Diabetes / 23.05.2014

Nitesh D. Kuhadiya MD, MPH Assistant Professor of Medicine Section of Endocrinology,Diabetes and Metabolism University of Buffalo, New YorkMedicalResearch.com Interview with: Nitesh D. Kuhadiya MD, MPH Assistant Professor of Medicine Section of Endocrinology,Diabetes and Metabolism University of Buffalo, New York MedicalResearch: What are the main findings of the study? Dr. Kuhadiya: This is the first randomized clinical trial to show that the addition of liraglutide 1.2 and 1.8mg to insulin significantly reduces HbA1c, mean blood glucose, total insulin doses, body weight, carbohydrate intake, C-Reactive protein (a marker of cardiovascular risk), significantly improves quality of life and reduces systolic blood pressure(top number in a blood pressure reading) in 1.8mg group in patients with type 1 diabetes over a period of 12 weeks. In 1.2mg, HbA1c fell by 0.78% from 7.84 to 7.06% and in 1.8mg group fell by 0.42% from 7.41 to 6.99% which means that more number of patients will be able to achieve HbA1c levels close to 7% and lower which is recommended by most diabetes organizations. Also the total daily dose of insulin fell by about 10-12 units in both groups.  The total daily carbohydrate intake in both the groups fell by an average of 40 grams.   There was a 5 kg weight loss in both 1.2 mg and 1.8 mg groups and both these groups on an average lowered their Body Mass Index from 29 to 28 kg/m2 .    In 1.8 mg group  there was fall in systolic blood pressure by 9 mm from  120 to 111 mm Hg. The improvements seen are important because 40 to 50 percent of people with Type 1 diabetes have the metabolic syndrome(Cluster of risk factors, including high blood pressure, large waistline, high blood sugar, low HDL ("good") cholesterol and high triglycerides (fats in the blood) which increases the chances of later developing Type 2 diabetes and heart disease. Our findings have significant implications for the future treatment of patients with Type 1 Diabetes. (more…)
Author Interviews, Compliance, JAMA, Pharmacology, Schizophrenia / 23.05.2014

Scott Stroup, MD, MPH Professor of Psychiatry Director, Program for Intervention Effectiveness Research, Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric Institute Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New YorkMedicalResearch.com Interview with: Scott Stroup, MD, MPH Professor of Psychiatry Director, Program for Intervention Effectiveness Research, Associate Director for Adult Services, Division of Mental Health Services and Policy Research,  New York State Psychiatric Institute Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York MedicalResearch: What are the main findings of the study? Dr. Stroup: We conducted a study sponsored by the National Institute of Mental Health that compared long-acting injectable antipsychotics for people with schizophrenia. Long-acting injectable antipsychotics, also known as depot antipsychotics, are used to promote treatment adherence.  We compared a newer injectable antipsychotic, paliperidone palmitate, to an older one, haloperidol decanoate.  We did not find an advantage for the newer drug in overall effectiveness.  The drugs performed very similarly, and were tolerated about the same. (more…)
Alzheimer's - Dementia, Author Interviews / 23.05.2014

Susan Farr, Ph.D. Research Professor of Geriatrics Saint Louis UniversityMedicalResearch.com Interview with: Susan Farr, Ph.D. Research Professor of Geriatrics Saint Louis University   MedicalResearch: What are the main findings of the study? Dr. Farr: We found that reducing the conversion of amyloid precursor protein (APP) to beta amyloid with an antisense targeting the beta amyloid portion of amyloid precursor protein in the Tg2576 mouse which overexpresses human beta amyloid, improves learning and memory and reduces neuroinflammatory cytokine (inflammation in the brain). (more…)
Nutrition, Prostate Cancer / 23.05.2014

Assistant Professor Department of Obstetrics & Gynecology Division of Clinical & Epidemiologic Research and Cancer Prevention, Detection and Control Research Program and Department of Surgery Division of Urology Duke University School of Medicine Durham, NC 27710 MedicalResearch.com Interview with: Adriana C. Vidal, Ph. D. Assistant Professor Department of Obstetrics & Gynecology Division of Clinical & Epidemiologic Research and Cancer Prevention, Detection and Control Research Program and Department of Surgery Division of Urology Duke University School of Medicine Durham, NC 27710 MedicalResearch: What are the main findings of the study? Dr. Vidal: Among 430 veterans at the VA Hospital in Durham, N.C., including 156 men with confirmed prostate cancer, we found that men who self-reported a higher intake of carbohydrates were at a reduced risk of both low-grade and high-grade prostate cancer. Moreover, we found that intake of foods with high glycemic index increased total prostate cancer risk in black men. However, a higher fiber intake was associated with reduced risk of high grade prostate cancer. (more…)
Author Interviews, Circadian Rhythm, Gastrointestinal Disease, Sugar / 23.05.2014

Dr. Robin Voigt PhD Department of Internal Medicine Division of Gastroenterology Rush University Medical Center Chicago, IllinoisMedicalResearch.com Interview with: Dr. Robin Voigt PhD Department of Internal Medicine Division of Gastroenterology Rush University Medical Center Chicago, Illinois MedicalResearch: What are the main findings of the study?  Dr. Voigt: We found that chronic circadian rhythm disruption has no effect on the intestinal microbiota when mice are fed a standard chow diet but when combined with a high-fat, high-sugar diet circadian rhythm disruption results in intestinal dysbiosis and an increase in pro-inflammatory bacteria. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, NEJM, Statins / 22.05.2014

Jonathon D. Truwit, MD, MBA Enterprise Chief Medical Officer Sr. Administrative Dean Froedtert-Medical College of Wisconsin Milwaukee, WI 53226MedicalResearch.com Interview with: Jonathon D. Truwit, MD, MBA Enterprise Chief Medical Officer Sr. Administrative Dean Froedtert-Medical College of Wisconsin Milwaukee, WI 53226 MedicalResearch.com: What are the main findings of the study? Dr. Truwit: Rosuvastatin did not reduce mortality, nor days free of the breathing machine, in patients with sepsis-associated acute respiratory distress syndrome (ARDS). One in four patients with ARDS die. (more…)
Author Interviews, BMJ, Genetic Research, Heart Disease / 22.05.2014

Christopher Labos MD CM, FRCPC, MSc candidate Division of Epidemiology, Biostatistics and Occupational Health McGill University Montreal, Quebec CanadaMedicalResearch.com Interview with: Christopher Labos MD CM, FRCPC, MSc candidate Division of Epidemiology, Biostatistics and Occupational Health McGill University Montreal, Quebec Canada MedicalResearch: What are the main findings of the study? Dr. Labos: A higher genetic risk score (GRS) composed of a set of recently discovered genetic markers strongly linked to cardiovascular disease is associated with an earlier age of first acute coronary syndromes (ACS). We also found that other traditional risk factors such as smoking, obesity and male sex were also associated with an earlier ACS. Two medication classes were also associated with age of first ACS: hormone replacement therapy was associated with earlier ACS while aspirin was associated with ACS occuring at a later age. (more…)
Author Interviews, Diabetes, JAMA, OBGYNE / 22.05.2014

Wei Bao MD, PhD Postdoc fellow, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852MedicalResearch.com Interview with: Wei Bao MD, PhD Postdoc fellow, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 MedicalResearch: What are the main findings of the study? Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are: (1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI). (2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI. (3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI. (more…)
Author Interviews, Diabetes, Diabetologia, Heart Disease / 22.05.2014

MedicalResearch.com Interview with: Malene Nøhr Demant Department of Cardiology Copenhagen University Hospital Gentofte Hellerup, Denmark MedicalResearch: What are the main findings of the study? Dr. Demant: Our study shows that increasing severity of heart failure is associated with an increased risk of developing diabetes. Increasing loop-diuretic dosage was used as a proxy for heart failure severity. Patients with the most severe heart failure were three times more likely to develop diabetes than those with the least severe. Patients who were also being treated with ACE inhibitors (angiotensin-converting-enzyme inhibitors) had a less pronounced increase in diabetes risk. Patients who developed diabetes were 16% more likely to die than those who did not develop diabetes. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Heart Disease, JACC / 22.05.2014

MedicalResearch.com Interview with: Nileshkumar J. Patel MD Staten Island University Hospital Staten Island, NY, 10304 and Abhishek J. Deshmukh MD University of Arkansas Little Rock, AR MedicalResearch: What are the main findings of the study? Answer: We analyzed data from almost 4 million hospitalizations for atrial fibrillation (AF) from more than 1,200 hospitals across 45 states in last decade, and found that -   Hospitalization rates for atrial fibrillation have increased exponentially among US adults during the past 10 years, particularly in those 65 years or older. -   The most frequent coexisting conditions were hypertension (59.99%), diabetes (21.47%) and chronic pulmonary disease (20.01%). -   In terms of geographic distribution of admissions, the hospitals in the South constitute (38.5%) the highest percentage of atrial fibrillation hospitalizations, followed by Midwest (24.9%), Northeast (22.2%) and West (14.4%). -   Overall in-hospital mortality was 1%. The mortality rate was highest in >80 years age group (1.93%) and patients with concomitant heart failure (8.2%). -   The percentage of patients discharged to nursing facility increased from 8.1% in 2000 to 11.5% in 2010 and need for home health care increased from 6.7% to 13.1%. Approximately one fourth of the patients (25.83%) were discharged to long-term care institution if atrial fibrillation hospitalization was complicated by acute ischemic stroke. -   Mean cost of AF hospitalization increased significantly from $6,410 in 2001 to $8,439 in 2010 (24.04% increase, p <0.001) even after adjusting for inflation. This represents an absolute increment in annual national cost from approximate 2.15 billion dollars in 2001 to 3.46 billion dollars in 2010. The mean cost of care was highest if AF hospitalization was associated with heart failure ($33,161) and valvular disorders ($28,030). (more…)
Author Interviews, JAMA, Neurological Disorders, Pediatrics / 21.05.2014

James Chamberlain, MD Division Chief, Emergency Medicine Children’s National Health System Washington, DCMedicalResearch.com Interview with: James Chamberlain, MD Division Chief, Emergency Medicine Children’s National Health System Washington, DC MedicalResearch: What are the main findings of the study? Dr. Chamberlain: Contrary to our hypothesis, lorazepam was not superior to diazepam for treating pediatric seizures. Both medications had similar effectiveness (72-73%) and safety (15-16% incidence of assisted ventilation). Lorazepam caused a longer period of sedation prior to waking up. The difference was approximately 15 minutes. (more…)
Author Interviews, Exercise - Fitness, General Medicine, JAMA, Rheumatology / 21.05.2014

Professor Kim Bennell ARC Future Fellow Department of Physiotherapy University of Melbourne Parkville, Vic 3010 AustraliaMedicalResearch.com Interview Professor Kim Bennell ARC Future Fellow Department of Physiotherapy University of Melbourne Parkville, Vic 3010 Australia MedicalResearch: What are the main findings of the study? Professor Bennell: In 102 people with painful hip osteoarthritis, we compared a 'real' physical therapy program involving exercise, manual therapy techniques,education and provision of a cane if appropriate to a sham physical therapy treatment that was made to look as though it was real but instead involved turned off ultrasound and gentle application of a hand crème to the hip region. Participants in both groups went to see a physical therapist on 10 occasions over 12 weeks and performed home exercises if in the 'real' physical therapy group or lightly applied the cream at home if in the sham group. Participants were followed for 9 months in total. We found that while both groups showed improvements in pain and physical function, the improvements were similar between the two groups. That is, the real physical therapy program did not show greater benefits over a sham treatment.  (more…)
Asthma, Author Interviews, Cost of Health Care / 21.05.2014

dr_vicki_fung MedicalResearch.com Interview with: Vicki Fung, Ph.D. Assistant Professor Department of Medicine, Harvard Medical School Mongan Institute for Health Policy, Massachusetts General Hospital   MedicalResearch: What are the main findings of the study? Dr. Fung: We found that lower income parents of children with asthma were more likely to delay or avoid taking their children to a doctor's office visit or to the emergency room if they had to pay higher out-of-pocket costs for care; they were also more likely to report borrowing money to pay for asthma care. (more…)
Author Interviews, JAMA, Kidney Stones, Urology / 21.05.2014

Charles D. Scales, Jr MD MSHS Assistant Professor of Surgery Division of Urologic Surgery Duke University Medical CenterMedicalResearch Interview with: Charles D. Scales, Jr MD MSHS Assistant Professor of Surgery Division of Urologic Surgery Duke University Medical Center   MedicalResearch: What are the main findings of the study? Dr. Scales: When it comes to treating kidney stones, less invasive is not always better. We used the best method short of a randomized trial to balance out patients in terms of factors that might influence the success of treatment.  In other words, we achieved a “statistical toss-up” for factors that could influence the outcome of the procedure. When we balanced out all of the factors that might influence the chance of a repeat procedure, we found that about 11% of patients treated with non-invasive SWL had a repeat procedure, as compared to <1% with minimally invasive URS. (more…)
ADHD, Author Interviews, OBGYNE, Smoking / 21.05.2014

MedicalResearch.com Interview with: Nathalie E. Holz, MA Department of Child and Adolescent Psychiatry and Psychotherapy Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany MedicalResearch: What are the main findings of the study? Dr. Holz: Using data from a prospective community sample followed since birth, we investigated the impact of prenatal maternal smoking on lifetime Attention-Deficit/ Hyperactivity Disorder (ADHD) symptoms and on brain structure and inhibitory control assessed with Magnetic Resonance Imaging in the adult offspring. Those who were prenatally exposed to tobacco not only exhibited more ADHD symptoms, but also showed decreased activity in the inhibitory control network encompassing the inferior frontal gyrus as well as the anterior cingulate cortex. Activity in these regions was inversely related to lifetime ADHD symptoms and novelty seeking, respectively. In addition volume in the inferior frontal gyrus was decreased in these participants. (more…)
Author Interviews, End of Life Care, Heart Disease / 21.05.2014

MedicalResearch.com Interview with: Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine University of Colorado, Division of Cardiology Section of Advanced Heart Failure and TransplantationMedicalResearch.com Interview with: Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine University of Colorado, Division of Cardiology Section of Advanced Heart Failure and Transplantation   MedicalResearch: What are the main findings of the study? Answer: We interviewed 22 patients who were offered destination therapy left ventricular assist devices (DT LVAD), 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an overriding desire to live as long as possible: [LVAD] was the only option I had…that or push up daisies…so I automatically took this. In contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: There are worse things than death. Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Education / 21.05.2014

Dr. Price Kerfoot MD, EdM Rabkin Fellow in Medical Education Associate Professor of Surgery, Harvard Medical SchoolMedicalResearch.com Interview with: Dr. Price Kerfoot MD, EdM Rabkin Fellow in Medical Education Associate Professor of Surgery, Harvard Medical School   MedicalResearch: What are the main findings of the study? Dr. Kerfoot: (1) An online spaced education game improved clinicians' knowledge of hypertension intensification and generated a modest but significant improvement in time to blood pressure target among their patients with hypertension. (2) As a method to increase clinicians' long-term knowledge, the spaced education game was significantly more effective than providing the identical content via a traditional method (online posting with e-mail reminders). (more…)
Asthma, Author Interviews, Lancet, Pediatrics / 20.05.2014

Adnan Custovic DM MD PhD FRCP Professor of Allergy Institute of Inflammation and Repair University of Manchester University Hospital of South Manchester Manchester M23 9LT, UKMedicalResearch.com Interview with: Adnan Custovic DM MD PhD FRCP Professor of Allergy Institute of Inflammation and Repair University of Manchester University Hospital of South Manchester Manchester M23 9LT, UK MedicalResearch: What are the main findings of the study? Dr. Custovic: In a longitudinal analysis of the data from our birth cohort study collected from birth to age eleven years, we demonstrated an association between early-life antibiotic prescription and development of wheezing, but not atopy. Furthermore, amongst children with wheezing, antibiotic prescription in infancy increases the risk of subsequent severe wheeze/asthma exacerbations and hospital admissions. This is the first demonstration that children who receive antibiotics in infancy have impaired antiviral immunity later in life, and that early-life antibiotic prescription is associated with variants on chromosome 17q21 locus (which is an asthma susceptibility locus). Our findings suggest that the association between antibiotics and childhood asthma reported in previous studies arises through a complex confounding by indication, in which hidden factors which increase the likelihood of both antibiotic prescription in early life and subsequent asthma development are increased susceptibility to virus infections consequent to impaired antiviral immunity, and genetic variants on 17q21. Our results raises an important issue that effects which are often attributed to environmental exposures may be a reflection of genetic predisposition. (more…)
Mayo Clinic, Urology / 20.05.2014

Daniel S. Elliott, M.D MAYO Clinic, Associate Professor Department of Urology Section of Pelvic and Reconstructive Surgery Rochester, MinnesotaMedicalResearch.com Interview with: Daniel S. Elliott, M.D MAYO Clinic, Associate Professor Department of Urology Section of Pelvic and Reconstructive Surgery Rochester, Minnesota MedicalResearch: What are the main findings of the study?  Dr. Elliott: The biggest issue is that we were able to devise a new procedure that is a simple outpatient anti-incontinence surgery for women that does NOT use any synthetic meshes.  The importance of this is that all traditional (meaning NON-mesh) surgeries for female incontinence have been large surgeries with fairly significant risks such as pain, bleeding and prolonged recovery.  When the meshes came out in the late ‘90’s, their big benefit was that they were outpatient and quick procedures.  But now that we are discovering all the long term complications from meshes such as chronic pain, scarring, painful intercourse, vaginal extrusion of the meshes, and organ injury, patients have become VERY reluctant and fearful to undergo any mesh type surgery.    Therefore, we devised a new procedure that used a very small piece of the patient’s own tissue (from the rectus fascia) and placed this via the “transobturator route.”  In the process, we melded together the “best” of both worlds---a NON-mesh, outpatient anti-incontinence procedure that is safe (no long term problems as seen with meshes) . (more…)
Cancer Research, Diabetes / 20.05.2014

MedicalResearch.com Interview with: Sarah P. Psutka, MD Fellow in Urologic Oncology Department of Urology, Mayo Clinic MedicalResearch: What are the main findings of each study?  Dr. Psutka: In this study we identified all diabetic patients with localized clear cell renal cell carcinomas who were surgically treated between 1990 and 2008 in our institution and matched them with nondiabetic patients. Our main findings were that, after controlling for major confounders such as age, sex, type of surgery, renal function, smoking status, performance status, and tumor grade and stage, diabetic patients had inferior overall survival than nondiabetic patients. Furthermore, among patients with clear cell carcinoma, diabetic patients also had shorter cancer-specific survival, suggesting that diabetes is a poor prognostic factor for patients with surgically treated renal cell carcinoma. (more…)
Mayo Clinic, Urology / 20.05.2014

MedicalResearch.com Interview with: Sarah P. Psutka, MD Fellow in Urologic Oncology Department of Urology, Mayo Clinic MedicalResearch: What are the main findings of each study?  Dr. Psutka: In this study, we analyzed 1335 patients who underwent radical cystectomy at the Mayo clinic between 1996 and 2006. We categorized patients who stayed in the hospital longer than 10 days, putting them in the top 25th percentile of the length of stay, as having a prolonged hospital stay. We noted that prolonged hospital stay was associated with adverse postoperative outcomes, including serious complications and early postoperative death. Patients who had a prolonged length of stay had a higher burden of comorbidities, American Society of Anesthesiologist score, and their Eastern Cooperative Oncology Group Score. A multivariable analysis, holding these factors and other clinically relevant potential confounders constant, revealed that only the ECOG performance score independently predicted whether or not a patient had a prolonged hospital course following radical cystectomy. (more…)
Author Interviews, NEJM, Pulmonary Disease, Statins / 20.05.2014

Dr. Gerard J. Criner MD, FACP, FACCP Professor, Medicine Director, Medical Intensive Care Unit and Ventilator Rehabilitation Unit Co-Director, Center for Inflammation, Translational and Clinical Lung Research Temple University Hospital in Philadelphia, PAMedicalResearch Interview with: Dr. Gerard J. Criner MD, FACP, FACCP Professor, Medicine Director, Medical Intensive Care Unit and Ventilator Rehabilitation Unit Co-Director, Center for Inflammation, Translational and Clinical Lung Research, Temple University Hospital in Philadelphia, PA MedicalResearch: What are the main findings of the study? Dr. Criner: The STATCOPE Trial (Simvastatin in the Prevention of COPD Exacerbations) found that a statin drug commonly used to lower cholesterol is not effective in reducing the number and severity of flare ups from chronic obstructive pulmonary disease (COPD).   The study rigorously tested the hypothesis that statin drugs may be beneficial to persons with COPD because of the drugs’ purported anti-inflammatory effect.  However, researchers found that:
  • 40 mg. of daily simvastatin (statin drug) added to usual care did not reduce exacerbation rate or prolong the time to exacerbation in patients with moderate to severe COPD.
  • Simvastatin had no effect on lung function, quality of life, severe adverse events or mortality.
  • The data do not demonstrate a therapeutic benefit from statins in patients with moderate to severe COPD.
(more…)
Addiction / 19.05.2014

Jennifer Peltzer-Jones, R.N., Psy.D. Henry Ford's Department of Emergency Medicine MedicalResearch.com Interview with: Jennifer Peltzer-Jones, R.N., Psy.D. Henry Ford's Department of Emergency Medicine MedicalResearch: What are the main findings of the study? Answer: We found that within our group of 255 known Emergency Department “super-frequent users,” 77% had with some type of addiction disorder, and 47 percent visited the Emergency Department seeking narcotics for pain. Women were more likely to be narcotic seeking. Using our individualized Electronic Medical Record care plan intervention, created and overseen by our multidisciplinary team (comprised of Emergency Department staff physicians, a psychologist, residents, nurses and support staff), we found that our plan significantly decreased annual rates of visits by these super-frequent users and those who sought pain-relief narcotics and other super-frequent users. (more…)
Blood Clots, General Medicine, UCSD / 19.05.2014

MedicalResearch.com Interview withTimothy Fernandes, M.D., M.P.H. University of California, San Diego - La Jolla, CA Timothy Fernandes, M.D., M.P.H. University of California, San Diego La Jolla, CA MedicalResearch: What are the main findings of this study? Dr. Fernandes: The fibrinopeptides are cleaved off of fibrinogen by thrombin during the generation of a new clot. These small molecules are excreted into the urine and we have developed a urine assay to measure the level of FPB. We examined the performance of urine FPB as a screening test for acute pulmonary embolism, blood clots that travel to the lungs. The study group consisted of 344 patients: 61 (18%) with pulmonary embolism and 283 (83%) without. At a threshold of 2.5 ng/ml, urine FPB demonstrated sensitivity of 75.4% (95% CI: 62.4-85.2%), specificity of 28.9% (95% CI: 23.8-34.7%), and negative likelihood ratio of 0.18 (0.11-0.29), weighted by prevalence in the sample population. However, the thresholds of 5 ng/ml and 7.5 ng/ml had sensitivities of only 55.7% (95% CI: 42.5-68.2%), and 42.6% (30.3-55.9%), respectively. The urine fibrinopeptide B assay at a cut-off of 2.5 ng/ml had a sensitivity of 75.4% for detecting pulmonary embolism. For diagnosis of PE, this sensitivity is comparable to previously published values for the first generation plasma latex and whole blood D-dimer assays (not as well and the D dimer ELISA assay). (more…)
Cognitive Issues, Heart Disease / 19.05.2014

T. Jared Bunch, MD Medical director for Heart Rhythm Services Director of Heart Rhythm research Intermountain Medical Center, UtahMedicalResearch.com Interview with T. Jared Bunch, MD Medical director for Heart Rhythm Services Director of Heart Rhythm research Intermountain Medical Center, Utah MedicalResearch: What are the main findings of the study? Dr. Bunch: The main findings of the study are: 1) Atrial fibrillation patients treated with warfarin anticoagulation that have lower percentages of time in therapeutic range have significantly higher risks of all forms of dementia. 2) The dementia relative risk related to lower percentages of time in therapeutic range was higher than all other variables associated with stroke or risk of bleeding. 3) The risk of dementia related to lower percentages of time in therapeutic range was highest in younger patients in the study (<80 years). (more…)
Author Interviews, CHEST, Pulmonary Disease / 19.05.2014

Dr. Hoi Nam Tse, FCCP, MRCP, MBChB Associate Consultant, Kwong Wah Hospital, Hong Kong Life member and Council member of Hong Kong Thoracic SocietyMedicalResearch.com Interview with: Dr. Hoi Nam Tse,  FCCP, MRCP, MBChB Associate Consultant, Kwong Wah Hospital, Hong Kong Life member and Council member of Hong Kong Thoracic Society MedicalResearch: What are the main findings of the study? Dr. Hoi Nam Tse: N-acetylcysteine (NAC) is an oral mucolytic containing anti-oxidative and anti-inflammatory property. Our study demonstrated that long term use of high-dose : N-acetylcysteine (600 mg twice daily for 1 year) was a well-tolerated treatment, and it reduced exacerbations and prolonged time to first exacerbation in ‘high-risk’ COPD patients--which was defined as patients who had 2 or more exacerbations per year, FEV1<50% or both. Such beneficial effect was not obvious in the ‘low-risk’ COPD patients. (more…)
Author Interviews, Blood Clots, CHEST / 18.05.2014

Scott C. Woller, MD Co-Director Thrombosis Program Intermountain Medical Center Associate Professor of Internal Medicine University of Utah School of Medicine Murray, UT 84157-7000MedicalResearch.com Interview with Scott C. Woller, MD Co-Director Thrombosis Program Intermountain Medical Center Associate Professor of Internal Medicine University of Utah School of Medicine Murray, UT 84157-7000 Dr. Woller: By way of background, D-dimer, a simple blood test that is used to investigate the diagnosis of suspected pulmonary embolism (PE), and it increases with age.  Recent research suggests that the use of an age-adjusted d-dimer threshold may improve diagnostic efficiency without compromising safety. We wished to assess the safety of using an age-adjusted d-dimer threshold in the work-up of patients with suspected pulmonary embolism. MedicalResearch:  What are the main findings of the study? Dr. Woller: In this retrospective cohort study we identified 923 patients age > 50 years who presented to our emergency department with suspected pulmonary embolism, and had their pretest probability of PE calculated along with a d-dimer performed. All patients underwent computed tomography pulmonary angiography (CTPA). We observed that among patients unlikely to have PE, adoption of an age-adjusted D-dimer cut-off (compared with a conventional D-dimer cut-off) reduced the need for CTPA in an additional 18.3% of patients, and was associated with a low 90-day rate of failure to diagnose PE. (more…)
Author Interviews, Fertility, Stanford / 17.05.2014

Michael Eisenberg, MD, PhD Director, Male Reproductive Medicine and Surgery Assistant Professor, Department of Urology Assistant Professor, Department of Obstetrics and GynecologyMedicalResearch. com Interview with: Michael Eisenberg, MD, PhD Director, Male Reproductive Medicine and Surgery Assistant Professor, Department of Urology Assistant Professor, Department of Obstetrics and Gynecology Stanford School of Medicine
MedicalResearch:   What are the main findings of the study? Dr. Eisenberg: There is an inverse relationship between semen quality and mortality so that as semen quality declines the likliehood of death increases. (more…)
Author Interviews, Diabetes, Diabetologia, Weight Research / 17.05.2014

Hana Kahleova, MD, PhD Diabetes Centre, Institute for Clinical and Experimental Medicine 140 21 Prague Czech RepublicMedicalResearch.com Interview with: Hana Kahleova, MD, PhD Diabetes Centre, Institute for Clinical and Experimental Medicine 140 21 Prague Czech Republic MedicalResearch: What was the aim of your study? Dr. Kahleova: The aim of the study was to compare the effect of six (A6 regimen) vs two meals a day, breakfast and lunch (B2 regimen), on body weight, hepatic fat content (HFC), insulin resistance and beta cell function. MedicalResearch: What are the main findings of the study? Dr. Kahleova: Comparison of the effect of six vs. two meals (breakfast and lunch) with the same daily caloric restriction (-500 kcal/day) and macronutrient content, each regimen lasting 12 weeks, demonstrated a superior effect of breakfast and lunch on body weight, hepatic fat content, fasting plasma glucose, C-peptide, glucagon and insulin sensitivity. (more…)
Author Interviews, BMJ, Karolinski Institute, Rheumatology, Weight Research / 17.05.2014

Maria E.C. Sandberg, MSc PhD Institutet för Miljömedicin / Institute of Environmental Medicine Karolinska Institutet Stockholm, SwedenMedicalResearch.com Interview with: Maria E.C. Sandberg, MSc PhD Institutet för Miljömedicin / Institute of Environmental Medicine Karolinska Institutet Stockholm, Sweden   MedicalResearch: What are the main findings of the study? Dr. Sandberg: Overweight at diagnosis significantly decreases the chance of achieving good disease control during the early phase of rheumatoid arthritis (RA). (more…)