Medical Research.com Interview with:Marc Righini, MD
Division of Angiology and Hemostasis
Geneva University Hospital, Geneva, Switzerland
MedicalResearch.com: What are the main findings of this study?Dr. Righini: The study shows that when compared with a fixed D-Dimer cutoff of 500 ng/ml, the combination of pretest clinical probability assessment with age-adjusted D-dimer cut-off was associated with a larger number of patients in whom Pulmonary Embolism could be excluded, with a low likelihood of recurrent VTE. The benefit was the most important in patients 75 years or older, in whom using the age-adjusted cutoff instead of the 500 ng/ml cutoff increased five-fold the proportion of patients in whom PE could be excluded on the basis of D-dimer measurement.
MedicalResearch.com Interview with: Cristen J. Willer, PhD
Division of Cardiovascular Medicine, Dept of Internal Medicine
Dept of Human GeneticsDept of Computational Medicine and Bioinformatics
University of Michigan Ann Arbor, MI 48109-5618
MedicalResearch.com: What are the main findings of the study?Dr. Willer: We wanted to find new genes related to heart disease, so we examined the DNA of approximately 10,000 Norwegian individuals and found 10 genes that are important regulators of blood cholesterol levels. Nine of these were well known to be related to lipids, but one gene was new. It turned out to be in a region we'd previously noticed to be related to cholesterol, but it was a big region and we hadn't been able to pinpoint the gene yet. Using this new approach, focusing on DNA differences that result in slightly different proteins in people, we zeroed in on the gene. We then altered this gene in mice, and saw the predicted changes in cholesterol levels in mice.
MedicalResearch.com Interview with:Yanzhuang Wang, PhD
Dept. of Molecular, Cellular and Developmental Biology and Dept. of Neurology University of Michigan
Ann Arbor, MI 48109-1048
MedicalResearch.com: What are the main findings of the study?Dr. Wang: We learned how to repair a cellular structure called the Golgi apparatus that is broken in Alzheimer’s disease. This helps us understand how to reduce the formation of the toxic plaques that kill cells in the brain of Alzheimer's patients. The formation of amyloid plaques is a hallmark of Alzheimer’s disease; but exactly how much the plaques contribute to the disease is still not known. Our study found that the broken Golgi in the disease may be a major source of the toxicity of amyloid plaques. We showed in this study that repairing the Golgi can reduce the formation of the toxic plaques and thus may delay the disease development.
MedicalResearch.com Interview with:Dr Joe Brierley
Great Ormond Street Hospital for Children
Ormond Street, London WC1N 3JH, UK
MedicalResearch.com: What are the main findings of the study?Dr. Brierley: In the UK babies under 2-months of age cannot be verified as having died using ‘neurological criteria,’ due to national guidelines; whereas in North America, Australasia and other European countries his is possible. Because of this no organ donation from those under 2-months occurs in the UK contributing to the lack organs for small children who could benefit from such lifesaving interventions.
Our study finds that if the rules were changed to be compatible with other countries their would be a significant yield of organs from one specialist children’s hospital, and likely to be many more nationally.
MedicalResearch.com Interview with:Prof. Lu Qi,
Assistant Professor, Department of Nutrition
Harvard School of Public Health and Channing Division of Network Medicine
Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
MedicalResearch.com: What are the main findings of the study?Dr. Lu Qi: In this study, we for the first time provide reproducible evidence from three large cohort studies to show that the association between regular consumption of fried foods and higher BMI was particularly pronounced among people with a greater genetic predisposition to obesity. On the other hand, the adverse genetic effects on BMI were also amplified by consuming more fried foods, the effects among those who ate fried foods more than four times a week was about twice as large compared with those who ate them less than once a week.
MedicalResearch.com Interview with: Michelle M. Mielke, Ph.D.
Department of Health Sciences Research, Division of Epidemiology
Department of Neurology
Mayo Clinic Rochester, MN 55905
MedicalResearch.com: What are the main findings of the study?Dr. Mielke: Using a population-based sample of cognitively normal individuals, aged 70-89 at baseline, we found that a medical-record confirmed diagnosis of COPD was associated with an increased risk of mild cognitive impairment, specifically non-amnestic mild cognitive impairment. The risk of mild cognitive impairment increased with a longer duration of COPD such that individuals who had COPD for more than 5 years had a 2.5-fold increased risk of developing non-amnestic mild cognitive impairment.
MedicalResearch.com Interview Invitation with: Dr. Eliana M. Perrin, MD, MPH
Associate Vice Chancellor for Research, and Director, Office of Research Development
University of North Carolina at Chapel Hill and
Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine University of North Carolina at Chapel Hill, School of Medicine
Chapel Hill, NC 27599-7225
MedicalResearch.com: What are the main findings of the study?Dr. Perrin: The study included a large, diverse sample of 863 low-income parents of two-month-olds participating in Greenlight, an obesity prevention trial taking place at four medical centers: UNC, New York University, Vanderbilt University and the University of Miami. Among all of the parents, behaviors that are thought to be related to later obesity were highly prevalent. Exclusive formula feeding was more than twice as common (45 percent) as exclusive breastfeeding (19 percent). Twelve percent had already introduced solid food, 43 percent put infants to bed with bottles, 23 percent propped bottles instead of holding the bottle by hand (which can result in overfeeding), 20 percent always fed when the infant cried, and 38 percent always tried to get their children to finish their milk. In addition, 90 percent of the infants were exposed to television and 50 percent actively watched TV (meaning parents put their children in front of the television in order to watch). There were differences in these behaviors by race and ethnicity, and study results show that culturally-tailored counseling should be offered to parents of different backgrounds who may feed and play with their children differently.
MedicalResearch.com Interview with:Dr. Maarten de Rooij MD, PhD Candidate
Department of Radiology
Radboud University Nijmegen Medical Centre
Nijmegen, Gelderland 6525 GA, The Netherlands
MedicalResearch.com: What are the main findings of the study?Dr. de Rooij : Prostate cancer is the most common cancer in men and the second leading cause of cancer related death. The current diagnosis is based on ‘random or blind’ systematic transrectal ultrasound guided prostate biopsies in men with an elevated PSA. This can lead to over-diagnosis and over-treatment of prostate cancer, but can also miss important tumors. The role of multiparametric MRI (mpMRI) to improve the diagnosis of prostate cancer is evolving. In this meta-analysis we determined the diagnostic accuracy of mpMRI for the detection of prostate cancer. Our analysis included 7 studies using mpMRI which showed high overall specificity (0.88; 95% CI 0.82-0.92), with variable but high negative predictive values (0.65 - 0.95) and sensitivities (0.74; 95% CI 0.66-0.81).
MedicalResearch.com Interview with:Dr. Atul Shinagare MD
Department of Radiology and Center for Evidence-Based Imaging, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115
MedicalResearch.com: What are the main findings of the study?Answer: We evaluated 100 randomly selected patients from a cohort of 1771 patients evaluated for asymptomatic hematuria in 2004 at our institution in order to assess physician adherence to the 2001 American Urological Association (AUA) guidelines for evaluating patients and its impact on the diagnosis of urologic cancer. We found that most (64%) patients were not evaluated according to the guidelines, that there was substantial variation in the evaluation, and that the evaluation depended largely on the type of hematuria and physician specialty. Only 5% of patients were found to have urologic cancer, and all of them were evaluated according to the guidelines. No additional urologic cancers were diagnosed in patients in whom guidelines were not followed; however, since not all patients were tested thoroughly, occult malignancies may have been present.
MedicalResearch.com Interview with:Dr Rachel J Sacks
Jefferiss Wing, St Mary's Hospital
Imperial College Healthcare NHS Trust,
MedicalResearch.com: What is the background of this study?Dr. Sacks: 2247 anonymous questionnaires were completed by young women, aged 13-19 years old, attending sexual health services across England, looking at their HPV vaccination outcomes and prevalence of risk factors associated with HPV acquisition and cervical cancer development, and comparing the survey results with national data where available. Known HPV acquisition and cervical cancer development risk factors include cigarette smoking, early age at first intercourse, increasing number of lifetime partners, co-infection with other sexually transmitted infections.
MedicalResearch.com: What are the main findings of the studyDr. Sacks:
Young women, aged 13 to 19 years old attending sexual health services across England had higher prevalence of known risk factors associated with HPV acquisition and cervical cancer development, compared with national data.
Survey respondents had lower HPV vaccination offer and lower HPV vaccination completion rates than nationally.
Subgroups within the survey respondents were identified as having a significantly lower offer and significantly lower completion rate of the HPV vaccination. These subgroups included respondents from London, those of non-white ethnicities, 17 to 19 year olds, smokers and those not in education, employment or training (NEETs).
The highest risk individuals, in terms of HPV related risk factors, were the least likely to be offered and additional the least likely to complete the HPV vaccination course.
Currently sexual health services in England are not involved in the delivery of the HPV vaccination programme and this is felt to be a huge missed opportunity for the primary prevention of HPV acquisition and its potential sequelae. Sexual health services should be included as a supplementary HPV vaccination delivery site in order to target these particularly vulnerable young women and to increase the success of the HPV vaccination programme in England.
MedicalResearch.com Interview with: Erica P. Gunderson, PhD, MS, MPH
Senior Research Scientist, Cardiovascular and Metabolic Section
Division of Research, Kaiser Permanente Northern California
Oakland, CA 94612-2304
MedicalResearch.com: What are the main findings of the study?Dr. Gunderson: The study found that:
- Gestational diabetes is a pregnancy complication that reveals a woman’s greater risk of future heart disease.
- Women who experience gestational diabetes face an increased risk of subclinical atherosclerosis (early heart disease) even if they do not develop type 2 diabetes or the metabolic syndrome years after pregnancy.
- Study participants with a history of gestational diabetes who did not develop diabetes or metabolic syndrome showed a greater carotid artery wall thickness (marker of early atherosclerosis) compared to those who never experienced gestational diabetes. The vessel narrowing also could not be attributed to obesity or other risk factors for heart disease that were measured before pregnancy.
- Weight gain and blood pressure elevations in women with gestational diabetes were responsible for these differences in the artery wall thickness.
MedicalResearch.com Interview with: Rajiv Chowdhury MD, PhD
Department of Public Health and Primary Care
University of Cambridge
MedicalResearch.com: What are the main findings of the study?Dr. Chowdhury:Total saturated fatty acid, whether measured as a dietary intake variable or in the bloodstream as a biomarker, was not associated with coronary disease risk in combining all available prospective observational studies. Similarly, there were non-significant overall associations in the prospective studies that involved assessments of total monounsaturated fatty acids, long-chain omega-3 and omega-6 polyunsaturated fatty acids.
However, we found diversity in the observational associations between specific circulating long-chain omega-3 and omega-6 fatty acids with coronary risk, with some evidence that circulating levels of eicosapentaenoic and docosahexaenoic acids (ie, the two main types of long-chain omega-3 polyunsaturated fatty acids), and arachidonic acid are each associated with lower coronary risk. Similarly, within saturated fatty acids, there were positive, however, non-significant associations observed for circulating blood composition of palmitic and stearic acids (found largely in palm oil and animal fats, respectively), whereas circulating margaric acid (a milk fat) had a significant inverse association.
Additionally, when we investigated the randomised controlled trials that reported on the effects of omega-3 and omega-6 fatty acids on reducing coronary outcomes, there was no significant overall association observed.
MedicalResearch.com Interview Invitation with:Dr. Brian C. Callaghan MD
Department of Neurology
University of Michigan Health System, Ann Arbor
MedicalResearch.com: What are the main findings of the study?Dr. Callaghan: The main findings are that we order headache neuroimaging (MRIs and CTs) frequently, this accounts for approximately $1 billion dollars annually, and the number of tests ordered is only increasing with time.
MedicalResearch.com Interview with:
Dr Tahir Hamid MRCP (UK), FESC
Department of Cardiology, Royal Albert Edward Infirmary
NHS Trust, Wigan, UK
MedicalResearch.com: What are the main findings of the study?Dr. Hamid:Traditionally patients undergoing diagnostic and interventional coronary artery procedures are kept Nil-by-mouth, but until yet there exists neither evidence nor clear guidance about the benefits of this practice in such patients. In our study performed at two National Health Services (NHS) institutes, we demonstrated in our 1916 patients, that such procedures could be undertaken without the need for being 4-6 hours fasting. None of our patients had major complications leading to pulmonary aspiration or emergency cardiac surgery.
MedicalResearch.com Interview with:Bheeshma Ravi, MD
University of Toronto Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Ravi: This study suggests that in persons with moderate-severe osteoarthritis of the hip or knee, total joint replacement is associated with a significant reduction in the risks for serious cardiovascular events.
MedicalResearch.com Interview with: Maryann Mazer-Amirshahi PharmD, MD
The Department of Emergency Medicine, The George Washington University
The Department of Clinical Pharmacology, Children's National Medical Center, Washington, DC
MedicalResearch.com: What are the main findings of the study?Answer:We found a significant increase in the prescribing of opioid pain medications in the emergency department. At the same time, this was not accounted for by a similar increase in pain-related visits and prescribing patterns of non-opioid analgesics did not change.
MedicalResearch.com Interview with: Peter F. Schnatz, D.O.
Associate Chair & Residency Program Director
The Reading Hospital
Department of OB/GYN
Reading, PA 19612-6052
MedicalResearch.com: What are the main findings of the study?Dr. Schnatz: In a subsample of 576 women from the parent WHI CaD (calcium plus vitamin D supplementation) trial* , there was a significant (38%) increase in mean serum 25OHD3 concentrations after two years (95% CI 1.29-1.47, p< 0.001) for women randomized to CaD (24.3ng/mL vs. 18.2 ng/mL).
Women randomized to CaD had a 4.5 mg/dL mean decrease in LDL-C which was statistically significant. After accounting for serum 25OHD3 concentration, the effect of CaD was attenuated, suggesting that higher concentrations of 25OHD3, in response to CaD supplementation, are associated with improved LDL-C.
In observational analyses, higher concentrations of 25OHD3 were associated with significantly higher HDL-C along with significantly lower LDL-C and TG concentrations.
* 1,000 mg of elemental calcium plus 400 IU of vitamin D3 daily
MedicalResearch.com Interview with:
Chandra Y. Osborn, PhD, MPH
Assistant Professor of Medicine & Biomedical Informatics
Division of General Internal Medicine & Public Health
Center for Health Services Research
Vanderbilt University Medical Center
Nashville, TN 37232-8300
MedicalResearch.com: What are the main findings of your study?Dr. Osborn: We found that knowing how to take your diabetes medications (e.g., what to do if a dose is missed), believing medications are good for you, and having the appropriate skills to take them regardless of the situation (e.g., when life is busy, when in public) accounts for 41% of why people successfully take their diabetes medications, which, in turn, explains 9% of their glycemic control.
MedicalResearch.com Interview with:Dr Tobias Teichert
Assistant Professor of Psychiatry
University of Pittsburgh
Pittsburgh, PA 15261
MedicalResearch.com: What are the main findings of the study?Dr. Teichert: "Our study provided three main findings:First, we measured how long it takes subjects to allocate attention to a relevant target and how effectively they can block out the distractors. We found that after 120 msec selective attention is fully engaged and completely blocks out the distractor. Based on this finding, we predicted that subjects should be able to improve decision accuracy by delaying decision onset, and that this should be more effective than simply prolonging the whole decision process.
Most importantly, we found that subjects indeed use this more effective way of improving decision onset: On average, subjects delayed decision onset by about 50 msec when we asked them be as accurate as possible. The good news is that people seem to use this more optimal mechanism automatically, without being told to do so and without being aware of what they do. The bad news is that we don’t seem to be using this skill quite as effectively as we could. In our case, subjects could have improved accuracy even further by delaying decision onset by an additional 50 ms. However, taken together, our findings show that decision onset is to some degree under cognitive control, and that we might be able to devise training strategies to harness its full potential”
MedicalResearch.com Interview with: Lynda D. Lisabeth, PhD
Interim Chair and Associate Professor
Department of Epidemiology
University of Michigan
Ann Arbor, Michigan
MedicalResearch.com: What are the main findings of the study?Dr. Lisabeth: The main findings were that Mexican Americans scored worse than non-Hispanic whites on all outcomes measured at 90 days following stroke, including neurologic, functional and cognitive outcomes, after adjustment for confounding factors. Further, we found that one-third of Mexican American stroke survivors have post-stroke dementia. Mexican Americans experienced more aphasia than non-Hispanic whites. Levels of functional impairment were substantial, with Mexican Americans on average experiencing moderate functional disability. Mexican Americans reported significantly greater difficulty than non-Hispanic whites with all activities of daily living (ADLs) and instrumental activities of daily living (IADLs) that were studied.
MedicalResearch.com Interview with:Prof Samy Hadjadj:
Université de Poitiers, UFR Médecine Pharmacie, Centre d’Investigation clinique,
CHU de Poitiers, Centre d’Investigation clinique, Poitiers, France
MedicalResearch.com: What are the main findings of the study?Prof: Hadjadj: The study helps to establish sTNFR1 as a valid biomarker not only for renal outcomes in type 2 diabetes but also for all cause death. Interestingly the addition of sTNFR1 concentration to the UKPDS model outcome equation showed to add some clinical prognostic value to this model for all-cause death.
MedicalResearch.com Interview with: Primo N. Lara, Jr, MD,
Professor of Medicine, University of California Davis School of Medicine
Associate Director for Translational Research
UC Davis Comprehensive Cancer Center
Sacramento, CA 95817
MedicalResearch.com: What are the main findings of the study:Dr. Lara: “We found that blood markers of bone turnover can be used to predict outcomes in men with advanced prostate cancer with spread to bone. We also found that a small proportion of men could be predicted to benefit from an investigational drug based on these same markers.”
MedicalResearch.com Interview with: Atte Meretoja, MD, PhD, MSc (Stroke Medicine)
Associate Professor and Principal Fellow (Neurology),
University of Melbourne
The Royal Melbourne Hospital Australia
Associate Professor of Neurology, University of Helsinki
Helsinki University Central Hospital, Finland
MedicalResearch.com: What are the main findings of the study?Dr. Meretoja: We used observational prospective data of consecutive stroke patients (n=2258) treated with intravenous thrombolysis in Australian and Finnish centers and a pooled analysis of thrombolysis trials to model the shift in patient outcomes with reducing treatment delays. We found out that each minute the treatment can be delivered faster granted on average 1.8 days of extra healthy life (95% prediction interval 0.9 to 2.7). In practice, this means that each 15 minute decrease in treatment delays provides an average equivalent of one month of additional disability-free life.
MedicalResearch.com Interview with: Pashtun Shahim, MD
Clinical Neurochemistry Laboratory
Institute of Neuroscience and Physiology
Department of Neurochemistry
Sahlgrenska University Hospital, Mölndal
MedicalResearch.com: What are the main findings of the study?Dr. Shahim: Sports-related concussion in professional ice hockey players is associated with acute axonal and astroglial injury. Plasma total tau, which is a highly central nervous system-specific protein, is a promising biomarker to be used both in the diagnosis of concussion and in the decision-making when an athlete can be declared fit to return to play.
MedicalResearch.com Interview with:Glenn Yiu, MD, PhD
Duke University Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Yiu:This paper reported a child who suffered injury to both eyes from a powerful blue laser pointer purchased via the internet from overseas. Our report reviews the scientific basis for laser injuries in eyes and the factors that may affect outcomes, such as power, wavelength, duration, and distance of exposure. Newer green and blue lasers, especially high-powered ones, may be more prone to inducing eye injuries. We summarized the clinical features of ocular laser injuries, methods of prevention, and discussed how consumer availability of high powered lasers may require careful federal regulations.
MedicalResearch.com Interview with: Martin Holzmann, MD, PhD
Department of Emergency Medicine,
Karolinska University Hospital
MedicalResearch.com: What are the main findings of the study?Dr. Holzmann: The main finding is that patients with renal dysfunction are at increased risk of cardiovascular events after undergoing CABG for acute coronary syndromes.
MedicalResearch.com Interview with: David R. Urbach, M.D
From the Institute for Clinical Evaluative Sciences
Department of Surgery
Institute of Health Policy, Management and Evaluation
University of Toronto, the University Health Network
Toronto, ON M5G 2C4, Canada
MedicalResearch.com: What are the main findings of the study?Dr. Urbach: After surgical safety checklists were adopted by hospitals in Ontario, surgical outcomes—death after surgery, complications, length of stay, readmissions—did not improve substantially.
MedicalResearch.com Interview with: Prof. Dr. Sven Cichon, PhD
Director, Division of Medical Genetics
University Hospital Basel
Human Genomics Research Group
Department of Biomedicine
University of Basel Basel, Switzerland
MedicalResearch.com: What were the main findings of the study?
Answer: We have identified two new gene regions that represent pieces of the jigsaw puzzle of genetic and non-genetic factors that lead to the development of bipolar disorder. One is the gene ADCY2 (Adenylate Cyclase 2) which is involved in signal transmission within nerve cells. The other region comprises two genes, both presumably playing a role in neurodevelopmental processes (MIR2113 and POU3F2). Importantly, these results come out of the largest of these kinds of studies so far, involving altogether more than 24,000 people.
MedicalResearch.com Interview with: Dingli Xu, MD
From Department of Cardiology
Nanfang Hospital, Southern Medical University, Guangzhou, China
MedicalResearch.com: What are the main findings of the study?Answer：Our study showed that after controlling for multiple cardiovascular risk factors, the blood pressure range at 120-139/80-89 mm Hg (defined as ‘prehypertension’ in JNC 7), is significant associated with long-term risk of stroke. The results were consistent across stroke type, stroke endpoint, age, study characteristics, follow-up duration, and ethnicity. More importantly, even low-range prehypertension (BP 120-129/80-84mmHg) increased the risk of stroke compared with optimal BP (<120/80 mm Hg), and the risk was higher in individuals with high-range prehypertension (BP 130-139/85-85mmHg). In particular, we found that compared with individuals with optimal blood pressure individuals with low-range prehypertension were 44% more likely to develop stroke, and this risk was even greater (95%) in individuals with high-range prehypertension.
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