Author: Marie Benz MD FAAD
01 Feb Hospital Leadership Important for Quality Improvement
MedicalResearch.com Interview with:
Joseph D. Restuccia, DrPH, MPH
Professor and Deans Research Fellow
Operations and Technology Management Department
Health Sector Management Program
Boston University School of Management
Boston, MA 02215
MedicalResearch.com: What are the main findings of the study?
Dr. Restuccia: The study resulted in three major findings regarding quality improvement activities in VA.
- The first is that of the three general categories, to date VA hospitals have devoted the most substantial effort to quality improvement activities (QIAs) related to prevention.
- The second is that a strong alignment of goals between senior medical center leadership and inpatient medicine service leadership is the greatest predictor of an institution’s use of QIAs.
- The third is that the medical centers that employ hospitalists, physicians who specialize in the practice of hospital medicine, show the strongest QIA adoption across all three categories.
31 Jan Pediatric Anxiety Disorders: Treatment Follow Up Course
Posted at 23:59h
in Author Interviews, Johns Hopkins, Mental Health Research, Pediatrics, Psychological Science
MedicalResearch.com Interview with:
Golda Ginsburg, Ph.D
Professor Director, Research,
Division of Child and Adolescent Psychiatry
Department of Psychiatry and Behavioral Sciences
The Johns Hopkins University School of Medicine
Baltimore, Maryland
MedicalResearch.com: What are the main findings of the study?
Dr Ginsburg: This study examined the long-term outcomes of youth treated for an anxiety disorders. Findings revealed that almost half of anxious youth treated for an anxiety disorder were in remission (i.e., did not meet diagnostic criteria for any of the three study entry anxiety disorders) at an average of six years since starting treatment. Youth showing clinically meaningful improvement after 12 weeks of treatment, were more likely to be in remission, had lower anxiety severity, and had better functioning compared to youth who showed minimal or no initial clinical improvement.
Treatment type did not affect long-term outcomes.
31 Jan Atrial Fibrillation: Dabigatran and Risk of Myocardial Infarction
MedicalResearch.com Interview with:
Professor Gregory Y.H. Lip MD, FRCP
Consultant Cardiologist & Professor of Cardiovascular Medicine, Director - Haemostasis Thrombosis & Vascular Biology Unit
Birmingham, United Kingdom
MedicalResearch.com: What are the main findings of the study?
[GYHL] In this large-scale nationwide cohort study, we found that switching to dabigatran increased the risk of MI compared to continued warfarin usage in the early period after switching. Caution may be warranted especially when switching prior VKA-experienced patients with atrial fibrillation to dabigatran. This risk was not evident in the warfarin-naïve cohort newly started on dabigatran.
31 Jan Tonsillectomy: Substantial Variability in Pediatric Hospital Care
MedicalResearch.com Interview with:
Dr. Sanjay Mahant, MD, FRCPC
Division of Pediatric Medicine, Pediatric Outcomes Research Team (PORT), Department of Pediatrics, Institute of Health Policy, Evaluation and Management, University of Toronto, Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, Toronto, Canada
MedicalResearch.com: What are the main findings of the study?
Dr. Mahant: In a large cohort of children undergoing same-day tonsillectomy at 36 children's hospitals in the U.S., we observed substantial variability in several areas. These include: processes of care, the use of steroids and antibiotics - for which there are national guidelines that outline the recommended use of these medications - and outcomes of usage, as well as revisits to hospital after surgery for complications within 30 days following surgery.
31 Jan Football Helmet Types: Large Differences in Concussion Risk
MedicalResearch.com Interview with:
Steven Rowson, Ph.D.
Research Assistant Professor
Virginia Tech
Wake Forest University
[caption id="attachment_3531" align="alignleft" width="125"]
A significant difference in concussion risk was found between these two helmet designs Riddell Revolution (left) and the Riddell VSR4 (right).Virginia Tech[/caption] MedicalResearch.com: What are the main findings of the study? Dr. Rowson: We found that there were large differences in concussion risk between football helmet types. This is the first study to address this question while controlling for the number of times each helmet type was impacted. This allowed us to compare apples to apples. For example, we're not comparing starters who frequently get hit in one helmet type to second string players who don't get hit as much.
30 Jan Risk of Suicide, Homicide Increases with Household Firearm Access
MedicalResearch.com Interview with:
Andrew Anglemyer, PhD, MPH;
Clinical Pharmacy and Global Health Sciences
University of California, San Francisco
San Francisco, CA
MedicalResearch.com: What are the main findings of the study?
Dr. Anglemyer: Over all, you are more than 3 times more likely to commit suicide if you have access to a firearm than if you do not. And, among men only, they are nearly 4 times more likely to commit suicide if they have access to a firearm than if they do not.
Additionally, over all, you are 2 times more likely to be a victim of homicide if you have access to a firearm than if you do not.
We also found that females have a higher likelihood of being a victim of homicide, than males when considering firearm access. And we know from empirical data that the majority of female victims knew their assailant—which, to us, suggests that they were victims of domestic violence.
29 Jan Autistic Spectrum Reclassification Should Not Affect Patient Services Eligibility
MedicalResearch.com Interview with:
Bennett L. Leventhal, MD
Nathan S. Kline Institue for Psychiatric Research
140 Old Orangeburg Road, Building 35
Orangeburg, NY 10962
MedicalResearch.com: What are the main findings of the study?
Dr. Leventhal: In the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders, 5th Edition (DSM5) released in May 2013, changes include major alterations in criteria for developmental disorders, in particular, the DSMIV diagnostic criteria for Pervasive Developmental Disorder (PDD), including elimination of subtypes found in DSMIV such as Asperger Disorder and PDD NOS. Additionally, DSM 5 adds a new diagnostic category, Social Communication Disorder (SCD): individuals with SCD have difficulties similar to ASD but these problems are solely restricted to the realm of social communication and do not include the restrictive and repetitive behaviors found in ASD.
28 Jan Weight Loss Healthy Living Program for Men
MedicalResearch.com Interview with:
Professor Sally Wyke
Deputy Director, Institute of Health and Wellbeing
Professor (Institute of Health and Wellbeing Social Sciences)
The University of Glasgow
MedicalResearch.com: What are the main findings of the study?
Prof. Wyke: The FFIT programme was very effective. The men who did the programme lost nine times as much weight as the men who did not. On average, they lost over 5.5kg (11lbs)and kept it off for the full 12 months.
In addition, we found highly significant differences in favour of the intervention objectively-measured waist, percentage body-fat, systolic and diastolic blood pressure, and self-reported physical activity, diet and indicators of well-being and physical aspects of quality of life.
28 Jan Life Expectancy: Urban-Rural Disparities Widen
Posted at 02:36h
in Author Interviews
MedicalResearch.com Interview with:
Gopal K. Singh, Ph.D., M.S., M.Sc.
Senior Epidemiologist/Health Care Administrator
Office of Epidemiology and Research
Division of Epidemiology
HRSA/ Maternal and Child Health Bureau
U.S. Department of Health & Human Services
Rockville, MD 20857, USA
and Mohammad Siahpush, PhD
Professor, Department of Health Promotion, Social & Behavioral Health
University of Nebraska Medical Center
College of Public Health
MedicalResearch.com: What are the main findings of the study?
Answer: There are significant disparities in life expectancy between rural and urban areas of the United States – and these disparities have widened over the past 4 decades. In 1969, life expectancy was 0.4 years longer in urban than in rural areas (70.9 vs. 70.5 years). In 2009, the life expectancy difference between urban and rural areas increased to 2.0 years (78.8 vs. 76.8 years). Much of the disparity appears to have increased since 1990. Life expectancy has increased more rapidly in urban than in rural areas, which has contributed to the widening gap in life expectancy.
Life expectancy is lower in more rural areas. In 2005-2009, life expectancy was 79.1 years in large metro areas, 77.8 in small metro areas, 76.9 years in small-urban towns, and 76.7 years in rural areas. So, the difference in life expectancy between the most-urban and most-rural was 2.4 years.
27 Jan Alzheimer Disease and Elevated Pesticide DDT Levels
MedicalResearch.com Interview with: Jason R. Richardson MS, PhD, Associate Professor Department of Environmental and Occupational Medicine Robert Wood Johnson Medical School and Resident Member Environmental and Occupational Health Sciences Institute Piscataway, NJ 08854 MedicalResearch.com: What are the main findings of the study? Dr. Richardson: We had 3 main findings in our study. First, Alzheimer Disease patients had almost...
27 Jan Breast Imaging with Combined MRI and Near Infrared Spectroscopy
MedicalResearch.com Interview with:
Michael Mastanduno
Thayer School of Engineering, Dartmouth College
14 Engineering Dr.
Hanover, NH 03755
MedicalResearch.com: What are the main findings of the study?
Answer: The study was able to illustrate the design and clinical testing of an MRI breast coil for combined MRI and Near Infrared Spectroscopy. The coil was tested on 8 healthy volunteers spanning all bra cup sizes and mammographic density categories. In the past, MRI/NIRS imaging was only possible in C and D cup sized breasts. The system also will give researchers the ability to target lesions in hard-to-reach areas close to the chest wall. With the successful completion of this study, simultaneous MRI/NIRS is possible in all breast sizes, tissue compositions, and lesion locations.
26 Jan Metastatic Melanoma: High-Dose IL2 and Survival in Autologous Tumor Cell Immunization
MedicalResearch.com Interview with:
Robert O. Dillman, M.D., F.A.C.P.
Executive Medical Director
Hoag Institute for Research and Education
Hoag Cancer Institute
MedicalResearch.com: What are the main findings of the study?
Dr. Dillman: The main finding of this study is that among 149 metastatic melanoma patients treated with high-dose interleukin-2 (IL2), survival was much better in the subset of 32 patients who also were treated with patient-specific vaccines (that is active specific immunotherapy or ASI) that contained antigens from tumor cell lines derived from there own metastases that had been surgically resected. The 5-year survival rate from the date of starting IL2 was 39% in those receiving vaccine compared to 13% in those who did not (p<0.001). A number of studies have reported that a 5-year survival rate of 15% is typical for patients treated with IL2. The data also suggested that 5-year survival was better in the 25 patients who received the vaccine after, rather than before IL2 (46% vs 14%), p<0.001). Among the 32 ASI-treated patients, there was a trend for survival benefit for the 16 patients treated with autologous dendritic cells pulsed with antigens from the autologous melanoma cells and injected with granulocyte-macrophage colony stimulating factor (GM-CSF) compared to injections of irradiated tumor cells with or without GM-CSF (p=0.17)
26 Jan Underserved Patients: Minority Physicians’ Role
MedicalResearch.com Interview with:
Dr. Lyndonna Marrast MD
Fellow in General Internal Medicine
Cambridge Health Alliance
Cambridge, MA 02139
MedicalResearch.com: What are the main findings of the study?
Dr. Marrast: We found that disadvantaged patients (categorized as racial and ethnic minorities, non-English home language speakers, being low income, having Medicaid, or reporting fair or poor health) were more likely than other patients to be cared for by a minority physician.
A majority, 54%, of black, Hispanic and Asian patients received care from a minority doctor and the vast majority, 70%, of those who report not speaking English at home got care from a minority physician.
26 Jan Total Hip Replacements: Failure rate of Cemented vs Uncemented
MedicalResearch.com Interview with: Keijo T Mäkelä Associate professor Department of Orthopaedics and Traumatology Turku University Hospital, Rauhankatu Turku, FI-20100, Finland MedicalResearch.com: What are the main findings of the study? Answer: • The implant survival of cemented total hip replacement was higher than that of uncemented total hip replacement in patients aged 65 years and older in our multinational register study with a comprehensive patient population. • The proportion of uncemented total hip replacement is rapidly increasing in Nordic countries. The increased use of uncemented total hip replacement group is not supported by these data.26 Jan Breast Cancer: Urban vs Rural Diagnosis Disparities
MedicalResearch.com Interview with: Deirdre McLaughlin PhD MAPS Associate Professor, Principal Research Fellow Centre for Longitudinal and Lifecourse Research and Janni Leung, BHS School of Population Health University of Queensland MedicalResearch.com: What are the main findings of the study? Answer: Breast cancer patients living in rural areas were diagnosed later than breast cancer patients living in urban areas. Evidence from Australia, Egypt, Italy, Canada, Poland, South Africa, Denmark, and parts of the United States indicated that patients residing in rural areas were more likely to be diagnosed with more advanced breast cancer. Our meta-analysis showed that rural breast cancer patients had 1.19 higher odds (95% confidence interval= 1.12-1.27) of diagnosis of a late stage breast cancer compared to urban breast cancer patients.25 Jan Hormone Replacement Therapy Found Protective of Hip, Knee Joint Replacements
MedicalResearch.com Interview with:
Professor Nigel Arden
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
Botnar Research Centre
Oxford OX3 7LD
MedicalResearch.com: What are the main findings of the study?
Professor Arden: We found that in a cohort of women who had used hormone replacement therapy (HRT) and underwent knee or hip replacement their risk of implant revision was reduced by about 40% compared to non-users of HRT.
24 Jan Vitamin D: Study Finds Little Justification For Prescribing For Most Disease Prevention
MedicalResearch.com Interview with: Professor Mark Bolland Senior Research Fellow in the Department of Medicine University of Auckland, New Zealand MedicalResearch.com: What are the main findings of the study? Prof. Bolland: We pooled data from randomised controlled trials of vitamin D supplements in traditional meta-analyses and trial sequential analyses to assess the effect on important health outcomes. We found that vitamin D supplements (with or without calcium) had no effect on myocardial infarction, stroke, total cancer, or total fracture, and further similar trials are unlikely to alter these conclusions. For hip fracture, the results were more complicated. There was uncertainty as to whether vitamin D by itself increased the risk of hip fracture or had no effect, whereas the combination of vitamin D with calcium had no effect on hip fracture in people living in the community, but reduced hip fracture risk in two trials of elderly women living in residential care.24 Jan Alzheimer’s: Two Phase 3 Trials of Bapineuzumab in Mild-to-Moderate Disease
MedicalResearch.com Interview with: Stephen Salloway, MD, MS Director of Neurology and the Memory and Aging Program, Butler Hospital Professor of Neurology and Psychiatry Warren Alpert Medical School Brown University MedicalResearch.com: What are the main findings of this study? Dr. Salloway: With the aging of the population, the G-8 and the US Congress have made finding...
23 Jan FDA Drug Approvals Have Variable Clinical Trial Evidence Record
MedicalResearch.com Interview with: Nicholas S. Downing, AB Yale University School of Medicine New Haven, Connecticut MedicalResearch.com: What are the main findings of the study? Answer: In our systematic review of all new drugs approved by the FDA over an 8 year period, we found that there was real variability in the quality and quantity of clinical trial evidence used as the basis of the agency’s approval decisions. Some drugs were studied in multiple randomized, double-blinded, controlled clinical trials that provide very helpful information for patients and physicians. However, other drugs were studied in clinical trials that did not produce as much information about their safety and effectiveness.22 Jan Bereavement During Pregnancy, Early Childhood and Psychosis Risk
MedicalResearch.com Interview with: Prof. Kathryn M Abel Professor of Psychiatry & Honorary Consultant Psychiatrist University of Manchester and Honorary Senior Lecturer at the Institute of Psychiatry, London. MedicalResearch.com: What are the main findings of the study? Answer: The main study findings were that exposure of a mother to a severe psychological stress of losing a close family member up to either 6 months before conception or at any time during pregnancy did not increase risk of subsequent psychotic illness in the offspring. Secondly, we found during childhood, if a close family member died then, especially a sibling of the child or one of their parents, these children were at slightly increased risk of developing a psychotic illness later in life. This was most likely to happen following a sudden death especially suicide and in particular following suicide a psychotic mood disorder was more likely than other kinds of psychosis such as schizophrenia (although the risk of schizophrenia was also increased following suicide). This effect was not accounted for by having a family history of a psychotic illness or suicide.22 Jan Concussions in Young Female Soccer Players
MedicalResearch.com Interview with:
John W. O'Kane M.D.
Associate Professor Family Medicine and Orthopaedics and Sports Medicine
Medical Coordinator, U.W. Intercollegiate Athletics
University of Washington Sports Medicine Clinic, Seattle
MedicalResearch.com: What are the main findings of the study?
Dr. O’Kane: In 11 to 14 year old female elite soccer players the concussion incidence was 13% with a rate of 1.2 per 1000 athletic exposures. Symptoms lasted a median of 4 days and players with light or noise sensitivity, emotional lability, memory loss, nausea, and concentration problems took significantly longer to recover. Heading the ball accounted for 30.5% of concussions and the vast majority of concussions (86%) occurred in games. The majority of players (58.6%) reported playing with symptoms and less than half (44.1%) sought medical attention for their symptoms. Those seeking medical attention were symptomatic longer and were less likely to play with symptoms.
22 Jan Transfers of Hospitalized Patients and Insurance Status
Posted at 01:00h
in Annals Internal Medicine, Author Interviews, Cost of Health Care, Health Care Systems, University of Pittsburgh
MedicalResearch.com Interview with:
Janel Hanmer, MD, PhD
University of Pittsburgh Medical Center
Montefiore Hospital
Pittsburgh, PA 15213
MedicalResearch.com: What are the main findings of the study?
Dr. Hanmer: We used the National Inpatient Sample - a sample of about 20% of US community hospitals with all discharges from those hospitals - to examine if insurance status is associated with transfer from one hospital to another. We were looking at patients who were already admitted to the hospital, not the patients who presented to the Emergency Department. We selected the five most common general medicine admissions for adults aged 18 to 64. We found that uninsured patients were less likely to be transferred than privately insured patients in four of the five conditions (about 20-40% less likely). We also found that women were less likely than men to be transferred in five of the conditions (about 35 to 40% less likely).
22 Jan Breast Cancer: Cognitive Therapy Plus Hypnosis For Radiation Fatigue
MedicalResearch.com Interview with:
Guy H. Montgomery, Ph.D.
Director, Integrative Behavioral Medicine Program
Cancer Prevention and Control
Department of Oncological Sciences
Icahn School of Medicine at Mount Sinai
New York, NY 10029-6574
MedicalResearch.com: What are the main findings of the study?
Dr. Montgomery: A brief psychological intervention comprised of cognitive behavioral techniques and hypnosis (CBTH) reduced fatigue during, and for up to six months after, radiotherapy in breast cancer patients.
21 Jan Genetic Factors Explain Substantial Part of Physical Aggression Differences
MedicalResearch.com Interview with:
Eric Lacourse, Ph.D.
Professeur agrégé
Département de sociologie
Université de Montréal
Groupe de Recherche sur l'Inadaptation Psychosociale chez l'enfant Centre de Recherche de l'Hôpîtal Ste-Justine
MedicalResearch.com: What are the main findings of the study?
Dr. Lacourse: The gene-environment analyses revealed that early genetic factors were pervasive in accounting for developmental trends, explaining most of the stability and change in physical aggression, ” Lacourse said. “However, it should be emphasized that these genetic associations do not imply that the early trajectories of physical aggression are set and unchangeable. Genetic factors can always interact with other factors from the environment in the causal chain explaining any behaviour.”
21 Jan Reducing Risk of Diabetes with Berries in Diet
MedicalResearch.com Interview with: Prof Aedin Cassidy University of East Anglia, Norwich Research Park, Norwich MedicalResearch.com: What are the main findings of the study? Answer: We know fruits and vegetables seem to be particularly important for prevention of heart disease and diabetes but what constituent may responsible for these benefits is unclear. These foods contain powerful bioactive compounds called flavonoids and in lab and animal experiments we know that flavonoids can reduce inflammation, improve BP, keep our arteries healthy and flexible, improve blood flow and reduce cholesterol levels. Our previous work had shown that a higher level of one class of flavonoids, the anthocyanins, responsible for the brilliant red/blue colours in fruits and other plant foods/products, could reduce the risk of developing type 2 diabetes and of having a heart attack. This study builds on this and now we have evidence in humans that following intake of one portion of berries per day we can see these heart health benefits, and benefits on how we control our insulin and glucose levels.21 Jan Most Advanced Age Adults are Women, Many Living in Community
MedicalResearch.com Interview with
Paula A. Rochon MD, MPH, FRCPC
Vice President, Research, Women's College Hospital
Senior Scientist, Women's College Research Institute
Professor, Department of Medicine
University of Toronto, Ontario Canada
MedicalResearch.com: What are the main findings of the study?
Dr. Rochon: Our main findings are that there are now more than 1800 centenarians in Ontario. Among those over 100 years of age, 60 per cent are 101 years of age or older. In addition, most centenarians are women (85 per cent), and this percentage increases to 90 per cent among those who are 105 years of age and older.
21 Jan Life Enjoyment Predicts Less Physical Decline with Age
MedicalResearch.com Interview with:
Professor Andrew Steptoe, MA, DPhil, DSc, FMedSci
Director, Institute of Epidemiology and Health Care
University College London
British Heart Foundation Professor of Psychology
Department of Epidemiology and Public Health
London WC1E 6BT
MedicalResearch.com: What are the main findings of the study?
Dr. Steptoe: We are trying to understand whether positive well-being has beneficial effects as far as health and physical function is concerned. The main findings are that the risk of developing impairments in activities of daily living (things life being able to bath or shower without help) over the next few years among older people is lower in people who enjoy life more. In addition, enjoyment of life predicted less decrease in walking speed over our 8 year study period in this sample of older men and women. Of course, these associations could be due to many things: the people with greater enjoyment of life could be more affluent, have less physical illness or disability to start with, or have healthier lifestyles at the outset, and these factors could predict the changes in physical function over time. But what we found is that baseline health, economic circumstances, and lifestyle explain only part of the association between enjoyment of life and deterioration in function. So the research suggests that enjoyment of life contributes to healthier and more active old age.
21 Jan Cannabis Withdrawal: Nabiximols as an Agonist Replacement Therapy
MedicalResearch.com Interview with:
David J. Allsop, PhD
National Cannabis Prevention and Information Centre, National Drug and Alcohol Research Centre, Faculty of Medicine
Now with the School of Psychology, University of Sydney, Sydney, Australia
MedicalResearch.com: What are the main findings of the study?
Dr. Allsop: We found that administering a botanical preparation of the cannabinoids Tetrahydrocannabidiol (THC - the main psychoactive ingredient in cannabis) and Cannabidiol (a lesser known component of the cannabis plant that
counteracts the psychotogenic effects of THC with anxiolytic properties) to
dependent cannabis smokers during initial abstinence from cannabis
substantially dampened their withdrawal experience. In essence this is akin
to Nicotine Replacement Therapy (NRT) but for cannabis users. It might seem
obvious - sure you give cannabis users a cannabis preparation and they find
it easier to quit - but this is important because it has never been done
before - and we currently have no consensus evidence based medicines to
offer cannabis users who ask for help.
20 Jan Macular Degeneration: Incidence, Susceptibility and Dietary Antioxidants
MedicalResearch.com Interview with:
Jie Jin Wang MMed (Clin Epi) MAppStat PhD
Professor Australian NHMRC Senior Research Fellow (Level B)
Centre for Vision Research
Westmead Millennium Institute University of Sydney C24
Westmead Hospital, NSW 2145 Australia
MedicalResearch.com: What are the main findings of the study?
Answer: We documented a consistent association between high dietary intake of lutein/zeaxanthin (LZ) and a reduced long-term risk of early age-related macular degeneration (AMD) in persons who carry ≥2 risk alleles of either or both the complement factor H (CFH-rs1061170) and/or the age-related maculopathy susceptibility gene 2 (ARMS2-rs10490924) in two older population-based cohorts.