Author Interviews, Weight Research / 24.07.2013

MedicalResearch.com Interview with: Maya Leventer-Roberts, MD, MPH Fellow Trainee Department of Preventive Medicine Mount Sinai School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Leventer-Roberts: Overweight status among medical and surgical residents is more likely by increasing PGY of training. Overweight residents are also unlikely to acknowledge their overweight status. These changes can differ significantly from matched controls and may affect long-term health. (more…)
Author Interviews, Cannabis, Lancet, Multiple Sclerosis, Neurological Disorders / 24.07.2013

Professor John Zajicek Professor of Clinical Neuroscience, Centre for Clinical Trials & Health Research - Translational & Stratified Medicine (Peninsula Schools of Medicine and DentistrMedicalResearch.com Interview with: Professor John Zajicek Professor of Clinical Neuroscience, Centre for Clinical Trials & Health Research - Translational & Stratified Medicine (Peninsula Schools of Medicine and Dentistry) MedicalResearch.com: What are the main findings of the study? Prof. Zajicek: Our study investigated whether dronabinol (one of the major active ingredients of cannabis) may slow the progression of multiple sclerosis. We currently have no treatments that are effective in modifying the disease course in people with either primary or secondary MS. We did a clinical trial across the UK involving nearly 500 patients, who were randomly allocated to dronabinol or placebo, and followed them up for three years to look at progression on rates. Overall we failed to find an effect of dronabinol on disease progression,  either clinically (using a variety of clinical measures) or using magnetic resonance imaging (MRI). There was a suggestion of an effect in people with the least disability (who didn't need a stick to help them walk), and there were no major problems with serious side effects.  However, over all the population that took part in the study also progressed less than we expected, which reduced our chances of finding an effect of treatment. The  study was not designed to investigate an effect on MS-related symptoms (such as pain and muscle stiffness), which have been investigated before. (more…)
Author Interviews, Diabetes, Disability Research / 23.07.2013

MedicalResearch.com Interview with: Abigail Franklin Vice President for Development & Communications The New York Academy of Medicine MedicalResearch.com: What are the main findings of the study? Answer: The New York State Department of Health (NYSDOH) Overweight and Obesity Brief was derived from information gathered for the NYS Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is an annual statewide telephone survey of adults administered by the provide information on behaviors, risk factors, and utilization of preventive services. The survey conducted in 2011 found that nearly 25% of adults in NYS are obese and another 36% overweight. It also found that obesity rates are higher among adults who are Black (32.5%), earn an annual household income less than $25,000 (26.8%), have less than a college education (27.1%), or are currently living with a disability (34.9%). These findings bring to light that social and economic factors in our communities can be a major contributor to health disparities, like greater risk of obesity among people of color, low income individuals, and people who are disabled. (more…)
Author Interviews, Cost of Health Care, Medicare, Outcomes & Safety / 23.07.2013

MedicalResearch.com Interview with: Alai Tan, MD, PhD Assistant Professor, Dept. of Preventive Medicine & Community Health Sr. Biostatistician, Sealy Center on Aging Univerisity of Texas Medical Branch 301 University Blvd., Galveston, TX  77555-0177 MedicalResearch.com: What are the main findings of the study? Dr. Tan: The study developed and validated sex-specific Cox proportional-hazards models with predictors of age and comorbidities to predict patient life expectancy using Medicare claims data. The predictive model was well-calibrated and showed good predictive discrimination for risk of mortality between 5 and 10 years. (more…)
Author Interviews, Mayo Clinic, Outcomes & Safety / 23.07.2013

MedicalResearch.com Interview with Dr. Vinay Prasad, MD Medical Oncology Branch, National Cancer Institute National Institutes of Health, 10 Center Dr 10/12N226, Bethesda, MD20892. MedicalResearch.com: What are the main findings of the study? Dr. Prasad: We reviewed all original articles in the New England Journal of Medicine over ten years.  1344 articles tested some medical practice-- which is a screening or diagnostic test, medication, procedure or surgery.  Only 27% or 363 articles tested current medical practice.  And of these articles 146 (40%) contradicted current standard of care, constituting a medical reversal. (more…)
Author Interviews, Blood Pressure - Hypertension / 23.07.2013

MedicalResearch.com Interview with: Igor F. Tsigelny, Ph.D. Department of Neurosciences, University of California at San Diego San Diego Supercomputer Center, University of California at San Diego Moores Cancer Center, University of California at San Diego La Jolla, California 92093 MedicalResearch.com: What are the main findings of the study? Dr. Tsigelny: We find a new set of possible very effective drug-candidates for cure of hypertension.  According to our preliminary testing these molecules are not toxic and can start a new series of drugs. (more…)
Anesthesiology, Author Interviews, Duke, Pain Research / 21.07.2013

Ru-Rong Ji, PhD Professor, Chief of Pain Research Department of Anesthesiology and Neurobiology Duke University Medical Center Durham, NC 27710MedicalResearch.com Interview with: Ru-Rong Ji, PhD Professor, Chief of Pain Research Department of Anesthesiology and Neurobiology Duke University Medical Center Durham, NC 27710 Neuroprotectin/Protectin D1 protects neuropathic pain in mice after nerve trauma MedicalResearch.com: What are the main findings of the study? Answer: We found the pro-resolution lipid mediator protectin D1 (PD1), derived from the fish oil DHA, can effectively prevent nerve injury-induced neuropathic pain. This treatment can also prevent nerve injury-induced neuroinflammation in the spinal cord (such as glial activation and expression of cytokines and chemokines, e.g., IL-1b, CCL2). These cytokines and chemokines are known to elicit pain. (more…)
Author Interviews, Cost of Health Care, OBGYNE / 19.07.2013

MedicalResearch.com Interview with: Robert E. Garfield, PhD Department of Perinatology, Division of Obstetrics and Gynecology University Medical Centre Ljubljana, Slovenia Costs of Unnecessary Admissions and Treatments for “Threatened Preterm Labor” MedicalResearch.com :What are the main findings of the study? Dr. Garfield: Unnecessary admissions and treatments for “threatened preterm labor” are still part of everyday clinical practice and contribute to exploding healthcare costs. This happens despite substantial evidence that measuring CL by trans-vaginal ultrasound can help to avoid needless interventions due to the high negative predictive values of this test. (more…)
Author Interviews, Diabetes, Johns Hopkins, Weight Research / 19.07.2013

MedicalResearch.com Interview with: Nisa M. Maruthur, MD, MHS Assistant Professor of Medicine & Epidemiology The Johns Hopkins University Early Response to Preventive Strategies in the Diabetes Prevention Program MedicalResearch.com: What are the main findings of the study? Dr. Maruther: For patients engaged in a lifestyle intervention to prevent diabetes, weight loss early on (at 6 months) is an extremely strong predictor of whether they will develop diabetes down the road.  Even in the setting of substantial weight loss (>10%) at 6 months, it is still beneficial to lower fasting glucose.  These results are unique in that we previously understood that weight loss over time (years) is important to prevent diabetes, but now we know the impact of early weight loss on longer-term diabetes risk. (more…)
Author Interviews, Heart Disease, OBGYNE / 18.07.2013

MedicalResearch.com Interview with Prof. Eyal Sheiner MD PhD Senior Obstetrician

Soroka Medical Center, Israel

MedicalResearch.com: What are the main findings of the study? Dr. Sheiner: The study was aimed to investigate whether a history of preterm delivery (PTD) poses a risk for subsequent maternal long-term cardiovascular morbidity. During the study period 47,908 women met the inclusion criteria; 12.5% (n=5992) patients delivered preterm. During a follow-up period of more than ten years, patients with PTD had higher rates of simple as well as complex cardiovascular events and higher rate of total cardiovascular related hospitalizations. A linear association was found between the number of previous PTD and future risk for cardiovascular hospitalizations (5.5% for two or more PTD, 5.0% for one PTD vs. 3.5% in the comparison group; P<0.001). The association remained significant for spontaneous vs. induced PTD and for early (<34 weeks) as well as late (34-36+6 weeks) PTD. In a Cox proportional hazards model that adjusted for pregnancy confounders such as labor induction, diabetes mellitus, preeclampsia and obesity, PTD was independently associated with cardiovascular hospitalizations (adjusted HR 1.4, 95% CI 1.2-1.6). (more…)
Author Interviews, Duke, Fish, Nutrition, Pain Research / 18.07.2013

MedicalResearch.com Interview with: Ru-Rong Ji, PhD Professor, Chief of Pain Research Department of Anesthesiology and Neurobiology Duke University Medical Center Box DUMC 3094, Durham , NC 27710 MedicalResearch.com: What are the main findings of the study? Answer: We found the pro-resolution lipid mediator protectin D1 (PD1), derived from the fish oil DHA, can effectively prevent nerve injury-induced neuropathic pain. This treatment can also prevent nerve injury-induced neuroinflammation in the spinal cord (such as glial activation and expression of cytokines and chemokines, e.g., IL-1b, CCL2). These cytokines and chemokines are known to elicit pain. (more…)
Author Interviews, Biomarkers, Heart Disease / 18.07.2013

Dr Nicholas D Gollop BSc (Hons) MB BCh Norfolk and Norwich University Hospital, Norwich, NR4 7UY Norfolk, United KingdomInterview with: Dr Nicholas D Gollop BSc (Hons) MB BCh Norfolk and Norwich University Hospital, Norwich, NR4 7UY Norfolk, United Kingdom     MedicalResearch.com: What are the main findings of the study? We completed a best evidence topic in interventional cardiac surgery to investigate the significance of elevated markers of cardiac damage following percutaneous coronary intervention (PCI). We compared the clinical and prognostic relevance of the elevation of creatinine kinase-myocardial band (CK-MB) and cardiac troponin (cTn) levels during peri-procedural period and post-procedural period, respectively, following an emergency or elective PCI. We found in excess of 390 papers after a systematic literature search, of which 10 represented the best evidence to answer the clinical question. From the best evidence available we showed that the monitoring of cardiac biomarkers following PCI can provide important clinical information about the health of the myocardium, as well as prognostic information on short to mid-term outcomes of mortality up to 3 years. (more…)
Author Interviews, Cleveland Clinic, Heart Disease, Surgical Research / 17.07.2013

MedicalResearch.com Interview with Dr. Frank Sellke, MD Chief of cardiothoracic surgery and co-director of the Cardiovascular Institute at Rhode Island, The Miriam and Newport hospitals MedicalResearch.com: What are the main findings of the study? Dr. Sellke: The main findings of the study are that outcomes of repair of an ascending aortic dissection are improved under a full moon compared to other phases of the moon. This was with regard to both mortality and length of hospital stay. Interestingly, there was no correlation with season of the year. (more…)
Author Interviews, Blood Pressure - Hypertension, Pediatrics / 17.07.2013

Dr. Bernard Rosner Harvard School of Public Health Professor in the Department of Biostatistics Department of Biostatistics Channing Laboratory 180 Longwood Avenue Boston, Massachusetts 02115MedicalResearch.com Interview with: Dr. Bernard Rosner Harvard School of Public Health Professor in the Department of Biostatistics Department of Biostatistics Channing Laboratory 180 Longwood Avenue Boston, Massachusetts 02115 MedicalResearch.com: What are the Main Findings of this study? Dr. Rosner: The risk of elevated blood pressure (BP) among children has increased 27% over a 13-year period based on a study among 11,636 children ages 8-17 seen in the NHANES study from 1988-2008. In NHANES III (1988-1994) the risk was 15.8% among boys and 8.2% among girls. In NHANES 1999-2008 (1999-2008) the risk was 19.2% among boys and 12.6% among girls. Important risk factors for elevated BP were BMI, waist-circumference and sodium intake. Risk approximately doubled for children in the highest age-sex-specific quartile of BMI vs. children in the lowest quartile Risk approximately doubled for children in the highest age-sex-specific quartile of waist circumference vs. children in the lowest quartile Risk increased 36% among children with dietary Na intake > 3450 mg/day vs. children with intake <2300 mg/day. Na intake was normalized per 2000 calories. There were large increases in both mean BMI and mean waist circumference over the 13-year period, especially for girls. (more…)
Author Interviews, Ophthalmology / 17.07.2013

Chiu-Fang Chou DrPH Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion CDC, 4770 Buford Hwy, NE (K-10) Atlanta GA 30341-3727MedicalResearch.com Interview with: Chiu-Fang Chou DrPH Division of Diabetes Translation National Center for Chronic Disease Prevention and Health Promotion CDC, 4770 Buford Hwy, NE (K-10) Atlanta GA 30341-3727 MedicalResearch.com: What are the main findings of the study? A: We estimated nearly 9 million people aged 40 years and older are visually impaired using the National Health and Nutrition Examination Survey. Three out of every four people aged 40 years and older with VI have uncorrected refractive error that could be easily corrected with simple glasses or contact lenses. The ocular disease most associated with visual impairment in our study sample was age-related macular degeneration. Finally, increasing age and low educational attainment were significant predictors of visual impairment. (more…)
Artificial Sweeteners, Author Interviews, Nutrition, Weight Research / 16.07.2013

Professor, Behavioral Neuroscience Department of Psychological Sciences and Ingestive Behavior Research Center Purdue University, 703 Third Street West Lafayette, IN 47907, USAMedicalResearch.com Interview with: Susan E. Swithers PhD Professor, Behavioral Neuroscience Department of Psychological Sciences and Ingestive Behavior Research Center Purdue University, 703 Third Street West Lafayette, IN 47907, USA MedicalResearch.com: What are the main findings of the study? Dr. Swithers: The paper examined the last 5 years of studies that looked at risks associated with consuming artificially sweetened beverages like diet soda. These studies indicated that those who consume diet soda were at significantly greater risk for a variety of negative health outcomes like type 2 diabetes, coronary heart disease, hypertension and stroke, along with being more likely to gain excess weight. These effects might be due to a disruption of basic learned response.  The idea is that normally things when things that taste sweet are consumed, the body receives calories and sugar. Our bodies can learn to prepare to deal with these calories and this sugar by starting up our digestive processes as soon as the sweet taste hits our mouth, for example by releasing hormones that not only help us regulate blood sugar, but also can contribute to feelings of fullness. When we consume diet sodas, the mouth gets the sweet taste, but the body doesn't get the calories or the sugar. The body may then learn that a sweet taste in the mouth doesn't always predict sugar and calories, so it makes adjustments in how many hormones it releases. So when we actually consume real sugar, the body doesn't produce the same kinds of physiological responses, which can lead to overeating, higher blood sugar, and over the long term could contribute to diseases like diabetes and stroke. (more…)
Author Interviews, JAMA, Surgical Research / 15.07.2013

Aneel Bhangu, MBChB, MRCS and Douglas M. Bowley, FRCS Royal Centre for Defense Medicine, Birmingham, EnglandMedicalResearch.com Interview with: Aneel Bhangu, MBChB, MRCS and Douglas M. Bowley, FRCS Royal Centre for Defense Medicine, Birmingham, England MedicalResearch.com: What are the main findings of the study?  Answer: Our study was a meta-analysis, which combined the findings from 8 randomized controlled trials that included a total of 623 patients. The key finding was that delayed primary skin closure (DPC) for contaminated and dirty abdominal incisions may reduce the rate of surgical site infection. However, due to high risk of bias from the included studies, including flaws in study design, definitive evidence is lacking. We believe that this meta-analysis represents an exciting development in biomedical publishing; this was a true collaboration between US and UK military surgeons to examine an area of major concern and interest to surgeons everywhere. This work uses experience hard-won on the battlefields of Iraq and Afghanistan, combined with published surgical trials, to inform both future research activity as well as military and civilian surgical practice. This cross-fertilization of ideas is one positive consequence of all the sacrifice and suffering of recent conflicts. (more…)
Author Interviews, Ophthalmology / 15.07.2013

Michael Belkin, MA, MD Professor of Ophthalmology Director, Ophthalmic Technologies Laboratory Goldschleger Eye Research Institute Tel Aviv University Sheba Medical Center Tel Hashomer 52621 IsraelMedicalResearch.com Interview with: Michael Belkin, MA, MD Professor of Ophthalmology Director, Ophthalmic Technologies Laboratory Goldschleger Eye Research Institute Tel Aviv University Sheba Medical Center Tel Hashomer 52621 Israel MedicalResearch.com: What are the main findings of the study? Dr. Belkin: Modern ophthalmic treatment, when freely available is able to reduce the incidence of blindness, and presumably visual impairment considerably. In Israel the rate of new cases of blindness per 100.000 people [age adjusted] was reduced between 1999 and 2010 from 33.8 to 14.8, i.e., by over 56%. The reduction was in all major causes of blindness, Age-related Macular Degeneration (AMD), Glaucoma, Diabetic Retinopathy and Cataract. In the non-treatable retinal dystrophies such as retinitis pigmentosa, there was no significant changes over this period. (more…)
Author Interviews, Diabetes, Infections, JAMA, Respiratory / 15.07.2013

Andreas Beyerlein, PhD Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, GermanyMedicalResearch.com Interview with: Andreas Beyerlein, PhD Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, Germany MedicalResearch.com What are the main findings of the study? Dr. Beyerlein: We identified respiratory infections in early childhood, especially in the first year of life, as a risk factor for islet autoimmunity, which is known as a precursor of type 1 diabetes (T1D). We also found some evidence for short term effects of infectious events on development of autoimmunity. (more…)
Author Interviews, Orthopedics / 12.07.2013

obesity and living kidney donationMedicalResearch.com Interview with: Mark V. Paterno PT, PhD, MBA, SCS, ATC Coordinator of Orthopaedic and Sports Physical Therapy Associate Professor, Sports Medicine Biodynamics Center Acting Scientific Director, Division of Occupational Therapy and Physical Therapy Cincinnati Children's Hospital Medical Center 3333 Burnet Ave. MLC 10001 Cincinnati, OH 45229-3039 MedicalResearch.com: What are the main findings of the study? Dr. Paterno: Our study suggests that young patients (average age 16 y/o) who return to pivoting and cutting sports after Anterior cruciate ligament (ACL) reconstruction are 6 times more likely to suffer a second ACL injury than an individual with no prior history of ACL injury.  In addition, females after ACL reconstruction may be more likely to injury their opposite limb than actually re-injure the same limb they initially hurt.  Finally, when you look at the results of this 2 year outcome study in conjunction with the 1 year outcomes we published last year, it would appear that the greatest risk of suffering a second ACL injury is within the first several months after returning to sports. (more…)
Author Interviews, Heart Disease / 11.07.2013

MedicalResearch.com Interview with: Andrew Brenyo MD Electrophysiologist Greenville University Health System Greenville SC MedicalResearch.com: What are the main findings of the study? Dr. Brenyo: We found that BNP values at the time of CRT implant and during follow up predict response to CRT and subsequent risk of heart failure admission and death. BNP at implant and at subsequent times was strongly correlated with echocardiographic response to CRT-D along with predicting clinical outcome. (more…)
Author Interviews, Diabetes, JAMA, Nutrition, Pediatrics / 11.07.2013

MedicalResearch.com Interview with Jill M. Norris, MPH, PhD Colorado School of Public Health, University of Colorado, Aurora MedicalResearch.com: What were the most significant findings? How do they relate to what was already known about this subject? Dr. Norris: One of the most intriguing findings is that if mothers are still breast-feeding when they introduce gluten-containing foods to their baby, they may reduce the risk for T1D.  This is similar to a finding from a Swedish study that found that breast-feeding while introducing gluten-containing foods may reduce the risk for celiac disease, an autoimmune condition that has several similarities with T1D. In children at increased genetic risk for T1D, our data suggest that parents should wait to introduce any solid foods until after the 4 month birthday.  And when the baby is ready, solid foods should be introduced by the 6 months birthday or soon thereafter, preferably while the mother is still breast-feeding the baby, which may reduce the risk of T1D. (more…)
Author Interviews, Cost of Health Care, JAMA / 10.07.2013

MedicalResearch.com Interview with: Ann M. Sheehy, M.D., M.S. Associate Professor Division Head, Hospital Medicine University of Wisconsin Department of Medicine Ann M. Sheehy, M.D., M.S. Associate Professor Division Head, Hospital Medicine University of Wisconsin Department of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Sheehy: There were three main findings of our study. First, we found that observation in clinical practice is very different from the CMS definition of observation. CMS states that observation should rarely last longer than 48 hours, yet 16.5% of our observation encounters lasted longer than 48 hours. CMS also states that observation care is “well-defined”. We found there were 1141 distinct observation codes for our 4578 observation encounters, indicating that observation care is not well defined. Second, we found that observation care disproportionately affects the general medicine population, as over half of our observation encounters were on the general medicine services. These patients also had longer length of stay, were older, more likely to be female, were more likely to need discharge to a skilled facility, and were more likely to have government insurance as compared to patients on other services. This indicates that observation care adversely affects the adult general medicine population more than other patients on other types of services. Finally, we found that observation cost was greater than reimbursement, resulting in a net negative financial margin. (more…)
Asthma, Author Interviews, Duke, Genetic Research, Lancet, NEJM / 10.07.2013

Daniel Belsky, PhD NIA Postdoctoral Fellow Center for the Study of Aging and Human Development Duke UniversityMedicalResearch.com Interview with: Daniel Belsky, PhD NIA Postdoctoral Fellow Center for the Study of Aging and Human Development Duke University Polygenic risk and the development and course of asthma: an analysis of data from a four-decade longitudinal study MedicalResearch.com: What are the main findings of the study? Dr. Belsky : We looked to the largest-ever genome-wide association study of asthma (that study by the GABRIEL Consortium included more than 26,000 individuals) to identify genetic variants that could be used to construct a genetic profile of asthma risk. We then turned to The Dunedin Multidisciplinary Health and Development Study, a unique cohort of 1,000 individuals who have been followed from birth through their fourth decade of life with extensive measurements of asthma and related traits. We computed a “genetic risk score” for each person based on the variants identified in GWAS.  Then, we looked at who developed asthma, when they developed asthma, and what that asthma looked like in terms of allergic response and impaired lung function. What we found: (1) People with higher genetic risk scores were more likely to develop asthma and they developed asthma earlier in life. (2) Among children who developed asthma, the ones at higher genetic risk were more likely to have persistent asthma through midlife. (3) Genetic risk was specifically associated with allergic asthma that resulted in chronic symptoms of impaired lung function. (4) People with higher genetic risk score developed more severe cases of asthma. As compared to people with a lower genetic risk, they were more often absent from school and work because of asthma and they were more likely to be hospitalized for asthma. (5) The genetic risk score provided new information about asthma risk that could not be obtained from a family history. (more…)
Author Interviews, Cancer Research, JAMA, Nutrition, Prostate Cancer / 10.07.2013

Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology University of Illinois at Chicago College of Medicine Chicago, IL 60612MedicalResearch.com Interview with: Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology University of Illinois at Chicago College of Medicine Chicago, IL  60612 MedicalResearch.com: What are the main findings of the study? Dr. Bosland: Daily consumption of a supplement containing soy protein isolate for two years following radical prostatectomy did not reduce recurrence of prostate cancer in men at high risk for this (radical prostatectomy is surgical removal of the prostate to treat prostate cancer). The study showed that this soy supplementation was safe. It is not clear whether this result indicates that soy does not prevent the development of prostate cancer, but men that have the disease probably do not benefit from soy supplementation. (more…)
Author Interviews, Diabetes, Diabetologia, Heart Disease, Race/Ethnic Diversity / 09.07.2013

MedicalResearch.com Interview with: Dr Nazim Ghouri MBChB, MRCP UK Specialty Registrar (Diabetes/Endocrinology/GIM) and Honorary Clinical Lecturer Institute of Cardiovascular and Medical Sciences BHF Glasgow Cardiovascular Research Centre University of Glasgow Glasgow G12 8TA Lower cardiorespiratory fitness contributes to increased insulin resistance and fasting glycaemia in middle-aged South Asian compared with European men living in the UK MedicalResearch.com: What are the main findings of the study? Answer: In this study we aimed to determine the extent to which increased insulin resistance and blood sugar levels in South Asian men, compared to white European men, living in the UK, was due to lower fitness and physical activity levels. We studied 100 South Asian and 100 European men aged 40-70 years living in Scotland without diagnosed diabetes and measured their blood sugar levels, insulin resistance and other risk factors. The men also undertook a treadmill exercise test to determine how much oxygen their bodies were able to use during intense exercise – a key measure of physical fitness, wore accelerometers for a week to assess their physical activity levels, and had a detailed assessment of their body size and composition. Statistical modeling was then used to determine the extent to which body size and composition, fitness and physical activity variables explained differences in insulin resistance and blood sugar between South Asians and Europeans. The results suggested that lower fitness, together with greater body fat in South Asians, explained over 80 per cent of their increased insulin resistance compared to white men with Low fitness being the single most important factor associated with the increased insulin resistance and blood sugar levels in middle-aged South Asian compared to European men living in the UK. (more…)
Author Interviews, Diabetes, Frailty, Lancet / 09.07.2013

MedicalResearch.com Interview with: Dr David Strain, MRCP MD Clinical senior lecturer and honorary consultant University of Exeter Medical School Institute of Biomedical and Clinical Science Department of Diabetes and Vascular Research Royal Devon & Exeter Hospital Exeter EX2 5AX MedicalResearch.com: What is the Background of the study? In early 2010 recent diabetes outcome trials such as ACCORD and ADVANCE had put into question the benefit of aggressive HbA1c reduction for all patients particularly in elderly population. After that there were several guidelines that suggested individualizing treatment targets for elderly patients according to their age, co-morbidities, frailty and baseline HbA1c. This featured in the Finnish guidelines and the European Working Party for the management of Diabetes in the Older Person. However this was also completely without any evidence base. I worked with Paivi Paldanius (the final author of the paper and a medical advisor for Novartis) to establish a pragmatic study. We both acknowledged the importance of having a patient-centric, pragmatic and 'real-life' approach and as there was already evidence that DPP-4 inhibitors, in this case vildagliptin (due to Päivi's affiliation), had demonstrated it's efficacious and had no tolerability issues in the elderly population we decided to go ahead with the study. It was obvious that we needed to implement a holistic approach and take into account as many clinically relevant parameters as possible, such as age, baseline HbA1c, duration of the disease, co-morbidities and frailty, for implementation of the individualized care. Our primary goal was to request that the physicians acting as investigators would still apply their clinical judgment based on these clinical features of each individual patient but also, follow their local guidelines as in their daily clinical practice. This would later provide us with invaluable information and perspective when interpreting the data and recommending implementation of the results.  For assessment of frailty we screened for many different methodologies but Prof Timo Strandberg (known expert of the field and mentioned in the acknowledgements section of our paper) suggested to apply modified Linda Fried's method for assessment of phenotype of frailty as this method is validated, very pragmatic, reproducible and also feasible to be used for the first time also by a non-geriatric investigator. All investigators were trained to follow these parameters by the protocol. We also wished to evaluate in parallel the conventional HbA1c drop assessment in order to be able to put the potential success of our new endpoint, meeting the individualized target, into perspective and for comparison against other standard data from other studies with DPP-4 inhibitors with elderly. We also wished to simulate a clinical, real-world setting as much as possible and included patients who would seem representative of most elderly T2DM patients. (more…)
Author Interviews, Frailty, Surgical Research / 09.07.2013

MedicalResearch.com Interview with Kenneth Ogan MD Department of Urology Emory University School of Medicine 1365 Clifton Rd. NE, Building B, Suite 1400 Atlanta, Georgia 30322 MedicalResearch.com: What are the main findings of the study? Dr. Ogan: Surgical risk assessment is traditionally a very subjective process, and an evaluation that more accurately measures a patient’s physiologic reserve would greatly aid in surgical decision making. In this study we sought to further characterize frailty as an objective risk assessment tool in surgical patients. We prospectively measured the five component frailty criteria described by Fried et al.1 (weight loss, exhaustion, low activity, grip strength, and gait speed).  Patients deemed “intermediately frail” and “frail” had twice the likelihood of experiencing any complication in the 30-day post-operative period. (more…)
Author Interviews, Cancer Research, CT Scanning, Heart Disease, JACC, Lung Cancer, Medical Imaging / 08.07.2013

Dr. Pim A. de Jong, Department of Radiology University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3508GA Utrecht, the Netherlands. MedicalResearch.com: What are the main findings of the study? Dr. de Jong: The main findings of the study is that lung cancer screening CT scans can predict future cardiovascular events. MedicalResearch.com: Where any of the findings unexpected? Dr. de Jong: The unexpected aspect is that the CT scans were not-ECG gated, but even these non-gated scans were good enough to quantify arterial calcifications and predict risk. (more…)