MedicalResearch.com Interview with: Dr. R.T. van Domburg
Clinical epidemiologist, Associate Professor
Erasmus Medical Center
Department of Cardiology Ba561
‘s-Gravendijkwal 230 3015 CE Rotterdam
MedicalResearch.com: What are the main findings of your study?Answer: We collected data from the first patients who underwent coronary angioplasty in the early 1980s and followed them for 25 to 30 years.
We found that patients who were able to quit smoking in the year following their PCI lived on average more than two years longer than those who continued to smoke.
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MedicalResearch.com Interview with:Pim A de Jong
Heidelberglaan 100, E01.1A32, 3508 GA Utrecht, the Netherlands
MedicalResearch.com: What are the main findings of the study?Answer: We observed that patients with a vertebral fracture on a routine clinical chest computed tomography exam had a tripled risk of future hip fracture after adjustment for age and gender.
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MedicalResearch.com Interview with: Ana P Lourenco MD
Assistant Professor of Diagnostic Imaging
Alpert Medical School of Brown University
MedicalResearch.com What are the main findings of the study?Dr. Lourenco: Our study found a significantly higher recall rate for screening mammography at a tertiary referral hospital compared with a community private practice. We compared recall rates for 5 fellowship trained radiologists reading at both sites, and all five radiologists had higher recall rates at the hospital site. When we analyzed patient factors in an effort to explain why this might be, we found that the average age of patients in the hospital was younger (which is known to be associated with higher recall rate) and that more patients at the hospital had a personal history of prior breast biopsy or surgery (also known to be associated with higher recall rate).
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MedicalResearch.com interview with: Matthew B. Schabath, Ph.D
Assistant Member, Department of Cancer Epidemiology
H. Lee Moffitt Cancer Center, 12902 Magnolia Drive
MRC-CANCONT, Tampa, Florida
MedicalResearch.com: What are the main findings of the study?
Dr. Schabath: In this study we found that Asian/Pacific Islander men had the lowest incidence of human papillomavirus (HPV) infection and that they exhibited a lower probability of acquiring new HPV infections. Furthermore, men of multiple and mixed race had the second lowest incidence of HPV infection and however, while they had a lower probability of acquiring HPV, they also had a lower probability of clearing an HPV infection once acquired.
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MedicalResearch.com Interview with:Clare Rock, MD
Department of Epidemiology and Public Health
University of Maryland School of Medicine
Baltimore, MD, 21201
Summary paragraph:
Dr. Rock: Hand hygiene is an essential step in infection prevention and a focus on improving and sustaining hand hygiene compliance is needed. However, it remains unclear whether or not hand hygiene is required prior to non-sterile glove use. Our study would support that it is not a necessary step and a potential waste of healthcare worker time.
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As of July 30, 2013 (5pm EDT), CDC has been notified of 378 cases of Cyclospora infection from the following 16 health departments: Iowa, Texas, Nebraska, Florida, Wisconsin, Illinois, New York City, Georgia, Missouri, Arkansas, Connecticut, Kansas, Minnesota, New Jersey, New York, and Ohio.
Most of the illness onset dates have ranged from mid-June through early July.
At least 21 persons reportedly have been hospitalized in three states.
Nebraska and Iowa have performed investigations within their states and have shared the results of those investigations with CDC. Based on their analysis, Cyclospora infections in their states are linked to a salad mix. CDC will continue to work with federal, state, and local partners in the investigation to determine whether this conclusion applies to the increase in cases of cyclosporiasis in other states.
It is not yet clear whether the cases from all of the states are part of the same outbreak.
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Hemodialysis.com Interview with:: Marcela G. del Carmen, M.D., M.P.H
Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology
Massachusetts General Hospital, 55 Fruit Street, Yawkey 9 E Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study?
Answer: The study sample included 7,973 women, including 7,363 (92.3%) whites and 610 (7.7%) AA, diagnosed with vulvar cancer from 1973 to 2009. African American women were younger and had a higher rate of distant metastasis compared to white women. African American women were more likely to be treated by radiaton therapy and less likely to receive survival therapy. Although the study found that compared to white women, African Americans were more likely to be younger and have more advanced disease upon diagnosis, they had lower rates of vulvar cancer related mortality compared to white women.
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Hybrid PET/MR Imaging of the Heart: Feasibility and Initial ResultsFelix Nensa, MD
Department of Diagnostic and Interventional Radiology and Neuroradiology
University Hospital Essen, University of Duisburg-Essen,
Hufelandstrasse 55, 45147 Essen, Germany;
MedicalResearch.com: What are the main findings of the study?Dr. Nensa: Cardiac positron emission tomography (PET)/magnetic resonance imaging (MRI) with fluorine 18 fluorodeoxyglucose (FDG) turned out to be feasible with an integrated whole-body 3-Tesla PET/MRI system. Despite the presence of a PET detector in the magnetic field of the MR imaging unit, high-quality cardiac MR images were acquired. PET images originating from a PET/CT and the PET/MR scanner showed very good visual agreement and no statistical significant difference of the mean was found in standardized uptake values, however, variance was considerable. In patients with myocardial infarction, PET and MR images were in good concordance regarding both, cine imaging and late gadolinium-enhanced imaging.
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MedicalResearch.com Interview with:Bruce Y. Lee, MD MBA
Associate Professor of International Health
Director of Operations Research
International Vaccine Access Center (IVAC)
Johns Hopkins Bloomberg School of Public Health
855 N. Wolfe Street Suite 600
Baltimore, MD 21205
MedicalResearch.com: What are the main findings of the study?Dr. Lee: Vancomycin resistant enterococci (VRE) is every hospital’s problem. A VRE outbreak in one hospital, even if the hospital is relatively small or distant, can readily spread to other hospitals in a region because patients leaving one hospital often will go to other hospitals either directly or after an intervening stay at home. These patients can then carry VRE with them to other hospitals. Therefore, as long a single hospital has a problem with VRE or any other healthcare associated infection, all other hospitals are at risk. Conquering VRE then requires cooperation among hospitals.
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MedicalResearch.com Interview with: Linda L. Humphrey, M.D., M.P.H.
Professor of Medicine
Informatics and Clinical Epidemiology and Public Health for Oregon Health & Science University;Associate Chief of Medicine at the Portland VA Medical Center
Dr. Humphrey comments on this important study on
Screening for Lung Cancer With Low-Dose Computed Tomography:
Lung cancer is the 3rd leading cause of cancer in the United States and the leading cause of cancer related death. It is estimated that in 2012 there were 226,160 cases of lung cancer and 160, 340 lung cancer related death in the US. In addition, lung cancer is the leading cause of years of life lost to cancer. Cigarette smoking is by far the leading cause of lung cancer in the US and while many people have quit smoking, data in the US indicate that 37% of adults are either current or former smokers and at risk of lung cancer. (more…)
MedicalResearch.com Interview with Dr. Brian Haas MD
Department of Diagnostic Radiology,Yale University School of Medicine, New Haven, CT
MedicalResearch.com: What are the main findings of the study?Dr. Haas: We found that tomosynthesis helped to reduce the number of women who undergo a screening mammogram and are called back for additional imaging and testing. Specifically, the greatest reductions in patients being called back were seen in younger patients and those with dense breasts. Tomosynthesis is analogous to a 3D mammogram, and improves contrast of cancers against the background breast parenchyma.
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MedicalResearch.com Interview with: Ole Raaschou-Nielsen, MSc, PhD
Head of Research Group for Work, Environment & Cancer
Danish Cancer Society Research Center
Strandboulevarden 49
2100 Copenhagen Ø
MedicalResearch.com: What are the main findings of the study?Answer: The study shows that people who live at locations with higher levels of particles in the air are at higher risk for development of lung cancer.
It seems that there is no threshold for air pollution with particles below which there is no risk; the results show that it is more like “the more air pollution the worse and the less pollution the better”.
The strongest association was seen for adenocarcinoma of the lung.
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MedicalResearch.com Interview with: Dr. Henna Cederberg MD PhD, Postdoctoral Fellow
University of Eastern Finland and Kuopio University Hospital Department of Medicine
70210 Kuopio, Finland
MedicalResearch.com: What are the main findings of the study?Dr. Cederberg: The association of risk variants previously identified for type 2 diabetes and hyperglycemia with gestational diabetes were evaluated in 533 Finnish women with gestational diabetes and 407 controls.
The main finding of the study was that gestational diabetes and type 2 diabetes share a similar genetic background. Two risk variants of MTNR1B were significantly associated with gestional diabetes. Our study suggests that risk variants of MTNR1B are associated with gestational diabetes by increasing fasting glucose and decreasing insulin secretion. In addition, another six single nucleotide polymorphisms associated with type 2 diabetes and hyperglycemia were nominally associated with gestational diabetes.
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MedicalResearch.com Interview with: Gary A. Smith, MD, DrPHCenter for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio;
The Ohio State University College of Medicine, Columbus, Ohio; and
Child Injury Prevention Alliance, Columbus, OhioMedicalResearch.com: What are the main findings of the study?Dr. Smith: During the nine-year study period, more than 12,000 children were treated each year in U.S. emergency departments for injuries from choking on food, which equals 34 children each day. Hard candy caused the most choking episodes (15 percent), followed by other candy (13 percent), meat, other than hot dogs (12 percent), and bones (12 percent). These four food types alone accounted for more than half of all the choking episodes in the study.
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MedicalResearch.com Interview with: Kalipada Pahan, Ph.D.
The Floyd A. Davis, M.D., Endowed Chair of Neurology
Professor
Departments of Neurological Sciences, Biochemistry and Pharmacology
Rush University Medical Center
1735 West Harrison St, Suite 320 Chicago, IL 60612
MedicalResearch.com: What are the main findings of the study?Dr. Pahan: While different toxins and a number of complex genetic approaches are used to model Parkinson’s disease in mice, this study delineates that simple castration is sufficient to cause persistent Parkinson’s like pathology and symptoms in male mice. This simple, but persistent, model may be helpful in discovering drugs against Parkinson’s disease. Furthermore, these results suggest that sudden drop of testosterone level could trigger Parkinson’s disease.
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MedicalResearch.com Interview with Dr. Pietro Manuel Ferraro
Division of Nephrology–Renal Program, Department of Internal Medicine and Medical Specialties, Columbus-Gemelli Hospital, Rome, Italy
MedicalResearch.com: What are the main findings of the study?Dr. Ferraro: We analyzed three large cohorts over time to see if those with prevalent or incident kidney stones might have a higher risk of developing coronary heart disease (fatal or non fatal myocardial infarction or the need for coronary revascularization). The cohorts consisted of over 200,000 participants without any prior history of coronary heart disease. After a median follow-up of over 8 years, we observed that women affected with stones seem to have a greater risk of developing coronary heart disease independent of a number of other known cardiovascular risk factors such as diabetes or high blood pressure. We did not observe a significant association among men. (more…)
MedicalResearch.com Interview with:Wendy Chung, MD PhD
Herbert Irving Associate Professor of Pediatrics and Medicine
Director of Clinical Genetics
Columbia University
1150 St. Nicholas Avenue, Room 620
New York, NY 10032
MedicalResearch.com: What are the main findings of the study?Dr. Chung: We have identified a potassium channel as a new genetic cause of pulmonary hypertension and demonstrated it as a cause of pulmonary hypertension in patients with familial disease and sporadic disease without a family history of pulmonary hypertension. In vitro we were able to rescue several of the mutations pharmacologically. This potassium channel now provides a new target for treatment for pulmonary hypertension.
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MedicalResearch.com Interview with:Catherine A. Matthews, MD
Associate Professor and Division Chief
Urogynecology and Reconstructive Pelvic Surgery
University of North Carolina, Chapel Hill
MedicalResearch.com: What are the main findings of the study?Dr. Matthews: Women under 50 should try and preserve their ovaries at the time of hysterectomy for benign disease; however, women over 50 should consider elective ovarian removal as a way to reduce ovarian cancer. There is no adverse impact on cardiovascular, bone or sexual health in women over 50 who elect ovarian removal.
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MedicalResearch.com Interview with:Michelle N. McDonnell, PhD
Division of Health Sciences
International Centre for Allied Health Evidence
University of South Australia
Adelaide, SA 5001 Australia.
MedicalResearch.com: What are the main findings of the study?Dr. McDonnell:In this study, we asked people how many times a week they engaged in intense physical activity, enough to work up a sweat. People responded that they were physically active 0, 1-3 or 4 or more times a week. When we followed up these people for several years, those who did not do any vigorous exercise were 20% more likely to have a stroke, compared to those who exercised four or more times a week. However, when we adjusted these results for other risk factors, this attenuated the effect down to 14% which was not statistically significant. We also noticed that people who exercised four or more times a week had less hypertension (high blood pressure), were less likely to be obese and less likely to have diabetes. Each of these things on their own reduces your risk of stroke, so when we adjust for that the association between physical activity and stroke is weaker (20% to 14%). So physical activity seems to have an effect on stroke risk by improving these other risk factors.
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MedicalResearch.com Interview with: Xiaolu Yang, Ph.D.
Professor of Cancer Biology at the Perelman School of Medicine
University of Pennsylvania
and the Abramson Family Cancer Research Institute,
MedicalResearch.com: What are the main findings of the study?Dr. Yang: TAp73 is a structural homologue of the preeminent tumor suppressor p53, but its role in tumorigenesis has been unclear. In this study, we show that TAp73 supports the proliferation of tumor cells. Mechanistically, TAp73 activates the expression of glucose-6-phosphate dehydrogenase (G6PD), a rate-limiting enzyme in the pentose phosphate pathway. This function of TAp73 is required for maintaining a robust biosynthesis and anti-oxidant defense in tumor cells. These finding connects TAp73 to oncogenic growth and suggest that G6PD may be a valuable target for tumor therapy.
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MedicalResearch.com Interview with:
Helena Hallström Ph.D., M.Sc. (Toxicology)
Department of Surgical Sciences, Section of Orthopedics
Uppsala University, Uppsala, Sweden and
Risk and Benefit Assessment Department National Food Agency, Uppsala, Sweden.
MedicalResearch.com: What are the main findings of the study?Answer: The aim of the study was to investigate whether high consumption of coffee is associated with osteoporosis and development of osteoporotic fractures, since results from previous fracture studies regarding potential associations between coffee drinking and fracture risk are inconsistent. The longitudinal population-based Swedish Mammography Cohort, including 61,433 women born between 1914 and 1948, was followed from 1987 through 2008. Coffee consumption was assessed with repeated food frequency questionnaires. During follow-up, 14,738 women experienced any type of fracture and of these 3,871 had a hip fracture. In a sub-cohort (n=5,022), bone density was measured and osteoporosis was determined (n=1,012). There was no evidence of a higher rate of any fracture or hip fracture with increasing coffee consumption. However, a high coffee intake (≥4 cups) in comparison with a low intake (<1 cup) was associated with a 2-4% reduction in bone mineral density (BMD), depending on site (p<0.001), but the odds ratio of osteoporosis was only 1.28 (95% confidence interval: 0.88, 1.87). Thus, high coffee consumption was associated with a small reduction in bone density that did not translate into an increased risk of fracture.
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MedicalResearch.com Interview with:
Jon C. Tilburt, MD, MPH
Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
Biomedical Ethics Program, Mayo Clinic
Knowledge & Evaluation Research Unit, Mayo Clinic
Healthcare Delivery Research Program, Center for the Science of Healthcare Delivery
Division of Health Care Policy and Research, Mayo Clinic
What did you set out to find, what was your objective in this study?
We wanted to know physicians perceived roles and responsibilities in addressing health care costs as well as their enthusiasm for proposed strategies to contain health care spending.
Who did you study and what did you look at?
Practicing US physicians under age 65, we randomly selected 3900 physicians representing all specialties and mailed them an 8-page survey entitled “Physicians, Health Care Costs, and Society.” We received 2,556 completed surveys (65% response rate).
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MedicalResearch.com Interview with: Lillian S. Kao, MD, MS
Associate Professor, Department of Surgery
The University of Texas School of Medicine at Houston
Houston, Texas 77030
MedicalResearch.com: What are the main findings of the study?Dr. Kao:
-The internal validity (methodological rigor) and external validity (generalizability) of quality improvement (QI) studies of implementation of surgical antibiotic prophylaxis measures are poor.
-Studies demonstrating large positive effect on compliance were often performed in settings where the baseline compliance was extremely low (i.e., less than 20%), thus further limiting their generalizability.
-Very few studies evaluated the effect of the QI interventions to increase appropriate antibiotic prophylaxis use on surgical site infections (SSIs). Moreover, those studies that included SSI as an outcome measures were usually underpowered to identify a significant effect.
-The majority of studies failed to report metrics relating to the quality of the implementation of the interventions to increase antibiotic prophylaxis compliance. Effectiveness of evidence-based measures is dependent upon their implementation. For example, did all of the targeted groups adopt the intervention? Or were the QI interventions sustained beyond the initial measurement or study period?
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MedicalResearch.com Interview with:Susan Matulevicius, MD, MSCS
Department of Medicine, The University of Texas Southwestern Medical Center, Dallas
MedicalResearch.com: What are the main findings of the study?Dr. Matulevicius: In our cohort of 535 transthoracic echocardiograms performed at a single academic medical center, we found that the majority (92%) of echocardiograms were appropriate by the 2011 Appropriate Use Criteria; however, only 1 in 3 echocardiograms lead to an active change in patient care while 1 in 5 resulted in no appreciable change in patient care.
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MedicalResearch.com Interview with: Roberta Re, Ph.D.
Nutrition research manager at Leatherhead Food Research in Surrey, England.
MedicalResearch.com: What are the main findings of the study?Dr. Re:The main finding of the study on snacking is that consumption of nuts (almonds and peanuts in particular) can help to a reduced subjective perception of appetite and reduce energy intake at the next meal.
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MedicalResearch.com Interview with: Sheree Boulet, DrPH, MPH
Assisted Reproductive Technology Surveillance and Research Team
Women's Health and Fertility Branch
Division of Reproductive Health
Centers for Disease Control and Prevention
MedicalResearch.com: What are the main findings of the study?Dr. Boulet: Between 1994-2009, the rate of pregnancy-related hospitalizations with venous thromboembolism (VTE) increased by 14%. We also found that the prevalence of hypertension, obesity, diabetes, and heart disease increased over the same time period for pregnancy hospitalizations with VTE.
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MedicalResearch.com Interview with:Alexey V. Pshezhetsky, Ph.D.
Professor
Departments of Pediatrics and Biochemistry
University of Montreal
Division of Medical Genetics
Sainte-Justine University Hospital
Research Center
Montréal, PQ, Canada, H3T 1C5.
MedicalResearch.com: What are the main findings of the study?Dr. Pshezhetsky: Our laboratory found that the presence of sugar known as sialic acid on the insulin receptor can determine whether cells react normally to insulin or are resistant. Sialic acid modifies molecules like the insulin receptor, and reduces their activity. We studied the enzyme that removes sialic acid, known as neuraminidase 1 or Neu1. Cells that lacked Neu1 had more sialic acid on the insulin receptor and were resistant to insulin. Genetically-modified mice with ~10% of the normal Neu1 activity exposed to a high-fat diet develop hyperglycemia and insulin resistance twice as fast as their wild type counterparts. Together, these studies identify Neu1 and sialic acid as novel components of the signaling pathways of energy metabolism and glucose uptake.
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MedicalResearch.com Interview with: Maya Leventer-Roberts, MD, MPH
Fellow Trainee
Department of Preventive Medicine
Mount Sinai School of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Leventer-Roberts: Overweight status among medical and surgical residents is more likely by increasing PGY of training. Overweight residents are also unlikely to acknowledge their overweight status. These changes can differ significantly from matched controls and may affect long-term health.
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MedicalResearch.com Interview with:Professor John Zajicek
Professor of Clinical Neuroscience, Centre for Clinical Trials & Health Research - Translational & Stratified Medicine (Peninsula Schools of Medicine and Dentistry)
MedicalResearch.com: What are the main findings of the study?Prof. Zajicek: Our study investigated whether dronabinol (one of the major active ingredients of cannabis) may slow the progression of multiple sclerosis. We currently have no treatments that are effective in modifying the disease course in people with either primary or secondary MS. We did a clinical trial across the UK involving nearly 500 patients, who were randomly allocated to dronabinol or placebo, and followed them up for three years to look at progression on rates. Overall we failed to find an effect of dronabinol on disease progression, either clinically (using a variety of clinical measures) or using magnetic resonance imaging (MRI). There was a suggestion of an effect in people with the least disability (who didn't need a stick to help them walk), and there were no major problems with serious side effects. However, over all the population that took part in the study also progressed less than we expected, which reduced our chances of finding an effect of treatment. The study was not designed to investigate an effect on MS-related symptoms (such as pain and muscle stiffness), which have been investigated before.
(more…)
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