MedicalResearch.com Interview with:Jakob Christensen
Department of Neurology, Aarhus University Hospital, Aarhus, Denmark;
Merete Juul Sørensen
Regional Centre of Child and Adolescent Psychiatry, Aarhus University Hospital
MedicalResearch.com: What are the main findings of the study?Answer: We found that the risk of autism spectrum disorder was increased by 50% in children of mothers who took antidepressants during pregnancy. However, when we controlled for other factors related to the medication, by comparing with children of mothers with a diagnosis of depression or with un-exposed siblings, the risk was smaller and not significantly increased.
MedicalResearch.com Interview with: Richard Schwartz, Ph.D.
Professor, Associate Dean for Graduate Academic and Student Affairs College of Natural Science Michigan State University
Department of Microbiology and Molecular Genetics
Michigan State University East Lansing, MI 48824-4320
MedicalResearch.com: What are the main findings of the study?Dr. Schwartz: The main finding is that exposure to a high fat diet from the age of puberty onwards hastened the development of chemical carcinogen-induced breast cancer in absence of weight gain. We also found that prior to the appearance of any tumors, we could detect changes in the mammary gland that included increased cellular proliferation, increased vascularity, and changes in immune function.
MedicalResearch.com Interview with:Dr. Victor W. Henderson MD
Professor of Health Research and Policy and of Neurology and Neurological Sciences
Stanford University, Stanford, CA 94305
MedicalResearch.com: What are the main findings of the study?Dr. Henderson: Estrogen or hormone therapy effects on some health outcomes differ by age, harmful at one age and beneficial at another.
This difference is sometimes referred to as the “critical window” or “timing” theory. It is controversial whether the so-called critical-window applies to memory or other cognitive skills.
In assessing the critical window hypothesis, we found that the relation between blood levels of estrogen and memory or reasoning skills is the same in younger postmenopausal women as in older postmenopausal women. Essentially, there is no association at either age.
MedicalResearch.com Interview with Marzia Lazzerini, PhD
Institute for Maternal and Child Health IRCCS “Burlo Garofolo,”
MedicalResearch.com: What are the main findings of the study?Answer: In children and adolescent with Crohn’s disease refractory to first and second line treatment, thalidomide was effective in inducing and maintaining clinical remission. About 60% of children achieved clinical remission, and clinical remission was maintained for a mean time of 180 weeks. The main reason to stop thalidomide was peripheral neuropathy.
MedicalResearch.com Interview with:Ida C. Svege PhD student / Physical Therapist NAR
Norwegian research centre for Active Rehabilitation Department of Orthopaedics, Oslo University Hospital / NIMI / Norwegian School of Sports Sciences
MedicalResearch.com: What are the main findings of the study?Answer: The main finding of the study was that exercise therapy in addition to patient education resulted in significantly higher 6-year cumulative survival of the native hip to total hip replacement compared with patient education only. Over the 6 year follow-up period the need for total hip replacement was reduced by 44% in the group who received both exercise therpay and patient education. Also, better self-reported physical function was demonstrated in the group who received exercise therapy and patient education, suggesting that the lower surgery rate in this group were due to better hip function, with or without the presence of pain.
MedicalResearch.com Interview with:Craig A Umscheid, MD, MSCE, FACP
Assistant Professor of Medicine and Epidemiology
Director, Center for Evidence-based Practice
Medical Director, Clinical Decision Support
Chair, Department of Medicine Quality Committee
Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center
University of Pennsylvania Philadelphia, PA 19104
MedicalResearch.com: What are the main findings of the study?Dr. Umscheid: We developed and successfully deployed into the electronic health record of the University of Pennsylvania Health System an automated prediction tool which identifies newly admitted patients who are at risk for readmission within 30 days of discharge. Using local data, we found that having been admitted to the hospital two or more times in the 12 months prior to admission was the best way to predict which patients are at risk for being readmitted in the 30 days after discharge. Using this finding, our automated tool identifies patients who are “high risk” for readmission and creates a “flag” in their electronic health record (EHR). The flag appears next to the patient’s name in a column titled “readmission risk.” The flag can be double-clicked to display detailed information relevant to discharge planning. In a one year prospective validation of the tool, we found that patients who triggered the readmission alert were subsequently readmitted 31 percent of the time. When an alert was not triggered, patients were readmitted only 11 percent of the time. There was no evidence for an effect of the intervention on 30-day all-cause readmission rates in the 12-month period after implementation.
MedicalResearch.com Interview with:Thomas D. Sequist, MD, MPH,
MedicalResearch.com: What are the main findings of the study?Dr. Sequist: Our study, the Impact of Cost Displays on Primary Care Physician Laboratory Test Ordering published in the Journal of General Internal Medicine found that when the costs of certain lab tests were displayed electronically in real time, the rate at which physicians ordered tests decreased. It was conducted among 215 primary care physicians working for Atrius Health, an alliance of six non-profit medical groups and a home health and hospice agency in Massachusetts, where an integrated electronic health record system is used. Physicians in the intervention group received real-time information on laboratory costs for 27 individual tests when they placed their electronic orders, while the control group did not. What we found was a significant decrease in the ordering rates of both high and low cost range tests by physicians to whom the costs of the tests were displayed electronically in real-time. This included a decrease in ordering rates for four of the 21 lower cost laboratory tests, and one of six higher cost laboratory tests.
In addition, physicians were generally very receptive to the intervention. A majority (81 percent) reported that the exercise increased their knowledge regarding costs of care and requesting real-time cost information on an expanded set of health care services.
MedicalResearch.com Interview with:Julie A. Schmittdiel, PhD
Kaiser Permanente Division of Research
Oakland, CA 94612
MedicalResearch.com: What are the main findings of the study?Dr. Schmittdiel:We found that patients with diabetes who used mail order pharmacy were less likely to visit the emergency room than those who did not use mail order pharmacy during a 3 year follow-up period. We also did not see safety concerns associated with mail order pharmacy for most diabetes patients.
MedicalResearch.com Interview with Deanna Kepka, PhD, MPH
College of Nursing & Huntsman Cancer Institute
University of Utah
MedicalResearch.com: What are the main findings of the study?
Dr. Kepka: Nearly two-thirds, 64.8% (95% CI: 62.2% - 67.3%) of women reporting a hysterectomy also reported a recent Pap test since their hysterectomy and more than half, 58.4% (95% CI: 55.3% - 61.4%) of women age 65 years and older without a hysterectomy reported a Pap test in the past three years. Together, this represents approximately 14 million in the United States.
MedicalResearch.com Interview with:Bledar Daka MD, PhD-student.
University of Gothenburg in Sweden
MedicalResearch.com: What are the main findings of your study?Answer:The main finding of our study was that low testosterone levels were associated with MI in both men and women but the association was stronger in men with type 2 diabetes.
This finding was in concert with findings that could associate the CVD death with low levels of testosterone especially in elder men.
MedicalResearch.com Interview with:Elin Ekblom Bak | Doktorand
Institutionen för Medicin, Enheten för klinisk epidemiologi,
Karolinska universitetssjukhuset Solna
114 86 Stockholm
MedicalResearch.com: What are the main findings of the study?
Answer: That we, in a large sample of 60 y old men and women, found that a generally active day life (compared with an inactive daily life) was significantly associated with a better metabolic health at baseline, and a reduced risk with 27% for a first time cardiovascular event and 30% for all-cause mortality during 12.5 years of follow up. This was seen regardless of intentional exercise. Why this is important is because the focus is often of just exercise for health benefits and longevity. Exercise is still important, but, as we saw in this study, the activity that we do during the extended hours of daily living is as important and has a significant effect on cardiovascular health and longevity. These results are in a reversed way in line with the detrimental effects of prolonged sitting (regardless exercise habits) now frequently reported in an increasing amount of research studies. This is because sedentary time mainly replaces time in daily activity, and vice versa (daily activity replace time spent sitting).
MedicalResearch.com InterviewDr. Michael Shevell
Chair of the Pediatrics Department at the McGill Faculty of Medicine and Pediatrician-in-Chief at the Montreal Children’s Hospital and the McGill University Health Centre
MedicalResearch.com: What are the main findings of the study?Dr. Shevell: At risk term infants who have spent some time in a Level III NICU after birth are at substantially increased later risk for an autistic spectrum disorder. Frequently this disorder occurs in conjunction with substantial co-morbidity.
MedicalResearch.com Interview with:Dr Julia Wade PhD
University of Bristol, Clifton, Bristol
MedicalResearch.com: What are the main findings of the study?Dr. Wade:We hope that our study provides men with more information about diagnosing prostate cancer. A diagnosis of prostate cancer can only be confirmed through prostate biopsies after the finding of a raised PSA. This biopsy process requires 10 or so samples to be taken rectally, with a local anaesthetic, and this has some side effects. Most men describe prostate biopsies as uncomfortable, but around 40% report pain and many experience bleeding; a small number, 1%, are admitted to hospital and 10% need to see a doctor because of post-biopsy symptoms. We found that the men who experienced post-biopsy symptoms as ‘problematic’ at 7 days post biopsy also experienced raised anxiety compared to men who experienced symptoms as non-problematic
MedicalResearch.com Interview with: Mehwish Qasim
PhD Candidate, Research & Teaching Assistant
Department of Health Management and Policy
University of Iowa, College of Public Health
MedicalResearch.com: What are the main findings of the study?Answer:This study focused on two questions: Do patients living in the poorest communities have worse post-surgical outcomes than those in the wealthiest communities? And has the level of these differences in post-surgical outcomes changed over time?
We found that although post-surgical outcomes improved in general from 2000-2009, (significant decreases in nine of twelve mortality and patient safety measures), patients from low-income areas had worse surgical outcomes than those from high-income areas for nine of twelve measures in both 2000 and 2009. The disparities in outcomes between low- and high-income groups did not change significantly for nine of the twelve measures.
MedicalResearch.com Interview with:Professor Clive Page
Director, Sackler institute of Pulmonary Pharmacology
Joint Head, Institute of Pharmaceutical Science
King's College London
150 Stamford Street Waterloo Campus
London SE1 9NH
MedicalResearch.com: What are the main findings of the study?Prof. Page: RPL 554 was shown to cause bronchodilation and anti-inflammatory activity at the same dose. The drug showed benefit in both patients with COPD and asthma.
MedicalResearch.com Interview with:Prof Ype Elgersma PhD
Neuroscience Institute, Erasmus University Rotterdam
MedicalResearch.com: What are the main findings of the study?Answer: Research in genetic mouse models suggested that inhibition of HMG-CoA-reductase by statins might ameliorate the cognitive and behavioral phenotype of children with Neurofibromatosis type 1 (NF1), an autosomal dominant disorder. In a 12-month randomized placebo-controlled study including 84 children with NF1, we found that simvastatin, an inhibitor of the HMG-CoA-reductase pathway had no effect on full-scale intelligence, attention problems or internalizing behavioral problems, or on any of the secondary outcome measures.
MedicalResearch.com Interview with:Michael Ho, MD, PhD
Assistant Professor of Medicine, Division of Cardiology
Cardiology 111B 1055 Clermont Street
Denver CO 80220
MedicalResearch.com: What are the main findings of the study?Dr. Ho: We found that testosterone use was associated with a 29% increased risk of death, MI and stroke over a follow-up period of 27 months. The risk was similar among patients with or without coronary artery disease on coronary angiography.
MedicalResearch.com Interview with:Dr. Jinoos Yazdany MD, MPH
Assistant Professor in Residence
UCSF School of Medicine
MedicalResearch.com: What are the main findings of the study?Answer: For almost all of the drugs we examined, we found that less than half of patients adhered to treatment. For some drugs, less than one-third of individuals were adherent. The average medication possession ratios were low across all drugs.
We found that several factors played an important part in adherence. Younger individuals were less likely to adhere to treatment for several drugs, and we also found racial/ethnic differences, with Black, Hispanic and Native populations having lower adherence. We also found geographic variation in adherence, with individuals in the Northeast being the most likely to adhere to treatment.
MedicalResearch.com Interview with:Laura N. Vandenberg, PhD
University of Massachusetts – Amherst School of Public Health,
Division of Environmental Health Science
Amherst, MA 01003
MedicalResearch.com: What are the main findings of the study?Dr. Vandenberg:Back in 2007, a group of 38 researchers wrote the Chapel Hill consensus statement about BPA (vom Saal et al. Reproductive Toxicology 2007). We also wrote 5 separate review articles summarizing what was known at the time about
1) BPA and cancer;
2) BPA and its effects on wildlife animals and in environmental matrices (air, water, soil, etc.);
3) BPA and molecular mechanisms in cultured cells;
4) BPA levels in humans and their exposure sources;
5) BPA’s effects on laboratory animals.
Several of these groups analyzed what effects BPA has at “low doses”, i.e. at doses below those tested in traditional toxicology studies. (These are doses that are thought to be “safe” for animals and humans.)
MedicalResearch.com Interview with:Li-Shu Wang, PhD
Department of Medicine, Medical College of Wisconsin,
Milwaukee, WisconsinMedicalResearch.com: What are the main findings of the study?Answer:Ulcerative colitis (UC) is frequently an intermediate step to colon cancer. The interleukin-10 knock-out (KO) mouse is a genetic model of this progression. We have now shown that KO mice fed 5% black raspberries (BRBs) had significantly less colonic ulceration as compared to KO mice that consumed the control diet. Dysfunction of the Wnt signaling pathway is a key event in UC-associated colon carcinogenesis. We investigated the effects of BRBs on the Wnt pathway and found that the BRB-fed KO mice exhibited significantly decreased promoter methylation of Wnt antagonists and a significantly lower level of β-catenin nuclear translocation. Our results suggest that BRBs inhibit colonic ulceration partly through inhibiting aberrant epigenetic events that dysregulate Wnt signaling.
MedicalResearch.com Interview with:Alize J. Ferrari
University of Queensland
School of Population Health
Herston, Queensland, Australia
MedicalResearch.com: What are the main findings of the study?Answer: In our paper recently published in PloS Medicine, we report findings from the Global Burden of Disease Study 2010 for depression. We found that depression (defined as major depressive disorder and dysthymia) accounted fr 8% of the non fatal burden in 2010, making it the second leading cause of disability worldwide. Burden due to depression increased by 35% between 1990 and 2010, although this increase was entirely driven by population growth and ageing. Burden occurred across the entire lifespan, was higher in females compared to males, and there were differences between world regions.When depression was considered a risk factor for other health outcomes it explained 46% of the burden allocated to suicide and 3% of the burden allocated ischemic heart disease.
MedicalResearch.com Interview with:Ira Tabas, M.D., Ph.D.
Richard J. Stock Professor and Vice-Chair of Research
Department of Medicine
Professor of Anatomy & Cell Biology (in Physiology and Cellular Biophysics)
Columbia University New York, NY 10032
MedicalResearch.com: What are the main findings of the study? Dr. Tabas: We discovered a new pathway in the liver, relevant to humans, that controls the two hallmarks of type 2 diabetes (T2D), namely, excessive glucose production and defective insulin signaling. Thus, if drugs could be developed to inhibit this pathway, they could be very effective at treating or preventing T2D.
MedicalResearch.com Interview with:Prof Eric Lawitz MD
Vice President of Scientific and Research Development at The Texas Liver Institute
Clinical professor of Medicine
San Antonio University of Texas Health Science Center.
MedicalResearch.com: What are the main findings of the study?Dr. Lawitz: Currently available treatments for HCV involve weekly injections of pegylated interferon and daily doses of oral antivirals that must be taken for up to a year. These regimens are not only burdensome for patients, but are not always effective and can cause serious and debilitating side effects, including anemia. So there is a significant need for new tablet-based treatment regimens for HCV that eliminate interferon and ribavirin, are more effective, better tolerated and easier for patients to take.
MedicalResearch.com Interview with:Ilke Sipahi, MD
Department of Cardiology
Acibadem University Medical School, Istanbul, Turkey
Harrington Heart and Vascular Institute, University Hospitals Case Medical Cente, Case Western Reserve University School of Medicine, Cleveland, Ohio
MedicalResearch.com: Were you surprised at the extreme difference between these 2analyses?Answer: I was surprised. However, it is not unusual to find completely
contradictory results in medical studies. I was more surprised at the
fact that FDA paid more attention to it administrative observational
dataset rather than the huge large randomized clinical trials, all
showing excess GI bleeds with dabigatran (Pradaxa). Anyone who is even
slightly familiar with the medical literature knows that randomized trials are the gold standard in medical studies.
MedicalResearch.com Interview with:Frits R. Rosendaal PhD
Department of Clinical Epidemiology
Leiden University Medical Center,
Leiden, The Netherlands
MedicalResearch.com: What are the main findings of the study?Answer: In our study, we found that moderately to severely decreased kidney function was associated with a 2.6-fold (95%CI 2.0-3.5) increased risk of venous thrombosis as compared with normal kidney function. Several hemostatic factors showed a procoagulant shift with decreasing kidney function, most notably factor VIII and von Willebrand factor. We showed that the increased risk of venous thrombosis in chronic kidney disease could not be explained by confounding factors such as body mass index, diabetes, hospitalization, or corticosteroid use. However, we found that factor VIII and von Willebrand factor fully explained the increased risk of venous thrombosis associated with impaired kidney function.
MedicalResearch.com Interview with:Dr. Kelly K. Hunt, M.D., F.A.C.S.
Professor, Department of Surgical Oncology, Division of Surgery
Chief, Breast Surgical Oncology Section, Department of Surgical Oncology
The University of Texas MD Anderson Cancer Center, Houston, TX
MedicalResearch.com: What are the main findings of the study?Dr. Hunt: The primary endpoint of the Z1041 trial was the proportion of patients who had pathological complete response in the breast, defined as the percentage of women who started the neoadjuvant treatment with no histological evidence of disease in the breast at surgery. We found that high pathologic response rates were observed in both treatment groups with similar cardiac safety profiles in both arms of the trial. Specifically, 56.5% of patients in the sequential group (fluorouracil, epirubicin and cyclophosphamide on day one of a 21-day cycle for four cycles followed by paclitaxel plus trastuzumab weekly for 12 weeks) had a complete pathological response versus 54.2% of the patients who received the concurrent regimen (paclitaxel and trastuzumab weekly for 12 weeks followed by fluorouracil, epirubicin and cyclophosphamide on day one of a 21-day cycle with trastuzumab on days one, eight and 15 of the 21-day cycle for four cycles). The difference in pathologic complete response rates between the treatment arms was not statistically significant. Cardiac safety was a secondary endpoint of the trial and we found that both regimens had acceptable cardiac safety profiles.
MedicalResearch.com Interview with:Alyshah Abdul Sultan, doctorate student
Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building Phase 2, City Hospital, Nottingham NG5 1PB, UK
MedicalResearch.com: What are the main findings of the study?Answer: Overall, we found that hospitalisation during pregnancy was associated with an excess risk of 16.6 cases per 1,000 person-years compared with time outside hospital (17.5-fold increase in risk). There was also an excess risk of 5.8 cases per 1,000 person years in the 28 days after discharge with VTE events more likely to occur in the third trimester of pregnancy and in women aged 35 years and over.
MedicalResearch.com Interview with:Dr. Soo Borson, M.D.
Professor Department of Psychiatry and Behavioral Sciences,
University of Washington School of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Borson: We developed a new short screen to help clinicians and health care systems identify dementia patients and their caregivers who have unmet needs for dementia care services - extra help from primary care providers or clinical specialists skilled in understanding and managing problems related to dementia, working with caregivers to alleviate stress and burden, and locating community-based support services.
MedicalResearch.com InterviewYuri E. Nikiforov, M.D., Ph.D.
Professor of Pathology, Vice Chair for Molecular Pathology
Director, Division of Molecular & Genomic Pathology
Department of Pathology, University of Pittsburgh Pittsburgh, PA
MedicalResearch.com: What are the main findings of the study?Dr. Nikiforov: This is examined temporal changes in mutational profiles and standardized histopathologic features of thyroid cancer in the U.S. over the last four decades. It showed a significant change in molecular profiles of thyroid cancer during the past 40 years as it determined two major trends in changing the mutational make-up of thyroid cancer: a rapid increase in the prevalence of RAS mutations, particularly for the last 10 years, and continuous decrease in frequency of RET/PTC rearrangement. The rising incidence of RAS mutations points to new and more recent etiologic factors, probably of a chemical or dietary nature. The decreasing incidence of RET/PTC rearrangements, a known marker of high-dose environmental and medical radiation, suggest that the impact of ionizing radiation, at least as related to high-dose environmental exposures and historical patterns of radiation treatment for benign conditions, is diminishing.
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