We found low level evidence that mindfulness meditation helps with symptoms of stress and distress, as well as with the mental health dimension of quality of life.
  • For the symptoms of anxiety and depression for which we find moderate evidence of benefit, we need to keep in mind that most of the trials didn't study people with a clinical diagnosis of anxiety or depression (although a few did).  Most were studying diverse patient populations who may have had a low level of these symptoms, such as those with  breast cancer, fibromyalgia, organ transplant recipients, and caregivers of people with dementia.
  • We found about a 5-10% improvement in anxiety symptoms compared to placebo groups.  For depression, we found a roughly 10-20% improvement in depressive symptoms compared to the placebo groups. This is similar to the effects that other studies have found for the use of antidepressants in similar populations.
  • While we found that the evidence was moderately strong that mindfulness meditation programs may improve pain, there weren't as many trials evaluating chronic pain, and so we don't understand what kinds of pain this type of meditation may be most useful for.
Author Interviews, Autism / 07.01.2014

Dr. Lisa Croen, PhD Senior Research Scientist Director, Autism Research Program Division of Research Kaiser Permanente Northern CaliforniaMedicalResearch.com Interview with Dr. Lisa Croen, PhD Senior Research Scientist Director, Autism Research Program Division of Research Kaiser Permanente Northern California MedicalResearch.com: What are the main findings of the study? Dr. Croen: Researchers found that hospital-diagnosed maternal bacterial infections during pregnancy were associated with an increased risk of autism spectrum disorders (ASD) in children. While infections are fairly common in pregnant women, this study only found increased risks in cases of bacterial infections. Women with bacterial infections diagnosed during a hospitalization (including of the genitals, urinary tract and amniotic fluid) had a 58 percent greater risk of having a child with ASD. Also of note, bacterial infections diagnosed during a hospitalization in the second trimester, while not very common in any of the mothers studied, were associated with children having more than a three-fold increased risk of developing ASD. These findings resulted from a study of 407 children with autism and 2,075 matched children who did not have autism. The study included infants born between January 1995 and June 1999 who remained members of the Kaiser Permanente health plan for at least two years following birth.