MedicalResearch.com Interview with: MedicalResearch.com Interview with: Albert L. Siu, MD, MSPH Co-Vice Chair Mount Sinai School of Medicine, New York MedicalResearch: What are the main...
MedicalResearch.com Interview with:
Edward Giovannucci, MD, ScD
Department of Nutrition
Harvard School of Public Health
Boston, MA
MedicalResearch: What are the main findings of the study?
Dr. Giovannucci: In 50,000 men followed over 24 years, we found that those regularly consuming tomato products, which are high in lycopene, had a 30% lower risk of developing lethal prostate cancer. Among men being screened regularly with PSA, the risk reduction from high tomato consumption was 50%. We also examined the prostate cancer tissue and found that higher dietary lycopene intake was associated with less new blood vessel formation, which may help explain why the cancers were less likely to progress.
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MedicalResearch.com Interview with:
Unab I. Khan, M.B.,B.S., M.S.
Assistant Professor of Pediatrics and Family & Social Medicine
Division of Adolescent Medicine
The Children’s Hospital at Montefiore
The Pediatric Hospital for Albert Einstein College of Medicine
Bronx, NY 10467
MedicalResearch: What are the main findings of the study?
Dr. Khan: We wanted to find factors that lead to either an increase or decrease in risk of developing cardiovascular disease. We found that in middle aged overweight and obese women, who may not have any medical problems like diabetes, high blood pressure, high cholesterol, an increase in weight over time and the development of any of the conditions stated above, increased the risk of cardiovascular disease significantly.
On the other hand, even moderate physical activity decreased the risk of heart disease, even in the presence of the above stated conditions.
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MedicalResearch.com Interview with:
Nitesh D. Kuhadiya MD, MPH
Assistant Professor of Medicine
Section of Endocrinology,Diabetes and Metabolism
University of Buffalo, New York
MedicalResearch: What are the main findings of the study?
Dr. Kuhadiya: This is the first randomized clinical trial to show that the addition of liraglutide 1.2 and 1.8mg to insulin significantly reduces HbA1c, mean blood glucose, total insulin doses, body weight, carbohydrate intake, C-Reactive protein (a marker of cardiovascular risk), significantly improves quality of life and reduces systolic blood pressure(top number in a blood pressure reading) in 1.8mg group in patients with type 1 diabetes over a period of 12 weeks.
In 1.2mg, HbA1c fell by 0.78% from 7.84 to 7.06% and in 1.8mg group fell by 0.42% from 7.41 to 6.99% which means that more number of patients will be able to achieve HbA1c levels close to 7% and lower which is recommended by most diabetes organizations. Also the total daily dose of insulin fell by about 10-12 units in both groups. The total daily carbohydrate intake in both the groups fell by an average of 40 grams. There was a 5 kg weight loss in both 1.2 mg and 1.8 mg groups and both these groups on an average lowered their Body Mass Index from 29 to 28 kg/m2 . In 1.8 mg group there was fall in systolic blood pressure by 9 mm from 120 to 111 mm Hg.
The improvements seen are important because 40 to 50 percent of people with Type 1 diabetes have the metabolic syndrome(Cluster of risk factors, including high blood pressure, large waistline, high blood sugar, low HDL ("good") cholesterol and high triglycerides (fats in the blood) which increases the chances of later developing Type 2 diabetes and heart disease.
Our findings have significant implications for the future treatment of patients with Type 1 Diabetes.
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MedicalResearch.com Interview with:
Scott Stroup, MD, MPH
Professor of Psychiatry
Director, Program for Intervention Effectiveness Research,
Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric Institute
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
MedicalResearch: What are the main findings of the study?
Dr. Stroup: We conducted a study sponsored by the National Institute of Mental Health that compared long-acting injectable antipsychotics for people with schizophrenia. Long-acting injectable antipsychotics, also known as depot antipsychotics, are used to promote treatment adherence. We compared a newer injectable antipsychotic, paliperidone palmitate, to an older one, haloperidol decanoate. We did not find an advantage for the newer drug in overall effectiveness. The drugs performed very similarly, and were tolerated about the same.
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MedicalResearch.com Interview with:
Susan Farr, Ph.D.
Research Professor of Geriatrics
Saint Louis University
MedicalResearch: What are the main findings of the study?
Dr. Farr: We found that reducing the conversion of amyloid precursor protein (APP) to beta amyloid with an antisense targeting the beta amyloid portion of amyloid precursor protein in the Tg2576 mouse which overexpresses human beta amyloid, improves learning and memory and reduces neuroinflammatory cytokine (inflammation in the brain).
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MedicalResearch.com Interview with:
Adriana C. Vidal, Ph. D.
Assistant Professor
Department of Obstetrics & Gynecology
Division of Clinical & Epidemiologic Research and
Cancer Prevention, Detection and Control Research Program and Department of Surgery Division of Urology
Duke University School of Medicine Durham, NC 27710
MedicalResearch: What are the main findings of the study?
Dr. Vidal: Among 430 veterans at the VA Hospital in Durham, N.C., including 156 men with confirmed prostate cancer, we found that men who self-reported a higher intake of carbohydrates were at a reduced risk of both low-grade and high-grade prostate cancer.
Moreover, we found that intake of foods with high glycemic index increased total prostate cancer risk in black men. However, a higher fiber intake was associated with reduced risk of high grade prostate cancer.
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MedicalResearch.com Interview with:
Dr. Robin Voigt PhD
Department of Internal Medicine
Division of Gastroenterology
Rush University Medical Center
Chicago, Illinois
MedicalResearch: What are the main findings of the study?
Dr. Voigt: We found that chronic circadian rhythm disruption has no effect on the intestinal microbiota when mice are fed a standard chow diet but when combined with a high-fat, high-sugar diet circadian rhythm disruption results in intestinal dysbiosis and an increase in pro-inflammatory bacteria.
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MedicalResearch.com Interview with:
Jonathon D. Truwit, MD, MBA
Enterprise Chief Medical Officer
Sr. Administrative Dean
Froedtert-Medical College of Wisconsin
Milwaukee, WI 53226
MedicalResearch.com: What are the main findings of the study?
Dr. Truwit: Rosuvastatin did not reduce mortality, nor days free of the breathing machine, in patients with sepsis-associated acute respiratory distress syndrome (ARDS). One in four patients with ARDS die.
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MedicalResearch.com Interview with:
Christopher Labos MD CM, FRCPC, MSc candidate
Division of Epidemiology, Biostatistics and Occupational Health
McGill University
Montreal, Quebec Canada
MedicalResearch: What are the main findings of the study?
Dr. Labos: A higher genetic risk score (GRS) composed of a set of recently discovered genetic markers strongly linked to cardiovascular disease is associated with an earlier age of first acute coronary syndromes (ACS). We also found that other traditional risk factors such as smoking, obesity and male sex were also associated with an earlier ACS. Two medication classes were also associated with age of first ACS: hormone replacement therapy was associated with earlier ACS while aspirin was associated with ACS occuring at a later age.
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MedicalResearch.com Interview with:
Wei Bao MD, PhD
Postdoc fellow, Epidemiology Branch
Division of Intramural Population Health Research
NICHD/National Institutes of Health
Rockville, MD 20852
MedicalResearch: What are the main findings of the study?
Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are:
(1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI).
(2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI.
(3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI.
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MedicalResearch.com Interview with:
James Chamberlain, MD
Division Chief, Emergency Medicine
Children’s National Health System
Washington, DC
MedicalResearch: What are the main findings of the study?
Dr. Chamberlain: Contrary to our hypothesis, lorazepam was not superior to diazepam for treating pediatric seizures. Both medications had similar effectiveness (72-73%) and safety (15-16% incidence of assisted ventilation). Lorazepam caused a longer period of sedation prior to waking up. The difference was approximately 15 minutes.
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MedicalResearch.com Interview
Professor Kim Bennell
ARC Future Fellow
Department of Physiotherapy
University of Melbourne
Parkville, Vic 3010 Australia
MedicalResearch: What are the main findings of the study?
Professor Bennell: In 102 people with painful hip osteoarthritis, we compared a 'real' physical therapy program involving exercise, manual therapy techniques,education and provision of a cane if appropriate to a sham physical therapy treatment that was made to look as though it was real but instead involved turned off ultrasound and gentle application of a hand crème to the hip region. Participants in both groups went to see a physical therapist on 10 occasions over 12 weeks and performed home exercises if in the 'real' physical therapy group or lightly applied the cream at home if in the sham group. Participants were followed for 9 months in total. We found that while both groups showed improvements in pain and physical function, the improvements were similar between the two groups. That is, the real physical therapy program did not show greater benefits over a sham treatment. (more…)
MedicalResearch.com Interview with:
Vicki Fung, Ph.D.
Assistant Professor
Department of Medicine, Harvard Medical School
Mongan Institute for Health Policy, Massachusetts General Hospital
MedicalResearch: What are the main findings of the study?
Dr. Fung: We found that lower income parents of children with asthma were more likely to delay or avoid taking their children to a doctor's office visit or to the emergency room if they had to pay higher out-of-pocket costs for care; they were also more likely to report borrowing money to pay for asthma care.
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MedicalResearch Interview with:
Charles D. Scales, Jr MD MSHS
Assistant Professor of Surgery
Division of Urologic Surgery
Duke University Medical Center
MedicalResearch: What are the main findings of the study?
Dr. Scales: When it comes to treating kidney stones, less invasive is not always better.
We used the best method short of a randomized trial to balance out patients in terms of factors that might influence the success of treatment. In other words, we achieved a “statistical toss-up” for factors that could influence the outcome of the procedure.
When we balanced out all of the factors that might influence the chance of a repeat procedure, we found that about 11% of patients treated with non-invasive SWL had a repeat procedure, as compared to <1% with minimally invasive URS.
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MedicalResearch.com Interview with:
Colleen K. McIlvennan, DNP, ANP
Assistant Professor of Medicine
University of Colorado, Division of Cardiology
Section of Advanced Heart Failure and Transplantation
MedicalResearch: What are the main findings of the study?
Answer: We interviewed 22 patients who were offered destination therapy left ventricular assist devices (DT LVAD), 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an overriding desire to live as long as possible: [LVAD] was the only option I had…that or push up daisies…so I automatically took this. In contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: There are worse things than death. Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually.
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MedicalResearch.com Interview with:
Dr. Price Kerfoot MD, EdM
Rabkin Fellow in Medical Education
Associate Professor of Surgery, Harvard Medical School
MedicalResearch: What are the main findings of the study?
Dr. Kerfoot:
(1) An online spaced education game improved clinicians' knowledge of hypertension intensification and generated a modest but significant improvement in time to blood pressure target among their patients with hypertension.
(2) As a method to increase clinicians' long-term knowledge, the spaced education game was significantly more effective than providing the identical content via a traditional method (online posting with e-mail reminders).
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MedicalResearch.com Interview with:
Adnan Custovic DM MD PhD FRCP
Professor of Allergy
Institute of Inflammation and Repair
University of Manchester
University Hospital of South Manchester
Manchester M23 9LT, UK
MedicalResearch: What are the main findings of the study?
Dr. Custovic: In a longitudinal analysis of the data from our birth cohort study collected from birth to age eleven years, we demonstrated an association between early-life antibiotic prescription and development of wheezing, but not atopy. Furthermore, amongst children with wheezing, antibiotic prescription in infancy increases the risk of subsequent severe wheeze/asthma exacerbations and hospital admissions. This is the first demonstration that children who receive antibiotics in infancy have impaired antiviral immunity later in life, and that early-life antibiotic prescription is associated with variants on chromosome 17q21 locus (which is an asthma susceptibility locus).
Our findings suggest that the association between antibiotics and childhood asthma reported in previous studies arises through a complex confounding by indication, in which hidden factors which increase the likelihood of both antibiotic prescription in early life and subsequent asthma development are increased susceptibility to virus infections consequent to impaired antiviral immunity, and genetic variants on 17q21. Our results raises an important issue that effects which are often attributed to environmental exposures may be a reflection of genetic predisposition.
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MedicalResearch.com Interview with:
Daniel S. Elliott, M.D
MAYO Clinic, Associate Professor
Department of Urology
Section of Pelvic and Reconstructive Surgery
Rochester, Minnesota
MedicalResearch: What are the main findings of the study?
Dr. Elliott: The biggest issue is that we were able to devise a new procedure that is a simple outpatient anti-incontinence surgery for women that does NOT use any synthetic meshes. The importance of this is that all traditional (meaning NON-mesh) surgeries for female incontinence have been large surgeries with fairly significant risks such as pain, bleeding and prolonged recovery. When the meshes came out in the late ‘90’s, their big benefit was that they were outpatient and quick procedures. But now that we are discovering all the long term complications from meshes such as chronic pain, scarring, painful intercourse, vaginal extrusion of the meshes, and organ injury, patients have become VERY reluctant and fearful to undergo any mesh type surgery. Therefore, we devised a new procedure that used a very small piece of the patient’s own tissue (from the rectus fascia) and placed this via the “transobturator route.” In the process, we melded together the “best” of both worlds---a NON-mesh, outpatient anti-incontinence procedure that is safe (no long term problems as seen with meshes) .
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MedicalResearch Interview with:
Dr. Gerard J. Criner MD, FACP, FACCP
Professor, Medicine
Director, Medical Intensive Care Unit and Ventilator Rehabilitation Unit
Co-Director, Center for Inflammation, Translational and Clinical Lung Research, Temple University Hospital in Philadelphia, PA
MedicalResearch: What are the main findings of the study?
Dr. Criner: The STATCOPE Trial (Simvastatin in the Prevention of COPD Exacerbations) found that a statin drug commonly used to lower cholesterol is not effective in reducing the number and severity of flare ups from chronic obstructive pulmonary disease (COPD). The study rigorously tested the hypothesis that statin drugs may be beneficial to persons with COPD because of the drugs’ purported anti-inflammatory effect. However, researchers found that:
MedicalResearch.com Interview with:
Jennifer Peltzer-Jones, R.N., Psy.D.
Henry Ford's Department of Emergency Medicine
MedicalResearch: What are the main findings of the study?
Answer: We found that within our group of 255 known Emergency Department “super-frequent users,” 77% had with some type of addiction disorder, and 47 percent visited the Emergency Department seeking narcotics for pain. Women were more likely to be narcotic seeking. Using our individualized Electronic Medical Record care plan intervention, created and overseen by our multidisciplinary team (comprised of Emergency Department staff physicians, a psychologist, residents, nurses and support staff), we found that our plan significantly decreased annual rates of visits by these super-frequent users and those who sought pain-relief narcotics and other super-frequent users.
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Timothy Fernandes, M.D., M.P.H.
University of California, San Diego
La Jolla, CA
MedicalResearch: What are the main findings of this study?
Dr. Fernandes: The fibrinopeptides are cleaved off of fibrinogen by thrombin during the generation of a new clot. These small molecules are excreted into the urine and we have developed a urine assay to measure the level of FPB. We examined the performance of urine FPB as a screening test for acute pulmonary embolism, blood clots that travel to the lungs.
The study group consisted of 344 patients: 61 (18%) with pulmonary embolism and 283 (83%) without. At a threshold of 2.5 ng/ml, urine FPB demonstrated sensitivity of 75.4% (95% CI: 62.4-85.2%), specificity of 28.9% (95% CI: 23.8-34.7%), and negative likelihood ratio of 0.18 (0.11-0.29), weighted by prevalence in the sample population. However, the thresholds of 5 ng/ml and 7.5 ng/ml had sensitivities of only 55.7% (95% CI: 42.5-68.2%), and 42.6% (30.3-55.9%), respectively.
The urine fibrinopeptide B assay at a cut-off of 2.5 ng/ml had a sensitivity of 75.4% for detecting pulmonary embolism. For diagnosis of PE, this sensitivity is comparable to previously published values for the first generation plasma latex and whole blood D-dimer assays (not as well and the D dimer ELISA assay).
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MedicalResearch.com Interview with
T. Jared Bunch, MD
Medical director for Heart Rhythm Services
Director of Heart Rhythm research
Intermountain Medical Center, Utah
MedicalResearch: What are the main findings of the study?
Dr. Bunch: The main findings of the study are:
1) Atrial fibrillation patients treated with warfarin anticoagulation that have lower percentages of time in therapeutic range have significantly higher risks of all forms of dementia.
2) The dementia relative risk related to lower percentages of time in therapeutic range was higher than all other variables associated with stroke or risk of bleeding.
3) The risk of dementia related to lower percentages of time in therapeutic range was highest in younger patients in the study (<80 years).
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MedicalResearch.com Interview with:
Dr. Hoi Nam Tse, FCCP, MRCP, MBChB
Associate Consultant, Kwong Wah Hospital, Hong Kong
Life member and Council member of Hong Kong Thoracic Society
MedicalResearch: What are the main findings of the study?
Dr. Hoi Nam Tse: N-acetylcysteine (NAC) is an oral mucolytic containing anti-oxidative and anti-inflammatory property. Our study demonstrated that long term use of high-dose : N-acetylcysteine (600 mg twice daily for 1 year) was a well-tolerated treatment, and it reduced exacerbations and prolonged time to first exacerbation in ‘high-risk’ COPD patients--which was defined as patients who had 2 or more exacerbations per year, FEV1<50% or both. Such beneficial effect was not obvious in the ‘low-risk’ COPD patients.
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