MedicalResearch.com Interview with:
Tobias Saam, MD
Institute of Clinical Radiology
Ludwig-Maximilians-Univ Hosp
Munich, Germany
MedicalResearch.com: What are the main findings of the study?
Dr. Saam: The results of our meta-analysis suggest that despite a large degree of detected heterogeneity of the published studies, the presence of intraplaque hemorrhage by MRI in patients with carotid artery disease is associated with an approximately 5.6-fold higher risk for cerebrovascular events, such as TIA or stroke, as compared to subjects without intraplaque hemorrhage.
MedicalResearch.com Interview with:
Shoshana M. Rosenberg, ScD, MPH
Researcher, Susan F. Smith Center for Women's Cancers
Dana-Farber Cancer Institute
MedicalResearch.com: What are the main findings of the study?
Answer: Rates of contralateral prophylactic mastectomy (CPM) have been increasing among all breast cancer patients, however this trend has been most pronounced among the youngest women with breast cancer. Because of this trend, we sought to better understand why the youngest women - those diagnosed at age 40 or younger - were deciding to have this surgery.
Many women not considered "high-risk", e.g., those without a cancer pre-disposing mutation, cited a desire to prevent the breast cancer from spreading as well as a desire to improve survival as reasons for undergoing the procedure, indicating they overestimate the benefit of having this surgery, as CPM does not affect these outcomes. While CPM does reduce the risk of developing breast cancer in the unaffected breast, in women who are not considered "high-risk", this risk is relatively low, however many women overestimated this risk as well.
MedicalResearch.com Interview with:
Ze'ev Ronai, Ph.D.
Professor and scientific director of Sanford-Burnham Medical Research Institute La Jolla San Diego, Calif.
MedicalResearch.com: What are the main findings of the study?
Answer: This study provides the first direct evidence of the importance of the PDK1 enzyme in the development of melanoma and in the metastasis of this aggressive tumor type. We demonstrate, with a genetic mouse melanoma model (harboring the Braf/Pten mutations commonly seen in human melanomas) and/or pharmacological inhibitors against PDK1, that melanoma requires this enzyme for its development, and more so – for its ability to metastasize. Since PDK1 is key kinase that regulates a number of protein kinases, which are currently being assessed in clinical trials (including AKT), our finding points to a new set of targets that could be more amenable for effective combination therapy in melanoma.
MedicalResearch.com Interview with:
Faisal G. Bakaeen, MD FACS
Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, Texas
MedicalResearch.com: What are the main findings of the study?
Dr. Bakaeen: The relative use of off-pump CABG peaked at 24% in 2003, followed by a slow decline after that to about 19%. In addition, the conversion rate from off- to on-pump decreased with time and has stayed below 3.5% in recent years. Perioperative mortality rates decreased over time for both on- and off-pump CABG and have stayed below 2% since 2006. The mortality associated with converted cases was high regardless of the surgery year.
MedicalResearch.com Interview with:
Mine Tezal, DDS, PhD
Oral Biology
University at Buffalo
NYS Center of Excellence in Bioinformatics and Life Sciences
MedicalResearch.com: What are the main findings of the study?
Dr. Tezal: We observed an inverse association between dental caries and head and neck cancer (HNSCC), which persisted among never smokers and never drinkers. Besides untreated caries, two other objective measures of long-standing caries history (endodontic treatments and crowns) were also inversely associated with HNSCC with similar effect sizes, supporting the validity of the association. Missing teeth was associated with increased risk of HNSCC in univariate analyses, but after adjustment for potential confounders, its effect was attenuated and was no longer statistically significant.
MedicalResearch.com Interview with:
Laura A. Petersen, MD, MPH
MEDVAMC Associate Chief of Staff, Research
Director, VA HSR&D Center of Excellence (152)
Houston TX 77030
Professor of Medicine
Chief, Section of Health Services Research
Baylor College of Medicine
HSR&D Center of Excellence
Michael E. DeBakey Veterans Affairs Medical Center
Houston, Texas 77030
MedicalResearch.com: What are the main findings of the study?
Dr. Petersen: VA physicians randomized to the individual incentive group were more likely than controls to improve their treatment of hypertension. The adjusted changes over the study period in Veterans meeting the combined BP/appropriate response measure were 8.8 percentage points for the individual-level, 3.7 for the practice-level, 5.5 for the combined, and 0.47 for the control groups. Therefore, a physician in the individual group caring for 1000 patients with hypertension would have about 84 additional patients achieving blood pressure control or appropriate response after 1 year. The effect of the incentive was not sustained after the washout period. Although performance did not decline to pre-intervention levels, the decline was significant. None of the incentives resulted in increased incidence of hypotension compared with controls. While the use of guideline-recommended medications increased significantly over the course of the study in the intervention groups, there was no significant change compared to the control group. The mean individual incentive earnings over the study represented approximately 1.6% of a physician’s salary, assuming a mean salary of $168,000.
MedicalResearch.com Interview with:
Dr Sandosh Padmanabhan
Institute of Cardiovascular and Medical Sciences
University of Glascow, Scotland
MedicalResearch.com: What are the main findings of the study?
Dr. Padmanabhan: In the study "Serum Chloride Is an Independent Predictor of Mortality in Hypertensive Patients" we analysed data on 12,968 patients with hypertension followed up at the Glasgow Blood Pressure Clinic. We found that patients in the lowest quintile of serum Cl− (<100 mmol/L), compared with all other patients, had a 23% higher mortality (all-cause, cardiovascular, and non-cardiovascular). Each 1-mmol/L increase in serum Cl− was associated with a 1.1% to 1.5% lower all-cause mortality, cardiovascular mortality and non-cardiovascular mortality. This was independent of serum concentrations of sodium, bicarbonate or potassium. We did not find any association with longitudinal blood pressure control.
MedicalResearch.com Interview with:
Fabian Bamberg, MD, MPH
Department of Clinical Radiology
Ludwig Maximilians University, Klinikum Grosshadern
Marchioninistrasse 15, 81377 Munich, Germany
MedicalResearch.com: What are the main findings of the study?
Dr. Bamberg: Our study shows that there is a substantial and heterogenous degree of subclinical cardiovascular disease burden in patients with diabetes undergoing whole-body MRI. These whole-body MRI findings have significant prognostic relevance. For instance, our results show that patients without any pathologic findings experience no adverse cardiovascular event over a period of six years while the risk for a heart attack or stroke increases with the degree of disease burden.
MedicalResearch.com Interview with:
Svetlana Popova, M.D., M.P.H., Ph.D.
Senior Scientist, Social and Epidemiological Research,
Centre for Addiction and Mental Health
Assistant Professor, Epidemiology Division
Dalla Lana School of Public Health, University of Toronto
Assistant Professor, Factor-Inwentash Faculty of Social Work, University of Toronto
Graduate Faculty Associate Member, Institute of Medical Science, University of Toronto
CAMH, 33 Russell Street, Room # T507
Toronto Ontario, Canada M5S 2S1
MedicalResearch.com: What are the main findings of the study?
Dr. Popova: We conducted a systematic literature review and meta-analysis of internationally published and unpublished studies that reported the prevalence of FAS and/or FASD in all types of child care systems (e.g., orphanage, foster care, boarding school, adoption centre, or child welfare system).
The primary objective was to estimate a pooled (combined) prevalence for FAS and FASD in various child care systems using data from existing studies that used an Active Case Ascertainment method (when researchers/clinicians actively seek and diagnose FASD cases). The available data was analyzed by using a standard statistical technique (called meta-analysis).
This study revealed that the vast majority of existing studies report that the prevalence of Fetal Alcohol Spectrum Disorder (FASD) in the various child-care settings in the different countries is extremely high.
Our analysis of these studies demonstrated that the pooled prevalence of FAS in child care settings (6%) was found to be approximately 9-30 times higher than the prevalence of FAS in the general population of North America, which is reported to range from 2 to 7 cases per 1,000 individuals in the USA and 1 per 1,000 in Canada. Thus, children in care represent a high-risk population for FASD.
MedicalResearch.com Interview with:
Dr. Eung Y. Kim
Department of Radiology
Gachon University Medical Center
Incheon, South Korea.
MedicalResearch.com: What are the main findings of the study?
Answer: The extent of calcification involving intracranial artery significantly correlates with that of coronary artery in patients with ischemic stroke. The Agatston score measured in the intracranial arteries may be an independent predictor of asymptomatic coronary artery disease in patients with ischemic stroke.
MedicalResearch.com Interview with:
Pranab K. Mukherjee, Ph.D.
Assistant Professor
Center for Medical Mycology
Department of Dermatology
University Hospitals Case Medical Center
Case Western Reserve University
Cleveland, OH 44106-5028
MedicalResearch.com: What are the main findings of the study?
Answer: We performed a randomized double-blinded placebo-controlled pilot clinical trial to assess the safety, tolerability and effectiveness of a cetylpyridinium chloride (CPC)-based oral spray in the prevention of acute upper respiratory tract infections (URIs).
MedicalResearch.com Interview with:
Nariya Cho, MD
Departments of Radiology
Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
MedicalResearch.com: What are the main findings of the study?
Dr. Cho: Smaller reduction in tumor volume and a smaller reduction in washout component on dynamic contrast agent–enhanced MR imaging assessed by computer-aided evaluation after neoadjuvant chemotherapy were independent parameters of worse recurrence-free survival and overall survival in breast cancer patients who received neoadjuvant chemotherapy.
R. Loch Macdonald, M.D., Ph.D., F.R.C.S.(C), F.A.A.N.S., F.A.C.S. Keenan Endowed Chair in Surgery Head, Division of Neurosurgery St. Michael's Hospital Professor of Surgery, University of Toronto 30 Bond Street Toronto, Ontario, Canada M5B 1W8 MedicalResearch.com: What are the main findings of the study? Answer: We found that Asian/Pacific Islander patients with a rupture brain aneurysm were more likely to...
MedicalResearch.com Interview with:
Lauren Doctoroff, MD
Hospitalist, Hospital Medicine Program
Beth Israel Deaconess Medical Center
Medical Director, HCA Post Discharge Clinic and PACT Transitional Care Program
Instructor, Harvard Medical School
Boston, MA 02215
MedicalResearch.com What are the main findings of the study?
Dr. Doctoroff: A dedicated post discharge clinic, staffed by hospitalists, led to a shorter interval to a clinic visit for patients after discharge. Patients with resident primary care doctors and those who are African American were most likely to use the clinic. The care provided in the clinic, in terms of testing, was consistent with the remainder of the practice.
MedicalResearch.com Interview with:
David F Jarrard, MD
Vice Chair for Clinical Affairs
Professor of Urology
John Livesey Chair in Urologic Oncology
MedicalResearch.com: What are the main findings of the study?
Dr. Jarrard: We have developed and externally validated an accurate nomogram for predicting Gleason score 6 upgrading for use in low-risk prostate cancer patients. This nomogram incorporates only variables available at the time of diagnosis and is unique in its assessment of clinical as well as pathological factors. Furthermore, we externally validated this study in patients with Gleason 6 prostate cancer of which 90% met the D’Amico criteria for low-risk cancer at 2 other centers (total 2000 patients). This nomogram will aid in the decision-making process of patients diagnosed with low-risk prostate cancer.
MedicalResearch.com Interview with:
Dr. Robert A. Wise MD
Professor of Medicine Johns Hopkins University School of Medicine
5501 Hopkins Bayview Circle
Baltimore, MD 21224
MedicalResearch.com: What are the main findings of the study?
Dr. Wise: The TIOSPIR trial was a landmark study, one of the largest ever conducted for chronic obstructive pulmonary disease (COPD). It was designed to test the comparative safety and effectiveness of two delivery devices of tiotropium, a long-acting bronchodilator. One formulation is the Respimat multi-dose soft mist inhaler and the other formulation is the single dose HandiHaler dry powder inhaler.
After following more than 17000 patients for an average of 2.3 years, TIOSPIR showed that there was no difference in either the safety in terms of mortality or adverse cardiovascular events between the two devices. Moreover, both devices showed similar effectiveness in terms of time to first COPD exacerbation.
A lung function substudy in 1370 patients showed that the 5 microgram dose of Respimat was equivalent to the HandiHaler as a bronchodilator, but the 2.5 microgram dose was not quite as effective.
Dr. Elsie Taveras
Massachusetts General Hospital for Children
Division of General Pediatrics, Department of Pediatrics
100 Cambridge St, 15th Floor
Boston, MA 02114
MedicalResearch.com: What are the main findings of the study?
Dr. Taveras: The main findings of the study were that, overall, the body mass index of children in the intervention group dropped an average of 0.18, while it rose 0.21 in the control group. Children in the intervention group were sleeping about 45 minutes longer than children in the control group. Time spent watching television on weekends dropped about an hour per day in the intervention group, leading to a significant difference from the control group, which increased weekend TV viewing. Both groups had a small reduction in weekday TV viewing, with a greater decrease in the intervention group, as well.
MedicalResearch.com Interview with:
Madelein Hoogwegt, MSc
Promovenda
Center of Research on Psychology in Somatic diseases (CoRPS)
Department of Medical and Clinical Psychology
Kamer P711 Tilburg University 5000 LE Tilburg
MedicalResearch.com: What are the main findings of the study?
Answer: The main finding was that we found a significant relation between positive affect and mortality, and that exercise explained this relationship. With respect to the second outcome, hospitalization, we found a significant relation between positive affect and hospitalization, a significant relation between positive affect and hospitalization, but exercise did not mediate this relationship.
Courtney A. Miller, PhD
Assistant Professor
Department of Metabolism & Aging
Department of Neuroscience
The Scripps Research Institute
Jupiter, FL 33458
MedicalResearch.com: What are the main findings of the study?
Dr. Miller: The relapse rate for drug abusers, smokers and alcoholics is high because abstinence is so difficult. A major factor is the craving that drug associations can trigger. These range from seeing the neighborhood where someone used to buy, in the case of illicit drugs, to social drinking for a smoker. We’ve found a way to disrupt these drug-associated memories without affecting other, more benign memories.
MedicalResearch.com Interview with:
Joel H. Rubenstein, MD, MSc, FACG, FASGE
Research Scientist, Veterans Affairs Center for Clinical Management Research
Assistant Professor, Division of Gastroenterology, University of Michigan Medical School
VA Medical Center Ann Arbor, MI 48105
MedicalResearch.com: What are the main findings of the study?
Dr. Rubenstein: In a set of case-control studies within the same population, we found that H. pylori was inversely associated with erosive esophagitis, and with Barrett’s esophagus, but we did not find such a relation with symptoms of gastroesophageal reflux disease (GERD).