AHA Journals, Author Interviews, Blood Pressure - Hypertension / 14.09.2014

MedicalResearch.com Interview with: Sourabh Aggarwal, MD University College of Medical Sciences Western Michigan University School of Medicine in Kalamazoo. Medical Research: What are the main findings of the study? Dr. Aggarwal: The main findings were that from 2006 to 2011:
  • ER visits for essential hypertension increased by 25 percent, while the admission percentage for these patients fell by 15 percent.
  • ER visits for hypertension with complication and secondary hypertension increased by 19 percent, while the admission percentage for these patients fell by 12 percent
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Author Interviews, Multiple Sclerosis, Sleep Disorders, UC Davis / 14.09.2014

Steven D. Brass, M.D., M.P.H., M.B.A. PI and Lead Author on the study Director of Neurology Sleep Clinical Program Co-Medical Director of Sleep Medicine Laboratory Associate Clinical Professor in the Department of Neurology UC Davis Health System 4860 Y Street — Suite 3700 Sacramento, CA 95817 MedicalResearch.com Interview with: Steven D. Brass, M.D., M.P.H., M.B.A. PI and Lead Author on the study Director of Neurology Sleep Clinical Program Co-Medical Director of Sleep Medicine Laboratory Associate Clinical Professor in the Department of Neurology UC Davis Health System 4860 Y Street — Suite 3700 Sacramento, CA 95817 Medical Research: What was the primary finding of your study? Dr. Brass : Among the 11,400 surveys mailed out to all members of the Northern California Chapter of the National Multiple Sclerosis Society, 2,810 (24.6%) were returned. Of these, 2,375 (84.5%) met the inclusion criteria. Among the completed surveys, 898 (37.8%) screened positive for obstructive sleep apnea, 746 (31.6%) for moderate to severe insomnia, and 866 (36.8%) for restless legs syndrome.  In contrast, only 4%, 11%, and 12% of the cohort reported being diagnosed by a health care provider with obstructive sleep apnea, insomnia, and restless legs syndrome, respectively. Excessive daytime sleepiness was noted in 30% of respondents based on the Epworth Sleepiness Scale. More than 60% of the respondents reported an abnormal level of fatigue based on the Fatigue Severity Scale.  There was also an increased risk between complaints of Fatigue based on screening positive for the Fatigue Severity Scale  and screening positive for Obstructive Sleep Apnea  (1.850, with a 95% p-value < 0.001). (more…)
Heart Disease, JACC / 13.09.2014

Thomas M. Maddox, MD MSc FACC FAHA Cardiology, VA Eastern Colorado Health Care System Associate Director, VA CART Program Associate Professor, Department of Medicine, University of Colorado School of MedicineMedicalResearch.com Interview with: Thomas M. Maddox, MD MSc FACC FAHA Cardiology, VA Eastern Colorado Health Care System Associate Director, VA CART Program Associate Professor, Department of Medicine, University of Colorado School of Medicine Medical Research: What are the main findings of the study? Dr. Maddox: We were curious to know if the VA, as a provider of PCI at centers without on-site CT surgery, was providing better access to its veterans without compromising their safety.  We were pleased to find that there was evidence of better access, with patients reducing their drive time to PCI facilities by, on average, 90 minutes.  In addition, there was no compromised safety.  Rates of both peri-procedural and 1-year adverse outcomes were low and no different between centers with and without on-site CT surgery. (more…)
Diabetes, Heart Disease / 13.09.2014

Carlos F. Sánchez-Ferrer, M.D., Ph.D. Professor of Pharmacology Universidad Autónoma de Madrid, Spain.MedicalResearch.com Interview with: Carlos F. Sánchez-Ferrer, M.D., Ph.D. Professor of Pharmacology Universidad Autónoma de Madrid, Spain. Medical Research: What are the main findings of the study? Dr. Sánchez-Ferrer: We were studying the possible ways of interaction between high glucose levels, which are found in diabetes mellitus, with vascular damage, which is the most common and devastating consequence of this disease. An intriguing fact is that a very strict control of blood sugar in diabetic patients is not sufficient to avoid the development of such diabetes-induced cardiovascular diseases. We think our results can explain why this is happening. Using cultured smooth muscle cells from the main human artery (aorta) in the presence of high concentrations of extracellular glucose, we observed: 1. In the absence of inflammation, excess glucose in the culture fluid didn’t enter the cells. 2. When extra glucose was forced into the cells, no harm was done in the absence of inflammation. 3. When the inflammation-stimulating protein interleukin-1 (IL-1) was introduced, more glucose entered the cells. 4. With IL-1, the glucose entering the cells was metabolized via chemical pathways that spur escalating inflammation, overwhelming the cells’ ability to counteract it. 5. In the presence of the anti-inflammatory drug anakinra, which blocks the activity of IL-1, the deleterious changes didn’t occur. (more…)
Author Interviews, Gastrointestinal Disease, General Medicine, Surgical Research / 13.09.2014

Dr. Dee Fenner, M.D. Professor of Obstetrics and Gynecology Director of Gynecology University of MichiganMedicalResearch.com Interview with: Dr. Dee Fenner, M.D. Professor of Obstetrics and Gynecology Director of Gynecology University of Michigan MedicalResearch.com Editor’s note: American Medical Systems Inc. (AMS), a subsidiary of Endo International plc (Nasdaq: ENDP) (TSX: ENL), released top-line results from its TRANSFORM study that show the investigational TOPAS™ System improves fecal incontinence in women. The results show that over a 12 month period, 69% of women suffering from fecal incontinence who were implanted with the TOPAS™ System experienced at least a 50% reduction in weekly incontinence episodes and experienced a durable, consistent effect across the study period. The results were presented in Cape Town, South Africa at the International Society of University Colon & Rectal Surgeon (ISUCRS) Congress. Dr. Fenner, a primary investigator of the study, kindly answered the questions below: Medical Research: How common/prevalent is the problem of fecal incontinence in women? Dr. Fenner: Fecal incontinence, also known as accidental bowel leakage (ABL), is estimated to affect nearly 11 million women and 10% of women over the age of 20 in the United States.1,2 Additionally, nearly one in five women over the age of 45 experience ABL at least once a year.3 (more…)
Author Interviews, Diabetes, Diabetes Care, Heart Disease / 12.09.2014

Kristian Filion, PhD FAHA Assistant Professor of Medicine Division of Clinical Epidemiology Jewish General Hospital/McGill University Montreal, Quebec H3T 1E2 CanadaMedicalResearch.com Interview with: Kristian Filion, PhD FAHA Assistant Professor of Medicine Division of Clinical Epidemiology Jewish General Hospital/McGill University Montreal, Quebec H3T 1E2 Canada Medical Research: What are the main findings of the study? Dr. Filion: Previous studies have raised concerns that the use of incretin-based drugs, a type of medication used to treat diabetes, may increase the risk of congestive heart failure.  We therefore examined this potential drug safety issue using a large, population-based database, which allowed us to study the safety of these medications in a real world setting.  In doing so, we found that the use of incretin-based drugs was not associated with an increased risk of congestive heart failure among patients with type 2 diabetes.  Similar results were obtained among both classes of incretin-based drugs (glucagon like peptide-1 [GLP-1] analogs and dipeptidyl peptidase-4 [DPP-4] inhibitors), and no duration-response relationship was observed. (more…)
Author Interviews, Diabetes, Diabetologia / 12.09.2014

MedicalResearch.com Interview with: Association Between Arterial Catheter Use and Hospital Mortality in Intensive Care UnitsDr. Sophia Zoungas: Faculty of Medicine, Nursing & Health Sciences Monash University, Clayton   Medical Research: What are the main findings of the study Dr. Zoungas: Our study shows that age (or age at diagnosis) and duration of diabetes disease are linked to the risk of death and marcovascular complications (those in larger blood vessels) whereas only diabetes duration is linked to the risk of microvascular complications (in smaller blood vessels such as those in the kidney and eyes) (more…)
Author Interviews, Diabetes, Obstructive Sleep Apnea / 12.09.2014

Paul M. Macey, Ph.D. Assistant Professor in Residence Associate Dean for Information Technology and Innovations, Chief Innovation Officer UCLA School of Nursing and Brain Research InstituteMedicalResearch.com Interview with: Paul M. Macey, Ph.D. Assistant Professor in Residence Associate Dean for Information Technology and Innovations, Chief Innovation Officer UCLA School of Nursing and Brain Research Institute Medical Research: What are the main findings of the study? Dr. Macey: People with sleep apnea are less able to control the blood flowing to their brain, in particular when they grip tightly, or have their foot put in cold water. We measured changes in blood flowing through the brain using an MRI scanner while people gripped hard, had their foot placed in cold water, and breathed out hard into a tube with a very small hole in it. These activities all lead to more blood flowing to the brain in healthy people, which probably helps protect the cells from being starved of blood and oxygen. However, people with sleep apnea send less blood that the healthy participants during the gripped and cold foot activities. A further important finding is that women with sleep apnea are worse off than men. The female patients showed much weaker blood flow than the males, even accounting for normal differences between men and women. (more…)
Author Interviews, Ebola, Infections / 12.09.2014

Dr. Gerardo Chowell-Puente Ph.D. Associate Professor School of Human Evolution and Social Change College of Liberal Arts and Sciences Arizona State UniversityMedicalResearch.com: Interview with: Dr. Gerardo Chowell-Puente Ph.D. Associate Professor School of Human Evolution and Social Change College of Liberal Arts and Sciences Arizona State University Medical Research: What are the main findings of the study? Dr. Chowell-Puente: 1.We estimated the effective reproduction number of Ebola virus disease, i.e. average number of secondary cases produced by a single primary case at calendar time t (Rt), for the ongoing epidemic in West Africa from March to August 2014. Estimates of Rt for the Guinea, Sierra Leone and Liberia, countries that are experiencing sustained community transmission were consistently above 1.0 since June 2014. 2.Country-specific estimates of the reproduction number for Liberia and Sierra Leone lied between 1.0 and 2.0, reflecting continuous growth of cases in these countries 3. Effective reproduction number below 2 indicate that control could be attained by preventing over half of the secondary transmissions per primary case (e.g. by means of effective case isolation and contact tracing). (more…)
Author Interviews, Autism / 12.09.2014

Anilkumar Pillai, Ph.D. Associate Professor Department of Psychiatry Medical College of Georgia Georgia Regents University (Formerly Georgia Health Sciences University)MedicalResearch.com: Interview with: Anilkumar Pillai, Ph.D. Associate Professor, Department of Psychiatry Medical College of Georgia, Georgia Regents University (Formerly Georgia Health Sciences University) Medical Research: What are the main findings of the study? Dr. Pillai: GABA receptors are responsible for binding GABA, the main inhibitory neurotransmitter in the human brain. Recent studies have indicated a potential role for alterations in GABAA receptors in the pathophysiology of Autism Spectrum Disorder (ASD). However, the mechanism of regulation of GABAA receptor in Autism Spectrum Disorder is not known. Our study shows that GABAA levels are altered at the protein level, but not at the mRNA level in the middle frontal gyrus of Autism Spectrum Disorder subjects. Our study also finds that Synoviolin 1 (SYVN1) plays a critical role as an E3 ligase in GABAAα1 degradation. SYVN1 has been previously determined to function as a removal system of inappropriately folded or unfolded proteins from the ER to the cytosol of the cell for degradation. Our study ultimately provides a mechanism for GABAAα1 deficits in Autism Spectrum Disorder subjects and possible new treatment strategies to reverse deficits seen in ASD and other related disorders. (more…)
Author Interviews, Cancer Research, NEJM / 12.09.2014

MedicalResearch.com Interview with: Dr. Charles Mullighan, M.D., MBBS(Hons), MSc Department of Pathology St. Jude Children's Research Hospital Memphis, TN 38105 MedicalResearch: What are the most important take home points from this study for practicing clinicians and their patients? Dr. Mullighan: Acute lymphoblastic leukemia (ALL) remains a leading cause of cancer death in children, and the prognosis worsens with increasing age. Current therapies are inadequate for many patients. This study has defined the genetic basis of a recently described subtype of Acute lymphoblastic leukemia called Ph-like ALL. We show that the prevalence increases with rising age, and that in both children and young adults the disease is driven by a diverse range of genetic changes that activate kinase signaling, which fuels the growth of leukemia cells. Ph-like Acute lymphoblastic leukemia currently has a poor outcome. The activated kinases may be inhibited by currently approved tyrosine kinase inhibitors (TKIs). We have shown efficacy of these inhibitors in cell lines and experimental models, and in a series of patients with Ph-like Acute lymphoblastic leukemia treated with TKIs. (more…)
Author Interviews, Cancer Research, Dartmouth, Melanoma, Nature / 12.09.2014

Dr. Constance Brinckerhoff Professor of Medicine Professor of Biochemistry Geisel School of Medicine at DartmouthMedicalResearch.com Interview with: Dr. Constance Brinckerhoff Professor of Medicine Professor of Biochemistry Geisel School of Medicine at Dartmouth Medical Research: What are the main findings of the study? Dr. Brinckerhoff: The genetic mutation BRAFV600E , frequently found in metastatic melanoma, not only secretes a protein that promotes the growth of melanoma tumor cells, but can also modify the network of normal cells around the tumor to support the disease’s progression. Targeting this mutation with Vemurafenib reduces this interaction, and suggests possible new treatment options for melanoma therapy. (more…)
Author Interviews, Cancer Research, Genetic Research, University of Pennsylvania / 12.09.2014

Renata Afi Rawlings-Goss, Ph.D. Postdoctoral Fellow Tishkoff Lab, University of PennsylvaniaMedicalResearch.com Interview with: Renata Afi Rawlings-Goss, Ph.D. Postdoctoral Fellow Tishkoff Lab, University of Pennsylvania   Medical Research: What are the main findings of the study? Dr. Rawlings-Goss: We found genetic mutations in key gene regulators that have been linked to ethnic disparities in cancer. Our investigation identified more than 30 previously undescribed mutations in important regulatory molecules called microRNAs. Individual microRNA molecules can regulate large numbers of genes in some cases over 6000 genes at once. Therefore, mutations in these genes have been linked to numerous diseases. By and large, however, microRNA mutations have not been studied in people of diverse ethnic backgrounds. (more…)
Author Interviews, CMAJ / 12.09.2014

Annemarieke de Jonghe Academic Medical Center University of Amsterdam Departement of Internal Medicine Section of Geriatric Medicine F4-218 Amsterdam, The NetherlandsMedicalResearch.com Interview with: Annemarieke de Jonghe Academic Medical Center University of Amsterdam Departement of Internal Medicine Section of Geriatric Medicine F4-218 Amsterdam, The Netherlands Medical Research: What are the main findings of the study? Dr. de Jonghe: We investigated the preventive properties of melatonin versus placebo in a prospective cohort of elderly hip fracture patients (n=378). We found that 3mg melatonin vs placebo, given for 5 days from the day of admission, did not influence the incidence of delirium. However, in a posthoc analysis we found that more patients in the placebo group more often had a longer lasting delirium. (more…)
Author Interviews, CHEST, Infections, Rheumatology / 12.09.2014

MedicalResearch.com Interview with: Theodore Marras, MD, FRCPC, M.Sc. Assistant Professor, University of Toronto Respirologist, Toronto Western Hospital University Health Network Toronto, ON, Canada Medical Research: What are the main findings of the study? Dr. Marras: Mycobacterial infections (TB and nontuberculous mycobacteria (NTM)) are more common in patients with rheumatoid arthritis (RA). Nontuberculous mycobacteria disease was far more common than TB disease in RA patients in Ontario, Canada. Nontuberculous mycobacteria disease was also associated with increased age, COPD, asthma, and GERD. The presence of nontuberculous mycobacteria disease was associated with increased mortality. (more…)
Author Interviews, JAMA, Ophthalmology, Telemedicine / 11.09.2014

Mary G. Lynch, MD Professor of Ophthalmology Atlanta Veterans Affairs Medical Center Decatur, Georgia. Department of Ophthalmology, Emory University School of Medicine, Atlanta, GeorgiaMedicalResearch.com Interview with: Mary G. Lynch, MD Professor of Ophthalmology Atlanta Veterans Affairs Medical Center Decatur, Georgia. Department of Ophthalmology, Emory University School of Medicine,  Atlanta, Georgia Medical Research: What are the main findings of the study? Dr. Lynch:
  • Since 2006, the VA has been systematically using teleretinal screening of patients with diabetes to screen for retinopathy in the Primary Care Clinics. Under this program, 90% of veterans with diabetes are evaluated on a regular basis. A number of patients who are screened have findings that warrant a face-to-face ophthalmic exam. No information exists on the effect of such a program on medical center resources.
  • 1,935 patients  underwent teleretinal screening through the Atlanta VA over a 6 month period.  We reviewed the charts of the 465 (24%) of the patients who were referred for a face to face exam in the Eye Clinic.
  • Data was collected for these patients to determine the reasons for referral, the accuracy of the teleretinal interpretation, the resources needed in the Eye Clinic of the Medical Center to evaluate and care for the referred patients over a two year period and possible barriers to patient care.
  • Of the 465 patients referred for an exam, 260 (55.9%) actually came in for an exam. Community notes were available for an additional 66 patients. Information was available for 326 (70.1%) of the referred patients.
  • The most common referring diagnoses were nonmacular diabetic retinopathy (43.2% of referrals), nerve related issues (30.8%), lens or media opacity (19.1%), age-related macular degeneration (12.9%) and diabetic macular edema (5.6%).
  • 16.9% of the referred patients had 2 or more concurrent problems that put them at high risk for visual loss.
  • The percentage agreement between teleretinal screening and the ophthalmic exam was high: 90.4%. Overall sensitivity was 73.6%. The detection of diabetic macular edema had the lowest sensitivity.
  • A visually significant condition was detected for the first time through teleretinal screening for 142 of the patients examined (43.6%).
  • The resource burden to care for referred patients was substantial.
  • 36% of patients required 3 or more visits over the ensuing 2 year period.
  • The treatment of diabetic macular edema had the highest resource use involving on average 5 clinic visits, 6 diagnostic procedures and 2 surgical procedures
  • The most common non-refractive diagnostic procedures were visual fields and optical coherence tomography.
  • The average cost to care for the referred patients (in Medicare dollars) in work RVUs alone was approximately $1,000 per patient. The cost to care for a patient with diabetic macular edema was $2673.36.
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Author Interviews, Mental Health Research / 11.09.2014

MedicalResearch.com Interview with: Patrick Corrigan Psy.D. Distinguished Professor of Psychology Illinois Institute of Technology PI: National Consortium on Stigma and Empowerment www.NCSE1.orgPatrick Corrigan Psy.D. Distinguished Professor of Psychology Illinois Institute of Technology PI: National Consortium on Stigma and Empowerment www.NCSE1.org Medical Research:  What are the main findings of this review? Dr. Corrigan: People with serious mental illness often do not seek out services, or drop out early, when in need. Stigma is a major reason for why this happens. Stigma refers to the stereotypes about a group that undermine status and lead to discrimination. Discrimination refers to the behaviors that block the opportunities of group members. Some employers do not hire people with mental illness, some landlords do not rent to them, and some primary care practitioners offer a substandard of care. Stereotypes and discrimination undermine engagement in mental health services in three ways (Corrigan, 2005): Label Avoidance: In order to escape the pernicious effects of stigma, people avoid settings where they are labeled mentally ill; for example, people coming out of a psychiatrist’s office may be perceived as “nuts.” Self-Stigma: Some people who internalize stereotypes suffer diminished self-esteem and self-efficacy leading to the “why try” effect. “Why should I try to get a job? Someone like me is not worthy.” “Why should I try to get mental health treatment? I am not able to benefit from it.” Structural Stigma: Stereotypes and discrimination become institutionalized in the laws and practices of government and business. For example, insurance coverage for mental health services was significantly below that for most other conditions.   (more…)
AHRQ, Author Interviews, BMJ, Outcomes & Safety / 11.09.2014

Yves A. Lussier, MD, Fellow ACMI Professor of Medicine Associate Vice President for Health Sciences (Chief Knowledge Officer) The University of ArizonaMedicalResearch.com Interview with: Yves A. Lussier, MD, Fellow ACMI Professor of Medicine Associate Vice President for Health Sciences (Chief Knowledge Officer) The University of Arizona Medical Research: What are the main findings of the study? Dr. Lussier:  The main finding is that reporting patient safety using ICD-10-CM coding schema rather than ICD-9-CM will change the reported percentage of adverse events reported for half the specific "patient safety indicators" (PSIs), even with a true unaltered frequency of reported events in the medical center. For some patient safety indicators, the reported frequency will appear to increase substantially and for others, it will appear to decrease.  The latter is particularly  worrisome as it may erroneously appease administrators and prospective clients (patients) as their apparent trend is improving, while their institution may inadvertently be under-reporting adverse events. (more…)
Author Interviews, Diabetes, Diabetes Care / 11.09.2014

Dr. Heather Stuckey D.Ed Department of Medicine Pennsylvania State University College of Medicine, Hershey, PAMedicalResearch.com: Interview with: Dr. Heather Stuckey D.Ed Department of Medicine Pennsylvania State University College of Medicine, Hershey, PA MedicalResearch: What are the main findings of this study? Dr. Stuckey: The main findings were that people with diabetes had both negative psychosocial and positive (adaptive) ways of coping with diabetes. Negative themes included:  1) Anxiety/fear, worry about hypoglycemia and complications of diabetes, depression and negative moods/hopelessness and 2) Discrimination at work and public misunderstanding about diabetes. Two psychosocial themes demonstrated adaptive ways of coping with diabetes: 1) Having a positive outlook and sense of resilience in the midst of having diabetes and 2) Receiving psychosocial support through caring and compassionate family, friends, healthcare professionals and other people with diabetes. Most diabetes social sciences research focuses on only the negative aspects of having diabetes.  Although this paper discussed negative aspects, it also focused on the adaptive, or positive, ways in which people with diabetes viewed their disease.  "We found that although these negative experiences with diabetes exist, people also held on to the positive aspects.  Some said diabetes made their lives a little richer because they ate healthier foods, or they were able to connect with their family more to overcome challenges. It gave them a better appreciation of what they have.  The discrimination at work and from society was a finding that was unexpected, but was evident throughout both the quantitative and qualitative data. (more…)
Author Interviews, Fish, General Medicine, Hearing Loss / 11.09.2014

Sharon G. Curhan, MD, ScM Channing Division of Network Medicine Department of Internal Medicine Brigham and Women's Hospital Harvard Medical School Boston, MA 02115MedicalResearch.com Interview with: Sharon G. Curhan, MD, ScM Channing Division of Network Medicine Department of Internal Medicine Brigham and Women's Hospital Harvard Medical School Boston, MA 02115 Medical Research: What are the main findings of the study? Dr. Curhan: We followed more than 65,000 women who were participants in the Nurses’ Health Study II over 18 years and found that eating 2 or more servings of fish per week was associated with a lower risk of hearing loss. For example, after adjusting for potential confounders in multivariable analyses, in comparison with women who rarely or never ate fish, women who consumed 2 or more servings of fish per week had a 20% lower risk of hearing loss. Eating any type of fish (tuna, dark fish, light fish or shellfish) tended to be associated with lower risk. Also, we found that higher intake of long-chain omega-3 polyunsaturated fatty acids (PUFAs) was inversely associated with risk. For example, in comparison with women with the lowest intake, women with the highest intake of long-chain omega-3 PUFAs had a 22% lower risk of hearing loss. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, PLoS / 11.09.2014

MedicalResearch.com Interview with: Eero Haapala, MSc in Exercise Medicine, BASc PhD student University of Eastern Finland,School of Medicine Institute of Biomedicine, Physiology Kuopio, Finland Medical Research: What are the main findings of the study? Answer: Our study is one of the first studies to investigate the different types of physical activity and sedentary behavior with academic achievement in children. Our main finding was that children who were more physically active during school recess were better readers in Grades 1-3 than less active children. We also found a direct relationship between physically active school transportation, which was mainly walking and cycling, and reading skills in boys. These findings suggest that particularly physical activity within a school day benefits academic achievement and that physical activity benefit academic achievement more in boys than in girls 6-8 years of age. (more…)
Aging, Author Interviews, Frailty / 11.09.2014

Professor Mark L. Wahlqvist, M.D., Ph.D. Institute of Population Health Sciences, National Health Research Institutes, Taiwan National Defense Medical Center, School of Public Health, Taiwan Monash Asia Institute, Monash University Melbourne, AustraliaMedicalResearch.com Interview with: Professor Mark L. Wahlqvist, M.D., Ph.D. Institute of Population Health Sciences, National Health Research Institutes, Taiwan National Defense Medical Center, School of Public Health, Taiwan Monash Asia Institute, Monash University Melbourne, Australia Medical Research: What are the main findings of the study? Prof. Wahlqvist: Poor appetite and dietary quality as judged by diversity separately (each by about 50%) and together (by about 80%) increase the mortality risk in older persons living in the community. (more…)
Author Interviews, Dermatology, JAMA, NIH, Transplantation / 11.09.2014

MedicalResearch.com Interview with: Rena Zuo, BA MD Candidate at Duke University School of Medicine and Edward W. Cowen, MD, MHSc Senior Clinician Head, Dermatology Consultation Service Dermatology Branch Center for Cancer Research National Cancer Institute National Institutes of Health MedicalResearch: What are the main findings of the study?
 Answer: Chronic graft-vs-host disease (cGVHD) is a debilitating multisystem disease that occurs in patients receiving allogeneic hematopoietic stem cell transplantations as treatment for hematologic disorders. Although the diverse clinical presentations of cGVHD frequently mimic other autoimmune diseases such as Sjögren syndrome and systemic sclerosis, and low-titer antibodies are commonly found in patients with cGVHD, the exact pathogenesis and role of autoimmunity in cGVHD are incompletely understood. Our study is the first to characterize and identify risk factors associated with the development of two uncommon autoimmune phenomena, specifically alopecia areata and vitiligo, in the setting of cGVHD. Laboratory markers, including 11 antibodies, transplant-related factors, and other cGVHD systemic manifestations were analyzed. Several particularly interesting results were found:
  1. Among 282 patients with cGVHD, 15 demonstrated vitiligo (14 of 282; 4.9%) and/or alopecia areata (2 of 282; 0.7%).
  2. Female donor and female donor to male recipient sex mismatch, in particular, are significantly associated with the development of vitiligo and/or alopecia areata.
  3. Positive anti-cardiolipin (ACA) IgG was also significantly associated with development of vitiligo and/or alopecia areata.
(more…)
Author Interviews, Diabetes, Diabetes Care, OBGYNE / 11.09.2014

MedicalResearch.com Interview With: Ruth C. E. Hughes Department of Obstetrics and Gynecology University of Otago, Christchurch Women’s Hospital Christchurch, New Zealand Medical Research: What are the main findings of the study? Dr. Hughes: The increasing prevalence of undiagnosed type 2 diabetes in women of childbearing age was the main driver behind our study.  In clinical practice, we were finding that women with probable undiagnosed diabetes (and pre-diabetes) had already started developing pregnancy complications at the time they were diagnosed with gestational diabetes diagnosis in the late second trimester. It seemed logical to try to identify them in early pregnancy, with the idea that they might benefit from earlier intervention.  We thus explored the usefulness of first trimester HbA1c measurements to identify women with unrecognised pre-existing diabetes. In our study, an HbA1c of 5.9% (41mmol/mol) was the optimal screening threshold for diabetes in early pregnancy.  We found that a threshold of 6.5% (48mmol/mol), which is endorsed by the World Health Organization and American Diabetes Association for diagnosing diabetes in pregnancy, would miss almost 50% of women with probable pre-existing diabetes.  Of great relevance, women with an early HbA1c of 5.9%-6.4% (41-46mmol/mol) had poorer pregnancy outcomes than those with an HbA1c <5.9% (<41mmol/mol), with a 2.5-3 fold higher relative risk of major congenital anomaly, preeclampsia, shoulder dystocia, and perinatal death.  These women were also more likely to deliver before 37 weeks gestation. (more…)
Author Interviews, Dermatology, Gastrointestinal Disease, JAMA, Mayo Clinic / 11.09.2014

Shadi Rashtak, MD Department of Dermatology Mayo Clinic College of Medicine Rochester, MinnesotaMedicalResearch.com Interview with: Shadi Rashtak, MD Department of Dermatology Mayo Clinic College of Medicine Rochester, Minnesota Medical Research:  What are the main findings of the study? Dr. Rashtak: We found that among a population of mainly acne patients those who received isotretinoin had a lower risk of inflammatory bowel disease as compared to those who did not take this medication. We carefully reviewed the medical records of patients to ensure that this finding was not simply because the drug was avoided in patients with a previous personal or family history of IBD. (more…)
AHA Journals, Author Interviews, Heart Disease, Obstructive Sleep Apnea / 11.09.2014

MedicalResearch.com Interview with: Marcia Klein M.D., Ph.D. Adjunctive professor Rio de Janeiro State University This study was conducted at the Discipline of Clinical and Experimental Pathophysiology - Rio de Janeiro State University and the financial support of FAPERJ. Medical Research: What was the main findings of the study? Dr. Klein: The main findings were that a diet with moderate calories restriction in obese patients with obstructive sleep apnea may be able not only to reduce body fat but also to reduce obstructive sleep apnea severity and blood pressure. (more…)
Author Interviews, Heart Disease, Lancet, Statins / 11.09.2014

Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Herlev Hospital, Copenhagen University Hospital Dept. Clinical Biochemistry Herlev Ringvej 75, DK-2730 Herlev, DenmarkMedicalResearch.com Interview with: Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Herlev Hospital, Copenhagen University Hospital Dept. Clinical Biochemistry Herlev Ringvej Herlev, Denmark Medical Research: What are the main findings of the study? Dr. Nordestgaard: Among all patients with diabetes in Denmark during 1996-2009 and compared with non-statin users, statin users had a 40% lower risk of diabetic retinopathy, a 34% lower risk of diabetic neuropathy, and a 12% lower risk of gangrene of the foot, while the risk of diabetic nephropathy was similar. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA / 10.09.2014

Hayley Gershengorn MD Assistant Professor, Department of Medicine (Critical Care) Assistant Professor, The Saul R. Korey Department of Neurology Albert Einstein College of Medicine Bronx, NY 10461MedicalResearch.com Interview with: Hayley Gershengorn MD Assistant Professor, Department of Medicine (Critical Care) Assistant Professor, The Saul R. Korey Department of Neurology Albert Einstein College of Medicine Bronx, NY 10461 Medical Research:  What are the main findings of the study? Dr. Gershengorn: Using a large national database, we found there to be no association between the use of arterial catheters and mortality in mechanically ventilated medical intensive care unit patients. Similarly, we found no beneficial association between arterial catheters and mortality in any of the eight other critically ill subgroups evaluated. (more…)
Flu - Influenza, Infections / 10.09.2014

Allison Weinmann MBBS, FRACP Senior Staff, Division Infectious Diseases Director HFHS Immunization Team Medical Director Infection Control and Prevention, West Bloomfield Hospital Henry Ford Health System Clinical Assistant Professor, Wayne State University Detroit, Mi 48202MedicalResearch.com Interview with: Allison Weinmann  MBBS, FRACP Senior Staff, Division Infectious Diseases Director HFHS Immunization Team Medical Director Infection Control and Prevention, West Bloomfield Hospital Henry Ford Health System Clinical Assistant Professor, Wayne State University Detroit, Mi 48202 Medical Research: What are the main findings of this study? Dr. Weinmann: The main findings included:
  • Mandatory influenza immunization for health care workers without allowing optional opt-out (and only allowing for documented medical or religious exemption) successfully raised our immunization uptake among all our employees to over 99% sustainable for the last 2 years which we consider a very important patient safety initiative.
  • Less than 2% of workers met a medical or religious exemption.
  • A prior optional opt out with mask wearing was problematic for staff and patients and did not reach our goal of close to 100% immunization uptake.
(more…)