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Aging, Author Interviews, Insomnia / 13.10.2014

MedicalResearch.com Interview with: Jen-Hao Chen, Ph.D. Assistant Professor, Department of Health Sciences University of Missouri, Columbia, MO 65211 Medical Research: What are the main findings of the study? Dr. Chen: In this study, we mapped four commonly-reported insomnia symptoms (feeling rested when waking up, having trouble falling asleep, waking up during the night, waking up too early and not being able to fall asleep again) to direct assessment of sleep characteristics in the general population of U.S. older adults. While we know older adults frequently complain about their sleep, we know little about how these complain reflect older adults’ actual sleep outcomes. Using innovative actigraphy data of 727 older adults aged 62-91 from the National Social Life, Health and Aging Project, we found that two of these four common report of insomnia symptoms did not match specific objective sleep characteristics as these questions intends to index. The question of feeling rested was not related to any objective sleep characteristic. The question of difficulty falling asleep was not related to the objective measure of time to fall sleep but was related to other objective sleep characteristics. For waking up during the night question, high frequency was associated with more wake time after sleep onset and numbers of wake bout (but was also related to other objective sleep characteristics). For waking up too earlier question, answer of this question was related to earlier wake up time. But again, other objective sleep characteristics also predicted frequency of waking up earlier. In sum, many of the relationships and non-relationships found in this study were unexpected. Findings suggested that these widely used questions did not related to older adults’ sleep outcomes as exactly as the wording suggested. Thus, while older adults’ report of these questions are related to objective sleep characteristics in some ways, insomnia symptoms and objective sleep characteristics did not complete match each other as expected. (more…)
Brigham & Women's - Harvard, Infections, Surgical Research / 11.10.2014

Michael S. Calderwood, MD MPH Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute Boston, MAMedicalResearch.com Interview with: Michael S. Calderwood, MD MPH Division of Infectious Diseases Brigham and Women's Hospital Boston, MA Medical Research: What are the main findings of the study? Dr. Calderwood: "In our study, we found that the risk of surgical site infection (SSI) following total hip arthroplasty and coronary artery bypass graft (CABG) surgery is higher for Medicare patients undergoing surgery in U.S. hospitals with lower surgical volume. This suggests that volume leads to experience, and experience leads to improved outcomes." "We found a significantly higher risk of surgical site infection in U.S. hospitals performing <100 total hip arthroplasty procedures and <50 CABG procedures per year on Medicare patients. In the lowest volume hospitals, 1 out of 3 infections following total hip arthroplasty and 1 out of 4 infections following CABG were in excess of expected outcomes based on experience in the highest volume hospitals." (more…)
Author Interviews, Hepatitis - Liver Disease, HIV / 11.10.2014

Dr Daniel Bradshaw Chelsea and Westminster Hospital, LondonMedicalResearch.com Interview with: Dr Daniel Bradshaw Chelsea and Westminster Hospital, London Medical Research: What are the main findings of the study? Dr. Bradshaw: Over 40% of men with hepatitis C (HCV) infection have HCV RNA in their semen, although the level of RNA was much lower than blood (usually 4 log less than blood). Neither HIV nor acute hepatitis C led to increased shedding of HCV RNA in semen. Interestingly, however, in acute HCV, HIV-positive men with higher blood levels of HCV RNA were more likely to shed RNA in their semen. (more…)
Anesthesiology, Author Interviews, Hepatitis - Liver Disease, Infections / 11.10.2014

MedicalResearch.com Interview with: Sana Dastgheyb National Institute of Allergy and Infectious Diseases, The National Institutes of Health, Bethesda, MDDepartment of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA and Dr. Noreen Hickok Department of Orthopedic Surgery Thomas Jefferson University, Philadelphia, PA Medical Research: What are the main findings of the study? Response: Physicians have long been resigned to the fact that staphylococcal joint infections are among the most challenging to treat. Our study points towards a definitive mechanism whereby bacteria become insensitive to antibiotics in the human joint environment. We added MRSA to synovial fluid and observed dense, biofilm-like aggregates, as well as a relative insensitivity to antibiotics as compared to ideal medium. Our findings suggest that serum/extracellular matrix proteins within synovial fluid contribute greatly to staphylococcal antibiotic insensitivity in synovial fluid. Furthermore, pre-treatment of synovial fluid with the enzyme plasmin, which degrades extracellular matrix proteins, significantly inhibits aggregate formation, and restores normal antibiotic sensitivity to MRSA. (more…)
Allergies, Author Interviews, Dermatology / 10.10.2014

MedicalResearch.com Interview with: Shawn Demehri, M.D., Ph.D. Instructor of Medicine Division of Dermatology Washington University in St. Louis andShawn Demehri, M.D., Ph.D. Instructor of Medicine Division of Dermatology Washington University in St. Louis and   Wayne M. Yokoyama, M.D. Howard Hughes Medical Institute Rheumatology Division Washington University Medical Center St. Louis, MO 63110-1093Wayne M. Yokoyama, M.D. Howard Hughes Medical Institute Rheumatology Division Washington University Medical Center St. Louis, MO 63110-1093 MedicalResearch: What are the main findings of the study? Research: This bedside to bench research has clearly demonstrated a cause and effect relationship between chronic allergic contact dermatitis and skin cancer development. This research originated from a clinical case of invasive skin cancer that developed in the context of chronic allergic contact dermatitis to a nickel-containing metal implant. Using animal models, we have demonstrated that chronic exposure to a contact allergen creates an inflammation that drive skin cancer development. (more…)
Author Interviews, C. difficile, General Medicine, Hospital Acquired / 10.10.2014

MedicalResearch.com Interview with: Esther van Kleef London School of Hygiene and Tropical Medicine, London, UK Medical Research: What are the main findings of the study? Response:  Existing evidence reveals a wide variation in estimated excess length of hospital stay (LoS) associated with healthcare-acquired C. difficile infection (HA-CDI), ranging from 2.8 to 16.1 days. Few studies considered the time-dependent nature of healthcare-acquired C. difficile (i.e. patients that spent a longer time in hospital have an increased risk of infection), and none have considered the impact of severity of healthcare-acquired C. difficile on expected delayed discharge. Using a method that adjusted for this so-called time-dependent bias, we found that compared to non-infected patients, the excess length of stay of severe patients (defined by increased white blood cell count, serum creatinine, or temperature, or presence of colitis) was on average, twice (11.6 days; 95% CI: 3.6-19.6) that of non-severe cases (5.3 days; 95% CI: 1.1-9.5). However, severely infected patients did not have a higher daily risk of in-hospital death than non-severe patients. Overall, we estimated that healthcare-acquired C. difficile prolonged hospital stay with an average of ~7 days (95% CI: 3.5-10.9) and increased in-hospital daily death rate with 75% (Hazard Ratio (HR): 1.75; 95% CI: 1. 16 – 2.62). (more…)
Annals Internal Medicine, Author Interviews, Heart Disease / 10.10.2014

Joseph A. Ladapo, MD, PhD New York University School of Medicine Department of Population Health New York, NY 10016MedicalResearch.com Interview with: Joseph A. Ladapo, MD, PhD New York University School of Medicine Department of Population Health New York, NY 10016 Medical Research: What are the main findings of the study? Dr. Ladapo: We showed that the use of cardiac stress testing has risen briskly over the past two decades, with the use of imaging growing particularly rapidly. We also showed that national growth in cardiac stress test use can largely be explained by population and provider characteristics, but the use of imaging cannot. Importantly, nearly one third of cardiac stress tests with imaging tests were probably inappropriate, because they were performed in patients who rarely benefit from imaging. These tests--about 1 million each year--are associated with about half a billion dollars in healthcare costs annually and lead to about 500 people developing cancer in their lifetime because of radiation they received during that cardiac stress test. (more…)
Author Interviews, Transplantation / 09.10.2014

Stan Rose, PhD President & CEO of Transplant Genomics Dr. Rose is also a kidney transplant recipientMedicalResearch.com Interview with: Stan Rose, PhD President & CEO of Transplant Genomics Dr. Rose is also a kidney transplant recipient MedicalResearch: What is the background for these studies?  Dr. Rose: The studies by the founding scientists of Transplant Genomics (TGI) presented at the World Transplant Congress (WTC) 2014 represent years of work by our scientific founders and their collaborators at leading institutions in their search for  minimally invasive diagnostic and monitoring tools enabling earlier and more accurate detection and characterization of graft injury in organ transplant recipients. In kidney transplant recipients, for example, current methods consist of tracking creatinine levels and periodic direct assessment of grafts through biopsies. But by the time creatinine levels are elevated, more than 50% of kidney function may be lost. Biopsies, considered the gold standard for assessing graft status, are invasive, risky, unsuited for serial monitoring, and yield inconclusive results as often as 30% of the time. Transplant Genomics is addressing the need for better monitoring by developing a peripheral blood test for genomic biomarkers of transplant graft status to detect early signs of graft injury, differentiate between actionable causes and enable optimization of immunosuppressive therapy. (more…)
Author Interviews, JAMA, Mental Health Research / 09.10.2014

Bret R Rutherford, MD Assistant Professor ,Clinical Psychiatry Columbia University College of Physicians and Surgeons Division of Geriatric Psychiatry New York State Psychiatric Institute New York, NY 10032MedicalResearch.com Interview with: Bret R Rutherford, MD Assistant Professor ,Clinical Psychiatry Columbia University College of Physicians and Surgeons Division of Geriatric Psychiatry New York State Psychiatric Institute New York, NY 10032 Medical Research: What are the main findings of the study? Dr. Rutherford: In this meta-analysis of 105 trials of acute antipsychotic drugs for schizophrenia, the placebo response was shown to be significantly increasing from 1960 to the present. Conversely, the treatment change associated with effective dose medication significantly decreased over the same time period. The average participant of a randomized clinical trial (RCT) receiving an effective dose of medication in the 1960s improved by 13.8 points in the BPRS, whereas this difference diminished to 9.7 BPRS points by the 2000s. The consequence of these divergent trends was a significant decrease in drug-placebo differences from 1960 to the present. (more…)
Author Interviews, JAMA, Schizophrenia / 09.10.2014

Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine Hofstra North Shore LIJ School of Medicine Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital Investigator Feinstein Institute for Medical Research North Shore Long Island Jewish Health SystemMedicalResearch.com Interview with: Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine Hofstra North Shore LIJ School of Medicine Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital Investigator Feinstein Institute for Medical Research North Shore Long Island Jewish Health System Medical Research: What are the main findings of the study? Dr. Correll: The main findings of the study of 398 patients with first-episode schizophrenia-spectrum disorders who were on average in their mid twenties are that:
  • 1) despite their young age, an average of only 47 days lifetime antipsychotic exposure and overweight/obesity figures that were comparable to similarly aged US population members, there was a clear pattern of increased smoking and several metabolic risk parameters compared to similarly aged persons in the general US population;
  • 2) dyslipidemia, a constellation of at least one relevant abnormal blood fat value, was as frequent as in a 15-20 years older general US population;
  • 3) body composition related risk markers were significantly associated with longer total psychiatric illness duration, whereas metabolic risk markers were significantly associated with the overall very short mean lifetime antipsychotic treatment duration; and
  • 4) relevant for treatment choice and recommendations for patients, significantly higher continuous metabolic risk factor values were associated with olanzapine treatment and, less so, with quetiapine treatment. (more…)
Author Interviews, Infections, JAMA / 09.10.2014

MedicalResearch.com Interview with: Dr. Nicolas Garin MD Division of General Internal Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland Division of Internal Medicine, Hôpital Riviera-Chablais, Monthey, Switzerland Medical Research: What are the main findings of the study? Dr. Garin: Empiric treatment with a betalactam drug (monotherapy) was not equivalent to the combination of a betalactam and a macrolide in patients hospitalized for moderate severity pneumonia (proportion of patients not having reached clinical stability at day 7 was 41.2 % in the monotherapy vs. 33.6 % in the combination therapy arm, between arm difference 7.6 %). This occurred despite systematic search for Legionella infection in the monotherapy arm. There was no difference in early or late mortality, but patients in the monotherapy arm were more frequently readmitted. Patients with higher severity of disease (in PSI category IV, or with a CURB-65 score higher than 1) seemed to benefit from combination therapy (HR 0.81 for the primary outcome of clinical instability at day 7), although it was statistically not significant. There was no difference in the primary outcome for patients in PSI category I to III. (more…)
Author Interviews, Infections, NEJM / 08.10.2014

Anders Perner, MD, PhD Overlæge / Senior staff specialist Professor / Professor in Intensive Care Dept of Intensive Care Rigshospitalet Copenhagen DenmarkMedicalResearch.com Interview with: Anders Perner, MD, PhD Overlæge / Senior staff specialist Professor / Professor in Intensive Care Dept of Intensive Care Rigshospitalet Copenhagen Denmark Medical Research: What are the main findings of the study? Dr. Perner: In the large international randomised trial, we showed similar outcomes in patients with septic shock with anemia transfused at a lower vs. a higher hemoglobin threshold. The lower threshold group received 50 % fewer transfusions and one-third of these patients were never transfused in ICU. (more…)
Cost of Health Care, MRSA / 08.10.2014

https://medicalresearch.com/cost-of-health-care/id_week_14_universal_mrsa_screening_may_be_too_expensive_to_implement/8166/Medical Research’s Interview with: James A. McKinnell, MD Los Angeles Biomedical Research Institute   Medical Research: What are the main findings of the study? Dr. McKinnell: Numerous experts and policy makers have called for hospitals to screen patients for methicillin-resistant Staphylococcus aureus (MRSA) infections and isolate anyone testing positive to prevent the spread of these so-called “Superbugs” in healthcare settings. Several states have enacted laws requiring patients be screened for MRSA upon admission. We conducted two studies, both of which were presented as abstracts at IDWeek, the annual scientific meeting for infectious disease specialists, which found universal MRSA screening and isolation of high-risk patients will help prevent MRSA infections but may be too economically burdensome for an individual hospital to adopt. Researchers at Los Angeles Biomedical Research Institute, the University of California, Irvine and John Hopkins University examined the cost of a hospital infection prevention strategy that tested all patients for MRSA and then took precautions to avoid contact with potential carriers. We found that using the traditional method of testing for MRSA in the nose, or nares surveillance, and then isolating MRSA carriers prevented nearly three MRSA infections. But it cost the hospital $103,000 per 10,000 hospital admissions. More extensive screening, through the use of other testing methods, which included PCR-based screening, prevented more infections, but increased the cost. In the second study, we also evaluated the cost of a hospital infection prevention strategy that targeted high-risk patients. Again, we found the costs of the program exceeded the potential savings to the hospital that would be generated by preventing MRSA infections. We found nares screening and isolation of high-risk patients prevented fewer than one infection (0.6) per 1,000 high-risk admissions to the hospital and created a financial loss of $36,899 for the hospitals. Using more extensive MRSA screening – which included nares, pharynx and inguinal folds screening – prevented slightly more infections (0.8 infections per 1,000 high-risk admissions), according to the study. But our abstract reported an even larger financial loss of $51,478 with the more extensive screening. (more…)
Author Interviews, OBGYNE, Surgical Research / 08.10.2014

MedicalResearch.com Interview with: Jason D. Wright, M.D. Sol Goldman Associate Professor of Obstetrics and Gynecology Chief, Division of Gynecologic Oncology Columbia University College of Physicians and Surgeons New York, New York 10032 Medical Research: What are the main findings of the study? Dr. Wright: The use of robotic assisted ovarian surgery (oophorectomy and cystectomy) has increased rapidly and compared to laparoscopic alternatives, robotically assisted surgery is associated with a small increase in complication rates and substantially greater costs. (more…)
Author Interviews, Cancer Research, Lancet, Thromboembolism / 08.10.2014

MedicalResearch.com Interview with: Prof Martin H Prins MD Maastricht University Medical Centre, Maastricht, Netherlands Medical Research: What are the main findings of the study? Dr. Prins: Patients with active cancer, i.e. a cancer that was diagnosed or treated within 6 months before the episode, that was recurrent or metastatic, or that was diagnosed during treatment, who had a symptomatic episode of venous thromboembolism, were included in this pooled subgroup analysis of the Einstein DVT and PE studies. The incidence of recurrent venous thromboembolism was similar between groups. It occurred in 16 (5%) of 354 patients allocated to rivaroxaban and 20 (7%) of 301 patients allocated to enoxaparin and vitamin K antagonist (hazard ratio [HR] 0•67, 95% CI 0•35 to 1•30). Clinically relevant bleeding was also similar and occurred in 48 (14%) of 353 patients receiving rivaroxaban and in 49 (16%) of 298 patients receiving standard therapy (HR 0•80, 95% CI 0•54 to1•20). However, major bleeding was less frequent among rivaroxaban recipients and occurred in eight (2%) of 353 patients receiving rivaroxaban and in 15 (5%) of 298 patients receiving standard therapy (HR 0•42, 95% CI 0•18 to 0•99). Mortality was also similar. (more…)
Author Interviews, Heart Disease, Hepatitis - Liver Disease / 08.10.2014

MedicalResearch.com Interview with: Naga Pothineni, MD Division of Cardiology University of Arkansas for Medical Science MedicalResearch: What are the main findings of the study? Dr. Pothineni: Hepatitis C is a blood borne infection that is very common worldwide. Most pateints who contract hepatitis C develop a chronic form on infection that progresses to liver damage and eventually hepatocellular cancer. Coronary heart disease is a worldwide problem as well. There has been interest in chronic infections being a mechanism of progression of atherosclerosis and coronary heart disease. We wanted to study the association of coronary heart disease events in patients with hepatitis C. We conducted a retrospective study of around 24,000 patients of which around 10,000 were hepatitis C positive. Our study showed that patients who have hepatitis C have a higher incidence of coronary heart disease events (myocardial infarction) when compared to patients who are negative for hepatitis C. In our analysis, we found that hepatitis C positivity is an independent risk factor for coronary events after adjusting for traditional cardiovascular risk factors like age, hypertension, smoking and diabetes. Another interesting finding in our study was that patients with hepatitis C have lower levels of cholesterol compared to patients without hepatitis C. Low cholesterol levels in these patients do not seem to be protective against future coronary heart disease events. (more…)
Author Interviews, Flu - Influenza, JAMA, Vaccine Studies / 08.10.2014

Robert B Belshe, MD Division of Infectious Diseases, Allergy & Immunology Saint Louis University School of MedicineMedicalResearch.com Interview with: Robert B Belshe, MD  Division of Infectious Diseases, Allergy & Immunology Saint Louis University School of Medicine   Medical Research: What are the main findings of the study? Response: A vaccine that protects against an old strain of avian flu primes the immune system to mount a rapid response when a vaccine designed to protect against a related but different and new strain of avian flu is given a year later, according to Saint Louis University research findings reported in JAMA. In addition, when combined with an adjuvant, which is a chemical that stimulates the immune system to produce more antibodies, a lower dose of the new avian flu vaccine worked better in triggering an immune response than a stronger dose without adjuvant. That means the amount of vaccine against a new strain of bird flu can be stretched to protect more people if an adjuvant is added. Both findings represent important strategies researchers can continue to study to fight new strains of bird flu that people previously have not been exposed to, and consequently can rapidly turn into a pandemic outbreak and public health emergency, said Robert Belshe, M.D., professor of infectious diseases, allergy and immunology at Saint Louis University and the lead author of the article, which appeared in the Oct. 8, 2014 issue of JAMA. (more…)
Author Interviews, JAMA, Nutrition / 08.10.2014

Daniel (Dong) Wang MD, MSc Department of Nutrition, Harvard School of Public Health Boston, MA 02115MedicalResearch.com Interview with: Daniel (Dong) Wang MD, MSc Department of Nutrition, Harvard School of Public Health Boston, MA 02115   Medical Research: What are the main findings of the study? Dr. Wang:
  • The overall dietary quality in US adults improved modestly from 1999 to 2010, but the quality of US diet remains far from optimal and huge room exists for further improvements.
  • The improvement in dietary quality was greater among adults with higher socioeconomic status and healthier body weight, thus disparities that existed in 1999 increased over the next decade.
  • More than half of the improvement in diet quality was due to a large reduction in consumption of trans fat.
(more…)
Author Interviews, Cognitive Issues, Radiology / 08.10.2014

Sven Haller, M.D. University of Geneva in Geneva, Switzerland. MedicalResearch.com Interview with: Sven Haller, M.D. University of Geneva in Geneva, Switzerland. Medical Research: What are the main findings of the study? Dr. Haller: The main finding is that some elderly individuals with intact cognitive function at baseline already have visible alterations of the brain perfusion measured in Arterial Spin Labeling (ASL)  MRI, which is similar to patients with mild cognitive impairment (MCI). This elderly individual may initially maintain intact cognitive functions due to the activation of their cognitive reserve, yet eventually the cognitive reserve is exhausted and those individuals develop subtle cognitive decline at follow-up 18 months later. Consequently, Arterial Spin Labeling MRI may predict the very earliest form of cognitive decline. (more…)
Author Interviews, Nutrition / 08.10.2014

Dr. Wenjun Li PhD Associate Professor of Medicine (Biostatistics) University of Massachusetts Medical School of Medicine University of Massachusetts Medical SchoolMedicalResearch.com Interview with: Dr. Wenjun Li PhD Associate Professor of Medicine (Biostatistics) University of Massachusetts Medical School of Medicine University of Massachusetts Medical School Medical Research: What are the main findings of the study? Dr. Li:  The study discovered that the effectiveness of dietary interventions is significantly influenced by the presence of a supportive community nutrition environment. (more…)
Stroke / 07.10.2014

dr_john-falconerMedicalResearch.com Interview with: John Falconer MD FRCPC Neurologist, Kelowna General Hospital; Clinical Associate Professor of Neurology, University of British Columbia Medical Research: What are the main findings of this study? Dr. Falconer: This study set out to investigate the possible benefits of having a physician with a proprietorial interest (Pro-MD) in a stroke unit, tightly combined with a multidisciplinary inter-professional team, and including the family and the patient in as essential members for the management of a stroke patient. This also involved the introduction of a geographic located Acute Stroke Unit. We compared Acute Bed Days used by patients from the five months before to five months after this system was put in place. Our main end point was number of days in acute hospital care before and after, but we also informally tracked patient and caregiver satisfaction and staff morale. The Proprietary Physician, or Pro-M Drefers to a physician who has a “proprietorial” interest in a hospital unit or ward. In other words, I was working at this unit in a wholistic sense, trying not only to manage patients as best they can, but also interested in the patient flow and family-patient communications. We found that patient bed days were reduced by approximately 25% overall, while at the same time, patient and family satisfaction was improved, and staff morale increased. Initially, we had supposed that patients and their family would be more satisfied, but we were surprised at the reduction in Acute Bed Days that resulted. (more…)
Author Interviews, Breast Cancer / 07.10.2014

Professor Xiaodong Zhang Professor of Macromolecular Structure and Function Department of Medicine Imperial College, London, UKMedicalResearch.com Interview with: Professor Xiaodong Zhang Professor of Macromolecular Structure and Function Department of Medicine Imperial College, London, UK Medical Research: What are the main findings of the study? Prof. Zhang: Since its discovery 20 years ago, the BRCA2 gene and its protein product, BRCA2, have been under intensive investigations. The importance of the BRCA2 protein lies in the central roles it plays in the most faithful DNA damage repair pathway. Mutations in BRCA2 thus can cause defects in this repair pathway, making the repair inefficient or forcing cells to use alternative repair methods that are prone to mistakes, all of which contribute to mutations in the genomic DNA, thus increase the risk of cancer development. Our study aims to understand how BRCA2 works through studying its 3-dimensional structures and its interactions with other key partners in the repair pathway. Our study provides first 3-dimensional views of BRCA2 and BRCA2-RAD51 and reveals that BRCA2 molecules exist as pairs and a BRCA2 pair recruit two sets of RAD51 molecules arranged in opposite orientations. Our study also shows a single stranded DNA binds across the BRCA2 dimer and that BRCA2 increases the frequency of RAD51 filament formation events, presumably to increase the efficiency of establishing a longer filament required for searching for matching strands of DNA in intact sister chromatin. Our results thus not only define the precise roles of BRCA2 in helping RAD51 filament formation, but how it helps RAD51 loading onto single stranded DNA. (more…)
Author Interviews, Heart Disease, Hospital Readmissions / 07.10.2014

Elizabeth Blanchard Hills, BSN MSJ President, Informed Health SolutionsMedicalResearch.com Interview with: Elizabeth Blanchard Hills, BSN MSJ President, Informed Health Solutions Medical Research: What is your role? Response: My name is Elizabeth Blanchard Hills, BSN, MSJ.  My company, Informed Health Solutions, currently has the privilege of “transitioning” Dr. Smith’s work into clinical practice.  We have been conducting an on-going pilot project with the University of Kansas Hospital since November 2013, and our results are corroborating the results of Dr. Smith’s randomized clinical trial.  We have renamed SMAC-HF; it is now called CareConnext. Medical Research: What are the main findings of the study?  Response: That we could, in fact, significantly lower hospital readmissions among heart failure patients. (more…)
Author Interviews, Prostate Cancer, Testosterone / 07.10.2014

Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology, College of Medicine University of Illinois at Chicago Chicago, IL 60612MedicalResearch.com Interview with:  Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology, College of Medicine University of Illinois at Chicago Chicago, IL 60612 Medical Research: What are the main findings of the study? Dr. Bosland: The two main findings are : (1) that long-term, low-dose testosterone treatment induces prostate cancer in rats (none occurred in control rats) and increases the number of rats with malignant tumors at any site in the body compared to control rats, and (2) that in rats treated long-term with testosterone after a single prostate-targeted chemical carcinogen treatment a high incidence of prostate cancer is induced, even at a very low testosterone dose. (more…)
AHA Journals, Author Interviews, Heart Disease / 07.10.2014

Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, The Leon H. Charney Division of Cardiology, Associate Professor of Medicine, New York University School of MedicineMedicalReseach.com Interview with: Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, The Leon H. Charney Division of Cardiology, Associate Professor of Medicine, New York University School of Medicine New York, NY 10016. Medical Research: What are the main findings of the study? Dr. Bangalore: Using data from the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial, we found that β-blocker use in patients with prior myocardial infarction but no heart failure was associated with a lower composite cardiovascular outcome, driven mainly by lower risk of recurrent myocardial infarction with no difference in mortality. However, in patients without prior myocardial infarction there was no benefit of β-blocker use with a suggestion of increase in stroke risk. (more…)
Author Interviews, CMAJ, Diabetes, Thyroid Disease / 07.10.2014

MedicalResearch.com Interview with: Jean-Pascal Fournier, MD, PhD Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada and Laurent Azoulay, PhD Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Department of Oncology, McGill University, Montreal, Quebec, Canada Medical Research: What are the main findings of the study? Response: Patients with type II diabetes and treated hypothyroidism showed a 55% increased risk for low levels of thyroid stimulating hormone (TSH) (below 0.4 mIU/L) when initiating metformin, compared with those initiating sulfonylurea (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.09–2.20). In contrast, this effect of metformin was not observed in euthyroid patients, with an adjusted HR for low TSH of 0.97(95% CI 0.69–1.36). (more…)
Alzheimer's - Dementia, Author Interviews, Neurology / 07.10.2014

Lena Johansson, PhD, MSc, RN Institute of Neuroscience and Physiology Department of Psychiatry and Neurochemistry Sahlgrenska Academy at Gothenburg UniversityMedicalResearch.com Interview with: Lena Johansson, PhD, MSc, RN Institute of Neuroscience and Physiology Department of Psychiatry and Neurochemistry Sahlgrenska Academy at Gothenburg University Medical Research: What are the main findings of the study? Dr. Johansson: We found that a higher degree of neuroticism in midlife was associated with increased risk of Alzheimer’s disease over 38 years. On the 24 point scale, the risk increased with 4% per each step. Women who score high on the neuroticism scale were more likely to experience feelings such as anxiety, nervousness, worry, and irritability, and they were more moodiness and stress-prone. The association between neuroticism and Alzheimer’s disease diminished after adjusting for longstanding perceived distress symptoms, which suggest that the associations was at least partly depended on long-standing distress symptoms. When the two personality dimensions were combined, women with high neuroticism/low extraversion had a double risk of Alzheimer’s disease compared to those with low neuroticism/high extraversion. (more…)
AHA Journals, Author Interviews, Stroke / 07.10.2014

Vijaya Sundararajan, MD, MPH, FACP Associate Professor Head, Health Outcomes Group, Head, Biostatistics Hub Research Advisor, Centre for Palliative Care Department of Medicine Eastern Hill Academic Centre Melbourne Medical School Faculty of Medicine, Dentistry and Health Sciences University of MelbourneMedicalResearch.com Interview with: Vijaya Sundararajan, MD, MPH, FACP Associate Professor Head, Health Outcomes Group, Head, Biostatistics Hub Research Advisor, Centre for Palliative Care Department of Medicine Eastern Hill Academic Centre Melbourne Medical School Faculty of Medicine, Dentistry and Health Sciences University of Melbourne Medical Research: What are the main findings of this study? Dr. Sundararajan: The main findings of the study are that over the last 10 years, there has been a measurable decline in people having a stroke 3 months after a new mini stroke (TIA); a mini stroke is also known as a ‘warning sign for stroke’. There has also been an overall decline in of the proportion of people having these mini strokes in the Australian State of Victoria (population 5.6million). These trends probably reflect improved primary and secondary prevention efforts for the last decade. These improvements are likely to include increased use of preventive medications and surgery for carotid artery narrowing in people identified as being at high risk of having a stroke, as well as improved behaviors (e.g. reducing smoking, improving diets, uptake of physical activity, among others). The most important aspect of our results is many fewer strokes occur when people with a TIA are managed in a hospital with a stroke unit (up to 6%).  Even when the patient’s TIA is managed in an Emergency Department and the patient released without admission, if the hospital has a stroke unit, these patients appear to have better outcomes. This likely reflects the cohesion and organization of the stroke unit in implementing the necessary tests and treatments promptly, and setting up the infrastructure to follow patients up. (more…)
Author Interviews, General Medicine, Pediatrics, Sexual Health / 07.10.2014

Jeff R. Temple, PhD Associate Professor and Psychologist Director, Behavioral Health and Research Department of Ob/Gyn UTMB Health Galveston, TX 77555-0587MedicalResearch.com Interview with: Jeff R. Temple, PhD Associate Professor and Psychologist Director, Behavioral Health and Research Department of Ob/Gyn UTMB Health Galveston, TX 77555-0587 Medical Research: What are the main findings of the study? Dr. Temple: Through previous research, we know that teen sexting is related to actual sexual behaviors, but we did not have any information on the temporal link between these two behaviors. In short, we found that teens who sexted had 32% higher odds of being sexually active over the next year relative to youth who did not sext – this was even after controlling for history of prior sexual behavior, ethnicity, gender, and age. We also found that active sexting (actually sending a naked picture to another teen) mediated the relationship between passive sexting (asking for or being asked for a sext) and sexual behaviors. In other words, while sending a sext was predictive of subsequent sexual behavior, asking for/being asked for a sext was only associated with sexual behavior through its relationship with active sexting. (more…)