Author Interviews, Hospital Readmissions / 27.08.2013

Allan Garland, MD, MA Co-Head, Section of Critical Care Medicine Associate Professor of Medicine and Community Health Sciences University of Maniitoba 820 Sherbrook St / GF-222 Winnipeg, Manitoba R3A 1R9MedicalResearch.com Interview with: Allan Garland, MD, MA Co-Head, Section of Critical Care Medicine Associate Professor of Medicine and Community Health Sciences University of Maniitoba 820 Sherbrook St / GF-222 Winnipeg, Manitoba R3A 1R9   MedicalResearch.com: What are the main findings of the study? Answer:   Our study evaluated consequences of leaving the hospital against medical advice (AMA).  It is a large, population-based analysis, that evaluated all hospitalizations from which patients were discharged alive, among all adults in the Canadian province of Manitoba over a 19 year period; this was over 1.9 million hospitalizations.  Outcomes assessed were hospital readmission and death over 6 months after the event.  Specifically, we compared these outcomes for those who left the hospital against medical advice, compared to those who remained in the hospital until their doctors felt it was safe to be discharged -- and these comparisons adjusted for a variety of patient and illness characteristics. Among the 1.9 million hospitalizations, there were 21,417 that ended with the patients leaving against medical advice, this is 1.1% of the total.  Without adjustment for other variables, leaving against medical advice was associated with double the rate of unscheduled hospital readmission within 30 days (24.0 vs. 12.1%); after adjustment, the odds of unscheduled hospital readmission within 30 days was 3-fold higher for someone who left against medical advice compared to one who did not.  After adjustment, the odds of death at 90 days were 2.51-fold higher for those who left against medical advice. (more…)
Blood Pressure - Hypertension, Depression / 27.08.2013

MedicalResearch.com Interview with: Marcos A Sanchez-Gonzalez, M.D., Ph.D., EPC Postdoctoral Associate Department of Biomedical Sciences College of Medicine The Florida State University 1115 W Call Street BMS 2300-24 & The Family Institute Behavioral Cardiology Laboratory Longmire 301 Tallahassee, FL 32306 MedicalResearch.com:  What are the main findings of the study? Answer: The findings of our study were the following: (1) The low frequency component of systolic blood pressure variability (LFSBP;  a marker of sympathovagal tone) was a stronger predictor of depressive symptoms than conventional measures of cardiovascular functioning such as laboratory measurement of blood pressure and heart rate variability as well as home based ambulatory blood pressure monitoring (2) Depressive symptoms were associated with a blunted LFSBP response to sympathetic stimulation via cold pressor test; and (3) Participants with acute depression (a score of ≥16 using the CES-D scale) had higher LFSBP than those with normal depressive symptom scores.  These findings suggest that depressive symptoms evoke alterations in vascular sympathetic activity, and more importantly, this alteration is occurs early in the progression of the disease.  This is fascinating owing to the fact that we have documented a common pathway of disease between depression and cardiovascular diseases. (more…)
Author Interviews, BMJ, Depression / 27.08.2013

MedicalResearch.com Interview with: David A Richards, PhD Professor of Mental Health Services Research and NIHR Senior Investigator University of Exeter Medical School Sir Henry Wellcome Building University of Exeter Washington Singer Building The Queen’s Drive Exeter EX4 4QQ United Kingdom MedicalResearch.com: What are the main findings of the study? Answer: We found that collaborative care improves depression immediately after treatment compared to usual care, has effects that persist to 12 month follow-up and is preferred bypatients over usual care. This difference in effect equated to a standardized effect size of 0.26 (95% CI 0.07 to 0.46). More participants receiving collaborative care than those receiving usual care met criteria for recovery (odds ratio 1.67 (95% confidence interval 1.22 to 2.29); number needed to treat=8.4) and response (1.77 (1.22 to 2.58); 7.8 at 4 months. At 12 months follow up more participants in collaborative care than those in usual care met criteria for recovery (odds ratio 1.88 (95% confidence interval 1.28 to 2.75); number needed to treat=6.5) and response (1.73 (1.22 to 2.44); 7.3. Collaborative care is as effective in the UK healthcare system—an example of an integrated health system with a well developed primary care sector—as in the US. (more…)
Author Interviews, Biomarkers, Orthopedics / 27.08.2013

MedicalResearch.com Interview with: Anna Eriksson MD, PhD Centre for Bone and Arthritis Research Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden MedicalResearch.com: What are the main findings of the study? Answer: The main findings of the study are that low-grade inflammation as measured by high sensitive CRP (hsCRP) is a risk factor for fractures in men, and that this is mainly driven by an increased risk for vertebral fractures. Previous epidemiological research has shown that higher levels of hsCRP is associated with an increased risk for fractures in women but until now it has not been known whether this applies also to men. The associations between hsCRP and fracture risk remained also after controlling for a wide range of known risk factors for fractures. There were no associations between hsCRP and BMD in our study. This implies that low-grade inflammation is an independent risk factor for fractures. (more…)
Author Interviews, Pediatrics / 26.08.2013

Dr. Jonathan Silverman, MD Department of Pediatrics University of Washington in Seattle, WashingtonMedicalResearch.com Interview with: Dr. Jonathan Silverman, MD Department of Pediatrics University of Washington in Seattle, Washington MedicalResearch.com: What are the main findings of the study? Dr. Silverman: We looked at the incidence of magnet foreign body injuries in children between 2002-2011, using a Consumer Products Safety Division surveillance database. We found an estimated 22, 581 cases over that period. Most strikingly, we found a rise in the incidence of magnet ingestions (in cases per 100,000 children/yr) from 0.57 (95% CI 0.22-0.92) in 2002-2003 to 3.06 (95% CI 2.16-3.96) in 2010-2011. The mean age for ingested magnets was 5, but for nasal magnets was 10. Multiple magnet ingestions and magnet injuries requiring hospital admission were much more common in the second half of the study period, corresponding with the rising popularity of small, high-powered, desktop magnet sets. However, due to limited detail from the database, we were unable to say with any certainty whether injuries were specifically due to these magnet sets. (more…)
Author Interviews, Heart Disease, JAMA / 26.08.2013

Dr Pamela N Peterson MD Denver Health Medical Center, CO MedicalResearch.com Interview with: Dr Pamela N Peterson MD Denver Health Medical Center, CO   MedicalResearch.com: What are the main findings of the study? Answer: We assessed the outcomes of mortality, rehospitalization, and procedural complications among 24,169 patients in the NCDR-ICD Registry with left ventricular systolic dysfunction receiving a cardiac resynchronization device in addition to an implantable defibrillator for the primary prevention of sudden cardiac death between 2006 and 2009. After stratification by the QRS complex morphology and duration on the ECG and adjustment for measured differences in other characteristics, patients with left bundle branch block (LBBB) and QRS durations of at least 150 msec had significantly lower rates of mortality and rehospitalization at 3 years compared with patients with non-LBBB QRS morphology and/or QRS duration of 120-149 msec. Rates of mortality and readmission were generally highest in patients with non-LBBB and QRS duration of 120-149 msec. Rates of procedural complications at 30- and 90-days were similar across strata of QRS morphology and duration. (more…)
General Medicine, Urology / 26.08.2013

MedicalResearch.com Interview with: Kirill Kosilov Far Eastern Federal University Department of Neurourology-Urodynamics, Primorsky Regional Diagnostic Center, Vladivostok, Russian Federation MedicalResearch.com What are the main findings of the study? Answer: Our study in a group of elderly patients showed that the combination of antimuscarinic drugs in a dosage which is higher than the usual recommended one is an effective treatment option for patients with OAB in those cases where treatment with one antimuscarinic drug was poorly effective. Side effects occurred almost equally in patients treated with only one antimuscarinic drug compared to the combined dosage. (more…)
Author Interviews, Diabetes, Exercise - Fitness, JCEM / 24.08.2013

Thomas P. J. Solomon, Ph.D. Associate Professor of Biomedical Sciences Department of Biomedical Sciences | Cellular & Metabolic Research Section Panum Institute 4.5 | University of Copenhagen | Blegdamsvej 3B | 2200 Copenhagen N | DenmarkMedicalResearch.com Interview with: Thomas P. J. Solomon, Ph.D. Associate Professor of Biomedical Sciences Department of Biomedical Sciences | Cellular & Metabolic Research Section Panum Institute 4.5 | University of Copenhagen | Blegdamsvej 3B | 2200 Copenhagen N | Denmark MedicalResearch.com: What are the main findings of the study? Dr. Solomon: The main findings were that when impaired glucose tolerant and type 2 diabetic subjects underwent 3-4 months of regular aerobic exercise training, although the majority of subjects (86-90%) increased increased VO2max, lost weight, and increased insulin sensitivity, only around two-thirds of subjects improved glycemic control (HbA1c, fasting glucose, and 2-hour OGTT glucose). The novel finding was that the changes in glycemic control were congruent with changes in oral glucose-stimulated insulin secretion (GSIS). We also found that exercise training-induced changes in glycemic control were related to changes in GSIS (P0.05), but not insulin sensitivity. Furthermore, we found that training-induced improvements in glycemic control were largest in subjects with greater pre-training GSIS, i.e. in subjects with greatest beta-cell function. And, we noted that high pre-training hyperglycemia blunted exercise-induced improvements in beta-cell compensation for insulin resistance. (more…)
Author Interviews, Breast Cancer, Cancer Research / 23.08.2013

Solveig Hofvind, PhD Cancer Registry of Norway, Oslo and Akershus University College of Applied Sciences, Majorstua 0403, Oslo, NorwayMedicalResearch.com Interview with: Solveig Hofvind, PhD Cancer Registry of Norway, Oslo and Akershus University College of Applied Sciences, Majorstua 0403, Oslo, Norway MedicalResearch.com: What are the main findings of the study? Dr. Hofvind: We find that if 100 women aged 50 years attend the Norwegian Breast Cancer Screening Program as recommended, every two years until they are 69 years, four women will undergo a needle biopsy with benign outcome (a false positive needle biopsy). In the same group of women, twenty women will be recalled for further examination and have additional imaging, ultrasound, and/or a biopsy with negative outcome (a false positive screening result). (more…)
Author Interviews, Bone Density, Breast Cancer, Mineral Metabolism / 23.08.2013

Richard R. Love, MD MS International Breast Cancer Research Foundation Professor of Medicine and Public Health The Ohio State University Columbus, OHMedicalResearch.com: Interview with: Richard R. Love, MD MS International Breast Cancer Research Foundation Professor of Medicine and Public Health The Ohio State University Columbus, OH MedicalResearch.com: What are the main findings of the study? Answer: Surgical oophorectomy and tamoxifen treatment was associated with no loss of bone mineral density (BMD) in the femoral neck, and loss of BMD in the first year, followed by stabilization in the lumbar spine. (more…)
Author Interviews, Dermatology, Genetic Research, Nature / 23.08.2013

MedicalResearch.com Interview with:  Joyce Y Tung Ph.D.MedicalResearch.com Interview with: Joyce Y Tung Ph.D. Research Team 23andMe Inc. Mountain View, California, USA MedicalResearch.com: What are the main findings of the study? Dr. Tung: 23andMe researchers identified four genetic markers that were significantly associated with the development of stretch marks, including one near the elastin (ELN) gene. This finding may further explain why some individuals are more susceptible to the skin condition. Given that loose skin is a symptom of syndromes caused by deletion or loss-of-function mutations in ELN, these results also support the hypothesis that variations in the elastic fiber component of the skin extracellular matrix contribute to the development of stretch marks. (more…)
Author Interviews, Mental Health Research, UCSF / 23.08.2013

MedicalResearch.com Interview with: Vanja Douglas, MD Sara & Evan Williams Foundation Endowed Neurohospitalist Chair Assistant Professor of Clinical Neurology UCSF Department of Neurology Neurology Clerkship Director Editor in Chief, The NeurohospitalistVanja Douglas, MD Sara & Evan Williams Foundation Endowed Neurohospitalist Chair Assistant Professor of Clinical Neurology UCSF Department of Neurology Neurology Clerkship Director Editor in Chief, The Neurohospitalist MedicalResearch.com: What are the main findings of the study? Answer: The study found that a simple 2-minute assessment performed at the time of hospital admission can accurately predict an adult medical inpatient's risk of developing delirium during that hospitalization. (more…)
Author Interviews, Cost of Health Care, Electronic Records, NYU / 23.08.2013

MedicalResearch.com Interview with: Saul Blecker, MD, MHS Assistant Professor Department of Population Health NYU School of Medicine 227 East 30th St., #648 New York, NY 10016Saul Blecker, MD, MHS Assistant Professor Department of Population Health NYU School of Medicine 227 East 30th St., #648 New York, NY 10016 MedicalResearch.com: What are the main findings of the study? Dr. Blecker: We tracked utilization of the inpatient electronic health record (EHR) as a proxy for hospital intensity of care. EHR utilization was found to have variations over time, particularly when comparing days to nights and weekdays to weekends. (more…)
Author Interviews, Mental Health Research, PLoS / 23.08.2013

MedicalResearch.com Interview with: Brian D. Glass Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary, University of London, London, United Kingdom Bradley C. Love Department of Cognitive, Perceptual and Brain Sciences, University College London, London, United Kingdom MedicalResearch.com: What are the main findings of the study? Answer: We had 72 non-gaming participants play 40 hours of video games over 6 to 8 weeks. We tested them on psychological tests before and after. The participants either played The Sims (a life simulator game), or one of two versions of StarCraft (a real-time strategy game) -- one which had a higher level of complexity. We found that the StarCraft players (especially on the higher complexity version) performed better on specifically the psychological tasks which tested cognitive flexibility. Cognitive flexibility is the ability to adapt to a changing environment by keeping multiple things in mind and switch between tasks effectively. This sort of ability is considered a higher level psychological ability because it requires strategic thinking and creativity. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Diabetes / 23.08.2013

MedicalResearch.com Interview with: Xiaohui Zhuo PhD Health economist Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? First, someone diagnosed with type 2 diabetes may pay an average of about $85,500 treating the disease over his or her lifetime. Lifetime cost is higher for women, and for patients who developed the disease earlier in life. Second, treating diabetic complications account for more than half of lifetime costs, and a majority of which is attributed by damage to large blood vessels, which can lead to coronary heart disease and stroke. (more…)
Author Interviews, Blood Pressure - Hypertension, JACC, Nature / 23.08.2013

Dr. Axel Bauer, MD, FESC, F-ISHNE Prof. Dr. med. Axel Bauer is head of the coronary care and chest pain unit and primary investigator in the research group of biosignal analysis and sudden death of the cardiology department of the Eberhard-Karls-Universität Tübingen, Germany.MedicalResearch.com Interview with: Dr. Axel Bauer, MD, FESC, F-ISHNE Prof. Dr. med. Axel Bauer is head of the coronary care and chest pain unit and primary investigator in the research group of biosignal analysis and sudden death of the cardiology department of the Eberhard-Karls-Universität Tübingen, Germany. MedicalResearch.com: What are the main findings of the study? Dr. Bauer: Catheter-based renal sympathetic denervation is a promising treatment option in patients with resistant arterial hypertension. However, it is invasive and might have presently unknown adverse side effects in the long-term. Therefore, identification of patients who benefit from RDN and, equally importantly, those who do not is of great importance.  With assessment of baroreflex sensitivity (BRS) we found a way to do that. Patients with resistant hypertension and impaired BRS at baseline benefited the most from RDN in terms of reduction of mean systolic BP on (ABPM) while RDN had no effect in patients with preserved BRS. (more…)
Author Interviews, JAMA, Pediatrics / 23.08.2013

Bjarke Feenstra, Ph.D. Senior Research Scientist Statens Serum Institut Artillerivej 5, 2300 Copenhagen S DenmarkMedicalResearch.com Interview with: Bjarke Feenstra, Ph.D. Senior Research Scientist Statens Serum Institut Artillerivej 5, 2300 Copenhagen S Denmark MedicalResearch.com: What are the main findings of the study? Dr. Feenstra: We discovered a new genome-wide significant locus for infantile hypertrophic pyloric stenosis (IHPS) in a region on chromosome 11 harboring the apolipoprotein (APOA1/C3/A4/A5) gene cluster and also confirmed three previously reported loci. Characteristics of the new locus led us to propose the hypothesis that low levels of circulating lipids in infants are associated with increased risk of IHPS. We addressed this hypothesis by measuring plasma lipid levels in prospectively collected umbilical cord blood from a set of 46 IHPS cases and 189 matched controls. We found that levels were on average somewhat lower in the children who went on to develop the condition. (more…)
Author Interviews, Coffee / 22.08.2013

MedicalResearch.com Interview with: Xuemei Sui, MD, MPH, PhD Assistant Professor Department of Exercise Science Arnold School of Public Health University of South Carolina 921 Assembly Street Room 226 Columbia, SC 29208 MedicalResearch.com: What are the main findings of the study? Answer: Coffee intake was a risk factor with higher mortality in men, but not in women. Men who drank more than 28 cups of coffee weekly had a 21% higher risk of dying when comparing with their non-coffee-consuming peers.  In addition, younger men (age<55 years) who drank more than 28 cups of coffee weekly had a 56% increase in mortality from all-cause and younger women had a greater than 2-fold higher risk of all-cause mortality than those who did not drink coffee. (more…)
Author Interviews, McGill, Sleep Disorders / 22.08.2013

MedicalResearch.com Interview with: Ruifeng Cao, MD,PhD Postdoctoral Fellow Laboratory of Nahum Sonenberg McGill University Department of Biochemistry Montreal, QC H3A 1A3, Canada MedicalResearch.com: What are the main findings of the study? Answer: Circadian (~24h) timing is a fundamental biological process, underlying cellular physiology in animals, plants, fungi, and cyanobacteria.  In mammals, including humans, a circadian clock in the brain drives daily rhythms in sleep and wakefulness, feeding and metabolism, and many other essential processes. We studied how protein synthesis, which is a fundamental process underlying many biological activities, is controlled in the brain clock in mice and identified a protein that functions as a clock repressor. By removing the repressor protein, the clock function is improved. (more…)
Author Interviews, JAMA, Rheumatology / 22.08.2013

MedicalResearch.com Interview with: Matthew Parkes Research Statistician Research in Osteoarthritis Manchester (ROAM) Arthritis Research UK Epidemiology Unit Centre for Musculoskeletal Research Institute of Inflammation and Repair The University of Manchester Manchester Academic Health Science Centre Manchester M13 9PT MedicalResearch.com: What are the main findings of the study? Answer: Looking at all trials of lateral wedge insoles, they seem to reduce pain slightly. However, looking at trials which compare lateral wedges to flat wedges, they don’t appear to differ in terms of pain reduction. (more…)
Author Interviews, Diabetes, JCEM, OBGYNE, Obstructive Sleep Apnea, Sleep Disorders / 22.08.2013

Sirimon Reutrakul MD Section of Endocrinology Department of Medicine Rush University Medical Center Chicago, Illinois 60612MedicalResearch.com: Interview with Sirimon Reutrakul MD Section of Endocrinology Department of Medicine Rush University Medical Center Chicago, Illinois 60612   MedicalResearch.com: What are the main findings of the study? Answer: We found a strong association between obstructive sleep apnea and gestational diabetes mellitus. In pregnant women diagnosed with gestational diabetes, the risk of obstructive sleep apnea is increased nearly 7-fold compared to those without gestational diabetes.  In addition, we found that in non-diabetic women, pregnancy is associated with more disrupted sleep. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease / 20.08.2013

Dr. Anthony Bavry, MD MPH Interventional Cardiology Assistant Professor of Medicine University of Florida 1600 SW Archer Road Gainesville, FL 32610MedicalResearch.com Interview with Dr. Anthony Bavry, MD MPH Interventional Cardiology Assistant Professor of Medicine University of Florida 1600 SW Archer Road Gainesville, FL 32610 MedicalResearch.com: What are the main findings of the study? Dr. Bavry: Among individuals with chronic stable coronary artery disease, it is possible to define a group who are at relatively low risk for adverse cardiovascular events. MedicalResearch.com:Were any of the findings unexpected? (more…)
Author Interviews, Stem Cells / 20.08.2013

Medical Research.com Interview with: Katrin Streckfuss-Boemeke, PhD Department of Cardiology and Pneumology Heart Research Center Göttingen (HRCG) University Medical Center Göttingen Georg-August-University Göttingen 37075 Göttingen Germany Medical ResearcH.com: What are the main findings of the study? Answer: The main finding is that human induced pluripotent stem cells (hiPSCs) can be generated from different somatic cell sources including bone marrow mesenchymal stem cells (MSCs), hair keratinocytes, and skin fibroblasts, but MSCs and fibroblasts are more easily reprogrammed than keratinocytes. All generated hiPSCs can differentiate into cardiomyocytes with an efficiency ranging from 3 to 42%. However, the highest cardiac differentiation efficiency was achieved from MSC-derived hiPSCs. Although the cardiac differentiation efficiency varied among different cell lines, there is no significant difference in the functionalities of cardiomyocytes derived from different hiPSC lines. (more…)
Author Interviews, Diabetes / 20.08.2013

Leonardo Trasande, MD, MPP  Departments of Pediatrics, Environmental Medicine,  Population Health, and  Medicine, School of Medicine, and  Wagner School of Public Service, and  Steinhardt School of Culture, Education, and Human Development, Department of Nutrition MedicalResearch.com: Interview with Leonardo Trasande, MD, MPP Departments of Pediatrics, Environmental Medicine,  Population Health, and  Medicine, School of Medicine, and  Wagner School of Public Service, and  Steinhardt School of Culture, Education, and Human Development, Department of Nutrition MedicalResearch.com: What are the main findings of the study? Answer: We detect associations of urinary phthalate metabolites in a cross-sectional study of US adolescents.  The association is highly robust to multiple sensitivity analyses, and specific to phthalates commonly found in food.  Further, longitudinal study of dietary phthalate exposures is needed. (more…)
Author Interviews, Autism, General Medicine, JAMA / 20.08.2013

MedicalResearch.com:  Interview with: Therese Koops Grønborg PhD student/ph.d.-studerende, MSc Section of Biostatistics/Sektion for Biostatistisk Department of Public Health/Institut for Folkesundhed Aarhus University Bartholins Allé 2, DK-8000 Aarhus C, Denmark MedicalResearch.com: What are the main findings of the study? Answer: There are three important findings in our study. We estimated a population-based Autism Spectrum Disorder (ASD) sibling recurrence risk relative to the background population and found an almost seven-fold increase. While this indeed is an increased risk, it is also lower than what other recent studies have suggested. We also compared the relative recurrence risk for full and maternal/paternal half siblings and found a lower relative recurrence risk in half siblings than in full siblings, which supports the genetic pathway to ASD. The recurrence risk for maternal half siblings is still higher than for the background population suggesting that factors unique to the mother, such as the intrauterine environment and perinatal history, may contribute to ASD. Last, but not least, we estimated the time trends in the relative recurrence risk. While the ASD prevalence has been increasing for several years, we found no time trends in the relative recurrence risk, suggesting that the factors contributing to the risk for ASDs recurrence in siblings (perhaps a combination of genes and environment) have not changed over time. (more…)
Author Interviews, Blood Pressure - Hypertension, Kidney Disease, Nature / 20.08.2013

MedicalResearch.com Interview with: Hemodialysis.com Author Interview: Csaba P. Kovesdy MD FASN. Csaba P. Kovesdy MD FASN.The Fred Hatch Professor of Medicine Director, Clinical Outcomes and Clinical Trials Program in Nephrology University of Tennessee Health Science Center Chief of Nephrology Division of Nephrology, Memphis VA Medical CenterDr.Csaba P. Kovesdy MD FASN. The Fred Hatch Professor of Medicine Director, Clinical Outcomes and Clinical Trials Program in Nephrology University of Tennessee Health Science Center Chief of Nephrology Division of Nephrology, Memphis VA Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Kovesdy: In this study of >650,000 US veterans with CKD we found that categories of lower SBP/DBP combinations are associated with lower mortality only as long as the DBP component remains above a threshold of approximately 70 mmHg, and that patients with BP values in the range of 130-159/70-89 mmHg had the lowest mortality.  Patients who might be considered to have “ideal” blood pressure (<130/80) actually had increased mortality due to the inclusion of individuals with low systolic and diastolic blood pressures. (more…)
Author Interviews, JAMA, Outcomes & Safety, Yale / 20.08.2013

Leora I. Horwitz, MD, MHS Section of General Internal Medicine, Department of Medicine, Yale School of Medicine, Center for Outcomes Research and Evaluation, Yale–New Haven Hospital, New Haven, ConnecticutMedicalResearch.com Interview with: Leora I. Horwitz, MD, MHS Section of General Internal Medicine, Department of Medicine, Yale School of Medicine, Center for Outcomes Research and Evaluation, Yale–New Haven Hospital, New Haven, Connecticut MedicalResearch.com: What are the main findings of the study? Answer: We interviewed nearly 400 older patients who had been admitted with heart failure, pneumonia or heart attack within one week of going home from the hospital. We also reviewed the medical records of 377 of the patients. We found, for example, that:
  • 40% of patients could not understand or explain the reason they were in the hospital in the first place;
  • A fourth of discharge instructions were written in medical jargon that a patient was not likely to understand;
  • Only a third of patients were discharged with scheduled follow-up with a primary care physician or cardiology specialist;
  • Only 44% accurately recalled details of their appointments.
In other words, we didn't do a very good job of preparing patients for discharge, and perhaps as a result, patients were pretty confused about important things they needed to know after they were home. We just published a companion paper in the Journal of Hospital Medicine last week in which we looked at the discharge summaries for the same patients - that is, the summary of the hospitalization that is meant to help the outpatient doctor understand what happened in the hospital. Turns out we were just as bad at communicating with doctors as with patients - we focused on details of the hospitalization rather than what needed to happen next or what needed to be followed up, and in a third of cases, we didn't even send the summary to the outpatient doctor. In fact out of 377 discharge summaries, we didn't find a single one that was done on the day of discharge, sent to the outpatient doctor, and included all key content recommended by major specialty societies. (more…)
Author Interviews, Lung Cancer, University of Pennsylvania / 20.08.2013

Sandra Ryeom, PhD, Assistant professor of Cancer Biology, Perelman School of Medicine, University of Pennsylvania MedicalResearch.com Interview with: Sandra Ryeom, PhD, Assistant professor of Cancer Biology, Perelman School of Medicine, University of Pennsylvania MedicalResearch.com: What are the main findings of the study? Answer: We identified an important pathway (calcineurin-NFAT-Angiopoeitin2) in the vasculature of early metastatic lung lesions that is critical for promoting lung metastases. MedicalResearch.com: Were any of the findings unexpected? Answer: Since there is limited understanding of regulation of tumor angiogenesis at metastatic sites, identification of the calcineurin pathway and a newly identified target of calcineurin-NFAT signaling  was all unexpected. (more…)