Author Interviews, Education, JAMA / 22.07.2014

MedicalResearch.com Interview with: Brian M. Wong, MD, FRCPC Staff Physician, Division of General Internal Medicine Assistant Professor, Department of Medicine Director, Continuing Education & Quality Improvement Associate Director, Centre for Quality Improvement & Patient Safety (C-QuIPS) Sunnybrook Health Sciences Centre Lisa Richardson, MD., MA, FRCPC Department of Medicine, University of Toronto, Division of General Internal Medicine, University Health Network, HoPingKong Centre for Excellence in Education and Practice, University Health Network, Toronto, Ontario, Canada Medical Research: What are the main findings of the study? Answer: Our study sought to characterize how many clinically important issues that occur during the overnight on-call period were handed over and discussed by the on-call resident with the daytime medical team. For example, if a patient developed chest pain in the middle of the night and the on-call resident evaluated the patient, did the resident then 'handover' this issue to the team the next morning so that they could follow up and make sure that the patient receives timely care? In our study, we found that approximately 40% of these issues did not get handed over. This finding was consistent across 2 major Canadian academic teaching hospitals. (more…)
Author Interviews, Nutrition, Rheumatology / 22.07.2014

Yang Hu From the Division of Rheumatology, Immunology, and Allergy Brigham and Women's Hospital and Harvard Medical School Boston, MAMedicalResearch.com Interview with: Yang Hu From the Division of Rheumatology, Immunology, and Allergy Brigham and Women's Hospital and Harvard Medical School Boston, MA MedicalResearch.com: What are the main findings of the study? Answer: We find regular (≥ 1 serving/day) consumption of sugar-sweetened soda, but not diet soda, is associated with increased risk of seropositive rheumatoid arthritis in women, independent of other dietary and lifestyle factor. (more…)
Author Interviews, Heart Disease, OBGYNE / 22.07.2014

MedicalResearch.com Interview with: Donna Parker, Sc.D., FAHA Director of Community Health and Research Center for Primary Care and Prevention Memorial Hospital of RI Pawtucket, RI 02860 MedicalResearch: What are the main findings of the study? Answer: The main findings of the study are that women with a history of one or more miscarriages or one or more stillbirths appear to be at increased risk of cardiovascular disease. We found that the multivariable adjusted odds ratio for coronary heart disease for one or more stillbirths was 1.27 (95 percent CI, 1.07-1.51) compared with no stillbirth; for women with a history of one miscarriage, the odds ratio was 1.19 (95 percent CI, 1.08-1.32); and for women with a history of two or more miscarriages, the odds ratio was 1.18 (95 percent CI, 1.04-1.34) compared with no miscarriage. However, we did not find a significant association of ischemic stroke and pregnancy loss. The association between pregnancy loss and CHD appeared to be independent of hypertension, body mass index, waist-to-hip ratio and white blood cell count. (more…)
AHA Journals, Author Interviews, Gender Differences, Heart Disease, JACC, Yale / 22.07.2014

Aakriti Gupta, MD, MBBS Center for Outcomes Research and Evaluation Yale-New Haven Hospital, New Haven, ConnecticutMedicalResearch.com Interview with: Aakriti Gupta, MD, MBBS Center for Outcomes Research and Evaluation Yale-New Haven Hospital, New Haven, Connecticut Medical Research: What were the main findings? Dr. Gupta: Using a national database, we found that heart attack hospitalization rates for patients under the age of 55 have not declined in the past decade while their Medicare-age counterparts have seen a 20 percent drop. We also found that among younger patients below 55 years of age, women fare worse because they have longer hospital stays, and are more likely to die in the hospital after a heart attack. Young women were also more likely to have higher prevalence of co-existing medical conditions including diabetes, high blood pressure and higher cholesterol levels. Overall, all patient groups in the study saw increases in these conditions including diabetes and high blood pressure in the past decade. (more…)
Author Interviews, HIV / 22.07.2014

Dr. Nelli Westercamp PhD, MPH, MBA University of Illinois at Chicago School of Public Health Kenya, Epidemiology and Public HealthMedicalResearch.com Interview with: Dr. Nelli Westercamp PhD, MPH, MBA University of Illinois at Chicago School of Public Health Kenya, Epidemiology and Public Health Medical Research: What are the main findings of the study? Dr. Westercamp: The three clinical control trials in Kenya, Uganda and South Africa found that male circumcision reduces the risk of female to male transmission by up to 60%, prompting the endorsement of medical male circumcision as an HIV prevention intervention by the WHO and UNAIDS.  However, as medical male circumcision services for HIV prevention are being rolled out in the priority countries, questions remain whether the male circumcision promotion will actually translate into decreases in HIV infections. One factor that could reduce the effectiveness of male circumcision for HIV prevention at the population level is the behavioral risk compensation.  In other words, if men who become circumcised believe that they are fully protected against HIV and engage in higher sexual risk taking behaviors as a result of this belief, this could reduce or even negate the protective effect of male circumcision against HIV. To answer this question, we conducted a large prospective study concurrently with the scale up of male circumcision services in Western Kenya.  We recruited 1,588 men seeking circumcision services as well as 1,598 men who decided to remain uncircumcised  and assessed their sexual behaviors over 2 years, every 6 months.  We then compared the behaviors of circumcised men before and after circumcision and also the behaviors of circumcised and uncircumcised men over time. In the beginning of the study, we found that men choosing to become circumcised believed they were at higher risk of HIV than their uncircumcised counterparts. This perception of HIV risk declined significantly among the circumcised men after circumcision (from 30% at baseline to 14% at 24 months of follow up), while remaining relatively stable among the uncircumcised men (24% to 21%, respectively).  Looking at sexual risk behaviors, we saw that the overall level of sexual activity increased equally in both groups, mostly driven by the youngest age group (18-24 year old). However, despite the decrease in risk perception among circumcised men and the increase in sexual activity among all men, all other risky behaviors decreased in both groups and protective behaviors – such as condom use – increased, particularly among circumcised men. (more…)
Author Interviews, Flu - Influenza, Lancet / 22.07.2014

MedicalResearch.com Interview with: Prof. Jean-Francois Rossignol, FRSC, FRCPath Romark Laboratories, LC MedicalResearch: What are the main findings of the study? Prof. Rossignol: Nitazoxanide, a new orally administered drug in development for treating influenza, reduced the duration of symptoms of uncomplicated influenza compared to a placebo. The drug also reduced viral shedding. Side effects were similar for the drug and placebo treatment arms. The study was designed and conducted in compliance with FDA guidelines for studying new drugs for influenza. (more…)
Author Interviews, Clots - Coagulation, JAMA / 21.07.2014

Riyaz Bashir MD, FACC, RVT Associate Professor of Medicine Director, Vascular and Endovascular Medicine Department of Medicine Division of Cardiovascular Diseases Temple University Hospital Philadelphia, PA 19140MedicalResearch.com Interview with Riyaz Bashir MD, FACC, RVT Associate Professor of Medicine Director, Vascular and Endovascular Medicine Department of Medicine, Division of Cardiovascular Diseases Temple University Hospital Philadelphia, PA 19140 Medical Research: What is the background for this study? Dr. Bashir : Blood clots of legs called deep vein thrombosis (DVT) is a very common disease that occurs in about 1.0 person per 1000 population per year. This condition is responsible for more than 600,000 hospitalizations each year in the United States and approximately 6% of these patients will die within 1 month of the diagnosis. Amongst these patients 20% - to 50% will go on to develop chronic leg pains, swelling, heaviness, skin discoloration, and ulcers, in spite of conventional treatment with Blood thinning medications (anticoagulation) and compression stockings.This condition, which is called Post-thrombotic syndrome PTS markedly impairs the quality of life of these patients and is a significant economic burden (2.4 billion dollars and 200 million work days lost annually in US) on the society.In fact, many of these people lose their jobs because of the disability it causes. Several small studies have shown that early clot removal by minimally invasive catheter-based clot busting procedure called Catheter-directed thrombolysis (CDT) leads to a significant reduction in Post-thrombotic syndrome along with improvements in quality of life. Unfortunately, due to the small number of patients in these studies, we did not have any data about the safety of this treatment option. This has led to conflicting recommendations by various medical societies like the American College of Chest Physicians recommending against its use while the American Heart Association recommends Catheter-directed thrombolysis as first-line treatment for these patients. In light of these conflicting directives, we reviewed the frequency and safety of CDT versus conventional treatment in these patients with blood clots above the knees in the United States using Nationwide Inpatient Sample database from 2005 to 2010. (more…)
AHA Journals, Author Interviews, Heart Disease / 21.07.2014

Kanako K. Kumamaru, MD PhD Assistant Professor, Departments of Radiology Brigham and Women’s Hospital & Harvard Medical School Boston, MA 02446MedicalResearch.com Interview with: Kanako K. Kumamaru, MD PhD Assistant Professor, Departments of Radiology Brigham and Women’s Hospital & Harvard Medical School Boston, MA 02115 Medical Research: What are the main findings of the study? Dr. Kumamaru: When a patient does not have diabetes and had no or ≤25% coronary stenosis in his/her previous coronary CT angiography (CCTA) performed within 3 years, the probability of newly developed coronary artery disease (CAD) is very low, suggesting no repeat CCTA necessary, even if the clinical scenario suggested CCTA to be appropriate. Especially, when coronary arteries were completely normal at the prior scan, no patient underwent subsequent revascularization during the study period. (more…)
Author Interviews, Brigham & Women's - Harvard, HIV, JAMA, Weight Research / 21.07.2014

Steven Grinspoon, MD Professor of Medicine, Harvard Medical School Director, MGH Program in Nutritional Metabolism Co-Director, Nutrition Obesity Research Center at Harvard Massachusetts General Hospital Boston, MA 02114MedicalResearch.com Interview with Steven Grinspoon, MD Professor of Medicine, Harvard Medical School Director, MGH Program in Nutritional Metabolism Co-Director, Nutrition Obesity Research Center at Harvard Massachusetts General Hospital Boston, MA 02114 Medical Research: What are the main findings of the study? Dr. Grinspoon: The primary finding is that tesamorelin, a hypothalamic peptide that increases the endogenous pulsatile secretion of growth hormone, reduced liver fat in HIV-infected patients with increased visceral (abdominal) fat.  Increased visceral fat is very closely linked with increased liver fat in HIV patients, but the effects on liver fat were not known.  Our data show that tesamorelin reduces liver fat in conjunction with decreasing visceral fat, which may be clinically important for patients with HIV-infection who have both increased abdominal fat and fatty liver disease. In addition the study demonstrated that this treatment strategy was neutral to glucose by the end of the 6 month study. (more…)
Author Interviews, CDC / 21.07.2014

MedicalResearch.com: Interview withDr. Sonia Singh Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA Dr. Sonia Singh Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA Medical Research: What are the main findings of the study? Dr. Singh: While there is a great deal of information about the epidemiology of HIV among MSM (men who have sex with men), there is much less information about a subset of MSM who also have sex with women – MSMW.  In this article, CDC researchers examined HIV diagnoses among MSMW and MSM only (MSMO) from 2008 to 2011 to obtain a better understanding of the characteristics of men diagnosed with HIV who have ever had sex with both men and women.  Of all MSM diagnosed with HIV during 2011, 26% also had sex with women with women in the past.  From 2008 to 2011, HIV diagnoses among MSMW were relatively stable while there was an increase among young MSMO aged 13 to 29 years. (more…)
Author Interviews, Gender Differences, Heart Disease, Pharmacology / 21.07.2014

Lisa A. McDonnell Program Manager, Prevention & Wellness Centre, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.MedicalResearch.com Interview with: Lisa A. McDonnell Program Manager, Prevention & Wellness Centre, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Medical Research: What are the main findings of the study? Answer: The analysis focuses on a comparison of women’s perceptions of their heart disease knowledge and heart health risk with their self‐reported knowledge and heart health risk status. In summary, it gives insight into the Perceptions vs Reality when it comes to women and their heart health. Heart disease knowledge: For the purposes of measuring knowledge related to heart health, a scoring index was created on which women responding to the survey could score as low as 0 or as high as 40. The overall mean score among women in the survey was 15.0, which is fairly modest given the maximum of 40. In a comparison of actual and perceived heart disease knowledge, 80% of respondents with a low knowledge score perceived that they were moderately or well informed. The risk factors that Canadian women most commonly associate with heart disease are being overweight/having abdominal obesity (ov/ob), physical inactivity, smoking, and lacking fruits/vegetables. Smoking, diabetes and high blood pressure account for up to 53% of MI’s, followed by Ov/Ob, psychosocial factors, a lack of physical activity, and a lack of fruits/vegetables. The limited awareness of high blood pressure, high cholesterol and diabetes as key risk factors is particularly surprising, given that these are key determinants of heart disease. Low awareness of symptomology among women in our survey were noted when comparing the occurrence of symptoms versus their recognition of these symptoms as possibly being related to their heart. Only 4 in 10 women could name chest pain as a symptom of heart disease, and a smaller proportion could identify symptoms including dyspnea, radiating pain, or typical prodromal symptoms. Such shortcomings might contribute to the greater number of unrecognized myocardial infarctions in women than in men, not to mention inappropriate treatment of acute events and premature discharge from emergency care. (more…)
Author Interviews, CDC, HIV / 21.07.2014

Anna Satcher Johnson MPH Division of HIV/AIDS Prevention Centers for Disease Control and Prevention (CDC) Atlanta, GeorgiaMedicalResearch.com: Interview with: Anna Satcher Johnson MPH Division of HIV/AIDS Prevention Centers for Disease Control and Prevention (CDC) Atlanta, Georgia Medical Research: What are the main findings of the study? Answer: The new analysis confirms historical trends suggesting that we’ve made significant progress in reducing HIV in the U.S. over time – overall and among several key populations, including injection drug users and heterosexuals.  Overall, new HIV diagnoses from 2002 to 2011 declined 33 percent.  However, these findings underscore continued concerns of a surging HIV epidemic among young gay and bisexual men.  We found a significant increase in HIV diagnoses among young men who have sex with men between the ages of 13 and 24. (more…)
AHA Journals, Author Interviews, Heart Disease / 21.07.2014

MedicalResearch.com Interview with: Cheol Whan Lee and Seung-Jung Park Division of Cardiology, Asan Medical Center, University of Ulsan Seoul, Korea Medical Research: What are the main findings of the study? Answer: The time window of DES (drug-eluting stent) failure is widely variable from soon after DES implantation to several years after DES implantation. We observed patients with late DES failure are commonly presented with acute coronary syndrome. We hypothesized that temporal patterns of DES failure may be different, and analyzed all patients with first DES failure at our institution. We found that late drug-eluting stent failure is more likely to progress to acute myocardial infarction, aggressive angiographic patterns, and worse outcomes following retreatment. (more…)
Author Interviews, HIV, JAMA / 20.07.2014

Dr Peter MacPherson MBChB PhD Wellcome Trust Clinical Research Fellow Liverpool School of Tropical Medicine Department of Clinical Sciences Liverpool School of Tropical Medicine Pembroke Place, Liverpool L3 5QAMedicalResearch.com Interview with: Dr Peter MacPherson MBChB PhD Wellcome Trust Clinical Research Fellow Liverpool School of Tropical Medicine Department of Clinical Sciences Liverpool School of Tropical Medicine Pembroke Place, Liverpool L3 5QA Medical Research: What are the main findings of the study? Dr. MacPherson: In 2012, an estimated 35 million individuals were infected with the human immunodeficiency virus (HIV) worldwide. Antiretroviral therapy (ART) substantially reduces the risk of HIV transmission as well as greatly reducing illness and death, raising hopes that high uptake of annual HIV testing and early initiation of ART could improve HIV prevention as well as care. Achieving high coverage of HIV testing and treatment is a major challenge however, with low rates of HIV testing and poor linkage into HIV care. Self-testing for HIV infection (defined as individuals performing and interpreting their HIV test in private) is a novel approach that has seen high acceptance in Malawi and the United States, and is a process that could overcome barriers to conventional facility-based and community-based HIV testing, which lack privacy and convenience. However, no studies in high HIV prevalence settings have investigated linkage into HIV care after HIV self-testing. Among 16,6660 adults in Blantyre, Malawi offered HIV self-testing, optional home initiation of HIV care (including two-weeks of ART for those eligible) compared with standard HIV care resulted in a substantial and significant increase in the proportion of adults initiating antiretroviral therapy. HIV self-testing was also extremely popular, with 58% of the adult population self-testing with just 6-months. To our knowledge, this is the first study to investigate a comprehensive home-based HIV testing, eligibility assessment and treatment initiation strategy. (more…)
Author Interviews, Neurology, Stroke / 20.07.2014

Sang-Beom Jeon, MD, PhD From the Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul, Republic of Korea.MedicalResearch.com Interview with: Sang-Beom Jeon, MD, PhD From the Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul, Republic of Korea. Medical Research: What are the main findings of the study? Dr. Sang-Beom Jeon: In this MRI study of 825 stroke patients, we demonstrated that high plasma concentrations of homocysteine, also known as hyperhomocysteinemia, were associated with small-vessel disease (lacunar infarcts and leukoaraiosis) and large-vessel atherosclerosis of cerebral arteries. (more…)
Author Interviews, HIV, Lancet / 20.07.2014

Dr. Colette SmithMedicalResearch.com Interview with: Dr. Colette Smith: PhD Research Department of Infection and Population Health University College London, London, UK   Medical Research: What are the main findings of the study? Dr. Smith: We followed a group of approximately 45,000 HIV-positive people from Europe, USA and Australia between 1999 to 2011. We found that the death rate approximately halved over the 12-year study period. For every 1,000 people, around 18 died per year in 1999-2001, reducing to 9 deaths per year in 2009-2011. We also studied what people died of. We found that the death rate from AIDS and from liver disease decreased by around two-thirds. Deaths from heart disease approximately halved. However, the rate of cancer deaths (excluding cancers that are classified as AIDS events) remained constant over time. One in three deaths were caused by AIDS in 1999 to 2011, and this decreased to one in five deaths in the last two years of the study. However, even in recent years it was the joint most common cause of death. The proportion of deaths from cancer increased over time. One in ten deaths were from cancer in 1999 to 2001, and this increased to one in five deaths in 2009 to 2011. By the end of the study it was the joint-most common cause of death. (more…)
Author Interviews, HIV, JAMA, OBGYNE / 19.07.2014

Jared Baeten, MD PhD Professor, Departments of Global Health and Medicine Adjunct Professor, Department of Epidemiology University of Washington Seattle, WA 98104MedicalResearch.com Interview with: Jared Baeten, MD PhD Professor, Departments of Global Health and Medicine Adjunct Professor, Department of Epidemiology University of Washington Seattle, WA 98104 Medical Research: What are the main findings of the study? Dr. Baeten: Among heterosexual African couples in which the male was HIV positive and the female was not, receipt of antiretroviral pre-exposure preventive (PrEP) therapy did not result in significant differences in pregnancy incidence, birth outcomes, and infant growth compared to females who received placebo. (more…)
Author Interviews, Rheumatology / 19.07.2014

Ling Zhao Ph. D. Associate Professor College of Acupuncture-Tuina, Shanghai University of Traditional Chinese Medicine, ChinaMedicalResearch.com Interview with: Ling Zhao Ph. D. Associate Professor College of Acupuncture-Tuina, Shanghai University of Traditional Chinese Medicine, China Medical Research: What are the main findings of the study? Dr. Zhao: In our study, we found that a 6-week course of moxibustion treatment (i.e., a modality of traditional acupuncture using burning moxa to warm and stimulate the acupoint) significantly reduced pain and improved function in patients with knee osteoarthritis compared to a credible placebo control. Our findings suggest that this ancient modality might be a useful adjunctive treatment for knee osteoarthritis. We also found that our sham device is credible for a double-blind randomized clinical trial assessing this traditional treatment modality. (more…)
Anemia, Author Interviews, Kidney Disease / 18.07.2014

MedicalResearch.com Interview with: Dennis J. Cotter President Medical Technology and Practice Patterns Institute, Inc. Bethesda, MD 20816 Medical Research: What are the main findings of the study? Answer: This is the first study to document anemia management practice patterns among predialysis CKD patients before and after publication of TREAT. Using a retrospective observational design based on a large US health plan database with over 1.2 million claims for predialysis CKD stage 3 and 4 patients, we report 4 main study findings. 1) For CKD stage 3 patients, the proportion prescribed ESA therapy declined from 17% pre-TREAT to 11% post-TREAT (a 38% decline) and for CKD stage 4 patients, from 34% to 27% (a 22% decline). 2) Prescribing of ESA therapy was declining even before TREAT, but the decline accelerated in the post-TREAT period. 3) ESA prescribing declined after TREAT regardless of anemia status; among patients with hemoglobin <10 g/dL, only 25% of stage 3 and 33% of stage 4 CKD were prescribed ESAs two years after TREAT, a notable 50% decline. 4) After adjusting for all covariates, the probability of prescribing ESAs was 35% less during a two year period after vs. before TREAT publication. (more…)
Author Interviews, Infections / 18.07.2014

MedicalResearch.com Interview with: Dr Joshua Thaden MD, PhD Duke University Division of Infectious Diseases Durham, North Carolina Medical Research: What are the main findings of the study? Dr. Thaden: The primary findings of the study are that
  • The rate of detection of particularly antibiotic resistant bacteria -- the carbapenem-resistant Enterobacteriaceae (CRE) -- has increased 5-fold in a set of community hospitals in the southeastern United States, and that
  • This increase is due to both changes in how we detect CRE and in increased endemicity (i.e., there are just more CRE around).
(more…)
Author Interviews, Exercise - Fitness, Frailty, Geriatrics / 18.07.2014

Dr. Wenjun Li , PhD Health Statistics and Geography Lab Division of Preventive and Behavioral Medicine University of Massachusetts Medical School, Worcester.MedicalResearch.com: Interview with: Dr. Wenjun Li , PhD Health Statistics and Geography Lab Division of Preventive and Behavioral Medicine University of Massachusetts Medical School, Worcester. Medical Research: What are the main findings of the study? Dr. Wenjun Li: Compared to those walking for recreational purposes only, older adults walking for utilitarian purposes had higher risk for outdoor falls and fall-related injuries that require medical attention. (more…)
Author Interviews, Karolinski Institute, Red Meat / 18.07.2014

Andrea Bellavia From the Unit of Nutritional Epidemiology and the Unit of Biostatistics Institute of Environmental Medicine Karolinska Institutet, Stockholm, SwedenMedicalResearch.com Interview with: Andrea Bellavia From the Unit of Nutritional Epidemiology and the Unit of Biostatistics Institute of Environmental Medicine Karolinska Institutet, Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Bellavia: By evaluating together the consumption of processed and fresh red meat, we observed that processed red meat consumption was associated with shorter life, implying a potential negative effect on health. On the other hand, consumption of only fresh red meat was not associated with either shorter or longer survival. Therefore, the main finding of this work is that the negative effects of red meat consumption might only be due to meat processing, which counteract the positive effects of the beneficial nutrients of meat. (more…)
Author Interviews, Breast Cancer, Cognitive Issues / 17.07.2014

Florien Boel MSc VU University Medical Center Department of Medical Psychology Amsterdam, The Netherlands MedicalResearch.com Interview with: Florien Boel MSc VU University Medical Center Department of Medical Psychology Amsterdam, The Netherlands Medical Research: What are the main findings of the study? Answer: In postmenopausal breast cancer patients, endocrine therapy is widely used, and often for many years on end. Endocrine therapy is thought to have an effect on cognitive functioning, but previous studies have not yet accounted for the possible influence of the diagnosis of cancer and subsequent anxiety, depression or fatigue on cognitive performance. In addition, the cognitive effects of endocrine therapy after long-term use are still mostly unknown. Therefore, we compared cognitive functioning of postmenopausal breast cancer patients who underwent surgery and/or radiotherapy (N=43) with the cognitive performance of women who also received adjuvant endocrine therapy (tamoxifen) (N=20) and a group of healthy matched individuals (N=44). In accordance with the literature, we found that especially cognitive domains that rely heavily on verbal abilities (verbal memory and fluency) seem to be at risk for deterioration during long-term treatment (~2.5 years) with tamoxifen. (more…)
Accidents & Violence, Author Interviews / 17.07.2014

Charles A. Jennissen, MD Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City, IA 52242MedicalResearch.com Interview with: Charles A. Jennissen, MD Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City, IA 52242   MedicalResearch: Why did you perform this study?  Dr. Jennissen: More youth 15 years and younger in the United States are killed in all-terrain vehicle (ATV) crashes than on bicycles. Since 2001, children represent nearly 30% of all ATV-related injuries and 20% of all ATV-related deaths.  Although previous studies have shown children to have high exposure to ATVs, these studies have been mostly limited to select rural and agricultural groups.  With this study, we wanted to investigate the epidemiology of ATV use and safety-related behaviors among a large cross-sectional sample of adolescents. (more…)
Author Interviews, Brain Injury, JAMA / 17.07.2014

MedicalResearch.com Interview with: Emmanuel Lagarde Director of Research at INSERM, France Medical Research: What are the main findings of the study? Dr. Lagarde: Concussion accounts for more than 90 percent of all traumatic brain injuries, although little is known about prognosis for the injury. The symptoms cited as potentially being part of post concussion syndrome fall into three areas: cognitive, somatic and emotional. But the interpretation of symptoms after concussion should also take into account that injuries are often sustained during psychologically distressing events which can lead to Posttraumatic Stress Disorder. Medical Research: Were any of the findings unexpected? Dr. Lagarde: Yes, as we were expecting to observe long term (3-month) symptoms following brain injury, but few were found to be specific : most of them were as frequent among patients with other injuries. Medical Research: What should clinicians and patients take away from your report? Dr. Lagarde: It seems as if there is little evidence of the existence of a specific syndrome following mild traumatic brain injury. However, patients who experienced a concussion are at risk of another well-known syndrome called Posttraumatic Stress Disorder, which is associated with the distressing event that led to the injury. Medical Research: What recommendations do you have for future research as a result of this study? Dr. Lagarde: The classification system of symptoms following mild brain injury should be revisited as our results are challenging the very relevance of the DSM-V post concussion syndrome. Citation: Association of Symptoms Following Mild Traumatic Brain Injury With Posttraumatic Stress Disorder vs Postconcussion SyndromeMedicalResearch.com Interview with: Emmanuel Lagarde Director of Research at INSERM, France Medical Research: What are the main findings of the study? Dr. Lagarde: Concussion accounts for more than 90 percent of all traumatic brain injuries, although little is known about prognosis for the injury. The symptoms cited as potentially being part of post concussion syndrome fall into three areas: cognitive, somatic and emotional. But the interpretation of symptoms after concussion should also take into account that injuries are often sustained during psychologically distressing events which can lead to Posttraumatic Stress Disorder. (more…)
AHA Journals, Author Interviews, Heart Disease, Red Meat / 17.07.2014

MedicalResearch.com Interview with: Dr inz. Joanna Kaluza Department of Human Nutrition Warsaw University of Life Sciences - SGGW Warsaw POLAND Medical Research: What are the main findings of the study? Response: The most important finding of my study is the fact that processed red meat consumption, but not unprocessed red meat, increases a risk of Heart Failure incidence and Heart Failure mortality. (more…)
Author Interviews, Heart Disease, Lipids, NEJM / 17.07.2014

Professor Jane Armitage Professor of Clinical Trials and Epidemiology Clinical Trial Service Unit, Oxford Cardiovascular Science Oxford, United KingdomMedicalResearch.com Interview with: Professor Jane Armitage Professor of Clinical Trials and Epidemiology Clinical Trial Service Unit, Oxford Cardiovascular Science Oxford, United Kingdom Medical Research: What are the main findings of the study? Prof. Armitage: The study showed that adding extended release niacin with laropiprant (to reduce the flushing) to standard treatment including statins in people with heart disease or strokes did not improve their outcome or reduce the risk of recurrent heart attacks or strokes. (more…)
Author Interviews, JAMA, Stroke, Surgical Research / 17.07.2014

Mads E. Jørgensen, M.B. University of Copenhagen, DenmarkMedicalResearch.com Interview with: Mads E. Jørgensen, M.B. University of Copenhagen, Denmark Medical Research: What are the main findings of the study? Answer: We included all patients undergoing non-cardiac surgery in 2005-2011, which were then categorized by time elapsed between stroke and surgery. Patients with a very recent stroke, i.e. less than 3 months prior to surgery, had a significant 14 times higher relative risk of 30-day MACE following surgery, compared with patients without prior stroke. Patients with a more distant stroke had a 2-5 fold higher risk of MACE following surgery, and still significantly higher than risks in patients without prior stroke. An additional model including time between stroke and surgery as a continuous measure showed a steep decrease in risks of perioperative MACE during the first 9 months. After 9 months, an increase in time between stroke and surgery did not further reduce the risks. The results for 30-day all-cause mortality showed similar patterns, although estimates were not as dramatic as for 30-day MACE. When analyzing the MACE components individually, we found that recurrent strokes were the main contributor to the high risk of MACE. A history of stroke any time prior to surgery was associated with a 16 fold increased relative risk of recurrent stroke, compared with patients without prior stroke. We also performed analyses stratified by surgery risk as low- (OR for stroke anytime, 3.97; 95% CI, 2.79-5.66), intermediate- (OR for stroke anytime, 4.46; 95% CI, 2.87-5.13) and high-risk (OR for stroke anytime, 1.98; 95% CI, 1.20-3.27), which were somewhat challenged in power. However, results indicated that stroke associated relative risk was at least as high in low and intermediate-risk surgery as in high risk surgery. (more…)
Author Interviews, Ophthalmology, Stem Cells, Transplantation / 17.07.2014

Ben Mead Molecular Neuroscience Group Neurotrauma and Neurodegeneration Section School of Clinical and Experimental Medicine University of Birmingham, BirminghamMedicalResearch.com Interview with: Ben Mead Molecular Neuroscience Group Neurotrauma and Neurodegeneration Section School of Clinical and Experimental Medicine University of Birmingham, Birmingham Medical Research: What are the main findings of the study? Answer: Traumatic and neurodegenerative disease of the retina lead to an irreversible loss of retinal ganglion cells (RGC) which are the neuronal cells located in the inner retina that transmit visual signals to the brain. Thus RGC injury results in visual defects which can ultimately progress into permanent blindness. One promising therapeutic approach is the use of stem cells as a source of replacement for lost retinal cells. However a theory has emerged suggesting that stem cells can act through the secretion of signalling molecules (growth factors). One stem cell that has recently shown great promise for neuronal repair are dental pulp stem cells (DPSC), which are multipotent stem cells easily isolated from adult teeth, including third molars (Mead et al 2013, 2014). In our research, we transplanted either dental pulp stem cells or the more widely studied bone marrow-derived mesenchymal stem cell (BMSC) into the vitreous chamber of the eye after optic nerve crush (Mead et al 2013). The main finding of this study was that DPSC, to a significantly greater degree than BMSC, promoted the survival of injured RGC and the regeneration of their axons. We also showed that the mechanism of action was not through differentiation and replacement of cells but was actually paracrine mediated, i.e. through DPSC-derived growth factors (Mead et al, 2013, 2014). (more…)