Blog – Medical Research News and Interviews
04 Jul Validating Medicare Claims Data For Stroke
MedicalResearch.com Interview with Hiraku Kumamar, MD, MPH Department of Epidemiology Harvard School of Public Health, Boston, MA and Soko Setoguchi-Iwata, M.D. Duke Clinical Research Institute Durham, NC 27715 Medical Research: What are the main findings of the study? Answer: We evaluated the accuracy of discharge diagnosis of stroke in the Medicare claims database by linking it to a nationwide epidemiological study cohort with 30239 participants called REasons for Geographic And Racial Differences in Stroke (REGARDS). We found that among the 282 events captured using a strict claims definition of stroke, 91% were true events. We also found that 12% of the overall strokes had been identified only by Medicare claims, strongly supporting the use of these readily available data for event follow-up in cohort studies.04 Jul Poor Sleep Plagues Socioeconomically Deprived Neighborhoods
MedicalResearch.com Interview with:
Nathaniel F. Watson, MD, MSc
Professor of Neurology, University of Washington
Co-director, University of Washington Medicine Sleep Center
Director, Harborview Medical Center Sleep Clinic
Seattle, Washington
MedicalResearch: What are the main findings of the study?
Dr. Watson: The Singh Index is a composite measure of socioeconomically deprived neighborhoods. We found that as Singh Index increased, sleep duration reduced. This was true in the total sample of twins, and within twin pairs. The fact that we saw this within twin pairs means the association is present after controlling for genetics and shared environment, which substantially strengthens the association.
03 Jul Newer Drug-Eluting Stents Narrow Gap Between Cardiac Bypass and Stent Surgery Outcomes
MedicalResearch.com Interview with:
Sripal Bangalore, MD, MHA
Director of Research, Cardiac Catheterization Laboratory,
Director, Cardiovascular Outcomes Group,
Associate Professor of Medicine,
New York University School of Medicine,
New York, NY 10016
Medical Research: What are the main findings of the study?
Dr. Bangalore: We found that while CABG was associated with mortality benefit when compared with bare metal stents or first generation drug eluting stent, the gap between CABG and PCI was smaller and non significant when PCI was with newer generation DES. The same was true for repeat revascularization with the magnitude of benefit with CABG descending considerable from comparison with balloon angioplasty to newer generation DES.
03 Jul Nasal Cavity Malignancies: Charged Particle Therapy May Be Superior To Conventional Photon Therapy
MedicalResearch.com Interview with:
Dr. Robert Foote MD
Chair, Department of Radiation Oncology
Mayo Clinic, Rochester, MN
MedicalResearch: What are the main findings of the study?
Dr. Foote: Charged particle therapy (mainly protons and carbon ions) provide superior overall survival, disease-free survival and tumor control when compared to conventional photon therapy. In particular, it appears that proton beam therapy provides superior disease-free survival and tumor control when compared to the state of the art intensity modulated radiation therapy using photons.
03 Jul Pediatric Celiac Disease: Using HLA Genotype To Help Determine Risk
MedicalResearch.com Interview with:
Dr. Daniel Agardh M.D., Ph.D
Department of Pediatrics
Diabetes and Celiac Disease Unit
Skåne University Hospital
Malmo, Sweden,
MedicalResearch: What are the main findings of the study?
Dr. Agardh: In this study, we stratify the risk of celiac disease among children according to their HLA genotype and country of residence. We confirm that HLA-DQ2/2 genotype is the major risk factor for early celiac disease, but also show how the risk differs between the participating countries despite of sharing similar HLA risk. This points to the direction of an interaction between HLA and the environment that eventually lead to an autoimmune response in genetic susceptible children.
03 Jul PAD: Polyphenols in Dark Chocolate May Improve Peripheral Artery Disease
MedicalResearch.com Interview with: Lorenzo Loffredo, MD and Francesco Violi, MD Department of Internal Medicine and Medical Specialties Sapienza University of Rome, Rome, Italy; MedicalResearch: What are the main findings of the study? Answer: Dark chocolate is rich of polyphenols; these natural substances exert antioxidant properties and, through an increase of nitric oxide, dilate arteries. Our research group applied this effect to enhance blood flow in a very common disease, the peripheral arterial disease. This disease is characterized by reduced blood flow to the limbs. There are not any drugs that improve this blood flow, but dark chocolate could. Our study suggest that dark chocolate, and only dark chocolate, could reduce oxidative stress and improve blood flow and walking autonomy in patients with peripheral arterial disease. We observed no effect on blood flow, oxidative stress and on walking autonomy in PAD patients after milk chocolate assumption. This lack of effect was probably due to the low concentration of polyphenols in milk chocolate.03 Jul Accidents and Violence Account For Most Deaths Among US Young People
MedicalResearch.com Interview with:
Tamara Haegerich, PhD
Deputy Associate Director for Science
Division of Unintentional Injury Prevention
CDC - National Center for Injury Prevention and Control
MedicalResearch: What are the main findings of the study?
Dr. Haegerich: In the first three decades of life, more people in the US die from injuries and violence than from any other cause. Approximately 60% of fatal injuries are unintentional (for example, from motor vehicle crashes, drug overdose, and falls), 20% are due to suicide, and 20% are due to homicide. Injuries and violence have been linked to a wide range of physical, mental health, and reproductive health problems, and chronic diseases. They take an enormous economic toll, including the cost of medical care and lost productivity. Importantly, injuries and violence are preventable through education, behavior change, policy, engineering, and environmental supports. For example, laws that promote the use of seat belts and child safety seats, and prevent drunk driving, can reduce motor-vehicle-related injuries. Early childhood home visitation, school-based programs, and therapeutic foster care are examples of evidence-based approaches to preventing violence. Improving proper prescribing of painkillers and access to treatment for substance misuse could prevent prescription drug overdoses. Improvements are possible by framing injuries and violence as preventable, identifying interventions that are cost-effective and based on research, providing information to decision makers, and strengthening the capacity of the health care system.
03 Jul Sickle Cell Disease Potentially Cured with Nonmyeloablative HLA-Matched Allogeneic Stem Cell Transplantation
MedicalResearch.com Interview with:
Dr. John Tisdale MD
Molecular and Clinical Hematology Branch
National Institute of Diabetes and Digestive and Kidney Diseases,
National Heart, Lung, and Blood Institute, Bethesda, Maryland
MedicalResearch: What are the main findings of the study?
Dr. Tisdale: Using a nonmyeloablative allogeneic HLA-match peripheral blood stem cell transplantation strategy aimed at tolerance induction, we were able to revert the phenotype in 26 of 30 adult patients with severe sickle cell disease ranging in age from 16 to 65 years. In contrast to standard transplantation strategies which rely on high doses of chemo and/or radiotherapy after which the entire bone marrow and blood system is replaced by that of the donor, our patients had a mixture of their own and that of their donor. This procedure was well tolerated, with no non-relapse mortality, and led to complete replacement of red blood cells by that of the donor in successfully engrafted patients. This replacement resulted in decreases in pain, pain medication usage, hospitalizations, and improvements in organ function.
03 Jul Systemic Sclerosis: Autologous Hematopoietic Stem Cell Transplantation vs IV Pulse Cyclophosphamide
MedicalResearch.com Interview with: Prof
. Dr. Jacob M. van Laar
Professor and Chair
Dept of Rheumatology & Clinical Immunology
University Medical Center Utrecht
MedicalResearch: What are the main findings of the study?
Prof. van Laar: The results of the ASTIS-trial demonstrate that stem cell transplantation in selected patients with early, diffuse cutaneous systemic sclerosis, a rare, autoimmune connective tissue disease, prolongs long-term survival and improves clinical manifestations (skin, lung) and quality of life, when compared to monthly infusions with cyclophosphamide. The benefits must be weighed against the risks which include early treatment-related mortality (10% in the ASTIS-trial) and viral infections.
03 Jul Poor Sleep Linked To Faster Brain Aging
MedicalResearch.com: Interview with:
Dr. June Chi-Yan Lo
Research Fellow
Cognitive Neuroscience Laboratory
Duke-NUS Graduate Medical School
Singapore
MedicalResearch: What are the main findings of the study?
Dr. Lo: The Duke-NUS study examined the data of 66 older Chinese adults, from the
Singapore-Longitudinal Aging Brain Study. Participants underwent
structural MRI brain scans measuring brain volume and neuropsychological
assessments testing cognitive function every two years. Additionally,
their sleep duration was recorded through a questionnaire. Those who slept
fewer hours showed evidence of faster brain aging and decline in cognitive
performance.
03 Jul Insulin Pump May Be A Valuable Option For Difficult Type 2 Diabetes
MedicalResearch.com Interview with: Professor Yves Reznik Department of Endocrinology, University of Caen Côte de Nacre Regional Hospital Center Caen, France MedicalResearch: What are the main findings of the study? Prof. Reznik: OPT2MISE definitively demonstrate that pump therapy is a valuable option for treating those type 2 diabetes patients with uncontrolled hyperglycemia despite a high dose insulin regimen including at least 3 injections per day of rapid-acting and slow-acting insulin analogues, the gold standard for intensified insulin therapy. Such benefit on glucose control is obtained with lower daily insulin doses and without weight gain in comparison with multiple injection therapy. Pump therapy is effective in a population of patients un-preselected for their ability to deal with a medical device.03 Jul Is Testosterone Protective Against Heart Attack in Older Men?
MedicalResearch.com Interview with:
Jacques Baillargeon, PhD
Director, Epidemiology Division
Associate Professor
Department of Preventive Medicine and Community Health
University of Texas Medical Branch
MedicalResearch: What are the main findings of the study?
Dr. Baillargeon: The main findings of the study were that older men who were treated with testosterone did not appear to have an increased risk of Myocardial Infarction. For men with high MI risk, testosterone use appeared to be modestly protective against MI.
03 Jul Changes in Gut Bacteria May Influence Diabetes and Obesity
MedicalResearch.com Interview with:
Yalcin Basaran, MD
Gulhane Military Medical Academy School of Medicine
Ankara, Turkey.
MedicalResearch: What are the main findings of the study?
Dr. Basaran: We designed a cross-sectional study to identify the relation between the gut microbiota composition and obesity and diabetes. 27 severely obese individuals (20 men and 7 women with mean BMI: 39.98±5.56 kg/m2), 26 patients with newly diagnosed type 2 diabetes (18 men and 8 women with mean BMI: 28.63±5.08 kg/m2) and 28 healthy control subjects (22 men and 6 women with mean BMI: 23.02±1.70 kg/m2), between 18-65 years of age, were included in the present study. None of the participants was undergoing chronic treatment and no antibiotics, probiotics or prebiotics were taken within 3 months before collecting fecal material. Fecal samples were self-collected in sterile boxes, stored at -80o until analysis, and analyzed by quantitative real-time PCR for the presence of the most common types of intestinal bacteria.
Although tended to increase, we observed no significant difference between the three groups in regards to fecal concentrations of Bacteroidetes. There was also no considerable difference in the fecal Bifidobacteria, Firmicutes and Clostridium Leptum levels among the obesity and diabetes groups. However, Bifidobacteria, Firmicutes and Clostridium Leptum counts were all significantly lower in obese and diabetic patients compared with healthy control individuals. Additionally, logistic regression analysis showed that parameters of adiposity (weight, BMI and waist circumference) and those of glucose control (FBG and HbA1c) were related to the altered gut microbiota composition. This suggests that alterations in the gut microbiota composition may influence metabolic profile in humans.
03 Jul Improving Breast Cancer Diagnosis With Non-Invasive PET/MRI
MedicalResearch.com Interview with:
Dr. Katja Pinker MD
Department of Radiology
Medical University of Vienna ·
MedicalResearch.com: What are the main findings of the study?
Dr. Pinker: We hypothesized that by imaging multiple key processes involved in cancer development and growth with multiparametric PET/MRI an improved non-invasive diagnosis of breast tumors is possible. To test this hypothesis, we conducted this first clinical feasibility study.
Mutliparametric PET/MRI allows an improved non-invasive differentiation of benign and mailgnant breast tumors than currently used contrast-enhanced MRI alone. By its use unnecessary breast biopsies in benign tumors can be avoided without missing cancer.
02 Jul St. John’s Wort May Cause Dangerous Drug Interactions
MedicalResearch.com Interview with: Scott A. Davis, MA Research Administrative Coordinator Department of Dermatology Wake Forest School of Medicine MedicalResearch: What are the main findings of the study? Answer: St. John’s wort (SJW), a common complementary and alternative medicine (CAM) treatment for depression, is frequently used together with drugs that may interact dangerously with it. In data from the 1993-2010 National Ambulatory Medical Care Survey, a nationally representative survey of physician visits from the National Center for Health Statistics, SJW was prescribed together with drugs such as selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, warfarin, statins, digoxin, verapamil, and oral contraceptives. Using SJW together with other antidepressants may cause serotonin syndrome, a potentially fatal condition.02 Jul Links Between Breast Cancer and Obesity Studied
MedicalResearch.com Interview with
Sai-Ching Jim Yeung, MD, PhD, FACP
Professor of Medicine
The University of Texas MD Anderson Cancer Center
Department of Emergency Medicine
Department of Endocrine Neoplasia & Hormonal Disorders
Houston, Texas 77230-1402
MedicalResearch: What are the main findings of the study?
Dr. Yeung: We believe that this study has bridged a significant gap in knowledge between epidemiological data (the association of obesity and poor breast cancer prognosis) and biological mechanisms mediating the impact of obesity on cancer. This study provides an important mechanistic insight into the causal relationship between obesity and breast cancer growth.
- Direct evidence for the links between obesity-associated changes in the biological processes and hallmarks of cancer in human estrogen receptor-positive (ER+) breast cancer.
- Experimental evidence that obesity causes accelerated oncogene-driven ER+ breast cancer carcinogenesis.
01 Jul Asymptomatic Atrial Fibrillation Relatively Common In Cryptogenic Stroke
MedicalResearch.com Interview with: Dr. Tommaso Sanna MD Institute of Cardiology Catholic University of the Sacred Heart Rome, Italy MedicalResearch: What are the main findings of the study? Dr. Sanna: In patients with cryptogenic stroke, continuous ECG monitoring with an implantable device, called the Reveal XT Insertable Cardiac Monitor (ICM), discovered Atrial Fibrillation in 6.4 times more patients than conventional diagnostic strategies at six months, 7.3 times more patients at 12 months, and 8.8 times more patients at 36 months. In more detail, after 36 months of follow-up, 30% of patients with cryptogenic stroke had at least one episode of atrial fibrillation.01 Jul Aspirin and Lifestyle Changes May Modulate Colon Cancer Risk
MedicalResearch.com Interview with:
Kaspar Truninger, MD, FMH
Gastroenterology and Internal Medicine
Langenthal, Switzerland
MedicalResearch: What are the main findings of the study?
Dr. Truninger: In our study, we investigated the effect of lifestyle exposure on DNA methylation. We measured genome-wide promoter CpG methylation in 1092 normal colon biopsies from 546 healthy females. We observed that fewer CpGs acquired age-dependent methylation in users of aspirin and hormonal replacement therapy compared with nonusers, whereas more CpGs were affected in smokers and individuals with a body mass index > 25 compared with nonsmokers and less obese females. Half of the CpGs showing age-dependent methylation gain were hypermethylated in tissue of colorectal cancer. These loci gained methylation with a higher rate and were particularly susceptible to lifestyle exposure compared to age-only methylated CpGs. In addition, these CpGs were enriched for polycomb regions. Finally, all effects were different according to the anatomic location along the colon.
01 Jul Women May Be More Comfortable Seeking Mental Health Support Than Men
MedicalResearch.com Interview with:
Dr. Flora I Matheson PhD
Centre for Research on Inner City Health
St. Michael's Hospital
Toronto, ON, Canada
MedicalResearch: What are the main findings of the study?
Dr. Matheson:
- We found that women were 10 per cent more likely to use mental health services than men.
- And that within any 3-year period, women with physical illness used medical services for mental health treatment 6 months earlier than men.
01 Jul Small Changes Improve Geographic Disparity in Kidney Transplantation
MedicalResearch.com Interview with
Daniela P Ladner, MD, MPH, FACS
Assistant Professor Transplant Surgery
Department of Surgery, Division of Organ Transplantation
Director Northwestern University Transplant Outcomes Research Collaborative (NUTORC)
Comprehensive Transplant Center
Feinberg School of Medicine, Northwestern University
MedicalResearch: What are the main findings of the study?
Dr. Ladner: With the current kidney organ allocation system, there exists significant geographic disparity between the 58 Donor Services Areas (DSAs) in the US, which are distributed among 11 regions. This means that depending on where a patient lives it might take shorter or longer to receive a kidney organ for transplantation. Despite efforts, this has not improved over the course of 20 years and in most regions this has worsened. In 1991 and 1992 respectively, two states changed their kidney allocation system, such that kidneys would first be allocated with the DSA of procurement, then statewide, then regionally (which may include several states) and then nationally. Usually kidneys don’t get allocated statewide before regionally.
The main finding of this study is that in those two states (FL, TN), where a minor change to the kidney allocation was put into place, there was significant reduction in the geographic disparity between their Donor Services Areas. In other comparable states (equal numbers of DSAs within the state) the geographic disparity did not improve and in many the geographic disparity worsened.
01 Jul Slowdown In US Health Care Costs Largely Due to Flat Physician Reimbursement, Use of Generic Drugs
MedicalResearch.com Interview with: M Luca Lorenzoni OECD Organisation for Economic Co-operation and Development Health Accounts, Asian Health and Social Policy Outreach ELS/Health Division MedicalResearch: What are the main findings of the study? Answer:- The United States is an outlier in the scenery of OECD as it ranks first for health care expenditure, but last for coverage.
- The slowdown in US health care spending during the past decade brought the growth rate closer to that of other high-spending countries -Canada, France, Germany, the Netherlands and Switzerland- at around 1%. Previously in 2002, the US's health expenditure growth was around 7%, much higher than the approximate 3% which was the average for the other countries examined in the study
- Higher health-sector prices (e.g., hospital care and prescription drugs) are thought to be the main driver of expenditure differences between the US and other high-spending countries, and recent price dynamics largely explain declines in health expenditure growth.
01 Jul Diabetes: Intensive Treatment May Cause More Quality-of-Life Loss than Gain
MedicalResearch.com Interview with:
Sandeep Vijan, MD, MS
Center for Clinical Management Research
Ann Arbor Veterans Affairs Hospital,
Department of Internal Medicine, University of Michigan,
Ann Arbor Michigan
MedicalResearch: What are the main findings of the study?
Dr. Vijan: The main finding was that the burdens and side effects of intensive glycemic treatment significantly detract from the overall benefit of lower risks of diabetes complications, often to the point where the treatments cause more loss than gain in quality of life. It takes many (often 15-20) years to gain benefit from treatment, but the burdens begin right away and continue throughout treatment. By the time you might experience treatment benefit in terms of reduced complication risk, you've had a lot of years to have the downsides of treatment - which commonly include significant weight gain, low blood sugars, gastrointestinal symptoms, not to mention having to take multiple pills or injections on a daily basis.
01 Jul Combat Factors Associated With Pain and Opioid Use Among Veterans
MedicalResearch.com Interview with:Dr. Robin L. Toblin LCDR Robin L. Toblin, PhD, MPH (USPHS) Clinical Research Psychologist Walter Reed Army Institute of Research MedicalResearch: What are the main findings of your study? Dr. Toblin: Our study focused on chronic pain and opioid use in an infantry brigade three months after returning from war. We surveyed...
01 Jul Oral HIV Prophylaxis May Also Provide Some Protection Against Herpes
MedicalResearch.com: Interview with
Connie Celum, MD, MPH
Professor of Global Health and Medicine
Director, International Clinical Research Center
University of Washington
Harborview Medical Center
Seattle WA 98104
MedicalResearch: What are the main findings of the study?
Dr. Celum: We conducted a randomized, double blind study of daily oral tenofovir and tenofovir combined with emtricitabine (FTC) as oral pre-exposure prophylaxis (PrEP) for HIV among HIV serodiscordant couples (in which onepartner had HIV and the other partner did not) in Kenya and Uganda. Because of recent studies showing that tenofovir gel could reduce the chances of becoming HSV-2 infected, we studied the subset of HIV-uninfected partners who did not have HSV-2 and compared the rates who became HSV-2 infected during follow-up among those who received oral pre-exposure prophylaxis versus those who received placebo. We found that oral pre-exposure prophylaxis reduced HSV-2 acquisition by 30%.
30 Jun Diabetes: Switching Off A Single Gene Allows GI Cells To Produce Insulin
MedicalResearch.com: Interview with
Dr. Domenico Accili MD
Professor of Medicine
Department of Medicine
Columbia University College of Physicians and Surgeons
New York, New York 10032
MedicalResearch: What are the main findings of the study?
Dr. Accili: By switching off a single gene (foxo1), scientists at Columbia University’s Naomi Berrie Diabetes Center have converted human gastrointestinal cells into insulin-producing cells, demonstrating in principle that a drug could retrain cells inside a person’s GI tract to produce insulin.
30 Jun Many Knee Replacement Surgeries Classified As Inappropriate
MedicalResearch.com Interview with:
Daniel L. Riddle, PT, Ph.D., F.A.P.T.A.
Otto D. Payton Professor
Assistant department chair
Department of Physical Therapy
Virginia Commonwealth University
MedicalResearch: What are the main findings of the study?
Dr. Riddle: We used a classification system developed by researchers in Spain in the late 1990s and found that classifications of appropriate, inappropriate and inclusive ratings for persons undergoing knee replacement surgery were 44.0%, 21.7%, and 34.3%, respectively. We studied 175 persons who underwent unilateral total knee replacement in the Osteoarthritis Initiative study, an NIH and privately funded multi-year cohort study of persons with are at high risk for knee osteoarthritis. These findings need to be considered cautiously because the classification system was developed more than 15 years ago and was designed to place greatest priority on persons with end stage knee osteoarthritis and severe pain and functional loss.
30 Jun Exchanging Medical Data Between Providers Leaves Room For Improvement
MedicalResearch.com Interview with
John D’Amore, President & CTO
Diameter Health
1005 Boylston St #304
Newton MA 02461
MedicalResearch: What are the main findings of the study?
Answer: We examined C-CDA (Consolidated Clinical Document Architecture) documents from electronic health records and other health information technology vendors. C-CDA documents are an XML format for transmitting patient data (e.g. problems, allergies, medications, results, vital signs, smoking status). Usage of C-CDA documents is required for Stage 2 of Meaningful Use in the United States. Overall, we were readily able to extract data elements from these documents, but we found many places where clinical content could be improved. This leads to policy recommendations on improving C-CDA production and consumption. Since thousands of hospitals and many more physicians will be required to exchange these documents in the coming year, we believe our findings to be important and timely for those seeking to improve care continuity and information exchange.
30 Jun Cardiac CT Associated With Enhanced Preventative Medical Care
MedicalResearch.com Interview with:
Eddie Hulten, MD MPH FACC FSCCT and
Ron Blankstein, MD FACC
Cardiovascular Imaging Noninvasive Cardiovascular Imaging
Walter Reed National Military Medical Center Brigham and Women’s Hospital
Bethesda, MD Boston, MA
MedicalResearch: What are the main findings of the study?
Answer: Although any medical test should be used to change management, the extent to which CCTA (Cardiac computed tomography angiography) findings are associated with medication changes (aspirin and lipid lowering) is not previously extensively studied.
Thus, we conducted the largest and one of the longest follow up studies of preventive cardiovascular medications before and after coronary computed tomography angiography (CCTA). We demonstrated that CCTA findings are associated with significant changes in preventive medications after CCTA.
29 Jun Maternal Anxiety Disorders Linked To Excessive Infant Crying
MedicalResearch.com Interview with:
Johanna Petzoldt
Institute of Clinical Psychology and Psychotherapy
Chemnitzer Straße
Dresden, Germany
MedicalResearch: What are the main findings of the study?
Answer: We investigated 286 mother-infant couples from the Maternal Anxiety in Relation to Infant Development (MARI) Study from Dresden (Germany) via standardized interview and questionnaire. We found a robust relation from maternal lifetime anxiety disorders as early as prior to pregnancy to excessive crying in the offspring. Also, the association increased when considering incident anxiety disorders during pregnancy and after delivery.