MedicalResearch.com Interview with:Dr. Rui Li
Division of Diabetes Translation
Centers for Disease Control and Prevention
MedicalResearch.com: What are the main findings of the study?Answer: The proportion of people with diabetes facing high out-of-pocket (OOP) burden declined between 2001 and 2011. Although insurance and income related disparities have declined, almost one-fourth of all people with diabetes still face a high out-of-pocket burden.
MedicalResearch.com Interview with: Dr. Marie Claude Ouimet, Ph.D.
Assistant Professor/ Professeure adjointe
University of Sherbrooke/ Université de Sherbrooke
Faculty of Medicine and Health Sciences/ Faculté de médecine et des sciences de la santé
Longueuil, QC, Canada, J4K 0A8
MedicalResearch.com: What are the main findings of the study?
Dr. Ouimet :The goal of our study was to examine if teenagers’ driving risk was associated with a neurobiological factor. Driving was continuously observed with cameras and sensors installed in the vehicles of teenagers during their first 18 months of licensure. Cortisol response was measured within the first weeks of licensing. Our study showed two main findings:
1) Higher cortisol response to a stressful event was associated with lower crash and near crash rates over the study period;
2) Higher cortisol response was also linked to a sharper decrease in crash and near crash rates over time.
MedicalResearch.com Interview Sandra L. Decker, Ph.D.Distinguished Consultant
Centers for Disease Control and Prevention
National Center for Health Statistics
Hyattsville, MD 20782
MedicalResearch.com: What are the main findings of the study?Dr. Decker: One of the main findings is that the percent of the low income population that is uninsured is higher in states not expanding Medicaid than those expanding. The low income uninsured in non-expansion states are more likely to report having or having had certain health conditions such as hypertension, cancer, stroke, emphysema, or a heart condition than those in expansion states. (more…)
MedicalResearch.com Interview with:Alex Leow, MD PhD
Chicago, IL 60612 and
Tony J. Simon, PhD
University of California,
Davis MIND Institute Sacramento,
MedicalResearch.com: What are the main findings of the study?Answer: Fragile X syndrome (FXS) is the most common inherited cause of intellectual disabilities and the most prevalent known single-gene cause of autism in males. The fragile X mental retardation 1 gene (FMR1) can be mutated with expanded numbers of CGG trinucleotide repeats in the 5’ untranslated region on the Xq27.3 site of the X chromosome. Normally, unaffected individuals have fewer than 45 CGG repeats in FMR1. When the size of the CGG repeat exceeds 200 FMR1 is silenced and the mutation is categorized as full, generating the FXS phenotype. If the expansion is between 55–200 repeats, then the individual is generally classified as a fragile X premutation carrier (fXPC). An estimated 40% of male and 8-16% of female premutation carriers later develop Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS), which is a late-onset (usually 50-70 years old) neurodegenerative disorder.
We recruited 46 neurologically symptomless young to middle aged carriers of the FMR1 gene mutation. They were age and gender matched with 42 unaffected control individuals without the gene mutation. Both groups were evaluated by cognitive testing as well as novel neuroimaging techniques termed “brain connectomics,” based on diffusion tensor imaging (DTI) whole-brain tractography. A connectome is a comprehensive map, like a wiring diagram, of neural connections in the brain. Our study is the first-ever connectome study to compare fXPCs and controls.
In short, brain connectomics enable scientists for the first time to study the global organizational properties of the human brain by applying cutting edge computational techniques, based on graph theory, to these comprehensive maps of neural connections (i.e., the brain graphs). Our main finding was that, in neurologically symptomless male carriers we detected a correlation between brain graphs’ efficiency in processing information and the number of CGG repeats in the mutated region of FMR1 (we estimated that each additional CGG repeat that in these males represents an effective increase of ~1.5 years of “brain aging”). The correlation may prove to be an effective marker of early brain aging in otherwise neurologically symptomless premutation carriers. The study also further confirmed previous findings of smaller brain stem volumes in male fXPCS than in male controls.
MedicalResearch.com Interview with:Dr. Ivo Lieberam
Lecturer, MRC Centre for Developmental Neurobiology
King's College London
New Hunt's House, Guy's Hospital Campus
London, SE1 1UL UK
MedicalResearch.com: What are the main findings of the study?Dr. Lieberam: In this study, which my group undertook in collaboration with Linda Greensmith’s group at University College London, we found that we could artificially control muscle activity using transplanted stem cell-derived nerve cells as an interface between an opto-electronic pacemaker and paralysed muscle in mice. The nerve cells were equipped with a molecular photosensor, so that they could be activated by light. We think that long-term, this technology may be used in neural prosthesis designed to re-establish relatively simple motor functions, such as breathing or swallowing, in patients suffering from spinal cord injury or neuromuscular diseases such as Motor Neuron Disease.
MedicalResearch.com Interview with: David R. Jacobs Jr, PhD
Divisions of Epidemiology
School of Public Health
University of Minnesota, Minneapolis
MedicalResearch.com: What are the main findings of this study?Dr. Jacobs: Vigorous activity is what is well understood to improve cardiorespiratory fitness. People with high fitness are likely (based on this study) to
a) Lose fitness more slowly as they age and
b) To maintain sharper "thinking skills" into late middle age.
I think the message of this study is primarily for the people in the low to mid range of fitness in young adulthood. Thus, of more importance to the general population, if the people with low to moderate fitness simply do things, be engaged in family, job, community, move around, they would be able to do better on a treadmill test such as we used. Because those who lost less fitness over average age 25 to average age 45 had higher thinking skills at age 50, people who start moving around are likely to reap the benefit of less loss of thinking skills by average age 50.
MedicalResearch.com Interview with: Dr. Heather Wakalee MD
Associate Professor of Medicine (Oncology)
Stanford University Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Wakalee: CO-1686, with the new hydrobromide formulation, has been active at multiple dose levels (500, 750 or 1000 mg orally twice daily). The response rate in patients with EGFR mutant (non-small-cell Lung Cancer) NSCLC that has progressed after therapy with EGFR TKI, and has centrally confirmed T790M, is 64% per RECIST. The majority of responses are ongoing at the time of this report. The drug has been overall very well tolerated.
MedicalResearch.com Interview with: Judith Kooiman
Department of Thrombosis and Hemostasis
Leiden University Medical Center
Leiden, The Netherlands
MedicalResearch.com: What are the main findings of the study?Dr. Kooiman: The main finding of our study is that trans radial PCI (TRI) is associated with a significantly lower risk of AKI compared with trans femoral PCI (TFI), after adjustment for confounding factors.
MedicalResearch.com Interview with: Professor Ben He
Department of Cardiology
Renji Hospital, School of Medicine
Shanghai Jiao Tong University, Shanghai China.
MedicalResearch.com: What are the main findings of the study?Professor He: Elimination of PVCs by catheter ablation can improve LVEF and reverse LV dimensions. The pooled mean change in LVEF post-ablation meets the prespecified borderline (5%) and can be considered clinically effective. Beneficial effects of ablation of frequent PVCs in improving LV function are more significant in patients with reduced LVEF at baseline.
MedicalResearch.com Interview with: Massimo Porta, MD PhD
Professor of Medicine Head, Unit of Internal Medicine 1
Department of Medical Sciences University of Turin
MedicalResearch.com: What are the main findings of the study?Dr. Porta: Type 2 diabetes has a slow, insidious onset and may remain undiagnosed for several years, during which complications may arise and progress. As a result, many patients already have retinopathy at the time a clinical diagnosis is finally made. Previous attempts at estimating the duration of this period of "hidden" diabetes relied upon extrapolations of a linear correlation between known duration of diabetes and prevalence of retinopathy.
This led to overestimates, because:
a) the best fitting correlation may not be linear,
b) series included insulin treated patients, who might have late-onset type 1 diabetes,
c) patients with any mild retinopathy were included whereas we now know that up to 10% of non diabetic individuals may have minimal retinal signs.
By taking these variables into account, ie including only patients not on insulin and with moderate or more severe retinopathy and applying different mathematical models, we ended up with an estimated duration preceding diagnosis of type 2 diabetes of 4-6 years, against longer than 13 years using "standard" criteria.
MedicalResearch.com Interview with:Dr. Juliane Bingener-Casey, M.D.
Mayo Clinic in Rochester, Minn.
MedicalResearch.com: What are the study’s main findings?Dr. Bingener-Casey: “Patient-reported outcomes such as pain and fatigue are sensitive tools to detect how well patients recover from surgery. These patient-reported outcome results are different for men and women and for older versus younger people.”
MedicalResearch.com Interview with:Martin J. Holzmann, MD, PHD
Department of Emergency Medicine
Karolinska University Hospital, Huddinge
MedicalResearch.com: What are the main findings of the study?Dr. Holzmann: In a cohort of 8900 consecutive patients who sought medical attention for chest pain, we found that an undetectable high-sensitivity cardiac troponin level (<5 ng/l), and an ECG with no ischemic changes has a negative predictive value of 99.8% (95%, 99.7-99.9%). Thus, this will rule out MI with nearly 100% accuracy, and independent of when the troponin was measured in relation to onset of chest pain, and independent of any risk factors for cardiovascular disease.
MedicalResearch.com Interview with:Dr. Anne Ingeborg Berg:
University of Gothenburg, Sweden
MedicalResearch.com: What are the main findings of the study?Answer: In our study of personality change in individuals aged 80+ we found that over a 6 year period individuals did not change in emotional stability, however, in line with previous research they got less extravert or outgoing. The only health aspect that could be related to an accelerated change in extraversion was impaired hearing at the first measurement occasion.
MedicalResearch.com Interview with: Prof Guangwei Li MD
Department of Endocrinology
China-Japan Friendship Hospital
Center of Endocrinology and Cardiovascular Disease, National Center of Cardiology & Fuwai Hospital, Beijing, China
MedicalResearch.com: What are the main findings of the study?Answer: Our study first shows that a six-year period of lifestyle intervention in Chinese people with IGT reduced the incidence of diabetes over a protracted time period and was ultimately associated with a significant reduction in total and cardio-vascular disease mortality. This reduction in mortality appears to be mediated in part by the delay in onset of diabetes resulting from the lifestyle interventions.
MedicalResearch.com Interview with:Professor Harvey White
MB ChB DSc FRACP FACC FESC FAHA FHKCC (Hon) FCSANZ FRSNZ La'auli (matai); Prince Mahidol Laureate; John Neutze Scholar, Director of Coronary Care & Green Lane Cardiovascular Research Unit, Green Lane Cardiovascular Service
Auckland City Hospital NEW ZEALAND
MedicalResearch.com: What are the main findings of the study?Prof. White: During follow-up (median 3.7 years), the composite primary end point (cardiovascular death, myocardial infarction or stroke) occurred in 9.7% of the 7,924 patients randomly assigned to darapladib and 10.4% of the 7,904 patients in the placebo group (HR 0.94, 95% CI 0.85-1.03 p=0.199).
In the first prespecified secondary endpoint of major coronary events (CHD death, MI or urgent revascularization) compared with placebo, darapladib reduced the rate (9.3% vs. 10.3%; HR=0.9; 95% CI, 0.82-1 p=0.045). Total coronary events (14.6% vs. 16.1%; HR = 0.91; 95% CI, 0.84-0.98,p=0.019). (CHD death, MI, any coronary revascularization, hospitalization for unstable angina) were also reduced. No major safety concerns arose during the trial. (more…)
MedicalResearch.com Interview with: Professor Ludwig Kuntz
Seminar for Business Administration and Health Care Management University of Cologne Albertus-Magnus-Platz
50923 Cologne Germany
MedicalResearch.com: What are the main findings of the study?Professor Kuntz: We have identified the point at which hospitals begin to fail, resulting in deaths of critically ill patients. The Safety Tipping Point for hospitals occurs when they reach occupancy levels far below 100%, namely we identified a tipping point strongly at around 92 per cent [patient occupancy relative to ward capacity]. Our research therefore demonstrates conclusively that far from maximizing efficiency, exceeding a capacity “tipping point” on a hospital ward can have dire consequences. This has major implications for the way we think about capacity and stress in the workplace.
MedicalResearch.com Interview with:Jeppe Romme Christensen MD PhD
From the Danish Multiple Sclerosis Center
Copenhagen University Hospital Hvidovre, Denmark.
MedicalResearch.com: What are the main findings of the study?Dr. Christensen: This study demonstrates that progressive multiple sclerosis (MS) patients have reduced inflammation and tissue damage in the brain after treatment with natalizumab. These findings highlight that progressive MS is an inflammatory disease and furthermore that peripheral circulating immune cells contribute to brain inflammation and tissue damage in progressive MS.
MedicalResearch.com Interview with:Niels Graudal, MD, DrMSc
Department of Internal medicine/Infectious Medicine/Rheumatology IR4242
Copenhagen University Hospital, Rigshospitalet
Dr. Graudal: There are no studies, which show what happens with the risk of cardiovascular death or mortality if you change your sodium intake. Our study shows the association of sodium intake as it is with cardiovascular disease and mortality, which is only the second best way to consider the problem, but as the best way does not exist we have accepted this approach. There have been two different assumptions concerning the risks of sodium intake. One is that there is an increasing risk of heart disease, stroke and death of salt intake above 2300 mg, and one is that salt is not dangerous at all. Our study shows that both positions partially may be true, as a salt intake above 4900 mg is associated with increased risk of cardiovascular disease and mortality, whereas the present normal salt intake of most of the world’s populations between 2300 mg and 4900 mg is not associated with any increased risks. In addition our study shows that a low sodium intake below 2300 mg is also associated with increased risk of cardiovascular disease and death.
MedicalResearch.com Interview with:
Dr. LydiaPace, MD, MPH
Division of Women’s Health, Brigham and Women’s Hospital
MedicalResearch.com: What are the main findings of the study?Dr. Pace: We reviewed the existing literature about the benefits and harms of mammography, focusing on the reduction of breast cancer deaths associated with mammography, as well as the two most often-discussed harms: false positive results and overdiagnosis. We also reviewed the literature about interventions to help patients make informed decisions. We found that the literature suggests that routine screening mammography does reduce mortality associated with breast cancer, across all age groups. However, it is also associated with high rates of false positive results, and considerable rates of overdiagnosis. Overdiagnosis is the most concerning potential risk of mammography screening. Overdiagnosis is the detection of a tumor through screening that would never have caused problems for a patient. It occurs either because of a very slow-growing tumor, or because a woman has medical problems (or is old enough) such that she will likely die of another cause before the cancer became apparent. Overdiagnosis is concerning because we cannot know when a cancer is overdiagnosed, and thus a patient who is overdiagnosed will receive unnecessary treatment for cancer. The scientific literature on mammography is complex, and there are important limitations to the studies both of mammography’s benefits and harms. However, we feel that the best available data suggest that among 10,000 50 year old women undergoing annual mammography for 10 years, 5 deaths will be averted through screening mammography, while about 6130 women will experience at least one positive result. Furthermore, there is about a 19% chance that, if that woman is diagnosed with cancer detected by a mammogram, that cancer is one that would never have caused her problems. Lastly, our review showed that we need more studies to guide us in how an individual woman’s risk should dictate her mammography decisions, and how to support women in making those decisions. However, we know that most women with higher risk for breast cancer will experience higher benefit from mammography screening. (more…)
MedicalResearch.com Interview with: Woon-Puay Koh (Associate Professor)
Office of Clinical Sciences
Duke-NUS Graduate Medical School Singapore
8 College Road Level 4 | Singapore 169857
MedicalResearch.com: What are the main findings of the study?Answer:The main finding is that coffee intake was associated with a lower risk of death from cirrhosis, specifically for non-viral hepatitis related cirrhosis. Subjects who drank two or more cups per day had a 66% reduction in mortality risk, compared to non-daily coffee drinkers. However, coffee intake was not associated with viral hepatitis B related cirrhosis mortality.
MedicalResearch.com Interview with:
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.
MedicalResearch.com: What are the main findings of your study?Dr.Bangalore: Patients with transient ischemic attack (TIA) are at increased risk of future full blown stroke, making institution of secondary prevention measures critical
Our data from 858,835 patients from 1545 sites indicate that hospital adherence to evidence-based secondary prevention discharge measures was consistently less for patients with transient ischemic attack when compared with those with ischemic stroke, thus representing a missed opportunity at instituting preventive measures to reduce the risk of future stroke.
MedicalResearch.com Interview with:
Shanthi Srinivasan, M.D. Associate Professor of Medicine
Division of Digestive Diseases Department of Medicine
Emory University Atlanta, GA 30322MedicalResearch.com: What are the main findings of the study?Dr. Srinivasan:The main findings of this study are that the neurotrophic factor GDNF is was able to protect against the weight gain induced by mice on a high fat diet. The mice that had overexpression of GDNF showed less weight gain while eating the same high fat diet as the control mice. GDNF seems to have effects on the genes regulating fat metabolism and energy expenditure and this could be the mechanism of prevention of weight gain.
MedicalResearch.com Interview with: Daniel J. Elliott, M.D., MSCE, FACPAssociate Chair of Research
Department of Medicine and Research Scholar
Value Institute, Christiana Care Health System
MedicalResearch.com: What are the main findings of the study?Dr. Elliott:The optimal workload for hospitalists has been a question since the earliest days of hospital medicine. However there has been very little empirical evidence to understand the relationship between workload and outcomes.
The objective of our study was to determine the association of daily workload for hospitalists on the efficiency, quality, and cost of care. We analyzed data from a single private practice hospitalist group at a community-based health system between February 2008 and January 2011. Our research showed that both length of stay and cost increased for patients as hospitalist workload increased.
At the same time, our research showed that workload did not affect patient satisfaction as measured by HCAHPS scores or quality and safety outcomes including admissions, rapid response team activation and mortality.
MedicalResearch.com Interview with:Dr. Milan K Piya
NIHR Clinical Lecturer in Diabetes and Endocrinology
Warwick Medical School, University of Warwick;
University Hospitals Coventry and Warwickshire NHS Trust
MedicalResearch.com: What are the main findings of the study?Answer: Our studies have identified two main findings:
Firstly that the size or frequency of the meal doesn’t affect the calories we burn in a day, but what matters most for losing weight is counting calories.
Secondly, by carrying more weight, more endotoxin enters the circulation to cause inflammation and eating more often will exacerbate this risk which has been linked to metabolic diseases such as type-2 diabetes.
MedicalResearch.com Interview with:Professor Rodney Sinclair
University of Melbourne and Epworth Hospital
Melbourne, VIC, Australia
MedicalResearch.com: What are the main findings of the study?Answer: Activation of Wnt signalling promoted hair growth and fat growth. Inhibition of Wnt signalling reduces fat growth and hair growth. We looked at the fat layer on the scalp. It was reduced by 50% over the bald areas of alopecia areata. The patch of alopecia areata we looked at was new- only appeared a few days earlier and so the changes in fat thickness are rapid.
What is interesting is that the fat layer is dynamic, and significant fluctuations can occur in a rapid period of time in sync with the hair cycle. It is also interesting that ligands for BMP6 and IGF2 are pro-adipogenic.
There are a couple of bigger questions that earlier media reports did not focus on- namely upstream factors regulating the hair cycle clock and the beauty of synchronization of fat and hair growth for seasonal thermal insulation.
MedicalResearch.com Interview with:Dr Oyinlola Oyebode
Specialist Registrar in Public Health
Dept of Epidemiology & Public Health
University College London
MedicalResearch.com: What are the main findings of the study?Dr. Oyebode: We found that the more fruit and vegetables consumed, the lower the risk of death from any cause, from cancer or from heart disease or stroke. We found that vegetables were better than fruit at equivalent amounts.
MedicalResearch.com Interview with: Jan Akervall, M.D., Ph.D.
Co-director, Head and Neck Cancer Multidisciplinary Clinic
Beaumont Hospital, Royal Oak
Clinical Director of Beaumont’s BioBank
MedicalResearch.com: What are the main findings of the study?Dr. Akervall: We identified biomarkers that can predict who will have an unfavorable response from radiation for head and neck cancer. These can be analyzed using standard laboratory techniques on biopsies that routinely are taken for diagnosis.
MedicalResearch.com Invitation with:Dr Valerie Sung MBBS(Hons) FRACP MPH
NHMRC PhD Candidate, Department of Paediatrics, University of Melbourne, and Community Health Services Research, Murdoch Childrens Research Institute
Paediatrician, Centre for Community Child Health
The Royal Children’s Hospital
MedicalResearch.com: What are the main findings of the study?Dr. Sung: Lactobacillus reuteri was NOT effective in reducing crying or fussing in infants with colic, whether they are breast or formula fed. This is the largest and most rigorous trial to date to show this.
MedicalResearch.com Interview with: Mary A.M. Rogers, PhD, MS
Research Associate Professor
Research Director, Patient Safety Enhancement Program
Department of Internal Medicine
University of Michigan Ann Arbor, MI 48109-2800
MedicalResearch.com: What are the main findings of the study?Dr. Rogers: The risk of serious infection is considerably elevated after receiving allogeneic (donor) red blood cell transfusions. For every 38 patients under consideration for transfusion, 1 patient could be spared an infection if more restrictive hemoglobin thresholds were used. When patients were given transfusions only after their hemoglobin fell below 7.0 g/dL, 1 patient avoided an infection of every 20 patients treated. The results were most consistent in elderly patients receiving hip and knee replacement surgeries. Their risk of infection decreased by 30% when lower hemoglobin thresholds were used.
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