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.
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MedicalResearch.com Interview with: Rajiv Chowdhury MD, PhD
Cardiovascular Epidemiologist
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.
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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.
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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.
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MedicalResearch.com Interview with:Bheeshma Ravi, MD
Orthopedic Surgery
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.
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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.
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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
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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.
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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”
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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.
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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.
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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.”
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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.
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MedicalResearch.com Interview with: Pashtun Shahim, MD
Clinical Neurochemistry Laboratory
Institute of Neuroscience and Physiology
Department of Neurochemistry
Sahlgrenska University Hospital, Mölndal
Sweden
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.
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MedicalResearch.com Interview with:Glenn Yiu, MD, PhD
Duke Ophthalmology
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.
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MedicalResearch.com Interview with: Martin Holzmann, MD, PhD
Department of Emergency Medicine,
Karolinska University Hospital
Stockholm Sweden.
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.
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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.
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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.
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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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MedicalResearch.com Interview with:Dr Josefin Vikström
Division of Obstetrics and Gynecology
Department of Clinical and Experimental Medicine
Faculty of Health Sciences
Linköping University, Linköping, Sweden
MedicalResearch.com: What are the main findings of the study?Dr. Vikström: Our study showed that women with a female infertility factor were more than two times more likely to have been born with a low birth weight (less than 2500g) or small for gestational age compared to women where the cause of infertility was unknown and/or male.
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MedicalResearch.com Interview with:Matthias Briel, MD, MSc
Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital of Basel, Basel, Switzerland
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
MedicalResearch.com: What are the main findings of the study?Dr. Briel: Using a retrospective cohort of 1017 randomized controlled trials (RCTs) based on archived protocols approved by six research ethics committees in Switzerland, Germany, and Canada between 2000 and 2003, we found that 25% of initiated RCTs were discontinued. While discontinuation was common with RCTs involving patients (28%), it was rare in RCTs with healthy volunteers (3%). The most commonly reported reason for RCT discontinuation was poor recruitment (10% of included RCTs). We found that trials with investigator sponsor (versus industry) and those with smaller planned sample sizes were at higher risk of discontinuation due to poor recruitment. Of discontinued RCTs, up to 60% remained unpublished. Trial investigators rarely informed research ethics committees about trial discontinuation and publication.
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MedicalResearch.com Interview with:Lauren Dutra, ScD
Postdoctoral Scholar, UCSF School of Medicine
Cardiovascular Research Institute
San Francisco, CA 94143
MedicalResearch.com: What are the main findings of the study?Answer:Middle and high school students who used e-cigarettes were more likely to smoke tobacco cigarettes. They were also more likely to progress from experimenting with tobacco cigarettes to becoming regular smokers.
Teen smokers who used e-cigarettes were more likely to be planning to quit in the next year and less likely to have abstained from smoking recently, compared to smokers who had never used e-cigarettes. They were also more likely to be heavier smokers (smoke more cigarettes per day) than those who had never tried e-cigarettes, that being said there are eliquids available that have no nicotine content whatsoever and these are therefore a much healthier option, you can see a wide variety of these at Gourmet E-Liquid.
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MedicalResearch.com Interview with: Liane J. Tinsley, MPH
Associate Research Scientist
Department of Epidemiology
New England Research Institutes, Inc.
Watertown, MA 02472
MedicalResearch.com: What are the main findings of the study?Answer: For this study, we analyzed health insurance data from a cohort of community-dwelling individuals between the ages of 30-79 at baseline, in Boston, MA. Massachusetts health care reform legislation, including the expansion of Medicaid, resulted in substantial overall gains in coverage in our study population. Despite being targeted by the law, the working poor (those currently working for pay, either part- or full-time and earning less than 200% of the US federal poverty threshold for household size) continued to report lower rates of insurance coverage following reform (13.3% without insurance), compared to the both non-working poor (4.7% without insurance) and the not poor (5.0% without insurance).
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MedicalResearch.com Interview with:Dr. Dewleen Baker MD
Veterans Affairs (VA) San Diego Healthcare System, San Diego, California
MedicalResearch.com: What are the main findings of the study?Dr. Baker:The main finding of this study is that a marker of peripheral inflammation, plasma CRP may be prospectively associated with PTSD symptom emergence, suggesting that inflammation may predispose to PTSD.
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MedicalResearch.com Interview with:Dr. Chuan-Ming Li MD, PhD
Statistician (Health/Medicine)
Division of Scientific Programs
The National Institute on Deafness and Other Communication Disorders
MedicalResearch.com: What are the main findings of the study?Dr. Chuan-Ming Li: We used data on adults 18 years or older from the National Health and Nutrition Examination Survey for the study and found that prevalence of moderate to severe depression was 4.9 percent for individuals who reported excellent hearing, 7.1 percent for those with good hearing and 11.4 percent for participants who reported having a little hearing trouble or greater hearing impairment (HI). Depression rates were higher in women than in men. The prevalence of depression increased as hearing impairment became worse, except among participants who were deaf. There was no association between self-reported HI and depression among people ages 70 years and older; however, an association between moderate HI measured by pure-tone threshold hearing exams and depression was found in women aged 70 years and older but not in men.
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MedicalResearch.com Interview with: Camilla Nykjaer, PhD Student
School of Food Science and Nutrition
University of Leeds, Leeds, UK
MedicalResearch.com: What are the main findings of the study?Answer:In our study, there was an association between the mother drinking alcohol during early pregnancy and being born preterm or small for gestational age. Babies of women who drank more than 2 units of alcohol per week in the first trimester were more likely to be born preterm, small for gestational age and with lower birth weight compared to non-drinkers, even after adjusting for a range of confounders including cotinine levels as a biomarker for smoking status. The association with preterm birth was present even in those mothers who reported drinking less than 2 units/week.
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MedicalResearch.com Interview with:Prof. Dr. Philip Van Damme, MD, PhD
Neuromuscular Reference Center, Neurology Department, University Hospitals Leuven
Vesalius Research Center, VIB, Leuven
Leuven Institute of Neurodegenerative Disorders (LIND)
KU Leuven, Belgium
MedicalResearch.com: What are the main findings of the study?Prof: Van Damme: Earlier FDG-PET studies carried out in the 80’ties already pointed out that patients with ALS had decrease glucose uptake in the brain that is more extended than the motor cortex, at least at the group level. Of course, this imaging technique has been improved since then.
We prospectively assessed the diagnostic and prognostic value of FDG-PET in patients that were referred to us because a diagnosis of ALS was suspected.
The most important finding of our study probably is that FDG-PET shows perirolandic and variable frontotemporal hypometabolism in most patients with ALS at the first presentation in our clinic. It suggests that FDG-PET is a very sensitive marker of cerebral involvement in ALS, which has a high sensitivity at the single patient level.
In addition our study revealed that the co-occurrence of extensive prefrontal or anterior temporal hypometabolism was present in about 10% of patients and had a negative effect on survival after disease onset.
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MedicalResearch.com Interview with:Brent J. Morris, M.D.
Shoulder and Elbow Surgery Fellowship
Texas Orthopaedic Hospital in affiliation with the University of Texas Houston Health Science Center, Houston, Texas
MedicalResearch.com: What are the main findings of the study? Dr. Morris: There are concerns that an increasing percentage of patients are receiving narcotics by “doctor shopping” or seeking narcotics from multiple providers. One in five of our postoperative orthopedic trauma patients received narcotics from one or more additional providers other than the treating surgeon.
Patients that doctor-shopped postoperatively had a significant increase in narcotic prescriptions, duration of narcotics, and morphine equivalent dose per day.
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MedicalResearch.com Interview with:
Andrew I. Geller, MD
Medical Officer in the Division of Healthcare Quality Promotion at CDC.
MedicalResearch.com: What are the main findings of the study?Dr. Geller: Using CDC’s national medication safety monitoring system, we estimated that, each year, there were about 100,000 visits made to U.S. emergency departments (EDs) for insulin-related hypoglycemia and errors during 2007-2011, or about half a million ED visits over the 5-year study period. This is important because many of these ED visits for insulin-related hypoglycemia may be preventable.
We also found these ED visits were more common with increasing age: every year, 1 in 49 insulin-treated seniors (aged 65 years or older) visited the ED because of hypoglycemia while on insulin or because of a medication error related to insulin. Among the very elderly (aged 80 years or older), this number was 1 in 8 annually.
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