Author Interviews, Diabetes, Diabetologia, Heart Disease, Race/Ethnic Diversity / 09.07.2013

MedicalResearch.com Interview with: Dr Nazim Ghouri MBChB, MRCP UK Specialty Registrar (Diabetes/Endocrinology/GIM) and Honorary Clinical Lecturer Institute of Cardiovascular and Medical Sciences BHF Glasgow Cardiovascular Research Centre University of Glasgow Glasgow G12 8TA Lower cardiorespiratory fitness contributes to increased insulin resistance and fasting glycaemia in middle-aged South Asian compared with European men living in the UK MedicalResearch.com: What are the main findings of the study? Answer: In this study we aimed to determine the extent to which increased insulin resistance and blood sugar levels in South Asian men, compared to white European men, living in the UK, was due to lower fitness and physical activity levels. We studied 100 South Asian and 100 European men aged 40-70 years living in Scotland without diagnosed diabetes and measured their blood sugar levels, insulin resistance and other risk factors. The men also undertook a treadmill exercise test to determine how much oxygen their bodies were able to use during intense exercise – a key measure of physical fitness, wore accelerometers for a week to assess their physical activity levels, and had a detailed assessment of their body size and composition. Statistical modeling was then used to determine the extent to which body size and composition, fitness and physical activity variables explained differences in insulin resistance and blood sugar between South Asians and Europeans. The results suggested that lower fitness, together with greater body fat in South Asians, explained over 80 per cent of their increased insulin resistance compared to white men with Low fitness being the single most important factor associated with the increased insulin resistance and blood sugar levels in middle-aged South Asian compared to European men living in the UK. (more…)
Author Interviews, Diabetes, Frailty, Lancet / 09.07.2013

MedicalResearch.com Interview with: Dr David Strain, MRCP MD Clinical senior lecturer and honorary consultant University of Exeter Medical School Institute of Biomedical and Clinical Science Department of Diabetes and Vascular Research Royal Devon & Exeter Hospital Exeter EX2 5AX MedicalResearch.com: What is the Background of the study? In early 2010 recent diabetes outcome trials such as ACCORD and ADVANCE had put into question the benefit of aggressive HbA1c reduction for all patients particularly in elderly population. After that there were several guidelines that suggested individualizing treatment targets for elderly patients according to their age, co-morbidities, frailty and baseline HbA1c. This featured in the Finnish guidelines and the European Working Party for the management of Diabetes in the Older Person. However this was also completely without any evidence base. I worked with Paivi Paldanius (the final author of the paper and a medical advisor for Novartis) to establish a pragmatic study. We both acknowledged the importance of having a patient-centric, pragmatic and 'real-life' approach and as there was already evidence that DPP-4 inhibitors, in this case vildagliptin (due to Päivi's affiliation), had demonstrated it's efficacious and had no tolerability issues in the elderly population we decided to go ahead with the study. It was obvious that we needed to implement a holistic approach and take into account as many clinically relevant parameters as possible, such as age, baseline HbA1c, duration of the disease, co-morbidities and frailty, for implementation of the individualized care. Our primary goal was to request that the physicians acting as investigators would still apply their clinical judgment based on these clinical features of each individual patient but also, follow their local guidelines as in their daily clinical practice. This would later provide us with invaluable information and perspective when interpreting the data and recommending implementation of the results.  For assessment of frailty we screened for many different methodologies but Prof Timo Strandberg (known expert of the field and mentioned in the acknowledgements section of our paper) suggested to apply modified Linda Fried's method for assessment of phenotype of frailty as this method is validated, very pragmatic, reproducible and also feasible to be used for the first time also by a non-geriatric investigator. All investigators were trained to follow these parameters by the protocol. We also wished to evaluate in parallel the conventional HbA1c drop assessment in order to be able to put the potential success of our new endpoint, meeting the individualized target, into perspective and for comparison against other standard data from other studies with DPP-4 inhibitors with elderly. We also wished to simulate a clinical, real-world setting as much as possible and included patients who would seem representative of most elderly T2DM patients. (more…)
Author Interviews, Frailty, Surgical Research / 09.07.2013

MedicalResearch.com Interview with Kenneth Ogan MD Department of Urology Emory University School of Medicine 1365 Clifton Rd. NE, Building B, Suite 1400 Atlanta, Georgia 30322 MedicalResearch.com: What are the main findings of the study? Dr. Ogan: Surgical risk assessment is traditionally a very subjective process, and an evaluation that more accurately measures a patient’s physiologic reserve would greatly aid in surgical decision making. In this study we sought to further characterize frailty as an objective risk assessment tool in surgical patients. We prospectively measured the five component frailty criteria described by Fried et al.1 (weight loss, exhaustion, low activity, grip strength, and gait speed).  Patients deemed “intermediately frail” and “frail” had twice the likelihood of experiencing any complication in the 30-day post-operative period. (more…)
Author Interviews, Cancer Research, CT Scanning, Heart Disease, JACC, Lung Cancer, Medical Imaging / 08.07.2013

Dr. Pim A. de Jong, Department of Radiology University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3508GA Utrecht, the Netherlands. MedicalResearch.com: What are the main findings of the study? Dr. de Jong: The main findings of the study is that lung cancer screening CT scans can predict future cardiovascular events. MedicalResearch.com: Where any of the findings unexpected? Dr. de Jong: The unexpected aspect is that the CT scans were not-ECG gated, but even these non-gated scans were good enough to quantify arterial calcifications and predict risk. (more…)
Author Interviews, Nutrition, OBGYNE, Race/Ethnic Diversity / 06.07.2013

MedicalResearch.com Interview with: Dr. Lauren A. Wise Slone Epidemiology Center 1010 Commonwealth Avenue Boston, MA MedicalResearch.com: What are the main findings of the study? Dr. Wise: We found that the strong inverse association between dairy and uterine fibroids in black women in the Black Women's Health Study is not explained by percent European ancestry. (more…)
Diabetes, Kidney Disease / 04.07.2013

MedicalResearch.com Interview with: C Raina Elley C Raina Elley Associate Professor and General Practitioner, Acting Head, Dept General Practice & Primary Health Care, Faculty Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New ZealandAssociate Professor and General Practitioner, Acting Head, Dept General Practice & Primary Health Care, Faculty Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand MedicalResearch.com: What are the main findings of the study? Answer: Type 2 Diabetes is the leading cause of end-stage renal failure and dialysis in many countries. Early identification of those who are at risk within primary care could prompt more intensive intervention to control glycaemia and blood pressure and use of ACE inhibitors or angiotensin receptor blockers to slow progression. Traditionally estimated glomerular filtration rate and/or urine albumin creatinine ratio have been used to alert clinicians of deteriorating renal function in people with diabetes. However, a far more accurate renal risk score has been developed that combines serum creatinine, demographic characteristics, albuminuria, glycaemia, blood pressure, cardiovascular co-morbidity and duration of diabetes. The 5-year renal risk score was developed by following more than 25,000 people with type 2 diabetes in New Zealand for a median of 7.3 years (equivalent to 180,497 person-years). The study identified those who commenced dialysis for end-stage renal disease, received a renal transplant or died from renal failure to derive the risk score. (more…)
Author Interviews, Gastrointestinal Disease, PLoS, Sleep Disorders / 04.07.2013

Keith Summa MD/PhD Student Northwestern University Feinberg School of Medicine Chicago, Illinois, United States of AmericaMedicalResearch.com Interview with: Keith Summa MD/PhD Student Northwestern University Feinberg School of Medicine Chicago, Illinois, United States of America   Disruption of the Circadian Clock in Mice Increases Intestinal Permeability and Promotes Alcohol-Induced Pathology and Inflammation MedicalResearch.com: What are the main findings of the study? Answer: The main findings of the study were that disruption of circadian rhythms, which we achieved using independent genetic and environmental strategies in mice, leads to impaired function of the intestinal epithelial barrier. This loss of epithelial barrier integrity, which has been associated with numerous diseases, results in "gut leakiness," a phenomenon in which endotoxin from gut bacteria can cross the intestinal wall and enter circulation, promoting inflammation. In particular, using in a disease model of gut-derived endotoxemia and inflammation, alcoholic liver disease, we found the circadian disruption interacted with alcohol, leading to increased gut leakiness, inflammation and liver damage. (more…)
Author Interviews, Nutrition, Pediatrics, Pulmonary Disease / 04.07.2013

MedicalResearch.com Interview with: Virender K. Rehan, MD Los Angeles Biomedical Research Institute (LA BioMed). MedicalResearch.com: What are the main findings of the study? Dr. Rehan: This is the first study to show that the active ingredient in Indian spice turmeric provides long term protection against neonatal lung damage that leads to chronic lung disease of prematurity. (more…)
Anemia, Author Interviews, BMJ, OBGYNE, Pediatrics / 04.07.2013

MedicalResearch.com Interview with Batool Haider, MD, MS, DSc candidate Departments of Epidemiology and Nutrition School of Public Health Harvard University Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis MedicalResearch.com: What are the main findings of the study? Dr. Haider: The main findings of the study are that iron use in the prenatal period increased maternal mean haemoglobin concentration by 4.59 (95% confidence interval 3.72 to 5.46) g/L compared with controls and significantly reduced the risk of anaemia (relative risk 0.50, 0.42 to 0.59), iron deficiency (0.59, 0.46 to 0.79), iron deficiency anaemia (0.40, 0.26 to 0.60), and low birth weight (0.81, 0.71 to 0.93). The effect of iron on preterm birth was not significant (relative risk 0.84, 0.68 to 1.03). Analysis of cohort studies showed a significantly higher risk of low birth weight (adjusted odds ratio 1.29, 1.09 to 1.53) and preterm birth (1.21, 1.13 to 1.30) with anaemia in the first or second trimester. Exposure-response analysis indicated that for every 10 mg increase in iron dose/day, up to 66 mg/day, the relative risk of maternal anaemia was 0.88 (0.84 to 0.92) (P for linear trend<0.001). Birth weight increased by 15.1 (6.0 to 24.2) g (P for linear trend=0.005) and risk of low birth weight decreased by 3% (relative risk 0.97, 0.95 to 0.98) for every 10 mg increase in dose/day (P for linear trend<0.001). Duration of use was not significantly associated with the outcomes after adjustment for dose. Furthermore, for each 1 g/L increase in mean haemoglobin, birth weight increased by 14.0 (6.8 to 21.8) g (P for linear trend=0.002); however, mean haemoglobin was not associated with the risk of low birth weight and preterm birth. No evidence of a significant effect on duration of gestation, small for gestational age births, and birth length was noted. (more…)
JAMA, Rheumatology / 04.07.2013

MedicalResearch.com Interview with: Jonas Eriksson, PhD-student Clinical Epidemiology Unit Karolinska Institutet, T2 171 76 STOCKHOLM Sweden Biological vs Conventional Combination Treatment and Work Loss in Early Rheumatoid Arthritis A Randomized Trial MedicalResearch.com:  What are the main findings of the study? Answer: The main finding from this study is that in patients with early rheumatoid arthritis and with an insufficient response to methotrexate, addition of biologic (infliximab) or conventional combination therapy (sulfasalazine+hydroxychlorquine) resulted in significant improvements in work ability over 21 months. However, at 21 months, no significant difference could be detected in work ability change between patients randomized to addition of biologic or conventional therapy. When comparing the randomized early rheumatoid arthritis patients to matched general population comparators, the average number of days of work loss did not return to the level of the general population, underscoring the need for more effective treatment strategies and earlier diagnosis. (more…)
Author Interviews, CT Scanning, Medical Imaging, Neurological Disorders / 04.07.2013

Dr. Juan Pablo Villablanca, MD Director, Neuroradiology Ronald Reagan UCLA Medical Center UCLA Medical Center, Santa MonicaMedicalResearch.com Interview with Dr. Juan Pablo Villablanca, MD Director, Neuroradiology Ronald Reagan UCLA Medical Center UCLA Medical Center, Santa Monica   The Natural History of Asymptomatic Unruptured Cerebral Aneurysms Evaluated Using CTA - Growth and Rupture Incidence and Correlation to Epidemiologic Risk Factors. MedicalResearch.com:  What are the main findings of the study?

Answer:   Our longitudinal study showed that growing aneurysms have a significantly higher risk of rupture than aneurysms that are stable in size over time. Due to this increased risk, we recommend that all aneurysms, regardless of size, should be followed regularly to look for growth. We have also found that larger aneurysm size, aneurysm growth and cigarette smoking may independently increase the risk of rupture. (more…)

Author Interviews, Lancet, Medical Imaging, MRI, Neurological Disorders / 03.07.2013

MedicalResearch.com Interview with: Dr Patrick Freund Spinal Cord Injury Center Balgrist University Hospital Zurich, University of Zurich Forchstrasse 380 8008 Zurich, SwitzerlandDr Patrick Freund Spinal Cord Injury Center Balgrist University Hospital Zurich, University of Zurich Forchstrasse 380 8008 Zurich, Switzerland MedicalResearch.com: What are the main findings of the study? Dr. Freund: Novel interventions targeting acute spinal cord injury (SCI) have entered clinical trials, but neuroimaging biomarkers reflecting structural changes within the central nervous system are still awaited. In chronic SCI, neuroimaging provided evidence of structural changes at spinal cord and brain level that could be related to disability. However, the pattern and time course of these structural changes and their potential to predict clinical outcomes is uncertain. In a prospective longitudinal study, thirteen patients with acute traumatic SCI were assessed clinically and by longitudinal MRI (within five weeks of injury, after two, six and twelve months) and were compared to eighteen healthy controls. Cross-sectional cord area, cranial white matter (CST) and grey matter (cortex) volume decrease was evident at baseline and progressed over twelve months. Multi-parametric mapping of myelin sensitive magnetization transfer (MT) and longitudinal relaxation rate (R1) was reduced both within and beyond the areas of atrophic changes. Better neurological and functional outcomes were associated with less atrophic changes of the CST in both cord and brain. (more…)
Author Interviews, Baylor College of Medicine Houston, Cost of Health Care, Heart Disease, JAMA / 03.07.2013

 MedicalResearch.com Interview with Salim S. Virani, MD, PhD Health Policy and Quality Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development Center of Excellence, and Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, Texas MedicalResearch.com: What are the main findings of the study? Dr. Virani: The main findings of the study are that despite having cholesterol levels at goal (LDL cholesterol <100 mg/dL), about one-third of patients (9200 out of 27947) with coronary heart disease had repeat cholesterol testing in 11 months from their last lipid panel. As expected, no intervention was performed as a response to these lipid panels. Collectively, 12686 additional lipid panels were performed in these patients.  Among 13,114 patients who met the optional treatment target of LDL-C<70 mg/dL, repeat lipid testing was performed in 8,177 (62.3% of those with LDL-C<70) during 11 months of follow-up. Patients with a history of diabetes mellitus (odds ratio [OR], 1.16; 95% CI, 1.10-1.22), a history of hypertension (OR, 1.21; 95%CI, 1.13-1.30), higher illness burden (OR, 1.39; 95%CI, 1.23-1.57), and more frequent primary care visits (OR, 1.32; 95%CI, 1.25-1.39) were more likely to undergo repeat testing, whereas patients receiving care at a teaching facility (OR, 0.74; 95%CI, 0.69-0.80) or from a physician provider (OR, 0.93; 95%CI, 0.88-0.98) and those with a medication possession ratio of 0.8 or higher (OR, 0.75; 95%CI, 0.71-0.80) were less likely to undergo repeat testing. (more…)
Author Interviews, Cancer Research, JAMA, Melanoma, Stanford / 03.07.2013

Susan Swetter, MD Professor of Dermatology Director, Pigmented Lesion & Melanoma Program Stanford University Medical Center & Cancer InstituteMedicalResearch.com Interview with: Susan Swetter, MD Professor of Dermatology Director, Pigmented Lesion & Melanoma Program Stanford University Medical Center & Cancer Institute  

Melanoma Survival Disadvantage in Young, Non-Hispanic White Males Compared With Females

MedicalResearch.com: What are the main findings of the study? Dr. Swetter: Women diagnosed with melanoma tend to fare better than men in terms of improved survival, and this has mostly been attributed to better screening practices and behaviors in women that result in thinner, more curable tumors, and/or more frequent physician visits in older individuals that result in earlier detection.  Our study focused on survival differences between young men and women (ages 15-39 years) diagnosed with cutaneous (skin) melanoma, who constitute a generally healthy population compared to the older adults that have usually been studied. We found that young men were 55% more likely to die of melanoma than age-matched women, despite adjustment for factors that may affect prognosis, such as tumor thickness, histology and location of the melanoma, as well as presence and extent of metastasis. Our results present further evidence that a biologic mechanism may contribute to the sex disparity in melanoma survival, since adolescent and young adults see physicians less frequently and are less likely to have sex-related behavior differences in skin cancer screening practices than older individuals. (more…)
Mineral Metabolism, Nutrition / 02.07.2013

Scott M. Smith, Ph.D. Nutritionist, Manager for Nutritional Biochemistry Biomedical Research and Environmental Sciences Division NASA Johnson Space Center Houston, TX 77058MedicalResearch.com Interview with: Scott M. Smith, Ph.D. Nutritionist, Manager for Nutritional Biochemistry Biomedical Research and Environmental Sciences Division NASA Johnson Space Center Houston, TX 77058 Iron status and its relations with oxidative damage and bone loss during long-duration space flight on the International Space Station MedicalResearch.com: What are the main findings of the study? Dr. Smith:  The key finding from this study is that the increase in iron stores during spaceflight is related to both oxidative damage and bone loss.  Iron stores increase in microgravity because blood volume decreases during the initial weeks of spaceflight. The iron in excess red blood cells is not reused by new RBCs during spaceflight and is stored.  This increase in iron stores was associated with increased indices of oxidative damage, and furthermore, the magnitude of the increase in iron stores during flight (i.e., the area under the curve) was correlated with bone mineral density loss.  That is, the greater the iron stores, the more bone loss. (more…)
Author Interviews, Infections, Lyme, NEJM / 02.07.2013

MedicalResearch.com Interview with: Sam R. Telford III, ScD Department of Infectious Disease and Global Health, Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA Borrelia miyamotoi Infection Presenting as Human Granulocytic Anaplasmosis: A Case Report MedicalResearch.com: What are the main findings of the study? Answer: The study presents two additional cases of BMD (Borrelia miyamotoi disease) that add to our knowledge of the spectrum of illness of this recently recognized zoonosis.  Our report of the North American index case in NEJM in January 2013 described a case-patient who was elderly and immunocompromised and it was not clear whether that case was just very unusual.  With our Annals report, we describe cases in immune-intact individuals and suggest that cases of BMD may have been under our noses all along, just presumptively diagnosed as HGA and successfully treated with doxycycline with no followup (e.g., lab confirmation of diagnosis of HGA Human Granulocytic Anaplasmosis).  Hence, individuals presenting with fever, headache, myalgia, and show leukopenia and elevated LFTs may have either HGA or BMD and confirmatory testing should be done accordingly.  It should be noted that all tick borne diseases are clinical diagnoses and treatment of an acute case should not depend on "lab tests".  Both these infections are effectively managed by oral doxycycline, hence those with these signs and symptoms might be empirically treated with doxycyline, which would be important in areas where RMSF and tularemia (which also produce leukopenia and elevated LFTs) co-occur with deer tick -transmitted infections such as Lyme disease; waiting for "lab tests" to confirm RMSF or tularemia might lead to a negative outcome.  RMSF and tularemia are the most dangerous of the tick American tick borne diseases, although I would certainly place the very rare deer tick virus and Powassan virus in the same category. (more…)
Author Interviews, Nature, UCSF, Vitamin C / 02.07.2013

Interview with: Miguel Ramalho-Santos, Ph.D. University of California - San Francisco stem-cell scientist,MedicalResearch.com  Interview with: Miguel Ramalho-Santos, Ph.D. University of California - San Francisco stem-cell scientist, Vitamin C induces Tet-dependent DNA demethylation and a blastocyst-like state in ES cells MedicalResearch.com: What are the main findings of the study? Answer: We found that Vitamin C has a profound effect in the regulation of gene activity in cultured mouse embryonic stem cells. Vitamin C specifically enhances the action of enzymes called Tet's, which remove certain chemical modifications to DNA (methylation). In this way, Vitamin C makes cultured mouse embryonic stem cells behave more like the early cells in the embryo that they represent. (more…)
Author Interviews, Breast Cancer, Cancer Research, Radiology, Yale / 01.07.2013

MedicalResearch.com Interview with: Sarah H. O'Connell M.D. PGY-4 Yale New Haven Hospital Yale School of Medicine Department of Diagnostic Radiology MedicalResearch.com:  What are the main findings of the study? Answer: The purpose of our study was to evaluate the visibility of cancers in women at high-risk for breast cancer on 2D mammography compared to digital breast tomosynthesis. In other words, how would the use of tomosynthesis contribute to cancer visualization in this population  of patients? We evaluated the cancers seen in both high-risk patients, those with a >20% lifetime risk of breast cancer, and intermediate risk  patients, those with a 15-20% lifetime risk of breast cancer, for a total of 56 cancers. We found that 41% (23/56) cancers were better seen on tomosynthesis and 4% (2/56) were only seen on tomosynthesis. The majority of the cancers seen better or only on tomosynthesis  presented as masses rather than as calcifications alone which were better seen on 2D mammography. (more…)
Cost of Health Care, JAMA / 28.06.2013

Genevieve Kenney Ph.D Senior Fellow and Co-Director, Health Policy Center The Urban Institute 2100 M Street NW Washington DC 20037MedicalResearch.com  Interview with Genevieve Kenney Ph.D Senior Fellow and Co-Director, Health Policy Center The Urban Institute 2100 M Street NW Washington DC 20037 MedicalResearch.com: What are the main findings of the study? Dr. Kenney: Our study is the first published analysis that draws on physical examinations, laboratory tests, and patient reports to assess the health needs and health risks of uninsured adults who could be eligible for Medicaid coverage under the Affordable Care Act relative to the adults who are already enrolled in Medicaid. Our main findings are that the uninsured adults who could enroll under the ACA are less likely than the adults with Medicaid coverage to be obese and to have functional limitations and chronic health problems, such as hypertension, hypercholesterolemia, or diabetes, but that the uninsured adults with these chronic conditions are less likely to be aware that they have them and less likely to have the condition under control. In comparison to the Medicaid population, the uninsured adults in our study were also less likely to have seen a health professional in the prior year and to have a routine place for care.  The rates of undiagnosed and uncontrolled chronic health care problems found in our study indicate that millions of low-income uninsured adults are currently at risk of premature mortality and other significant health issues.  These findings provide new evidence of the potential health benefits associated with the Medicaid expansion under the Affordable Care Act. (more…)
Author Interviews, Diabetes, General Medicine / 28.06.2013

MedicalResearch.com:  Interview with Christina Ellervik Associate Professor Faculty of Health and Medical Sciences University of Copenhagen , Denmark MedicalResearch.com: What are the main findings of the study? Answer: Early measurement of transferrin saturation leading to early intervention in patients with late-onset type 1 diabetes improves life expectancy. Excess death is mainly due to cancer-specific death. (more…)
Author Interviews, BMJ, Breast Cancer, Cancer Research, Fish, Nutrition / 28.06.2013

MedicalResearch.com Interview with Duo Li (PhD, MSc, BMed) Co-Editor, Asia Pacific Journal of Clinical Nutrition Associate Editor, Journal of Nutrigenetics & Nutrigenomics Professor of Nutrition Dept. of Food Science & Nutrition Zhejiang University 866 Yu-Hang-Tang Road Hangzhou 310058, China MedicalResearch.com: What are the main findings of the study? Dr. Li: The main finding is that intake marine n-3 polyunsaturated fatty acids (n-3 PUFAs) from both fish and fish oil lower the risk of breast cancer. Women with a high intake of marine n-3 PUFAs had a 14-percent reduction in risk of breast cancer compared with those who had a low intake. Every 0.1 g increase in marine n-3 PUFA per day was linked to a five-percent reduction in breast cancer risk. (more…)
Author Interviews, Diabetes, JAMA, Nutrition, Red Meat / 28.06.2013

MedicalResearch.com: An Pan, PhD

Research Associate, Dept Nutrition 655 Huntington Avenue Building 2, Room 351 Boston, Massachusetts 02115

Changes in Red Meat Consumption and Subsequent Risk of Type 2 Diabetes Mellitus: Three Cohorts of US Men and Women MedicalResearch.com: What are the main findings of the study? Answer: -- Compared with people who did not change their intake of red meat, those who increased it by as little as half a serving a day (about 1.5 ounces) over a four-year period had a 48% increased risk of developing type 2 diabetes in the subsequent 4 years. -- People who decreased their intake by half a serving a day over four years did not have an acute reduced risk in the next four years compared to people who did not change their intake, but had a reduced risk of developing the disease by 14% in the entire follow-up period, suggesting a prolonged effect. -- The findings included both processed meat such as lunch meat and hot dogs and unprocessed meats such as hamburger, steak and pork. And the association was generally stronger for processed red meat compared to unprocessed red meat. -- Adjusting for weight modestly reduced the association between red meat consumption and diabetes suggesting that weight gain played a role in the development of the disease. (more…)
Author Interviews, Infections, Lyme / 27.06.2013

MedicalResearch.com Interview with: Xin Li, Ph.D. Assistant Professor Department of Veterinary Biosciences The Ohio State University 344 Veterinary Medicine Academic Building Columbus, OH 43210 MedicalResearch.com: What are the main findings of the study? Dr. Xin Li : Antibody responses to borrelial antigens that are primarily expressed during the tick phase the spirochetes’ life cycle are common in American patients with Lyme arthritis, a late-stage manifestation of Lyme borreliosis, but are rare in American patients with early-stage infection or European patients with early- or late-stage infection. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Medical Research Centers / 26.06.2013

Dr. Karen E. Joynt, MD MPH Cardiovascular Division Brigham and Women's Hospital and VA Boston Healthcare System Department of Health Policy and Management, Harvard School of Public HealthMedicalResearch.com Interview with Dr. Karen E. Joynt, MD MPH Cardiovascular Division Brigham and Women's Hospital and VA Boston Healthcare System Department of Health Policy and Management, Harvard School of Public Health MedicalResearch.com: What are the main findings of the study? Dr. Joynt:  The main findings of the study were two-fold. First, high-cost patients in Medicare (the top decile of spenders) are responsible for about 80% of inpatient spending in the Medicare program, so understanding more about these patients' patterns of care is really important. Second, we found that only about 10% of acute-care spending for these high-cost Medicare patients were for causes that we generally think of as preventable in the short term, like uncontrolled diabetes, COPD, or heart failure. The rest of the spending was for acute conditions that we generally don't think of as preventable (at least in the short term), such as orthopedic procedures, sepsis, and cancer. (more…)
Author Interviews, Heart Disease, JAMA, Yale / 25.06.2013

Dr. Kumar Dharmarajan MD MBA Yale School of Medicine Center for Outcomes Research & Evaluation (CORE)Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart FailureMedicalResearch.com  Interview with Dr. Kumar Dharmarajan MD MBA

Yale School of Medicine Center for Outcomes Research & Evaluation (CORE)Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart Failure MedicalResearch.com: What are the main findings of the study? We found that among a large contemporary cohort of heart failure hospitalizations, beta blockers are frequently started in patients with markers of clinical instability such as residence in an intensive care unit (ICU), volume overload requiring intravenous diuresis, and poor cardiac output requiring intravenous inotropes. Approximately 40% of patients in whom a beta blocker is started has at least one of these three potential contraindications to treatment. This finding is concerning, as recent performance measures for heart failure recommend that a beta blocker be started during hospitalization for heart failure among patients with left ventricular systolic dysfunction. However, these performance measures also state that persons in whom a beta blocker is started "should not be hospitalized in an ICU, should have no or minimal evidence of fluid overload or volume depletion, and should not have required recent treatment with an intravenous positive inotropic agent." Moving forward, we are concerned that the unselective application of the new performance measure may lead to the further use of beta blocker therapy in patients at higher risk for adverse consequences of therapy. (more…)
Author Interviews, Stroke / 22.06.2013

MedicalResearch.com Interview with: Saeid Shahidi, MD. Chief Consultant in supra-aortic surgery. Vascular Unit, Regional Hospital Slagelse, Region Zealand, Denmark. MedicalResearch.com: What is the background of your study? Answer: Our Prospective Population-based study showed, an expedited CEA can be performed in the subacute period ( >2 - <30 days) without significantly increasing the operative risk. The acute admission and urgent aggressive BMT with dual therapy in our cohort was associated with significant reduction P<0.00001 in the risk of early neurological recurrent (NR) in the CEA patient. It seems that in neurologically stable patients CEA can wait up to 30 days provided urgent BMT has been started in specialized stroke/ TIA clinics. Our study also adds to the data on the benefit of specialist TIA clinics. (more…)
HIV, Infections, JAMA, Race/Ethnic Diversity / 21.06.2013

MedicalResearch.com Interview with Dr. H. Irene Hall, PhD Division of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC 1600 Clifton Road, MS E-47, Atlanta, GA 30333 MedicalResearch.com: What are the main findings of the study? Dr. Hall: Our research finds that, across all populations, far too few Americans with HIV receive the care they need to stay healthy and reduce risk of transmission. According to our research, gaps in care are the largest among African Americans and young people. Moving forward, improving care for all HIV-infected people will be critical to achieving the goal of an AIDS-free generation in America. More specifically, some of the key findings of the study include:
  • Overall, only a quarter of all Americans with HIV have a suppressed viral load – meaning the level of HIV in their bodies is low enough to stay healthy and dramatically reduce the chance of transmitting to others.
  • By race/ethnicity, African-Americans and Hispanics or Latinos are less likely to be aware of their infection compared to whites.
  •  By age, younger Americans are less likely to be in ongoing care and have a suppressed viral load; HIV care and viral suppression generally improved with age. For example:
  • Fifteen percent of those aged 25-34 were virally suppressed, compared to 36 percent of those aged 55-64.
  • In terms of ongoing care, 28 percent of those 25-34 years old were retained in care, compared to 46 percent of those aged 55-64. (more…)
Brigham & Women's - Harvard, General Medicine, Medical Research Centers / 20.06.2013

Dr. Susan Redline M.D.,M.P.H. Peter C. Farrell Professor of Sleep Medicine at Harvard Medical School Brigham and Women's Hospital 221 Longwood Ave., Boston, MA 02115MedicalResearch.com Interview with: Dr. Susan Redline M.D.,M.P.H. Peter C. Farrell Professor of Sleep Medicine at Harvard Medical School Brigham and Women's Hospital 221 Longwood Ave., Boston, MA 02115 MedicalResearch.com: What are the main findings of the study? Dr. Redline: Among children with sleep apnea, early adenotonsillectomy  resulted in significant improvements in breathing during sleep, daytime behavior, sleep related symptoms, sleepiness and quality of life when we valuated 6 months after surgery. MedicalResearch.com:  Were any of the findings unexpected? (more…)