Annals Internal Medicine, Author Interviews, Heart Disease, Menopause / 03.08.2014

S. Mitchell Harman, M.D., Ph.D. CAPT US Public Health Service, retired Professor, Clinical Medicine, U of AZ College of Medicine Interim Chief, Dept. of Internal Medicine Chair, IRB Subcommitee Phoenix VA Health Care System Phoenix, AZ 85012-1892MedicalResearch.com Interview with: S. Mitchell Harman, M.D., Ph.D. CAPT US Public Health Service, retired Professor, Clinical Medicine, U of AZ College of Medicine Interim Chief, Dept. of Internal Medicine Chair, IRB Subcommitee Phoenix VA Health Care System Phoenix, AZ 85012-1892 Medical Research: What are the main findings of the study? Dr. Harman: The major findings are: 1.       Neither transdermal nor oral estrogen treatment significantly accelerates or decelerates rate of change of carotid artery intimal medial thickness (CIMT) in healthy recently menopausal women. 2.       Both estrogen treatments have some potentially beneficial effects on markers of CVD risk, but these differ depending on the route of estrogen delivery with improvements in LDL and HDL cholesterol seen with oral, and reduced insulin resistance with transdermal. 3.       No significant effects were observed on rate of accumulation of coronary artery calcium. 4.       Women reported significant relief of vasomotor (hot flush) symptoms with both estrogen treatments (more…)
Author Interviews, Brigham & Women's - Harvard, Rheumatology, Weight Research / 01.08.2014

Dr. Bing Lu, M.D., Dr.P.H. Division of Rheumatology Immunology & Allergy Brigham & Women's Hospital and Harvard Medical School Boston, MA 02115MedicalResearch.com Interview with: Dr. Bing Lu, M.D., Dr.P.H. Division of Rheumatology Immunology & Allergy Brigham & Women's Hospital and Harvard Medical School Boston, MA 02115 Medical Research: What are the main findings of the study? Dr. Lu: In two large cohorts of women, we observed that being obese increased the risk of rheumatoid arthritis in women by 40–70% depending on age and serologic status. The highest risk for rheumatoid arthritis was among women who were overweight or obese at age 18 years, emphasizing the public health importance of combating the obesity epidemic at all ages. Our study implicates being overweight or obese throughout adult life as a risk factor in the development of seropositive and seronegative RA for women diagnosed with rheumatoid arthritis at age 55 years or younger. The attenuated association between BMI and rheumatoid arthritis diagnosed at older ages may reflect differences in the pathophysiology of RA diagnosed at earlier ages compared with that diagnosed at older ages, or may be a result of the limitations of BMI as a measure of total fat mass as women age. (more…)
Author Interviews, Melanoma / 01.08.2014

Marianne Berwick, PhD, MPH for the GEM Study Team Professor, Division of Epidemiology University of New Mexico, Department of Internal Medicine New Mexico Cancer Research Facility University of New Mexico, Albuquerque, NM 87131MedicalResearch.com Interview with: Marianne Berwick, PhD, MPH for the GEM Study Team Professor, Division of Epidemiology University of New Mexico, Department of Internal Medicine New Mexico Cancer Research Facility University of New Mexico, Albuquerque, NM 87131 Medical Research: What are the main findings of this study? Dr. Berwick: In our study of Sun Exposure and Melanoma Survival: A GEM Study we found that there is little strong evidence that sun exposure at any time in life influences melanoma-specific survival. This study took place in Australia, Italy, Canada and the United States among 3,578 individuals newly diagnosed with melanoma, who we followed for a mean of 7.4 years. (more…)
Author Interviews, Dermatology, Melanoma / 01.08.2014

MedicalResearch.com Interview with: Estee L. Williams, MD SUNY Downstate Medical Center, Brooklyn, New York Madfes Integrated Dermatology, New York, New York [email protected] Medical Research: What are the main findings of the study? Dr. Williams: In our retrospective review of all melanomas diagnosed at the Veterans’ Affairs Hospital in Brooklyn since 2000, we discovered that although a majority of the melanomas (63%) were found by the dermatologist during a yearly “full body” screening examination (versus detection by the patient), melanomas found by the dermatologist were not necessarily thinner (hence, earlier, more curable) than those found by the patient. (more…)
Anesthesiology, Author Interviews, Emergency Care / 01.08.2014

MedicalResearch.com Interview with: Lindsay Cohen MD Department of Emergency Medicine University of British Columbia Medical Research: What are the main findings of the study? Dr. Cohen: In our systematic review of the literature, we sought to synthesize the available evidence on the effect of ketamine on clinical outcomes as compared to other sedative agents in intubated patients. Our outcomes of interest included intracranial and cerebral perfusion pressures, neurologic outcomes, ICU length of stay, and mortality. We included only randomized controlled trials and prospective controlled studies, and identified a total of ten studies that met our inclusion criteria. Due to the lack of homogeneity in the studies, data was analyzed in a qualitative manner. None of the studies reported significant differences between ketamine and other sedative agents for any of our outcomes of interest. (more…)
Author Interviews, Pediatrics, Vaccine Studies / 01.08.2014

Jana Shaw MD, MPH, FAAP Associate Professor of Pediatrics Pediatric Infectious Diseases SUNY Upstate Medical University 750 East Adams Street Syracuse, NY 13210MedicalResearch.com Interview with: Jana Shaw MD, MPH, FAAP Associate Professor of Pediatrics Pediatric Infectious Diseases SUNY Upstate Medical University 750 East Adams Street Syracuse, NY 13210 Medical Research: What are the main findings of the study? Dr. Shaw: In this study, we looked at exemptions to school immunization requirements in the US during 2009-2010 school year. We found that private schools have higher rates for all types of exemptions (medical, religious, and personal belief/philosophical). In addition, states that permitted personal belief exemptions had higher rates of exemptions overall compared to states that did not allow them. (more…)
Author Interviews, Electronic Records / 01.08.2014

MedicalResearch.com Interview Celeste Campos-Castillo PhD Assistant Professor Department of Sociology University of Wisconsin-Milwaukee Medical Research: What are the main findings of the study? Dr. Campos-Castillo: Approximately 13% of adults in the U.S. have held back information from doctors out of privacy or security concerns. When we compare adults with the same characteristics (e.g., age and education, overall health, and health care characteristics like having insurance and seeing a doctor in the past year) based on whether their doctor uses an electronic health record (EHR) system or not, we find that those with a doctor that uses an electronic health record were more likely to hold back information than those whose doctor does not use an electronic health record. Other studies have looked at whether electronic health records are related to withholding information out of privacy concerns, but the evidence was mixed: sometimes patients with EHRs were more likely to hold back information from doctors, other times there but sometimes there was no difference in withholding between patients of doctors who used EHRs and those who did not. What makes our study unique is that we consider a range of factors in the analysis that can disguise the real relationship between EHRs and withholding information because of privacy concerns. In particular, we take into account how patient ratings of quality of care play a complicated role in this situation. Patients with doctors who use EHRs often rate the quality of care they receive higher than those with doctors who are not using these systems. At the same time, higher quality ratings generally mean that patients feel comfortable sharing information with doctors, even the sensitive information that we tend to keep to ourselves. Because quality ratings are associated both with EHRs and with holding back information from doctors, it is necessary to consider this in the analysis. Otherwise – as we show in the study – we would mistakenly conclude that EHRs are unrelated to holding back information. Instead, we show that when we accurately compare patients with the same characteristics, including quality ratings, patients with EHRs are more likely to withhold information from their doctors out of concerns for privacy. (more…)
Allergies, Author Interviews / 01.08.2014

Supinda Bunyavanich, MD, MPH, MPhil Department of Pediatrics- Allergy/Immunology Department of Genetics and Genomic Sciences Icahn Institute for Genomics and Multiscale Biology Mindich Child Health and Development Institute Icahn School of Medicine at Mount Sinai New York, NY 10029 USAMedicalResearch.com Interview with: Supinda Bunyavanich, MD, MPH, MPhil Department of Pediatrics- Allergy/Immunology Department of Genetics and Genomic Sciences Icahn Institute for Genomics and Multiscale Biology Mindich Child Health and Development Institute Icahn School of Medicine at Mount Sinai New York, NY 10029 USA Medical Research: What are the main findings of the study? Dr. Bunyavanich: What is the prevalence of peanut allergy among US children? Given that 90% of US households consume peanut butter, this is an important question. We report and compare prevalence estimates of childhood peanut allergy according to varying criteria among 7-10 year-old children participating in a US birth cohort not selected for any disease. The prevalence of peanut allergy ranged from 2.0% to 5.0%, depending on definition. (more…)
Author Interviews, Diabetes, Mediterranean Diet, Nutrition, PLoS, Sugar / 01.08.2014

Effie Viguiliouk M.Sc. Candidate, Department of Nutritional Sciences University of TorontoMedicalResearch.com Interview with: Effie Viguiliouk M.Sc. Candidate, Department of Nutritional Sciences University of Toronto Medical Research: What are the main findings of the study? Effie Viguiliouk: This systematic review and meta-analysis of the totality of evidence from 12 randomized clinical trials in 450 participants with type 2 diabetes found that eating about 1/2 a cup of tree nuts per day (equivalent to about 60 g or 2 servings) significantly lowered the two key markers of blood sugar, HbA1c and fasting glucose, in comparison to calorically matched control diets without tree nuts. (more…)
Alcohol, Author Interviews, Social Issues / 31.07.2014

Magdalena Cerdá, DrPH MPH Assistant Professor, Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032-3727MedicalResearch.com Interview with: Magdalena Cerdá, DrPH MPH Assistant Professor, Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032-3727 Medical Research: What are the main findings of the study? Dr. Cerdá: We evaluated 1,095 Ohio National Guard soldiers, who had primarily served in Iraq and Afghanistan between 2008 and 2009 to determine the effect of civilian stressors and deployment-related traumatic events and stressors on post-deployment alcohol use disorder. Participants were interviewed three times over 3 years about alcohol use disorder, exposure to deployment-related traumatic events like land mines, vehicle crashes, taking enemy fire, and witnessing casualties, and about experiences of civilian life setbacks since returning from duty, including job loss, legal problems, divorce, and serious financial and legal problems. We found that having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders. In contrast, combat-related traumatic events were only marginally associated with alcohol problems. (more…)
Author Interviews, BMJ, Heart Disease, Nutrition / 31.07.2014

Prof. Frank B Hu Department of Nutrition Department of Epidemiology Harvard School of Public HealthMedicalResearch.com Interview Invitation Prof. Frank B Hu Department of Nutrition Department of Epidemiology Harvard School of Public Health Medical Research: What are the main findings of the study? Prof. Hu: We found that increasing consumption of fruits and vegetables is associated with reduced risk of mortality, especially cardiovascular mortality. The largest reduction in mortality can be achieved at 5 servings per day of fruits and vegetables. (more…)
Author Interviews, Genetic Research, JAMA, Schizophrenia / 31.07.2014

Dr Angelica Ronald Genes Environment Lifespan (GEL) laboratory Centre for Brain and Cognitive Development Department of Psychological Sciences Birkbeck, University of London London WC1E 7HXMedicalResearch.com Interview with: Dr Angelica Ronald Genes Environment Lifespan (GEL) laboratory Centre for Brain and Cognitive Development Department of Psychological Sciences Birkbeck, University of London London WC1E 7HX Medical Research: What are the main findings of the study? Dr. Ronald: Psychotic experiences, such as paranoia, hallucinations and disorganised thinking, are commonly reported by adolescents. Until now it has not been understood whether mild variations in psychotic experiences in the community are part of the same construct as more severe psychotic experiences in adolescence. Our findings suggest that they are. In our study, over 10,000 16-year-old adolescents in England and Wales were assessed on measures of psychotic experiences. The study identified a close link between normal, less frequent psychotic experiences and more severe and frequent experiences in the general population. A classic twin design was employed, which enabled us to conduct analyses investigating the role of genetic and environmental influences on psychotic experiences. The same genetic influences appeared to play a role across the spectrum of severity of psychotic experiences. The study found that psychotic experiences are moderately heritable in adolescence in the general population. This suggests it would be worth directing molecular genetic endeavours towards this area, which has so far received very little attention in terms of causal explanations. We also show that psychotic experiences have considerable environmental influence; in fact, environmental influence appears to play a larger role in causing psychotic experiences in adolescence than for diagnosed psychotic disorders in adults, such as schizophrenia. This result suggests a fruitful avenue will be to tackle what environmental risk factors influence adolescents to have psychotic experiences. (more…)
Author Interviews, Gender Differences, Kidney Disease, Mayo Clinic, Weight Research / 31.07.2014

Dr. John C. Lieske, MD Mayo Clinic, Rochester, MNMedicalResearch.com Interview with Dr. John C. Lieske, MD Mayo Clinic, Rochester, MN Medical Research: What are the main findings of the study? Dr. Lieske: We followed 11 women before, 6 and 12 months after Roux en Y gastric bypass surgery.  The patients successfully lost weight as mean BMI fell from 46 kg/m2 preoperatively to 28 kg/m2 postoperatively.   Mean serum creatinine did not significantly change from baseline (0.8 mg/dl) to 12 months (0.7 mg/dl).  Hence mean GFR estimated by the CKD-EPI equation (eGFR) did not significantly change from 84 ml/min/1.73 m2 (baseline) to 90 ml/min/1.73 m2 (12 months).  However, GFR measured by iothalamate clearance (mGFR) significantly decreased from 108 ml/min/1.73m2 (121 ml/min) to 85 ml/min/1.73 m2 (90 ml/min). (more…)
Author Interviews, Genetic Research, JCEM, Weight Research / 31.07.2014

Dr. Agatha van der Klaauw, PhD Wellcome Trust Postdoctoral Clinical Fellow Wellcome Trust-MRC Institute of Metabolic Science University of Cambridge Metabolic Research Laboratories Addenbrooke's Hospital Cambridge, United KingdomMedicalResearch.com Interview with: Dr. Agatha van der Klaauw, PhD Wellcome Trust Postdoctoral Clinical Fellow Wellcome Trust-MRC Institute of Metabolic Science University of Cambridge Metabolic Research Laboratories Addenbrooke's Hospital Cambridge, United Kingdom   Medical Research: What are the main findings of the study? Dr. van der Klaauw: Obesity occurs when we eat more calories than we burn which is often easy to do as many foods are highly palatable and high in calories. Highly palatable foods such as chocolate trigger signals in the brain that give a feeling of pleasure and reward (sometimes called cravings) which can contribute to overeating. These signals are processed in the reward centres in the brain, where sets of neurons release chemicals such as dopamine. However, very little is known about whether the reward centres of the brain work differently in some people who are overweight. In this study, we were interested in studying overweight people who had a problem with the melanocortin 4 receptor (MC4R) gene. About 1% of obese people have a problem in this gene which contributes to weight gain from a young age. We compared three groups of people: people who were overweight due to a problem in the MC4R gene, people who were overweight but the gene was normal and some people who were normal weight. We performed functional Magnetic Resonance Imaging (fMRI) scans to look at how the reward centres in the brain were activated by pictures of appetizing food such as chocolate cake compared to bland food such as rice or broccoli and non-food items such as staplers. We found that in normal weight people, the reward centres are activated (light up) when they are shown pictures of cake or chocolate and the same was seen in overweight people with a problem in the MC4R gene. But we found that the reward centres were underactive in overweight volunteers (in whom the gene was normal). (more…)
Author Interviews, Hematology, NEJM, Sloan Kettering, Transplantation / 31.07.2014

MedicalResearch.com Interview with: Richard J. O'Reilly, MD Memorial Sloan Kettering Cancer Center Medical Research: What are the main findings of the study? Dr. O'Reilly: 1.       In a comparison of the results of HLA-matched sibling transplants with other established transplant approaches, including T-cell depleted half-matched parental marrow grafts, unmodified transplants from matched unrelated donors and cord blood transplants in the current era (2000-2009), transplants from donors other than HLA-matched siblings had 5 year survival outcomes similar to those of matched siblings when applied to young infants (≤ 3.5 months of age) or infants of any age that were not infected at the time of transplants. Thus any child born with SCID can now be successfully transplanted. 2.       Active infection at the time of transplant significantly reduced chances of long-term survival for all infants except those who received transplants from HLA-matched siblings. Thus, infection is a dominant determinant of transplant outcome.  Control of treatable infections prior to transplant should be a major clinical objective. 3.       Treatment with chemotherapy containing busulfan significantly enhances the likelihood of recovering a normal ability to make antibodies and fosters better recovery of T-cells that provide cell mediated immunity, and may be an acceptable risk in uninfected infants. However, use of any chemotherapy prior to transplant in an infant who is infected, greatly decreases chances of survival. In infected patients who lack a matched sibling, T-cell depleted transplants from half matched related donors had the best outcomes. (more…)
Author Interviews, Duke, General Medicine, Mental Health Research, Nature / 31.07.2014

Rainbo Hultman, PhD Postdoctoral Research Associate Laboratory for Psychiatric Neuroengineering, Principal Investigator Affective Cognitive and Addiction Disorders (ACAD) Research Group Department of Psychiatry and Behavioral Sciences Center for Neuroengineering Duke University Medical Center Durham, NC 27710MedicalResearch.com Interview with: Rainbo Hultman, PhD Postdoctoral Research Associate Laboratory for Psychiatric Neuroengineering, Principal Investigator Affective Cognitive and Addiction Disorders (ACAD) Research Group Department of Psychiatry and Behavioral Sciences Center for Neuroengineering Duke University Medical Center Durham, NC 27710 Medical Research: What are the main findings of the study? Dr. Hultman: Using a mouse model of stress-induced psychiatric dysfunction, we found that the brainwave patterns in two key brain regions (prefrontal cortex, PFC and amygdala, AMY) encode for susceptibility to such dysfunction. Furthermore, such susceptibility can be predicted from the brainwave patterns in these regions before the onset of stress. (more…)
Author Interviews, Insomnia, Mental Health Research / 31.07.2014

MedicalResearch.com Interview with: Pasquale K Alvaro School of Psychology University of Adelaide South Australia, Australia Medical Research: What are the main findings of the study? Answer: In adolescents, insomnia is related to depression beyond chronotype (a classification system for circadian rhythms or body clock), anxiety and age. Insomnia is also related to Generalised Anxiety Disorder (GAD) beyond chronotype, depression and age. Depression accounts for the relationship between insomnia and Obsessive Compulsive Disorder (OCD), Separation Anxiety Disorder (SAD) and Social Phobia (SP). Furthermore, an evening chronotype  (delayed sleep phase, that is, preferring to go to bed in the early morning) predicts insomnia beyond depression, anxiety and age. Moreover, an evening chronotype predicts depression beyond insomnia, anxiety and age. Finally, insomnia and depression account for the relationships between an evening chronotype and panic disorder, OCD, SAD and SP. (more…)
Author Interviews, Dartmouth, Kidney Disease / 31.07.2014

MedicalResearch.com Interview with: Jeremiah R. Brown, PhD MS Assistant Professor of Health Policy and Clinical Practic The Dartmouth Institute Lebanon, NHMedicalResearch.com Interview with: Jeremiah R. Brown, PhD MS Assistant Professor of Health Policy and Clinical Practic The Dartmouth Institute Lebanon, NH   Medical Research: What are the main findings of the study? Dr. Brown: Using simple team-based quality improvement methods we prevented kidney injury in 20% of patients having a procedure in the cardiac catheterization lab.  Among patients with pre-existing kidney disease, we prevent kidney injury in 30% of patients. We believed that using a team-based approach and having teams at different medical centers in northern New England learn from one-another to provide the best care possible for their patients.  Some of the most innovative ideas came from these teams and identified simple solutions to protect patients from kidney injury from the contrast dye exposure; these included:
  • Getting patients to self-hydrate with water before the procedure (8 glasses of water before and after the procedure),
  • Allow patient to drink fluids up to 2-hours before the procedure (whereas before they were "NPO" for up to 12 hours and came in dehydrated),
  • Training the doctors to use less contrast in the procedure (which is good for the patient and saves the hospital money),
  • and creating stops in the system to delay a procedure if that patient had not received enough oral or IV fluids before the case (rather, they would delay the case until the patient received adequate fluids).Our success was really about hospital teams talking and innovating with one another instead of competing in the health care market, which resulted in simple, homegrown, easy to do solutions that improved patient safety.
(more…)
Author Interviews, Diabetologia, Weight Research / 31.07.2014

Joshua Bell, MSc Department of Epidemiology & Public Health University College LondonMedicalResearch.com Interview with: Joshua Bell, MSc Department of Epidemiology & Public Health University College London   Medical Research: What are the main findings of the study? Answer: We found that physical activity and leisure time sitting interact to affect the long-term risk of becoming obese, with protective effects of high physical activity depending upon low levels of leisure time sitting. Adults engaging in both high physical activity and low leisure time sitting showed nearly 4-fold lower odds of becoming obese after 5 years, compared with those engaging in both low physical activity and high leisure time sitting. (more…)
Author Interviews, Genetic Research, Mental Health Research / 30.07.2014

dr_zachary_kaminskyMedicalResearch.com Interview with: Zachary A. Kaminsky, Ph.D. Assistant Professor Johns Hopkins University School of Medicine Department of Psychiatry Baltimore, MD, 21205 Medical Research: What are the main findings of the study? Dr. Kaminsky: A DNA methylation increase at the SKA2 gene was identified and observed across three post mortem brain tissue cohorts and was associated with suicide. The DNA methylation at the SKA2 gene was associated with lower gene expression of the gene. The same association was found in blood allowing us to attempt to predict suicidal behaviors in living individuals. (more…)
Author Interviews, Diabetes, Diabetes Care, Kidney Disease / 30.07.2014

MedicalResearch.com Interview with: Petter Bjornstad, M.D. Children's Hospital Colorado University of Colorado Denver Aurora, CO 80045 Medical Research: What are the main findings of the study? Dr. Bjornstad: Type 2 diabetes is the most common cause of end-stage renal disease in the Western world. It is therefore of paramount importance to develop a better understanding of the determinants of diabetic nephropathy risk and progression, to improve outcome in adolescents with type 2 diabetes. We report high rates of microalbuminuria and renal hyperfiltration in adolescents with type 2 diabetes, which forecast early renal morbidity and mortality. In our observational study, insulin sensitivity measured by hyperinsulinemic-euglycemic clamp studies, rather than adiposity, blood pressure, lipid and glycemic control was associated with markers of renal health (albumin-to-creatinine ratio and estimated glomerular filtration rate). (more…)
Author Interviews, Neurology, Parkinson's / 30.07.2014

Associate Professor of Psychiatry and Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA 19104-2676 Parkinson's Disease Research, Education and Clinical Center (PADRECC) Mental Illness Research, Education and Clinical Center (MIRECC) Philadelphia Veterans Affairs Medical CenterMedicalResearch.com Interview with: Daniel Weintraub, M.D. Associate Professor of Psychiatry and Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA 19104-2676 Parkinson's Disease Research, Education and Clinical Center (PADRECC) Mental Illness Research, Education and Clinical Center (MIRECC) Philadelphia Veterans Affairs Medical Center Medical Research: What are the main findings of the study? Dr. Weintraub: That there is mixed evidence for the efficacy of naltrexone in the treatment of impulse control disorders in Parkinson’s disease, and the evidence is sufficient to support further study of this compound class for this indication.  In addition, the study demonstrates that it is possible to conduct a clinical trial in this area. (more…)
Author Interviews, BMJ, Mediterranean Diet, Nutrition / 30.07.2014

Dr Michelle Morris Research Fellow Nutritional Epidemiology Group School of Food Science & Nutrition University of LeedsMedicalResearch.com Interview with: Dr Michelle Morris Research Fellow Nutritional Epidemiology Group School of Food Science & Nutrition University of Leeds Medical Research: What are the main findings of the study? Dr. Morris: The healthiest diets consumed by UK Women are the most expensive. This study is UK centric, using dietary patterns consumed by UK women and scored for healthiness according to the UK Department of Health Eatwell Plate. Cost of diet was estimated using average prices taken from an evaluated UK food cost database. (more…)
Author Interviews, Diabetes, Diabetes Care, Weight Research / 30.07.2014

Grant Brinkworth PhD Associate Professor Senior Research Scientist CSIRO Animal, Food and Health Sciences Adelaide BC, South AustraliaMedicalResearch.com Interview with: Grant Brinkworth PhD Associate Professor Senior Research Scientist CSIRO Animal, Food and Health Sciences Adelaide BC, South Australia Medical Research: What are the main findings of the study? Dr. Brinkworth: Both a very low carbohydrate, high protein, high unsaturated fat diet and a high carbohydrate, low fat diet achieved similar weight loss, improvements in body composition and health risk markers. However, compared to the high carbohydrate, low fat diet, a very low carbohydrate high protein, high unsaturated fat diet had more favourable effects on blood lipid profile, glycemic control (indicated by greater reductions in glycosylated haemoglobin – primary clinical measure of blood glucose control and the requirements for blood glucose controlling drugs) and for reducing daily blood glucose fluctuations. The findings from this study suggests that a novel eating pattern that markedly limits carbohydrates, increases protein and unsaturated fat may have more favourable therapeutic potential for optimising the management of type 2 diabetes and reducing cardiovascular disease risk. (more…)
Addiction, Author Interviews, JAMA, Pediatrics / 29.07.2014

Sharon Levy, M.D., M.P.H. Director, Adolescent Substance Abuse Program Assistant Professor in Pediatrics Boston Children’s HospitaMedicalResearch.com Interview with: Sharon Levy, M.D., M.P.H. Director, Adolescent Substance Abuse Program Assistant Professor in Pediatrics Boston Children’s Hospital   Medical Research: What are the main findings of the study? Dr. Levy: We found that questions that asked about the frequency of alcohol, tobacco and drug use accurately triaged adolescents into "risk categories".  In other words, kids who reported using alcohol or marijuana "once or twice" last year were unlikely to have a substance use disorder, those who reported "monthly" use were very likely to meet diagnostic criteria for a "mild" or "moderate" substance use disorder while those who reported use weekly or more were very likely to meet diagnostic criteria for a "severe" substance use disorder. (more…)
Author Interviews, Urology / 29.07.2014

MedicDavid C. Johnson, MD, MPH Department of Urology University of North Carolina School of MedicinealResearch.com Interview with: David C. Johnson, MD, MPH Department of Urology University of North Carolina School of Medicine   Medical Research: What are the main findings of the study? Dr. Johnson: The first main finding from this study is that the likelihood of benign pathology after surgical removal of a renal mass suspected to be malignant based on pre-operative is inversely proportionate to size. This concept is well-established, however we systematically reviewed the literature for surgical series that published rates of benign pathology stratified by size and combined these rates to determine a single pooled estimate of benign pathology of pre-operatively suspicious renal masses for each size strata. Using benign pathology rates from US studies only, we found that 40.4% of masses < 1 cm, 20.9% of masses 1-2 cm, 19.6% of masses 2-3 cm, 17.2% of masses 3-4 cm, 9.2% of masses 4-7 cm, and 6.4% of masses >7 cm are benign. The more novel finding from this study was the quantification of a previously unmeasured burden of over treatment in kidney cancer. By combining the above mentioned rates of benign pathology with epidemiological data, we estimated that the overall burden of benign renal masses surgically removed in the US to approach 6,000 per year in 2009. This represented an 82% increase over the course of a decade. Most importantly, we found an overwhelmingly disproportionate rise in the surgical treatment of renal masses in the smallest size categories – those which were most likely to be benign. We found a 233%, 189% and 128% increase in surgically removed benign renal lesions < 1 cm, 1-2 cm, and 2-3 cm, respectively from 2000 – 2009 in the US. (more…)
Author Interviews, BMJ, Circadian Rhythm, Diabetes, Occupational Health / 28.07.2014

Professor Zuxun Lu School of Public Health Tongii Medical College Huazhong University of Science and Technology Wuhun, Hubei, China.MedicalResearch.com Interview with: Professor  Zuxun Lu School of Public Health Tongii Medical College Huazhong University of Science and Technology Wuhun, Hubei, China. Medical Research: What are the main findings of the study? Prof. Lu: The main finding of this systematic review and meta-analysis was that shift work is associated with an increased risk of diabetes mellitus (DM). The association between shift work and DM appeared to be independent of physical activity, family of history of DM and body mass index. We found that the increased risk of diabetes mellitus was more pronounced in rotating shift group and male shift workers than in other shift group and female shift workers, respectively. (more…)
Author Interviews, Kidney Disease, Lancet, Transplantation / 28.07.2014

MedicalResearch.com Interview with Dr. Richard Haynes Clinical Trial Service Unit and Epidemiological Studies Unit Roosevelt Drive, Headington Oxford OX3 Medical Research: What are the main findings of the study? Dr. Haynes: The main result from this analysis is that alemtuzumab-based induction therapy (ie, alemtuzumab followed by low-dose mycophenolate and tacrolimus with steroid avoidance) reduced biopsy-proven acute rejection by about half during the first 6 months after transplantation among a wide variety of different types of participant, compared to standard basiliximab-based induction therapy (basiliximab followed by standard dose mycophenolate, tacrolimus and steroids). This reduction was achieved despite the lower doses of tacrolimus used and there was no excess of infection observed. (more…)
Addiction, Author Interviews, Emergency Care / 28.07.2014

Wendy Macias Konstantopoulos, MD, MPH Department of Emergency Medicine Division of Global Health & Human Rights Massachusetts General Hospital Harvard Medical SchoolMedicalResearch.com Interview with: Wendy Macias Konstantopoulos, MD, MPH Department of Emergency Medicine Division of Global Health & Human Rights Massachusetts General Hospital Harvard Medical School Medical Research: What are the main findings of the study? Dr. Macias-Konstantopoulos: Nearly two-thirds (64%) of 3240 emergency department (ED) patients who endorsed using drugs in the last 30 days, met criteria for problematic drug use (DAST-10 score ≥3). Of patients who identified their primary drug of use as being a substance other than cannabis, approximately 91% met criteria for problematic drug use, including nearly 94% of those using illicit drugs and 76% of those using pharmaceuticals. Compared to those who used cannabis primarily, primary non-cannabis users had an almost 15 times higher odds of meeting criteria for problematic drug use. Finally, we know from previous studies that drug-using individuals are more likely to access medical care through the ED and more likely to require hospitalization than their non-drug using counterparts. Our study found that drug-using ED patients who met criteria for problematic drug use tended to have ED triage levels associated with higher levels of severity or resource utilization when compared to drug-using ED patients who did not meet criteria for a drug problem. (more…)