AHA Journals, Author Interviews, Heart Disease, Sleep Disorders / 12.09.2015

Chan-Won Kim, M.D. Clinical Associate Professor Center for Cohort Studies Kangbuk Samsun Hospital Sungkyunkwan University School of Medicine Seoul, South KoreaMedicalResearch.com Interview with: Chan-Won Kim, M.D. Clinical Associate Professor Center for Cohort Studies Kangbuk Samsun Hospital Sungkyunkwan University School of Medicine Seoul, South Korea Medical Research: What is the background for this study? Dr. Chan-Won Kim: In modern society, inadequate sleep either in quantity or in quality is a common problem and widely recognized as a potential determinant of adverse health outcomes including cardiovascular health. Very long or very short duration of sleep are associated with an increased risk for clinical cardiovascular events such as coronary heart disease and strokes. In these previous studies, however, it was possible that extreme sleep duration or poor sleep quality was a consequence of previous co-morbidities such as depression and obesity, and it was still unclear if these co-morbidities were really responsible for the effects of sleep disturbances. Therefore, we evaluated the association of sleep duration and quality with early markers of subclinical arterial disease in asymptomatic apparently healthy men and women. Medical Research: What are the main findings? Dr. Chan-Won Kim:  In our study, we found that sleep duration had a U-shaped association with two early markers of vascular disease. Both short and long sleep duration were associated with a greater amount of calcification in the coronary arteries, a very good measure of subclinical atherosclerosis that predicts the risk of a heart attack. We also found a similar pattern of association with arterial stiffness, a marker of vascular aging. For both markers, we found the lowers risk in study participants who reported 7 hours of sleep. In addition, poor subjective sleep quality was also associated with these markers of vascular disease. Few studies had explored these associations before, and they were inconsistent partly because of small sample sizes. Our research also indicates that these associations were present irrespective of traditional risk factors such as hypertension, hypercholesterolemia, or diabetes. (more…)
Author Interviews, Diabetes, Heart Disease, Karolinski Institute, Kidney Disease / 12.09.2015

MedicalResearch.com Interview with: Dr. Daniel Hertzberg M.D., Ph.D. Student Department of Medicine, Solna Karolinska University Hospital Medical Research: What is the background for this study? Dr. Hertzberg: Acute Kidney Injury (AKI) is a common complication in patients undergoing cardiac surgery. It is associated with increased short and long-term mortality, myocardial infarction, heart failure and chronic kidney disease. Diabetes is often considered as a risk factor for AKI. However, when we searched the literature we did not find any studies which specifically studied diabetes as a risk factor for AKI. In addition, in observational studies, it is uncommon that diabetes is subtyped into type 1 or type 2 even though they have different etiologies and thus may have different impact on risk of adverse outcomes. Thus, we designed this study in order to study the association between the two subtypes of diabetes and risk of AKI. (more…)
Author Interviews, Cleveland Clinic, Flu - Influenza, Vaccine Studies / 11.09.2015

Dr. Glen Taksler, PhD Medicine Institute Cleveland Clinic Main CampusMedicalResearch.com Interview with: Dr. Glen Taksler, PhD Medicine Institute Cleveland Clinic Main Campus Medical Research: What is the background for this study? What are the main findings? Dr. Taksler: Although young, healthy adults who develop influenza are usually able to recover, they may spread the flu to other people in the community who have a higher risk of hospitalization or other serious complications. These higher-risk people have a limited ability to protect themselves from influenza, because flu vaccines are less effective in the elderly and in people with weakened immune systems. To better understand whether young, healthy adults could help the community-at-large by getting a flu vaccine, we looked at data on more than 3 million Medicare beneficiaries across 8 influenza seasons. We found that the elderly had 21% lower odds of developing influenza if they lived in areas where more nonelderly adults (people aged 18-64 years old) got a flu vaccine. Importantly, we found these benefits even in elderly adults who obtained an influenza vaccine, perhaps because flu vaccines are less effective in the elderly.  This means that elderly adults who were proactive to try to prevent influenza still benefited from communitywide vaccination. (more…)
Aging, Author Interviews, Genetic Research, Smoking, UCLA / 11.09.2015

Dr. Morgan Elyse Levine PhD Postdoctoral Fellow Department of Human Genetics University of California, Los Angeles MedicalResearch.com Interview with: Dr. Morgan Elyse Levine PhD Postdoctoral Fellow Department of Human Genetics University of California, Los Angeles Medical Research: What is the background for this study? What are the main findings? Dr. Levine: Studies using mice, worms, and flies have suggested that longevity may be linked to stress resistance. All of us are constantly encountering things that damage our cells and tissue and disrupt physiological functioning. Therefore, people who are genetically predisposed to better prevent or repair this damage may age slower. Smoking is one of the most damaging things someone can do to their health, yet some smokers are able to survive to extreme ages. This study looked at long-lived smokers to see if we could identify a "genetic signature". We generated a genetic risk score that was found to be associated with longevity both in smokers and non-smokers, and also appeared to be associated with cancer risk. (more…)
Author Interviews, Fertility, OBGYNE / 10.09.2015

Audrey J. Gaskins, Sc.D. Postdoctoral Fellow Department of Nutrition Harvard T.H. Chan School of Public Health Boston, MA 02115 MedicalResearch.com Interview with: Audrey J. Gaskins, Sc.D.  Postdoctoral Fellow Department  of Nutrition Harvard T.H. Chan School of Public Health Boston, MA 02115     Medical Research: What is the background for this study? What are the main findings? Dr. Gaskins: Infertility, defined as the inability to conceive after 12 months of unprotected intercourse, is a common reproductive disorder affecting ~15% of couples who attempt to become pregnant. Assisted reproductive technologies (ART), which include in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI), have become the main treatment modalities for couples facing infertility. Pre-conceptional folate and vitamin B12 have been linked to many beneficial early pregnancy outcomes among couples undergoing assisted reproductive technologies treatment in Europe but mixed results have been found in regards to clinical pregnancy and live birth rates. Therefore, we sought to investigate whether higher levels of serum folate and vitamin B12 could increase reproductive success in a cohort of women undergoing assisted reproductive technologies at an academic medial center in the United States. We found that high concentrations of folate and vitamin B12 in serum are associated with increased chance of live birth following assisted reproduction. Moreover, women with higher concentrations of both serum folate and vitamin B12 had the greatest likelihood of reproductive success. Analysis of intermediate endpoints suggests that folate and vitamin B12 may exert their favorable effects on pregnancy maintenance following implantation. (more…)
Author Interviews, HIV, PLoS / 10.09.2015

MedicalResearch.com Interview with: Augustine T. Choko MSc Malawi–Liverpool–Wellcome Trust Clinical Research Programme Blantyre, Malawi Medical Research: What is the background for this study? Response: Despite rapid scale up of HIV testing in the sub Saharan African region, half of people living with HIV are unware of their status. We investigated a novel approach of HIV self testing as an additional strategy to existing HIV testing options. Medical Research: What are the main findings? Response: Population uptake of HIV self testing was high at the first offer and remained high at the second offer 12 months later. The approach saw high numbers of adolescents and men testing. Community participants with 8% illiterate were able to do the test and correctly interpret it on their own with minimal training. People who self-tested positive were able to link into the clinic for antiretroviral therapy eligibility assessment. (more…)
Author Interviews, Opiods, Pain Research / 10.09.2015

Lynn Webster, M.D. Vice President of Scientific Affairs PRA Health Sciences (lead study investigator, and former President of the American Academy of Pain Medicine) photo: WikipediaMedicalResearch.com Interview with: Lynn Webster, M.D. Vice President of Scientific Affairs PRA Health Sciences (lead study investigator, and former President of the American Academy of Pain Medicine) Medical Research: What is the background for this study? What are the main advantages of the buccal film? Dr. Webster: Because of its partial agonist activity and high affinity for mu-opioid receptors, buprenorphine has the potential to precipitate withdrawal in patients who are already on mu-opioid full agonists.  As a result, the current practice is to taper patients who are on around-the-clock (ATC) opioid therapy to a morphine sulfate equivalent (MSE) dose before switching to buprenorphine.  But tapering can result in a loss of pain control for patients.  For this study, we wanted to determine if patients on around-the-clock opioid full agonist therapy could be safely transitioned to buprenorphine HCl buccal film – an opioid partial agonist administered through the buccal mucosa – without the need for an opioid taper, and without inducing opioid withdrawal or sacrificing pain control.  Buprenorphine HCl buccal film is the first pain product in development to combine the efficacy of buprenorphine with this unique delivery system, which allows for efficient and convenient delivery of buprenorphine into the bloodstream. (more…)
Author Interviews, Education, MRI, Pediatrics / 10.09.2015

Henrik Ullman, MD, PhD Candidate Department of Neuroscience Karolinska Institutet Stockholm, Sweden MedicalResearch.com Interview with: Henrik Ullman, MD, PhD Candidate Department of Neuroscience Karolinska Institutet Stockholm, Sweden Megan Spencer-Smith, PhD School of Psychological Sciences Monash University Melbourne, AustraliaMegan Spencer-Smith, PhD School of Psychological Sciences Monash University Melbourne, Australia     Medical Research: What is the background for this study? What are the main findings? Response: Infants born preterm are at risk for school-age cognitive and academic impairments. While some will suffer severe impairments, many more will experience mild impairments, and it is these children who might not raise sufficient concern for referral and intervention. Identifying early markers and methods for classifying preterm infants at risk for school-age impairments, many years before difficulties emerge, would provide important information for clinicians in advising families regarding intervention and ongoing monitoring. Brain alterations are common in preterm populations. Any brain alterations associated with school-age impairments are likely already present in the neonatal period but are not detected with the current standard clinical and radiological evaluations. In this study we wanted to see how well we could use advanced analysis of volumetric and diffusion MRI collected in the neonatal period from 224 very preterm children to predict cognitive functions at five and seven years of age. We used statistical models to look for localised regions as well as machine learning methods to correlate patterns in the neonatal MRI data that could predict school-age outcomes. We found that localised volumes in the insula and basal ganglia as well as a distributed patterns of diffusion MRI could predict working memory and early mathematical skills even after co-varying for important perinatal clinical factors. It has previously been shown that quantitative and pattern analysis can catch subtle patterns in MRI data not easily detected by eye and may predict cognitive development. The current study builds further on these results showing clinically relevant predictions in preterm children. (more…)
Author Interviews, CDC, Heart Disease / 10.09.2015

Dr. Quanhe Yang PHD Epidemiologist CDC’s Division for Heart Disease and Stroke PreventionMedicalResearch.com Interview with: Dr. Quanhe Yang PHD Epidemiologist CDC’s Division for Heart Disease and Stroke Prevention Medical Research: What is the background for this study? What are the main findings? Dr. Yang:  One in every three Americans dies of cardiovascular disease. For both men and women, it is the number one cause of death. Heart age is the predicted age of a person’s vascular system based on his or her cardiovascular risk factor profile. The concept was created as a way to more effectively illustrate an individual’s future risk of developing or dying from a heart attack or stroke. Using information from the Framingham Heart Study and data collected from every U.S. state, this study is the first to provide population-level estimates of heart age and to highlight disparities in heart age nationwide. Our research found one in two U.S. men and two in five U.S. women have a heart age that is five or more years older than their chronological age, a sign they are at higher risk for heart attacks and stroke. In all, we found nearly 69 million adults between the ages of 30 and 74 have a heart age five or more years older than their actual age. That’s about the number of people living in the 130 largest U.S. cities combined. In addition, there are variations in heart age based on gender, race/ethnicity, region and other demographics. The good news is, heart age can be lowered through lifestyle changes or appropriate medication. U.S. adults both young and old can use this information to take charge of their own heart health and take immediate steps to prevent future heart attacks or strokes. (more…)
Accidents & Violence, Author Interviews, JAMA / 10.09.2015

Antti Latvala PhD Post-doctoral researcher Department of Public Health, University of Helsinki Helsinki, Finland MedicalResearch.com Interview with: Antti Latvala PhD Post-doctoral researcher Department of Public Health, University of Helsinki Helsinki, Finland   Medical Research: What is the background for this study? Dr. Latvala: Motivation for the study came from the fact that antisocial and aggressive behavior has been associated with lower resting heart rate in children and adolescents. Heart rate, being regulated by the autonomic nervous system, has been viewed as an indicator of stress responding or autonomic arousal, and the association has been hypothesized to indicate low levels of stress or a chronically low level of autonomic arousal in antisocial individuals. However, empirical evidence for such an association in adulthood has been very limited. Medical Research: What are the main findings? Dr. Latvala: We found that men with lower resting heart rate had an increased risk of violent and nonviolent criminality. Specifically, men in the lowest fifth of the heart rate distribution had an estimated 39% increased risk for violent criminality and a 25% increased risk for nonviolent crimes compared with men in the highest fifth. These are estimates after adjusting for physical, cardiovascular, cognitive and socioeconomic covariates. When we further adjusted for cardiorespiratory fitness, which was available in a subsample, the associations were even stronger. In addition to the crime outcomes, we found that low resting heart rate predicted exposure to assaults and accidents, such as traffic crashes, falls and poisonings, in a very similar fashion. (more…)
Author Interviews, Mental Health Research, Sexual Health / 10.09.2015

Emmanuele A. Jannini, MD Chair of Endocrinology and Medical Sexology Department of Systems Medicine Tor Vergata University of Rome Roma, Italy.MedicalResearch.com Interview with: Emmanuele A. Jannini, MD Chair of Endocrinology and Medical Sexology Department of Systems Medicine Tor Vergata University of Rome Roma, Italy Medical Research: What is the background for this study? What are the main findings? Prof. Jannini: The background is due to the large experience of the researcher of my team, Dr. Giacomo Ciocca, on homophobia, a largely diffuse phenomenon in various forms. Although many social and cultural factors predispose to homophobic attitude, we have hypothesized that some psychological aspects of personality were in association with homophobia. Therefore, we found that psychoticism, a dysfunctional trait of thought, immature defense mechanisms, i.e., primitive responses to anxiety states, and a fearful model of relationship with other due to an insecure attachment style, could be considered risk factors for homophobic attitude. (more…)
Author Interviews, HIV, Lancet, Sexual Health / 10.09.2015

Prof-Sheena-McCormack.jpgMedicalResearch.com Interview with: Professor Sheena McCormack Clinical Epidemiology Medical Research Council Clinical Trials Unit University College London Medical Research: What is the background for this study? What are the main findings? Prof. McCormack: PROUD is the first study of pre-exposure prophylaxis (PrEP) to prevent HIV carried out in the UK. The results show that PrEP could play a major role in reducing the number of new infections among men who have sex with men who are at risk of catching HIV. Pre-exposure prophylaxis (PrEP) is a HIV prevention strategy that involves HIV-negative people taking some of the drugs we use for treatment of HIV to reduce the risk of becoming infected. The PROUD study (www.proud.mrc.ac.uk) looked at whether offering daily PrEP to men who have sex with men was an effective way to prevent HIV infection. The results show that pre-exposure prophylaxis is highly protective, reducing the risk of infection for this group by 86%. The drug used in the trial – the antiretroviral Truvada – was already known to reduce the incidence of HIV infection compared to placebo (a dummy pill).  The PROUD study was designed to see how good Truvada would be found as pre-exposure prophylaxis in a real world situation when participants knew they were taking an active drug.  It aimed to address outstanding questions such as whether taking PrEP would change sexual risk behaviour – for example increasing the number of partners they did not use condoms with and increasing the rate of other sexually transmitted infections (STIs) – and whether or not it would be cost-effective to make it available on the NHS. (more…)
Author Interviews, JAMA, Surgical Research, Urology / 10.09.2015

MedicalResearch.com Interview with: Blayne Welk MD Assistant Professor in the Division of Urology The University of Western OntarioBlayne Welk MD Assistant Professor in the Division of Urology The University of Western Ontario Medical Research: What is the background for this study? What are the main findings? Dr. Welk: Stress incontinence is a common problem among women. The most frequently used surgical treatment is a mesh-based midurethral sling. This procedure is commonly called a transvaginal sling, and is usually an outpatient procedure that takes about an hour in the operating room. However, there has been significant concern about some of the complications of this procedure, which include chronic pain, and mesh erosions into the urinary tract. This prompted the FDA and Health Canada to issue warnings regarding the use of transvaginal mesh, and numerous lawsuits have been launched against manufactures of transvaginal mesh products. This study by Dr Welk and colleagues identifies the long term rate of surgical treated complications among a group of almost 60,000 women who had mesh based incontinence procedures between 2002-2012. The rate of surgically treated complications at 1 year is 1.2%, however this increased to 3.3% after 10 years of followup. The FDA and Health Canada recommend that surgeons obtain training and experience in their chosen type of midurethral sling, and we demonstrated that patients of high volume surgeons (who frequently performed mesh based incontinence procedures) were 27% less likely to have one of these complications. (more…)
Addiction, Author Interviews, CMAJ, Mental Health Research / 09.09.2015

Dr. Evan Wood MD, PhD, ABIM, FRCPC, ABAM Diplomat Professor of Medicine, UBC Canada Research Chair in Inner City Medicine Co-Director, Urban Health Research Initiative Medical Director for Addiction Services, Vancouver Coastal Health Physician Program Director for Addiction, Providence Health CareMedicalResearch.com Interview with: Dr. Evan Wood MD, PhD, ABIM, FRCPC, ABAM Diplomat Professor of Medicine, UBC Canada Research Chair in Inner City Medicine Co-Director, Urban Health Research Initiative Medical Director for Addiction Services, Vancouver Coastal Health Physician Program Director for Addiction Providence Health Care  Medical Research: What is the background for this study? What are the main findings? Dr. Wood: Drugs with the potential to produce altered states of consciousness were once the focus of intensive study in the 1950s and 1960s. While promising, this field of research has been dormant for decades but is now re-emerging as an area of intensive investigation and showing real potential as a new therapeutic paradigm in addiction medicine and mental health. While in its infancy, this is expected to be an area of much study in the coming years. Medical Research: What should clinicians and patients take away from your report? Dr. Wood: Psychedelic medicine is in its infancy and not ready for implementation in clinical practice. Clinicians and the community of individuals suffering from addiction and other concerns will hopefully support this area of research so that critical information on impacts and safety can be gathered. (more…)
Author Interviews, Diabetes, JAMA / 09.09.2015

Dr. Andy Menke PhD Social & Scientific Systems Inc Silver Spring, MD 20910MedicalResearch.com Interview with: Dr. Andy Menke PhD Social & Scientific Systems Inc Silver Spring, MD 20910 Medical Research: What is the background for this study? What are the main findings? Dr. Menke: Previous studies have shown an increase in diabetes over time. We wanted to use the most recent data available to estimate the prevalence and trends in diabetes in the US population. We found that 14% of US adults had diabetes and the prevalence was higher in blacks, Hispanics, and Asians. About 1 in 3 people with diabetes were unaware that they had the condition and this was even higher in Asians and Hispanics where half were unaware that they had it. Also, among US adults, 1 in 3 people have prediabetes, which means that roughly half of all US adults have either diabetes or prediabetes. Between 1988-1994 and 2011-2012, diabetes prevalence increased by 25% among adults in the US population. The increase over time occurred in every age group, race group, and both genders. (more…)
Author Interviews, Exercise - Fitness, Heart Disease / 09.09.2015

Carl "Chip" Lavie MD, FACC FACP, FCCP Medical Director, Cardiac Rehabilitation and Prevention Director, Exercise Laboratories John Ochsner Heart and Vascular Institute Professor of Medicine Ochsner Clinical School-UQ School of Medicine Editor-in-Chief, Progress in Cardiovascular DiseasesMedicalResearch.com Interview with: Carl "Chip"  Lavie MD, FACC FACP, FCCP Medical  Director, Cardiac  Rehabilitation and Prevention Director, Exercise Laboratories John Ochsner Heart and Vascular Institute Professor of Medicine Ochsner Clinical  School-UQ School of Medicine Jefferson, LA Editor-in-Chief, Progress in Cardiovascular Diseases  Medical Research: What is the background for this study? What are the main findings? Dr. Lavie: My co-authors and I reviewed the published literature on the impact of running on chronic diseases and cardiovascular disease and all-cause mortality. Although we reviewed substantial running literature, the major 4 studies were from Dr. Paul Williams and 18 of his papers from the National Runners' and Walkers' Study, The National Aging Runners Study, 2 papers from the Copenhagen City Heart Study, and 2 reports from DC Lee and Steven Blair and one from the Aerobics Center Longitudinal Study. Medical Research: What should clinicians and patients take away from your report? Dr. Lavie: This data showed tremendous impact of running to  lower weight and prevent obesity, dyslipidemia,  hypertension, and type 2 diabetes mellitus. Runners also had less osteoarthritis, need for hip replacement, lower disability with aging, less benign prostatic hypertrophy, lower mortality from several cancers and lower stroke, but the most impressive impact was the large reductions in cardiovascular disease and all-cause mortality, particularly the dramatic impacts of quite low running doses. (more…)
Author Interviews, Mayo Clinic, Thyroid / 09.09.2015

Juan P. Brito Campana, MBBS Division of Diabetes, Endocrinology, Metabolism, and Nutrition, Department of Medicine Mayo Clinic , Rochester, MinnesotaMedicalResearch.com Interview with: Juan P. Brito Campana, MBBS Division of Diabetes, Endocrinology, Metabolism, and Nutrition, Department of Medicine Mayo Clinic , Rochester, Minnesota Medical Research: What is the background for this study? Dr. Brito: The occurrence of thyroid cancer is increasing faster than any other cancer in the United States. If this trend continues, thyroid cancer will become the third most frequent cancer in women in the next five years. Despite this increase, death related to thyroid cancer has not increased.  The reason is that the majority of the new cases of thyroid cancer are small papillary thyroid cancers. These cancers are the most benign variant of thyroid cancer and most patients diagnosed with this type of cancer never experience any symptoms or other negative effects. To better understand how these new cases of thyroid cancer are diagnosed we studied every case of thyroid cancer diagnosed in Olmsted, County, MN from 1935-2012. Medical Research: What are the main findings? Dr. Brito: We found that almost half the new cases of thyroid cancer were found among people who did not have any symptoms related to thyroid cancer. The most frequent reasons for identifying these patients presenting were review of thyroid tissue removed for benign conditions; incidental discovery during an imaging test ; and investigations of patients with symptoms or palpable nodules that were clearly not associated with thyroid cancer, but triggered the use of imaging tests of the neck. (more…)
Author Interviews, Infections / 09.09.2015

MedicalResearch.com Interview with: Yongjie Wang PhD College of Food Science and Technology Shanghai Ocean University Laboratory of Quality and Safety Risk Assessment for Aquatic Products on Storage & Preservation Ministry of Agriculture Shanghai China Medical Research: What is the background for this study? Dr Wang: Norovirus (NoVs) are recognized as the most important food-borne viruses. They cause acute gastroenteritis in humans and infect people of all ages across the world. In our previous study, we found that approximate 90% of human norovirus sequences were discovered in the coastal regions in China, which likely result from the consumption of NoV-contaminated oysters. Oysters are well recognized as the main vectors of environmentally transmitted noroviruses, and disease outbreaks linked to oyster consumption have been commonly observed. In order to gain a better understanding of how noroviruses are transmitted via oysters in the environment, we examined the genetic variants associated with oyster-related NoV outbreaks. Medical Research: What are the main findings? Dr Wang: A high degree of genetic diversity was observed for oyster-related noroviruses, and almost all the human norovirus genotypes were found in oyster-related norovirus sequences. These sequences were widely but unevenly distributed geographically, and most of them were detected in coastal regions. A higher frequency of GI strains was found in oyster-related than in human-related NoV sequences, while the yearly distributions of oyster-related sequences and human outbreak sequences were similar, indicating that oysters may act as a reservoir of noroviruses in the environment. (more…)
Author Interviews, Heart Disease, JACC, NYU / 08.09.2015

MedicalResearch.com Interview with: Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, The Leon H. Charney Division of Cardiology, Associate Professor of Medicine, New York University School of Medicine, New York, NY 10016.Dr.Sripal Bangalore MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, Associate Professor of Medicine, New York University School of Medicine, New York, NY 10016, Principal Investigator ISCHEMIA-CKD trial  Medical Research: What is the background for this study? What are the main findings? Dr. Bangalore: Patients with chronic kidney disease are at high risk of coronary artery disease. However, they are also at risk for worsening kidney function from revascularization procedures and have been routinely excluded from clinical trials of stenting vs bypass surgery. In this registry study of over 5900 patients with multivessel coronary artery disease who underwent bypass surgery or stenting using the latest generation drug eluting stent (everolimus eluting stent), we showed that there are trade off between both procedures. With bypass surgery there was increase in the risk of death, myocardial infarction and stroke in the short term (in-hospital/30-days). For PCI, there was long term risk of repeat revascularization and also increase in myocardial infarction in those who achieved incomplete revascularization. (more…)
Author Interviews, Infections, JAMA, OBGYNE / 08.09.2015

Dr. Martin N. Mwangi Researcher Division of Human Nutrition, Nutrition and Health over the lifecourse International Nutrition Unit Wageningen University The Netherlands MedicalResearch.com Interview with: Dr. Martin N. Mwangi Researcher Division of Human Nutrition, Nutrition and Health over the lifecourse International Nutrition Unit Wageningen University The Netherlands   Medical Research: What is the background for this study? Dr. Mwangi : Anemia in pregnancy is a moderate or severe health problem in more than 80 percent of countries worldwide, but particularly in Africa, where it affects 57 percent of pregnant women. Iron deficiency is the most common cause, but iron supplementation during pregnancy has uncertain health benefits. There is some evidence to suggest that iron supplementation may increase the risk of infectious diseases, including malaria. Our main objective was to measure the effect of antenatal iron supplementation on maternal Plasmodium infection risk, maternal iron status, and neonatal outcomes. We randomly assigned 470 pregnant Kenyan women living in a malaria endemic area to daily supplementation with 60 mg of iron (n = 237 women) or placebo (n = 233) until 1 month postpartum. All women received 5.7 mg iron/day through flour fortification during intervention and usual intermittent preventive treatment against malaria. Medical Research: What are the main findings? Dr. Mwangi : Overall, we found no effect of daily iron supplementation during pregnancy on risk of maternal Plasmodium infection. Iron supplementation resulted in an increased birth weight [5.3 ounces], gestational duration, and neonatal length; enhanced maternal and infant iron stores at 1 month after birth; and a decreased risk of low birth weight (by 58 percent) and prematurity. The effect on birth weight was influenced by initial maternal iron status. Correction of maternal iron deficiency led to an increase in birth weight by [8.4 ounces]. (more…)
Author Interviews, C. difficile, JAMA, UC Davis / 08.09.2015

Christopher R. Polage, M. D. Associate Professor of Pathology and Infectious Diseases University of California, Davis School of Medicine Medical Director, Microbiology Laboratory and SARC UC Davis Health System MedicalResearch.com Interview with: Christopher R. Polage, M. D. Associate Professor of Pathology and Infectious Diseases University of California, Davis School of Medicine Medical Director, Microbiology Laboratory and SARC UC Davis Health System   Medical Research: What is the background for this study? Dr. Polage: Clostridium difficile is a frequent cause of diarrhea and infection in U.S. hospitals but common diagnostic tests often disagree about which patients are infected or need treatment. We compared clinical symptoms and outcomes in hospitalized patients with different C. difficile test results to determine which type of test (molecular or PCR test versus toxin test) was the better predictor of need for treatment and disease. Medical Research: What are the main findings? Dr. Polage: Twice as many patients were positive by the molecular test versus the conventional toxin test. However, patients with a positive molecular test only had a shorter duration of symptoms than patients with toxins, and outcomes that were similar to patients withoutC. difficile by all test methods. Virtually all traditional complications of C. difficile infection occurred in patients with a positive toxin test; none occurred in patients with a positive molecular test only, despite little or no treatment. (more…)
Author Interviews, Cost of Health Care, JAMA / 08.09.2015

James C. Robinson PhD MPH Leonard D. Schaeffer Professor of Health Economics Director, Berkeley Center for Health Technology Head, Division of Health Policy & Management School of Public Health, University of California– Berkeley University Hall, Berkeley, CA MedicalResearch.com Interview with: James C. Robinson PhD MPH Leonard D. Schaeffer Professor of Health Economics Director, Berkeley Center for Health Technology Head, Division of Health Policy & Management School of Public Health, University of California– Berkeley University Hall, Berkeley, CA   Medical Research: What is the background for this study? What are the main findings? Dr. Robinson: Employers and insurers face wide variation in the prices of similar tests and procedures within the same local communities, resulting from the indifference to price on the part of well-insured patients.  They are raising deductibles to increase price sensitivity, but deductibles mostly target low-cost primary care services whereas their concerns often center on high-cost specialty and facility services.  Some are adopting reference pricing, which sets a maximum insurer contribution for a particular type of test or procedure and then requires consumers selecting more expensive options to pay the difference themselves.  The insurers contribution limit typically is set at the median or other midpoint in the market distribution of prices. We studied the implementation of reference pricing for colonoscopy, using data from the California Public Employees Retirement System (CalPERS) from 2009-13, with a control group from Blue Cross of California.  Our data include detailed claims from almost 300,000 colonoscopy procedures and patients.  We find that patients who must pay the extra fees themselves are much more likely to select cheaper ambulatory facilities for their colonoscopies, compared to consumers who do not face reference pricing.  This leads to lower prices being paid by the employer and significant savings.  Detailed analyses of gastroenterological and cardiovascular complications of the colonoscopy procedures found no adverse effect of reference pricing on quality. (more…)
Author Interviews, CHEST, Occupational Health, Pulmonary Disease / 08.09.2015

MedicalResearch.com Interview with: Metin Akgun, MD, FCCP Department of Pulmonary Medicine Atatürk University, Faculty of Medicine Erzurum, Turkey Medical Research: What is the background for this study? What are the main findings? Dr. Akgun: The first cases of silicosis due to denim sandblasting were reported in 2005. In 2007, we evaluated 145 former male denim sandblasters who had an exposure history to at least 1 month with a latency period at least ten months; 77 (53%) were diagnosed as silicosis according to the profusion category of opacities of 1/0 or greater. In this study, we reported 4-year follow-up results of this cohort. Out of 83 sandblasters who were evaluated in this follow-up study, nine died and of the remaining 74, 96% had radiographic evidence of silicosis based on the same criteria and 66% had pulmonary function loss, which was defined as at least 12% or more decrease on FVC, predicted. (more…)
Author Interviews, Exercise - Fitness, Mental Health Research / 07.09.2015

MedicalResearch.com Interview with: Eric A.F. Herbst MSc Ph.D. student Human Health and Nutritional Sciences University of Guelph Guelph, ONEric A.F. Herbst MSc Ph.D. student Human Health and Nutritional Sciences University of Guelph Guelph, ON Medical Research: What is the background for this study? What are the main findings? Response: Many neurological diseases result in declines in mitochondrial content and function in the brain. Therefore, the purpose for this study was to determine if mitochondrial content could be enhanced in the brain through exercise, as previously demonstrated in skeletal muscle, and also to determine if similar exercise-signaling pathways are activated between the two tissues in the process. This study found that despite reproducing similar findings in skeletal muscle, acute and chronic exercise did not activate traditional signaling mechanisms (AMPK, ERK1/2, CAMKII, P38) in either the cortex or striatum of the brain, nor did it result in sustained increases in mitochondrial respiration, DNA copy number, or protein content. (more…)
Author Interviews, Frailty, Geriatrics, Nutrition / 07.09.2015

MedicalResearch.com Interview with: Dr. Alberto Lana Department of Medicine, Preventive Medicine and Public Health Area School of Medicine and Health Sciences University of Oviedo, Oviedo, Spain Medical Research: What is the background for this study? What are the main findings? Dr. Lana: Healthy diets are associated with lower risk of frailty among elderly, but we thought that knowing the role of particular foods is essential to establish prevention measures. Dairy products are substantial sources of proteins, vitamins, and minerals, especially for older adults. Thus, dairy products could theoretically reduce the incidence of frailty. But high milk consumption could also have deleterious effects because it adds saturated fatty acids to diet and could increases oxidative stress. So the advice regarding dairy consumption remains unclear. Medical Research: What should clinicians and patients take away from your report? Dr. Lana: According to our results, clinicians should recommend replacing whole-fat products with low-fat ones. Generally, patients should be educated to perform always healthy dietetic choices. (more…)
Author Interviews, Ophthalmology / 05.09.2015

Paul Miller PhD student The University of Queensland Australia MedicalResearch.com Interview with: Paul Miller PhD student The University of Queensland Australia Medical Research: What is the background for this study? What are the main findings? Response: All humans have a blind spot in each eye where the optic nerve, which sends signals to the brain, passes through the retina, the light sensitive layer in each eye. Where this happens you cannot detect light, so people are blind to images that project to this location. Behaviorally, people tend to report blindness for an area that is larger than physiology dictates. We found this curious, and thought it might be driven by people reporting blindness for regions that border the blind spot, where sensitivity is degraded, but not absent. If so, we thought that this could be improved by training. When we tested this theory, we found it was true - we were able to reduce the extent of functional blindness by about 10%. (more…)
Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, Geriatrics / 05.09.2015

Christine McGarrigle PhD Research Director The Irish Longitudinal Study on Ageing (TILDA) Lincoln Gate Trinity College Dublin Dublin MedicalResearch.com Interview with: Christine McGarrigle PhD Research Director The Irish Longitudinal Study on Ageing (TILDA) Lincoln Gate Trinity College Dublin Dublin   Medical Research: What is the background for this study? What are the main findings? Dr. McGarrigle: Mild cognitive impairment (MCI) is the intermediate state between healthy ageing and dementia and is a stage at which intervention could be effective in reducing conversion to dementia. Neurocardiovascular instability is an age-related dysregulation of the blood pressure systems manifesting as exaggerated blood pressure variability and orthostatic hypotension (OH). Previous evidence has shown that autonomic dysfunction, blood pressure variation and hypotension are associated with mild cognitive impairment. Our study found that systolic blood pressure variation was associated with cognitive decline. Mild cognitive impairment participants were more likely to have had OH and more prolonged OH compared to cognitively normal controls. Mild cognitive impairment participants with impaired orthostatic blood pressure responses were twice more likely to convert to dementia than mild cognitive impairment participants without the impaired response over a three year follow-up period. (more…)
Author Interviews, Breast Cancer, Genetic Research, UCSF / 04.09.2015

Dr. Elisa Long PhD Assistant professor UCLA Anderson School of ManagementMedicalResearch.com Interview with: Dr. Elisa Long PhD Assistant professor UCLA Anderson School of Management Medical Research: What is the background for this study? What are the main findings? Dr. Long: The study was motivated by my own diagnosis of triple-negative breast cancer last year, at the age of 33. I also learned that I carried a BRCA1 mutation, despite no family history. As a patient, I would have benefitted tremendously from a universal BRCA screening program, but as a health services researcher, I had to ask if indiscriminate screening of all women in the U.S.—where only 1 in 400 carry a mutation—is a good use of resources. Using a previously published decision analytic model, we calculated the cost-effectiveness of universal BRCA screening. We find that compared to screening based on family history, it is not cost-effective, assuming a test price of $2,000 to $4,000. However, as the price of genetic testing continues to fall, as indicated by the $249 test now offered by Color Genomics, universal BRCA screening becomes much more affordable. Additionally, population screening of Ashkenazi Jewish women—among whom 1 in 50 carry a BRCA mutation—is very cost-effective, because the chances of finding a carrier are much higher. (more…)
Anesthesiology, Author Interviews, Orthopedics, Surgical Research / 04.09.2015

Dr. Gregory M.T. Hare MD PhD Department of Anesthesia St. Michael's HospitaMedicalResearch.com Interview with: Dr. Gregory M.T. Hare MD PhD Department of Anesthesia St. Michael's Hospital Medical Research: What is the background for this study? What are the main findings? Dr. Hare: While many randomized trials had demonstrated that tranexamic acid (TXA therapy) was effective at reducing surgical blood loss and red blood cell transfusion in patients undergoing hip and knee replacement surgery, our hospital and many other centers in Ontario were not fully utilizing this therapy. Part of the reason was a concern about drug safety and potential side effects. While no serious adverse events had been reported using TXA, we set out to assess the impact of a protocol designed to ensure that we administered TXA (20 mg/kg iv preoperatively) to all eligible patients undergoing hip and knee replacement and determining the effect on our red blood cell transfusion rate and adverse effects including blood clot, stroke, heart attack, kidney injury and death. We excluded patients at high risk of any thrombotic complication. After implementing our protocol, we increased utilization of the drug from 46% to 95% of eligible patients. With this increase in TXA use, we observed a 40% reduction in red blood cell transfusion. The impact was greater in patients with pre-operative anemia, but was also effective in non-anemic patients. The threshold for transfusion was not different after initiating our protocol and patients were discharged with higher red blood cell counts. Length of hospital stay remained constant and the incidence of adverse events did not increase. (more…)
Author Interviews, Chemotherapy, Genetic Research, Melanoma / 04.09.2015

Rutao Cui M. D., Ph. D. Vice Chair, Professor, Department of Pharmacology and Experimental Therapeutic Associate Professor of Pharmacology and Dermatology, and Member The Cancer Center Director The Laboratory of Skin Cancer Therapeutics (LSCT) Boston UniversityMedicalResearch.com Interview with: Rutao Cui M. D., Ph. D.  Vice Chair, Professor Department of Pharmacology and Experimental Therapeutic Associate Professor of Pharmacology and Dermatology, and Member The Cancer Center Director The Laboratory of Skin Cancer Therapeutics (LSCT) Boston University Medical Research: What is the background for this study? What are the main findings? Dr. Cui: Recent studies have revealed that the APC/CCdh1 E3 ubiquitin ligase may function as a tumor suppressor. However, the tumor suppressor role of APC/CCdh1 in melanoma remains largely unclear. Here, we report sporadic mutations occurring in APC components, including Cdh1 in human melanoma samples and that loss of APC/CCdh1 may predispose human melanomagenesis. (more…)