Author Interviews, Cost of Health Care, Duke, JAMA, Radiation Therapy, Thyroid / 19.02.2015

Sanziana Roman MD FACS Professor of Surgery Duke University Section of Endocrine Surgery Director of the Endocrine Surgery Fellows and Scholars Program Duke University School of Medicine Chief, General Surgery and Associate Chief of Surgery for Clinical Affairs, DVAMCMedicalResearch.com Interview with: Sanziana Roman MD FACS Professor of Surgery Duke University Section of Endocrine Surgery Director of the Endocrine Surgery Fellows and Scholars Program Duke University School of Medicine Chief, General Surgery and Associate Chief of Surgery for Clinical Affairs, DVAMC Medical Research: What is the background for this study? Dr. Roman: Adjuvant radioactive iodine (RAI) is commonly used in the management of differentiated thyroid cancer. The main goals of adjuvant RAI therapy are to ablate remnant thyroid tissue in order to facilitate long-term follow-up of patients, decrease the risk of recurrence, or treat persistent and metastatic lesions. On the other hand, Adjuvant radioactive iodine ( therapy is expensive, with an average cost per patient ranging between $5,429.58 and $9,105.67. It also carries the burden of several potential complications, including loss of taste, nausea, stomatitis with ulcers, acute and/or chronic sialoadenitis, salivary duct obstruction, dental caries, tooth loss, epiphora, anemia, neutropenia, thrombocytopenia, acute radiation pneumonitis, pulmonary fibrosis, male infertility, and radiation-induced malignancies. Therefore, Adjuvant radioactive iodine ( should be used only for appropriately selected patients, for whom the benefits would outweigh the risks. Based on current guidelines, adjuvant RAI is not recommended for patients with papillary thyroid cancers confined to the thyroid gland when all foci are ≤1 cm (papillary thyroid microcarcinoma, or PTMC). Similarly, Adjuvant radioactive iodine ( does not have a role in the treatment of medullary and anaplastic thyroid cancer. Given the fact that variation in treatments exist, our goal was to analyze patterns of inappropriate adjuvant RAI use in the U.S. in order to identify potential misuses leading to an increase of costs for the healthcare system and unnecessary patients’ exposure to risks of complications. (more…)
Author Interviews, Breast Cancer, NEJM / 19.02.2015

  Swain_SandraMedicalResearch.com Interview with: Sandra M Swain, MD, FACP, FASCO Medical Director, Washington Cancer Institute MedStar Washington Hospital Center Washington DC 20010 MedicalResearch: What take-home message would you like the general public to understand about this new analysis from the Cleopatra study? Potential Key Message Options:
  • Updated results from the CLEOPATRA study showed that people treated with the combination of pertuzumab, trastuzumb and chemotherapy lived 15.7 months longer than those who received trastuzumab and chemotherapy alone (median survival of 56.5 months versus 40.8 months).
  • The survival improvement of nearly 16 months observed in CLEOPATRA is unprecedented among studies of metastatic breast cancer. This is the kind of survival improvement that those of us who treat breast cancer strive for, and this data will be incredibly meaningful to patients and their families.
  • Furthermore, the median survival of nearly five years observed in CLEOPATRA patients treated with the pertuzumab regimen is the longest ever observed in a clinical study of people with HER2-positive metastatic breast cancer, once one of the most aggressive forms of breast cancer.
  • Patients who responded with shrinkage of their tumor had a response that was 8 months longer with the pertuzumab regimen compared to the trastuzumab and chemotherapy regimen.
(more…)
Author Interviews, Genetic Research, UCSD / 18.02.2015

Dr. Rahul S. Desikan MD, PhD Department of Radiologoy University of California, San Diego School of MedicineMedicalResearch.com Interview with: Dr. Rahul S. Desikan MD, PhD Department of Radiologoy University of California, San Diego School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Desikan: The MAPT gene encodes the tau protein, which plays an integral role in Alzheimer's disease (AD) neurodegeneration. Though a number of studies have investigated this issue, the role of the MAPT gene in Alzheimer's disease is still unclear. In contrast, a number of studies have found a robust association between MAPT and increased risk for other 'tauopathies' like Parkinson's disease (PD). In our study, rather than evaluating all possible genetic loci, we only assessed shared genetic variants between Alzheimer's disease and PD. By using this type of approach, we were able to increase our statistical power for gene discovery in Alzheimer's disease. We found genetic overlap between Alzheimer's disease and Parkinson's disease at a locus on chromosome 17 within the MAPT region. Our findings demonstrate that this MAPT associated locus increases risk for Alzheimer's disease, correlates with gene expression of MAPT and is associated with brain atrophy of the entorhinal cortex and hippocampus on longitudinal MRI scans. (more…)
Asthma, Author Interviews, OBGYNE, Smoking / 18.02.2015

Virender K. Rehan, MD LA BioMed Lead ResearcherMedicalResearch.com Interview with: Virender K. Rehan, MD LA BioMed Lead Researcher   Medical Research: What are the main findings? Dr. Rehan: A new study holds hope for reversing asthma caused by smoking during pregnancy. The study, published online by the American Journal of Physiology - Lung Cellular and Molecular Physiology, reported that a medication that stimulates certain proteins in the body reversed airway damage in disease models of asthma caused by prenatal exposure to nicotine. This is the first study to indicate that the damage caused by exposure to nicotine during pregnancy could actually be reversed. Earlier studies found this medication could prevent nicotine-induced asthma when given during pregnancy. Researchers at Los Angeles Biomedical Research Institute (LA BioMed) conducted the study to determine if the lung and airway damage caused by nicotine could be reversed and found it could be. (more…)
Author Interviews, End of Life Care / 18.02.2015

Eva E. Bolt MD Physician researcher Dept. Public and Occupational Health EMGO+ Institute for Health and Care Research (VU University Medical Center) Medical Faculty Amsterdam, The NetherlandsMedicalResearch.com Interview with: Eva E. Bolt MD Physician researcher Dept. Public and Occupational Health EMGO+ Institute for Health and Care Research (VU University Medical Center) Medical Faculty Amsterdam, The Netherlands Medical Research: What is the background for this study? What are the main findings? Dr. Bolt: Three-quarter of all Dutch physicians have ever been asked by a patient to perform euthanasia. Each request for euthanasia calls for careful deliberation. Firstly, the physician needs to judge whether euthanasia would be possible within the limits of the law. Above that, a physician needs to decide whether performing euthanasia is in line with his personal believes and values. This study shows that cause of suffering is an important factor in this decision. In the Netherlands, the euthanasia law gives physicians the possibility of performing euthanasia, if they adhere to strict rules. The euthanasia law is not restricted to certain diseases. However, this study shows that the attitude of physicians towards performing euthanasia varies by condition. Most Dutch physicians would consider granting a request for euthanasia in case of cancer (85%) or another severe physical disease (82%). In contrast, only four out of ten physicians would consider granting a request for euthanasia in case of early-stage dementia. One in three would consider it in case of advanced dementia or psychiatric disease, and one in four in case of a person who is tired of living without suffering from a severe disease. (more…)
Alcohol, Author Interviews, Personalized Medicine / 18.02.2015

Sean M. Murphy, Ph.D. Assistant Professor Department of Health Policy & Administration Washington State University MedicalResearch.com Interview with: Sean M. Murphy, Ph.D. Assistant Professor  Department of Health Policy & Administration Washington State University Medical Research: What is the background for this study? What are the main findings? Dr. Murphy: Professional healthcare advice regarding excessive alcohol consumption has been shown to reduce demand in a controlled setting. However, success in a clinical trial isn’t always indicative of an intervention’s effectiveness in everyday use. Studies testing the effect of provider advice on alcohol demand in a non-controlled environment are few, and have failed to control for non-moderate drinkers.  Therefore, it is possible that the estimated effect of professional-health advice primarily reflected moderate-drinkers’ responses. The distinction between moderate and non-moderate drinkers is an important one, as society bears a large cost for those who consume above-moderate quantities, while moderate drinkers have been shown to be relatively productive and healthy. Excise taxes may not be efficient given that they impose negative externalities on moderate drinkers, while excessive drinkers have been shown to be relatively unresponsive to price increases. We found that personalized information from a healthcare professional was negatively associated with reported alcohol consumption among both “risky” and “binge" drinkers. Moreover, we found that personalized drinking advice may have an impact on those who are reluctant to state that they were given such advice. (more…)
Author Interviews, Heart Disease, JAMA, Karolinski Institute / 18.02.2015

Karolina Szummer, MD, PhD Section of Cardiology, Department of Medicine Karolinska Institutet Karolinska University Hospital Stockholm, Sweden MedicalResearch.com Interview with: Karolina Szummer, MD, PhD Section of Cardiology, Department of Medicine Karolinska Institutet Karolinska University Hospital Stockholm, Sweden Please note: This work is comparing the anticoagulant fondaparinux with low-molecular-weight heparin (not heparin). Medical Research: What is the background for this study? What are the main findings? Dr. Szummer: Since the publication of the OASIS-5 trial in 2006, many hospitals chose to change their medical practice and start using fondaparinux instead of low-molecular-weight heparin in the treatment of myocardial infarctions. In this study from the nation-wide near-complete myocardial infarction registry we were able to follow how the use of fondaparinux instead of low-molecular-weight heparin translated in clinical life was associated to a reduction in bleeding events and death. It is a very satisfying study, that confirms that the randomized clinical trial results are transferred with improvements in outcome to the treated patients. (more…)
Author Interviews, BMJ, Sleep Disorders / 18.02.2015

Karen Thorpe PhD Professor, Developmental Psychology Program Leader, Early Education and Development Group Program leader, Sleep in Early Childhood Group School of Psychology and Counselling Queensland University of Technology Australia MedicalResearch.com Interview with: Karen Thorpe PhD Professor, Developmental Psychology Program Leader, Early Education and Development Group Program leader, Sleep in Early Childhood Group School of Psychology and Counseling Queensland University of Technology Australia MedicalResearch: What is the background for this study? Professor Thorpe: Sleep is undoubtedly important not only for how well we think, feel and behave in our daily lives but also for longer-term health. In childhood, the quantity and quality of night-time and 24 hour sleep have consistently been identified as predictor of health. For example, night sleep predicts weight status. These findings have led to the hypothesis that increasing quantity of sleep through promoting daytime sleep would benefit child health. We sought to look for evidence on the independent effects of daytime sleep on child health, learning and behavior to assess whether this hypothesis was supported. (more…)
Author Interviews, Toxin Research / 18.02.2015

Dr. Prashant Kumar PhD (Cantab), MTech, BEng, FHEA, FCPS, FCCT, CEng(IEI), MIEnvSc, MIAQM, MIAAPC Senior Lecturer in Wind Engineering Department of Civil and Environmental Engineering (C5) Faculty of Engineering and Physical Sciences University of Surrey, GuildfordMedicalResearch.com Interview with: Dr. Prashant Kumar PhD (Cantab), MTech, BEng, FHEA, FCPS, FCCT, CEng(IEI), MIEnvSc, MIAQM, MIAAPC Senior Lecturer in Wind Engineering Department of Civil and Environmental Engineering (C5) Faculty of Engineering and Physical Sciences University of Surrey, Guildford Medical Research: What is the background for this study? What are the main findings? Dr. Kumar: Pollution is disproportionately spread in urban areas due to scattered mobile and stationary sources. Exhaust emissions from vehicles are one of the major sources of air pollution in urban areas. When vehicles stop at red lights, they go through different driving cycles such as idling, acceleration and deceleration. At the same time, a number of other vehicles are also queuing at red lights, emitting further emissions – these emissions take more time to disperse, especially in built-up areas, and end up accumulating in the air at traffic lights. In our study, we found that because drivers were decelerating and stopping at lights, then revving up to move quickly when lights go green, peak particle concentration was 29 times higher than that during free flowing traffic conditions. We also found that while drivers spent just two per cent of their journey time passing through traffic intersections managed by lights, that short duration contributes to about 25 per cent of their total exposure to these harmful particles. (more…)
Author Interviews, Autism, Biomarkers / 17.02.2015

Alisa G. Woods, Ph.D., MSMedicalResearch.com Interview with: Alisa G. Woods, Ph.D., MS Assistant Professor Biochemistry & Proteomics Group Department of Chemistry & Biomolecular Science Clarkson University, Potsdam, NY, 13699 Medical Research: What is the background for this study? What are the main findings? Dr. Woods: Objective assessments for autism are greatly needed in order to understand autism cause and also to diagnose autism. Currently autism is diagnosed based on behavior, despite theories that autism may have a biological cause. We sought to develop a non-invasive biological test for autism, using saliva and mass spectrometry-based proteomics. We found nine statistically significant proteins that were elevated in the saliva of children with autism relative to typically developing controls and three proteins that were significantly decreased or absent. (more…)
Author Interviews, JAMA, Mayo Clinic, Smoking / 17.02.2015

Jon Ebbert, M.D. Associate director for research Mayo Clinic Nicotine Dependence CenterMedicalResearch.com Interview with: Jon Ebbert, M.D. Associate director for research Mayo Clinic Nicotine Dependence Center   Medical Research: What is the background for this study? What are the main findings? Dr. Ebbert: Some cigarette smokers prefer to reduce the number cigarettes that they smoke before quitting smoking completely. Previous studies have evaluated the use of nicotine replacement therapy and one smaller study looked at varenicline to help smokers quit through smoking reduction. We wanted to conduct a larger study with varenicline using a longer duration of treatment. We enrolled cigarette smokers who had no intention of quitting in the next month but who were willing to reduce the number of cigarettes they smoked while working toward a quit attempt in the next 3 months. (more…)
Author Interviews, Weight Research / 17.02.2015

Dr. med. Laurence Genton, FMH Médecine Interne Médecin adjointe agrégée, chargée de cours Nutrition Clinique Hôpitaux universitaires de Genève GenèveMedicalResearch.com Interview with: Dr. med. Laurence Genton, FMH Médecine Interne Médecin adjointe agrégée, chargée de cours Nutrition Clinique Hôpitaux universitaires de Genève Genève Medical Research: What is the background for this study? What are the main findings? Response: Several studies have shown that body mass index is linked to mortality through a U- or J-curve, i.e. that a low and maybe a high body mass index are related to a higher risk of mortality in elderly people. However, body mass index consists of fat mass and fat-free mass, and the former studies cannot differentiate the impact of these body compartments. However, this differentiation may be important to guide our public health care strategies. For instance, fat and fat-free mass can both be reduced by hypocaloric diet and endurance exercise, while fat-free mass can be increased with adequate calorie and protein intakes, resistance exercise and anabolic treatments. Thus, this study aimed at evaluating the impact of fat mass and fat-free mass on mortality. We found that body mass index and body composition did not predict mortality in older women. However, a high fat-free mass was associated with a lower risk of mortality in men, even when adjusting for body mass index. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease / 17.02.2015

Dr. Miranda ArmstrongMedicalResearch.com Interview with: Dr Miranda Armstrong M.Phil. Physical Activity Epidemiologist Cancer Epidemiology Unit University of Oxford Oxford, UK Medical Research: What is the background for this study? What are the main findings? Dr. Armstrong: Physical activity has generally been associated with reduced risk of heart disease. However, there is limited evidence on the associations between the frequency and durations of various activities with stroke and blood clots, especially in middle-aged women. This is a very large study of 1.1 million middle-aged women, which confirms the benefits of moderate activity for reducing the risk of heart disease and stroke. Further to this, it shows that benefits may be more wide ranging than previously thought as the risk of blood clots was also lower in women reporting moderate activity when compared to inactive women. We found little evidence to suggest that activity more frequent than a few times per week provided further benefits in relation to these diseases. (more…)
Annals Internal Medicine, Author Interviews, Infections / 17.02.2015

Robert M Centor, MD, MACP Chair ACP Board of Regents Regional Dean, UAB Huntsville Regional Medical Campus Huntsville, AL 35801 Professor, General Internal Medicine UAB Birmingham, AL 35294-3407MedicalResearch.com Interview with: Robert M Centor, MD, MACP Chair ACP Board of Regents Regional Dean, UAB Huntsville Regional Medical Campus Huntsville, AL 35801 Professor, General Internal Medicine UAB Birmingham, AL 35294-3407 Medical Research: What is the background for this study? What are the main findings? Dr. Centor: European researchers have shown that Fusobacterium necrophorum, an obligate gram-negative anaerobe, likely causes approximately 10% of young adult pharyngitis.  This same organism is the major cause of peritonsillar abscess in the age group (and this age group has the highest rate of peritonsillar abscess).  The organism also causes around 80% of the Lemierre Syndrome.  We knew of no US data evaluating the role of this bacteria as a cause of pharyngitis.  The European studies also did not report the signs and symptoms of Fusobacterium pharyngitis. (more…)
Author Interviews, Dermatology, JAMA, Melanoma / 17.02.2015

MedicalResearch.com Interview with: Caroline Watts| PhD Candidate Cancer Epidemiology and Services Research | Sydney School of Public Health The University of Sydney MedicalResearch: What is the background for this study? What are the main findings? Response: A clinic for people at high risk of melanoma was established at the Royal Prince Alfred Hospital, Sydney in 2006 to look at the impact of surveillance regime which included regular full body skin examination supported by dermoscopy and total body photography at 6 monthly intervals. If a suspicious lesion was identified, the lesion was either removed or sequential digital dermoscopy was performed and the patient returned in 3 months for review. This study aimed to estimate the costs associated with surveillance in this type of specilaised clinic. The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]) and mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710). Diagnosis of melanoma or non-melanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for skewed health system costs. (more…)
Author Interviews, MRSA, University of Pennsylvania / 17.02.2015

MedicalResearch.com Interview with: Valerie Cluzet, MD Hospital of the University of Pennsylvania Division of Infectious Diseases Philadelphia, PA 19104 MedicalResearch: What is the background for this study? What are the main findings? Dr. Cluzet: MRSA is a major cause of skin and soft tissue infection (SSTI) in the community and we know that colonization is an important risk factor for subsequent infection. Past studies have calculated duration of colonization based on colonization at hospital admission or focused on populations not representative of the typical community-dwelling patient. We wanted to identify the factors associated with duration of colonization in a typical patient that clinicians would see (i.e. adults and children presenting to ambulatory setting with a MRSA SSTI), so that the findings would be generalizable and relevant to their practice. In addition, there has been an increasing focus on the role of the household in transmission of MRSA, so wanted to specifically examine that in a longitudinal, systematic way. There are a few major points that emerged from our study. 1) The first is that the duration of colonization after treatment for a methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infection (SSTI) is relatively short, but there is a significant subset of patients (approximately 20%) who will have persistent colonization. 2) We also found that treatment of the MRSA SSTI with clindamycin was associated with shorter duration of colonization, an association we did not see with other MRSA-active agents. 3) Finally, this study highlights the potential role of MRSA colonization among household members as a contributing factor in duration of colonization in patients. (more…)
Author Interviews, Blood Pressure - Hypertension, BMJ, Brigham & Women's - Harvard / 17.02.2015

dr-alexander-turchinMedicalResearch.com Interview with: Dr. Alexander Turchin M.D.,M.S. Director of Informatics Research Division of Endocrinology, Brigham and Women’s Hospital Boston, MA Medical Research: What is the background for this study? What are the main findings? Dr. Turchin: Hypertension is the most common risk factor for cardiovascular events. High blood pressure increases the risk for stroke, myocardial infarction, heart failure and kidney failure. Treatment of high blood pressure reduces these risks. However, our understanding of optimal treatment of hypertension is incomplete. In particular, there is little information to guide clinicians on how quickly they should achieve blood pressure control in their patients. There have been no clinical trials focusing on this question. Current guidelines are sparse and are based only on expert opinion. Our study analyzed treatment of nearly 90,000 patients in primary care practices in the U.K. between 1986 and 2010. We found that patients whose blood pressure medications were adjusted within 1.4 months after systolic blood pressure reached over 150 mm Hg and whose blood pressure was re-assessed within 2.7 months after their treatment was adjusted had the lowest risk for acute cardiovascular events and death from any cause. (more…)
Author Interviews, JAMA, Sleep Disorders / 16.02.2015

David S. Black, Ph.D., M.P.H. Associate Professor of Preventive Medicine Keck School of Medicine of USC.MedicalResearch.com Interview with: David S. Black, Ph.D., M.P.H. Associate Professor of Preventive Medicine Keck School of Medicine of USC. Medical Research: What is the background for this study? What are the main findings? Dr. Black: Sleep disturbances pose a significant medical and public health concern for our nation’s aging population. An estimated 50% of people aged 55 years and older suffer from some form of sleep problem, including initiating and maintaining sleep. Sleep can be affected by a number of things. There are obvious factors like disturbances, dealing with insomnia or any form of aches and pains. But there is also one that many people have probably not considered. Traffic noise. Just like the factors listed previously, there is always a solution to a problem. There isn't anything that cannot be fixed. If you are someone that is having trouble sleeping due to the high level of traffic noises around your area, it may be best to look into a site like soundproofpanda.com to find a solution that can help reduce this issue and eventually provide you with a good's night sleep. Older adults report the highest prevalence of sleep problems compared to younger age groups when quantified by both self-report and biological assessment. Moderate sleep complaints in older adults are often associated with deficits in daytime functioning, including elevated levels of fatigue, disturbed mood such as depressive symptoms and reduced quality of life, and lead to the onset of clinical insomnia. Addressing moderate sleep complaints and sleep-related daytime dysfunction using community-accessible programs is a promising public health approach. Our main findings indicate that the mindfulness training program, which is available to the general community, resulted in improvement in sleep quality at post-intervention relative to a highly active and standardized sleep hygiene education program. Effect size for improvement in sleep quality was large (0.89) and of clinical relevance considering that effect sizes obtained from all types of behavioral interventions on self-reported sleep quality outcomes averages 0.76 in older adults. Meta-analyses comparing treatment modalities indicate that the mean effect size for self-reported sleep improvements resulting from pharmacotherapy (0.87) (i.e., benzodiazepines, benzodiazepine receptor agonists) and behavioral therapy (0.96) are of medium-to-large magnitude in mixed-age adult samples with primary insomnia. Thus, our observed changes are consistent with previous studies and are at the level of a minimally important difference for insomnia severity. The mindfulness program also yielded relative improvements on sleep-related daytime impairments of depression and fatigue symptoms that were of medium-to-large effect size. (more…)
Author Interviews, Gender Differences, Heart Disease, Psychological Science / 16.02.2015

Xiao Xu, PhD Assistant Professor Department of Obstetrics, Gynecology and Reproductive Sciences Yale University School of Medicine andMedicalResearch.com Interview with: Xiao Xu, PhD Assistant Professor Department of Obstetrics, Gynecology and Reproductive Sciences Yale University School of Medicine and Harold H. Hines, Jr. Professor of Medicine (Cardiology) and Professor of Faculty of Arts and Sciences, of Investigative Medicine and of Public Health (Health Policy); Co-Director, Clinical Scholars Program; Director, Yale-New Haven Hospital Center for Outcomes Research and Evaluation New Haven, CT 06510Harlan M Krumholz MD, SM Harold H. Hines, Jr. Professor of Medicine (Cardiology) and Professor of Faculty of Arts and Sciences, of Investigative Medicine and of Public Health (Health Policy);  Co-Director, Clinical Scholars Program;  Director, Yale-New Haven Hospital Center for Outcomes Research and Evaluation New Haven, CT 06510 Medical Research: What is the background for this study? What are the main findings? Response: Prior research of heart attack has mostly examined older patients, while few studies have focused on younger patients. Although we know that younger women differ from men and older patients in heart attack etiology and mortality, there is limited data on non-mortality outcomes of younger women and factors influencing their recovery. Mental stress is a particularly relevant factor for younger women as prior research showed higher stress in women than in men and an inverse association between age and stress. Therefore, in this study, we compared women and men 18-55 years old with heart attack and examined gender difference in mental stress and its potential role in explaining the worse recovery in women. We addressed these questions using data from the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) project, which is the largest prospective observational study of young and middle-aged women and men with heart attack and has comprehensive information on patients’ clinical and psychosocial characteristics. Our findings showed significantly higher stress in women than in men. Moreover, mental stress is associated with worse recovery in multiple health outcomes 1 month after heart attack, such as angina-specific and overall quality of life. The greater stress in women may partially contribute to their worse recovery. (more…)
Author Interviews, Diabetes, Hospital Readmissions / 16.02.2015

dr-syed-gillaniMedicalResearch.com Interview with: Dr Syed M R Gillani Diabetes Centre, New Cross Hospital, Wolverhampton, UK MedicalResearch: What is the background for this study? Dr. Gillani: NHS is facing the greatest challenge of its history in the form of A&E pressures and bed availabilities. Unplanned admissions are considered one of the key reasons. With an aging population, multiple co-morbidities and increasing pressures on social and primary care, we need to develop a proactive strategy to deal with this situation. It is a high priority agenda for the DOH. Initiatives such as “named GP for over 75” and “directly enhanced services to avoid unplanned admissions” have been rolled out by DOH in the last 2 years. In order to find an innovative way to assist in reduction of unplanned admissions, we decided to conduct an audit on all recurrent unplanned admissions with diabetes in the hospital over 12 months period. Its objective was to determine any unmet patient needs during an index admission to explore potential of changes in the service and to utilize available resources more effectively in an attempt to prevent next hospital admission for that patient. (more…)
AHA Journals, Author Interviews, Stroke, UCLA / 15.02.2015

Dr. May Nour MD PhD Neurology Fellow UCLA MedicalResearch.com Interview with: Dr. May Nour MD PhD Neurology Fellow UCLA Medical Research: What is the background for this study? What are the main findings? Dr. Nour: In October of 2014, results from the MR CLEAN trial were the first to demonstrate better functional outcomes in stroke patients as a result of endovascular therapy. Among patients whose stroke was caused by clot blocking a large vessel responsible for delivering blood to the vital tissue of the brain, the use of endovascular therapy, primarily utilizing second-generation clot retrieval devices, showed improved outcomes in most cases evaluated in combination with medical therapy, when compared to medical therapy alone. Currently, the standard of care involves delivery of intravenous tissue plasminogen activator (IV tPA) within a short time window (up to 3-4.5 hrs) with the intention of dissolving, rather than physically removing the clot as in the case of endovascular retrieval. (more…)
Author Interviews, Dermatology, Hand Washing, Occupational Health / 15.02.2015

MedicalResearch.com Interview with: Dr Jill Stocks PhD, Research Fellow Centre for Occupational and Environmental Health, Centre for Epidemiology; NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Centre for Primary Care Institute of Population Health, University of Manchester, UK. Medical Research: What is the background for this study? What are the main findings? Dr. Stocks: Reducing healthcare-associated infections has been a priority in the UK over recent decades; and this has been reflected in interventions and guidelines focussing on improving hygiene procedures. During 2004 to 2008 the Cleanyourhands campaign promoted hand hygiene in all NHS trusts. There was anecdotal evidence from dermatologists and occupational physicians that irritant contact dermatitis was on the increase in healthcare workers, and that it was caused by hand hygiene. We investigated whether or not there was an increase in the incidence of irritant contact dermatitis in healthcare workers due to hand hygiene or other types of hygiene coinciding with the interventions and guidelines promoting hygiene. We used reports made by dermatologists to the Occupational and Health reporting network, a voluntary surveillance scheme collecting reports of work-related ill-health. Trends in incidence of irritant contact dermatitis due to hygiene in healthcare workers were compared with trends in control groups (irritant contact dermatitis in workers with other jobs) using a quasi-experimental (interrupted time series) design. We found a 4.5 fold increase in irritant contact dermatitis due to hand hygiene and hygiene in general in healthcare workers between 1996 and 2012. The results also suggested a steepening of the increase in incidence during the rollout period of the Cleanyourhands campaign but the limitations of the data made this less clear cut. (more…)
Author Interviews, Endocrinology, Sexual Health / 15.02.2015

Joshua D. Safer MD, FACP Director, Endocrinology Fellowship Training and Endocrinology Education Boston University Medical Center Associate Professor of Medicine and Molecular Medicine Boston University School of Medicine MedicalResearch.com Interview with: Joshua D. Safer MD, FACP Director, Endocrinology Fellowship Training and Endocrinology Education Boston University Medical Center Associate Professor of Medicine and Molecular Medicine Boston University School of Medicine   Medical Research: What is the background for this study? What are the main findings? Dr. Safer: This is a review of the current medical literature in favor of the biologic nature of gender identity.  The main barrier to medical care for transgender patients is lack of physicians with the knowledge and willingness to provide that care. A major concern of physicians is that this is a mental health issue, meaning that transgender hormone therapy and surgery may be too drastic a response to an individual who should be counseled instead.  The review lays out the evidence to make it clear that a major component of gender identity is biologic even if we don’t have the exact details worked out.  Therefore, counseling alone cannot address the disconnect between transgender individuals’ gender identity and their physical bodies. (more…)
Aging, Author Interviews, Inflammation / 15.02.2015

Dr. Jeremy Van Raamsdonk Laboratory of Aging and Neurodegenerative Disease (LAND), Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, Michigan, Department of Translational Science and Molecular Medicine, Department of Genetics, Michigan State University, East Lansing, Michigan, Department of Biology, McGill University, Montreal, Quebec, CanadaMedicalResearch.com Interview with: Dr. Jeremy Van Raamsdon PhD Laboratory of Aging and Neurodk egenerative Disease (LAND), Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, Michigan, Deptment of Translational Science and Molecular Medicine, Department of Genetics, Michigan State University, East Lansing, Michigan,Dep. of Biology, McGill University, Montreal, Quebec, Canada Medical Research: What is the background for this study? What are the main findings? Dr. Van Raamsdonk : The free radical theory of aging is one of the most widely accepted theories of aging. This theory suggests that reactive oxygen species (ROS), which are also known as free radicals, cause a type of damage, called oxidative damage, that accumulates over time to cause the functional decline associated with aging. ROS have also been proposed to play a role in many diseases including neurodegenerative disorders such as Parkinson’s disease and Huntington’s disease. However, recent work has demonstrated that ROS are not necessarily detrimental. ROS perform functional roles in the body and thus it is possible to have too little ROS. We previously showed that increasing ROS by decreasing the levels of an antioxidant enzyme called superoxide dismutase (SOD) does not decrease lifespan even when all of the SOD genes are removed. We also showed that in some cases treatment with an antioxidant, such as Vitamin C, can lead to decreased lifespan. This finding is consistent with human clinical trials in which it has not been possible to show a beneficial effect of antioxidants on longevity. In this paper we further examine the relationship between ROS and aging. We use a simple genetic model organism, the worm Caenorhabditis elegans, which has been used extensively in aging research, to determine how location impacts the effect of ROS on lifespan. We used a genetic approach to increase the levels of ROS in different parts of a cell and found that location is crucial in determining the effect of ROS on lifespan. Mildly increasing the levels of ROS in the mitochondria increases lifespan, while increasing ROS in the cytoplasm has the opposite effect of decreasing lifespan. (more…)
Author Interviews, Disability Research, Pediatrics, Race/Ethnic Diversity / 14.02.2015

MedicalResearch.com Interview with: Ying Wang, PhD, MPH Data Management, Analysis & Research Office of Primary Care and Health System Management New York State Department of Health Empire State Plaza  Albany, NY  12237 Medical Research: What is the background for this study? What are the main findings? Dr. Wang: The purpose of the study was to examine the survival of children with one or more of 21 major birth defects in the United States.  We used data from 12 population-based birth defects surveillance programs that participate in the National Birth Defects Prevention Network.  The study included nearly 100,000 infants born with birth defects between 1997 and 2007. We found that children who were born with hypoplastic left heart syndrome (a severe congenital heart defect) had the lowest chance of survival across multiple ages (up to 28 days of life, 1 year, 2 years, and 8 years of life), compared to children with any other birth defects studied.  We also found that the chances of survival up to 1 year of life was greater than 90% for babies born with spina bifida, cleft palate, cleft lip with or without cleft palate, pyloric stenosis, gastroschisis, or Down syndrome. For most birth defects, survival was poorer among non-Hispanic black mothers and Hispanic mothers compared to non-Hispanic white mothers. (more…)
Author Interviews / 14.02.2015

Michael D Hill, MD MSc FRCPC Calgary Stroke Program Professor, Dept Clinical Neurosciences Hotchkiss Brain Institute University of Calgary, Cumming School of Medicine Calgary, CanadaMedicalResearch.com Interview with: Michael D Hill, MD MSc FRCPC Calgary Stroke Program Professor, Dept Clinical Neurosciences Hotchkiss Brain Institute University of Calgary, Cumming School of Medicine Calgary, Canada Medical Research: What is the background for this study? What are the main findings? Dr. Hill: ESCAPE examine endovascular therapy for major acute ischemic stroke. The study found that among acute stroke patients with proximal occlusions (blocked ICA or MCA), good collaterals and fast endovascular treatment, there was a substantial reduction in morbidity (24% absolute reduction) and in mortality (a 9% absolute and 50% relative reduction in death). Medical Research: What should clinicians and patients take away from your report? Dr. Hill: The finding are a major and compelling validation of endovascular treatment of major ischemic stroke.  In combination with results from other studies - MRCLEAN, SWIFT-prime, EXTEND-IA, we believe that the standard of care for major acute ischemic stroke has been definitively changed. (more…)
Author Interviews, CDC, HIV, Sexual Health / 14.02.2015

MedicalResearch.com Interview with: Kristen Hess  ORISE Fellow Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention Atlanta, GA MedicalResearch: What is the background for this study? Response: Men who have sex with men (MSM) of all races continue to be the risk group most severely affected by HIV in the United States. CDC’s most recent HIV incidence data show that the number of new infections among MSM increased 12 percent between 2008 and 2010, with an even steeper increase among the youngest MSM. These data clearly show the urgent need to better understand the factors that affect their risk and to develop effective prevention interventions. One specific factor is excessive alcohol use, which is responsible for 88,000 deaths in this nation each year, and cost the U.S. about $224 billion in 2006. Binge drinking (consuming ≥5 drinks for men on an occasion; ≥4 drinks for women) is the most common form of excessive alcohol consumption. The association between excessive alcohol consumption, including binge drinking, and risky sexual behaviors among MSM has had mixed results in the literature with some studies finding an association and others not. One limitation of previous work is that the definition of excessive alcohol consumption varies between studies, so results are not easily compared between studies and populations. Our study examines the relationship between binge drinking and sexual risk behaviors among MSM who are current drinkers and who were either HIV-negative or unaware of their HIV status. MedicalResearch: What are the main findings? Response: We assessed the prevalence of binge drinking, using a standard definition, among a sample of MSM recruited from 20 cities across the U.S. We also examined the association between binge drinking and several risky sexual behaviors. The findings show that 6 in 10 MSM reported binge drinking. Those who binge drank, in comparison to non-binge drinkers, were more likely to engage in risky sexual behaviors such as sex with an HIV-positive or unknown status partner and exchange sex for money or drugs at last sex, as well as more likely to have concurrent partners and more condomless sex partners in the past year. We also found that the likelihood of risky sexual behaviors went up with increased frequency of binge drinking. In fact, MSM who reported 10 or more binge-drinking episodes in the past month were more likely to report risky behaviors. This is a critical point, especially given that, among those who binged, 22 percent reported 10 or more binge drinking episodes in the past month. (more…)
Author Interviews / 13.02.2015

MedicalResearch.com Interview with: Dr. rer. nat. Detlef Bartkowiak Klinik für Strahlentherapie und Radioonkologie Universitätsklinikum Ulm Albert-Einstein-Allee MedicalResearch: What is the background for this study? What are the main findings? Dr. Bartkowiak: After surgery of prostate cancer, the lab marker for prostate specific antigen PSA should fall below detection limits. If the PSA does not decline, this can be a due to residual normal prostate tissue but also due to tumor cells remaining in the patient. If it is tumor cells residing in or near the area of the resected prostate, then this can be treated locally with radiotherapy. If the tumor has already produced metastases at remote sites of the body, irradiating the prostate region is pointless. In our clinical trial into post-operative therapy options, patients who did not achieve an undetectable PSA after radical prostatectomy received additional radiotherapy with 66 Gy. Despite this immediate treatment, the risk of recurrence within 10 years was 37%. Therefore, a more aggressive early treatment should be considered in such patients. (more…)
Addiction, Author Interviews, Methamphetamine / 13.02.2015

MedicalResearch.com Interview with: Kyoon Lyoo, M.D., Ph.D Ewha W. University Seoul, South Korea MedicalResearch: What is the background for this study? What are the main findings? Dr. Lyoo: Recent studies increasingly suggested that the developing brain shows unique characteristics of neuroplasticity to environmental stimuli. Still, it remains unclear whether the adolescent brain would undergo adaptive or dysfunctional changes when exposed to highly neurotoxic substances including methamphetamine. However, despite an increasing prevalence of methamphetamine use in this population, human studies have not yet found clear answers to these questions regarding the effects of methamphetamine exposure on the adolescent brain. This study reports novel in vivo findings in adolescent methamphetamine users, and thus provides a new perspective regarding adolescent-specific brain correlates of methamphetamine-induced neurotoxicity. Using cortical thickness and diffusion tensor image analyses, we found greater and more widespread gray and white matter alterations, particularly affecting the frontostriatal system, in adolescent methamphetamine users compared with adult users. Our findings highlight that the adolescent brain, which undergoes active myelination and maturation, is much more vulnerable to methamphetamine-induced neurotoxicity than the adult brain. This may help explain why adolescent-onset methamphetamine users show more severe and chronic clinical course than adult-onset users. (more…)