Erasmus, General Medicine / 12.05.2014

Dr. Adriaan J van der Meer Department of Gastroenterology and Hepatology Erasmus MC, University Medical Center Rotterdam, The NetherlandsMedicalResearch.com Interview with: Dr. Adriaan J van der Meer Department of Gastroenterology and Hepatology Erasmus MC, University Medical Center Rotterdam, The Netherlands MedicalResearch: What are the main findings of the study? Dr. J van der Meer: The main finding of our study is that the prognosis of patients with compensated HCV-induced advanced liver disease can be adequately assessed by risk scores which merely include objective variables that are readily available in daily practice. Our analyses resulted in two separate prognostic scores by which the individual patient's risk of mortality or clinical disease progression (defined as occurence of Hepatitis C Cirrhosis (HCC), liver failure, liver transplantation or death) can be assessed. (more…)
Author Interviews, Cancer Research, JAMA, Surgical Research / 10.05.2014

Dr. Carlo Riccardo Rossi, MD Melanoma and Sarcoma Unit, Veneto Institute of Oncology Surgery Branch, Department of Surgery Oncology, and Gastroenterology, University of Padova, Padova, ItalyMedicalResearch.com Interview with: Dr. Carlo Riccardo Rossi, MD Melanoma and Sarcoma Unit, Veneto Institute of Oncology Surgery Branch, Department of Surgery Oncology, and Gastroenterology, University of Padova, Padova, Italy MedicalResearch: What are the main findings of the study? Dr. Rossi: A total of 90% patients undergone lymph node dissection for melanoma had 12, 7, 14, 6 and 13 excised lymph nodes (10th percentile of the distribution) after 3 level axillary, 3 level or less neck, 4 level or more neck, inguinal, or ilio-inguinal dissections, respectively. (more…)
Author Interviews, Flu - Influenza, Vaccine Studies / 10.05.2014

MedicalResearch Interview: Dr Nicoline van der Maas MD Epidemiologist National Institute for Public Health and the Environment Centre for Infectious Disease Control Epidemiology and Surveillance The Netherlands MedicalResearch: What are the main findings of the study? Dr. van der Maas: The main finding, presented at the ESPID, is that we found no difference in growth, development and infection related contact rates with the general practitioner after the first year of life between infants of unvaccinated mothers and infants of mothers, vaccinated with an adjuvanted Influenza A (H1N1) vaccine during the second and third trimester of pregnancy. The offer of a H1N1 vaccination to pregnant women in their second and third trimester did not have a negative impact on infants’ health during the first year of life. (more…)
Author Interviews, Frailty, Geriatrics, JAMA, Surgical Research / 10.05.2014

MedicalResearch.com Interview with: Kwang-il Kim, MD, PhD Associate Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of KoreaMedicalResearch.com Interview with: Kwang-il Kim, MD, PhD Associate Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea MedicalResearch: What are the main findings of the study? Answer: There are few tools of preoperative risk stratification for the older adults. We found that not only disease itself but also frailty can lead to post-operative complication and mortality. So we made a scoring model to predict post-operative mortality and morbidity based on comprehensive geriatric assessment and it worked exactly. MedicalResearch: Were any of the findings unexpected? Answer: Under our predictive model, there was inflection point of mortality slope at point 5. Post-operative mortality of someone who scores 4~5 is below 10%, but it of other who scores 6~7 is about 30%. It was unexpected drastic change, so we think that there is physiologic threshold point. MedicalResearch: What should clinicians and patients take away from your report? Answer: Because the elderly are different from adults, clinicians have to focus on functional capacity, co-morbidity, and frailty for their older surgical patients. Make operative decision base on comprehensive geriatric assessment or our scoring model. If you depend on your own feeling, some older patients will suffer from post-operative complication and someone will forfeit his chance of surgery. (more…)
Author Interviews, Infections / 09.05.2014

Meagan F. Vaughn, PhD Postdoctoral Trainee Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel HillMedicalResearch.com Interview with: Meagan F. Vaughn, PhD Postdoctoral Trainee Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill MedicalResearch: What are the main findings of the study? Dr. Vaughn: Outdoor workers are at high-risk for tick-borne diseases. Adherence to recommended tick-bite prevention methods is poor.  While permethrin treatment of clothing is highly protective against many arthropod vectors, the need for frequent reapplication lessens adherence.  A double-blind randomized intervention was conducted to determine the effectiveness of long-lasting permethrin-impregnated uniforms for tick bite prevention among outdoor workers from North Carolina.  Treatment group uniforms were factory-impregnated with long-lasting permethrin by Insect Shield, while control group uniforms received sham treatment.  Participants completed weekly tick bite logs during two tick seasons.  130 participants reported 1,045 work-related tick bites over 5,251 person-weeks of follow-up.  The effectiveness of long-lasting permethrin impregnated uniforms for prevention of work-related tick bites was 82% (p<0.001) for the first year and 34% (p=0.38) for the second year. These results indicate that long-lasting permethrin impregnated uniforms are highly effective for at least one year against tick bites among North Carolina outdoor workers. (more…)
Pediatrics, Vaccine Studies / 09.05.2014

Tessa Schurink-van 't Klooster Epidemioloog Rijksvaccinatieprogramma Epidemiologie en Surveillance RIVM - Centrum Infectieziektebestrijding 3720 BA BilthovenMedicalResearch.com Interview with Tessa Schurink-van 't Klooster Epidemioloog Rijksvaccinatieprogramma Epidemiologie en Surveillance RIVM - Centrum Infectieziektebestrijding 3720 BA Bilthoven MedicalResearch: What are the main findings of the study? Answer: The main finding of this study was that we observed no differences in mortality rate ratios for females compared to males related to the type of last offered vaccination in DTP- and MMR-eligible age groups. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Mayo Clinic, Outcomes & Safety / 09.05.2014

MedicalResearch Interview with: Dr. David Cook MD Professor in the Department of Anesthesiology Division of Cardiovascular Anesthesiology Center for the Science of Health Care Delivery Mayo Clinic College of Medicine Rochester, Minnesota. MedicalResearch: What are the main findings of the study? Dr. Cook: The main finding of the study was that segmentation of a population of surgical patients into groups of higher and lower complexity allowed us to apply a standardized practice, focused factory model to surgical care delivery. A standardized care model improved care process measures such as time on mechanical ventilation or duration of a bladder catheter indwelling. The model reduced resource utilization, decreasing patient time in all care environments (operating room, ICU and on ?the floor?). The care model improved outcomes at 30 days and reduced the costs overall and in every care environment. In addition to the absolute improvements in quality and in cost, the standardized care model reduced variation in all measured variables. That reduction in variation may be even more important than the improved outcomes or reduced costs because we now know it is possible to make the health care experience predictable for these patients. That predictability is critically important to patients and providers, but it also has implications for health care metrics and payment models. (more…)
Cannabis, Neurology, Stroke / 09.05.2014

MedicalResearch.com Interview with: Tara Dutta M.D. Vascular Neurology Fellow University of Maryland Medical Center MedicalResearch: What are the main findings of the study? Dr. Dutta: We analyzed data from the Stroke Prevention in Young Adults Study in order to evaluate for an association between self-reported marijuana use and ischemic stroke.   1,101 cases and 1,154 age, gender, and race-matched controls, aged 15-49 years old, were recruited from the greater Baltimore-Washington area between 1992 and 2008. Interviews were conducted to assess for various potential stroke risk factors, including illicit drug, alcohol, and tobacco use. Individuals reporting use of vasoactive illicit drugs, including cocaine and amphetamines, were excluded, yielding 751 cases and 813 controls. Logistic regression analysis was used to determine the association between marijuana use and ischemic stroke, adjusting for age, gender, race, current tobacco use, current alcohol use, hypertension, and diabetes. We did not find a positive association between marijuana use and ischemic stroke risk in our population of young-onset stroke patients compared to matched controls, even after controlling for current tobacco and alcohol use, hypertension, and diabetes.   A statistically significant inverse relationship was observed between remote use (defined as any use over one year ago) and stroke risk (adjusted OR 0.77, CI 0.61-0.98, p = 0.03). We also looked to see whether recent use (in the past 30 days), and particularly recent heavy use, was associated with ischemic stroke risk as has been suggested in the medical literature. Though our data did not show this association, the number of patients reporting recent use in our study was very small­­­­­­­. (more…)
Author Interviews, Hepatitis - Liver Disease / 09.05.2014

Zobair Younossi, MD, MPH Chairman, Department of Medicine, Inova Fairfax Hospital Vice President for Research, Inova Health System Falls Church, Virginia, USAMedicalResearch.com Interview with: Zobair Younossi, MD, MPH Chairman, Department of Medicine, Inova Fairfax Hospital Vice President for Research, Inova Health System Falls Church, Virginia, USA   MedicalResearch: What are the main findings of the study? Dr. Younossi: We conducted the analysis of the patient reported outcomes (PROs) data that were systematically collected during clinical trials of sofosbuvir-containing regimens. The highlights of our findings are as follows:
  1. Patients with Hepatitis C (HCV)  have a significant impairment of their health related quality of life including those related to activity and fatigue. Their work productivity is also impaired.
  2. Cirrhosis can add additional negative impact on some of these patient reported outcomes.
  3. During treatment, patients with cirrhosis who were treated with an interferon-free sofosbuvir and ribavirin containing regimen did experience mild decline in their patient related outcome scores. However, this decline was similar for HCV patients with or without cirrhosis.
  4. On the other hand, patients with cirrhosis who were treated with an interferon-containing regimen showed a significant decline in their patient reported outcomes scores compared to those with Hepatitis C and without cirrhosis.
  5. Nevertheless, at the end of week 12 follow up, there was no longer a significant deficit in PROs noted regardless of the treatment arm for patients with cirrhosis.
  6. Furthermore, for the patients (HCV and cirrhosis) who achieved a sustained virologic response at 12 weeks, there were significant improvements (compared to baseline) in some PRO scores.
  7. During treatment, changes in patient reported outcomes scores were similar between cirrhotics and non-cirrhotics for both treatment regimens (all p>0.05).
(more…)
Cannabis, Mental Health Research / 08.05.2014

Meesha Ahuja, MD Department of Psychiatry and Human Behavior of the Warren Alpert Medical School of Brown University Young Adult Behavioral Health Program at Rhode Island Hospital Mentors: Laura Whiteley, MD and Larry Brown, MDMedicalResearch.com Interview with: Meesha Ahuja, MD Department of Psychiatry and Human Behavior of the Warren Alpert Medical School of Brown University Young Adult Behavioral Health Program at Rhode Island Hospital Mentors: Laura Whiteley, MD and Larry Brown, MD MedicalResearch: Why did you decided to study this topic? Dr. Ahuja: Severe mental illness is more common among college students than it was a decade ago, and the number of college students presenting for psychiatric care both on and off campus has dramatically increased. The rates of cannabis use have also been increasing among college students in the United States since the mid-1990s. The concomitant use of cannabis and other substances among general samples in psychiatric treatment has been linked to poorer clinical outcomes including increased hospitalizations, increased symptomatology, poorer treatment adherence, higher treatment resistance. However, before doing this study, there was no research that examined the effect of cannabis and other substance use disorders on the scholastic and general functioning of college students in psychiatric care. (more…)
Breast Cancer, Mayo Clinic, Weight Research / 08.05.2014

Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn.MedicalResearch.com Interview with: Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn. MedicalResearch.com: What are the main findings of the study? Dr. Boughey: Rates of bilateral mastectomy are higher in hospitals with immediate breast reconstruction available. Bilateral mastectomy rates were highest in hospitals with high volumes of immediate breast reconstruction. Large, teaching, urban, and Northeastern hospitals were more likely to have higher immediate breast reconstruction volumes. (more…)
Author Interviews, Nutrition, Weight Research / 08.05.2014

Mireille Serlie, MD PhD Academic Medical Center University of Amsterdam Department of Endocrinology and Metabolism Amsterdam, The NetherlandsMedicalResearch.com Interview with: Mireille Serlie, MD PhD Academic Medical Center University of Amsterdam Department of Endocrinology and Metabolism Amsterdam, The Netherlands MedicalResearch What are the main findings of the study? Dr. Serlie: We studied the effects of hypercaloric high sugar or high fat/high sugar drinks consumed with the 3 main meals (representing an increase in meal size) or in between the 3 main meals (representing an increase in meal frequency or snacking). All subjects gained a similar amount of body weight but only the ones that snacked showed an increase in liver and abdominal fat. This suggests that besides caloric content and diet composition, eating pattern independently contributes to liver and abdominal fat accumulation. We also observed a trend for a decrease in hepatic insulin sensitivity in the high fat/high sugar frequency group only. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Geriatrics, Heart Disease / 08.05.2014

Luisa Soares-Miranda, PhD Research Center in Physical Activity, Health and Leisure Faculty of Sport, University of Porto Rua Dr. Plácido Costa, Porto PORTUGALMedicalResearch.com Interview with: Luisa Soares-Miranda, PhD Research Center in Physical Activity, Health and Leisure Faculty of Sport, University of Porto Rua Dr. Plácido Costa, Porto PORTUGAL MedicalResearch: What are the main findings of the study? Dr. Soares-Miranda: Modest physical activity, such as the distance and pace of walking, is important for the heart’s electrical well being of older adults. In our study, older adults that increased their walking pace or distance had a better heart rate variability when compared with those that decreased their walking pace or distance. Our results suggest not only that regular physical activity later in life is beneficial, but also that certain beneficial changes that occur may be reduced when physical activity is reduced. This supports the need to maintain modest physical activity throughout the aging process. Even small increases can lead to a better health, while reducing physical activity has the opposite effect. So, any physical activity is better than none, and more is better. (more…)
Author Interviews, BMJ, Prostate Cancer, Testosterone / 07.05.2014

dr_san_franciscoMedicalResearch.com Interview with: Dr. Ignacio F. San Francisco Departamento de Urología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile MedicalResearch: What are the main findings of the study? Answer: Increasingly, men with low-risk prostate cancer are undergoing a close monitoring regimen called active surveillance, instead of moving forward immediately with treatment. However it is still unclear which men will develop evidence for worsening or more aggressive disease during active surveillance. In this study of 154 men with Gleason 6 prostate cancer followed for 38 months, we found that low levels of free testosterone were significantly associated with increased risk of developing more aggressive disease. We found no significant association with total testosterone concentrations, although there was a general trend towards increased risk with lower levels. (more…)
Annals Internal Medicine, Author Interviews, Cost of Health Care, Health Care Systems / 07.05.2014

MedicalResearch.com Interview with: Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard School of Public Health / Brigham & Women's Hospital Boston, MA 02115MedicalResearch.com Interview with: Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard School of Public Health / Brigham & Women's Hospital Boston, MA 02115   MedicalResearch.com: What are the main findings of the study? Dr. Sommers: We find that over the first four years since Massachusetts' 2006 comprehensive health reform law, all-cause mortality in the state fell by 2.9%, compared to a similar population of adults living in counties outside Massachusetts that did not expand insurance during this period.  We also found that the law reduced the number of adults in Massachusetts without insurance, reduced cost-related barriers to care, increased use of outpatient visits, and led to improvement in self-reported health.  Overall, we estimate that the health reform law prevented over 320 deaths per year in the state - or one life saved per 830 adults gaining health insurance.  Mortality rates declined primarily due to fewer deaths from causes amenable to health care, such as cancer, infections, and heart disease.  We also found that the health benefits were largest for people living in poor counties in the state, areas with higher percentage of uninsured adults before the law was passed, and for minorities. (more…)
Author Interviews, Cancer Research, Hepatitis - Liver Disease, UT Southwestern / 07.05.2014

Amit Singal MD MS Assistant Professor of Medicine Medical Director, Liver Tumor Program Dedman Scholar of Clinical Care Division of Digestive and Liver Diseases University of Texas Southwestern Dallas TX 75201 - 8887MedicalResearch.com Interview with: Amit Singal MD MS Assistant Professor of Medicine Medical Director, Liver Tumor Program Dedman Scholar of Clinical Care Division of Digestive and Liver Diseases University of Texas Southwestern Dallas TX 75201 - 8887 MedicalResearch: What are the main findings of the study? Dr. Singal: We conducted a meta-analysis of current studies to characterize the association between hepatocellular carcinoma surveillance and early detection, curative treatment rates, and overall survival in patients with cirrhosis.  We identified 47 studies with 15,158 patients, of whom 6,284 (41.4%) had hepatocellular carcinoma  detected by surveillance. Hepatocellular carcinoma  surveillance was associated with improved early stage detection (OR 2.08, 95% CI 1.80–2.37) and curative treatment rates (OR 2.24, 95% CI 1.99–2.52). These associations were robust to several sensitivity analyses, including study design, study location, and study period. Hepatocellular carcinoma  surveillance was associated with significantly prolonged survival (OR 1.90, 95% CI 1.67–2.17), which remained significant in the subset of studies adjusting for lead-time bias. Three-year survival rates were 50.8% among patients who underwent surveillance, compared to only 28.2% among hepatocellular carcinoma  patients with tumors detected outside of a surveillance program. (more…)
Breast Cancer, Mayo Clinic, Pain Research, Pharmacology / 06.05.2014

Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn.MedicalResearch.com Interview with: Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn. MedicalResearch.com: What are the main findings of the study? Dr. Boughey: Use of paravertebral block (a form of regional anesthesia) in women undergoing mastectomy results in less need for opioid medications and less frequent use of anti-nausea medication after surgery. (more…)
Author Interviews, Mayo Clinic, Neurology, Stroke / 06.05.2014

Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 MedicalResearch.com Interview with: Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 MedicalResearch: What are the main findings of the study? Dr. Kantarci: Microinfarcts are one of the most common pathologies identified in the brains of older individuals and they impact cognition. However they are invisible lesions on MRI. We demonstrated that presence of microinfarcts in autopsied individuals are associated with the macroinfarcts identified on their MRI scans than they were alive. We also demonstrated that the presence of these invisible lesions are related to greater brain atrophy rates that are localized to watershed zones. (more…)
Author Interviews, Diabetes, JAMA, Pediatrics / 06.05.2014

Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045MedicalResearch.com Interview with:  Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045 MedicalResearch.com: What are the main findings of the study? Dr. Dabelea: We found that the proportion of US youth living with Type 1 Diabetes has increased by at least 21% over a period of only 8 years. This increase was seen in both boys and girls, most age-groups and race/ethnic groups.  While we do not completely understand the reasons for this increase, since the causes of Type 1 Diabetes are still unclear, it is likely that something has changed in our environment- both in the US and elsewhere in the world- causing more youth to develop the disease, maybe at increasingly younger ages. (more…)
Author Interviews, Nutrition, OBGYNE / 05.05.2014

Jessica A. Grieger (BSc(hons), R Nutr, PhD) Post-doctoral research fellow Robinson Research Institute, University of AdelaideMedicalResearch.com Interview with: Jessica A. Grieger (BSc(hons), R Nutr, PhD) Post-doctoral research fellow Robinson Research Institute, University of Adelaide   MedicalResearch:  What are the main findings of the study? Dr. Grieger: The study aimed to identify associations between maternal dietary patterns in the 12 months before conception on fetal growth and preterm delivery. We report that a one standard deviation increase in the scores on the high-protein/fruit pattern was associated with decreased likelihood for preterm birth, whereas a one standard deviation increase on the high-fat/sugar/takeaway pattern was associated with increased likelihood for preterm birth as well as shorter gestation and birth length. (more…)
Author Interviews, Brain Cancer - Brain Tumors / 05.05.2014

MedicalResearch.com Interview with: Dr Andrea Schuessler QIMR Berghofer Medical Research Institute Herston, Queensland 4006 MedicalResearch.com: What are the main findings of the study? Dr . Schuessler: Recurrent glioblastoma is a very aggressive brain cancer and most patients do not survive much longer than 6 months. Our study has assessed a novel immunotherapy and treated 10 patients with late stage cancer. The treatment did not have any serious side effects and most of the patients have survived much longer than the expected 6 months. Importantly, four of the 10 patients have not shown signs of disease progression during the study period with one of them still being cancer free four years after the treatment. (more…)
Author Interviews, Gastrointestinal Disease, Hepatitis - Liver Disease, NEJM / 05.05.2014

Stefan Zeuzem, M.D. Professor of Medicine, Chief Department of Medicine JW Goethe University Hospital Frankfurt GermanyMedicalResearch.com Interview with: Stefan Zeuzem, M.D. Professor of Medicine, Chief Department of Medicine JW Goethe University Hospital Frankfurt Germany   MedicalResearch.com: What are the main findings of the study? Dr. Zeuzem: Main finding is that also patients infected with HCV 3 can be cured with an IFN-free regimen. However, duration of therapy must be prolonged to 24 weeks. (more…)
Author Interviews, Coffee, Diabetes, Diabetologia / 04.05.2014

Dr. Frank B. Hu MD MPH PhD Professor of Nutrition and Epidemiology From the Departments of Nutrition and Epidemiology Harvard School of Public Health, Boston, MAMedicalResearch.com Interview with: Dr. Frank B. Hu MD MPH PhD Professor of Nutrition and Epidemiology From the Departments of Nutrition and Epidemiology Harvard School of Public Health, Boston, MA   MedicalResearch.com: What are the main findings of the study? Dr. Hu: We found that people who increased the amount of coffee they drank each day by more than one cup over a four-year period had a 11% lower risk for type 2 diabetes than those who made no changes to their coffee consumption, but those who decreased their coffee consumption by more than a cup per day increased their type 2 diabetes risk by 17%. (more…)
Author Interviews, Nature, Nutrition / 04.05.2014

Professor Gary Frost PhD RD Head of the Nutrition and Dietetic Research Group NIHR Senior Investigator Division of Diabetes, Endocrinology and Metabolism Faculty of Medicine Imperial College Hammersmith Campus London W12 ONNMedicalResearch.com Interview with: Professor Gary Frost PhD RD Head of the Nutrition and Dietetic Research Group NIHR Senior Investigator Division of Diabetes, Endocrinology and Metabolism Faculty of Medicine Imperial College Hammersmith Campus London W12 ONN MedicalResearch.com: What are the main findings of the study?  Prof. Frost: That acetate that is derived from the fermentation of dietary fiber in the colon by the microbiota is taken up by the hypothalamus in the brain.  In the hypothalamus the way the cells metabolize acetate creates a signal that suppresses appetite (more…)
Author Interviews, BMJ, Emergency Care, Heart Disease / 03.05.2014

Dr. Richard Body Emergency Department Manchester Royal Infirmary Manchester UKMedicalResearch.com Interview with:  Dr. Richard Body Emergency Department Manchester Royal Infirmary Manchester UK   MedicalResearch.com: What are the main findings of the study? Dr. Body: This paper actually reports the findings of two consecutive, separate studies.  We aimed to derive and then externally validate a clinical decision rule to risk stratify patients with suspected acute coronary syndromes in the Emergency Department (ED).  This rule could then be used to reduce unnecessary hospital admissions while also making judicious use of specialist high dependency resources. In the first study we derived a clinical decision rule that incorporates 8 variables: high sensitivity troponin T, heart-type fatty acid binding protein; ECG ischaemia; worsening angina; hypotension (systolic blood pressure <100mmHg on arrival); sweating observed in the ED; pain associated with vomiting; and pain radiating to the right arm or shoulder.  When we validated the rule at a different centre, we found that its use could have avoided hospital admission for over a quarter of patients while effectively risk stratifying others.  Of the 10% of patients who were identified as 'high risk', approximately 95% had a major adverse cardiac event within 30 days.  The findings suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule could be used to 'rule in' and 'rule out' acute coronary syndromes immediately, using information gathered at the time of initial presentation to the ED.  Before clinical implementation, we recommend that effect of using the MACS rule in practice should first be evaluated in a trial setting.  This will enable us to determine: (a) whether physicians and patients are likely to comply with (and be satisfied with) the MACS rule; (b) the safety of the MACS rule when used in practice; and (c) whether use of the MACS rule leads to cost savings for the health service. (more…)
Author Interviews, Prostate Cancer / 03.05.2014

dr_arturo_araujoMedicalResearch.com Interview with: Arturo Araujo, PhD IMO Moffitt Cancer Center Tampa, FL 33612   MedicalResearch: What are the main findings of the study? Dr. Araujo: Using in vivo approaches it is often challenging to study the multiple simultaneous interactions occurring at various time points in the setting of bone metastasis. However, integrating biological data with a powerful computational model allowed us to build a tool that could not only mimic the in vivo growth of cancer in bone but also to determine how the disease was behaving at any given time point. The key finding for us was that the computational model demonstrated the phasic or cyclical nature of how the prostate cancers grow in bone. For example, a wave of osteoclast mediated bone resorption would be followed by sustained bone formation by osteoblasts, followed again by bone reposition. We think these findings could provide novel insights into when the best time to apply therapies might be in order to obtain maximum efficiency. (more…)
Author Interviews, Diabetes, Diabetes Care, Mental Health Research / 02.05.2014

Marianna Virtanen Finnish Institute of Occupational Health Helsinki, FinlandMedicalResearch.com Interview with: Marianna Virtanen PhD Finnish Institute of Occupational Health Helsinki, Finland MedicalResearch: What are the main findings of the study? Dr. Virtanen: We examined whether psychological distress predicts incident type 2 diabetes and if the association differs between populations at higher or lower risk of type 2 diabetes. We used a clinical type 2 diabetes risk score to assess future diabetes risk and in addition, participants’ prediabetes status. We found that psychological distress did not predict future type 2 diabetes among participants who were normoglycemic and among those with prediabetes combined with a low diabetes risk score. However, psychological distress doubled the risk of type 2 diabetes among participants with prediabetes and a high diabetes risk score. (more…)
Author Interviews, BMJ, Cancer Research, Surgical Research, Transplantation / 02.05.2014

MedicalResearch.com Interview with: Rajeev Desai SpR Gastroenterology, City Hospital Birmingham Honorary Clinical Research Fellow University Hospital Birmingham / NHS Blood and Transplant, Bristol MedicalResearch: What are the main findings of the study? Dr. Desai: This study of a large national cohort of organ donors shows that, following careful assessment and selection, organs from some donors with a previous history of cancer can be used safely for transplantation. The risks of accepting such organs for transplantation should be balanced with risks of non-acceptance and its consequences including delayed transplantation or non-transplantation. (more…)
Annals Thoracic Surgery, Author Interviews, Cost of Health Care, Hospital Readmissions, Pharmacology / 02.05.2014

Michael H. Hall, MD North Shore-LIJ Health SystemMedicalResearch.com Interview with: Michael H. Hall, MD North Shore-LIJ Health System MedicalResearch: What are the key points of your research? Dr. Hall: Our study was designed to improve care transition from the hospital to home after coronary bypass surgery. The innovative program (Follow Your Heart), implemented at one of our system hospitals, involves sending cardiac surgery nurse practitioners (NPs) who cared for the patients in the hospital to the homes of discharged patients for at least two visits in the first two weeks after discharge. Their goal is to provide continuity of care for patients that they know from the hospital setting and to provide robust medication management, coordinate community services, and be a communications hub for hospital and community providers (primary care, cardiology, and community nurse home visit services). The  nurse practitioners interact with community resources to ensure understanding and satisfaction of the patients’ needs prior to hand-off to those resources after two weeks. Our  nurse practitioners utilize encrypted smart phones to provide reports to all appropriate providers and can even send pictures of incisions to the surgeon when necessary. (more…)