Author Interviews, JAMA, Pediatrics, Surgical Research / 18.04.2016

MedicalResearch.com Interview with: Thomas J. Sandora, M.D., M.P.H. Senior Associate Physician in Medicine; Hospital Epidemiologist; Medical Director, Infection Control Boston Children’s Hospital Associate Professor of Pediatrics, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Sandora: Giving antibiotics before certain types of operations results in lower rates of surgical site infections. However, there are limited data about which pediatric operations require antibiotic prophylaxis. We examined national variability in antibiotic prophylaxis for the 45 most commonly performed pediatric operations at children's hospitals in the U.S. We found that antibiotic use was considered appropriate for only 64.6% of cases, with a high degree of variability within procedures and between hospitals. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 18.04.2016

MedicalResearch.com Interview with: Dr. Lara B. McKenzie PhD MA Principal Investigator Center for Injury Research and Policy The Research Institute Nationwide Children’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Dr. McKenzie: Skateboarding is a popular recreational sport and participation has increased the last several decades, faster than any other sport or recreation activity between 1998 and 2007 (National Sporting Goods Association Sports Participation in 2007). With growing participation, has come an increasing rate of injuries from skateboarding. The study examined data for youth and adolescents 5-19 years of age who were treated in U.S. emergency departments (EDs) for skateboarding-related injuries from 1990-2008. It found that nationally, over the 19-year period, there was an average of 64,572 children and adolescents treated each year for skateboarding-related injuries – about 176 a day. Most patients were male (89 percent), and were injured either at home (38 percent) or in the street and/or highway (30 percent). The most commonly injured body regions were the upper (45 percent) and lower (32 percent) extremities. The most common diagnoses were fractures or dislocations (33 percent), sprains and strains (25 percent) and bruises (20 percent). Children and adolescents 11-14 years of age were hospitalized more often than younger or older children/adolescents. Lower extremity injuries increased with age, while face and head or neck injuries decreased with age. (more…)
Author Interviews, Cancer Research, HPV, NYU / 18.04.2016

MedicalResearch.com Interview with: Adam S. Jacobson, MD Associate Professor, Department of Otolaryngology-Head and Neck Surgery Associate Director, Head and Neck Surgery NYU Langone Medical Center and Perlmutter Cancer Center MedicalResearch.com Editor’s note: Dr. Jacobson is an Otolaryngologist, an Ear-Nose-Throat (ENT) physician specializing in the diagnosis of head and neck tumors and cancers, including cancers of the mouth and throat. Dr. Jacobson discussed oral (mouth) and pharyngeal (throat) cancers in recognition of Oral, Head and Neck Cancer Awareness Week. MedicalResearch.com: How prevalent is the problem of Oral, Head and Neck Cancer?  Is this type of cancer becoming more frequent? Dr. Jacobson: Oropharynx cancer is currently on the rise.  MedicalResearch.com: Have HPV-induced cancers become more common? (Note HPV or Human Papilloma Virus is a virus associated with various wart infections.) Dr. Jacobson: Yes - Specifically tonsil and base of tongue cancer. (more…)
Author Interviews, Heart Disease / 18.04.2016

MedicalResearch.com Interview with: Gjin Ndrepepa, MD Deutsches Herzzentrum München München, Germany Medical Research: What is the background for this study? Dr. Ndrepepa: Prevention of atherosclerosis or promotion of its regression when it had developed, are among the greatest problems in clinical medicine. Recent imaging studies have shown that high-intensity statin therapy slows progression and may even result in regression of atherosclerosis. Despite the positive results in terms of retardation of progression or regression of atherosclerosis, the number of clinical events in these studies was too small to allow meaningful analysis of the relationship between slow progression or regression of atherosclerosis and morbidity or mortality and to date no specifically designed studies have been performed to investigate the association of progression or regression of the atherosclerosis with the long-term mortality. In the current study we addressed this clinically relevant problem. Medical Research: What are the main findings? Dr. Ndrepepa: In brief, the main findings of current study may be summarized as follows:
  • 1) Progression of atherosclerosis in patients with coronary artery disease treated with statins and other secondary prevention measures was associated with 2.5-fold increase in the adjusted risk of 8-year cardiac mortality compared to patients with no progression/regression of atherosclerosis.
  • 2) Regression of atherosclerosis was associated with a significant decrease in the risk of 8-year all-cause and cardiac mortality (75% and 80% reduction, respectively).
  • 3) Diabetes mellitus increased the odds of progression and decreased the odds of regression of coronary artery atherosclerosis.
(more…)
Author Interviews, Diabetes, Kidney Disease / 17.04.2016

MedicalResearch.com Interview with: Axel C. Carlsson, PhD Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University Uppsala Sweden MedicalResearch.com: What is the background for this study? Dr. Carlsson: Circulating endostatin levels has been shown to be associated with duration of hypertension and cardiovascular events. Moreover, endostatin levels were recently shown to parallel kidney function decline, and has been associated with increased mortality risk in different settings. However, less is known of circulating endostatin in patients with type 2 diabetes.  (more…)
Author Interviews, CMAJ, Opiods / 17.04.2016

MedicalResearch.com Interview with: Dr. Zainab Samaan, MBChB, MSc, DMMD, PhD, MRCPsych Associate Professor Dept of Psychiatry and Behavioural Neurosciences Member Population Genomics Program Member Peter Boris Centre for Addiction Research Associate Faculty Dept of Clinical Epidemiology and Biostatistics McMaster University Hamilton, ON, Canada Medical Research: What is the background for this study? Response: Opioid addiction has become a leading public health concern in North America with Canada leading the way in the amount of opioid use per capita. Opioid addiction has moved from heroin use by young men to prescription pain killers such as oxycodone and fentanyl with devastating impact on individuals and society including increasing number of deaths due to opioid overdose. In addition many people on treatment will also relapse (go back using drugs). We wanted to understand the problem of opioid addiction by investigating the factors that increase the risk of relapse in people with opioid addiction receiving methadone treatment. Medical Research: What are the main findings? Response: People who injected drugs and used benzodiazepines (BDZ) are more likely to relapse faster than people who did not use injection or benzodiazepines. (more…)
AACR, Author Interviews, Cancer Research, Colon Cancer, HPV, MD Anderson / 16.04.2016

MedicalResearch.com Interview with: Dr. Van K. Morris, MD Assistant Professor, GI Medical Oncology The University of Texas MD Anderson Cancer Center MedicalResearch.com: What is the background for this study? Dr. Morris: Anal cancer is a very rare cancer and accounts for approximately 2% of all gastrointestinal malignancies. Currently, there is no accepted standard of care for patients with metastatic disease, which raises challenges for oncologist who may not have extensive experience caring for patients with metastatic anal cancer given that there are not accepted agents to treat with. This clinical trial was the first clinical trial ever conducted for patients with stage IV disease who had received prior chemotherapy in the past. Given the well-known association with human papilloma virus (HPV) and the development of anal cancer, we were interested in the use of immunotherapy drugs as a new possible way to awaken the immune system to attack this tumor, especially as there may be viral components in the tumor cells which the immune system could potentially recognize. Nivolumab is an immunotherapy drug which has shown activity in other solid tumors like melanoma, kidney cancer, non-small cell lung cancer, and bladder cancer. (more…)
Author Interviews, CT Scanning, Heart Disease, Lifestyle & Health / 16.04.2016

MedicalResearch.com Interview with: Jacquelyn Kulinski, MD Assistant Professor Division of Cardiovascular Medicine Medical College of Wisconsin Milwaukee, WI 53226 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Kulinski: Sedentary behavior, or “sitting disease”, is increasingly recognized as a risk factor for cardiovascular disease, diabetes, cancer and early death.  Many of these associations appear to be independent of exercise activity. The mechanisms through which sedentary behavior influences cardiovascular risk are largely unknown.  Therefore, we investigated the association between accelerometer measured sedentary behavior and coronary artery calcium (CAC), a marker of subclinical heart disease, in over 2,000 participants using data from the Dallas Heart Study (DHS) population. We found a significant association between increasing sitting time and CAC in a population without prior history of cardiovascular disease.  This association was independent of measured exercise activity, traditional risk factors, and even socioeconomic factors.  Each hour of sedentary time was associated with a 16% increase in CAC burden.  Interestingly, the association between exercise and CAC was not significant in the fully-adjusted model.  (more…)
Author Interviews, HPV, Kidney Disease, Transplantation, Vaccine Studies / 15.04.2016

MedicalResearch.com Interview with: Dr. Delphine Robotham MD Division of Pediatric Nephrology Johns Hopkins University School of Medicine Baltimore, Maryland Medical Research: What is the background for this study? What are the main findings? Response: Cervical cancer is the second most common cancer in women worldwide and is almost entirely caused by high risk HPV genotypes.  Vaccines to high risk HPV genotypes have shown great success in protecting healthy women from the sequelae of infection, including cervical cancer and genital warts. Young women with a kidney transplant as well as those with chronic kidney disease have abnormal immune systems and as a result have a significantly increased burden of HPV-related disease making the potential health benefits of the HPV vaccine substantial in this particularly vulnerable population.  This study examined the immune response to the HPV vaccine among girls and young women with kidney disease. The goal of this research was to determine if girls and young women with chronic kidney disease (abnormal kidney function, on dialysis, or post kidney transplant) showed evidence of immune response to the quadrivalent HPV vaccine.  Immune response was determined by measuring the amount of antibody made by the patients against each of the 4 HPV genotypes included in the vaccine.  There are established thresholds of antibody above which patients are believed to have protection from infection.  We found that study participants with chronic kidney disease and those on dialysis had antibody levels above the threshold, indicating the vaccine should be effective in protecting them from HPV related disease.  A significant proportion of patients with kidney transplants showed evidence of inadequate antibody response.  This is important information as it means patients with a kidney transplant, whom we know are at increased risk of developing cervical cancer from HPV infection, may not be protected from HPV infections from the HPV genotypes included in the vaccine. (more…)
Author Interviews, Infections, Outcomes & Safety / 15.04.2016

MedicalResearch.com Interview with: Thomas C King, MD, PhD Department of Pathology and Laboratory Medicine Chief of Pathology and Laboratory Medicine St. Vincent Hospital Worcester, MA MedicalResearch.com: What is the background for this study? What are the main findings? Dr. King: This landmark study provides a broad based, real world appraisal of the reliability of the T-SPOT®.TB test, an interferon gamma release assay (IGRA), based on results in screening workers in 19 U.S. hospitals. The large size of the study (more than 42,000 test results from more than 16,000 healthcare workers analyzed) provides a solid benchmark to assess performance of T-SPOT.TB in serial screening healthcare workers. In recent years, results from several studies have shown that there can be significant differences between using an IGRA and the tuberculin skin test (TST) in terms of accuracy and cost. Several studies have confirmed a risk of high false positive rates and numerous conversion/reversion rates when retesting patients with the TST. (more…)
Accidents & Violence, Author Interviews, Karolinski Institute, Social Issues / 15.04.2016

MedicalResearch.com Interview with: Zheng Chang, PhD Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Medical Research: What is the background for this study? What are the main findings? Dr. Chang: More than 30 million people are released from prison worldwide every year. Despite reported decreases in violence in many countries, repeat offending remains high across many high-income and middle-income countries. Because there is considerable inconsistency and inefficiency in identifying those who are at high risk of reoffending and most in need of interventions, we developed and validated a clinical prediction rule to determine this risk in released prisoners. We did a cohort study of 47 326 prisoners released in Sweden between 2001 and 2009. We developed a 14-item model to predict violent reoffending, which includes modifiable risk factors and has been externally validated. The model showed good measures of discrimination and calibration. The study uses the methods to develop the prediction model on the basis of TRIPOD guidelines, and it is a brief, easy to use, and scalable tool. This tool has also been translated into a freely available web application (OxRec). (more…)
Author Interviews, Weight Research / 15.04.2016

MedicalResearch.com Interview with: Keigo Saeki, MD, PhD Nara Medical University School of Medicine Nara, Japan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cold exposure causes higher blood pressure and higher coagulation status, and it may be a trigger of higher mortality from cardiovascular diseases in winter. In contrast, cold exposure may have preventive effect on obesity. Recent study found that most of human have brown adipose tissue (BAT) which play an important role in thermogenesis and in the regulation of body weight. Cold exposure activates thermogenesis in BAT, and increase energy expenditure. However, in real life situation, the association between the amount of cold exposure and obesity stays unclear. The HEIJO-KYO study is a community based study to investigate association between housing environment and health. We found that people living in colder housing environment showed lower abdominal circumference in simple correlation and even after adjustment for physical activity, total energy intake, and socioeconomic status. (more…)
Author Interviews, Fertility, OBGYNE, Pediatrics / 15.04.2016

MedicalResearch.com Interview with: Dr. Kieron Barclay PhD Department of Social Policy London School of Economics MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Barclay: Mean age at childbearing has been increasing in most countries in the OECD since the early 1970s. A wealth of research has shown that childbearing at advanced ages is associated with greater difficulty in terms of getting pregnant, higher rates of miscarriage, stillbirth, and increased risk of poor peri-natal outcomes such as pre-term birth and low birth weight. Studies also indicate that the offspring of older mothers have a greater risk of Alzheimer’s disease, diabetes, and mortality in adulthood. However, from the perspective of any individual woman, delaying childbearing to an older age necessarily also means that she will give birth in a later birth year. The last 40 to 50 years have seen substantial improvements in educational opportunities, and better public health conditions and medical knowledge. As a result, these positive secular trends may outweigh or counterbalance the negative effects of reproductive aging for the child. (more…)
Author Interviews, Cancer Research, PLoS, Vitamin D / 15.04.2016

MedicalResearch.com Interview with: Sharon L. McDonnell MPH GrassrootsHealth Encinitas, California Medical Research: What is the background for this study? What are the main findings? Response: Higher vitamin D levels in the blood have been associated with a lower risk of multiple cancer types including colorectal and breast. Using data from two study cohorts of women aged 55 years and older (N=2,304), we investigated the association between serum 25(OH)D concentration, the marker of vitamin D in the blood, and risk of all non-skin cancers combined across a broad range of 25(OH)D concentrations. We found that women with 25(OH)D concentrations ≥40 ng/ml had a 67% lower risk of cancer compared to women with concentrations <20 ng/ml. We also found that the greatest decrease in risk occurred between ~10-40 ng/ml. These findings suggest that increasing 25(OH)D concentrations to a minimum of 40 ng/ml could substantially reduce  cancer incidence and associated mortality in the population. (more…)
Author Interviews, Cancer Research, Hepatitis - Liver Disease, HPV, JNCI, MD Anderson / 15.04.2016

MedicalResearch.com Interview with: Harrys A. Torres, MD, FACP, FIDSA Associate Professor Director of Hepatitis C Clinic Department of Infectious Diseases, Infection Control and Employee Health The University of Texas MD Anderson Cancer Center Houston TX 77030 Medical Research: What is the background for this study? What are the main findings? Dr. Torres: Hepatitis C virus (HCV) is an oncogenic virus and is associated with an increased risk of liver cancer and certain types of non-Hodgkin lymphomas. In 2009, at MD Anderson Cancer Center, we set up the first clinic in the United States, and probably in the world, specifically devoted to managing HCV infection in cancer patients. In the clinic, we expected to see a number of patients with liver cancers and non-Hodgkin’s lymphoma, as these have documented associations with HCV. Unexpectedly, we saw a high number of HCV-infected patients with head and neck cancers, and wondered whether there was an undiscovered association between having the infection and head and neck cancers. To explore this, we conducted a case-control study using 409 head and neck cancer subjects (164 oropharyngeal, 245 non-oropharyngeal [oral cavity, nasopharynx, larynx] cancers) and 694 control subjects with other smoking-associated cancers (378 lung, 168 esophagus, and 148 urinary bladder cancers), and compared the prevalence of HCV infection in the two groups. We observed a high prevalence of HCV infection in oropharyngeal (14%) and non-oropharyngeal (20%) cancer patients when compared to control subjects (6.5%). After adjusting for confounders such as smoking, alcohol intake, and socioeconomic status, HCV-infected individuals were 2.04 times more likely to have oropharyngeal cancers and 2.85 times more likely to have non-oropharyngeal cancers. Of note, HCV was associated only with patients with oropharyngeal cancers that tested positive for human papilloma virus, which is one of the main virus linked with increased risk of oropharyngeal cancers. (more…)
Author Interviews, Gender Differences, Heart Disease, JACC, Women's Heart Health / 15.04.2016

MedicalResearch.com Interview with: Dr. Neha J. Pagidipati Duke Clinical Research Institute Duke University School of Medicine Durham, North Carolina Medical Research: What is the background for this study? What are the main findings? Dr. Pagidipati: Women and men experience coronary artery disease differently, and a great deal of literature has shown that these differences extend to the diagnostic performance of various noninvasive testing modalities. However, little is known about the sex-specific prognostic value of computed tomographic angiography (CTA) and functional stress testing. We used data from the recent PROMISE trial to address this question. The PROMISE trial enrolled 10,003 patients (53% women) with stable symptoms suggestive of coronary artery disease to a diagnostic strategy of CTA vs stress testing, and found no differences in outcomes overall or by sex. We found that in women, a CTA is less likely to be positive, but when it is positive, it appears to have greater predictive value for a future cardiovascular event (all cause death, myocardial infarction, or unstable angina hospitalization) than stress testing. In men, a stress test is less likely to be positive, and though stress testing trended towards being more predictive of future events, there was no statistically significant difference in the prognostic value of either test type. (more…)
Author Interviews, Cancer Research, Inflammation, Microbiome, PLoS, UCLA / 15.04.2016

MedicalResearch.com Interview with: Robert H. Schiestl PhD Department of Environmental Health Sciences, Fielding School of Public Health, Department of Pathology Department of Radiation Oncology Geffen School of Medicine University of California Los Angeles, Los Angeles, California Medical Research: What is the background for this study? What are the main findings? Dr. Schiestl: When we moved from Harvard to UCLA 13 years ago, after 6 years at UCLA our Atm mouse colony lived significantly 4 fold longer and the frequency of DNA deletions was 4.5 fold reduced and the latency of lymphoma 2.5 fold different. Ultimately we identified the reason behind this as a difference in the intestinal bacteria. The Atm deficient mice are hypersensitive to inflammation and the bacteria reduced inflammation. Then I isolated the most prevalent bacterium among the health beneficial bacteria and this bacterium by itself called Lactobacillus johnsonii 456 reduced genotoxicity and all markers of inflammation. (more…)
Author Interviews, Heart Disease / 15.04.2016

MedicalResearch.com Interview with: Dr. Charles Pollack MD MA Thomas Jefferson University Philadelphia, PA 19107 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Pollack:: We are continuing research on PRAXBIND in the ongoing global phase III patient study, RE-VERSE AD™. RE-VERSE AD includes two groups of dabigatran patients: those who had serious bleeding or those who required an urgent procedure. At ACC, we presented results from an updated interim analysis from 123 patients enrolled in RE-VERSE AD™, which showed a single 5g of PRAXBIND immediately reversed the anticoagulant effect of dabigatran in all patients evaluated. (more…)
Author Interviews, Breast Cancer, Fertility, Gender Differences, Karolinski Institute, Mammograms, Radiology / 14.04.2016

MedicalResearch.com Interview with: Frida Lundberg | PhD Student Dept. of Medical Epidemiology and Biostatistics Karolinska Institutet Medical Research: What is the background for this study? Response: Fertility treatments involve stimulation with potent hormonal drugs that increase the amount of the sex hormones estrogen and progesterone. These hormones have been linked to breast cancer risk. Further, as these treatments are relatively new, most women who have gone through them are still below the age at which breast cancer is usually diagnosed. Therefore we wanted to investigate if infertility and fertility treatments influences mammographic breast density, a strong marker for breast cancer risk that is also hormone-responsive. Medical Research: What are the main findings? Response: We found that women with a history of infertility had higher absolute dense volume than other women. Among the infertile women, those who had gone through controlled ovarian stimulation (COS) had the highest absolute dense volume. The results from our study indicate that infertile women, especially those who undergo COS, might represent a group with an increased risk of breast cancer. However, the observed difference in dense volume was relatively small and has only been linked to a modest increase in breast cancer risk in previous studies.  As the infertility type could influence what treatment the couples undergo, the association might also be due to the underlying infertility rather than the treatment per se. (more…)
Author Interviews, Biomarkers, Lancet, Pulmonary Disease / 14.04.2016

MedicalResearch.com Interview with: Dr Henrik Watz MD Pulmonary Research Institute at Lung Clinic Grosshansdorf Airway Research Center North, German Center for Lung Research Grosshansdorf, Germany Medical Research: What is the background for this study? What are the main findings? Dr Watz : While bronchodilators are the mainstay therapy for all patients with COPD some patients benefit from the addition of inhaled corticosteroids in case of frequent exacerbations. So far only little data exist that help clinicians to better characterize those patients that may benefit from the continuation of inhaled corticosteroids on top of dual bronchodilation with a LABA and a LAMA. Post-hoc analyses of the WISDOM dataset suggest that those patients, who have blood eosinophil counts of 4 % or greater or 300 eosinophils per µL or more have less exacerbations, when inhaled corticosteroids are continued compared to patients, in whom inhaled corticosteroids are withdrawn. Patients with less than 4 % eosinophils or less than 300 eosinophils in peripheral blood, who represent 80 % of the study population in WISDOM, did not benefit from a continuation of inhaled corticosteroids. (more…)
Author Interviews, Heart Disease, JACC / 14.04.2016

MedicalResearch.com Interview with: Vincent Roolvink, MD Isala hospital, Department of Cardiology Zwolle, The Netherlands Medical Research: What is the background for this study? Dr. Roolvink: The goal of the trial was to assess the safety and efficacy of early administration of intravenous (IV) metoprolol in patients presenting with ST-elevation myocardial infarction (STEMI) and scheduled for primary percutaneous coronary intervention (PCI). (more…)
Author Interviews, JAMA, Thyroid / 14.04.2016

MedicalResearch.com Interview with: Dr. Luc G. T. Morris, MD, MSc Head and Neck Service, Department of Surgery Memorial Sloan Kettering Cancer Center New York, New York Medical Research: What is the background for this study? What are the main findings? Dr. Morris:  Over the past 30 years, the incidence of thyroid cancer in the US has tripled. It used to be a mystery why this was happening. But recently, many researchers have shown that this is mainly happening because of improvements in medical technology that allow us to better identify and biopsy small nodules in the thyroid gland. Many of these small nodules turn out to be thyroid cancers. In fact, up to 30% of healthy persons have small cancers in their thyroid glands, and nearly all of these would not go on to cause any problems for the person if the cancer were never discovered. In other words, a large reservoir of small thyroid cancers has always been present, like a huge submerged iceberg, but we are just getting better at finding them. Therefore, the dramatically rising incidence of thyroid cancer is best characterized as an "epidemic of diagnosis," not an epidemic of disease. This is highly relevant to patients found to have these small thyroid cancers, because it means that many of these cancers would not have caused problems for the patient, and that there would be no benefit (only potential harm) to diagnosing and surgically removing them. (more…)
Author Interviews, NEJM, Pain Research, Surgical Research / 14.04.2016

MedicalResearch.com Interview with: Zoher Ghogawala MD FACS Department of Neurosurgery Lahey Hospital and Medical Center Burlington, MA 01805 MedicalResearch.com: What is the background for this study? Dr. Ghogawala: There is enormous practice variation around the utilization of lumbar spinal fusion in the United States and across the world.  In the United States, lumbar spinal fusion utilization has increased to 465,000 hospital-based procedures in 2011 according to a report from the AHRQ (published in 2014).  Spinal fusion accounts now for the highest aggregate hospital cost (12.8 billion dollars in 2011) of any surgical procedure performed in US hospitals.  What is problematic is that there are no top tier studies that address the question of whether or not adding a lumbar spinal fusion when performing a simple decompression is necessary or helpful.  The question is whether we perform too many fusions in the United States. The SLIP study is the first class I study that demonstrates that the addition of a lumbar fusion when performing a lumbar laminectomy to decompress spinal nerves improves health-related quality of life for patients suffering from low back pain and sciatica from lumbar stenosis with spondylolisthesis - a very common cause of low back pain caused by nerve compression associated with one spinal bone being slightly out of alignment.  MedicalResearch.com: What are the main findings? Dr. Ghogawala: 1)  Adding a lumbar fusion when performing a lumbar laminectomy results in superior health-related quality of life at 2,3, and 4 years after surgery. 2)  Patients with fusion obtained durable results but 14% required re-operation for problems adjacent to their fusion over the 4 year study period. 3)  Lumbar laminectomy alone provided good results for 70% of patients.  There was less blood loss and faster recovery for these patients.  On the other hand, the outcomes were less durable.  One in three patients who underwent a lumbar laminectomy alone required re-operation within 4 years because their back became unstable.  These patients underwent fusion and their health-related quality of life improved. (more…)
Author Interviews, Breast Cancer, Journal Clinical Oncology, Menopause / 14.04.2016

MedicalResearch.com Interview with: Giorgia Razzini, PhD Unit of Medical Oncology Civil Hospital Carpi Italy; MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Razzini: Hot flashes experienced by breast cancer patients is a significant clinical problem because there are few reliable treatment that are free of side effects and it sometime reduces compliance with endocrine therapy for prevention of cancer recurrence. Menopausal symtoms overall  heavily impact on quality of life.. Acclimat found that acupuncture combined with self-care for 3 months, is associated with significantly lower hot flash scores, compared to self-care alone ( advices on diet, physical exercise and psycoloigical support if needed). Beneficial effects persisted up to 6 months follow-up. These effects were not associated with significant adverse events. MedicalResearch.com: What should clinicians and patients take away from your report?  Dr. Razzini:  Research suggests that breast cancer women do not receive adequate care for menopausal symptoms in the clinical practice of most oncology department. Our study showed that oncologists can offer them specific integrative management strategy for menopausal symptoms including acupuncture and enhanced self-care to women with breast cancer, particularly in younger women when treatment with hormonal treatment is recommended, in order to help women to stay on their therapy and improve their quality of life. (more…)
Accidents & Violence, Author Interviews, BMJ, Radiology, Zika / 14.04.2016

MedicalResearch.com Interview with: Maria de Fatima Vasco Aragao MD, PhD Radiologist and Neuroradiologist Professor of Radiology, Mauricio de Nassau University, Recife, Brazil Scientific Director of Multimagem Radiology Clinic, Recife - PE, Brazil President of Pernambuco Radiology Society MedicalResearch.com: What is the background for this study? Response: The new Zika virus epidemic in Brazil was recognized as starting in the first half of 2015 and the microcephaly epidemic was detected in the second half of that same year. MedicalResearch.com: What are the main findings?
  • Response:  In our study of the 23 mothers, only one did not report rash during pregnancy (rash is a sign that can happen in Zika virus infection). However, Zika virus infection can be asymptomatic in three of every four infected patients. All of the 23 babies had the same clinical and epidemiological characteristics and other congenital infection diseases had been excluded. Of these 23 babies, six were tested for IgM antibodies, specific to Zika virus and all six proved positive. So, by deduction, the other 17 babies on whom it was not possible to make the IgM test, were considered as also having presumed congenital infection related to the Zika virus, after other congenital infections being excluded.
  • All the babies showed malformations of cortical development and sulcation.  The most frequent cortical malformation were: Microcephaly with a simplified cortical gyral pattern and areas of thick cortex of polymicrogyria or pachygyria which were located predominantly in the frontal lobes.
  • Abnormalities of the corpus callósum (hypogenesis and hypoplasia) were common.
  • Decreased brain volume was a common finding. Ventriculomegaly was present in all the babies, with a predominant enlargement of the posterior portions of the lateral ventricles,
  • Delayed myelination were also common. The cisterna magna was enlarged in most of the cases, with or without cerebellar hypoplasia.
  • Some of the babies showed a symmetrical enlargement of the anterior subarachnoid space of the supratentorial compartment, associated with severe ventriculomegaly.
(more…)
Author Interviews, Chemotherapy, Lancet, Leukemia / 13.04.2016

MedicalResearch.com Interview with: Prof Jeffrey H Lipton, PhD, MD, FRCPC Princess Margaret Cancer Centre Toronto, ON Canada MedicalResearch.com: What is the background and purpose for this study? Dr. Lipton: Ponatinib is a third generation tyrosine kinase inhibitor that has been shown to be extremely effective in treating patients with chronic myeloid leukemia resistant to other drugs.  Because of this, it was decided to look at it in newly diagnosed patients in a randomized study against imatinib.  The study was terminated prematurely because of evidence of vascular toxicity that became evident in the phase 1 and 2 studies of ponatinib in previously treated patients with resistant disease.   (more…)
Author Interviews, Herpes Viruses, Ophthalmology / 13.04.2016

MedicalResearch.com Interview with: Kimberly D Tran, MD Bascom Palmer Eye Institute MedicalResearch.com: What is the background and purpose for this study?  Dr. Tran: Approximately 30% of the population will suffer from herpes zoster (also known as shingles) at some point in their lifetime, with an estimated 1 million cases in the U.S. each year (1).  The most common long term complication of  herpes zoster is postherpetic neuralgia (PHN), or persistent neuropathic pain lasting beyond three months after initial presentation of  herpes zoster. PHN can negatively affect quality of life to a degree similar to congestive heart failure, depression, acute myocardial infarction,diabetes. Postherpetic neuralgia is a leading cause of suicide in patients over 70 with chronic pain.(3,4) Of all the cases of herpes zoster, an estimated 10-20% will have herpes zoster ophthalmicus (HZO), which is defined as shingles in the area of the face near the eye, and sometimes the eye itself becomes involved.  Approximately 50% of individuals with HZO will develop ocular complications without antiviral treatment, while antiviral induction within the first 72 hours of rash onset reduces this number to 20-30% (2). Randomized control trial has demonstrated the efficacy antiviral therapy in the treatment of herpes zoster on first presentation.(6) What is less understood is the course of HZ after its initial presentation. Traditionally studied and treated in the acute phase,(5-7) recent data suggest that some patients experience a chronic or recurrent disease course. Based on this data, it is clear that more information is needed on the long term clinical course of herpes zoster ophthalmicus. The purpose of this study was to characterize the epidemiology of recurrent and chronic HZO in a unique South Florida population, with an ethnically and racially mixed, predominately male population. (more…)
Author Interviews, Hepatitis - Liver Disease, HIV, JAMA, Vaccine Studies / 13.04.2016

MedicalResearch.com Interview with: Odile Launay MD, PhD Paris Descartes University Assistance Publique Hôpitaux de Paris, Cochin Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Launay: In patients with HIV infection, responses to standard HBV vaccination regimens remain suboptimal compared with responses in HIV seonegative individuals. We previously reported that alternative regimens (a 4 injection IMdouble dose regimen and a 4 injection intradermal low dose regimen) improve antibody response compared with the standard HBV vaccination regimen (ANRS HB03 VIHVAC-B study). Further precision on the duration of response achieved with alternative HBV vaccination regimes was needed. We report in this paper the results from the follow-up of the study. The results of this study show that the 4 dose IM regimen induces higher seroconversion rate but also higher long term seroprotection in HIV infected patients (more…)
Author Interviews, Brain Injury, Neurological Disorders / 13.04.2016

MedicalResearch.com Interview with: Thomas A. Buckley Ed.D Assistant Professor Kinesiology & Applied Physiology 144 Human Performance Lab College of Health Sciences University of Delaware MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Buckley: The most recent international consensus statement recommends 24 - 48 hours of cognitive and physical rest in the immediate aftermath of a concussion; however, our clinical experience was that patients who were "shut down" for a few days did worse than patients who were allowed to be out and about as tolerated by symptoms.  This was a retrospective study (chart review) comparing symptom reporting among patients who were shut down for 24 hours and those who were not. The main finding of the study was the addition of a day of cognitive and physical rest (i.e., 'shut down") did not improve symptom recovery recovery.  In fact, we were surprised to see that the non-rest group was symptom free 1.3 days sooner than the rest group and this was statistically significant. (more…)