Author Interviews, Cost of Health Care, Pharmacology, University of Pittsburgh / 09.06.2014

MedicalResearch.com Interview with: Yuting Zhang, Ph.D. Associate professor Graduate School of Public Health Department of Health Policy and Management. University of Pittsburgh MedicalResearch: What are the main findings of the study? Dr. Zhang: Since 2006, the government has randomly assigned low-income enrollees to stand-alone Part D plans, based upon the region in which they live. If low-income Medicare Part D enrollees were assigned to the least expensive plan instead of a random plan, the government and beneficiaries could save more than $5 billion in the first year. (more…)
Author Interviews, Melanoma / 09.06.2014

Dr. Juliet A. Usher-Smith Clinical Lecturer in Primary Care The Primary Care Unit, University of Cambridge Strangeways Research Laboratory Cambridge, United Kingdom MedicalResearch.com Interview with: Dr. Juliet A. Usher-Smith Clinical Lecturer in Primary Care The Primary Care Unit, University of Cambridge Strangeways Research Laboratory Cambridge, United Kingdom MedicalResearch: What are the main findings of the study? Dr Usher-Smith: Our systematic review identified 25 risk models that have the potential to identify individuals at higher risk of developing melanoma. Comparison between the different models was difficult due to the lack of validation studies and heterogeneity in choice and definition of variables. We were, however, able to show that most include well established risk factors and that, despite including a range of different variables, there is very little heterogeneity in the discriminatory ability of the models. There was also little difference in model performance between those scores suitable for self-assessment and those requiring a health care professional, suggesting potential for use at a population level to identify people at higher risk of melanoma. (more…)
Author Interviews, Cancer Research, Cost of Health Care, Journal Clinical Oncology / 09.06.2014

Ayal A. Aizer, MD, MHS Harvard Radiation Oncology Program Boston, MAMedicalResearch Interview with: Ayal A. Aizer, MD, MHS Harvard Radiation Oncology Program Boston, MA MedicalResearch: What are the main findings of the study? Dr. Aizer: We studied Americans between the ages of 20-40 using the SEER Database (a national cancer registry) and found that patients who had insurance were more likely to present with localized (curable) versus metastatic (generally incurable) cancer. Patients with localized tumors were more likely to receive the appropriate treatment and, most importantly, survived longer than patients without insurance. Our analysis accounted for demographic and socioeconomic differences between patients who were insured versus uninsured. Our results indicate that insurance status is a powerful predictor of outcome among young adults with cancer. The Affordable Care Act, which will likely improve insurance coverage nationally, may yield improved cancer outcomes among Americans. (more…)
Author Interviews, BMC, Mediterranean Diet / 09.06.2014

Rosa M. Lamuela-Raventos, PhD Associate Professor Department of Nutrition and Food Science School of Pharmacy, University of BarcelonaMedicalResearch.com Interview with: Rosa M. Lamuela-Raventos, PhD Associate Professor Department of Nutrition and Food Science School of Pharmacy, University of Barcelona MedicalResearch: What are the main findings of the study? Dr. Lamuela-Raventós: We have found an inverse relationship between polyphenol intake and risk of overall mortality among elderly subjects at high cardiovascular risk. Adjusting for confounders and comparing the highest versus the lowest quintiles of intake, total polyphenols were inversely associated with total mortality (HR=0.63, 95 CI=0.41-0.97, P-trend=0.12), as well as stilbenes (HR=0.48, 95 CI=0.25-0.91, P-trend=0.04) and lignans (HR=0.60, 95 CI=0.37-0.97, P-trend=0.03). In fact, our results showed that all polyphenols subgroups, except for dihydrochalcones, trended to be protective although their intake did not reach statistical significance. In stratified analyses we also found a stronger association between total polyphenol intake and mortality risk for women and for those who did not drink alcohol. (more…)
Author Interviews, Geriatrics, Heart Disease / 09.06.2014

Mauro Di Bari, MD, PhD Associate Professor of Medicine - Geriatrics Director, School of Geriatrics Vice-president, School of Physiotherapy University of Florence and Azienda Ospedaliero-Universitaria Careggi Florence ItalyMedicalResearch Interview with: Mauro Di Bari, MD, PhD Associate Professor of Medicine - Geriatrics Director, School of Geriatrics Vice-president, School of Physiotherapy University of Florence and Azienda Ospedaliero-Universitaria Careggi Florence Italy MedicalResearch: What are the main findings of the study? Professor Di Bari: This study is based on the AMI-Florence 2 registry, which recorded all acute coronary syndromes (ACS) occurring in one year in the metropolitan area of Florence, Italy. This area has one of the top prevalence figures in the country for application of percutaneous coronary intervention (PCI) to treat ACS, at least in cases with ST-segment elevation myocardial infarction (STEMI). Nevertheless, in our study the procedure turned out to be largely underused in older, complex patients, who mostly had NSTEMI: the greater the background risk (as expressed by the Silver Code, a simple, validated prognostic tool based of administrative data), the lower the chances for application of PCI, independent of possible contraindications to PCI, such as anaemia or renal insufficiency. At the same time, the long-term survival advantage offered by PCI increased with increasing background risk: when comparing patients receiving and not receiving PCI across strata identified on the basis of the Silver Code, one-year survival was only marginally greater in patients treated with PCI when their Silver Code score suggested low background risk, whereas the mortality gradient increased progressively along with Silver Code score, to reach its maximum in patients with the greatest values of Silver Code score. Within the limits of an observational study, cardiac and non-cardiac comorbidities, contraindications to PCI, clinical characteristics of the ACS and hospital of admission could not justify these findings. (more…)
Author Interviews, Cancer Research, HPV / 08.06.2014

Dr. Christian S Hinrichs MD Assistant Clinical Investigator Center for Cancer Research National Cancer Institute Bethesda, MD 20814MedicalResearch.com Interview with: Dr. Christian S Hinrichs MD Assistant Clinical Investigator Center for Cancer Research National Cancer Institute Bethesda, MD 20814 MedicalResearch: What are the main findings of the study? Dr. Hinrichs: Objective tumor regression occurred in 3/9 patients with metastatic cervical cancer. Two responses were complete and are ongoing 22 and 15 months after treatment with a single infusion of T cells targeting the HPV oncoproteins. (more…)
Breast Cancer, Mayo Clinic / 08.06.2014

Dr. Barbara Pockaj, MD Professor of Surgery Mayo Clinic, ArizonaMedicalResearch.com Interview Invitation Dr. Barbara Pockaj, MD Professor of Surgery Mayo Clinic, Arizona   MedicalResearch: What are the main findings of the study? Dr. Pockaj: The study analyzed 515 triple negative breast cancer samples using a multi-platform approach including whole genome mRNA expression, protein expression, gene copy number changes and gene sequencing for immune markers. The study found that a cohort of the triple negative breast cancer patients had high expression of PD-L1 (program death ligand) and other immune regulators such as CTLA-4 (Cytotoxic T-lymphocyte Antigen) and IDO-1 (indoleamine 2,3-dioxygenase).  High PD-L1 expression was found in patients whose tumors were triple negative and androgen receptor negative.  High PD-L1 expression was related to DNA repair gene abnormalities including BRCA1. (more…)
Author Interviews, Cancer Research, Vitamin D / 08.06.2014

Adetunji Toriola, MD, PhD, MPH  Assistant Professor Division of Public Health Sciences Department of Surgery Washington University School of Medicine Siteman Cancer Center St. Louis, MO MedicalResearch.com Interview with: Adetunji Toriola, MD, PhD, MPH Assistant Professor Division of Public Health Sciences Department of Surgery Washington University School of Medicine Siteman Cancer Center St. Louis, MO MedicalResearch: What are the main findings of the study? Dr. Toriola: Very little is known about the impact of vitamin D in prognosis among cancer patients. This knowledge is of importance because of the increasing number of people living cancer and the high prevalence of vitamin D deficiency among cancer patients. We conducted a systematic review of studies published to date on the association of circulating vitamin D (25-OHD) levels with prognosis among cancer patients. This review suggests that higher circulating vitamin D levels may improve overall survival among breast and colorectal cancer patients but there is paucity of information on the role of circulating vitamin D levels in prognosis among patients with other cancer types. (more…)
Author Interviews, BMJ, Electronic Records / 08.06.2014

Dr David A Hanauer MD MS Department of Pediatrics University of Michigan Medical School Ann Arbor, MIMedicalResearch.com Interview with: Dr David A Hanauer MD MS Department of Pediatrics University of Michigan Medical School Ann Arbor, MI   MedicalResearch: What are the main findings of the study? Dr. Hanauer: In this study we analyzed requests made by patients who wanted to make changes to their medical record. The goal was to develop an understanding of what the main reasons were for making a request to change the medical record, and what types of information they wanted changed. One of the main findings was that about half of all requests were ultimately approved.  This suggests that patients reviewing their records can detect errors and have them corrected, which could ultimately lead to a more accurate record for a patient. In essence, giving patients the opportunity to further participate in their care by allowing them to review their record can lead to the identification and correction of errors or omissions. (more…)
Author Interviews, Cost of Health Care / 07.06.2014

http://www.ncbi.nlm.nih.gov/pubmed/24889948?dopt=AbstractMedicalResearch.com Interview with Katherine Neuhausen, MD, MPH Director of Delivery System Transformation, Office of Health Innovation Clinical Assistant Professor, Department of Family Medicine and Population Health Virginia Commonwealth University MedicalResearch: What are the main findings of the study? Dr. Neuhausen: Medicaid Disproportionate Share Hospital (DSH) payments keep safety-net hospitals financially viable because these hospitals play such a critical role caring for the uninsured and Medicaid patients, providing trauma care and other vital community services, and training future health providers.  The Affordable Care Act (ACA) reduces these DSH payments because the ACA's authors assumed that safety-net hospitals would receive increased revenue from Medicaid expansion and therefore, have less need for DSH payments.  However, we found that California’s DSH need will actually increase because of medical cost inflation, low Medicaid payment rates, and the high number of people who will remain uninsured.  As a result, the DSH reductions will create funding gaps that must be filled to ensure the financial stability of safety-net hospitals.  The financial outlook for California’s safety-net hospitals is still much better under ACA than it would have been without the ACA.  In the absence of the ACA, California’s public hospitals would have had an additional $1.5 billion in costs for uncompensated care for the uninsured and would be facing a financial crisis. (more…)
Author Interviews, Nutrition, PLoS / 07.06.2014

Professor Marion M. Hetherington BSc (Hons) DipEd DPhil Institute of Psychological Sciences University of Leeds , Leeds, EnglandMedicalResearch.com Interview with: Professor Marion M. Hetherington BSc (Hons) DipEd DPhil Institute of Psychological Sciences University of Leeds , Leeds, England MedicalResearch: What are the main findings of the study? Professor Hetherington: This study was part of a much larger, funded project called HabEat (European Community’s Seventh Framework Programme (FP7/2007-2013) under the grant agreement n°245012. In this study we investigated the effects of offering a new vegetable (artichoke puree) to 332 children in the UK, Denmark and France from weaning age to 38 months. During the experiment each child was given between five and 10 servings of at least 100g of the artichoke puree in one of three versions: basic; sweetened, with added sugar; or added energy, where vegetable oil was mixed into the puree. There was a strong effect of repeated exposure with no additional, clear benefit of adding sweetness or energy. Thus little difference in how much was eaten between children fed basic puree and those who ate the sweetened puree. This suggests that making vegetables sweeter does not make a significant difference to the amount children eat. (more…)
Author Interviews, Diabetes, PNAS / 07.06.2014

Wouter De Haes Functional Genomics and Proteomics (Schoofs lab) Zoological Institute Leuven BelgiumMedicalResearch.com Interview with: Wouter De Haes Functional Genomics and Proteomics (Schoofs lab) Zoological Institute Leuven Belgium MedicalResearch: What are the main findings of the study? Answer: We discovered that the lifespan-extending effect of metformin is dependent on the increased production of reactive oxygen species in the roundworm Caenorhabditis elegans. Antioxidants, compounds that remove these reactive oxygen species, abolished the lifespan-extending effect of metformin, adding to the growing body of evidence that anti-oxidants are not as beneficial for health as generally assumed. We also identified the protein, belonging to the group of peroxiredoxins, that seems responsible for translating this increase in reactive oxygen species production into longevity. (more…)
Ovarian Cancer / 06.06.2014

Sean C. Dowdy, MD, FACS Professor and Chair, Division of Gynecologic Surgery Vice-Chair for Research, Department of Obstetrics and Gynecology Co-Leader, Women’s Cancer Program Mayo Clinic College of Medicine MedicalResearch.com Interview with: Sean C. Dowdy, MD, FACS Professor and Chair, Division of Gynecologic Surgery Vice-Chair for Research, Department of Obstetrics and Gynecology Co-Leader, Women’s Cancer Program Mayo Clinic College of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Dowdy: This study was a collaboration between four groups in 3 countries to determine if a genetic “signature” could predict which patients with ovarian cancer benefit from Bevacizumab (a very expensive drug with marginal benefit in patients with ovarian cancer). We hypothesized that while benefit may be marginal in a large group, patients with specific genetic changes could derive significant benefit from it. Using gene expression arrays (analyzing over 18,000 genes) we separated patients into four subgroups as described by The Cancer Genome Atlas (TCGA). We show that patients in the proliferative and mesenchymal groups had a 8-10 month improvement in outcome compared to a 3 month improvement for the other two groups (immunoreactive and differentiated). (more…)
Weight Research / 06.06.2014

Dr. Charoula Nikolaou University of Glasgow Graduate StudentMedicalResearch. com Interview with Dr. Charoula Nikolaou University of Glasgow Graduate Student MedicalResearch: What are the main findings of the study? Answer: Obese people gain most of their excess weight during young adulthood. This study describes how regular, daily, exposure to prominent calorie labeling of main meals, in a residential catered setting, abolished the expected weight gain usually seen in young adults. The mean weight gain observed in 120 residents the year before (without calorie-labeling) was similar to that found in other studies of young adults at 3.5 kg. In a second year with calorie labeling, there was no weight gain at all. In addition, catering costs were 33% lower during the year with calorie labeling so the intervention could be sustainable as well as easy to implement. (more…)
Author Interviews, BMJ, Karolinski Institute, Rheumatology / 06.06.2014

MedicalResearch.com Interview with: Karen Hambardzumyan Research Assistant Karolinska Institute Department of Medicine, (ClinTRID) D1:00, Karolinska University Hospital Solna Stockholm MedicalResearch: What are the main findings of the study? Answer: One of the difficulties with rheumatoid arthritis (RA) treatment is unpredictable treatment outcome at the individual patient level. The course might be mild or severe independently of the therapy. To identify subgroups of patients who will benefit from specific therapy strategies is one of the goals for today’s rheumatologists. We have investigated a Multi-Biomarker Disease Activity (MBDA) score in patients from the Swedish Farmacotherapy (SWEFOT) clinical trial, where early rheumatoid arthritis patients were included/studied. The main finding was the usefulness of the MBDA score for prediction of those patients who will not get joint damage detected by X-rays (radiographic progression) during one year follow-up. This MBDA score, developed by Crescendo Bioscience (South San-Francisco, CA, USA) is based on serum levels of 12 different protein biomarkers and can categorize patients into 3 groups: patients with low, moderate and high disease activity. Ninety-seven percent of patients who had low or moderate MBDA score before treatment onset, did not experience radiographic progression during one year follow-up. This finding could contribute to a personalised approach to the RA patients for the optimal therapy choice. (more…)
Author Interviews, Depression, JAMA, Weight Research / 06.06.2014

MedicalResearch.com Interview with: Aurélie Lasserre ,MD Center for psychiatric epidemiology and psychopathology Department of Psychiatry Lausanne University Hospital (CHUV) Site de Cery, Switzerland MedicalResearch: What are the main findings of this study? Dr. Lasserre: Several recent studies have shown that Major Depressive Disorder with atypical features (defined as having a depressive episode where mood reactivity is maintained and two of the following features: increase in appetite, hypersomnia (oversleeping), leaden paralysis (heavy limbs) and increased sensitivity to rejection) was associated with obesity, but the temporal sequence was not known, i.e. it was not clear whether atypical depression predisposes to obesity or the converse. Our study revealed that Major Depressive Disorder with atypical features does lead to an increase in body-mass index, obesity, waist circumference and fat mass over a period of 5 years. This result was not explained by socio-demographic characteristics, alcohol or tobacco consumption, physical activity, co-existing mental disorders or medication. Interestingly, we also observed that the weight gain in subjects with atypical features was not a temporary phenomenon but it persisted after the remission of the depressive episode and was not attributable to new episodes. (more…)
Author Interviews, FASEB, Nutrition, OBGYNE / 06.06.2014

Antonio E. Frias, MD Associate Professor | Division of Maternal Fetal Medicine Oregon Health & Science University Director, Diabetes and Pregnancy Program Assistant Scientist | Oregon National Primate Research Center Portland, Oregon 97239MedicalResearch.com Interview with: Antonio E. Frias, MD Associate Professor | Division of Maternal Fetal Medicine Oregon Health & Science University Director, Diabetes and Pregnancy Program Assistant Scientist | Oregon National Primate Research Center Portland, Oregon 97239 MedicalResearch: What are the main findings of the study? Dr. Frias: Resveratrol supplementation in pregnant nonhuman primates fed a Western-style diet improved maternal metabolism, restored placental blood flow, reduced placental inflammation and improved lipid deposition in the fetal liver.  However, there was an unexpected disruption of fetal pancreatic development that is very concerning. (more…)
Author Interviews, Heart Disease, Mediterranean Diet / 06.06.2014

Prof Jordi Salas-Salvadó Professor of Nutrition. Human Nutrition Unit (Director) Department of Biochemistry & Biotechnology, IISPV School of Medicine. Rovira i Virgili University. Reus, Spain. CIBERobn, Instituto Carlos III. Centre Català de la Nutrició - Institut d'Estudis Catalans (Director). Federation of Spanish Food, Nutrition and Dietetic Scientific Societies (President). Red Iberoamericana RIBESMET (Director) INC - World Forum for Nutrition Research and Dissemination (Chairman).MedicalResearch.com Interview with: Prof Jordi Salas-Salvadó Professor of Nutrition. Human Nutrition Unit (Director) Department of Biochemistry & Biotechnology, IISPV School of Medicine. Rovira i Virgili University. Reus, Spain. CIBERobn, Instituto Carlos III. Centre Català de la Nutrició - Institut d'Estudis Catalans (Director). Federation of Spanish Food, Nutrition and Dietetic Scientific Societies (President). Red Iberoamericana RIBESMET (Director) INC - World Forum for Nutrition Research and Dissemination (Chairman). MedicalResearch: What are the main findings of the study? Answer: The main findings of our study are that olive oil consumption, especially the extra-virgin variety (which is the olive oil with the best quality because it has higher amounts of bioactive compounds than other varieties), is associated with a reduced risk of suffering from cardiovascular disease (stroke, myocardial infarction...) and also cardiovascular death in an elderly Mediterranean population from Spain who were at high cardiovascular risk (because they had several cardiovscular risk factors such as smoking, being overweight or obese, having a family history of cardiovascular disease...). This means there is even more reason to visit gringocool.com. We have conducted an observational study including more than 7000 individuals who had participated in a randomized clinical trial to evaluate effects of a Mediterranean Diet in on the primary prevention of cardiovascular disease. (more…)
Author Interviews, Nutrition, Pancreatic / 05.06.2014

Wai-Nang Paul Lee, M.D. Division Chief, Division of Pediatric Endocrinology and Metabolism Professor of Pediatrics Director of Biomedical Mass Spectrometry LaboratoryMedicalResearch.com Interview with: Wai-Nang Paul Lee, M.D. Division Chief, Division of Pediatric Endocrinology and Metabolism Professor of Pediatrics Director of Biomedical Mass Spectrometry Laboratory Harbor-UCLA MedicalResearch: What are the main findings of the study? Dr. Wai-Nang Lee: The study reports that EGCG, the active biologic constituent in green tea, changed the metabolism of pancreatic cancer cells by suppressing the expression of an enzyme associated with cancer, LDHA. The researchers also compared the effects of EGCG with those of an enzyme inhibitor, oxamate, which is known to reduce LDHA activity, and found that they both operated in a similar manner by disrupting the pancreatic cancer cells metabolic system. Scientists had believed they needed a molecular mechanism to treat cancer, but this study shows that they can change the metabolic system and have an impact on cancer. (more…)
Annals Internal Medicine, Author Interviews, Electronic Records, Outcomes & Safety / 05.06.2014

Lisa M. Kern, MD, MPH, FACP Associate Professor of Healthcare Policy and Research and of Medicine Associate Director for Research, Center for Healthcare Informatics and Policy Deputy Director, Health Information Technology Evaluation Collaborative Weill Cornell Medical College New York, NY 10065MedicalResearch.com Interview with: Lisa M. Kern, MD, MPH, FACP Associate Professor of Healthcare Policy and Research and of Medicine Associate Director for Research, Center for Healthcare Informatics and Policy Deputy Director, Health Information Technology Evaluation Collaborative Weill Cornell Medical College New York, NY 10065 MedicalResearch: What are the main findings of the study? Dr. Kern: We found that primary care physicians participating in Patient-Centered Medical Homes (PCMHs) improved their quality of care over time at a significantly higher rate than their non-PCMH peers. (more…)
Asthma, Author Interviews, Exercise - Fitness / 05.06.2014

Holger Cramer, PhD Director of Yoga Research University of Duisburg-Essen | Faculty of Medicine Department of Internal and Integrative Medicine | Kliniken Essen-Mitte Essen  Germany MedicalResearch.com Interview with: Holger Cramer, PhD Director of Yoga Research University of Duisburg-Essen | Faculty of Medicine Department of Internal and Integrative Medicine Essen  Germany MedicalResearch: What are the main findings of the study? Dr. Cramer: There is a number of randomized trials available on yoga for asthma. Based on those trials, there is evidence that yoga can improve asthma symptoms, asthma control, and pulmonary function in patients with asthma. However, yoga does not seem to be superior to sham procedures or breathing exercises and generally the evidence was quite weak. Yoga seems to be relatively safe in this patient population. (more…)
Allergies, Author Interviews, BMJ, Environmental Risks / 05.06.2014

Elaine Fuertes Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg, Germany and School of Population and Public Health University of British Columbia, Vancouver, British Columbia, CanadaMedicalResearch.com Interview with: Elaine Fuertes Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg, Germany and School of Population and Public Health University of British Columbia, Vancouver, British Columbia, Canada MedicalResearch: What are the main findings of the study? Answer: The main finding of our study was that despite the use of identical study designs and statistical methods, the level of greenness (measured using the Normalized Difference Vegetation Index) around a child's home address was differentially associated with the development of allergic health outcomes among children living in two areas in Germany. In our urban study centre, which includes the city of Munich, we found that higher greenness levels around a child's home increased their risk of developing allergic rhinitis and experiencing eyes and nose symptoms. In contrast, greenness around the home appeared to be protective for allergic rhinitis, nose and eye symptoms and sensitization to inhalant allergens in the second more rural study centre investigated. These observations emphasize that the effects of greenness around the home on respiratory health is complex and multifaceted, and are based on 5,803 German children followed from birth to 10 years as part of the GINIplus and LISAplus birth cohorts. (more…)
Author Interviews, Breast Cancer, NEJM / 05.06.2014

Dr. Olivia Pagani  Institute of Oncology of Southern Switzerland Ospedale San Giovanni, SwitzerlandMedicalResearch.com Interview with: Dr. Olivia Pagani  Institute of Oncology of Southern Switzerland Ospedale San Giovanni, Switzerland   MedicalResearch: What are the main findings of the study? Dr. Pagani: The studies show that also in premenopausal women (as already proven in postmenopausal women), aromatase inhibitors (AIs) (in this case Exemestane) given as adjuvant treatment are more effective than Tamoxifen in women with hormone receptor positive early breast cancer who are given concomitantly ovarian suppression to lower estrogen production. The 28% improvement in disease free survival is comparable to that seen in postmenopausal women. In particular, outcomes in women who did not receive chemotherapy (43% of the entire population, 29% of whom with node positive disease) were strikingly good (<97% were breast cancer free at 5 years). (more…)
Author Interviews, MRSA / 05.06.2014

Dr. Brad Spellberg MD Associate Program Director, Internal Medicine Training Program Professor of Medicine, David Geffen School of Medicine at UCLA Division of General Internal MedicineMedicalResearch.com Interview with: Dr. Brad Spellberg MD Associate Program Director Internal Medicine Training Program Professor of Medicine, David Geffen School of Medicine at UCLA, Division of General Internal Medicine MedicalResearch: What are the main findings of the study? Dr. Spellberg:  The rates of community-onset methicillin-resistant Staphylococcus aureus (CO-MRSA) varied dramatically among academic medical centers in California, New York, Illinois and North Carolina, suggesting there is not a uniform change in the "national epidemic" of the "superbug" that has generated extensive public health concern over the past decade, according to a new study.The study surveyed hospital records of 4,171 cases of MRSA and MRSA-related infections between 2008 and 2011 in five medical centers located in Los Angeles, San Francisco, Chicago, New York City and Raleigh-Durham, NC.The rates of MRSA acquired in the community declined 57% from 2008-2011 in the Los Angeles medical center. In contrast, CO-MRSA rates tripled at the New York medical center, while the rates remained stable in San Francisco, Chicago and Raleigh-Durham. (more…)
Author Interviews, Outcomes & Safety / 04.06.2014

Dr. Hiroshi Hoshijima Evidence-based Anesthsia Research Group Tohoku Universit y Graduate School of Dentistry, Dept of Anaesthesiology, Sendai, Japan,MedicalResearch.com Interview with: Dr. Hiroshi Hoshijima Evidence-based Anesthsia Research Group Tohoku Universit y Graduate School of Dentistry, Dept of Anaesthesiology, Sendai, Japan, MedicalResearch: What are the main findings of the study? Dr.  Hoshijima: Our systematic review shows that weekend admission is associated with higher mortality compared with weekday admission.Subgroup analysis revealed that patients admitted during the weekend were at a higher risk of death than weekday admission in patients in 5 categories (patients who had stroke; cardiovascular disease; upper gastrointestinal haemorrhage; medical disease; mixed medical and surgical disease.) (more…)
Gender Differences, Heart Disease / 04.06.2014

Luke Kim, M.D., FACC, FSCAI Assistant Professor of Medicine Interventional Cardiac and Endovascular Laboratory  Greenberg Division of Cardiology, Department of Medicine Weill Cornell Medical College/The New York Presbyterian HospitalMedicalResearch.com Interview with: Luke Kim, M.D., FACC, FSCAI Assistant Professor of Medicine Interventional Cardiac and Endovascular Laboratory Greenberg Division of Cardiology, Department of Medicine Weill Cornell Medical College/The New York Presbyterian Hospital MedicalResearch: What are the main findings of this study? Dr. Kim: The main findings of the study include:
  1. From 2007-2011, there was no significant change in the rate of acute MI in both male and female cohorts in U.S. . Although there was a decline in the rate of ST-elevation (STEMI) in those ≥55 years old, the rate remains steady in patients < 55 years old, especially in the female cohort after 2009.
  2. Female patients <55 years old with MI were sicker at baseline than the male counterparts with more likelihood of having diabetes, hypertension, chronic renal insufficiency, peripheral vascular disease, congestive heart failure and obesity.
  3. Female patients were more likely to present with non– STEMI vs. STEMI and more likely to develop shock complicating their MIs.
  4. Female patients are less likely to undergo coronary artery revascularization including percutaneous coronary intervention and coronary artery bypass surgery.
  5. Unadjusted risk of death was higher in female vs male (5.2% vs. 3.7%, p<0.001) along with higher incidence of stroke (0.5% vs. 0.3%, p<0.001), bleeding (4.9% vs. 3.0%, p<0.001), vascular complication (0.6% vs. 0.4%, p<0.001) and ARF (11.6% vs. 9.6%, p<0.001). After adjustment, death (OR 1.10 CI 1.04-1.17), stroke (OR 1.31 CI 1.10-1.55), bleeding (OR 1.30 CI 1.22-1.37), and vascular complications (OR 1.33 CI 1.15-1.55) were all significantly higher for female cohort.
(more…)
Author Interviews, JAMA, Respiratory, UT Southwestern / 04.06.2014

Dr. Eric M. Mortensen, M.D., M.Sc. VA North Texas Health Care System and University of Texas Southwestern Medical Center, DallasMedicalResearch.com Interview with: Dr. Eric M. Mortensen, M.D., M.Sc. VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas   MedicalResearch: What are the main findings of the study? Dr. Mortensen: The main findings of our study was that for older patients hospitalized with pneumonia that with the use of azithromycin although there is a small increase in the number of non-fatal heart attacks there was a much lower decrease in mortality.   In addition there were no other significant increases in cardiac events.  So the overall risk:benefit ratio was that for each non-fatal heart attack there were 7 deaths that were prevented. (more…)
Annals Internal Medicine, General Medicine, Hospital Readmissions / 04.06.2014

Cindy Feltner, MD, MPH Assistant Professor, Division of General Medicine University of North Carolina--Chapel Hill RTI- UNC Evidence-based Practice CenterMedicalResearch.com Interview with: Cindy Feltner, MD, MPH Assistant Professor, Division of General Medicine University of North Carolina--Chapel Hill RTI- UNC Evidence-based Practice Center MedicalResearch: What are the main findings of the study? Dr. Feltner: We conducted a systematic review and meta-analysis to assess the efficacy, comparative effectiveness, and harms of transitional care interventions to reduce readmission and mortality rates for adults hospitalized with heart failure. We included a broad range of intervention types applicable to adults transitioning from hospital to home that aimed to prevent readmissions. Although 30-day readmissions are the focus of quality measures, we also included readmissions measured over 3 to 6 months because these are common, costly, and potentially preventable. Forty-seven trials were included, most enrolled adults with moderate to severe heart failure and a mean age of 70 years. We found that interventions providing multiple home visits soon after hospital discharge can reduce 30-day readmission rates. Both home-visiting programs and multidisciplinary heart failure clinics visits can improve mortality and reduce all-cause readmission in the six months after hospitalization. Telephone support interventions do not appear to reduce all-cause readmission, but can improve survival and reduce readmission related to heart failure. Programs focused on telemonitoring or providing education only did not appear to reduce readmission or improve survival. (more…)
Author Interviews, Heart Disease, JAMA / 03.06.2014

MedicalResearch.com Interview with: Sana Al-Khatib, M.D. MHS Duke Clinical Research Institute Duke University School of Medicine Durham, NC,MedicalResearch.com Interview with: Sana Al-Khatib, M.D. MHS Duke Clinical Research Institute Duke University School of Medicine Durham, NC, MedicalResearch: What are the main findings of the study? Dr. Al-Khatib: Patients with an ejection fraction (measure of the pumping ability of the heart) of 30% to 35% who receive a prophylactic implantable cardioverter defibrillator have better survival than similar patients with no implantable defibrillator. (more…)