MedicalResearch.com Interview with: Pietro Manuel Ferraro, MD PhD Candidate
Division of Nephrology
Catholic University of the Sacred Heart
Rome Italy
Medical Research: What are the main findings of the study?Dr. Ferraro: We analyzed the association between physical activity and energy intake and the risk of developing kidney stones in three large cohorts of U.S. health professionals. The 215,133 participants included did not have any history of kidney stones when follow-up began. During 20 years of follow-up, 5,355 of them developed a kidney stone. Initially, we found that participants with higher physical activity levels had a reduced risk of developing stones in two of the three cohorts. However, after accounting for a number of factors that could potentially confound the association such as age, body mass index and dietary intake, the association was no longer significant. Similarly, energy intake was not associated with a reduced risk of developing kidney stones. (more…)
MedicalResearch.com Interview with: Richard J. Kryscio, PhD, Professor
Sanders-Brown Center on Aging
University of Kentucky
Medical Research: What are the main findings of the study?Dr. Kryscio: We followed 531 elderly over time assessing their cognition annually; of these 105 (about 20%) eventually were diagnosed with a serious cognitive impairment (either a mild cognitive impairment or a dementia) and 77% of the latter declared a subjective memory complaint prior to the diagnosis of the impairment. In brief, declaration of a memory problem put a subject at three times the risk of a future impairment.
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MedicalResearch.com Interview with: Tuomo Tompuri, MD
Clinical Physiology and Nuclear Medicine
Kuopio University Hospital, Finland
Medical Research: What are the main findings of the study?Dr. Tompuri: Measures of the cardiorespiratory fitness should be scaled by lean mass instead of body weight, while aiming to enable comparison between the subjects. Our result is physiologically logical and confirms earlier observations of the topic. Scaling by body weight has been criticized, because body fat, per se, does not increase metabolism during exercise. We did observe that scaling by body weight introduces confounding by adiposity.
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MedicalResearch.com Interview with:Rebecca J. Schmidt, M.S., Ph.D.
Assistant Professor
Department of Public Health Sciences
The MIND Institute School of Medicine
University of California Davis
Davis, California 95616-8638
MedicalResearch: What are the main findings of the study?Dr. Schmidt: Women who had children with autism reported taking iron supplements during pregnancy and breastfeeding less often than women who children who were typically developing. Mothers of children with autism also had lower average iron intake.
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MedicalResearch.com Interview with:Dr Fergus Hamilton
University of Bristol, Centre for Academic Primary Care, School of Social and Community Medicine, Canyngne Hall, Bristol UK.
Medical Research: What are the main findings of the study?Dr. Hamilton:The findings of this study showed a stepwise increase in risk of cancer as calcium levels increase above the normal range, most notably in men. This relationship did occur in women, but was much less strong
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MedicalResearch.com Interview with: Dennis Kim, MD
Los Angeles Biomedical Research Institute Researcher
Medical Research: What are the main findings of the study?
Dr. Kim: Laparoscopic cholecystectomy, a minimally invasive procedure to remove the
gallbladder, is one of the most common abdominal surgeries in the U.S. Yet
medical centers around the country vary in their approaches to the procedure
with some moving patients quickly into surgery while others wait. Our study
found gallbladder removal surgery can wait until regular working hours
rather than rushing the patients into the operating room at night.
The gallbladder is a pear-shaped organ on the upper right side of the
abdomen that collects and stores bile, a digestive fluid produced by the
liver. Gallbladders may need to be removed from patients who suffer pain
from gallstones that block the flow of bile.
In a laparoscopic cholecystectomy, surgeons insert a tiny video camera and
special surgical tools through small incisions in the abdomen to remove the
gallbladder. Occasionally, surgeons may need to create a large incision to
remove the gallbladder, and this is known as an open cholecystectomy.
We conducted a retrospective study of 1,140 patients at two large urban
referral centers who underwent gallbladder removal surgeries. We found 11%
of the surgical procedures performed at night (7 a.m.-7 p.m.) were converted
to the more invasive procedure, open cholecystectomies. Only 6% of those who
underwent the surgery during the day required the more invasive form of
surgery.
(more…)
MedicalResearch.com Interview with: Prof. Bin He M.S. Ph.D
University of Minnesota’s College of Science and Engineering
Director of the University’s Institute for Engineering in Medicine.
MedicalResearch: What are the main findings of the study?Prof. He: It is found that people with long term mind body awareness training including yoga and meditation can learn much faster and better the brain-computer interface skills to control a computer cursor by their minds.
(more…)
MedicalResearch.com Interview with:Dr. Holly R. Wyatt, MD
Endocrine Society spokeswoman
Associate Professor, University of Colorado Denver
Medical Director, Anschutz Health and Wellness Center
Medical Director, ABC’s TV series “Extreme Weight Loss”.
MedicalResearch.com Editor’s note: Dr. Wyatt is a nationally known expert on obesity and weight control. Dr. Wyatt is co-founder of ‘The State of Slim’ behavioral weight management program and has been the National Program Director for the Centers for Obesity Research and Education (C.O.R.E.) since 1999. Dr. Wyatt publishes extensively in the obesity and metabolism literature including publications in the NEJM, Obesity, Annals of Internal Medicine, Journal of Clinical Endocrinology & Metabolism and American Journal of Clinical Nutrition among others. Dr. Wyatt kindly answered questions regarding weight loss and maintenance for the MedicalResearch.com audience.
Medical Research: How did you become interested in weight control?Dr. Wyatt: Basically, because I struggled with my weight all my life. I was always planning on going to medical school and had been interested in learning more about the science of weight gain and metabolism, but at the time the subject was not well studied. When I came to the University of Colorado for my medical residency, I met researchers who were investigating the growing problem of obesity and were passionate about finding effective strategies for weight management. I have been active in clinical practice and obesity research since that time.
Medical Research: Why does weight loss or even weight maintenance become so much harder as we age?
Dr. Wyatt: We don’t know all the reasons for certain, but the problem is most likely multifactorial.
First, as we age we lose muscle mass. To a large degree, muscle mass determines our metabolic rate so even if our body weight stays stable, our metabolic engine slows down as we lose muscle and it becomes harder to maintain that weight.
Secondly, there is some role with for hormonal changes, but this role is incompletely understood. With menopause we tend to store weight centrally in our bodies, which may be a hormonal effect.
Perhaps most importantly, life changes as we get older and our lifestyle and environment evolves. We may not realize how much these changes affect the amount of energy we burn as our environment become more sedentary and obesogenic.
I should also point out that it is harder for everyone in our society to avoid gaining weight, even for children. Increasing numbers of children and adolescents are overweight and fighting obesity.
(more…)
MedicalResearch.com Interview with: Dr. MichaelD. Keall PhD
Otago University, Wellington, New Zealand
Medical Research: What are the main findings of the study?Dr. Keall: We found that home injuries from falls could be reduced by 26% by making some simple modifications to people’s homes, consisting of handrails for steps and stairs, grab rails for bathrooms, outside lighting, edging for outside steps and slip-resistant surfacing for outside surfaces such as decks and porches.
(more…)
MedicalResearch.com Interview with: Prof Mika Kivimäki PhD
Department of Epidemiology and Public Health,
University College London, London, UK
Hjelt Institute, Medical Faculty, University of Helsinki, Helsinki, Finland
Medical Research: What are the main findings of the study?Prof. Kivimäki: In our study, we pooled published and unpublished data from 222 120 men and women from the USA, Europe, Japan, and Australia. Of them, 4963 individuals developed type 2 diabetes during the mean follow-up of 7.6 years. This is the largest study to date on this topic.
In an analysis stratified by socioeconomic status, the association between long working hours and diabetes was evident in the low socioeconomic status group, but was null in the high socioeconomic status group. The association in the low socioeconomic status group did not change after taking into account age, sex, obesity, physical activity, and shift working. So, the association was very robust.
In brief, the main finding of our meta-analysis is that the link between longer working hours and type 2 diabetes was apparent only in individuals in the low socioeconomic status groups.
(more…)
MedicalResearch.com Interview with: Dr. Lorraine Yeung
Division of Birth Defects and Developmental Disabilities
National Center on Birth Defects and Developmental Disabilities, CDC
Medical Research: What are the main findings of the study?Dr. Yeung: In this report, we looked at the percentages of children who received various recommended clinical preventive services. We found that millions of infants, children, and adolescents in the U.S. did not receive key clinical preventive services.
This report provides a baseline snapshot of the use of 11 key clinical preventive services before or shortly after the Affordable Care Act went into effect. A focus of the Affordable Care Act is on improving prevention of illness and disability and it does so by requiring new health insurance plans to provide certain clinical preventive services at no additional cost — with no copays or deductibles. This is important because we know increasing the use of these services can improve children’s health and promote healthy lifestyles that will enable them to reach their full potential.
Some of the important findings in this report were:
In 2007, parents of almost eight in 10 (79 percent) children aged 10-47 months reported that they were not asked by healthcare providers to complete a formal screen for developmental delays in the past year.
In 2009, more than half (56 percent) of children and adolescents did not visit the dentist in the past year and nearly nine of 10 (86 percent) children and adolescents did not receive a dental sealant or a topical fluoride application in the past year.
Nearly half (47 percent) of females aged 13-17 years had not received their recommended first dose of HPV vaccine in 2011.
Approximately one in three (31 percent) outpatient clinic visits made by 11-21 year-olds during 2004–2010 had no documentation of tobacco use status; eight of 10 (80 percent) of those who screened positive for tobacco use did not receive any cessation assistance.
Approximately one in four (24 percent) outpatient clinic visits for preventive care made by 3-17 year olds during 2009-2010 had no documentation of blood pressure measurement.
(more…)
MedicalResearch.com Interview with: Jerry D. Estep, M.D., FACC
Assistant Professor of Medicine, Weill Cornell Medical College
Medical Director, Heart Transplant & LVAD Program
Methodist DeBakey Heart & Vascular Center
Houston Methodist Hospital
Medical Research: What are the main findings of the study?Dr. Estep: There were two major findings:
1-Non-invasive Doppler echocardiographic and invasive measures of mean right atrial pressure (RAP) (r = 0.863; p < 0.0001), systolic pulmonary artery pressure (sPAP) (r=0.880; p<0.0001), right ventricular outflow tract stroke volume (r=0.660; p < 0.0001), and pulmonary vascular resistance (r = 0.643; p= 0.001) correlated significantly.
2-An algorithm integrating mitral inflow velocities, RAP, sPAP, and left atrial volume index was 90% accurate in distinguishing normal from elevated left ventricular filling pressures.
(more…)
MedicalResearch.com Interview with
Agneta Åkesson
Associate professor, senior lecturer Nutritional Epidemiology
IMM Institute of Environmental Medicine
Karolinska Institutet Stockholm, Sweden
Medical Research: What are the main findings of the study?Dr. Åkesson: Our study indicates that a healthy diet together with low-risk lifestyle practices such as being physically active, not smoking and having a moderate alcohol consumption, and with the absence of abdominal adiposity may prevent the vast majority of myocardial infarctions in men.
(more…)
MedicalResearch.com Interview with:
Dr. Philippe Courtet MD PhD
Centre Hospitalier Régional Universitaire de Montpellier, Institut National de la Santé et de la Récherche Médicale ,
Université Montpellier, Montpellier, France
Fondation Fondamental, Créteil, France
Medical Research: What are the main findings of the study?Dr. Courtet: Depressed outpatients who are beginning the treatment with a SSRI at higher dose than recommended present an increased risk (x2) of worsening of suicidal ideation during the first 6 weeks of treatment.
This is consistent with the study by Miller et al published in the same journal few weeks ago, reporting a double risk of suicide attempt in young subjects (<24 yrs) who are begun an SSRI at higher dose than recommended.
Our results showed that the increased suicide risk with the high dose of SSRI is not restricted to youngsters and is independent of the severity of the depression.
(more…)
MedicalResearch.com Interview with:Todd C. Lee, MD, MPH
Division of General Internal Medicine and Infectious Diseases
Department of Medicine, McGill University Health Centre
McGill Centre for Quality Improvement, Montreal, Quebec, Canada
Medical Research: What are the main findings of the study?Dr. Lee: We found that in our cross-sectional study of six inpatient units in five hospitals that, in general, only 11% of patients were wearing lower body garments despite the fact that probably 55% of them could have been doing so. The remainder were wearing open backed gowns. When specifically asked, the majority of these patients would like to have been afforded the opportunity to wear more dignified attire and the patients were surprised that they were allowed to do so.
(more…)
MedicalResearch.com Interview with:Prof. Moses Elisaf
Professor of Internal Medicine
University of Ioannina, Greece
Medical Research: What are the main findings of the study?Dr. Elisaf:We evaluated the effects of rosuvastatin in two groups of hyperlipidemic patients: one group had impaired fasting glucose (IFG) while the second group had normal fasting glucose. After study end, both groups had similar changes in their lipidemic profile.
However, patients with IFG had a significant greater decrease in the cholesterol concentration of the more atherogenic small dense low-density lipoprotein (sdLDL) particles (-65.7%) compared with controls (-38.5%). Moreover, a greater increase in the mean LDL particle size was observed in the impaired fasting glucose group (+1.5% vs +0.4%).
In addition, redistribution from the more atherogenic sdLDL to large buoyant
LDL (lbLDL) subfractions was observed in the IFG group.
(more…)
MedicalResearch.com Interview with:Dr. Peter Griffiths PhD, RN
Centre for Innovation and Leadership in Health Sciences
University of Southampton, Southampton, UK
Medical Research: What are the main findings of the study?Dr. Griffiths: This study found that hospital nurses who are working on a 2 shift system, where care is provided by nurses working long shifts of 12-13 hours, report lower quality and safety of care than nurses who work a traditional three shift system where nurses typically work shifts of 8 hours. We also found that nurses who were working overtime reported lower quality and safety of care. We found that these shifts are common in some European countries – most notably Poland, Ireland and England.
(more…)
MedicalResearch.com: Interview with: Girija Syamlal MBBS, MPH , Epidemiologist
Division of Respiratory Disease Studies
National Institute for Occupational Safety and Health
CDC, Morgantown, West Virginia
CDC/NIOSH/DRDS
Morgantown,WV 26505
Medical Research: What are the main findings of the study?
Dr. Syamlal: During 2004–2011, of the 141 million U.S. adults, 20.7% were current cigarette smokers. Smoking prevalences were higher among men (22.8%) than women (18.3%). In both men and women, cigarette smoking prevalence varied widely by occupational group. In certain occupations, the prevalence of smoking was three times greater than the Healthy People 2020 goal that aims to reduce cigarette smoking prevalence to 12%.
(more…)
MedicalResearch.com Interview with:Chester G. Chambers PhD
Armstrong Institute for Patient Safety and Quality
Johns Hopkins Carey Business School, Baltimore, Maryland
Medical Research: What are the main findings of the study?
Dr. Chambers: The main findings of this study are that several metrics of system performance can be improved by using simple methods proven to be effective in many production settings.
Specifically, the idea of using “Pre-processing” as an aspect of medical education improves patient flow times, waiting times, system throughput, and system capacity.
When fixed costs are spread across more patients, we are effectively reducing the cost per patient as well.
In this context “Pre-processing” simply refers to the practice of having medical trainees present and review cases with the attending prior to patient clinic visits as opposed to doing it in the midst of the patient visit. This simple idea is common in many areas including surgery but tends to get omitted in other settings involving ambulatory care. Our simple experiment verified that this practice has real value in a wide array of settings.
(more…)
MedicalResearch.com Interview with: Yuli Huang and Yunzhao Hu
Department of Cardiology, the First People's Hospital of Shunde,
Shunde District, Foshan, PR China.
Medical Research: What are the main findings of the study?Response: “Prediabetes” is a general term that refers to an intermediate stage between normoglycaemia and overt type 2 diabetes mellitus (T2DM). It includes 2 groups of individuals, those with impaired glucose tolerance (IGT) and those with impaired fasting glucose (IFG). In 2003, the American Diabetes Association (ADA) redefined the fasting plasma glucose (FPG) concentration range for diagnosing IFG from 110 to 125 mg/dl to 100 to 125 mg/dl in order to better identify individuals at future type 2 diabetes mellitus risk. However, this change has been contentious and was not adopted by the World Health Organization (WHO) Expert Group or other international guidelines.
In this meta-analysis, we included data from 26 prospective cohort studies with for 280,185 participants and found that, after controlling for multiple cardiovascular risk factors, the presence of prediabetes at baseline, defined as defined as IFG of 110 to 125 mg/dL(IFG 110), IGT or combined IFG 110 and/or IGT, was associated with increased risk of all-cause and cardiovascular mortality. Specifically, IFG 110 was associated with 12% and 19% increase of all-cause and cardiovascular mortality, IGT was associated with 33% and 23% increase of all-cause and cardiovascular mortality, combination of IFG110 and/or IGT was associated with 21% and 21% increase of all-cause and cardiovascular mortality, respectively. Although IFG 100 was not associated with all-cause or cardiovascular mortality in the overall analysis, the risk was greater in young and middle age males according to subgroup analyses.
(more…)
MedicalResearch.com Interview with: Dr. David O'Brart
Keratoconus Research Institute, Department of Ophthalmology
St. Thomas' Hospital, London, United Kingdom
Medical Research: What are the main findings of the study?Dr. O'Brart: There was a slight but significant increase in myopic spherical equivalent refractive error after Photorefractive Keratectomy between 1 and 20 years, particularly in those under 40 at the time of treatment and female patients.
Corneal curvature/power remained unchanged but axial length increased over two decades. The procedure was safe with no long-term sight-threatening complications and improvements in CDVA (corrected distance visual acuity) and corneal transparency with time.
(more…)
MedicalResearch.com: Interview InvitationDr. Csaba P. Kovesdy, MD
Professor of Medicine
University of Tennessee Health Science Center
Chief of Nephrology
Memphis Veterans Affairs Medical Center
Medical Research: What are the main findings of the study?Dr. Kovesdy: We applied the structure of a clinical trial of hypertension management to our cohort of >600,000 patients with prevalent Chronic Kidney Disease (CKD). We first identified patients with baseline uncontrolled hypertension (using the definition applied by the SPRINT trial), then isolated the ones who had a decline in their baseline systolic blood pressure to two different levels (<120 and 120-139 mmHg) in response to a concomitant increase in prescribed antihypertensives, similar to what would happen in a trial examining two different systolic blood pressure targets. We then matched patients in the two groups to end up with identical baseline characteristics, similar to a randomized trial. When we examined the all-cause mortality of these two groups, we found that the group with follow-up systolic blood pressure of <120 had a 70% higher mortality.
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MedicalResearch.com Interview with: Mario Mandalà, MD
Unit of Clinical Research
Department of Oncology and Haematology
Papa Giovanni XXIII Hospital
Piazza OMS 1, 24100, Bergamo, Italy
Medical Research: What are the main findings of the study?Dr. Mandalà: We evaluated PD-L1 expression by IHC in 81 consecutive metastatic melanoma patients, with well-defined demographic and clinical characteristics. Protein expression levels were correlated with clinical outcome. PD-L1+ and PD-L1- subsets of the A375 cell line were stabilized in vitro and compared using gene expression profiling and functional assays. Results were confirmed using xenograft models. In our study PD-L1 membrane positivity was an independent negative prognostic marker. Furthermore PD-L1 expression defined a subset of the BRAF-mutated A375 cell line characterized by a highly invasive phenotype and by enhanced ability to grow in xenograft models. If confirmed, our clinical and experimental data suggest that PD-L1+ melanomas should be considered a disease subset with distinct genetic and morpho-phenotypic features, leading to enhanced aggressiveness and invasiveness.
(more…)
MedicalResearch.com Interview with: Andrea Gershon MD, MSc, FRCP(C)
Scientist, Institute for Clinical Evaluative Sciences
Respirologist, Division of Respirology, Sunnybrook Health Sciences Centre
Assistant Professor of Medicine, University of Toronto
ICES Central Bayview Avenue, Toronto, Ontario
Medical Research: What are the main findings of the study?Dr. Gershon: Within a large real world population of people with COPD, those who initiated combination long-acting beta-agonists (LABA) and inhaled corticosteroids (ICS) were less likely to die or be hospitalized for COPD than those who initiated LABA alone. Further those who initiated LABA/ICS combination therapy did not appear to have more pneumonia or osteoporotic fractures – side effects that have been associated with ICS use—than those initiating LABA alone.
A second interesting finding was that people with a co-diagnosis of asthma experienced a greater incremental benefit of LABA/ICS over LABA than people without a co-diagnosis of asthma.
Finally, we found that people who were not also taking an inhaled long-acting anticholinergic medication experienced a greater incremental benefit of LABA/ICS over LABA than people who were.
(more…)
MedicalResearch.com Interview with: Lynn L. Moore, DSc, MPH
Co-Director, Nutrition and Metabolism
Assoc Prof of Medicine
Preventive Medicine & Epidemiology Department of Medicine
Boston University School of Medicine
Boston, MA 02118
Medical Research: What are the main findings of the study?Response: Our data were derived from 1,361 adults (aged 30-54 years) enrolled in the Framingham Offspring Study and showed that men and women who consumed higher amounts of protein had lower blood pressures (both systolic and diastolic blood pressures) after four years of follow-up. We then followed them for an average of about 11 years and found that those who consumed the most protein (approximately 103 g/day) had about a 40% lower risk of developing high blood pressure than those consuming about half that amount. These beneficial effects were even more pronounced when higher protein intakes were combined with high fiber intakes.
(more…)
MedicalResearch.com Interview with: James J. Yoo, M.D., Ph.D.
Professor, Institute for Regenerative Medicine
Office of Women in Medicine and Science
Physiology & Pharmacology
Translational Science Institute
Wake Forest School of Medicine Winston-Salem, NC
Medical Research: What are the main findings of the study?Dr. Yoo: Our research is part of a long-term effort to engineer replacement kidneys in the lab to help solve the shortage of donor organs. In this particular report, we worked with human-sized kidneys and developed a method to help keep blood vessels in the new organs open and flowing with blood. Until now, lab-built kidneys had been rodent-sized and functioned for only one or two hours after transplantation because blood clots developed.
Our method to minimize clot formation involved two steps. First, we identified the most effective way to coat the vessels of the kidney scaffold with endothelial cells. We found that infusing cells with a syringe, followed by a period of pumping cells through the vessels at increasing flow rates, was most effective. Next, we looked for a way to ensure that the cells we introduced actually stayed in the vessels and did not wash away when blood flow was initiated. For this, we coated the vessel walls with an antibody to make them bind the endothelial cells.
(more…)
MedicalResearch.com Interview Dongyi (Tony) Du, MD, PhD
Division of Epidemiology
FDA/CDRH/OSB
Medical Research: What are the main findings of the study?Dr. Du: The risk for death on the date of surgery was 60% higher for recipients of mechanical aortic valves than recipients of bioprosthetic aortic valves (OR, 1.61 [95%CI, 1.27-2.04; P < .001]; risk ratio [RR], 1.60). The risk difference decreased to 16% during the 30 days after the date of surgery (OR, 1.18 [95%CI, 1.09-1.28; P < .001]; RR, 1.16). The risk for operative mortality was 19% higher for recipients of mechanical compared with bioprosthetic valves (OR, 1.21 [95%CI, 1.13-1.30; P < .001]; RR, 1.19). The number needed to treat with mechanical valves to observe 1 additional death on the surgery date was 290; to observe 1 additional death within 30 days of surgery, 121.
(more…)
MedicalResearch.com Interview with:Bindu Kalesan PhD MPH
Department of Epidemiology
Mailman School of Public Health
Columbia University
Medical Research: What are the main findings of the study?Dr. Kalesan:There were on average 84 gun deaths per day in the US between 2000 and 2010. The main message of the study is that the 11-year stable national firearm fatality rates mask the wide variation between states, racial and ethnic subgroups and intent of injury. Across 11 years, African-Americans had firearm fatality rates twice greater than Caucasians and 6-times greater than other minority races; the rates showing a decline only among other races. We found that the lowest rates are in HI while very high rates are observed in AK, LA and DC. Seven states (NY, IL, MD, NC, CA, AZ, NV) and DC showed declining rates while FL and MA had rising rates. The widely varying inter-state differences were driven by race specific differences within states.
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MedicalResearch.com Interview with: Szilárd Kiss, MD
Director of Clinical Research
Director of Compliance Associate Professor of Ophthalmology
Weill Cornell Medical College NewYork-Presbyterian Hospital
New York, New York 10021
Medical Research: What is the background for your study?Dr. Kiss: There has been a good deal of publicity about bevacizumab (Avastin; a Genetech/Roche antibody originally developed for treatment of cancer but now used widely to treat macular degeneration and diabetic retinopathy) being prepared by (mostly unregulated) compounding pharmacies for injection into the eye, and being associated with pathogen contamination.
(more…)
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