Author Interviews, Genetic Research, JAMA, Stroke / 28.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25665" align="alignleft" width="160"]Dr. Yongjun Wang Principal Investigator No. 6 Tiantanxili Dongcheng District, Beijing, China Dr. Yongjun Wang[/caption] Dr. Yongjun Wang  Principal Investigator No. 6 Tiantanxili Dongcheng District, Beijing, China MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clopidogrel requires conversion to an active metabolite by hepatic cytochrome p450 (CYP) iso-enzymes to exert an antiplatelet effect, and polymorphisms of the CYP2C19 gene have been identified as strong predictors of clopidogrel nonresponsiveness. However, data are limited regarding the association between CYP2C19 genetic variants and clinical outcomes of clopidogrel-treated patients with minor stroke or transient ischemic attack. The main findings of this study is that the combined treatment of clopidogrel and aspirin compared with aspirin alone reduced the risk of a new stroke only in the subgroup of patients with minor ischemic stroke or TIA who were not carriers of the CYP2C19 loss of function alleles.
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Pulmonary Disease / 28.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25567" align="alignleft" width="149"]Peter E. Morris, MD, FACP, FCCP Chief, Division of Pulmonary, Critical Care and Sleep Medicine University of Kentucky Lexington, KY Dr. Peter Morris[/caption] Peter E. Morris, MD, FACP, FCCP Chief, Division of Pulmonary, Critical Care and Sleep Medicine University of Kentucky Lexington, KY MedicalResearch.com: What is the background for this study? What are the main findings? Response: ICU survivors demonstrate weakness. It has been postulated that interventions to promote early rehabilitation strategies might be linked to improved functional outcomes for ICU survivors. This study was based upon findings from a quality improvement endeavor that linked early rehabilitation with indications of shortened hospital stays for ICU survivors.
Author Interviews, Infections, JAMA, Primary Care / 28.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25559" align="alignleft" width="145"]Jochen Gensichen, MD, MSc, MPH Institute of General Practice and Family Medicine Konrad Reinhart, MD Center of Sepsis Control and Carecopy right for the-photo is with: Michael Fuchs, Remseck Dr. Jochen Gensichen[/caption] Jochen Gensichen, MD, MSc, MPH Institute of General Practice and Family Medicine [caption id="attachment_25560" align="alignleft" width="133"]Konrad Reinhart, MD Center of Sepsis Control and Care Dr. Konrad Reinhart[/caption] Konrad Reinhart, MD Center of Sepsis Control and Care Jena University Hospital Friedrich-Schiller-University School of Medicine Jena, Germany MedicalResearch.com: What are the main findings? Response: Sepsis survivors face multiple long-term sequelae which result in increased primary care needs as a basic support in medication, physiotherapy or mental health. Process of care after discharge from the intensive care unit often is fragmented.
Author Interviews, End of Life Care / 28.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25531" align="alignleft" width="133"]Dr Magnolia Cardona-Morrell, MPH, PhD Senior Research Fellow The Simpson Centre for Health Services Research South Western Sydney Clinical School Sydney Magnolia Cardona-Morrell[/caption] Dr Magnolia Cardona-Morrell, MPH, PhD Senior Research Fellow The Simpson Centre for Health Services Research South Western Sydney Clinical School Sydney MedicalResearch.com: What is the background for this study? What are the main findings? Response: We name the non beneficial treatments – those intensive procedures, medications or tests administered to elderly patients who are naturally dying and which will not make a difference to their survival, will probably impair their remaining quality of life or potentially or cause them pain or suffering – that are still occurring in hospitals. Think of these as unnecessary or excessive for the expected benefit. Our review of 38 studies, including 1.2 million patients, doctors, nurses and relatives in 10 countries, showed that on average 33% of elderly patients in the last six months of life and up to the last seven days of life received some of these treatments. Examples include: • attempting CPR on elderly patients with advanced disease or who have a “not-for-resuscitation” order (11-25%) • admission to intensive care in patients with advanced chronic disease (average 10% and up to 33%) • initiation or continuation of chemotherapy at the end of life (24-41%) • hemodialysis, transfusions, oral or intravenous medications to patients in terminal admissions (7-77%) These treatments continue happen after two decades due to a combination of factors: • patients’ lack of communication with families about end-of-life care wishes • unrealistic social expectation of survival due to technological advances • family pressure for doctors to “try everything possible” • medico-legal concerns • doctors’ uncertainty about the time until death and • the default position of intervening because doctors are trained to cure disease and save lives.
Author Interviews, CDC, Infections, Sexual Health, STD / 28.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25617" align="alignleft" width="112"]Dr. Andrew Amato-Gauci MD Head of the European Centre for Disease Prevention and Control Programme on HIV/AIDS, sexually transmitted infections and viral hepatitis Dr. Andrew Amato Gauci[/caption] Dr. Andrew Amato-Gauci MD Head of the European Centre for Disease Prevention and Control Programme on HIV/AIDS, sexually transmitted infections and viral hepatitis MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our surveillance data (http://bit.ly/1sXdbVv) show that between 2008 and 2014, the overall rate of officially reported gonorrhoea infections has more than doubled across Europe, going up from 8 per 100 000 population to 20 cases per 100 000 persons. In total, 66 413 gonorrhoea cases were reported in 27 countries of the European Union and European Economic Area (EU/EEA) in 2014 – which constitutes an increase of 25% compared with 2013. The majority of gonorrhoea infections were diagnosed among young adults aged 15–24 years who accounted for 38% of cases; followed by the 25–34-year-olds (34%). For the first time since 2010, the number of cases among women was higher than the number of cases among heterosexual men. Given the risk of reproductive tract complications, e.g. pelvic inflammatory disease or, if untreated, infertility, as well as possible transmission from mother to child, this trend among women is of particular concern.
Author Interviews, Ophthalmology / 28.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25610" align="alignleft" width="205"]Jeffrey R. Willis, MD, PhD University of California Davis Eye Center Sacramento, CA Dr. Jeffrey Willis[/caption] Jeffrey R. Willis, MD, PhD University of California Davis Eye Center Sacramento, CA MedicalResearch.com: What is the background for this study? What are the main findings? Response: The goal of this study was to understand how "Big Data" in ophthalmology could be utilized to assess the prevalence of rare diseases such as myopic choroidal neovascularization (mCNV). Prior to our study, there was limited knowledge on the burden of this devastating condition as previous estimates were done more than 20 years ago, had a small sample size, and were not generalizable to the current U.S. population. In order to address this knowledge gap, we realized the potential of two large datasets with ophthalmic information, including the National Health and Nutrition Examination Survey (NHANES) and the IRIS Registry. The former provides nationally representative data, but with limited ophthalmic disease information. The latter dataset, supported by the American Academy of Ophthalmology (AAO), is the nation's only comprehensive database of ophthalmic patient outcomes. By triangulating data from the these two data sources in conjunction with population estimates from the U.S. Census Bureau, we were able to calculate the mCNV prevalence in the United States. Specifically, we showed that mCNV is a rare condition, affecting about 41,000 adult Americans, with a higher burden on women than men. This study effectively showed that using "Big Data" in ophthalmology could help us better understand the epidemiology of rare ophthalmic conditions in the US.
Aging, Author Interviews, Dermatology / 28.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25605" align="alignleft" width="166"]Dr-Ava-Shamban.jpg Dr. Ava Shamban[/caption] Dr. Ava Shamban MD Assistant Clinical Professor of Dermatology UCLA-Geffen School of Medicine MedicalResearch.com Editor’s note: Dr. Ava Shamban, a dermatologist frequently featured on CBS’ The Doctors as the skin maven on ABC’s Extreme Makeover discusses the recent announcement of the 20th Global Anniversary of Restylane. MedicalResearch.com: Would you briefly explain what Restylane® is? What are the main indications for the Restylane® portfolio of products? Response: Restylane is a non-animal, stabilized hyaluronic acid (NASHA), a unique patented HA stabilization technology which contains pure hyaluronic. The Restylane family of products can be used to design individualized treatments with natural-looking results and long-lasting effects. With 190 scientific publications and 150 clinical studies, and more than 3,000 patients in clinical studies, the Restylane family of products are safe and effective products that have been FDA approved based on extensive clinical data. Restylane® is one of the world’s most studied wrinkle fillers and has been used in more than 65 countries worldwide in over 28 million treatments. The main indications for the Restylane portfolio products is to improve the overall appearance of the aging face. Whether you’re young or old, whether you have a fine line or wrinkle or a deeper fold there is a product in this portfolio that can improve the appearance of your face and reverse signs of aging.
Author Interviews, Education, Exercise - Fitness / 28.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25601" align="alignleft" width="157"]Peter Krustrup PhD Professor of Team Sport and Health Department of Nutrition, Exercise and Sports Copenhagen Centre for Team Sport and Health University of Copenhagen, Denmark Dr. Peter Krustrup[/caption] Peter Krustrup PhD Professor of Team Sport and Health Department of Nutrition, Exercise and Sports Copenhagen Centre for Team Sport and Health University of Copenhagen, Denmark Dr. Krustrup discusses ideas formulated in the Copenhagen Consensus Conference 2016: children, youth, and physical activity in schools and during leisure time. MedicalResearch.com: What is the background for this study? What are the main findings? Response: A desire to improve children’s and youth’s health, well-being and social inclusion motivated researchers at University of Copenhagen, Department of Nutrition, Exercise and Sports to gather 24 international top level researchers from a variety of academic disciplines at a consensus conference in Denmark on 4-7 April 2016. The aim of the Copenhagen Consensus Conference in 2016 was to reach an evidence-based consensus within the four themes: 1) Physical activity in children and youth: Fitness and health. 2) Physical activity in children and youth: Cognitive functioning 3) Physical activity in children and youth: Engagement, motivation and psychological well-being 4) Physical activity in children and youth: Social inclusion and physical activity implementation strategies.
Author Interviews, NYU/NYMC, Sleep Disorders / 27.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25590" align="alignleft" width="200"]Valerie Newsome, PhD, Postdoctoral fellow Department of Population Health, Division of Health and Behavior NYU Langone Medical Center Dr. Valerie Newsome[/caption] Valerie Newsome, PhD, Postdoctoral fellow Department of Population Health, Division of Health and Behavior NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although sleep duration has been related to a number of negative health outcomes, few studies have examined the relationship between place of birth and sleep duration. We examined data for 416,152 adult participants living in the United States between 2000-2013 who responded to the National Health Interview Survey (NHIS); associations were explored between healthy sleep duration (7-8hrs.), references to unhealthy sleep duration (8 hrs.) and place of birth. After adjusting for socio-demographic factors, health risks, and physician-diagnosed medical conditions, multivariate logistic regression revealed that respondents born in the Indian subcontinent were more likely to report healthy sleep duration, compared with US-born respondents (OR=1.86, 95% CI: 1.57-2.20, p < 0.001), while individuals born on the continent of Africa were least likely to report healthy sleep duration (OR= 0. 86, 95% CI: 0.73-1.02, p< 0.001). We also noted a trend suggesting that the longer immigrants reside in the U.S., the greater their likelihood to experience unhealthy sleep.
Author Interviews, Brain Cancer - Brain Tumors, Diabetes / 27.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25583" align="alignleft" width="133"]Dr. Judith Schwartzbaum PhD Associate professor of epidemiology Ohio State's Comprehensive Cancer Center Dr. Judith Schwartzbaum[/caption] Dr. Judith Schwartzbaum PhD Associate professor of epidemiology Ohio State's Comprehensive Cancer Center MedicalResearch.com: What is the background for this study? Response: Meningioma is a slow-growing brain tumor that is associated with obesity. To further understand this risk we examined records of blood sugar levels within approximately 15 years before tumor diagnosis comparing blood sugar levels of people who developed meningioma to those in people who did not. MedicalResearch.com:What are the main findings? Response: To our surprise we found that risk of this tumor was lower in people with high levels of blood sugar and diabetes.
Author Interviews, Frailty, Geriatrics, Nursing / 27.06.2016

MedicalResearch.com Interview with [caption id="attachment_25579" align="alignleft" width="144"]Oleg Zaslavsky PhD Assistant Professor at the department of Biobehavioral Nursing and Health System School of Nursing University of Washington Dr. Oleg Zaslavsky[/caption] Oleg Zaslavsky PhD Assistant Professor at the department of Biobehavioral Nursing and Health System School of Nursing University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: Frailty is a common, but serious medical condition among older adults. It is characterized by weight and muscle loss, fatigue, slow walking and low levels of physical activity. It’s important to accurately diagnose and treat frailty, especially because demographic trends show the percentage of U.S. adults age 65 years and older will increase 19% by 2030. Frailty is commonly assessed by the Cardiovascular Health Study (CHS) frailty phenotype, which includes a set of physical measurements for slowness, weakness, fatigue, low physical activity and body-weight loss. According to the CHS phenotype, individuals with three or more of these characteristics are at increased risk for falls, hip fractures, disability and mortality. Although the CHS phenotype is good for predicting adverse conditions, it requires direct measurement of physical performance. Refining the phenotype so it doesn’t involve physical measurements of patients in a doctor’s office has practical advantages for research and clinical purposes. For this study, University of Washington School of Nursing researchers worked with Fred Hutchinson Cancer Research Center faculty to refine the Women’s Health Initiative (WHI) frailty phenotype, originally developed in 2005. This new phenotype uses self-reporting from patients instead of measurements of physical performance to determine frailty and associated health outcomes. In this report, we show that our newly-proposed WHI measuring scheme performs as well as the more complex CHS phenotype in predicting death, hip fractures and falls in older women.
Author Interviews, BMJ, Immunotherapy, Johns Hopkins, Rheumatology / 27.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25574" align="alignleft" width="146"]Laura C. Cappelli, M.D Johns Hopkins University School of Medicine Dr. Laura Cappelli[/caption] Laura C. Cappelli, M.D Johns Hopkins University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: We had been referred several patients with inflammatory arthritis or dry mouth and dry eyes after being treated with immune checkpoint inhibitors. When searching the literature for information on how to evaluate and treat these patients, we realized that there was minimal information available. We wanted to describe our experience and inform the medical community about these events so that recognition could increase.
Author Interviews, Heart Disease, JAMA, Pharmacology, UCSF / 27.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25514" align="alignleft" width="126"]Dr. Gregory M. Marcus MD Associate Professor UCSF School of Medicine Dr. Gregory Marcus[/caption] Dr. Gregory M. Marcus MD Gregory M Marcus, MD, MAS, FACC, FAHA, FHRS Director of Clinical Research Division of Cardiology Endowed Professor of Atrial Fibrillation Research  University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Conduction system disease, or blockages in the electrically system (as opposed to blockages in the blood vessels, of which most are well-aware), is a common condition responsible for both heart failure in many patients as well as the need for pacemaker implantation. Although treatments for the disease are available, there are no known means to prevent it. This is important as the primary treatment, a pacemaker, can itself cause problems (including procedural complications, a long-term risk of infection with repeated battery changes, and even a greater risk of heart failure). In addition, predictors of what types of individuals are at risk for developing conduction disease has largely remained unknown. Based on the fact that the majority of conduction disease is due to fibrosis, or scarring, of the conduction system, we sought to test the hypothesis that a common drug for high blood pressure with anti-fibrotic properties, Lisinopril, might reduce the risk of new conduction system disease. We took advantage of the fact that more than 20,000 patients with hypertension were randomized to three common high blood pressure drugs that work via different mechanisms in the ALLHAT trial: Lisinopril, amlodipine, and chlorthalidone. We found that participants randomly assigned to Lisinopril were statistically significantly less likely to develop conduction disease. In addition, our analyses revealed several risk factors for the development of conduction disease: older age, male sex, diabetes, smoking, a thicker heart, and white race (compared to black race).
Author Interviews, Colon Cancer, Geriatrics, Kaiser Permanente, NIH / 27.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25554" align="alignleft" width="133"]Carrie N. Klabunde, PhD Office of Disease Prevention Office of the Director NIH Rockville MD Dr. Carrie Klabunde[/caption] Carrie N. Klabunde, PhD Office of Disease Prevention Office of the Director NIH Rockville MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many studies of colorectal cancer screening focus on adults 50-75 years of age; few specifically look at screening in the elderly. We wanted to examine colorectal cancer screening use, including follow-up diagnostic testing for those with abnormal fecal blood screening tests, in adults 65 years of age and older. We also wanted to assess whether screening use in this population is influenced more by elderly individual’s chronological age, or their health status (called comorbidity in our study). The study was conducted in three large, integrated healthcare systems: Kaiser Permanente in Northern California and Southern California, and Group Health in Washington state and Idaho. We examined data on nearly 850,000 patients aged 65-89.
Author Interviews, Diabetes, Diabetologia, OBGYNE, Pediatrics / 27.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25432" align="alignleft" width="200"]Lu Qi, MD, PhD, FAHA HCA Regents Distinguished Chair and Professor Director, Tulane University Obesity Research Center Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans, LA 70112 Dr. Lu Qi[/caption] Lu Qi, MD, PhD, FAHA HCA Regents Distinguished Chair and Professor Director, Tulane University Obesity Research Center Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans, LA 70112 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prenatal malnutrition and other stresses may cause small newborn babies, who are more likely develop type 2 diabetes and other chronic diseases during adulthood. However, whether such relation is causal remains to be determined. Genetic associations provide a new approach to provide evidence for such causality.
Author Interviews, Gender Differences, JAMA / 27.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25534" align="alignleft" width="150"]Gilbert Gonzales, PhD, MHA Assistant Professor Department of Health Policy Vanderbilt University School of Medicine Dr. Gilbert Gonzales[/caption] Gilbert Gonzales, PhD, MHA Assistant Professor Department of Health Policy Vanderbilt University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Using data from one of the largest, most representative health surveys, we found lesbian, gay and bisexual adults were more likely to report substantially higher rates of severe psychological distress, heavy drinking and smoking, and impaired physical health than straight adults.
Alcohol, Author Interviews, BMJ, Heart Disease / 26.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25514" align="alignleft" width="126"]Dr. Gregory M. Marcus MD Associate Professor UCSF School of Medicine Dr. Gregory Marcus[/caption] Gregory M Marcus, MD, MAS, FACC, FAHA, FHRS Director of Clinical Research Division of Cardiology Endowed Professor of Atrial Fibrillation Research University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: Multiple epidemiologic studies have demonstrated that alcohol consumption likely increases the risk for atrial fibrillation and reduces the risk for myocardial infarction. However, the results have been conflicting, they generally all rely on self-report of alcohol consumption (which is known to be unreliable, particularly in those that drink more heavily), and there is almost certainly confounding related to an individual’s choice to consume alcohol (which in most settings is ubiquitously available). In addition, the relationship between alcohol and heart failure remains poorly understood, with evidence suggesting there may be both harmful and beneficial effects. Finally, the relationship between alcohol consumption and these various cardiovascular diseases (atrial fibrillation, myocardial infarction, and heart failure) have not been examined within the same cohort of individuals in a simultaneous fashion.
Author Interviews, NEJM, OBGYNE, University Texas, Zika / 26.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25543" align="alignleft" width="129"]Abigail R.A. Aiken, MD, MPH, PhD Assistant Professor LBJ School of Public Affairs University of Texas at Austin Austin, TX, 78713 Dr. Abigail Aiken[/caption] Abigail R.A. Aiken, MD, MPH, PhD Assistant Professor LBJ School of Public Affairs University of Texas at Austin Austin, TX, 78713 MedicalResearch.com: What is the background for this study? Response: As Zika began to emerge as an epidemic in Latin America and its links with microcephaly began to be realized, we were aware that women in the region who were already pregnant or who would become pregnant would have a very limited set of reproductive options. Research and media attention about the possible biological effects of Zika in pregnancy began to appear rapidly. But much less attention was been paid to the impacts of Zika on women. We followed the responses of governments and health organizations and when they began to issue advisories warning women to avoid pregnancy, we knew it would be important to investigate the impacts of those advisories. A country-wide policy that is impossible to follow if you are pregnant or cannot avoid pregnancy is an unusual and important public issue. Accurate data on abortion are very difficult to obtain in Latin America because in most countries, abortion is highly restricted. We wanted to provide a window on the issue of how women were responding to the risks of Zika and its associated advisories, so we worked with Women on Web (WoW), an online non-profit telemedicine initiative that provides safe medical abortion to women in countries where safe, legal abortion is not universally available.
Author Interviews, Breast Cancer, Microbiome / 26.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25539" align="alignleft" width="123"]Gregor Reid, B.Sc. Hons., Ph.D., MBA, ARM, CCM, Dr. HS, FCAHS Director, Canadian Centre for Human Microbiome and Probiotic Research Lawson Health Research Institute London, Ontario, Canada Dr. Gregory Reid[/caption] Gregor Reid, B.Sc. Hons., Ph.D., MBA, ARM, CCM, Dr. HS, FCAHS Director, Canadian Centre for Human Microbiome and Probiotic Research Lawson Health Research Institute London, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Women who breast feed have reduced risk of breast cancer. Human milk has bacteria passed on to the child. These bacteria reach the breast through the nipple and from the gut via the blood. Lactobacilli and Bifidobacteria, beneficial bacteria, grow well in milk. So, I wondered what if women never lactate or breast feed, could bacteria be there? Could bacteria be in the tissue itself and influence whether you got or did not get cancer. Proving there are bacteria in the actual breast tissue itself was an interesting discovery defying previous beliefs.
Author Interviews, Bone Density, Endocrinology, Menopause, Mineral Metabolism, UCLA / 25.06.2016

MedicalResearch.com Interview with: Albert Shieh, MD Division of Endocrinology, Diabetes and Hypertension David Geffen School of Medicine University of California, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: Whether an individual loses or gains bone mass is dependent on how much bone is being broken down (by osteoclasts) and being formed (by osteoblasts). Both processes occur simultaneously in the human body. At present, we can measure markers of bone breakdown (resorption) and formation. However, we hypothesized that to better predict the amount of bone mass that will be lost in the future, these markers should be combined in an "index" to reflect both processes, rather than being interpreted in isolation. Indeed, we found that the ability of our new bone balance index predicted future bone loss across the menopause transition better than the bone resorption marker alone.
Author Interviews, Geriatrics / 25.06.2016

MedicalResearch.com Interview with: Dr-Jinmyoung-ChoJinmyoung Cho, PhD Assistant Investigator Center for Applied Health Research Baylor Scott & White Health Temple, TX 76508 Texas A&M Health Science Center College Station, Texas MedicalResearch.com: What is the background for this study? What are the main findings? Response: Early life-course transition experiences to the adult years result in continuing consequences for health in later life. Many veterans have encountered life-threatening environments while they were on military service leading to a higher incidence of physical and mental diseases; greater comorbidity profiles in veterans contribute to higher mortality rate compared to non-veterans. With increased life expectancy and demographic shifts in our population, the proportion of oldest-old adults, aged over 80 years, continues to increase. The publicly funded Veterans Health Administration (VHA) must care efficiently and effectively for its increasing population of veterans, who are older, sicker, and socioeconomically disadvantaged relative to non-veterans. Given the large number of veterans over age 80 and the increasing emphasis on managing the aging process, it is important to identify associations between healthcare utilization and survival for VHA’s oldest patients. We identified protective and risk factors associated with mortality by age group. During a 5-year follow-up period, 44% of patients aged 85 years and over died with survival rates of 59% for 80’s, 32% for 90’s and 15% for 100’s. In the multivariable model, protective effects for veterans 80-99 were female sex, minority race or ethnicity, being married, having certain physical and mental diagnoses (e.g., hypertension, cataract, dyslipidemia, posttraumatic stress disorder, bipolar disorder), urgent care visits, invasive surgery, and few (one to three) prescriptions. Risk factors were lower VHA priority status, physical and mental conditions (e.g., diabetes, anemia, congestive heart failure, dementia, anxiety, depression, smoking, substance abuse disorder), hospital admission, and nursing home care. For those in their 100s, married status, smoking, hospital admission, nursing home care, invasive surgery, and prescription use were significant risk factors; only emergency department (ED) use was protective.
Author Interviews, Genetic Research, Science, University Texas / 25.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25521" align="alignleft" width="200"]Jared Ellefson, PhD Postdoctoral fellow University of Texas Austin's Center for Systems and Synthetic Biology Dr. Jared Ellefson[/caption] Jared Ellefson, PhD Postdoctoral fellow University of Texas Austin's Center for Systems and Synthetic Biology MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reverse transcriptases (RT) have revolutionized the field of biology - enabling the conversion of RNA into DNA. This initially allowed the cloning of mature messenger RNA into cDNA libraries (e.g. cloning human genes), but has since been finding a more modern role in high throughput RNA-seq which can accurately depict the physiological status of a cell. Despite its critical role, an inherent flaw exists in all known reverse transcriptases. They make many errors while copying RNA - due to the lack of an error-checking (proofreading) domain. Consequently, the errors produced in reverse transcription are propagated into RNA sequencing potentially leading to corrupted data. The reason for the low fidelity of reverse transcriptases is due to their evolutionary heritage. All RTs are evolved from polymerase enzymes which lack the proofreading domain. This is in stark contrast to certain DNA polymerases which have extreme fidelity. The idea was, what if you could take a high fidelity DNA polymerase and transform it into a high fidelity RT. To do this we developed directed evolution techniques that would enrich these DNA polymerases for reverse transcriptase activity. After a monumental engineering effort, we were left with the world's first reverse transcriptase that could error-check during polymerization. We found that this increased the fidelity of RNA sequencing, in addition to a number of other interesting properties (for instance this single enzyme can do both reverse transcription and PCR).
Author Interviews, Infections, Pharmacology, Urinary Tract Infections / 25.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25517" align="alignleft" width="162"]Amanda Paschke, MD Director, Infectious Disease Clinical Research Merck Research Laboratories Dr. Amanda Paschke[/caption] Amanda Paschke, MD Director, Infectious Disease Clinical Research Merck Research Laboratories MedicalResearch.com: What is the background for this study? What are the main findings? Response: Relebactam is an investigational beta-lactamase inhibitor being developed as a fixed-dose combination with imipenem/cilastatin, which is a broad-spectrum antibiotic in the carbapenem class. In preclinical studies, this combination demonstrated antibacterial activity against a broad range of multidrug-resistant Gram-negative pathogens, including those producing extended-spectrum beta-lactamases such as Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae and AmpC-producing Pseudomonas aeruginosa. Many of the most concerning infections caused by “superbugs” are caused by Gram-negative bacteria. These bacteria have evolved to be resistant to commonly used antibacterials, and even to antibacterials used as “last resort” treatment, which is why finding ways to treat them has become urgent. The addition of relebactam to imipenem is designed to restore activity of imipenem against certain imipenem-resistant strains of Gram-negative bacteria known to cause serious infections among people who often have other underlying medical conditions, which complicates treatment. This was a Phase 2, multicenter, randomized, double-blind, non-inferiority study. The study looked at the use of relebactam plus imipenem versus imipenem alone for the treatment of adult patients with complicated urinary tract infections. The primary endpoint for the trial was microbiological response at the completion of IV study therapy. The study met its primary endpoint, demonstrating that the combination of relebactam with imipenem was as at least as effective as imipenem alone for the treatment of complicated urinary tract infections. The trial also demonstrated that the combination of relebactam plus imipenem is well-tolerated, with a safety profile similar to that of imipenem alone in this patient.
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, MRI, Surgical Research / 24.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25507" align="alignleft" width="120"]Eva C. Gombos, MD Assistant Professor, Radiology Harvard Medical School Brigham and Women’s Hospital Dr. Eva Gombos[/caption] Eva C. Gombos, MD Assistant Professor, Radiology Harvard Medical School Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? Response: Treatment of early stage breast cancer, breast-conserving therapy (BCT), which consists of lumpectomy followed by whole-breast irradiation, requires re-excision 20 %–40% of patients due to positive margins. Breast MR is the imaging modality with the highest sensitivity to detect breast cancer. However, patients who undergo breast MR imaging have not experienced reduced re-excision or improved survival rates. Our hypothesis is that supine (performed with patient lying on her back) MR imaging within the operating room can be used to plan the extent of resection, to detect residual tumor immediately after the first attempt at definitive surgery, and to provide feedback to the surgeon within the surgical suite. The aim of this study was to use intraoperative supine MR imaging to quantify breast tumor deformation and displacement secondary to the change in patient positioning from imaging (prone performed the patient lying on her stomach) to surgery (supine) and to evaluate the residual tumor immediately after BCT.
Author Interviews, NEJM, Occupational Health, Opiods / 24.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25503" align="alignleft" width="125"]Professor Ellen Meara, PhD Professor The Dartmouth Institute for Health Policy and Clinical Practice Prof. Ellen Meara[/caption] Professor Ellen Meara, PhD Professor The Dartmouth Institute for Health Policy and Clinical Practice MedicalResearch.com: What is the background for this study? Response: Responding to a fourfold rise in death rates, between 2006 and 2012, states collectively enacted 81 laws restricting prescribing and dispensing of prescription opioids. Jill Horwitz, PhD, JD, said “states hoped passing a range of laws might help. So they are enacting small fixes — forbidding patients from “doctor-shopping,” and requiring doctors to use tamper-resistant prescription forms. They are also implementing major efforts such as prescription drug monitoring programs (PDMPs) — online databases that allow law enforcement and clinicians to monitor prescriptions.”
Author Interviews, Weight Research / 24.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25499" align="alignleft" width="125"]Dr. Ir. Gerda Pot Universitair Docent Gezondheid en Leven| Assistant Professor Health and Life Faculteit Aard- en Levenswetenschappen | Faculty of Earth and Life Sciences Dr. Gerda Pot[/caption] Dr. Ir. Gerda Pot PhD Universitair Docent Gezondheid en Leven| Assistant Professor Health and Life Faculteit Aard- en Levenswetenschappen | Faculty of Earth and Life Sciences MedicalResearch.com: What is the background for this study? Response: I was inspired to start this work by my grandmother. She was a stickler for timekeeping of her meals and I wondered whether this was her secret for healthy aging. It seems common wisdom but surprisingly very little scientific evidence exist. Therefore we conducted this review to see all the studies out there before setting out doing our own research.
Author Interviews, Cancer, Cancer Research, Nutrition / 23.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25449" align="alignleft" width="180"]Lindsay Kohler MPH Mel and Enid Zuckerman College of Public Health Tucson, Arizona Lindsay Kohler[/caption] Lindsay Kohler MPH Mel and Enid Zuckerman College of Public Health Tucson, Arizona MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several studies have reported that following health promotion guidelines for diet, physical activity, and maintenance of a healthy body weight may reduce the risk of getting cancer or dying from cancer. We performed a systematic review to examine the associations between established cancer prevention guidelines for diet and physical activity and cancer outcomes. We found that adhering to cancer prevention guidelines set forth by the American Cancer Society or the World Cancer Research Fund/American Institute for Cancer Research consistently reduced the risk of overall cancer incidence and mortality (10-61%) in the studies included in this review. In addition, higher adherence to the guidelines consistently reduced the risk of breast, colorectal, and endometrial cancers. Adherence to a pattern of healthy behaviors may significantly reduce cancer incidence and mortality.
Author Interviews, Heart Disease, JACC, Surgical Research / 23.06.2016

MedicalResearch.com Interview with: Dr. Stefan Toggweiler, MD Heart Center, Luzerner Kantonsspital Lucerne, Switzerland MedicalResearch.com: What is the background for this study? Response: Transcatheter aortic valve replacement (TAVR) is increasingly used for the treatment of aortic stenosis in inoperable and high-risk patients. It is well known that TAVR is associated with acute and delayed occurrence of conduction disorders. Namely, delayed high-degree atrioventrcular block is a feared complication. Thus, patients are usually monitored by telemetry for a few days, but there is currently no consensus on the duration of telemetry. In this study, we evaluated how the postprocedural ECG determines the need for permanent pacemaker implantation in patients undergoing TAVR.
Author Interviews, Cancer Research, CT Scanning, Lymphoma, NEJM / 23.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25380" align="alignleft" width="150"]Peter Johnson MA, MD, FRCP Professor of Medical Oncology Cancer Research UK Centre Southampton General Hospital Southampton Prof. Peter Johnson[/caption] Peter Johnson MA, MD, FRCP Professor of Medical Oncology Cancer Research UK Centre Southampton General Hospital Southampton MedicalResearch.com: What is the background for this study? What are the main findings? Prof. Johnson: Based upon retrospective series looking at the ability of interim PET to predict the outcomes of treatment, we aimed to test the idea of modulating treatment in response to an early assessment of the response to ABVD: could we safely reduce the amount of treatment by omitting bleomycin in the group who had responded well? Although the risk of severe toxicity from bleomycin is generally low, for the small number of patients who experience it, it can be life-changing or even fatal. We also wanted to test whether it might be possible to reduce the use of consolidation radiotherapy by comparison to our previous trials, and this seems to have worked too: we used radiotherapy in less than 10% of patients in RATHL, as compared to around half in our previous trials. We have seen better survival figures than in our previous studies with less treatment overall, so it feels as though we are on the right track.
Author Interviews, Mental Health Research, Pediatrics, Telemedicine / 23.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25473" align="alignleft" width="135"]Mirna Becevic, PhD, MHA Assistant Research Professor University of Missouri - Department of Dermatology Missouri Telehealth Network Dr. Mima Becevic[/caption] Mirna Becevic, PhD, MHA Assistant Research Professor University of Missouri - Department of Dermatology Missouri Telehealth Network MedicalResearch.com: What is the background for this study? Response: Psychiatry is, by far, the biggest utilizer of telemedicine services on the Missouri Telehealth Network (MTN). MTN supports an average of 4000 tele-psychiatry appointments every month, and 10% of those are provided by the University of Missouri Department of Psychiatry. Since we are all aware of the ever-increasing demand for child and adolescent psychiatry, but also the stigma that goes along with it, we wanted to examine more closely the actual usage of those services at the University of Missouri.