Accidents & Violence, Author Interviews, Exercise - Fitness / 01.05.2014

Lara McKenzie, Ph.D. MA Associate Professor of Pediatrics Center for Injury Research and Policy The Research Institute at Nationwide Children's Hospital Columbus, OhioMedicalResearch.com Interview with: Lara McKenzie, Ph.D. MA Associate Professor of Pediatrics Center for Injury Research and Policy The Research Institute at Nationwide Children's Hospital Columbus, Ohio MedicalResearch.com: What are the main findings of the study? Dr. McKenzie: Our study was the first to compare and describe epidemiological patterns of basketball-related injuries presenting for treatment to emergency departments and to the high school athletic training setting using surveillance data captured from large, nationally representative samples. Specifically, we compared estimated national incidence, rates of injury and body sites injured, and diagnoses. Nationally, an estimated 1,514,957 athletes with basketball-related injuries reported to the emergency department and 1,064,551 presented to the athletic training setting. Patterns of basketball-related injuries presenting to the emergency department differ from those presenting to the high school athletic training setting for treatment, with those presenting to the emergency department being more severe. In general, injuries that could be relatively quickly assessed and more easily diagnosed and treated, such as strains and/or sprains, presented more commonly to the athletic training setting, while injuries that required more extensive diagnostic or treatment procedures, such as fractures, were treated more commonly in the emergency department. (more…)
Author Interviews, Infections, Stroke / 01.05.2014

Professor Stuart Allan Faculty of Life Sciences, AV Hill Building The University of Manchester Manchester, M13 9PTMedicalResearch.com Interview with: Professor Stuart Allan Faculty of Life Sciences, AV Hill Building The University of Manchester Manchester, M13 9PT MedicalResearch.com: What are the main findings of the study? Dr. Allan: Using an experimental model of stroke it was found that animals with preceding Streptococcus pneumoniae infection had a worse outcome than uninfected animals. This confirms and extends previous data, both clinical and preclinical, that systemic inflammation is a key contributor to stroke outcome. Importantly, effects of infection were also demonstrated in animals with co-morbidities associated with stroke (atherosclerosis and age), with outcomes worse than observed in healthy young subjects. Exacerbating effects of infection on stroke are mediated via the pro-inflammatory cytokine, interleukin-1 (IL-1), shown by reversal of the increased ischaemic brain damage and functional impairments by treatment with the IL-1 receptor antagonist (IL-1Ra). Infection also leads to increased platelet activation and microvascular coagulation after stroke, which contributes to the increased injury. Collectively, these data are the first to show, how systemic inflammatory mechanisms induced by one of the most common non-invasive, human S.pneumoniae isolates, lead to critical illness after stroke in different rodent species and strains, and how common stroke comorbidities interact with infection to worsen outcome after stroke. (more…)
Author Interviews, Diabetes, Lancet / 30.04.2014

Prof. Paul E O'Brien Centre for Obesity Research and Education Monash University Melbourne, AustraliaMedicalResearch.com Interview with: Prof. Paul E O'Brien Centre for Obesity Research and Education Monash University Melbourne, Australia   MedicalResearch.com: What are the main findings of the study? Prof. O'Brien: Using a randomised trial format we compared the diabetes status at two years after a program of multidisciplinary diabetes care (MDC) alone or with the addition of a Lap-Band procedure in 50 people who were overweight (BMI 25-30) and with diabetes. 52% of the Lap-Band group had remission of their diabetes as measured by glucose tolerance testing compared to 8% in the multidisciplinary diabetes care group. The Lap-Band procedures were performed as outpatients with a 2-3 hr length of stay. There were no perioperative adverse events. The surgical group had lost a mean of 11.5kg in weight. The incremental cost effectiveness ratio (ICER) for remission of diabetes was AUD $20,700. (more…)
General Medicine / 30.04.2014

MedicalResearch.com: Egle Avizienyte, PhD Senior Research Fellow, Institute of Cancer Sciences Faculty of Medical and Human Sciences The University of Manchester, Manchester M20 4BX MedicalResearch.com: What are the main findings of the study? Dr. Avizienyte: Angiogenesis, the formation of new blood vessels, has been validated as a target in ovarian cancer. However, the benefit from anti-angiogenic therapies, e.g. Vascular Endothelial Growth Factor (VEGF) pathway inhibitors that are currently used in the clinic for the treatment of ovarian cancer has been modest, largely because of redundancy in angiogenic cytokines that regulate tumour angiogenesis. In this study we validated heparan sulphate 6-O-sulfotranferases 1 and 2 (HS6ST-1 and -2) as targets for developing new therapeutic anti-angiogenic agents for the treatment of ovarian cancer. The data generated in our laboratory show that HS6STs induce the angiogenic programme in ovarian cancer cells and has a major effect on tumour angiogenesis. (more…)
Author Interviews, Surgical Research, Weight Research / 30.04.2014

Mr. David Bowrey, MD FRCS (Gen Surg) MMedEd FHEA Consultant General / Oesophagogastric Surgeon & Honorary Senior Lecturer, Dept Cancer Studies, Training Programme Director for Core Surgery, East Midlands South University Hospitals of Leicester NHS Trust, Leicester Royal InfirmaryMedicalResearch.com Interview with: Mr. David Bowrey, MD FRCS (Gen Surg) MMedEd FHEA  Consultant General / Oesophagogastric Surgeon & Honorary Senior Lecturer, Dept Cancer Studies, Training Programme Director for Core Surgery, East Midlands South University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary MedicalResearch.com: What are the main findings of this study? Dr. Bowrey: Of 103 patients who had undergone Roux en Y gastric bypass surgery, changes in appetite, taste and smell were noted in 97%, 73% and 42% respectively. Seventy-three percent of patients developed aversions to certain types of foods, most frequently meat, starch and dairy produce. The change in taste sensation for the three common modalities of "sweet", "salt" and "sour" was decreased in some patients and increased in other patients. Patients who experienced food aversions typically experienced more weight loss than patients not developing aversions. (more…)
Author Interviews, Blood Pressure - Hypertension, BMJ, OBGYNE / 30.04.2014

MedicalResearch.com Interview with: Dr Kate Bramham Division of Women's Health King's College London Women's Health Academic Centre KHP London, SE1 7ER MedicalResearch.com: What are the main findings of the study? Dr. Bramham: This meta-analysis of nearly 800,000 pregnancies from 55 studies has shown that women with chronic hypertension have a significantly increased incidence of pregnancy complications including superimposed pre-eclampsia, preterm delivery, low birth weight infants, perinatal loss and neonatal unit admission. (more…)
Author Interviews, BMJ, Gastrointestinal Disease, Transplantation / 29.04.2014

Mr. Thamara Perera FRCS Consultant Surgeon - Multi Organ Retrieval and Liver Transplant Liver Transplant - University Hospitals Birmingham NHS Foundation Trust Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, Birmingham, UKMedicalResearch.com Interview with: Mr. Thamara Perera FRCS Consultant Surgeon - Multi Organ Retrieval and Liver Transplant Liver Transplant - University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, Birmingham, UK MedicalResearch.com: What are the main findings of the study? Answer: In this study we compared the basic energy metabolism of liver grafts obtained from conventional and widely practiced form of organ donation, the donation after brain death (DBD) donors, and recently revived form of organ donation called donation after circulatory death (DCD) donors. To introduce a background to this study - DCD liver grafts are perceived as marginal liver grafts, owing to the basic differences surrounding the organ donation. DCD organs suffer a period of warm ischemia from the time of treatment withdrawal in a potential donor up until the organs are actually recovered and preservation is initiated. Although the DCD liver grafts have supplemented the donor organ pool, the initial and short-term results following liver transplantation are comparatively poor and these differences are attributable to the donor warm ischemia. However there were no studies in the literature examining the energy status of DCD liver grafts and our study is the first such study. (more…)
Author Interviews, Breast Cancer, Genetic Research / 29.04.2014

Dr. Yvonne Bombard, PhD Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital Assistant Professor, Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of TorontoMedicalResearch.com Interview with: Dr. Yvonne Bombard, PhD Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital Assistant Professor, Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto MedicalResearch.com: What are the main findings of the study? Dr. Bombard: The main finding of the study is that gene expression profiling tests play a critical role when women with early-stage breast cancer decide whether to have chemotherapy, but many of them do not fully understand what some of the test results mean. For many the gene expression profiling test was the main factor in their treatment decision. The women we interviewed understood the test would indicate whether chemotherapy would be beneficial to them. But many thought the test reflected their unique circumstances and did not understand that their test result was based on larger population statistics. Patients often viewed their gene expression profiling results as providing information that was more scientifically valid, uniquely personalized and emotionally significant than any other information they had received. For many, the test was a transformational element that empowered them, allowed them to feel confident in their decisions and may even have rescued them from unnecessary chemotherapy. Patients described emotionally and socially complex reasons why they valued gene expression profiling testing in making their treatment decisions. Patients valued the test because it provided them with certainty amidst confusion, with options and a sense of empowerment, and with personalized, authoritative information. (more…)
Author Interviews, JAMA, Statins, Weight Research / 29.04.2014

Takehiro Sugiyama, MD, MSHS, PhD Project Director, Diabetes Policy Planning Office Management and Planning Bureau Fellow, Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Shinjuku-ku, Tokyo JapanMedicalResearch.com Interview with: Takehiro Sugiyama, MD, MSHS, PhD Project Director, Diabetes Policy Planning Office Management and Planning Bureau Fellow, Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Shinjuku-ku, Tokyo Japan MedicalResearch.com: What are the main findings of the study? Dr. Sugiyama: In the US nationally representative sample from the National Health and Nutrition Examination Survey 1999-2010, we found that statin users in 2009-2010 eat 9.6% more calories and 14.4% more fat than statin users in 1999-2000. These increases were not observed in statin non-users; the trends of caloric and fat intake were statistically different between statin users and non-users. In 1999-2000, caloric and fat intake was significantly less for statin users compared with non-users, but the difference between the groups because smaller as time went by and there was no statistical difference in 2009-2010. Body mass index increased more rapidly for statin users compared to non-users. (more…)
Author Interviews, Cognitive Issues, JAMA / 28.04.2014

Tara Lagu MD PhD Assistant Professor of Medicine Tufts University School of MedicineMedicalResearch.com Interview with: Tara Lagu MD PhD Assistant Professor of Medicine Tufts University School of Medicine   MedicalResearch.com: What are the main findings of the study? Dr. Lagu: We found that use of mechanical ventilation in patients 65 and older is increasing rapidly. If current rates of increase continue, we expect that by 2020 there will be more than 600,000 hospitalizations per year that involve mechanical ventilation. This is a doubling in 20 years (2001-2020), and represents demand that could easily exceed the capacity of the US critical care system. We also found that increase in use among patients with dementia is 4 times faster than those without dementia. This is important because dementia is a terminal illness, and use of mechanical ventilation in patients with end-stage dementia is associated with poor 30-day and 1-year outcomes. (more…)
Author Interviews, Cost of Health Care, Diabetes, JAMA / 28.04.2014

Juliana C. N. Chan, MBChB MD FHKAM FRCP Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong.MedicalResearch.com Interview with: Juliana C. N. Chan, MBChB MD FHKAM FRCP Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong. MedicalResearch.com: What are the main findings of the study? Dr. Chan: In this 1-year randomized study, we asked the question whether type 2 diabetic patients receiving team-based integrated care augmented by information technology would further improve in their glycemic control if given additional peer support through the telephone. All patients underwent comprehensive risk assessment guided by the web-based JADE portal which generated personalized risk report with attained treatment targets and decision support. After 1 year, all patients improved significantly in all risk factors including A1c with improved treatment adherence, self efficacy and psychological wellbeing. Although the peer support group did not further improve in A1c, short-stay hospitalization rates were substantially reduced by 50% , especially amongst those with emotional distress. These patients accounted for 20% of the intervention group, in whom peer support further reduced psychological distress and treatment non-adherence. (more…)
Author Interviews, CMAJ, OBGYNE / 28.04.2014

Professor Khalid Khan MMEd, MRCOG, MSc, FCPS, MBBS Women's Health Research Unit | Multi-disciplinary Evidence Synthesis Hub The Blizard Institute | 58 Turner Street | London | E1 2ABMedicalResearch.com Interview with: Professor Khalid Khan MMEd, MRCOG, MSc, FCPS, MBBS Women's Health Research Unit | Multi-disciplinary Evidence Synthesis Hub The Blizard Institute | 58 Turner Street | London | E1 2AB MedicalResearch.com: What are the main findings of the study? Prof. Khan: The risk of cesarean section was 12% lower among women undergoing induction of labor in comparison to the one that were managed expectantly. The subgroup comparison showed that the effect was significant in term and post-term however not in preterm gestations. Furthermore, induction of labor was associated with 50% and 14% reduction in risk of fetal death and admission to a neonatal intensive care unit, respectively. (more…)
Author Interviews, Endocrinology, JCEM / 28.04.2014

Dr. Dorte Glintborg PhD Senior Hospital Physician, PhD Dorte Glintborg, Department of Endocrinology, OUH Odense University HospitalMedicalResearch.com Interview with: Dr. Dorte Glintborg PhD Senior Hospital Physician, PhD Dorte Glintborg, Department of Endocrinology, OUH Odense University Hospital MedicalResearch.com: What are the main findings of this study? Dr. Glintborg: The main finding of the study is that one year’s metformin treatment is associated with a minor but significant weight loss in patients with PCOS irrespective of BMI at study inclusion. Treatment with oral contraceptives improves sex-hormone levels but is associated with at minor weight gain. Based on the study results, clinicians should consider the combined treatment with metformin and oral contraceptives in patients with PCOS. (more…)
Author Interviews, CMAJ, Cost of Health Care, Prostate Cancer / 26.04.2014

MedicalResearch.com Interview with: Alice Dragomir, MSc, PhD Assistant Professor, Urology/Surgery, McGill University Scientist, RI-MUHC MedicalResearch.com: What are the main findings of the study? Authors’ response: Our study demonstrates that for eligible patients, active surveillance could offer not only the known clinical advantages from the patient’s perspective, but also economic benefits from the health care system’s perspective. At the national level, the cost savings of an annual cohort of incident prostate cancers managed with active surveillance over a first year and 5 years of follow-up could be substantial. These are estimated at $96 million. (more…)
Author Interviews, JAMA / 26.04.2014

MedicalResearch.com Interview Invitation Karin J. H. Verweij, PhD Department of Developmental Psychology and EMGO Institute for Health and Care Research,  VU University Amsterdam, the Netherlands MedicalResearch.com: What are the main findings of the study? Dr. Verweij: We performed a twin study using over 10,000 adult Australian twins to determine the relative importance of genetic and environmental influences on individual differences in non-suicidal self-injury (NSSI) and suicidal ideation and their covariation. We found that individuals that report self-harm are approximately eight times more likely to also report suicidal ideation. Results from the bivariate genetic model indicated that the substantial correlation between non-suicidal self-injury and suicidal ideation (r=0.49 for males and 0.61 for females) is largely explained by overlapping genetic factors: 62% and 76% for males and females, respectively. Overlapping residual influences, including nonshared environmental influences and measurement error, also explain part of the covariance between the two traits. These findings suggest that the two behaviors share similar biological underpinnings. (more…)
Author Interviews, Brain Injury, CMAJ / 26.04.2014

Jane Topolovec-Vranic, PhD Clinical Researcher, Trauma and Neurosurgery Program Associate Scientist, Li Ka Shing Knowledge Institute Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto Associate Member, Graduate Department of Rehabilitation Sciences, University of Toronto MedicalResearch.com Interview with: Jane Topolovec-Vranic, PhD Clinical Researcher, Trauma and Neurosurgery Program Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto Associate Member, Graduate Department of Rehabilitation Sciences, University of Toronto MedicalResearch.com What are the main findings of the study? Answer: In our study we found that almost half of the men interviewed in a homeless shelter in Toronto had experienced a traumatic brain injury in their past, and that most of them had experienced their first brain injury prior to becoming homeless, usually in the early teenage years. (more…)
Author Interviews, Erasmus, Neurology, Stroke / 25.04.2014

M. Arfan Ikram, MD, PhD Assistant professor in Neuroepidemiology Erasmus Medical Center Rotterdam, the NetherlandsMedicalResearch.com Interview with: M. Arfan Ikram, MD, PhD Assistant professor in Neuroepidemiology Erasmus Medical Center Rotterdam, the Netherlands MedicalResearch.com: What are the main findings of this study? Dr. Ikram: We show that the risk of stroke might be increased due to an increased risk of ischemic stroke or increased risk of hemorrhagic stroke. Because these subtypes of stroke require different -often opposite- clinical management, currently available prediction rules for any stroke are insufficient. We propose a novel prediction rule that provides separate risks for ischemic stroke and hemorrhagic stroke. (more…)
Author Interviews, JAMA, Ophthalmology / 25.04.2014

Michael Wall, MD Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins D Iowa City, IA 52242-1091MedicalResearch.com Interview with: Michael Wall, MD Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins D Iowa City, IA 52242-1091 MedicalResearch.com: What are the main findings of the study? Dr. Wall: We studied patients with idiopathic intracranial hypertension (formerly called pseudotumor cerebri) with mild visual loss. We found that subjects taking acetazolamide, a type of diuretic, along with a low sodium weight loss program had significantly better visual outcomes than those taking placebo along with the diet. (more…)
Alzheimer's - Dementia, Author Interviews, Geriatrics, Mental Health Research / 24.04.2014

Ziad Nasreddine MD FRCP(C) Professeur adjoint Université de Sherbrooke et McGill University Neuro Rive-Sud/CEDRA: Centre Diagnostique et Recherche sur la Maladie d'Alzheimer Québec, CanadaMedicalResearch.com Interview with: Ziad Nasreddine MD FRCP(C) Professeur adjoint Université de Sherbrooke et McGill University Neuro Rive-Sud/CEDRA: Centre Diagnostique et Recherche sur la Maladie d'Alzheimer Québec, Canada MedicalResearch.com: What are the main findings of this study? Dr. Nasreddine: The Montreal Cognitive Assessment (MoCA) total score (MoCA-TS) and Memory Index Score (MoCA-MIS) are useful in predicting conversion to Alzheimer’s disease (AD) in individuals with mild cognitive impairment (MCI). Identifying individuals with MCI at high of conversion to Alzheimer’s disease is important clinically and for selecting appropriate subjects for therapeutic trials. (more…)
Author Interviews, JAMA, Stroke, UCLA / 24.04.2014

Dr. Gregg C. Fonarow MD Director, Ahmanson-UCLA Cardiomyopathy Center UCLA CHAMP - Cholesterol, Hypertension, and Atherosclerosis Management Program Professor, Department of Medicine Associate Chief, Cardiology David Geffen School of Medicine Los Angeles, CAMedicalResearch.com Interview with: Dr. Gregg C. Fonarow MD Director, Ahmanson-UCLA Cardiomyopathy Center Professor, Department of Medicine Associate Chief, Cardiology David Geffen School of Medicine Los Angeles, CA MedicalResearch.com: What are the main findings of the study? Dr. Fonarow: This study examined data from hospitals that have adopted the American Heart Association/ American Stroke Association’s national quality initiative, Target: Stroke, which aims to increase the number of stroke patients treated with clot-busting drugs for ischemic stroke within 60 minutes or less after hospital arrival.  Initiated nationwide in 2010, Target: Stroke provided 10 key strategies as well as tools to facilitate timely tPA administration, as well as additional approaches to improve stroke care and outcome. Data from 71,169 tPA-treated stroke patients at 1,030 hospitals participating in Target: Stroke were analyzed to compared the time to treatment and incidence of complications before implementation, from 2003 to 2009, to the post-implementation years, from 2010 to 2013. This study found that the percentage of patients treated within the recommended timeframe increased from less than one-third before Target: Stroke to more than half afterwards. The Target: Stroke program goal of 50 percent or more of patients having door-to-needle times within 60 minutes was successfully achieved. In addition, the average time to treatment dropped by 15 minutes, from 74 to 59 minutes. Faster treatment was associated with lower rates of complications, including death. Before Target: Stroke, 9.9% of stroke patients died in the hospital, compared to 8.3% of patients treated after the initiative started, a difference which was statistically significant. In addition, patients treated by Target: Stroke strategies were less likely to develop the complication of symptomatic intracranial hemorrhage. (more…)
Author Interviews, Dengue, Ebola, Genetic Research, Infections, NEJM, NIH / 24.04.2014

Sergio D. Rosenzweig, MD, PhD Director, Primary Immunodeficiency Clinic (PID-C) LHD, NIAID, NIH Head of the Infectious Diseases Susceptibility Unit at the Laboratory of Host Defenses, National Institutes of Allergy and Infectious Diseases National Institutes of Health Bethesda, MD, 20892MedicalResearch.com Interview with: Sergio D. Rosenzweig, MD, PhD Director, Primary Immunodeficiency Clinic (PID-C) Head of the Infectious Diseases Susceptibility Unit at the Laboratory of Host Defenses, National Institutes of Allergy and Infectious Diseases National Institutes of Health Bethesda, MD, 20892 MedicalResearch.com: What are the main findings of the study? Dr. Rosenzweig: We diagnosed a disease called CDG-IIb in two siblings with severe development issues and very low levels of immunoglobulins, which include infection-fighting antibodies. These children were referred to the NIAID Primary Immunodeficiency Clinic through the NIH Undiagnosed Diseases Program. CDG-IIb is an extremely rare congenital disorder of glycosylation (CDG), with only one other case reported. The genetic defect of the disease disrupts glycosylation, the process for attaching and trimming sugars from proteins. Almost 50% of our proteins have sugars attached, and these are called glycoproteins. They include immunoglobulins and also some viral glycoproteins that are made when cells are infected by a virus. The spread of some viruses, including HIV and influenza, depend on viral glycoproteins in order to infect additional cells and form viral protective shields. We found that this type of virus was less able to replicate, infect other cells, or create adequate protective shields in CDG-IIb patient cells because of the glycosylation defect. In comparison, adenovirus, poliovirus, and vaccinia virus, which either do not rely on glycosylation or do not form protective glycoprotein shields, replicated normally when added to both CDG-IIb and healthy cells. (more…)
Author Interviews, Diabetes, Heart Disease / 24.04.2014

Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K.MedicalResearch.com Interview with: Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K. MedicalResearch.com: What are the main findings of the study? Prof. Heller: We explored the potential to hypoglycaemia to cause cardiac arrhythmias since we have previously shown that a low glucose can alter the electrocardiogram.  We had a hypothesis that alterations in heart rhythm or ectopic beats might contribute to cardiac mortality and in part explain the association between intensive diabetic therapy and increased mortality.  We therefore undertook continuous glucose monitoring and 12 lead EKG monitoring for a period of 5 days in individuals with Type 2 diabetes at increased CV risk.  We found that hypoglycaemia was fairly common and that nocturnal episodes in particular, were generally marked by a pattern whereby glucose levels dropped to low levels for some hours during which patients slept.  These periods of hypoglycemia were associated with a high risk of marked slow heart rates (bradycardia) accompanied by ectopic beats.  Our data suggest that this was due to overactivity of the vagus nerve.  We have therefore identified a mechanism which might contribute to increased mortality in individuals with Type 2 diabetes and high CV risk during intensive insulin therapy. (more…)
Author Interviews, Frailty, Lancet, Vitamin D / 23.04.2014

MedicalResearch.com Interview with: Dr Mark Bolland, PhD Bone and Joint Research Group, Department of Medicine University of Auckland, Auckland, New Zealand MedicalResearch.com: What are the main findings of the study? Prof. Bolland: In a meta-analysis of 20 randomized clinical trials, there was no effect of vitamin D with or without calcium on falls.  In a trial sequential analysis of these trials, the effect estimate for vitamin D with or without calcium on falls lay within the futility boundary, providing reliable evidence that vitamin D supplementation does not alter the relative risk of falls by ≥15% and suggesting that future trials that are similar in design to current trials are unlikely to change that conclusion. (more…)
AHA Journals, Author Interviews, Cannabis, Heart Disease / 23.04.2014

Emilie Jouanjus, PharmD, PhD Risques, maladies chroniques et handicaps Facult_e de M_edecine, Guesde, Toulouse 31073, France.MedicalResearch.com Interview with: Emilie Jouanjus, PharmD, PhD Risques, maladies chroniques et handicaps Facult_e de M_edecine, Guesde, Toulouse 31073, France. MedicalResearch.com: What are the main findings of the study? Dr. Jouanjus: Our study emphasizes that cardiovascular complications make up 1.8 percent of cannabis-related health complications reported in France. These were cases of peripheral arteriopathies, and cardiac and cerebrovascular disorders, some of which resulted in the death. These findings conducted us to conclude that marijuana is a possible risk factor for cardiovascular disease in young adults. (more…)
Author Interviews, CMAJ, Cost of Health Care, Orthopedics / 23.04.2014

MedicalResearch.com Interview with: Susan Jaglal, PhD Senior Scientist Toronto Rehabilitation Institute University of Toronto, Toronto, Ontario MedicalResearch.com: What are the main findings of the study? Dr. Jaglal: Bone Mineral Density (BMD) tests are used to both diagnose osteoporosis and assess and individual’s risk of fracture. While the tests play an important role in bone health, they are sometimes ordered inappropriately. For example, while women age 40-44 are typically not at risk of fragility fracture or in need of Bone Mineral Density testing, these individuals received almost half the Bone Mineral Density tests performed in Ontario in 2007/2008. Policy changes have been made in recent years in an effort to curb unnecessary testing of low risk individuals in both the United States and Canada. Policy efforts in Ontario included a 2008 fee schedule change that limited repeated testing among low-risk patients and included a new fee code for a “baseline” tests. Patients were limited to 1 baseline test in their lifetime. The goal of the present study was to determine the impact of this fee schedule change on Bone Mineral Density testing rates. The study was based on an analysis of provincial administrative data including physician billings, hospital discharges, and emergency department visits. Results demonstrated that while fee schedule changes were associated with a decrease in BMD testing rates, the decreases affected both low and high-risk patients. Most decreases were seen in testing rates of low-risk women. However, the associated decrease in testing among high-risk patients (e.g., those over 65 or with a recent fracture) is concerning, as high-risk patients benefit from screening and monitoring of Bone Mineral Density. (more…)
Author Interviews, Geriatrics, Mental Health Research / 23.04.2014

Helen C. Kales MD Professor of Psychiatry Director, Section of Geriatric Psychiatry and The Program for Positive Aging, University of Michigan Research Scientist, VA Center for Clinical Management Research and Geriatric Research Education and Clinical Center VA Ann Arbor Healthcare SysteMedicalResearch.com Interview with Helen C. Kales MD Professor of Psychiatry Director, Section of Geriatric Psychiatry and The Program for Positive Aging, University of Michigan Research Scientist, VA Center for Clinical Management Research and Geriatric Research Education and Clinical Center VA Ann Arbor Healthcare System Please note that this paper is the result of the deliberations of a multi-disciplinary national expert panel, not a specific study. MedicalResearch.com: What were the main findings of the expert panel? Dr. Kales: Often more than memory loss, behavioral symptoms of dementia are among the most difficult aspects of caring for people with dementia. These symptoms are experienced almost universally, across dementia stages and causes, and are often associated with poor outcomes including early nursing home placement, hospital stays, caregiver stress and depression, and reduced caregiver employment.  Doctors often prescribe these patients psychiatric medications like antipsychotics, despite little hard evidence that they work well in this population and despite the risks they pose including hastening death.  Meanwhile, studies show promise for non-medication behavioral and environmental approaches (such as providing caregiver education/support, creating meaningful activities and simplifying/enhancing the environment), but too few health providers are trained in their use.  The method created by the national multidisciplinary group of experts (DICE which stands for Describe, Investigate, Create and Evaluate) represents a comprehensive approach to assessment and management of behavioral symptoms in dementia.  For example, a new report of “agitation” from a caregiver, should be fully understood and described (e.g. who/what/when/where/risk/safety); underlying causes should be investigated (e.g. pain, changes in medications, medical conditions, poor sleep, fear); a treatment plan should be created (e.g. responding to physical problems, working collaboratively with the caregiver and other team members to institute non-pharmacologic interventions); and evaluating whether the interventions tried were effective. (more…)
Author Interviews, Autism, JAMA, Johns Hopkins / 22.04.2014

Li-Ching Lee, PhD, ScM Associate Scientist, Departments of Epidemiology and Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205MedicalResearch.com Interview with: Li-Ching Lee, PhD, ScM Associate Scientist, Departments of Epidemiology and Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205 MedicalResearch.com: What are the main findings of the study? Dr. Li-Ching Lee: This population-based case-control study in young children provides evidence that prenatal selective serotonin reuptake inhibitor (SSRI) use may be a risk factor for autism and other developmental delays (DD). Among boys, prenatal SSRI exposure was nearly 3 times as likely in children with autism spectrum disorder (ASD) relative to children with typical development; the strongest association occurred with first-trimester exposure. Exposure was also elevated among boys with DD and was strongest in the third trimester. (more…)
Author Interviews, JAMA, Outcomes & Safety, Stroke / 22.04.2014

Priv.-Doz. Dr. med. Dr. phil. Martin Ebinger Oberarzt der Klinik und Hochschulambulanz für Neurologie am Campus Charité Mitte Center for Stroke Research Berlin (CSB) Charité - Universitätsmedizin Berlin | CCM Charitéplatz 1 | 10117 Berlin | GermanyMedicalResearch.com Interview with: Priv.-Doz. Dr. med. Dr. phil. Martin Ebinger Oberarzt der Klinik und Hochschulambulanz für Neurologie am Campus Charité Mitte Center for Stroke Research Berlin (CSB) Charité - Universitätsmedizin Berlin | CCM Charitéplatz 1 | 10117 Berlin | Germany MedicalResearch.com: What are the main findings of the study? Dr. Ebinger: The main findings of our study was a significant time reduction during randomized weeks with prehospital thrombolysis compared to control weeks with regular care. (more…)
Author Interviews, JAMA, Surgical Research / 22.04.2014

MedicalResearch.com Interview with: Rustam Al-Shahi Salman Professor of clinical neurology and MRC senior clinical fellow, University of Edinburgh Honorary consultant neurologist, NHS Lothian upcoming JAMA publication:MedicalResearch.com Interview with: Rustam Al-Shahi Salman Professor of clinical neurology and MRC senior clinical fellow University of Edinburgh Honorary consultant neurologist, NHS Lothian MedicalResearch.com: What are the main findings of the study? Prof. Al-Shahi Salman: Patients with arteriovenous malformations (abnormal connection between arteries and veins) in the brain that have not ruptured had a lower risk of stroke or death for up to 12 years if they received conservative management of the condition compared to an interventional  treatment. Interventional treatment for brain arteriovenous malformations (bAVMs) with procedures such as neurosurgical excision, endovascular embolization, or stereotactic radiosurgery can be used alone or in combination to attempt to obliterate bAVMs. Because interventions may have complications and the untreated clinical course of unruptured bAVMs can be benign, some patients choose conservative management (no intervention). Guidelines have endorsed both intervention and conservative management for unruptured brain arteriovenous malformations. Whether conservative management is superior to interventional treatment for unruptured bAVMs is uncertain because of the lack of long-term experience, according to background information in the article. (more…)
Cancer Research, Journal Clinical Oncology / 22.04.2014

Danielle Blanch Hartigan, PhD, MPH Cancer Prevention Fellow National Cancer InstituteMedicalResearch.com Interview with: Danielle Blanch Hartigan, PhD, MPH Cancer Prevention Fellow National Cancer Institute MedicalResearch.com: What are the main findings of the study? Dr. Blanch-Hartigan: Results from this nationally-representative survey of oncologists and PCPs suggest that discussion of survivorship care planning with cancer survivors does not always occur. Training and knowledge specific to survivorship care and coordinated care between PCPs and oncologists were associated with increased survivorship discussions with survivors. (more…)