Accidents & Violence, Author Interviews, Biomarkers, Brain Injury, JAMA / 14.03.2014

Pashtun Shahim, MD Clinical Neurochemistry Laboratory Institute of Neuroscience and Physiology Department of Neurochemistry Sahlgrenska University Hospital, Mölndal SwedenMedicalResearch.com Interview with: Pashtun Shahim, MD Clinical Neurochemistry Laboratory Institute of Neuroscience and Physiology Department of Neurochemistry Sahlgrenska University Hospital, Mölndal Sweden MedicalResearch.com: What are the main findings of the study? Dr. Shahim: Sports-related concussion in professional ice hockey players is associated with acute axonal and astroglial injury. Plasma total tau, which is a highly central nervous system-specific protein, is a promising biomarker to be used both in the diagnosis of concussion and in the decision-making when an athlete can be declared fit to return to play. (more…)
Accidents & Violence, Author Interviews, Duke, JAMA, Ophthalmology / 14.03.2014

Glenn Yiu, MD, PhD Duke Ophthalmology Duke University Medical CenterMedicalResearch.com Interview with: Glenn Yiu, MD, PhD Duke Ophthalmology Duke University Medical Center MedicalResearch.com:  What are the main findings of the study? Dr. Yiu: This paper reported a child who suffered injury to both eyes from a powerful blue laser pointer purchased via the internet from overseas. Our report reviews the scientific basis for laser injuries in eyes and the factors that may affect outcomes, such as power, wavelength, duration, and distance of exposure. Newer green and blue lasers, especially high-powered ones, may be more prone to inducing eye injuries. We summarized the clinical features of ocular laser injuries, methods of prevention, and discussed how consumer availability of high powered lasers may require careful federal regulations. (more…)
AHA Journals, Heart Disease, Karolinski Institute, Kidney Disease / 13.03.2014

Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden.MedicalResearch.com Interview with: Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden. MedicalResearch.com: What are the main findings of the study? Dr. Holzmann: The main finding is that patients with renal dysfunction are at increased risk of cardiovascular events after undergoing CABG for acute coronary syndromes. (more…)
Author Interviews, NEJM, Outcomes & Safety, Surgical Research / 13.03.2014

David R. Urbach, M.D From the Institute for Clinical Evaluative Sciences Department of Surgery Institute of Health Policy, Management and Evaluation University of Toronto, the University Health Network Toronto, ON M5G 2C4, CanadaMedicalResearch.com Interview with: David R. Urbach, M.D From the Institute for Clinical Evaluative Sciences Department of Surgery Institute of Health Policy, Management and Evaluation University of Toronto, the University Health Network Toronto, ON M5G 2C4, Canada MedicalResearch.com: What are the main findings of the study? Dr. Urbach: After surgical safety checklists were adopted by hospitals in Ontario, surgical outcomes—death after surgery, complications, length of stay, readmissions—did not improve substantially. (more…)
Author Interviews, Genetic Research, Mayo Clinic, Mental Health Research, Nature / 12.03.2014

MedicalResearch.com Interview with: Prof. Dr. Sven Cichon, PhD Director, Division of Medical Genetics University Hospital Basel Human Genomics Research Group Department of Biomedicine University of Basel Basel, Switzerland MedicalResearch.com: What were the main findings of the study? Answer: We have identified two new gene regions that represent pieces of the jigsaw puzzle of genetic and non-genetic factors that lead to the development of bipolar disorder. One is the gene ADCY2 (Adenylate Cyclase 2) which is involved in signal transmission within nerve cells. The other region comprises two genes, both presumably playing a role in neurodevelopmental processes (MIR2113 and POU3F2). Importantly, these results come out of the largest of these kinds of studies so far, involving altogether more than 24,000 people. (more…)
Author Interviews, Blood Pressure - Hypertension, Stroke / 12.03.2014

MedicalResearch.com Interview with: Dingli Xu, MD From Department of Cardiology Nanfang Hospital, Southern Medical University, Guangzhou, China MedicalResearch.com:  What are the main findings of the study? Answer：Our study showed that after controlling for multiple cardiovascular risk factors, the blood pressure range at 120-139/80-89 mm Hg (defined as ‘prehypertension’ in JNC 7), is significant associated with long-term risk of stroke. The results were consistent across stroke type, stroke endpoint, age, study characteristics, follow-up duration, and ethnicity. More importantly, even low-range prehypertension (BP 120-129/80-84mmHg) increased the risk of stroke compared with optimal BP (<120/80 mm Hg), and the risk was higher in individuals with high-range prehypertension (BP 130-139/85-85mmHg). In particular, we found that compared with individuals with optimal blood pressure individuals with low-range prehypertension were 44% more likely to develop stroke, and this risk was even greater (95%) in individuals with high-range prehypertension. (more…)
Author Interviews, BMJ, OBGYNE / 12.03.2014

MedicalResearch.com Interview with: Dr Josefin Vikström Division of Obstetrics and Gynecology Department of Clinical and Experimental Medicine Faculty of Health Sciences Linköping University, Linköping, Sweden MedicalResearch.com: What are the main findings of the study? Dr. Vikström: Our study showed that women with a female infertility factor were more than two times more likely to have been born with a low birth weight (less than 2500g) or small for gestational age compared to women where the cause of infertility was unknown and/or male. (more…)
Author Interviews, JAMA / 12.03.2014

Matthias Briel, MD, MSc Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital of Basel, Basel, Switzerland Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, CanadaMedicalResearch.com Interview with: Matthias Briel, MD, MSc Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital of Basel, Basel, Switzerland Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada  MedicalResearch.com: What are the main findings of the study? Dr. Briel: Using a retrospective cohort of 1017 randomized controlled trials (RCTs) based on archived protocols approved by six research ethics committees in Switzerland, Germany, and Canada between 2000 and 2003, we found that 25% of initiated RCTs were discontinued. While discontinuation was common with RCTs involving patients (28%), it was rare in RCTs with healthy volunteers (3%). The most commonly reported reason for RCT discontinuation was poor recruitment (10% of included RCTs). We found that trials with investigator sponsor (versus industry) and those with smaller planned sample sizes were at higher risk of discontinuation due to poor recruitment. Of discontinued RCTs, up to 60% remained unpublished. Trial investigators rarely informed research ethics committees about trial discontinuation and publication. (more…)
Author Interviews, JAMA, Pediatrics, Tobacco, UCSF / 12.03.2014

Lauren Dutra, ScD Postdoctoral Scholar, UCSF School of Medicine Cardiovascular Research Institute San Francisco, CA 94143MedicalResearch.com Interview with: Lauren Dutra, ScD Postdoctoral Scholar, UCSF School of Medicine Cardiovascular Research Institute San Francisco, CA 94143 MedicalResearch.com: What are the main findings of the study? Answer: Middle and high school students who used e-cigarettes were more likely to smoke tobacco cigarettes. They were also more likely to progress from experimenting with tobacco cigarettes to becoming regular smokers. Teen smokers who used e-cigarettes were more likely to be planning to quit in the next year and less likely to have abstained from smoking recently, compared to smokers who had never used e-cigarettes. They were also more likely to be heavier smokers (smoke more cigarettes per day) than those who had never tried e-cigarettes, that being said there are eliquids available that have no nicotine content whatsoever and these are therefore a much healthier option, you can see a wide variety of these at Gourmet E-Liquid. (more…)
Author Interviews, Cost of Health Care, Health Care Systems / 12.03.2014

MedicalResearch.com Interview with: Liane J. Tinsley, MPH Associate Research Scientist Department of Epidemiology New England Research Institutes, Inc. Watertown, MA 02472 MedicalResearch.com: What are the main findings of the study? Answer: For this study, we analyzed health insurance data from a cohort of community-dwelling individuals between the ages of 30-79 at baseline, in Boston, MA. Massachusetts health care reform legislation, including the expansion of Medicaid, resulted in substantial overall gains in coverage in our study population. Despite being targeted by the law, the working poor (those currently working for pay, either part- or full-time and earning less than 200% of the US federal poverty threshold for household size) continued to report lower rates of insurance coverage following reform (13.3% without insurance), compared to the both non-working poor (4.7% without insurance) and the not poor (5.0% without insurance). (more…)
Author Interviews, Inflammation, JAMA, Mental Health Research, PTSD / 12.03.2014

Dr. Dewleen Baker MD Veterans Affairs (VA) San Diego Healthcare System, San Diego, California MedicalResearch.com Interview with: Dr. Dewleen Baker MD Veterans Affairs (VA) San Diego Healthcare System, San Diego, California MedicalResearch.com: What are the main findings of the study? Dr. Baker: The main finding of this study is that a marker of peripheral inflammation, plasma CRP may be prospectively associated with PTSD symptom emergence, suggesting that inflammation may predispose to PTSD. (more…)
Author Interviews, Depression, Hearing Loss, JAMA / 12.03.2014

Dr. Chuan-Ming Li MD, PhD Statistician (Health/Medicine) Division of Scientific Programs The National Institute on Deafness and Other Communication DisordersMedicalResearch.com Interview with: Dr. Chuan-Ming Li MD, PhD Statistician (Health/Medicine) Division of Scientific Programs The National Institute on Deafness and Other Communication Disorders MedicalResearch.com: What are the main findings of the study? Dr. Chuan-Ming Li: We used data on adults 18 years or older from the National Health and Nutrition Examination Survey for the study and found that prevalence of moderate to severe depression was 4.9 percent for individuals who reported excellent hearing, 7.1 percent for those with good hearing and 11.4 percent for participants who reported having a little hearing trouble or greater hearing impairment (HI). Depression rates were higher in women than in men. The prevalence of depression increased as hearing impairment became worse, except among participants who were deaf. There was no association between self-reported HI and depression among people ages 70 years and older; however, an association between moderate HI measured by pure-tone threshold hearing exams and depression was found in women aged 70 years and older but not in men. (more…)
Alcohol, Author Interviews, BMJ, OBGYNE / 12.03.2014

Camilla Nykjaer, PhD Student School of Food Science and Nutrition University of Leeds, Leeds, UKMedicalResearch.com Interview with: Camilla Nykjaer, PhD Student School of Food Science and Nutrition University of Leeds, Leeds, UK   MedicalResearch.com: What are the main findings of the study? Answer: In our study, there was an association between the mother drinking alcohol during early pregnancy and being born preterm or small for gestational age. Babies of women who drank more than 2 units of alcohol per week in the first trimester were more likely to be born preterm, small for gestational age and with lower birth weight compared to non-drinkers, even after adjusting for a range of confounders including cotinine levels as a biomarker for smoking status. The association with preterm birth was present even in those mothers who reported drinking less than 2 units/week. (more…)
ALS, Author Interviews, JAMA, Radiology / 12.03.2014

Prof. Dr. Philip Van Damme, MD, PhD Neuromuscular Reference Center, Neurology Department, University Hospitals Leuven Vesalius Research Center, VIB, Leuven Leuven Institute of Neurodegenerative Disorders (LIND) KU Leuven, BelgiumMedicalResearch.com Interview with: Prof. Dr. Philip Van Damme, MD, PhD Neuromuscular Reference Center, Neurology Department, University Hospitals Leuven Vesalius Research Center, VIB, Leuven Leuven Institute of Neurodegenerative Disorders (LIND) KU Leuven, Belgium MedicalResearch.com: What are the main findings of the study? Prof: Van Damme: Earlier FDG-PET studies carried out in the 80’ties already pointed out that patients with ALS had decrease glucose uptake in the brain that is more extended than the motor cortex, at least at the group level. Of course, this imaging technique has been improved since then. We prospectively assessed the diagnostic and prognostic value of FDG-PET in patients that were referred to us because a diagnosis of ALS was suspected. The most important finding of our study probably is that FDG-PET shows perirolandic and variable frontotemporal hypometabolism in most patients with ALS at the first presentation in our clinic. It suggests that FDG-PET is a very sensitive marker of cerebral involvement in ALS, which has a high sensitivity at the single patient level. In addition our study revealed that the co-occurrence of extensive prefrontal or anterior temporal hypometabolism was present in about 10% of patients and had a negative effect on survival after disease onset. (more…)
Addiction, Opiods, Orthopedics, Pharmacology, Surgical Research / 11.03.2014

Brent J. Morris, M.D. Shoulder and Elbow Surgery Fellowship Texas Orthopaedic Hospital in affiliation with the University of Texas Houston Health Science Center, Houston, TexasMedicalResearch.com Interview with: Brent J. Morris, M.D. Shoulder and Elbow Surgery Fellowship Texas Orthopaedic Hospital in affiliation with the University of Texas Houston Health Science Center, Houston, Texas MedicalResearch.com: What are the main findings of the study?

 Dr. Morris: There are concerns that an increasing percentage of patients are receiving narcotics by “doctor shopping” or seeking narcotics from multiple providers. One in five of our postoperative orthopedic trauma patients received narcotics from one or more additional providers other than the treating surgeon. Patients that doctor-shopped postoperatively had a significant increase in narcotic prescriptions, duration of narcotics, and morphine equivalent dose per day. (more…)
Author Interviews, Diabetes, Emergency Care, JAMA / 11.03.2014

Andrew I. Geller, MD Medical Officer in the Division of Healthcare Quality Promotion at CDC.MedicalResearch.com Interview with: Andrew I. Geller, MD Medical Officer in the Division of Healthcare Quality Promotion at CDC. MedicalResearch.com: What are the main findings of the study? Dr. Geller: Using CDC’s national medication safety monitoring system, we estimated that, each year, there were about 100,000 visits made to U.S. emergency departments (EDs) for insulin-related hypoglycemia and errors during 2007-2011, or about half a million ED visits over the 5-year study period.  This is important because many of these ED visits for insulin-related hypoglycemia may be preventable. We also found these ED visits were more common with increasing age:  every year, 1 in 49 insulin-treated seniors (aged 65 years or older) visited the ED because of hypoglycemia while on insulin or because of a medication error related to insulin. Among the very elderly (aged 80 years or older), this number was 1 in 8 annually. (more…)
Author Interviews, BMJ, Mental Health Research, Pediatrics, Psychological Science / 11.03.2014

Mitch van Geel, PhD Institute of Education and Child Studies, Leiden University Leiden, the NetherlandsMedicalResearch.com Interview with: Mitch van Geel, PhD Institute of Education and Child Studies, Leiden University Leiden, the Netherlands MedicalResearch.com: What are the main findings of the study? Dr.van Geel: We performed a meta-analysis, which is a way to statistically summarize effect sizes from earlier studies. Individual studies often provide varying effect sizes, which makes it difficult to judge whether and how strong variables are related. Furthermore, study characteristics (sampling methods, response rates, controlling for certain confounders) might influence study results. By using a meta-analysis it can be analyzed to what extent study characteristics are related to results; if a particular result only tends to be established in studies with certain designs (for example a convenience sample), we might wonder whether such an effect really exists; but if we find that a particular outcome is unrelated to study characteristics or found in studies with relatively stronger designs, we might feel more certain in concluding that a relation between variables (bullying-suicide thoughts or attempts) exists. By using a meta-analysis we established a significant relation between bullying and thoughts about suicide, and bullying and suicide attempts, and we found that these results were unrelated to study characteristics. (more…)
Addiction, Author Interviews, CMAJ / 11.03.2014

MedicalResearch.com Interview with: Dr. Dagmar Haller, MD, PhD Médecin adjointe agrégée Unité Santé Jeunes Hôpitaux Universitaires de Genève Suisse MedicalResearch.com: What are the main findings of the study? Dr. Haller: One year after a consultation with a family doctor there was a 28% reduction in the proportion of excessive substance users among those who had reported excessive use at the start of the study but there was no significant difference between the group that received counseling and the one that did not. (more…)
Annals Thoracic Surgery, Author Interviews, NIH, Pulmonary Disease / 09.03.2014

Surya P Bhatt MD Assistant Professor Division of Pulmonary and Critical Care Medicine University of Alabama at BirminghamMedicalResearch.com Interview with: Surya P Bhatt MD Assistant Professor Division of Pulmonary and Critical Care Medicine University of Alabama at Birmingham MedicalResearch.com: What are the main findings of the study? Dr. Bhatt:  The forced vital capacity (FVC) maneuver is a difficult maneuver for many patients and the forced expiratory volume in the first 6 seconds (FEV6) has been shown to be a reliable substitute. We used imaging findings on computed tomography, COPD questionnaires and tests of exercise capacity to compare these two spirometric measures (FEV1/FVC and FEV/FEV6) in the diagnosis of airflow obstruction, and showed that FEV6 can be reliably substituted for FVC. Our findings suggest that using FEV6 may in fact identify more patients with disease than by using FVC. (more…)
Author Interviews, Hospital Acquired, Infections, NIH, Surgical Research, University of Pennsylvania, Wake Forest / 09.03.2014

William G Ward, Sr. MD Chair of Orthopaedic Surgery, Chief of Musculoskeletal Service Line - Guthrie Clinic One Guthrie Square Sayre, Pennsylvania 18840 (Professor Emeritus - Wake Forest University Dept of Orthopaedic Surgery)MedicalResearch.com Interview with: William G Ward, Sr. MD Chair of Orthopaedic Surgery, Chief of Musculoskeletal Service Line - Guthrie Clinic Sayre, Pennsylvania 18840 (Professor Emeritus - Wake Forest University Dept of Orthopaedic Surgery) MedicalResearch.com: What are the main findings of this study? Dr. Ward: The main findings of the study include:
  1. The use of disposable spun-lace “paper” gowns was associated with a dramatic decrease in the likelihood of culture-detected bacterial contamination on the surgeon’s gloved hand and gown sleeve.
  2. For a double-gloved surgeon, changing the outer glove just prior to implant handling should decrease bacterial contamination from the surgeon by about 50%.
  3. Bacteria suspended in saline solution transgressed the material of standard reusable scrub attire in 96% (26/27) of tested gowns and in 0% (0/27) of spun-lace disposable “paper” gowns. (more…)
Author Interviews, BMJ, Electronic Records / 07.03.2014

MedicalResearch.com Interview with: Stephanie Parks Taylor MD MS Associate Professor Director of Clinical Research Associate Division Director, Hospital Medicine USF Department of Internal Medicine MedicalResearch.com: What are the main findings of your study? Dr. Parks Taylor: The integration of electronic medical records has been proposed to have many benefits for the healthcare system. We investigated the effect of EMR implementation on communication between physicians and nurses in a hospital setting. The primary finding was that overall agreement about a patient's plan of care actually worsened after the implementation of EMR. This seemed to be related to a decrease in face-to-face communication between physicians and nurses. (more…)
Author Interviews, Blood Pressure - Hypertension, Nutrition, Weight Research / 06.03.2014

Beverly B. Green, MD, MPH GroupHealth Research Institute Seattle WAMedicalResearch.com Interview with: Beverly B. Green, MD, MPH GroupHealth Research Institute Seattle WA   MedicalResearch.com: What are the main findings of the study? Dr. Green: We found that Group Health patients who were overweight and had hypertension were more likely to have lost 10 pounds in six months if they had secure online access to a dietitian than if they received only information and usual care. The patients really loved this intervention—and having access to a dietitian to work with them toward a healthier lifestyle. Although blood pressure and heart risk trended lower in the intervention group, the differences weren’t significant—unlike their weight. (more…)
Author Interviews, BMJ, Nutrition / 06.03.2014

Dr James J DiNicolantonio PharmD Ithaca, New York MedicalResearch.com Interview with: Dr James J DiNicolantonio PharmD Ithaca, New York   MedicalResearch.com: What are the main findings of the study? Dr. DiNicolantonio:  The increase in the prevalence of diabetes and obesity in the United States occurred with an increase in the consumption of carbohydrate not saturated fat.  There is no conclusive proof that a low-fat diet has any positive effects on health (good or bad).  The public fear that saturated fat raises cholesterol is completely unfounded as the low-density lipoprotein (LDL) particle size distribution is worsened when fat is replaced with carbohydrate. A public health campaign is drastically needed to educate on the harms of a diet high in carbohydrate/sugar. (more…)
Author Interviews, BMJ, Outcomes & Safety, Surgical Research / 06.03.2014

MedicalResearch.com Interview with: Mr. Aneel Bhangu West Midlands Research Collaborative, Academic Department of Surgery Queen Elizabeth Hospital Birmingham UK MedicalResearch.com: What are the main findings of the study?  Mr. Bhangu:  Out study was based on a novel collaborative approach, spanning 95 centres in the UK. It was led by surgical trainees, who form a natural network and work in a rotational pattern. These networks will mature to allow a future of clinical research to be embedded into routine NHS care. Our study found no increase in complications based on weekend operating. It’s possible that patients present differently at weekends, or that surgeons select less complex patients to operate upon. A key secondary finding is that patients operated on at weekends were less likely to undergo laparoscopy. This means that they are exposed to different processes of care, which may introduce risk. This may be a surrogate marker for other differences in weekend care that require exploration. (more…)
Author Interviews, BMJ, General Medicine, Outcomes & Safety / 06.03.2014

Karen Yeung Professor of Law Centre for Technology, Ethics Law & Society King's College London London WC2R 2LSMedicalResearch.com Interview with: Karen Yeung Professor of Law Centre for Technology, Ethics Law & Society King's College London London WC2R 2LS MedicalResearch.com: What are the main findings of the study? Professor Yeung: This study found a gap in existing legal regulation of healthcare quality in the UK.  While patients receiving treatment under mental health legislation are protected by the criminal law against wilful neglect or ill treatment, other patients are not subject to the same level of protection, although many such patients are just as vulnerable as those who are mentally incapacitated.  Hence we argue that a new criminal offence of 'wilful neglect or ill treatment' of patients in the healthcare sector is needed. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, Genetic Research, University of Pennsylvania / 05.03.2014

MedicalResearch.com Interview with: Brendan Keating D.Phil Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania Lead Clinical Data Analyst, Center for Applied Genomics Children's Hospital of Philadelphia,Brendan Keating D.Phil Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania Lead Clinical Data Analyst, Center for Applied Genomics Children's Hospital of Philadelphia Michael V. Holmes, MD, PhD, MSc, BSc, MRCP Transplant Surgery Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USAMichael V. Holmes, MD, PhD, MSc, BSc, MRCP Transplant Surgery Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA MedicalResearch.com: What are the main findings of the study? Answer: We found that individuals with a genetically-elevated BMI had higher blood pressure, inflammatory markers, metabolic markers and a higher risk of type 2 diabetes, although there was little correlation with coronary heart disease in this study population of over 34,500 European-descent individuals of whom over 6,000 had coronary heart disease. (more…)
Author Interviews, BMJ, Nutrition, OBGYNE / 05.03.2014

MedicalResearch.com Interview with: Dr Linda Englund-Ögge Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Sahlgrenska Academy, Sahlgrenska University Hospital Gothenburg, SwedenDr Linda Englund-Ögge Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Sahlgrenska Academy, Sahlgrenska University Hospital Gothenburg, Sweden MedicalResearch.com: What are the main findings of the study? Answer: Women adhering to a prudent* or a traditional** dietary pattern during pregnancy had a significantly reduced risk of preterm delivery, even after adjusting for a range of confounders. The prudent pattern was also significantly associated to lower risk in the nulliparous, in spontaneous and in late preterm delivery. *, characterized by high intake of e.g. vegetables, fruit, whole grains and water to drink. **, characterized by high intake of e.g. boiled potatoes, fish and cooked vegetables. (more…)
Author Interviews, BMJ, Cancer Research, Chemotherapy, End of Life Care / 05.03.2014

Holly G. Prigerson, Ph.D. Irving Sherwood Wright Professor in Geriatrics Professor of Sociology in Medicine Co-Director, Center for End-of-Life Research Weill Cornell Medical College New York Presbyterian Hospital New York City, New York 10065MedicalResearch.com Interview with: Holly G. Prigerson, Ph.D. Irving Sherwood Wright Professor in Geriatrics Professor of Sociology in Medicine Co-Director, Center for End-of-Life Research Weill Cornell Medical College New York Presbyterian Hospital New York City, New York 10065 MedicalResearch.com: What are the main findings of the study? Dr. Prigerson: The main outcome of the research was end-of-life treatment and location of death with secondary outcomes being length of survival, late hospice referrals and attainment of preferred place of death. We found that 56 percent of patients receiving palliative chemotherapy in their final months.  Patients treated with palliative chemotherapy were five to 10 times more likely to receive intensive medical care and to die in an intensive care unit (ICU). Fewer than half died at home as compared with two-thirds of patients with metastatic cancer not treated with palliative chemotherapy. More specifically, we found that palliative chemotherapy was associated with:
  • Increased use of CPR and mechanical ventilation: 14% versus 2%
  • Late hospice referral: 54% versus 37%
  • Death in an ICU: 11% versus 2%
  • Death away from home: 47% versus 66%
  • Death away from their preferred place: 65% versus 80%
Survival did not differ significantly between patients who received palliative chemotherapy and those who did not (hazard ratio 1.11, 95% CI 0.90-1.38). Additionally, patients receiving palliative chemotherapy were less likely to acknowledge their illness as terminal (35% versus 49%, P=0.04), to have discussed end-of-life wishes with a physician (37% versus 48%, P=0.03), and to have completed a do-not-resuscitate order (36% versus 49%, P<0.05). (more…)
Author Interviews, BMJ, Cancer Research, HPV, Vaccine Studies / 05.03.2014

MedicalResearch.com Interview with: Dr Julia Brotherton Victorian Cytology Service, Melbourne, Victoria, Australia Dr Elizabeth Crowe The University of Queensland, School of Population Health, Brisbane, Australia NHS Borders, Department of Public Health, Melrose, Scotland, UK Prof. David Whiteman Group Leader / Department Coordinator QIMR Berghofer Medical Research Institute Royal Brisbane Hospital, QLD 4029 MedicalResearch.com: What are the main findings of the study? 1.       We conducted a case-control study in which we retrieved the HPV vaccination histories of young Australian women who were notified to the Pap smear registry with high-grade cervical lesions or with other types of cervical lesions, and compared them with the vaccination histories of women whose Pap smears showed only normal cytology. 2.       We found that women with high grade cervical lesions were significantly less likely than women with normal cytology to have received 3 doses of the quadrivalent HPV vaccine, equivalent to a vaccine effectiveness of 46%. 3.       The vaccine effectiveness among 15-19 year old women was even higher at 57%. We believe this reflects the fact that HPV16 causes an even higher proportion of high grade disease in young women due to its higher oncogenicity and shorter latent period. 4.       The HPV vaccine had 34% effectiveness against other cervical lesions (i.e. those not proven to be high grade lesions on histology). 5.       We also observed that 2 doses of the vaccine were 21% effective in preventing both high grade lesions and other grade lesions. (more…)