Author Interviews, CDC, Infections, Outcomes & Safety / 19.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28031" align="alignleft" width="180"]James Baggs, PhD CDC Dr. James Baggs[/caption] James Baggs, PhD Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: What is the background for this study? What are the main findings? Response: We used medical claims data to estimate the amount of antibiotics used in US hospitals from 2006 - 2012. Data came from the Truven Health MarketScan Hospital Drug Database, which included about 300 hospitals and more than 34 million discharges. Antibiotic use in hospitals was very common with more than half of patients receiving at least one antibiotic during their hospital stay. Overall rates of antibiotic use in U.S. hospitals did not change over time; however, there were significant changes in the types of antibiotics prescribed. Importantly, the types of antibiotics with the largest increases in use were the types of antibiotics often considered to be the most powerful. Of particular concern, there was a 37% rise in the use of carbapenems, commonly referred to as “last resort” antibiotics.
Author Interviews, Memory, Scripps / 19.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28094" align="alignleft" width="144"]Ron L. Davis, PhD Professor and Chair Department of Neuroscience Florida campus of The Scripps Research Institute Dr. Ron L. Davis[/caption] Ron L. Davis, PhD Professor and Chair Department of Neuroscience Florida campus of The Scripps Research Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: While calcium’s importance for our bones and teeth is well known, its role in neurons—in particular, its effects on processes such as learning and memory—has been less well defined. Our new study, published in the journal Cell Reports, offers new insights how calcium in mitochondria—the powerhouse of all cells—can impact the development of the brain and adult cognition. Specifically, we show in fruit flies, a widely used model system, that blocking a channel that brings calcium to the mitochondria called “mitochondrial calcium uniporter” causes memory impairment but does not alter learning capacity. That surprised us – we thought they wouldn’t be able to learn at all. This is important because defects in the same calcium channel function have been shown to be associated with intellectual disability in humans.
Author Interviews, Endocrinology, Prostate, Prostate Cancer, Testosterone, Urology / 19.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28090" align="alignleft" width="133"]Dr. Jesse Ory Department of Urology, Faculty of Medicine Dalhousie University, Halifax Nova Scotia, Canada Dr. Jesse Ory[/caption] Dr. Jesse Ory Department of Urology, Faculty of Medicine Dalhousie University, Halifax Nova Scotia, Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of Testosterone Therapy (TT) in men diagnosed with and treated for prostate cancer (CaP) has been highly controversial for several decades. Unfortunately, this controversy is largely founded on the results of a single patient in a study by Huggins and Hodges in the 1940s [1]. This wasn't challenged until recently, when Morgentaler reviewed the literature on the topic and found no scientific basis for the assumption that TT will act like fuel on the fire of prostate cancer [2]. He also proposed a mechanism, the "saturation hypothesis" that helps account for why TT may in fact be safe for men with prostate cancer. [3]. Over the past decade, retrospective evidence has been accumulating that supports the safety of Testosterone Therapy in hypogonadal men with CaP on Active Surveillance, or in those who have been definitively treated for prostate cancer..
Author Interviews, Nutrition, Ovarian Cancer, Race/Ethnic Diversity, Vitamin D / 19.09.2016

MedicalResearch.com Interview with: [caption id="attachment_24508" align="alignleft" width="200"]Bo (Bonnie) Qin, Ph.D. Postdoctoral Scholar Rutgers Cancer Institute of New Jersey New Brunswick, NJ 08903 Dr. Bo Qin[/caption] Bo (Bonnie) Qin, Ph.D. Post-Doctoral Associate Rutgers Cancer Institute of New Jersey New Brunswick, NJ 08903 MedicalResearch.com: What is the background for this study? Response: Ovarian cancer is the leading cause of death from gynecologic cancer in the US. African-American patients diagnosed with ovarian cancer tend to have a worse 5-year survival rate compared to their European-American patients. Therefore, identifying preventive factors in African-Americans women is particularly important. African Americans tend to consume less calcium and vitamin D from dietary sources, due to a higher prevalence of lactose intolerance, and supplemental intake. Meanwhile, darker color of the skin reduces the synthesis of vitamin D upon sun exposure. They together place African-American women at risk for calcium and vitamin D deficiency. It remains unknown whether calcium, vitamin D, lactose and dairy products are associated with ovarian cancer risk in African-American women and our study aimed to answer this question.
Author Interviews, Diabetes, Endocrinology, Hormone Therapy / 19.09.2016

MedicalResearch.com Interview with: Jon Rasmussen, MD, PhD fellow Department of Internal Medicine Herlev Hospital, Denmark MedicalResearch.com: What is the background for this study? Response: Abuse of anabolic androgenic steroids has become highly prevalent among young men involved in recreational strength training. A recent meta-analysis estimated that approximately 18% of young men involved recreational strength training abuse anabolic steroids. Well-known adverse effects following abuse of anabolic steroids include hypogonadism (For those who have interest, we have recently published a paper concerning this issue, it can be read and downloaded at: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161208). Yet, we have a poor understanding on the adverse effects these compounds might have on the metabolism and insulin sensitivity.
Author Interviews, Diabetes, OBGYNE / 19.09.2016

MedicalResearch.com Interview with: Anastasia Katsarou PhD LUND University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study is using data from the Mamma study which screened pregnant women during 2003-2005. During this period, we gathered results from the oral glucose tolerance tests that the women underwent at the 28th week of pregnancy. We used data on the 2hour blood glucose levels from these tests and the frequency of women who were diagnosed with gestational diabetes and grouped them into months and seasons. We gathered also data on the mean monthly temperatures from the Swedish Meteorological and Hydrological Institute. We observed that the 2hour glucose levels and the frequency of women diagnosed with gestational diabetes were statistically significantly higher during the summer months.
Author Interviews, Biomarkers, Diabetes, Pancreatic / 19.09.2016

MedicalResearch.com Interview with: Dr. Pavel Škrha Charles University, Prague Czech Republic MedicalResearch.com: What is the background for this study? What are the main findings? Response: Incidence of pancreatic cancer (PAC) is still increasing. The main problem is in the late diagnosis of the cancer. It was found, that diabetes mellitus was much more frequent in the pancreatic cancer patients than in the general population. DM can be already the first symptom of the disease (secondry T3cDM). In our study nearly 80 % of all the pancreatic cancer patients had DM/prediabetes and it was of new-onset (less than 2 years before the cancer diagnosis) in 73 % out of them. We have measured the current marker of PAC (CA 19-9) together with serum microRNA-196 and -200 (that we have chosen in the previous pilot study). All the markers were significantly elevated in the pancreatic cancer patients, without any difference between the subgroups according to DM presence/absence. While the sensitivity of CA 19-9 alone (to detect the cancer) was 85 % (specificity 73 %), combining all the three markers improved it to 95 % (specificity 77 %). In the pancreatic cancer group, there were only six patients with T1 or T2 stage (others had an advanced stage of the disease - T3, T4). While CA 19-9 alone identified only 2 patients of them, the combined test identified all the six patients (data not shown in the poster).
Author Interviews, Heart Disease, JAMA, Surgical Research / 19.09.2016

MedicalResearch.com Interview with: Nish Patel, MD and Nileshkumar J. Patel, MD University of Miami Miller School of Medicine MedicalResearch.com: What is the background for this study? Response: Out of hospital cardiac arrest (OHCA) is estimated to affect approximately 300,000 people in the United States annually. Pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) contributes 23-54% of OHCA patients, with the median values at the lower end of this range. Coronary artery disease is thought to be responsible for up to 70% of these OHCA cases. It has been suggested that urgent coronary intervention in unconscious patients after cardiac arrest may improve survival. In the 2015 American Heart Association (AHA) guidelines, coronary angiography is recommended in patients with OHCA patients with a suspected cardiac etiology and ST elevations (STE) on ECG (Class of recommendation I, Level of evidence B), and it should be considered in patients after cardiac arrest presenting without STE but with suspected cardiac etiology of cardiac arrest (Class of recommendation II a, Level of evidence B). However, there is paucity of information about the use of coronary angiography and percutaneous coronary intervention (PCI) and its potential benefit for the VT/VF OHCA patient population. Therefore, we reviewed the Nationwide Inpatient Sample (NIS), to examine temporal trends of coronary angiography and PCI in VT/VF OHCA in the United States, for patients with and without STE. We also studied the temporal trends of survival to discharge in these patient populations.
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 19.09.2016

MedicalResearch.com Interview with: Islam Elgendy, MD Cardiology Fellow University of Florida MedicalResearch.com: What is the background for this study? What are the main findings? Response: The optimal systolic blood pressure target in adults with coronary artery disease is not well known. The Eighth Joint National Committee Panel recommended a target therapeutic goal <150 mm Hg for adults aged ≥60 years and <140 mm Hg in those aged <60 years. These recommendations are inconsistent with the different society guidelines (such as American Heart Association/American College of Cardiology, European Society of Cardiology, and American Society of Hypertension) which recommended a therapeutic target < 140 mm Hg. Given that the dyad of hypertension and coronary artery disease is the most prevalent chronic disease dyad among adults, we aimed to assess the long term risk of all-cause mortality with the different systolic blood pressure targets. Using the extended follow-up data from the US cohort of the INVEST trial, we demonstrated that achieving a systolic blood pressure of 130 to <140 mm Hg in the initial 2-3 years of treatment is associated with reduced all-cause mortality after ≈11.6 years of follow-up in hypertensive patients with coronary artery disease.
Author Interviews, Mayo Clinic, Nutrition, Pediatrics, Weight Research / 17.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28058" align="alignleft" width="133"]David R. Jacobs, Jr., PhD Mayo Professor of Public Health Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN 55454-1075 Dr. David R. Jacobs, Jr.[/caption] David R. Jacobs, Jr., PhD Mayo Professor of Public Health Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN 55454-1075 MedicalResearch.com: What is the background for this study? Response: Project EAT (Eating and Activity in Teens and Young Adults) is on ongoing longitudinal study which began by screening middle and secondary school students in the Minneapolis and St Paul Metropolitan are. Students were the 11-18 years old (average age 15), then followed up at average ages 20 and 25. We had devised an eating pattern in about 2006, which a) predicts a lot of things in several different studies (including total mortality in the Iowa Women's Health Study) and b) looks a great deal like the recently released 2015 Dietary Guidelines for Americans (DGA). We call our diet pattern A Priori Diet Quality Score (APDQS) and think of it as close to or in the style of a Mediterranean/prudent/healthy diet. We hypothesized that this pattern would be associated with lower weight (in general with better long term health, but the focus in Project EAT was weight and BMI), probably least so at age 15. The minimal hypothesized effect in adolescence relates to the very large energy expenditure in adolescent growth years; we thought that diet composition would be less important for body weight at that time than energy intake (and APDQS is about diet composition).
AHA Journals, Author Interviews, Brigham & Women's - Harvard, Endocrinology, Heart Disease, Thyroid Disease / 17.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28053" align="alignleft" width="200"]Layal Chaker, MD, MSc Research and Curriculum Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Boston, MA Dr. Layal Chaker[/caption] Layal Chaker, MD, MSc PhD candidate Department of Endocrinology and Epidemiology Erasmus Medical Center Rotterdam, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association of thyroid function with coronary heart disease is well–established but not much was known about the association of thyroid function with sudden cardiac death. We conducted the study with the hypothesis that thyroid hormone levels affect cardiovascular risk factors and therefore could also affect the risk of sudden cardiac death (SCD). We were surprised to see that when we control our analyses for these cardiovascular risk factors, the association of high and high-normal thyroid function with SCD remained similar, suggesting that other pathways could play a role. Thyroid hormone has different effects on the cardiovascular systems and future studies should identify which pathway could be responsible for the increased risk of sudden cardiac death with higher thyroid hormone levels. This could lead to better assessment of individual risk and identify possible prevention targets.
Author Interviews, Brigham & Women's - Harvard, Infections, JAMA, Ophthalmology / 17.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28049" align="alignleft" width="133"]Dr. Daria Van Tyne, PhD The Gilmore Lab Department of Ophthalmology Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, Massachusetts Dr. Daria Van Tyne[/caption] Dr. Daria Van Tyne, PhD The Gilmore Lab Department of Ophthalmology Harvard Medical School Massachusetts Eye and Ear Infirmary Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: A specific clone of E. coli, type ST131, which produces an extended-spectrum beta-lactamase (ESBL – an enzyme that inactivates many penicillin-type antibiotics), has rapidly spread around the globe to become the leading cause of multidrug-resistant, non-intestinal E. coli infection. Despite this, E. coli is a rare cause of infection of the cornea. A patient was recently seen at the Massachusetts Eye and Ear Infirmary with a severe E. coli infection of the cornea, and the large number of antibiotic resistances of this strain tipped us off to the possibility that it might be the highly virulent ST131 ESBL type. By sequencing the DNA of its genome, we found that it was indeed ST131 ESBL E. coli. Moreover, we discovered a new mutation in this strain that allows it to produce a slimy outer coating on its surface. This slime layer, or capsule, makes the bacteria more resistant to removal by phagocytic cells of the immune system. The slime layer also makes these particular colonies appear different on a special type of agar that contains the dye Congo Red.
Accidents & Violence, Author Interviews, Cannabis, Columbia, Opiods / 17.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28045" align="alignleft" width="163"]June H. Kim Doctoral candidate,Department of Epidemiology Mailman School Public Health Columbia University June Kim[/caption] June H. Kim Doctoral candidate,Department of Epidemiology Mailman School Public Health Columbia University MedicalResearch.com: What is the background for this study? What are the main findings? Response: A previous study indicated that states with medical marijuana laws had a reduced rate of opioid overdoses. If this is true, we'd expect to see similar reductions in opioid use associated with these laws. For this study, we used data from the FARS, a national surveillance system that records any crash events on US public roads that result in a fatality. Some states provide uniform testing of the majority of their deceased drivers, year to year. Among these states, we found that there was a lower prevalence of positive opioid toxicology tests among drivers crashing in states with an operational medical marijuana versus drivers crashing in states before a future medical marijuana law is implemented, particularly among drivers aged 21-40.
Author Interviews, Pediatrics, Social Issues, Toxin Research / 17.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28039" align="alignleft" width="151"]Dr. Katherine Ahrens PhD Office of Population Affairs Rockville, MD 20852 Dr. Katherine Ahrens[/caption] Dr. Katherine Ahrens PhD Office of Population Affairs Rockville, MD 20852 MedicalResearch.com: What is the background for this study? Response: Lead exposure among children is linked to many adverse effects on health and cognitive development, which can be irreversible. The National Center for Health Statistics (NCHS) has linked 1999 to 2012 National Health and Nutrition Examination Survey (NHANES) data to administrative data for the Department of Housing and Urban Development’s (HUD) largest rental assistance programs (1999 through 2014), and these linked data allow calculation of the first-ever national blood lead level estimates among children living in HUD-assisted housing. Here we compare blood lead levels among children 1 to 5 years of age in 2005 to 2012 who received housing assistance during 1999 to 2014 with levels among children who did not receive housing assistance during that period.
Author Interviews, Cost of Health Care, OBGYNE, Outcomes & Safety, University Texas / 17.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28034" align="alignleft" width="200"]Fangjian Guo, MD, PhD Assistant Professor BIRCWH Scholar Department of Obstetrics & Gynecology Center for Interdisciplinary Research in Women’s Health The University of Texas Medical Branch Dr. Fangjian Guo[/caption] Fangjian Guo, MD, PhD Assistant Professor BIRCWH Scholar Department of Obstetrics & Gynecology Center for Interdisciplinary Research in Women’s Health The University of Texas Medical Branch MedicalResearch.com: What is the background for this study? What are the main findings? Response: National guidelines consistently recommend against cervical cancer screening among women with a history of a total hysterectomy for a benign condition. These women are unlikely to develop high-grade cervical lesions. The goal of our study was to assess whether these guidelines are being followed. We examined the use of Pap testing among US adult women with a history of total hysterectomy for a benign condition and the roles of health care providers and patients in the initiation of Pap test use. We found that in 2013, 32% of women who have had a hysterectomy received an unnecessary recommendation for cervical cancer screening from a health care provider in the past year; 22.1% of women with hysterectomy received unnecessary Pap testing. Although the majority of Pap tests were performed at a clinician’s recommendation, approximately one fourth were initiated by patients without clinician recommendations. According to standard 2010 US Census population figures, about 4.9 million unnecessary Pap tests are performed annually among women who have had a total hysterectomy for a benign condition. At approximately $30 per test, $150 million in direct medical costs could be saved annually if screening guidelines were followed for these women.
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 17.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28022" align="alignleft" width="165"]Holly Mattix-Kramer, MD, MPH</strong> Public Health Sciences Medicine, Nephrology Associate Professor Loyola Medicine, Illinois Dr. Holly Mattix-Kramer[/caption] Holly Mattix-Kramer, MD, MPH Public Health Sciences Medicine, Nephrology Associate Professor Loyola Medicine, Illinois MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that the Systolic Blood Pressure Lowering Intervention Trial (SPRINT) showed that intensive systolic blood pressure lowering reduces all-cause mortality by 27% compared to standard blood pressure lowering among adults age 50 years and older without diabetes or stroke but with high cardiovascular disease risk. We applied these findings to the U.S. population and asked "What if intensive systolic blood pressure lowering were applied to the U.S. population who meet SPRINT eligibility criteria? We found that approximately 18.1 million U.S. adults meet SPRINT criteria and that their annual mortality rate is 2.2%. If intensive systolic blood pressure lowering reduces all-cause mortality by 27%, then the annual mortality rate would be reduced to 1.6% and approximately 107,500 deaths would be prevented each year.
Addiction, Alcohol, Author Interviews, Psychological Science / 16.09.2016

MedicalResearch.com Interview with: [caption id="attachment_28028" align="alignleft" width="150"]Kristina J. Berglund Department of Psychology University of Gothenburg Dr. Kristina J. Berglund[/caption] Kristina J. Berglund Department of Psychology University of Gothenburg MedicalResearch.com: What is the background for this study? What are the main findings? Response: In Sweden, care providers do offer different treatment strategies for individuals who have alcohol problems, where some offer a treatment where the goal is abstinence and other offer a treatment where the goal is low-risk consumption. We wanted to investigate how important it was for having a successful treatment when there was congruence between the patient’s goals and the advocated goal of the treatment, and when there was not. The main findings was that that if the patient had a goal of abstinence than it was much more likely to reach that goal if the patient went to a treatment that advocated abstinence. It was less likely to reach the goal if a patient had a goal of low-risk consumption and went to a treatment that advocated low-risk consumption. The treatment that advocated abstinence was also more effective when the patient were ambivalent of his/her own goal.
Author Interviews, Diabetes, Social Issues, Weight Research / 16.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27851" align="alignleft" width="200"]Professor Timothy Frayling PhD Professor of Human Genetics University of Exeter Medical School Exeter, UK Prof. Timothy Frayling[/caption] Professor Timothy Frayling PhD Professor of Human Genetics University of Exeter Medical School Exeter, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that genes and environmental factors influence our Body mass index. We know less about if and how they interact. We wanted to answer the question of whether or not aspects of the environment and our lifestyles accentuate any genetic predisposition to obesity. The question is important as it may highlight aspects of the environment that cause some people to be particularly susceptible to gaining weight. Previous, separate, studies have suggested that specific aspects of the environment are to blame. These included sugary drinks, fried food and TV watching.
Author Interviews, Diabetes, Vitamin D / 16.09.2016

[caption id="attachment_27954" align="alignleft" width="133"]Elisa Benetti, PhD Elisa Benetti, PhD[/caption] MedicalResearch.com Interview with: Dr. Elisa Benetti PhD Department of Drug Science and Technology University of Turin Turin, Italy MedicalResearch.com: What is the background for this study? Response: The idea for this study comes from the debate on the role of vitamin D supplementation in the prevention or progression of type 2 diabetes (T2DM). Epidemiological data point at a strong association between vitamin D deficiency and T2DM prevalence, however a causal relationship is still lacking. Here we wanted to explore the effect of vitamin D administration on insulin-sensitivity, particularly focusing on skeletal muscle, which is a crucial tissue in the maintenance of glucose homeostasis and which was suggested to be a tissue target of vitamin D. Using a murine model of insulin-resistance induced by a High Fat-High Sugar Diet (HFHS), we demonstrated that a vitamin D supplementation (7 μg•kg-1, i.p. three times/week) was able to revert the deleterious effects evoked by the diet, including the increase in body weight and in the HOMA-IR (a parameter of insulin resistance) and the glucose tolerance impairment. Consistently, at the muscle level, vitamin D increased the insulin sensitivity by reducing tissue inflammation and fat accumulation (myosteatosis). These effects are due, at least in part, to the inhibition exerted by vitamin D on carboxymethyl-lysine (CML) production, one of the main Advanced Glucose End-products (AGEs), and on its receptor RAGE. Collectively, our data indicate the ability of vitamin D to reduce the development of muscle insulin resistance, the primary defect in T2DM patients.
Author Interviews, Depression, Diabetes / 16.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27956" align="alignleft" width="173"]Dr Cathy E. Lloyd Professor of Health Studies School of Health, Wellbeing and Social Care Faculty of Wellbeing, Education and Language Studies The Open University Milton Keynes Prof. Cathy Lloyd[/caption] Dr Cathy E. Lloyd Professor of Health Studies School of Health, Wellbeing and Social Care Faculty of Wellbeing, Education and Language Studies The Open University Milton Keynes UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know from earlier epidemiological research that people with diabetes have an increased risk of developing depression and other mental health problems compared to those without diabetes. However the impact of this and what treatment and care should be provided is still unclear, in particular in countries other than the US or the UK. Our study aims to redress that imbalance, collecting data on diabetes and depression in 16 countries across the globe. Ours is the first study to measure depressive symptoms but also use a standardised clinical interview to diagnose depression according to ICD criteria. Overall 10.6% received a diagnosis of Major Depressive Disorder (MDD), however prevalence rates differed widely between countries with 1% diagnosed with MDD in Uganda and nearly 30% in Bangladesh. Twenty-five percent reported subthreshold levels (PHQ-9 score 5 -9) of depression. Those with MDD were significantly more likely to be female and living in an urban rather than rural location (p<0.001). Age and duration of diabetes did not significantly differ between those with and without MDD. Multi-variable analyses demonstrated that while controlling for country, a diagnosis of MDD was significantly associated with female sex, lower education, taking insulin, less exercise, higher levels of diabetes-related distress and a previous diagnosis of MDD. A negligible proportion of those with either MDD or subthreshold levels of depression had a diagnosis or any treatment for their depression recorded in their medical records.
Author Interviews, Blood Pressure - Hypertension, JAMA, Stanford / 16.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27999" align="alignleft" width="146"]Ilana B. Richman, MD Palo Alto VA Health Care System, Palo Alto, California Center for Primary Care and Outcomes Research/Center for Health Policy Department of Medicine Stanford University School of Medicine Stanford, California Dr. Ilana B. Richman[/caption] Ilana B. Richman, MD Palo Alto VA Health Care System, Palo Alto, California Center for Primary Care and Outcomes Research/Center for Health Policy Department of Medicine Stanford University School of Medicine Stanford, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: In November of 2015, researchers published results from the Systolic Blood Pressure Intervention Trial (SPRINT). This large, NIH-funded study compared a systolic blood pressure target of 120 mm Hg vs 140 mm Hg among hypertensive, nondiabetic patients at elevated risk for cardiovascular disease. SPRINT reported a 25% reduction in the rate of cardiovascular disease and death among those treated to a lower target. Those treated to a lower target blood pressure, though, experienced certain adverse events more frequently. Our cost effectiveness analysis asked two questions: given the potential risks and benefits described in SPRINT, does achieving a lower systolic blood pressure result in net benefit over the course of a lifetime? And if it does, how much would it cost, compared to standard treatment? We found that achieving a lower blood pressure target does result in a net benefit, with a gain of about 0.9 years of life (quality adjusted) among those treated to a lower target compared to those treated to a standard target. This gain, though, required some investment. We found that treating to a lower blood pressure target cost $23,777 per quality-adjusted life year gained. Compared to other commonly used interventions here in the US, this would be considered an excellent value.
Author Interviews, OBGYNE, Pediatrics, PLoS / 16.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27981" align="alignleft" width="104"]Dr. Joseph Leigh Simpson Dr. Joseph Leigh Simpson[/caption] Joseph Leigh Simpson, MD FACOG, FACMG President at International Federation of Fertility Societies March of Dimes Foundation White Plains, NY MedicalResearch.com: What is the background for this study? Response: Preterm birth (PTB) is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. A total of 1.1 million infants die each year. Preterm births and their complications are the leading cause of deaths in children under age 5. The biological basis of preterm birth remains poorly understood, and for that reason, preventive interventions are often empiric and have only limited benefit. Large differences exist in preterm birth rates across high income countries: 5.5 percent in Sweden and at present 9.6 percent in the U.S. The International Federation of Gynecologists and Obstetricians (FIGO)/March of Dimes Working Group on Preterm Birth Prevention hypothesized that identifying the risk factors underlying these wide variations could lead to interventions that reduce preterm birth in countries having high rates.
Author Interviews, Diabetes / 16.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27951" align="alignleft" width="125"]Dr. Samiul Mostafa Dr. Samiul Mostafa[/caption] Dr. Samiul Mostafa Honorary Clinical Lecturer Diabetes Trials Unit University of Oxford MedicalResearch.com: What is the background for this study? Response: In managing people with Type 2 diabetes mellitus (T2DM), international guidelines recommend individualisation of HbA1c (glucose) targets for long term maintenance; however, few data are available on the potential benefits that different blood sugar control targets might achieve. Therefore, there is a need to learn more about the incremental benefits of progressively lowering blood sugar levels. In this computer modelling study, we used the UKPDS Outcomes Model version 2.0 to estimate 10-year event rates for myocardial infarction (MI, heart attack), stroke, blindness and amputation by entering baseline risk factor variables (for example, weight, height, LDL-cholesterol, systolic blood pressure) taken from a for a current population of 5766 people with T2DM. Complication rates were estimated with HbA1c levels held constant at 10%, 9%, 8%, 7% and 6% for each individual whilst maintaining their risk factors at their baseline values. Standard statistical methods were used to calculate relative risk reductions of complications at each HbA1c level.
Author Interviews, HIV, Infections, STD / 16.09.2016

MedicalResearch.com Interview with: Noah Kojima David Geffen School of Medicine University of California Los Angeles, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the most exciting new methods to prevent human immunodeficiency virus (HIV) type 1 infection is through the use of chemical pre-exposure prophylaxis (PrEP), which has been shown to be safe and effective in randomized-controlled trials and “real world” studies among men who have sex with men (MSM). However, reports of high incidence of sexually transmitted infections (STIs) and condomless sex in PrEP trials has led clinicians and public health advocates to be concerned that the use of PrEP for HIV might lead to higher STI incidence due to increased sexual risk behavior. We found that PrEP for HIV infection is associated with increased risk of STI acquisition among MSM in a meta-analysis of prior studies.
Author Interviews, Outcomes & Safety / 15.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27973" align="alignleft" width="200"]Charlotte Yeh MD FACEP Chief Medical Officer AARP Services, Inc Dr. Charlotte Yeh[/caption] Charlotte Yeh MD FACEP Chief Medical Officer AARP Services, Inc Dr. Charlotte Yeh is the Chief Medical Officer for AARP Services, Inc . In her role, Dr. Yeh works with the independent carriers that make health-related products and services available to AARP members, to identify programs and initiatives that will lead to enhanced care for older adults. Dr. Yeh has more than 30 years of healthcare experience – as a practitioner and Chief of Emergency Medicine at Newton-Wellesley Hospital and Tufts Medical Center, as the Medical Director for the National Heritage Insurance Company, a Medicare Part B claims contractor, and as the Regional Administrator for the Centers for Medicare and Medicaid Services in Boston. In this interview, Dr. Yeh comments on the September 2016 AARP Bulletin feature that focuses on twelve common health care blunders and how they can be avoided. MedicalResearch.com: What is the background for this report? How big is the problem of medical errors? Dr. Yeh: Medical errors first became widely acknowledged in 1999 with the publication of the landmark study by the National Academy of Sciences (IOM), formerly called the Institute of Medicine (IOM), estimating as many as 98,000 hospital in-patient deaths per year were caused by medical errors. More recently, a study from Johns Hopkins noted that medical errors may claim as many as 251,000 lives per year.
Abuse and Neglect, Mental Health Research, Psychological Science, Technology / 15.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27968" align="alignleft" width="200"]Yu Chen, Ph.D. Post-doc researcher Department of Informatics University of California, Irvine Dr. Yu Chen[/caption] Yu Chen, Ph.D. Post-doc researcher Department of Informatics University of California, Irvine MedicalResearch.com: What is the background for this study? What are the main findings? Response: College students are facing increasing amount of stress these days. We are interested in leveraging information technology to help them become happier. We week to implement happiness-boosting exercises in positive psychology using technology in a lightweight way. Since college students frequently take photos using their smartphones, we started to investigate how to use smartphone photography to help students conduct the happiness-boosting exercises. Participants were divided into three groups and instructed to take a photo per day in one of the following three conditions: 1) a smiling selfie; 2) a photo of something that makes himself/herself happy; 3) a photo of something that makes another person happy, which is then sent to that person. We found that participants have become more positive after purposefully taking the assigned type of photo for three weeks. Participants who took photos that make others happy also became calmer. Some participants who took smiling selfies reported becoming more confident and comfortable with their smiles. Those who took photos to make themselves happy reported becoming more reflective and appreciative. Participants who took photos to make others happy found connecting with strong ties help them reduce stress.
Author Interviews, CDC, Emory, Opiods / 15.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27960" align="alignleft" width="180"]Curtis Florence, PhD National Center for Injury Prevention and Control and Assistant professor, Department of Health Policy Management Rollins School of Public Health at Emory Curtis Florence, PhD[/caption] Curtis Florence, PhD National Center for Injury Prevention and Control and Assistant professor, Department of Health Policy Management Rollins School of Public Health Emory MedicalResearch.com: What is the background for this study? Response:
  • This study presents most recent CDC estimates of the economic burden of prescription opioid abuse, dependence and overdose in the United States.
  • In 2013, over 16,000 persons died of prescription opioid overdoses, and almost 2 million people met the diagnostic criteria for abuse and/or dependence.
Author Interviews, Gender Differences, Heart Disease, JAMA, Menopause / 15.09.2016

MedicalResearch.com Interview with: Taulant Muka, MD, MPH, PhD Postdoctoral Researcher Erasmus University, Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: Menopause marks a major life transition for women, resulting in the loss of ovarian follicle development. Although menopause is a universal phenomenon among women, the timing of the final menstrual period differ greatly between women, and is considered a marker of aging. By quantifying data of nearly 310,329 non-overlapping women, we found that women who experienced an early menopause (i.e. younger than 45 years) have an excess risk of CHD, CVD-mortality and all-cause mortality. Furthermore, being 45-49 years at menopause compared to ≥50 years was associated with increased risk of carotid atherosclerosis.
Author Interviews, Breast Cancer, JAMA / 15.09.2016

MedicalResearch.com Interview with: Tehillah S. Menes, MD Department of Surgery Tel Aviv-Sourasky Medical Center Tel Aviv, Israel MedicalResearch.com: What is the background for this study? Response: Atypical ductal hyperplasia (ADH) is a known risk factor for breast cancer. The diagnosis is made by a biopsy showing a uniform proliferation of cells lining the ducts of the breast. These cells have monomorphic round nuclei and characteristically fill only part of the involved duct. Women diagnosed with ADH are recommended to undergo increased surveillance and offered chemoprevention (i.e. Tamoxifen) for risk reduction. Most studies reporting on the risk of subsequent breast cancer in women with ADH were done prior to the wide use of screening mammography and percutaneous needle biopsy. Our study examined 10-year risk of invasive breast cancer in women diagnosed with ADH (by needle biopsy or excisional biopsy), using data collected by the Breast Cancer Surveillance Consortium (BCSC).
Author Interviews, Education / 15.09.2016

MedicalResearch.com Interview with: [caption id="attachment_27938" align="alignleft" width="200"]Mr. Alexander Burgoyne Department of Psychology Michigan State University East Lansing, MI Chess (Wikipedia image)[/caption] Mr. Alexander Burgoyne Department of Psychology Michigan State University East Lansing, MI MedicalResearch.com: What is the background for this study? What are the main findings? Response: Within the field of psychology, the question of whether intelligence has a role in chess expertise has been debated since at least 1927 with the publication of "Psychologie des schachspiels" by Djakow, Petrowski, and Rudik. More recently, the titles of popular press books such as Talent is Overrated speak to the belief that individual differences in abilities, such as intelligence, do not matter, or can be circumvented by training. We analyzed a half-century worth of research on intelligence and chess skill and found that cognitive ability contributes meaningfully to individual differences in chess skill, particularly in younger and/or less skill players.