Author Interviews, Cost of Health Care, PAD / 13.09.2013

MedicalResearch.com Interview with: Nasser Malyar, MD Division of Vascular Medicine Department of Cardiovascular Medicine University Hospital Muenster Albert-Schweitzer-Campus 1, A1 48149 Muenster, Germany MedicalResearch.com: What are the main findings of the study? Dr. Malyar: The main findings of the study were that 1) PAD as a main or co-diagnosis is common among in-hospital treated patients 2) The prevalence of PAD among hospitalized patients is disproportionately increasing, particularly in the subset with critical limb ischemia 3) Despite all efforts and increasingly use of endovascular and surgical revascularization procedures PAD patients still have a poor in-hospital outcome in terms of limb amputation and in-hospital mortality 4) Last but not least the reimbursement costs for in-hospital treatment of patients with PAD are markedly increasing. (more…)
Author Interviews, Genetic Research, Metabolic Syndrome, Nature, Surgical Research, Weight Research / 13.09.2013

MedicalResearch.com Interview with: Koji Ikeda, MD, PhD Assistant Professor Department of Cardiology Graduate School of Medical Science, Kyoto Prefectural University of Medicine Kyoto, Japan MedicalResearch.com: What are the main findings of the study?  Dr. Ikeda: The main findings of this study is the identification of a novel mechanism that regulates glucose homeostasis and energy metabolism, provided by Ecscr. Consequently, Ecscr modifies the insulin sensitivity and the progression of obesity, indicating that Ecscr is a new target for the treatment of metabolic syndrome. (more…)
Author Interviews, Breast Cancer, MRI / 13.09.2013

Nariya Cho, MD Departments of Radiology Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.MedicalResearch.com Interview with: Nariya Cho, MD Departments of Radiology Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.   MedicalResearch.com: What are the main findings of the study? Dr. Cho: Smaller reduction in tumor volume and a smaller reduction in washout component on dynamic contrast agent–enhanced MR imaging assessed by computer-aided evaluation after neoadjuvant chemotherapy were independent parameters of worse recurrence-free survival and overall survival in breast cancer patients who received neoadjuvant chemotherapy. (more…)
Health Care Systems, Outcomes & Safety / 12.09.2013

MedicalResearch.com Interview with: Lauren Doctoroff, MD Hospitalist, Hospital Medicine Program Beth Israel Deaconess Medical Center Medical Director, HCA Post Discharge Clinic and PACT Transitional Care Program Instructor, Harvard Medical School Boston, MA 02215MedicalResearch.com Interview with: Lauren Doctoroff, MD Hospitalist, Hospital Medicine Program Beth Israel Deaconess Medical Center Medical Director, HCA Post Discharge Clinic and PACT Transitional Care Program Instructor, Harvard Medical School Boston, MA 02215 MedicalResearch.com What are the main findings of the study? Dr. Doctoroff: A dedicated post discharge clinic, staffed by hospitalists, led to a shorter interval to a clinic visit for patients after discharge.  Patients with resident primary care doctors and those who are African American were most likely to use the clinic.  The care provided in the clinic, in terms of testing, was consistent with the remainder of the practice. (more…)
Author Interviews, Heart Disease / 12.09.2013

MedicalResearch.com Interview with: Dr. Evgeny Pokushalov, MD, PhD State Research Institute of Circulation Pathology, Rechkunovskaya 15, 630055 Novosibirsk 55, Russia MedicalResearch.com: What are the main findings of the study? Dr. Pokushalov: The main finding of this study is that after the failure of the first catheter ablation procedure for PAF, a redo ablation was more effective at eradicating recurrent AF than treatment with AAD. In this randomized controlled clinical trial, we observed that: 1. The AF progression rate was considerably higher in patients randomized to AAD (79%) use compared with patients treated with a second ablation procedure (25%). 2. The AF burden significantly increased on AAD during followup compared with patients of reablation group (18.8±11.4% versus 5.6±9.5%, respectively). 3. There was a much greater rate of progression to persistent AF if AAD was used rather than redo ablation (23% versus 4%, respectively). These findings support the need for consideration of a timely intervention in patients with PAF who have responded inadequately to an initial PVI. (more…)
Author Interviews, Prostate Cancer / 11.09.2013

David F Jarrard, MD Vice Chair for Clinical Affairs Professor of Urology John Livesey Chair in Urologic OncologyMedicalResearch.com Interview with: David F Jarrard, MD Vice Chair for Clinical Affairs Professor of Urology John Livesey Chair in Urologic Oncology   MedicalResearch.com: What are the main findings of the study? Dr. Jarrard: We have developed and externally validated an accurate nomogram for predicting Gleason score 6 upgrading for use in low-risk prostate cancer patients.  This nomogram incorporates only variables available at the time of diagnosis and is unique in its assessment of clinical as well as pathological factors.  Furthermore, we externally validated this study in patients with Gleason 6 prostate cancer of which 90% met the D’Amico criteria for low-risk cancer at 2 other centers (total 2000 patients).  This nomogram will aid in the decision-making process of patients diagnosed with low-risk prostate cancer. (more…)
Author Interviews, HIV, Kidney Disease / 11.09.2013

MedicalResearch.com Interview with: Magnus G. Rasch MD Faculty of Health Sciences, University of Copenhagen 1455 København K, Denmark Department of Infectious Diseases Copenhagen University Hospital, Rigshospitalet, Denmark MedicalResearch.com: What are the main findings of the study? Dr. Rasch: In the study “Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population” we found that the risk of acute renal replacement therapy (aRRT) and the risk of chronic renal replacement therapy (cRRT) was increased substantially in HIV patients compared with the background population. The risk of aRRT was highest the first year after HIV diagnosis. Factors associated with increased risk of aRRT were intravenous drug use, hypertension and an AIDS-defining illness. Risk factors for cRRT were hypertension and baseline estimated glomerular filtration rate. (more…)
Author Interviews, Johns Hopkins, NEJM, Pulmonary Disease / 11.09.2013

MedicalResearch.com Interview with: Dr. Robert A. Wise MDMedicalResearch.com Interview with: Dr. Robert A. Wise MD Professor of Medicine Johns Hopkins University School of Medicine 5501 Hopkins Bayview Circle Baltimore, MD 21224   MedicalResearch.com: What are the main findings of the study?
 Dr. Wise: The TIOSPIR trial was a landmark study, one of the largest ever conducted for chronic obstructive pulmonary disease (COPD).  It was designed to test the comparative safety and effectiveness of two delivery devices of tiotropium, a long-acting bronchodilator.  One formulation is the Respimat multi-dose soft mist inhaler and the other formulation is the single dose HandiHaler dry powder inhaler. After following more than 17000 patients for an average of 2.3 years, TIOSPIR showed that there was no difference in either the safety in terms of mortality or adverse cardiovascular events between the two devices.  Moreover, both devices showed similar effectiveness in terms of time to first COPD exacerbation. A lung function substudy in 1370 patients showed that the 5 microgram dose of Respimat was equivalent to the HandiHaler as a bronchodilator, but the 2.5 microgram dose was not quite as effective. (more…)
Author Interviews, JAMA, Pediatrics, Weight Research / 11.09.2013

MedicalResearch.com Interview with: Dr. Elsie Taveras Massachusetts General Hospital for Children Division of General Pediatrics, Department of Pediatrics 100 Cambridge St, 15th Floor Boston, MA 02114Dr. Elsie Taveras Massachusetts General Hospital for Children Division of General Pediatrics, Department of Pediatrics 100 Cambridge St, 15th Floor Boston, MA 02114   MedicalResearch.com: What are the main findings of the study? Dr. Taveras: The main findings of the study were that, overall, the body mass index of children in the intervention group dropped an average of 0.18, while it rose 0.21 in the control group. Children in the intervention group were sleeping about 45 minutes longer than children in the control group. Time spent watching television on weekends dropped about an hour per day in the intervention group, leading to a significant difference from the control group, which increased weekend TV viewing. Both groups had a small reduction in weekday TV viewing, with a greater decrease in the intervention group, as well. (more…)
Author Interviews, Cognitive Issues, Diabetes, Genetic Research / 11.09.2013

MedicalResearch.com Interview with: Ramit Ravona-Springer M.D., Psychiatrist Director of Memory Clinic, Sheba Medical Center, Tel Hashomer, Israel MedicalResearch.com: What are the main findings of the study? Answer: In a cohort of elderly, cognitively normal type 2 diabetes (T2D) subjects, those with Haptoglobin (Hp) 1-1 genotype present lower cognitive performance compared to Hp 2 carriers (Hp 1-2 and Hp 2-2). The contribution of cardiovascular risk factors to cognition was significantly higher in subjects with Hp1-1 genotype compared to Hp 2 carriers. (more…)
Author Interviews, Exercise - Fitness, Heart Disease / 11.09.2013

Madelein Hoogwegt, MSc Promovenda Center of Research on Psychology in Somatic diseases (CoRPS) Department of Medical and Clinical Psychology Kamer P711 Tilburg University 5000 LE TilburgMedicalResearch.com Interview with: Madelein Hoogwegt, MSc Promovenda Center of Research on Psychology in Somatic diseases (CoRPS) Department of Medical and Clinical Psychology Kamer P711 Tilburg University 5000 LE Tilburg MedicalResearch.com: What are the main findings of the study? Answer: The main finding was that we found a significant relation between positive affect and mortality, and that exercise explained this relationship. With respect to the second outcome, hospitalization, we found a significant relation between positive affect and hospitalization, a significant relation between positive affect and hospitalization, but exercise did not mediate this relationship. (more…)
Addiction, Author Interviews, Memory, Methamphetamine, Scripps / 11.09.2013

MedicalResearch.com Interview with: Ph.D., Neurobiology & Behavior and Center for the Neurobiology of Learning & Memory (2005), University of California, Irvine, CaliforniaCourtney A. Miller, PhD Assistant Professor Department of Metabolism & Aging Department of Neuroscience The Scripps Research Institute Jupiter, FL 33458 MedicalResearch.com: What are the main findings of the study? Dr. Miller: The relapse rate for drug abusers, smokers and alcoholics is high because abstinence is so difficult. A major factor is the craving that drug associations can trigger. These range from seeing the neighborhood where someone used to buy, in the case of illicit drugs, to social drinking for a smoker. We’ve found a way to disrupt these drug-associated memories without affecting other, more benign memories. (more…)
Case Western, Esophageal, Gastrointestinal Disease, University of Michigan / 11.09.2013

Joel H. Rubenstein, MD, MSc, FACG, FASGE Research Scientist, Veterans Affairs Center for Clinical Management Research Assistant Professor, Division of Gastroenterology, University of Michigan Medical School VA Medical Center 111-D 2215 Fuller Rd. Ann Arbor, MI 48105MedicalResearch.com Interview with: Joel H. Rubenstein, MD, MSc, FACG, FASGE Research Scientist, Veterans Affairs Center for Clinical Management Research Assistant Professor, Division of Gastroenterology, University of Michigan Medical School VA Medical Center Ann Arbor, MI 48105 MedicalResearch.com: What are the main findings of the study? Dr. Rubenstein: In a set of case-control studies within the same population, we found that H. pylori was inversely associated with erosive esophagitis, and with Barrett’s esophagus, but we did not find such a relation with symptoms of gastroesophageal reflux disease (GERD). (more…)
Author Interviews, Diabetes, Diabetes Care, Mental Health Research / 11.09.2013

MedicalResearch.com Interview with: Jean-Pierre Le Floch, MD Diabetology-Endocrinology Villecresnes Medical Hospital 94440 Villecresnes MedicalResearch.com: What are the main findings of this study? Answer: The main finding of the study is the association between classical macrovascular complications of diabetes and impaired scores of five geriatric scale scores exploring cognition, activities of daily life, instrumental activities, mood and nutrition. (more…)
AHA Journals, Author Interviews, Stroke / 11.09.2013

R. Gilberto González, MD, PhD Massachusetts General Hospital Department of Radiology, PO Box 9657 Boston, MAMedicalResearch.com Interview with: R. Gilberto González, MD, PhD Massachusetts General Hospital Department of Radiology, PO Box 9657 Boston, MA MedicalResearch.com: What are the main findings of the study? Dr. González: Administration of IV tPA to patients with a severe stroke syndrome caused by occlusion of the distal internal carotid artery and/or the proximal middle cerebral arteries results in good outcomes in 35% compared to 17% of similar patients who did not receive tPA. (more…)
Author Interviews, Heart Disease, Pediatrics / 11.09.2013

David R. Fulton, M.D. Associate Cardiologist-in-Chief for Administration Tommy Kaplan Chair in Cardiovascular Studies Chief, Cardiology Outpatient Services Department of Cardiology Children's Hospital Boston Boston, MA 02115David R. Fulton, M.D. Associate Cardiologist-in-Chief for Administration Tommy Kaplan Chair in Cardiovascular Studies Chief, Cardiology Outpatient Services Department of Cardiology Children's Hospital Boston Boston, MA 02115 MedicalResearch.com:   What are the main findings of this study? Dr. Fulton: The main findings of this study demonstrated that using a quality improvement methodology (SCAMPs), a diverse population of children and adolescents with chest pain could be managed  with relative uniformity and cost effectiveness in a multi-center collaborative.  Only 2 patients of the 1016 children who formed the basis for this review were shown to have a cardiac etiology.   The clinicians were able to screen and reach a diagnostic conclusion in a  large segment of this population using history, physical examination and ECG. (more…)
Author Interviews, Cost of Health Care, Critical Care - Intensive Care - ICUs, JAMA / 11.09.2013

Thanh N. Huynh, MD, MSHS Clinical Instructor UCLA Division of Pulmonary Critical CareMedicalResearch.com Interview with: Thanh N. Huynh, MD, MSHS Clinical Instructor UCLA Division of Pulmonary Critical Care MedicalResearch.com: What are the main findings of the study? Dr. Huynh: Our study shows that it is common for ICU doctors to recognize that futile treatment is provided to patients who cannot benefit from it.  In our study, 11% of ICU patients were perceived as receiving futile treatment.  The outcomes of these 123 patients were uniformly poor, with 85% dying within 6 months.  Advances in critical care medicine has allowed us to save lives, but it has also allowed us provide aggressive life-sustaining treatments that may not benefit all patients.  When aggressive treatment is poorly matched with a patient’s prognosis, doctors will consider such treatment as futile and our study shows that this is not an uncommon occurrence in our health system. (more…)
Author Interviews, JAMA, Mental Health Research / 10.09.2013

MedicalResearch.com Interview with: Ricardo E. Carrión, PhD Division of Psychiatry Research The Zucker Hillside Hospital, North Shore–Long Island Jewish Health System, Glen Oaks, New YorkCenter for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Manhasset, New York MedicalResearch.com: What are the main findings of your study: Answer: Reduced neurocognition, poor functioning, and other behavioral symptoms at baseline were associated with an increased risk of long-term social difficulties and school/work problems in adolescents and young adults at high clinical risk for psychosis. (more…)
Author Interviews, Colon Cancer / 10.09.2013

Dr. Bettina Scholtka Universität Potsdam Institut für Ernährungswissenschaft Abt. Ernährungstoxikologie Arthur-Scheunert-Allee 114-116 14558 Nuthetal, Germany.Dr. Bettina Scholtka Universität Potsdam Institut für Ernährungswissenschaft Abt. Ernährungstoxikologie Arthur-Scheunert-Allee 114-116 14558 Nuthetal, Germany. MedicalResearch.com: What are the main findings of the study? Answer: The extremely high sensitivity of the WTB-HRM technique allows to find very low amounts of different types of colon cancer initiating gene mutations even in stool samples of patients. The method is able to find the expected mutations as well as unknown mutations. So, by applying WTB-HRM to a panel of especially selected marker genes, it is possible to detect cancer precursors in feces before they progress into a malignant stage. (more…)
Author Interviews, Weight Research / 10.09.2013

Lu Qi, MD, PhD, FAHA Assistant Professor of Medicine Harvard Medical School Assistant Professor of Nutrition Harvard School of Public HealthMedicalResearch.com Interview with: Lu Qi, MD, PhD, FAHA Assistant Professor of Medicine Harvard Medical School Assistant Professor of Nutrition Harvard School of Public Health MedicalResearch.com: What are the main findings of the study? Answer: It has been known that weight loss diets may improve metabolic status, in parallel with reduction of body weight. We found that the beneficial of various weight loss diets, such as high-fat and low-fat diets, may be different for people carrying different genotype. (more…)
Author Interviews, JAMA / 10.09.2013

Dr. Amy Sanderson MD Department of Anesthesiology Perioperative & Pain Medicine Boston Children’s Hospital Boston, MassachusettsMedicalResearch.com Interview with: Dr. Amy Sanderson MD Department of Anesthesiology Perioperative & Pain Medicine Boston Children’s Hospital Boston, Massachusetts MedicalResearch.com: What are the main findings of the study? Dr. Sanderson: There is substantial variability in the interpretation of a DNR order. 66.9% of clinicians believed that a DNR order indicates limitation of resuscitative measures only on cardiopulmonary arrest, whereas 33.1% considered a DNR order to be the threshold for the limitation of treatments not specifically related to resuscitation. 68.7% of clinicians reported that the care of a patient changes once a DNR order is written. Of those reporting changes in care, 11.2% reported that this happens only if a cardiopulmonary arrest occurs, while 36.7% believed that there is an increased attention to comfort. Finally, 52.1% reported that care changes beyond both resuscitative measures and focusing on comfort, including limitation or withdrawal of diagnostic and therapeutic interventions. Most clinicians reported that resuscitation status discussions happen later in the illness course than is ideal. (more…)
Author Interviews, Diabetes, Kidney Disease, Stroke / 10.09.2013

MedicalResearch.com Interview with: Yongjun Wang, MD Department of Neurology, Beijing Tiantan Hospital Capital Medical University, Beijing, China MedicalResearch.com: What are the main findings of the study? Answer: Our study demonstrated that reduced eGFR was independently associated with all-cause mortality and other post-stroke outcomes in type 2 diabetic patients; stroke subtype analysis in our cohort showed that this association was only evident in ischemic stroke and TIA. We also observed a U-shaped relationship between variation of eGFR and post-stroke outcomes, that is, increased odds ratios were seen among those with low and high levels of eGFR. The cutoff points of eGFR associated with poor outcomes of stroke were eGFR<45 ml/min/1.73m2 and≥ 120 ml/min/1.73m2, respectively. (more…)
Author Interviews, Heart Disease, JAMA, Nutrition / 10.09.2013

MedicalResearch.com Interview with: Shanshan Li, MD, MSc, ScD Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts On behalf of Drs. Chuive, Flint, Pai, Forman, Hu, Willett, Mukamal and Rimm. MedicalResearch.com: What are the main findings of the study? Answer: In our prospective study of diet quality among MI survivors, we found that a higher diet quality post-MI, measured by Alternative Healthy Eating Index 2010, was associated with 24% lower death rate and 26% lower death rate from cardiovascular disease. Greater improvement of diet quality from pre- to post-MI was associated with 30% lower death rate and 40% lower cardiovascular disease death rate. In addition to reducing the bad fats intake, for example, saturated and transfat intake, MI patients also tended to reduce the good healthy polyunsaturated fats. (more…)
Author Interviews, Heart Disease / 07.09.2013

MedicalResearch.com Interview with: Jonathan Hsu, MD, MAS Cardiac Electrophysiology, Division of Cardiology University of California, San Diego (UCSD) MedicalResearch.com: What are the main findings of the study? Dr. Hsu: We found that the prevalence of cardiac perforation during modern day ICD implantation is 0.14%. We also found that specific patient and implanter characteristics predict cardiac perforation risk: older age, female sex, left bundle branch block, worsened heart failure class, higher left ventricular ejection fraction, and non-single chamber ICD implant are associated with a greater odds of perforation, whereas atrial fibrillation, diabetes, previous cardiac bypass surgery, and higher implanter procedural volume are associated with a lower odds of perforation. (more…)
Author Interviews, Duke, Heart Disease, Outcomes & Safety, Surgical Research / 05.09.2013

Marco D. Huesch, MBBS, Ph.D., Assistant professor at the USC Sol Price School of Public Policy Adjunct professor with Duke’s School of Medicine and Fuqua School of Business.MedicalResearch.com Interview with: Marco D. Huesch, MBBS, Ph.D. Assistant professor at the USC Sol Price School of Public Policy Adjunct professor with Duke’s School of Medicine and Fuqua School of Business. MedicalResearch.com: What are the main findings of the study? Answer: This study asked whether ‘learning by doing’ works backwards too, as ‘forgetting by not doing’. In an nutshell, the answer is ‘no’ among the Californian cardiac surgeons I examined with short breaks of around a month. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Kidney Disease, Medical Research Centers / 05.09.2013

MedicalResearch.com Interview with: Gearoid M. McMahon, MB, BCh Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Framingham Heart Study, National Heart, Lung, and Blood Institute, and Center for Population Studies, Framingham, Massachusetts MedicalResearch.com: What are the main findings of the study? Answer: This study examined the incidence, causes and outcomes of rhabdomyolysis in two large University Teaching hospitals. Rhabdomyolysis is a characterized by an increase in serum creatine phosphokinase (CPK) and results from muscle damage from a variety of causes. The most important complication of rhabdomyolysis is acute kidney injury which can result in a need for dialysis. Using a series of laboratory and clinical variables that are readily available on admission, we constructed a risk score that can predict with some accuracy the likelihood that a patient with rhabdomyolysis might die or need dialysis during an admission. The final variables included in the model were age, gender, the cause of rhabdomyolysis and the admission CPK, creatinine, phosphate, bicarbonate and calcium. One of the advantages of this study was, because we had access to data from two institutions, we were able to derive the risk score in one hospital and confirm its accuracy in the second institution. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Medical Research Centers, PLoS, Social Issues / 05.09.2013

Bert Uchino PhD Department of Psychology and Health Psychology Program University of Utah, Salt Lake City, UtahMedicalResearch.com Interview with: Bert Uchino PhD Department of Psychology and Health Psychology Program University of Utah, Salt Lake City, Utah, MedicalResearch.com: What are the main findings of the study? Dr. Uchino: The main findings from our paper is that independent of one’s own social network quality, the quality of a spouse’s social network was related to daily life ambulatory blood pressure (ABP) levels.  More specifically, the more supportive (positive) ties, and the less aversive (negative) or ambivalent (both positive and negative) ties in a spouse’s social network, the lower was one’s own  ABP.  In addition, looking at the social networks of couples as a whole showed that couples who combined had more supportive ties and less aversive or ambivalent ties showed lower ABP. (more…)
Author Interviews, Orthopedics, PLoS / 04.09.2013

Assistant Professor School of Biological & Population Health Sciences, Exercise & Sport Science Program College of Public Health and Human Sciences Oregon State University Corvallis, OR 97331Marc F. Norcross, PhD, ATC Assistant Professor School of Biological & Population Health Sciences, Exercise & Sport Science Program College of Public Health and Human Sciences Oregon State University Corvallis, OR 97331 MedicalResearch.com: What are the main findings of the study? Dr. Norcross: In the scientific community, there remains considerable disagreement over which direction of knee loading is most responsible for causing an anterior cruciate ligament (ACL) injury event.  Many researchers tend to fall into one of three “camps” in which they believe quadriceps loading (sagittal plane), “knock-kneed” landing (frontal plane), or twisting (transverse plane) is the essential factor in the injury mechanism.  However, we know from cadaver studies that combined loading from all of these different planes puts the most strain on the ACL.  We found that men and women are equally likely to use a sagittal plane landing strategy that we believe increases the risk for ACL injury.  However, females were about 3.6 times more likely than males to use a higher risk frontal plane landing strategy.  This suggests that the increased likelihood of greater frontal plane loading in women coupled with the equal likelihood of using a high-risk sagittal plane strategy is likely at least partly responsible for women’s 2-6 times greater risk for ACL injury. (more…)