Author Interviews, Karolinski Institute, Red Meat / 18.07.2014

Andrea Bellavia From the Unit of Nutritional Epidemiology and the Unit of Biostatistics Institute of Environmental Medicine Karolinska Institutet, Stockholm, SwedenMedicalResearch.com Interview with: Andrea Bellavia From the Unit of Nutritional Epidemiology and the Unit of Biostatistics Institute of Environmental Medicine Karolinska Institutet, Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Bellavia: By evaluating together the consumption of processed and fresh red meat, we observed that processed red meat consumption was associated with shorter life, implying a potential negative effect on health. On the other hand, consumption of only fresh red meat was not associated with either shorter or longer survival. Therefore, the main finding of this work is that the negative effects of red meat consumption might only be due to meat processing, which counteract the positive effects of the beneficial nutrients of meat.
Author Interviews, Breast Cancer, Cognitive Issues / 17.07.2014

Florien Boel MSc VU University Medical Center Department of Medical Psychology Amsterdam, The Netherlands MedicalResearch.com Interview with: Florien Boel MSc VU University Medical Center Department of Medical Psychology Amsterdam, The Netherlands Medical Research: What are the main findings of the study? Answer: In postmenopausal breast cancer patients, endocrine therapy is widely used, and often for many years on end. Endocrine therapy is thought to have an effect on cognitive functioning, but previous studies have not yet accounted for the possible influence of the diagnosis of cancer and subsequent anxiety, depression or fatigue on cognitive performance. In addition, the cognitive effects of endocrine therapy after long-term use are still mostly unknown. Therefore, we compared cognitive functioning of postmenopausal breast cancer patients who underwent surgery and/or radiotherapy (N=43) with the cognitive performance of women who also received adjuvant endocrine therapy (tamoxifen) (N=20) and a group of healthy matched individuals (N=44). In accordance with the literature, we found that especially cognitive domains that rely heavily on verbal abilities (verbal memory and fluency) seem to be at risk for deterioration during long-term treatment (~2.5 years) with tamoxifen.
Accidents & Violence, Author Interviews / 17.07.2014

Charles A. Jennissen, MD Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City, IA 52242MedicalResearch.com Interview with: Charles A. Jennissen, MD Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City, IA 52242   MedicalResearch: Why did you perform this study?  Dr. Jennissen: More youth 15 years and younger in the United States are killed in all-terrain vehicle (ATV) crashes than on bicycles. Since 2001, children represent nearly 30% of all ATV-related injuries and 20% of all ATV-related deaths.  Although previous studies have shown children to have high exposure to ATVs, these studies have been mostly limited to select rural and agricultural groups.  With this study, we wanted to investigate the epidemiology of ATV use and safety-related behaviors among a large cross-sectional sample of adolescents.
Author Interviews, Brain Injury, JAMA / 17.07.2014

MedicalResearch.com Interview with: Emmanuel Lagarde Director of Research at INSERM, France Medical Research: What are the main findings of the study? Dr. Lagarde: Concussion accounts for more than 90 percent of all traumatic brain injuries, although little is known about prognosis for the injury. The symptoms cited as potentially being part of post concussion syndrome fall into three areas: cognitive, somatic and emotional. But the interpretation of symptoms after concussion should also take into account that injuries are often sustained during psychologically distressing events which can lead to Posttraumatic Stress Disorder. Medical Research: Were any of the findings unexpected? Dr. Lagarde: Yes, as we were expecting to observe long term (3-month) symptoms following brain injury, but few were found to be specific : most of them were as frequent among patients with other injuries. Medical Research: What should clinicians and patients take away from your report? Dr. Lagarde: It seems as if there is little evidence of the existence of a specific syndrome following mild traumatic brain injury. However, patients who experienced a concussion are at risk of another well-known syndrome called Posttraumatic Stress Disorder, which is associated with the distressing event that led to the injury. Medical Research: What recommendations do you have for future research as a result of this study? Dr. Lagarde: The classification system of symptoms following mild brain injury should be revisited as our results are challenging the very relevance of the DSM-V post concussion syndrome. Citation: Association of Symptoms Following Mild Traumatic Brain Injury With Posttraumatic Stress Disorder vs Postconcussion SyndromeMedicalResearch.com Interview with: Emmanuel Lagarde Director of Research at INSERM, France Medical Research: What are the main findings of the study? Dr. Lagarde: Concussion accounts for more than 90 percent of all traumatic brain injuries, although little is known about prognosis for the injury. The symptoms cited as potentially being part of post concussion syndrome fall into three areas: cognitive, somatic and emotional. But the interpretation of symptoms after concussion should also take into account that injuries are often sustained during psychologically distressing events which can lead to Posttraumatic Stress Disorder.
AHA Journals, Author Interviews, Heart Disease, Red Meat / 17.07.2014

MedicalResearch.com Interview with: Dr inz. Joanna Kaluza Department of Human Nutrition Warsaw University of Life Sciences - SGGW Warsaw POLAND Medical Research: What are the main findings of the study? Response: The most important finding of my study is the fact that processed red meat consumption, but not unprocessed red meat, increases a risk of Heart Failure incidence and Heart Failure mortality.
Author Interviews, Heart Disease, Lipids, NEJM / 17.07.2014

Professor Jane Armitage Professor of Clinical Trials and Epidemiology Clinical Trial Service Unit, Oxford Cardiovascular Science Oxford, United KingdomMedicalResearch.com Interview with: Professor Jane Armitage Professor of Clinical Trials and Epidemiology Clinical Trial Service Unit, Oxford Cardiovascular Science Oxford, United Kingdom Medical Research: What are the main findings of the study? Prof. Armitage: The study showed that adding extended release niacin with laropiprant (to reduce the flushing) to standard treatment including statins in people with heart disease or strokes did not improve their outcome or reduce the risk of recurrent heart attacks or strokes.
Author Interviews, JAMA, Stroke, Surgical Research / 17.07.2014

Mads E. Jørgensen, M.B. University of Copenhagen, DenmarkMedicalResearch.com Interview with: Mads E. Jørgensen, M.B. University of Copenhagen, Denmark Medical Research: What are the main findings of the study? Answer: We included all patients undergoing non-cardiac surgery in 2005-2011, which were then categorized by time elapsed between stroke and surgery. Patients with a very recent stroke, i.e. less than 3 months prior to surgery, had a significant 14 times higher relative risk of 30-day MACE following surgery, compared with patients without prior stroke. Patients with a more distant stroke had a 2-5 fold higher risk of MACE following surgery, and still significantly higher than risks in patients without prior stroke. An additional model including time between stroke and surgery as a continuous measure showed a steep decrease in risks of perioperative MACE during the first 9 months. After 9 months, an increase in time between stroke and surgery did not further reduce the risks. The results for 30-day all-cause mortality showed similar patterns, although estimates were not as dramatic as for 30-day MACE. When analyzing the MACE components individually, we found that recurrent strokes were the main contributor to the high risk of MACE. A history of stroke any time prior to surgery was associated with a 16 fold increased relative risk of recurrent stroke, compared with patients without prior stroke. We also performed analyses stratified by surgery risk as low- (OR for stroke anytime, 3.97; 95% CI, 2.79-5.66), intermediate- (OR for stroke anytime, 4.46; 95% CI, 2.87-5.13) and high-risk (OR for stroke anytime, 1.98; 95% CI, 1.20-3.27), which were somewhat challenged in power. However, results indicated that stroke associated relative risk was at least as high in low and intermediate-risk surgery as in high risk surgery.
Author Interviews, Ophthalmology, Stem Cells, Transplantation / 17.07.2014

Ben Mead Molecular Neuroscience Group Neurotrauma and Neurodegeneration Section School of Clinical and Experimental Medicine University of Birmingham, BirminghamMedicalResearch.com Interview with: Ben Mead Molecular Neuroscience Group Neurotrauma and Neurodegeneration Section School of Clinical and Experimental Medicine University of Birmingham, Birmingham Medical Research: What are the main findings of the study? Answer: Traumatic and neurodegenerative disease of the retina lead to an irreversible loss of retinal ganglion cells (RGC) which are the neuronal cells located in the inner retina that transmit visual signals to the brain. Thus RGC injury results in visual defects which can ultimately progress into permanent blindness. One promising therapeutic approach is the use of stem cells as a source of replacement for lost retinal cells. However a theory has emerged suggesting that stem cells can act through the secretion of signalling molecules (growth factors). One stem cell that has recently shown great promise for neuronal repair are dental pulp stem cells (DPSC), which are multipotent stem cells easily isolated from adult teeth, including third molars (Mead et al 2013, 2014). In our research, we transplanted either dental pulp stem cells or the more widely studied bone marrow-derived mesenchymal stem cell (BMSC) into the vitreous chamber of the eye after optic nerve crush (Mead et al 2013). The main finding of this study was that DPSC, to a significantly greater degree than BMSC, promoted the survival of injured RGC and the regeneration of their axons. We also showed that the mechanism of action was not through differentiation and replacement of cells but was actually paracrine mediated, i.e. through DPSC-derived growth factors (Mead et al, 2013, 2014).
Author Interviews, JAMA, Prostate Cancer, Testosterone / 16.07.2014

Grace Lu-Yao PhD, MPH Professor of Medicine Robert Wood Johnson Medical School Rutgers, The State University of New Jersey Rutgers Cancer Institute of New Jersey New Brunswick, NJ 08903-2681MedicalResearch.com Interview with: Grace Lu-Yao PhD, MPH Professor of Medicine Robert Wood Johnson Medical School Rutgers, The State University of New Jersey Rutgers Cancer Institute of New Jersey New Brunswick, NJ 08903-2681 Medical Research: What are the main findings of the study? Dr. Lu-Yao: Primary ADT (ie., use of androgen deprivation as an alternative to surgery, radiation or conservative management for the initial management of prostate cancer) is not associated with improved overall or disease specific survival.
Author Interviews, Cancer Research / 16.07.2014

John D'Orazio, M.D., Ph.D. Drury Pediatric Research Endowed Chair Associate Professor, Univ. KY College of Medicine Pediatric Hematology-Oncology The Markey Cancer Center Lexington, KY 40536-0096MedicalResearch.com Interview with: John D'Orazio, M.D., Ph.D. Drury Pediatric Research Endowed Chair Associate Professor, Univ. KY College of Medicine Pediatric Hematology-Oncology The Markey Cancer Center Lexington, KY 40536-0096 Medical Research: What is the background for this study? Dr. D'Orazio: Malignant melanoma is the deadliest of skin cancers, and it’s incidence has increased enormously over the last several decades.  In the 1930’s only one in every fifteen hundred Americans would get melanoma in his/her lifetime.  Now it’s one in fifty or sixty.  Plus, it often affects young adults in the prime of their lives.  Altogether, nearly 10,000 Americans die of melanoma every year.  However, risk is not equally shared.  Fair-skinned people who tend to burn rather than tan from sun exposure have a much higher risk than dark skinned people.  On the surface, it would appear that the amount of melanin in the skin would be the only determinant of melanoma risk but the truth is more complex.  Our lab has been interested in a particular hormonal pathway in the skin that directly influences melanoma risk.  When UV radiation (sunlight) hits the skin, it causes damage to the cells of the skin.  Cells respond to this damage to protect themselves against further injury.  One way in which they do this is by turning on a hormone called melanocyte stimulating hormone, abbreviated “MSH”.  Made by keratinocytes, the most abundant cells in the epidermis, MSH is directly responsible for ramping up melanin production by melanocytes, the cells that make the pigment in the skin that gives us a tan.  This pigment called melanin acts as natural sunscreen and blocks UV radiation from penetrating into the skin.  This is very important because people who can tan are in a much safer state the next time they get sun exposure.  Because they have more melanin in the skin, the UV won’t cause as much damage.  The key is to realize that UV causes mutations in melanocytes, and with enough damage to the DNA, melanocytes can turn cancerous and become melanomas.   People who have the melanoma-prone, “can’t tan” skin type often have problems in this MSH hormonal pathway.  Specifically, they have inherited problems with the receptor on melanocytes that binds to MSH and makes the cells make more pigment.  This protein, called the melanocortin 1 receptor (or “MC1R”), is the way that melanocytes sense that the skin has been injured and needs more melanin.  If the MC1R won’t signal, then melanocytes just sit there and can’t be induced to make more melanin pigment.  Surely this is a major reason why people with MC1R signaling defects are at high risk of melanomas.
Author Interviews, Cancer, Cancer Research / 16.07.2014

Rebecca H. Johnson, MD Assistant Professor, Clinical Genetics University of Washington Seattle, WashingtonMedicalResearch.com Interview with  Rebecca H. Johnson, MD Assistant Professor, Clinical Genetics University of Washington Seattle, Washington Medical Research: What are the main findings of the study? Dr. Johnson: We observed that, over the past two decades, there has been an increase in the incidence of testicular cancer in Hispanic American adolescents and young adults (AYAs) between 15 and 39 years of age. This increase is seen in both major subtypes of testicular cancer and affects Hispanic AYA patients with all stages of disease at the time of diagnosis. No comparable increase was observed in non-Hispanic white AYA,s or in older American men regardless of Hispanic ethnicity.  Between 1992 and 2010, the incidence of testicular cancer in AYA Hispanics has increased 58% in contrast to just 7% in non-Hispanic white AYAs.
Author Interviews, JAMA, Pain Research / 15.07.2014

Kurt Kroenke, M.D. Professor of Medicine, Indiana University School of Medicine Research Scientist, Indiana University Center for Health Services and Outcomes Research Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc. Director of Education and Training Programs, Regenstrief Institute, Inc. Core Investigator, VA HSR&D Center for Health Information and CommunicationMedicalResearch.com Interview with: Kurt Kroenke, M.D. Professor of Medicine, Indiana University School of Medicine Research Scientist, Indiana University Center for Health Services and Outcomes Research Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc. Director of Education and Training Programs, Regenstrief Institute, Inc. Core Investigator, VA HSR&D Center for Health Information and Communication
Medical Research: What are the main findings of the study? Dr. Kroenke: The telecare intervention including monitoring of pain using automated phone calls or the Internet with contacts by a nurse care manager who met weekly with a physician pain specialist to discuss treatment of new patients or patients already being followed who were not improving.
  • Almost twice as many patients in the telecare group had improvement in their pain compared to the usual care control group (52% vs. 27%).
  • Moreover, nearly twice as many patients in the usual care group got worse over 12 months (36% vs. 19%).  Thus, patients with chronic pain may not only fail to improve with current treatment, they in fact can get worse over time.
  • Although one-third of these chronic pain patients were on opioids at start of study, there were very few patients in which opioids needed to be started or dose increased.
  • The intervention group was about equally divided between those who chose to do automated symptom monitoring (ASM) by IVR (51%) or internet (49%).  The majority of patients rated the monitoring as easy to do, and the telecare intervention helpful.
Author Interviews, Kidney Disease, Transplantation / 15.07.2014

Dr Hallvard Holdaas Consultant in Nephrology National Hospital of Oslo, NorwayMedicalResearch.com Interview with: Dr Hallvard Holdaas Consultant in Nephrology Department of Transplant Medicine Oslo University Hospital Rikshospitalet, Oslo Norway. Medical Research: What are the main findings of the study? Dr. Holdaas: Most studies examining long-term risk for living kidney donors have included  comparators from the background population with hypertension, diabetes mellitus, reduced renal function, cancer and other concomitant diseases; or for the few studies with more “healthy” comparators the follow-up time have been restricted. In our study we compared living donors to a healthy non-donor population which would have qualified as donors themselves, with median follow-up of 15.1 years for the donors. The relative risk for the living donors compared to a healthy control was 11.38 for endstage renal disease (ESRD), 1.4 for cardiovascular death and 1.3 for all-cause mortality (Mjoen et al., 2014).
Author Interviews, Kidney Disease, NEJM, Transplantation / 15.07.2014

Paul Kimmel, M.D. Division of Kidney, Urologic and Hematologic Diseases National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health Professor Division of Renal Diseases and Hypertension The George Washington UniversityMedicalResearch.com Interview with: Paul Kimmel, M.D. Division of Kidney, Urologic and Hematologic Diseases National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health Professor Division of Renal Diseases and Hypertension The George Washington University Medical Research:   What are the main findings of the review? Dr. Kimmel: AKI (Acute Kidney Injury) and CKD (Chronic Kidney Disease), two syndromes approached separately in medical school  curricula  as well as in the clinical arena are inextricably intertwined.  They should be taught as a combined entity, culminating in progressive loss of renal function necessitating renal replacement therapy (dialysis or transplantation). The two syndromes increase risk for cardiovascular disease and diminished quality of life as well.  Preventive and therapeutic strategies should be directed at the combined entity.
AHA Journals, Author Interviews, Stroke / 15.07.2014

Iftikhar J. Kullo, MD Division of Cardiovascular Diseases Mayo Clinic Rochester, MNMedicalResearch.com Interview with: Iftikhar J. Kullo, MD Division of Cardiovascular Diseases Mayo Clinic Rochester, MN   Medical Research: What are the main findings of the study? Dr. Kullo: The main findings of the study are: 1) Family history of stroke or heart attack is associated with presence of significant narrowing (greater than 70%) of the carotid arteries. These are the arteries that supply blood to the brain and narrowing or blockage of these arteries is associated with increased risk of stroke; 2) Having a sibling history of stroke or heart attack was more strongly associated with narrowing of the carotid artery than having a parent with such history; 3) The greater number of relatives with history of stroke or heart attack, the greater the odds of having narrowing in one of the carotid arteries.
Author Interviews, BMJ, End of Life Care / 15.07.2014

Dr. Kirsty Boyd Programme theme head (Clinical Communication) Honorary Clinical Senior Lecturer Primary Palliative Care Research Group Division of Community Health Sciences: General Practice University of EdinburghMedicalResearch.com Interview with: Dr. Kirsty Boyd Programme theme head (Clinical Communication) Honorary Clinical Senior Lecturer Primary Palliative Care Research Group Division of Community Health Sciences: General Practice University of Edinburgh Medical Research: What do we know already about people with ‘multimorbidity’? Dr. Boyd: We know that an increasing number of patients have multiple life-limiting illnesses or progressively deteriorating health due to several long term conditions or general frailty. Caring for them well poses major challenges and they are often hospitalised in the last year of life. They do not fit well into illness and healthcare models that focus on single conditions. Understanding the experiences of patients and their family caregivers is vital to inform improvements in best supportive care and palliative care. We wanted to build on care models for integrated care of people with long term conditions and consider the needs of those at risk of dying with multiple conditions in more detail.
Author Interviews, BMJ, Emergency Care / 15.07.2014

MedicalResearch.com Interview with: Jeffrey Allen Kline Vice Chair of Research Department of Emergency Medicine MedicalResearch.com Interview with: Jeffrey Allen Kline Vice Chair of Research Department of Emergency Medicine Indiana University Health Medical Research: What are the main findings of this study? Dr. Kline: We believe that clinicians use information from their patients’ faces to make decisions about diagnostic testing. This is particularly relevant in emergency medicine, where the clinicians make decisions rapidly with limited information. We videotaped patients’ faces who had chest pain and dyspnea and used the most well-known facial scoring system to assess their facial expression variability in response to seeing visual stimuli. We found that patients who ultimately had emergent problems tended to hold their faces in a neutral position and be less likely to show the expression of surprise. The investigators were not surprised at this, but we did find that patients with emergent problems also tended to have less negative affect as well as less positive affect. In other words, patients who were sickest even tended to frown less than patients with no medical problem.
Author Interviews, Blood Pressure - Hypertension, Cost of Health Care / 15.07.2014

Alejandro Arrieta, PhD Assistant Professor Department of Health Policy and Management Florida International UniversityMedicalResearch.com Interview with: Alejandro Arrieta, PhD Assistant Professor Department of Health Policy and Management Florida International University Medical Research: What are the main findings of the study? Dr. Arrieta: We found that it makes business sense for insurance companies to reimburse patients for the cost of blood pressure monitors that they can use at home. In just the first year, we estimate that insurance companies can produce returns that range from $0.85 to $3.75 per dollar invested in blood pressure monitors provided to their members.
Author Interviews, Brigham & Women's - Harvard, Nutrition, Vitamin C / 14.07.2014

MedicalResearch Interview with: Dr. Lu Wang MD PhD Associate Epidemiologist, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Preventive Medicine Boston, MA 02115 Medical Research: What are the main findings of the study? Dr. Wang: We found that vitamin E supplement 400 IU every other day and vitamin C supplement 500 mg daily had no effect on total cancers, the incidence of prostate cancer and other site-specific cancers during periods of intervention, post-trial observation, or overall.
AHA Journals, Author Interviews, Lipids / 14.07.2014

Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI Director of Research, Cardiac Catheterization Laboratory Director, Cardiovascular Outcomes Group Associate Professor of Medicine, New York University School of Medcine Principal Investigator ISCHEMIA-CKD trialMedicalResearch.com Interview with: Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI Director of Research, Cardiac Catheterization Laboratory Director, Cardiovascular Outcomes Group Associate Professor of Medicine, New York University School of Medcine Principal Investigator ISCHEMIA-CKD trial Medical Research: What are the main findings of the study? Dr. Bangalore: Our objective was to evaluate whether non-fasting LDL has similar prognostic significance as that of the conventionally measured fasting LDL values. We found that in an analysis of over 16,000 patients from the National Health and Nutrition Examination Survey that the non-fasting LDL values had similar prognostic significance as that of fasting LDL values for the prediction of long term (up to 14 years) death or cardiovascular death, thus questioning the traditional practice of insisting that patients fast prior to blood draw for a lipid panel. This was also true for other components of the lipid panel including the triglycerides and total cholesterol.
Author Interviews, Depression, Journal Clinical Oncology, Metabolic Syndrome, Prostate Cancer / 14.07.2014

MedicalResearch.com with: Sandip M. Prasad MD Assistant Professor Medical University of South Carolina, Charleston, SCSandip M. Prasad MD Assistant Professor Medical University of South Carolina, Charleston, SC and Scott E. Eggener, MD Associate Professor of Surgery Co-Director, Prostate Cancer Program Director of Translational and Outcomes Research, Section of Urology University of Chicago Medical Center, Chicago, IL;Scott E. Eggener, MD Associate Professor of Surgery Co-Director, Prostate Cancer Program Director of Translational and Outcomes Research, Section of Urology University of Chicago Medical Center, Chicago, IL; Medical Research: What are the main findings of the study? Answer: Depressed men with a diagnosis of intermediate- or high-risk prostate cancer have worse overall outcomes than those without baseline depression and are less likely to undergo definitive therapy. The difference in overall survival between men with and without a depression diagnosis was independent of prostate cancer treatment type.
Author Interviews, CMAJ, Metabolic Syndrome, Pulmonary Disease, Weight Research / 14.07.2014

MedicalResearch.com Interview with: Dr Gundula Behrens Department of Epidemiology and Preventive Medicine University of Regensburg Franz-Josef-Strauss-Allee 11 93053 Regensburg, Germany Medical Research: What are the main findings of the study? Dr Behrens: We studied the relations of obesity and physical activity to the incidence of chronic obstructive pulmonary disease (COPD) among more than 100,000 middle-aged to elderly men and women living in the U.S. People with a large waist circumference (43.5 inches (110 cm) or over in women and 46.5 inches (118 cm) or over in men) had a 72% increased risk of COPD as compared to people with a normal waist circumference. In contrast, individuals who were physically active five times or more per week had a 29% decreased risk of COPD as compared to their physically inactive counter-parts.
AHA Journals, Author Interviews, Diabetes, Heart Disease / 14.07.2014

MedicalResearch.com Interview with: Dr Alex Dregan Lecturer in Translational Epidemiology and Public Health, Division of Primary Care and Public Health Research King's College London, London Medical Research: What are the main findings of the study? Dr. Dregan: Our study showed that chronic inflammation was associated with increased risk of developing cardiovascular disease, specifically type II diabetes and coronary heart disease. The risk of cardiovascular disease increased with the severity of inflammatory disorders. In addition, inflammation also increased the risk of multiple morbidity (two or more cardiovascular diseases).
Author Interviews, BMJ, Multiple Sclerosis / 14.07.2014

Dr Nils Muhlert Wellcome Trust ISSF Research Fellow School of Psychology Cardiff UniversityMedicalResearch.com Interview with: Dr Nils Muhlert Wellcome Trust ISSF Research Fellow School of Psychology Cardiff University Medical Research: What are the main findings of the study? Dr. Muhlert: Decision making impairments are known to occur in people with multiple sclerosis (MS), and are important, given they can contribute to employment status, treatment compliance and function in everyday life. Studies by Kleeberg, Simioni and others have demonstrated that decision-making impairments can occur early in the course of multiple sclerosis and get worse as the disease progresses. Questions however remain over whether these impairments are linked to more general cognitive difficulties, differences between multiple sclerosis subtypes, and their relationship with MRI changes. We assessed decision-making and examined MRI changes in a relatively large sample of people with multiple sclerosis (N = 105) and healthy controls (N = 43). All participants performed the Cambridge Gambling Task, which independently measures risk-taking, impulsivity, deliberation and risk adjustment, and underwent an MRI scan including T1-weighted and diffusion MRI sequences. We demonstrate that people with multiple sclerosis experience difficulties with risk adjustment (gauging risk and adapting accordingly) and in the speed of making decisions but not in impulsivity. These problems were seen in those classified as having cognitive impairment and those not (i.e. cognitively unimpaired). We found that decision-making impairments were twice as common in people with relapsing-remitting and primary progressive MS than healthy controls, and almost four times as common in people with secondary progressive multiple sclerosis. In addition, decision making impairments in multiple sclerosis were linked to MRI changes in regions previously linked to decision-making in other conditions, including fronto-striatal and hippocampal regions. These findings offer insight into the precise decision-making difficulties experienced by people with multiple sclerosis, the relative prevalences in different subtypes of the disease and the pathological processes that may underlie them.
Author Interviews, Diabetes, Diabetes Care / 13.07.2014

MedicalResearch.com Interview with: dr_Eric RavussinEric Ravussin, Ph.D., Boyd Professor Director Nutrition Obesity Research Center Douglas L. Gordon Chair in Diabetes and Metabolism Associate Executive Director for Clinical Science Baton Rouge LA Medical Research: What is the background of this study? Dr. Ravussin: It has long been postulated that hypoxia is bad for metabolic health. Hypoxia of adipose tissue has been thought to cause oxidative stress, resulting in the recruitment of macrophages with resultant secretion of cytokines and inflammation.  However, repeated bouts of hypoxia induced during vigorous exercise results in increased glucose uptake and vascularization of muscle tissue. In addition, living at high altitude is associated with a lower prevalence of impaired fasting glucose and type 2 diabetes compared with living at low altitude. Therefore, we asked the question, “What is the balance between the beneficial effects of hypoxia in muscle tissue and ‘bad’ effects in adipose tissue”? We devised a study in eight healthy men of different ethnicities, put into a hypoxic environment for 10 consecutive nights for 10 hours. The subjects slept in a hypoxic tent, using nitrogen dilution. Medical Research: What are the main findings of the study? Dr. Ravussin: The main findings of this study included:
  • Adipose tissue hypoxia was confirmed;
  • Subjects lost an average of 1.2 kg;
  • This study reports for the first time a reduced fasting glucose level and improved whole-body (skeletal muscle) and hepatic insulin sensitivity after nightly exposure to moderate hypoxia.
Orthopedics / 12.07.2014

Christoher C. Kaeding M.D. Judson Wilson Professor, Department of Orthopaedics Executive Director, Sports Medicine Center Head Team Physician, Department of Athletics The Ohio State UniversityMedicalResearch.com Interview with: Christoher C. Kaeding M.D. Judson Wilson Professor, Department of Orthopaedics Executive Director, Sports Medicine Center Head Team Physician, Department of Athletics The Ohio State University MedicalResearch: What are the main findings of the study? Dr. Kaeding:
  • Younger age and high activity level were predictors off another ACL injury after an ACL Reconstruction.
  • Allograft use in younger more active patients Had an increased risk of re-injury.
Author Interviews, Kidney Stones, Urology / 12.07.2014

Gregory Tasian, MD, MSc, MSCE Attending Urologist The Children’s Hospital of Philadelphia MedicalResearch.com Interview with: Gregory Tasian, MD, MSc, MSCE Attending Urologist The Children’s Hospital of Philadelphia    Medical Research: What are the main findings of the study? Dr. Tasian: The risk of developing kidney stones increased during the study period in all the cities except Los Angeles when mean daily temperatures rose above 50°F (10°C). Mean daily temperatures reaching 86°F (30°C) were associated with risk increases of 38% in Atlanta, 37% in Chicago, 36% in Dallas, and 47% in Philadelphia compared with 50°F (10°C). Kidney stone risk peaked within 3-5 days of exposure to high temperatures but then decreased within 7 to 10 days afterward.
Author Interviews, JAMA, Mental Health Research / 12.07.2014

MedicalResearch.com interview with: Lee M. Hampton, MD, MSc: Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Atlanta, Georgia Medical Research: What are the main findings of the study? Dr. Hampton: The study, which used CDC's national outpatient adverse drug event surveillance system (NEISS-CADES), found that there are almost 90,000 estimated annual emergency department visits by adults for adverse drug events from therapeutic use of antipsychotics, antidepressants, sedatives and anxiolytics, lithium salts or stimulants between 2009 and 2011. Almost one in five of those emergency department visits (19.3%) resulted in hospitalization. Sedatives and anxiolytics, antidepressants, and antipsychotics each caused 20,000 to 30,000 emergency department visits annually. However, relative to how often each of these types of medications was prescribed at outpatient visits, antipsychotics and lithium salts were more likely to cause emergency department visits for adverse drug events than were sedatives, stimulants, and antidepressants. Antipsychotics caused 3.3 times more emergency department visits for adverse drug events than sedatives, 4.0 times more emergency department visits than stimulants, and 4.9 times more emergency department visits than antidepressants relative to their outpatient use. Out of the 83 specific drugs the study looked at, ten drugs were implicated in nearly 60% of the emergency department visits for ADEs from therapeutic use of antipsychotics, antidepressants, sedatives and anxiolytics, lithium salts or stimulants. Zolpidem was implicated in nearly 12% of all such emergency department visits and 21% of such emergency department visits involving adults aged 65 years or older, more than any other antipsychotic, antidepressant, sedative or anxiolytic, lithium salt or stimulant.
Author Interviews, Kidney Disease / 11.07.2014

MedicalResearch.com Interview with: Victoria A. Kumar, M.D. Internal Medicine/Nephrology Division of Nephrology Department of Internal Medicine Southern California Permanente Medical Group Los Angeles, California, USA Medical Research: What are the main findings of the study? Dr. Kumar: There was over a 2 fold increase in patient survival in incident peritoneal dialysis patients in the first year on dialysis compared to propensity matched incident hemodialysis patients.  We excluded any patients who utilized a central dialysis catheter at any point during the first 90 days on hemodialysis in an effort to reduce the mortality bias associated with hemodialysis patients who start with a catheter.  All hemodialysis patients had pre-dialysis care by a nephrologist prior to starting dialysis. The 2+ fold increase in survival among peritoneal dialysis patients resulted in a 2-3 year cumulative survival advantage for peritoneal dialysis patients, using both intent to treat and as-treated analyses.
Author Interviews, Cost of Health Care, General Medicine, Heart Disease / 10.07.2014

Jeff Trost, MD Assistant Professor of Medicine Johns Hopkins MedicineMedicalResearch.com Interview with: Jeff Trost, MD Assistant Professor of Medicine Johns Hopkins Medicine Medical Research: What are the main findings of the study? Dr. Trost: In our study, we reported the use of two relatively simple tactics to significantly reduce the number of unnecessary blood tests to assess symptoms of heart attack and chest pain and to achieve a large decrease in patient charges. Specifically, we
  • 1) Provided information and education to physicians about proven testing guidelines and
  • 2) Made changes to the computerized provider order entry system at the medical center, part of the Johns Hopkins Health System. The guidelines call for more limited use of blood tests for so-called cardiac biomarkers. A year after implementation, our intervention led to an estimated $1.25 million reduction in laboratory charges.