Author Interviews, Breast Cancer, Chemotherapy, Journal Clinical Oncology, Mayo Clinic / 21.10.2014

dr_edith_perezMedicalResearch.com Interview with: Edith A. Perez, MD Mayo Clinic Jacksonville, FL 32224 Medical Research: What are the main findings of the study? Dr. Perez: Our joint analysis of two large prospective trials showed that adding one year of Trastuzumab to otherwise standard adjuvant chemotherapy significantly improved long term survival in women with resected HER2+ breast cancer. (more…)
Author Interviews, Dermatology, Melanoma / 21.10.2014

Prof. David Whiteman Group leader, Cancer Control Group QIMR Berghofer Herston, QueenslandMedicalResearch.com Interview with: Prof. David Whiteman Group leader, Cancer Control Group QIMR Berghofer Herston, Queensland   Medical Research: What are the main findings of the study? Dr. Whiteman: Mortality from melanoma has continued to rise in Queensland, Australia, the jurisdiction with the world’s highest incidence of this disease. We analysed more than 4000 deaths from melanoma over the last 2 decades, and calculated mortality rates according the thickness of the primary lesion. (more…)
Author Interviews, Bipolar Disorder, Genetic Research, Nature / 21.10.2014

Edward I. Ginns, MD, PhD, Director Program in Medical Genetics and Lysosomal Disorders Treatment and Research Program University of Massachusetts Medical School Reed Rose Gordon Building, Room 137 Shrewsbury, MA 01545MedicalResearch.com: Interview with: Edward I. Ginns, MD, PhD, Director Program in Medical Genetics and Lysosomal Disorders Treatment and Research Program University of Massachusetts Medical School Reed Rose Gordon Building, Room 137 Shrewsbury, MA 01545 Medical Research: What are the main findings of the study? Dr. Ginns: Our study identified that sonic hedgehog signaling, an important brain pathway, is involved in bipolar affective disorder. This finding shows a mechanism and provides new targets for drug development. It suggests that sonic hedgehog signaling can be modulated to help manage bipolar symptoms in adults by using drugs already being studied in clinical trials for other medical conditions. The new findings were uncovered by decades of translational research in the Old Order Amish families of Pennsylvania, where in a few special families in the Amish Study there is a high incidence of both bipolar disorder and a rare genetic dwarfism, Ellis van‐Creveld (EvC) syndrome. No person with EvC had bipolar disorder despite forty years of documented research across multiple generations, suggesting that the genetic cause of this rare dwarfism was protective of bipolar affective disorder. (more…)
Author Interviews, JAMA, Opiods, Yale / 21.10.2014

David A. Fiellin, M.D. Professor of Medicine, Investigative Medicine and Public Health Yale University School of MedicineMedicalResearch.com Interview with David A. Fiellin, M.D. Professor of Medicine, Investigative Medicine and Public Health Yale University School of Medicine   Medical Research: What are the main findings of the study? Dr. Fiellin: The main finding of our randomized clinical trial, conducted in primary care, was that among prescription opioid dependent patients, ongoing buprenorphine therapy resulted in better treatment retention and reduced illicit opioid use when compared to buprenorphine taper (detoxification). (more…)
Author Interviews, Cancer Research, Journal Clinical Oncology, MD Anderson / 21.10.2014

MedicalResearch.com Interview with: Joanna-Grace M. Manzano, MD Assistant Professor Department of General Internal Medicine Maria E. Suarez-Almazor, MD, PhD Barnts Family Distinguished Professor Chief, Section of Rheumatology & Deputy Chair, Dept. of General  Internal Medicine UT MD Anderson Cancer Center Houston, TX Medical Research: What are the main findings of the study? Response: Our study established that unplanned hospitalization among elderly patients with GI cancer are very common – 93 events per 100-person years. Certain characteristics were found to have an increased risk for an unplanned hospitalization in our cohort, namely: older age, black race, advanced disease, higher comorbidity score, residing in poor neighborhoods and dual eligibility for Medicare and Medicaid. Esophageal and gastric cancer had the highest risk for unplanned hospitalization among all GI cancer types. Some of the observed reasons for unplanned hospitalization were potentially preventable and related to the patient’s comorbid illness. (more…)
Author Interviews, FASEB, Heart Disease, Yale / 20.10.2014

David L. Katz, MD, MPH, FACPM, FACP Director, Yale University Prevention Research Center Griffin HospitalMedicalResearch.com Interview with: David L. Katz, MD, MPH, FACPM, FACP Director, Yale University Prevention Research Center Griffin Hospital   Medical Research: What are the main findings of the study? Dr. Katz: We did not see any adverse effects of short-term, daily egg ingestion in adults with established coronary artery disease. Medical Research: What was most surprising about the results? Dr. Katz: Eggs are routinely banned from 'heart healthy diets.'  in particular eggs are always absent from cardiac care units, with egg beaters substituting.  However, these same units routinely serve products with refined starch and added sugar.  The scientific basis for excluding eggs from diets to improve cardiac health has long been suspect.  Here, we show that in the short term at least, there are no discernible harms of daily egg ingestion even in adults with heart disease. (more…)
Author Interviews, Blood Pressure - Hypertension / 20.10.2014

Dr. Brent M. Egan MD Adjunct Professor Medical University of South CarolinaMedicalResearch.com Interview with: Dr. Brent M. Egan MD Professor of Medicine University of South Carolina School of Medicine Greenville Senior medical director of the Care Coordination Institute Greenville, South Carolina Medical Research: What are the main findings of the study? Dr. Egan: The study was undertaken to determine progress toward the Healthy People 2020 goals of controlling hypertension or high blood pressure in 61.2% of all adults with the condition. What we found is that hypertension control has changed very little from 2007 through 2012. In 2011-2012, an estimated 51.2% of all hypertensive adults were controlled, which is 10% below the 2020 goal.  The analysis indicated that healthcare insurance and at least two healthcare visits yearly were related to both the likelihood that hypertension would be treated and controlled. (more…)
Author Interviews, Dermatology, JAMA / 20.10.2014

Marie C. Leger, MD, PhD Ronald O. Perelman Department of Dermatology New York University School of Medicine, New YorkMedicalResearch.com Interview with Marie C. Leger, MD, PhD Ronald O. Perelman Department of Dermatology New York University School of Medicine, New York Medical Research: What are the main findings of the study?
What was most surprising about the results?

 Dr. Leger: Alopecia areata is a T-cell mediated autoimmune disease. As such, there was initially hope that inhibiting the helper T cell cytokine TNF-α could effectively treat this condition. This has not been shown to be the case—in fact, one open-label study of etanercept in 17 patients with moderate to severe alopecia showed no hair regrowth and even worsening of alopecia in several subjects. There have been many other case reports in the dermatologic literature of TNF-α inhibitors causing alopecia areata. In contrast, our case report presents a patient who very clearly grew hair on adalimumab—its strength lies in the fact that her hair loss and regrowth were replicated on withdrawal and rechallenge with the medication. Our patient’s paradoxical response to adalimumab complements other literature suggesting that there are genetic variations in the way a patient’s immune system responds to TNF-α inhibitors. In different individuals, these medications can either treat or cause conditions such as psoriasis or lupus. It seems that this is also the case with alopecia areata. (more…)
Author Interviews, Pediatrics / 20.10.2014

MedicalResearch.com: Interview with: Dr. Huiyun Xiang, MD, MPH, PhD Center for Injury Research and Policy The Ohio State University College of Medicine, Columbus, OhioDr.  Huiyun Xiang, MD, MPH, PhD Center for Injury Research and Policy The Ohio State University College of Medicine, Columbus, Ohio Jeb Phillips, BA Project Specialist, Injury Research and Policy Staff Nationwide Children’s Hospital, Columbus, OhioJeb Phillips, BA Project Specialist, Injury Research and Policy Staff Nationwide Children’s Hospital,  Columbus, Ohio   Medical Research: What are the main findings of the study? Response: From 2002-2012, a child younger than 6 years old experienced an out-of-hospital medication error every 8 minutes. That’s a total of 696,937 during the study period, or 63,358 per year. Almost all happened at the child’s residence. The rate and number of errors decreased with increasing age. Analgesics were the mostly commonly involved medications (25.2%), followed by cough and cold medications (24.6%). More than 1 in 4 (27%) of the errors happened when a child inadvertently took or was given medication twice. Errors also happened when children took or were given an incorrect dose, when medication measurements were confused, and when the wrong medication was taken or given. (more…)
Infections, Respiratory, Vaccine Studies / 20.10.2014

Dr. Susanne Huijts – Pulmonary resident UMC Utrecht | Research physician UMCU Julius Center for Health Sciences and Primary Care NetherlandsMedicalResearch.com Interview with:  Dr. Susanne Huijts Research Physician at UMCU Julius Center for Health Sciences Pulmonary resident, UMC Utrecht Center Utrecht, Netherlands   Medical Research: What are the main findings of the study? Dr. Huijts: The CAPiTA trial evaluated the efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13) in adults of 65 years and older. In the per protocol analysis vaccine efficacy of 45.6% was demonstrated for the first episode vaccine type (VT) pneumococcal community acquired pneumonia (CAP); 45.0% for the first episode of non-bacteremic/ non-invasive (NB/NI) VT-CAP, and 75.0% for the first episode of VT-invasive pneumococcal disease. (more…)
Author Interviews, Diabetes, Infections / 20.10.2014

MedicalResearch.com Interview with: Dr Tsai Chung-Li Graduate Institute of Biostatistics, College of Management, China Medical University,Taichung, Taiwan and Dr. Hsiao-Chuan Lin Department of Public Health, College of Public Health, and Department of Pediatrics, China Medical University, Taichung, Taiwan Medical Research: What are the main findings of the study? Response: We conducted a nationwide population-based cohort study that included two groups. Children with enterovirus infection (aged < 18 years) during 2000-2007 were identified and followed up until December 31, 2008 or until first occurrence of type 1 diabetes. The group without enterovirus infection comprised half of all insured children of the same age and without a diagnosis of enterovirus infection. By use of frequency-matching with sex and birth year, children in the group with enterovirus were selected from those eligible. This nationwide retrospective cohort study found:
  • type 1 diabetes is positively correlated with enterovirus infection in patients younger than 18 years.
  • the incidence rate of type 1 diabetes was lower in the non-enterovirus than the enterovirus group (4 vs 6 per 100,000 person-years; incidence rate ratio 1.48 [95% CI 1.19, 1.83]).
  • children that have been infected with enterovirus are 48% more likely to have developed type 1 diabetes.
  • the risk of developing type 1 diabetes is 2.18 times greater among children aged 10 years and older than among those aged younger than 1 year.
(more…)
Author Interviews, Heart Disease, Obstructive Sleep Apnea / 19.10.2014

Adrian Baranchuk MD FACC FRCPC Associate Professor of Medicine Director, EP Training Program Queen's University Kingston, Ontario, CanadaMedicalResearch.com Interview with: Adrian Baranchuk MD FACC FRCPC Associate Professor of Medicine Director, EP Training Program Queen's University Kingston, Ontario, Canada Medical Research: What are the main findings of the study? Dr. Baranchuk: In this study, we investigated whether obstructive sleep apnea increases the risk of atrial fibrillation after coronary artery bypass surgery. We found the risk to increase by approximately two-fold for patients with obstructive sleep apnea, suggesting that this disease is a strong predictor of atrial fibrillation after coronary artery bypass surgery. We also found that the risk increases in patients with more severe obstructive sleep apnea. This is an important association to explore since atrial fibrillation after coronary artery bypass surgery increases patient mortality, the risk of stroke, hospital stay, healthcare costs, and has substantial burden on patients and their families. It is also a common complication of the surgery, occurring in up to half of the patients. Knowing which factors increase its risk gives us a better understanding of how to manage it and mitigate its negative consequences. (more…)
Author Interviews, Primary Care, Race/Ethnic Diversity / 19.10.2014

Arjumand Siddiqi, Sc.D., Assistant Professor Departments of Epidemiology and Social and Behavioral Sciences Dalla Lana School of Public Health University of Toronto Toronto, Ontario CanadaMedicalResearch.com Interview with: Arjumand Siddiqi, Sc.D., Assistant Professor Departments of Epidemiology and Social and Behavioral Sciences Dalla Lana School of Public Health University of Toronto Toronto, Ontario Canada MedicalResearch: What are the main findings of the study? Dr. Siddiqi: The main finding of the study is that, in a society with universal health insurance (Canada), racial disparities in access to primary care are drastically reduced, with some important exceptions. (more…)
Author Interviews, Dartmouth, Mental Health Research / 18.10.2014

MedicalResearch.com Interview with: John A. Naslund, MPH – PhD Student at The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH Stuart W. Grande, PhD, MPA – Post–doctoral fellow at The Dartmouth Center for Health Care Delivery Science, Dartmouth College, Hanover, NH Medical Research: What are the main findings of the study? Naslund: In this study we explored whether people with severe mental illness such as schizophrenia, schizoaffective disorder, or bipolar disorder, use a popular social media website like YouTube to naturally provide and receive peer support. We found that people with severe mental illness use YouTube to feel less alone and to find hope, to support and to defend each other, and to share personal stories and strategies for coping with day-to-day challenges.   Dr. Grande: They also sought to learn from the experiences of others about using medications and seeking mental health care.  YouTube appears to serve as a platform that helps these individuals to overcome fears associated with living with mental illness, and it also creates a sense of community among them. (more…)
Author Interviews, Johns Hopkins, Nutrition, Sugar / 18.10.2014

Sara N. Bleich, Ph.D. Associate Professor Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore, MD 21205 MedicalResearch.com Interview with: Sara N. Bleich, Ph.D. Associate Professor Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore, MD 21205 Medical Research: What are the main findings of the study? Dr. Bleich: Providing easily understandable calorie information — particularly in the form of miles of walking — makes adolescents more likely to buy a beverage with fewer calories, a healthier beverage or a smaller size beverage. Adolescents were also more likely to not buy any drink at all after seeing the signs with calorie information. (more…)
Author Interviews, Melanoma, Ophthalmology / 17.10.2014

MedicalResearch.com Interview with: Prof I. Jolanda M. de Vries Professor, Dept of Tumor Immunology Radboud University Nijmegen Medical Research: What are the main findings of the study? Prof. de Vries: Dendritic cells are antigen-presenting cells with the unique capacity to activate naive antigen-specific T cells, and by this means are very suitable to induce immunologic antitumor responses. Dendritic cells cultured from monocytes can be matured and loaded with tumor antigen ex vivo and administered back into the patient. Within the lymph node, dendritic cells present antigens to T cells to initiate an immune response. Metastatic uveal melanoma patients were vaccinated with autologous DCs loaded with tumor antigens (gp100 and tyrosinase), obtained by leukapheresis, according to a schedule of 3 biweekly vaccinations. One to 2 weeks after the last vaccination, a skin test was performed to analyse the induction of immunologic responses. We can conclude that dendritic cell vaccination is feasible and safe in metastatic uveal melanoma. Dendritic cell-based immunotherapy is potent to enhance the host’s antitumor immunity against uveal melanoma in approximately one third of patients. (more…)
Author Interviews, Cancer Research, MD Anderson / 17.10.2014

Steven J. Frank, M.D. Associate Professor of Radiation Oncology Medical Director of the Proton Therapy Center The University of Texas MD Anderson Cancer CenterMedicalResearch.com Interview with: Steven J. Frank, M.D. Associate Professor of Radiation Oncology Medical Director of the Proton Therapy Center The University of Texas MD Anderson Cancer Center MedicalResearch.com Editor’s Note: A recent research published in Oncology Payers, discusses the quality of life benefits and cost-savings of intensity modulated proton therapy (IMPT or proton therapy) with traditional x-ray therapy for advanced stage head and neck cancer. The senior author of the paper, Dr. Steven Frank, highlights two oropharyngeal cancer patients, one of whom received proton therapy and the other x-ray treatments. Both patients received chemotherapy. The study showed that although the upfront costs of proton therapy were three times that of standard x-ray treatments, the proton therapy patient was spared the necessity of a feeding tube, nutritional and supportive care and weight loss that accompanied the x-ray treatments. By the end of the treatment period, the total care costs for the proton therapy patient were 20% lower than the x-ray treatment plan. To evaluate the costs, Dr. Frank has been employing a costing tool used elsewhere at MD Anderson called Time-driven Activity-based Costing that places the emphasis on the value of medical care, both monetary and in terms of quality of life. Dr. Frank plans to enroll 360 patients over the next five years as well as to open the study to other cancer centers. He notes that the results will be especially valuable as health insurance companies look to further bundled insurance payments. Dr. Frank was kind enough to answer several questions regarding his work for the MedicalResearch.com audience. Medical Research: From a patient's perspective, what are the main differences between traditional x-ray therapy and proton therapy for cancer treatment? Dr. Frank: In proton therapy, the radiation hits the cancer, while with traditional x-ray the radiation hits the cancer and the normal tissues in the head and neck, causing more side effects during and after treatment. The main advantage is that proton therapy eliminates unnecessary radiation. As radiation oncologists, our primary goal is to effectively kill cancer while sparing the patient the side effects of excessive radiation. Proton therapy achieves this for many patients with a variety of cancers, including lymphoma, lung, head and neck, prostate, esophageal and pediatric cancers. (more…)
Author Interviews, Mediterranean Diet, Metabolic Syndrome, Weight Research / 17.10.2014

Deborah Clegg, PhD Research Scientist, Diabetes and Obesity Research Institute Associate Professor, Department of Biomedical Science Cedars-Sinai Medical Center Los Angeles, CA 90048MedicalResearch.com Interview with: Deborah Clegg, PhD Research Scientist, Diabetes and Obesity Research Institute Associate Professor, Department of Biomedical Science Cedars-Sinai Medical Center Los Angeles, CA 90048 Medical Research: What are the main findings of the study? Dr. Clegg: The main findings are that males and females differ with respect to how they process and respond to diets high in fat!!!!  Males following consumption of a diet that is 42% of the calories coming from saturated fat (it would be analogous to eating a big mac and having a coke), gained the same amount of weight as did the females BUT the males had increased markers of inflammation in their brains and the females did not.  With the elevated markers of inflammation, the males had dysregulation in glucose homeostasis and alteration in cardiovascular function – yet the females did not!! (more…)
Author Interviews, Melanoma, UCSF / 17.10.2014

Martina Sanlorenzo, MD Department of Dermatology Mt. Zion Cancer Research Bldg. San Francisco, CA 94143-0808MedicalResearch.com Interview with: Martina Sanlorenzo, MD Department of Dermatology Mt. Zion Cancer Research Bldg. San Francisco, CA 94143-0808 Medical Research: What are the main findings of the study? Dr. Sanlorenzo: In the treatment of BRAF mutant melanoma, the combination of BRAF inhibitor and MEK inhibitor has a better cutaneous safety profile compared with BRAF inhibitor monotherapy. Combination regimen shows fewer cutaneous adverse events and longer cutaneous adverse event-free interval. In particular, the development of squamous cell carcinoma or keratoacanthoma was significantly less frequent. (more…)
AHA Journals, Author Interviews, Clots - Coagulation, Erasmus, Stroke / 17.10.2014

MedicalResearch.com: Interview Invitation S. Akoudad, MD Msc PhD candidate Dep. Epidemiology, Radiology, Neurology Erasmus MC, Rotterdam , the Netherlands Medical Research: What are the main findings of the study? Dr.  Vernooij: We found that compared to never users, coumarin users had a higher prevalence of deep or infratentorial microbleeds and probably also a higher incidence of any microbleeds. A higher maximum international normalized ratio (INR) was associated with deep or infratentorial microbleeds, and among coumarin users, a greater variability in INR was associated with a higher prevalence of microbleeds. (more…)
ADHD, Author Interviews / 17.10.2014

MedicalResearch.com Interview with: Joanna Martin, PhD student MRC Centre for Neuropsychiatric Genetics and Genomics Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff Medical Research: What are the main findings of the study? Response: In this study, we found that genetic risks which are collectively important for ADHD diagnosis also predict higher levels of traits of hyperactivity/impulsiveness, inattention and  pragmatic language difficulties in childhood in the general population. (more…)
Author Interviews, JAMA, Surgical Research / 16.10.2014

MedicalResearch.com Interview with: Sayaka Suzuki, MD Department of Clinical Epidemiology and Health Economics, School of Public Health, Faculty of Medicine, Department of Otolaryngology–Head and Neck Surgery, University of Tokyo, Tokyo, Japan Medical Research: What are the main findings of the study? Dr.  Suzuki: We found a slight increase in the risk of severe bleeding requiring surgery for hemostasis in children who were administrated intravenous steroid on the day of tonsillectomy. Physicians should carefully make a decision to use steroids, taking into account patients' choice under being well informed on the risks and benefits of steroid use. (more…)
Outcomes & Safety, Surgical Research / 16.10.2014

Terrence Loftus, MD, MBA, FACS Medical Director, Surgical Service & Clinical Resources Banner Health Phoenix, Arizona 85006Medical Research.com Interview with: Terrence Loftus, MD, MBA, FACS Medical Director, Surgical Service & Clinical Resources Banner Health Phoenix, Arizona 85006 Medical Research: What are the main findings of the study? Dr. Loftus: This study demonstrated that a standardized safe surgery program effectively and systematically implemented across a diverse healthcare system resulted in a significant reduction in serious reportable events (SREs), thereby improving the quality of patient care and leading to significant cost avoidance.   For the purposes of the study, SREs were defined as any reported retained surgical item, wrong site, wrong patient or wrong procedure event. Following implementation of the Safe Surgery Program there was a 52% reduction in the SRE rate in the operating rooms and L&D areas in our system. The most dramatic change and greatest area of improvement was in wrong site events which demonstrated a 70% reduction for this type of serious reportable events. This was achieved through a Safe Surgery Program which consisted of three main components.
  • The first component was patient focused procedures. These are steps designed to prevent wrong site, wrong patient or wrong procedure events.
  • The second component was sponge, sharp and instrument count procedures. These are steps designed to prevent retained surgical items.
  • The final component was monthly observational audits that were performed to assess program compliance. (more…)
Accidents & Violence, Author Interviews, JAMA / 16.10.2014

Richard M. Costanzo, PhD. Professor of Physiology and Biophysics and Special Assistant to the Vice President for Research Virginia Commonwealth UniversityMedicalResearch.com Interview with: Richard M. Costanzo, PhD. Professor of Physiology and Biophysics and Special Assistant to the Vice President for Research Virginia Commonwealth University Medical Research: What are the main findings of the study? Dr. Costanzo: In this study we found that individuals with varying degrees olfactory impairment have an increased risk of experiencing a hazardous event.  Those with complete loss (anosmia) were three times more likely to experience an event than those with normal olfactory function.  Factors such as age,sex, and race were found to affect an individual’s risk. (more…)
Author Interviews, Cost of Health Care, Emergency Care, NEJM, UCLA / 16.10.2014

Daniel A. Waxman, MD, PhD Department of Emergency Medicine David Geffen School of Medicine University of California, Los Angeles RAND Corporation Santa Monica, CaliforniaMedicalResearch.com Interview with: Daniel A. Waxman, MD, PhD Department of Emergency Medicine David Geffen School of Medicine University of California, Los Angeles RAND Corporation Santa Monica, California Medical Research: What are the main findings of the study? Dr. Waxman: About 10 years ago, three states (Texas, Georgia, and South Carolina) passed laws which made it much harder for doctors to be sued for malpractice related to emergency room care.   The goal of our research was to determine whether the lower risk of being sued translated into less costly care by emergency physicians.  To figure this out, we looked at the billing records of nearly 4 million Medicare patients and compared care before and after the laws took effect, and between states that passed reform and neighboring states that didn’t change their laws.   We found that these substantial legal protections didn’t cause ER doctors to admit fewer patients to the hospital, to order fewer CT or MRI scans, or to spend less for the overall ER visit. (more…)
Author Interviews, Melanoma, PLoS / 16.10.2014

Professor Robert Insall CR-UK Beatson Institute for Cancer Research Glasgow UKMedicalResearch.com Interview with: Professor Robert Insall CR-UK Beatson Institute for Cancer Research Glasgow UK Medical Research: What are the main findings of the study? Prof. Insall: The principal message is that melanoma cells make their own steering signals, and thus drive themselves out of the tumour and into the bloodstream.  This comes in two parts: (a) The principal steering signal when we assay melanoma spread in vitro is lysophosphatidic acid, LPA.  LPA steers cells with really remarkable accuracy; blocking LPA receptors stops them from spreading without hurting their health or ability to move. (b) Where does the LPA gradient come from?  They make it themselves.  There seems to be lots of LPA around; they break down the LPA near them, leading to a gradient that's low near the cells and high further away.  This is the gradient that steers the tumour cells. (more…)
AHRQ, Author Interviews, Infections, University of Pennsylvania / 15.10.2014

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 19104MedicalResearch.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 Medical Research: What are the main findings of the study? Dr. Umscheid: We developed an automated early warning and response system for sepsis that has resulted in a marked increase in sepsis identification and care, transfer to the ICU, and an indication of fewer deaths due to sepsis. Sepsis is a potentially life-threatening complication of an infection; it can severely impair the body’s organs, causing them to fail. There are as many as three million cases of severe sepsis and 750,000 resulting deaths in the United States annually. Early detection and treatment, typically with antibiotics and intravenous fluids, is critical for survival. The Penn prediction tool, dubbed the “sepsis sniffer,” uses laboratory and vital-sign data (such as body temperature, heart rate, and blood pressure) in the electronic health record of hospital inpatients to identify those at risk for sepsis. When certain data thresholds are detected, the system automatically sends an electronic communication to physicians, nurses, and other members of a rapid response team who quickly perform a bedside evaluation and take action to stabilize or transfer the patient to the intensive care unit if warranted. We developed the prediction tool using 4,575 patients admitted to the University of Pennsylvania Health System (UPHS) in October 2011.  We then validated the tool during a pre-implementation period from June to September 2012, when data on admitted patients was evaluated and alerts triggered in a database, but no notifications were sent to providers on the ground.  Outcomes in that control period were then compared to a post-implementation period from June to September 2013.  The total number of patients included in the pre and post periods was 31,093. (more…)
Author Interviews, Cancer / 15.10.2014

Cathryn Bock, PhD Associate Professor, Oncology Department Karmanos Cancer Institute Wayne State University School of Medicine Detroit, MI 48201MedicalResearch.com Interview with: Cathryn Bock, PhD Associate Professor, Oncology Department Karmanos Cancer Institute Wayne State University School of Medicine Detroit, MI 48201 Medical Research: What are the main findings of the study? Dr. Bock: This study examined the association between dietary antioxidant micronutrients and risk of renal cell carcinoma (RCC) among a cohort of 96,196 postmenopausal women from the Women’s Health Initiative (WHI). During follow-up (median follow-up time was 12 years), there were 240 cases of confirmed renal cell carcinoma in the cohort. Dietary lycopene intake, measured at  baseline, was associated with a decreased risk of renal cell carcinoma (RCC). Women with the highest quartile of lycopene intake (>6427.7 mcg/day) had approximately 40% lower risk of RCC compared to those women in the lowest quartile of lycopene intake (<2727.6 mcg/day). There were no statistically significant associations observed between intake of beta-carotene, alpha-carotene, beta-cryptoxanthin, lutein + xeazanthin, vitamin C, or vitamin E and renal cell carcinoma. (more…)
Author Interviews, CDC, JAMA, Tobacco / 15.10.2014

Dr. Brian Rostron PhD, MPH Center for Tobacco Products US Food and Drug Administration Silver Spring, MarylandMedicalResearch.com Interview with: Dr. Brian Rostron PhD, MPH Center for Tobacco Products US Food and Drug Administration Silver Spring, Maryland Medical Research: What are the main findings of the study? Dr. Rostron: We estimated that Americans in 2009 had had 14 million major medical conditions such as heart attack, stroke, lung cancer, and COPD that were attributable to smoking.  COPD was the leading cause of smoking-attributable morbidity, with over 7.5 million cases of COPD attributable to smoking. (more…)