Blog – Medical Research News and Interviews
21 May Pediatric Status Epilepticus: Lorazepam vs Diazepam?
MedicalResearch.com Interview with:
James Chamberlain, MD
Division Chief, Emergency Medicine
Children’s National Health System
Washington, DC
MedicalResearch: What are the main findings of the study?
Dr. Chamberlain: Contrary to our hypothesis, lorazepam was not superior to diazepam for treating pediatric seizures. Both medications had similar effectiveness (72-73%) and safety (15-16% incidence of assisted ventilation). Lorazepam caused a longer period of sedation prior to waking up. The difference was approximately 15 minutes.
21 May Hip Osteoarthritis: How Beneficial is Physical Therapy?
MedicalResearch.com Interview
Professor Kim Bennell
ARC Future Fellow
Department of Physiotherapy
University of Melbourne
Parkville, Vic 3010 Australia
MedicalResearch: What are the main findings of the study?
Professor Bennell: In 102 people with painful hip osteoarthritis, we compared a 'real' physical therapy program involving exercise, manual therapy techniques,education and provision of a cane if appropriate to a sham physical therapy treatment that was made to look as though it was real but instead involved turned off ultrasound and gentle application of a hand crème to the hip region. Participants in both groups went to see a physical therapist on 10 occasions over 12 weeks and performed home exercises if in the 'real' physical therapy group or lightly applied the cream at home if in the sham group. Participants were followed for 9 months in total. We found that while both groups showed improvements in pain and physical function, the improvements were similar between the two groups. That is, the real physical therapy program did not show greater benefits over a sham treatment.
21 May Childhood Asthma: Higher Out-of-Pocket Costs May Cause Some Parents to Avoid Care
MedicalResearch.com Interview with:
Vicki Fung, Ph.D.
Assistant Professor
Department of Medicine, Harvard Medical School
Mongan Institute for Health Policy, Massachusetts General Hospital
MedicalResearch: What are the main findings of the study?
Dr. Fung: We found that lower income parents of children with asthma were more likely to delay or avoid taking their children to a doctor's office visit or to the emergency room if they had to pay higher out-of-pocket costs for care; they were also more likely to report borrowing money to pay for asthma care.
21 May Kidney Stones: Non-Invasive Treatment Not Always Better
MedicalResearch Interview with:
Charles D. Scales, Jr MD MSHS
Assistant Professor of Surgery
Division of Urologic Surgery
Duke University Medical Center
MedicalResearch: What are the main findings of the study?
Dr. Scales: When it comes to treating kidney stones, less invasive is not always better.
We used the best method short of a randomized trial to balance out patients in terms of factors that might influence the success of treatment. In other words, we achieved a “statistical toss-up” for factors that could influence the outcome of the procedure.
When we balanced out all of the factors that might influence the chance of a repeat procedure, we found that about 11% of patients treated with non-invasive SWL had a repeat procedure, as compared to <1% with minimally invasive URS.
21 May Prenatal Exposure To Tobacco Increases Risk of ADHD Symptoms
MedicalResearch.com Interview with: Nathalie E. Holz, MA Department of Child and Adolescent Psychiatry and Psychotherapy Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany MedicalResearch: What are the main findings of the study? Dr. Holz: Using data from a prospective community sample followed since birth, we investigated the impact of prenatal maternal smoking on lifetime Attention-Deficit/ Hyperactivity Disorder (ADHD) symptoms and on brain structure and inhibitory control assessed with Magnetic Resonance Imaging in the adult offspring. Those who were prenatally exposed to tobacco not only exhibited more ADHD symptoms, but also showed decreased activity in the inhibitory control network encompassing the inferior frontal gyrus as well as the anterior cingulate cortex. Activity in these regions was inversely related to lifetime ADHD symptoms and novelty seeking, respectively. In addition volume in the inferior frontal gyrus was decreased in these participants.21 May How Do Patients Decide to Accept a LVAD – Left Ventricular Assist Device?
MedicalResearch.com Interview with:
Colleen K. McIlvennan, DNP, ANP
Assistant Professor of Medicine
University of Colorado, Division of Cardiology
Section of Advanced Heart Failure and Transplantation
MedicalResearch: What are the main findings of the study?
Answer: We interviewed 22 patients who were offered destination therapy left ventricular assist devices (DT LVAD), 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an overriding desire to live as long as possible: [LVAD] was the only option I had…that or push up daisies…so I automatically took this. In contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: There are worse things than death. Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually.
21 May Online Educational Game Improved Clinicians’ Hypertension Knowledge and Patient Outcomes
MedicalResearch.com Interview with:
Dr. Price Kerfoot MD, EdM
Rabkin Fellow in Medical Education
Associate Professor of Surgery, Harvard Medical School
MedicalResearch: What are the main findings of the study?
Dr. Kerfoot:
(1) An online spaced education game improved clinicians' knowledge of hypertension intensification and generated a modest but significant improvement in time to blood pressure target among their patients with hypertension.
(2) As a method to increase clinicians' long-term knowledge, the spaced education game was significantly more effective than providing the identical content via a traditional method (online posting with e-mail reminders).
20 May Antibiotics In Infancy and Childhood Asthma, Viral Infections
MedicalResearch.com Interview with:
Adnan Custovic DM MD PhD FRCP
Professor of Allergy
Institute of Inflammation and Repair
University of Manchester
University Hospital of South Manchester
Manchester M23 9LT, UK
MedicalResearch: What are the main findings of the study?
Dr. Custovic: In a longitudinal analysis of the data from our birth cohort study collected from birth to age eleven years, we demonstrated an association between early-life antibiotic prescription and development of wheezing, but not atopy. Furthermore, amongst children with wheezing, antibiotic prescription in infancy increases the risk of subsequent severe wheeze/asthma exacerbations and hospital admissions. This is the first demonstration that children who receive antibiotics in infancy have impaired antiviral immunity later in life, and that early-life antibiotic prescription is associated with variants on chromosome 17q21 locus (which is an asthma susceptibility locus).
Our findings suggest that the association between antibiotics and childhood asthma reported in previous studies arises through a complex confounding by indication, in which hidden factors which increase the likelihood of both antibiotic prescription in early life and subsequent asthma development are increased susceptibility to virus infections consequent to impaired antiviral immunity, and genetic variants on 17q21. Our results raises an important issue that effects which are often attributed to environmental exposures may be a reflection of genetic predisposition.
20 May New Anti-Incontinence Surgery Uses No Synthetic Mesh
MedicalResearch.com Interview with:
Daniel S. Elliott, M.D
MAYO Clinic, Associate Professor
Department of Urology
Section of Pelvic and Reconstructive Surgery
Rochester, Minnesota
MedicalResearch: What are the main findings of the study?
Dr. Elliott: The biggest issue is that we were able to devise a new procedure that is a simple outpatient anti-incontinence surgery for women that does NOT use any synthetic meshes. The importance of this is that all traditional (meaning NON-mesh) surgeries for female incontinence have been large surgeries with fairly significant risks such as pain, bleeding and prolonged recovery. When the meshes came out in the late ‘90’s, their big benefit was that they were outpatient and quick procedures. But now that we are discovering all the long term complications from meshes such as chronic pain, scarring, painful intercourse, vaginal extrusion of the meshes, and organ injury, patients have become VERY reluctant and fearful to undergo any mesh type surgery. Therefore, we devised a new procedure that used a very small piece of the patient’s own tissue (from the rectus fascia) and placed this via the “transobturator route.” In the process, we melded together the “best” of both worlds---a NON-mesh, outpatient anti-incontinence procedure that is safe (no long term problems as seen with meshes) .
20 May Diabetes May Have Imply Poorer Prognosis For Renal Cell Cancer
MedicalResearch.com Interview with: Sarah P. Psutka, MD Fellow in Urologic Oncology Department of Urology, Mayo Clinic MedicalResearch: What are the main findings of each study? Dr. Psutka: In this study we identified all diabetic patients with localized clear cell renal cell carcinomas who were surgically treated between 1990 and 2008 in our institution and matched them with nondiabetic patients. Our main findings were that, after controlling for major confounders such as age, sex, type of surgery, renal function, smoking status, performance status, and tumor grade and stage, diabetic patients had inferior overall survival than nondiabetic patients. Furthermore, among patients with clear cell carcinoma, diabetic patients also had shorter cancer-specific survival, suggesting that diabetes is a poor prognostic factor for patients with surgically treated renal cell carcinoma.20 May Radical Cystectomy: Simple Test of Functional Status Identifies Higher Risk Patients
MedicalResearch.com Interview with: Sarah P. Psutka, MD Fellow in Urologic Oncology Department of Urology, Mayo Clinic MedicalResearch: What are the main findings of each study? Dr. Psutka: In this study, we analyzed 1335 patients who underwent radical cystectomy at the Mayo clinic between 1996 and 2006. We categorized patients who stayed in the hospital longer than 10 days, putting them in the top 25th percentile of the length of stay, as having a prolonged hospital stay. We noted that prolonged hospital stay was associated with adverse postoperative outcomes, including serious complications and early postoperative death. Patients who had a prolonged length of stay had a higher burden of comorbidities, American Society of Anesthesiologist score, and their Eastern Cooperative Oncology Group Score. A multivariable analysis, holding these factors and other clinically relevant potential confounders constant, revealed that only the ECOG performance score independently predicted whether or not a patient had a prolonged hospital course following radical cystectomy.20 May Are Statins Effective In Reducing COPD Flares?
MedicalResearch Interview with:
Dr. Gerard J. Criner MD, FACP, FACCP
Professor, Medicine
Director, Medical Intensive Care Unit and Ventilator Rehabilitation Unit
Co-Director, Center for Inflammation, Translational and Clinical Lung Research, Temple University Hospital in Philadelphia, PA
MedicalResearch: What are the main findings of the study?
Dr. Criner: The STATCOPE Trial (Simvastatin in the Prevention of COPD Exacerbations) found that a statin drug commonly used to lower cholesterol is not effective in reducing the number and severity of flare ups from chronic obstructive pulmonary disease (COPD). The study rigorously tested the hypothesis that statin drugs may be beneficial to persons with COPD because of the drugs’ purported anti-inflammatory effect. However, researchers found that:
- 40 mg. of daily simvastatin (statin drug) added to usual care did not reduce exacerbation rate or prolong the time to exacerbation in patients with moderate to severe COPD.
- Simvastatin had no effect on lung function, quality of life, severe adverse events or mortality.
- The data do not demonstrate a therapeutic benefit from statins in patients with moderate to severe COPD.
19 May Most Emergency Room Super Frequent Users Have Addiction Disorder
Posted at 23:38h
in Addiction
MedicalResearch.com Interview with:
Jennifer Peltzer-Jones, R.N., Psy.D.
Henry Ford's Department of Emergency Medicine
MedicalResearch: What are the main findings of the study?
Answer: We found that within our group of 255 known Emergency Department “super-frequent users,” 77% had with some type of addiction disorder, and 47 percent visited the Emergency Department seeking narcotics for pain. Women were more likely to be narcotic seeking. Using our individualized Electronic Medical Record care plan intervention, created and overseen by our multidisciplinary team (comprised of Emergency Department staff physicians, a psychologist, residents, nurses and support staff), we found that our plan significantly decreased annual rates of visits by these super-frequent users and those who sought pain-relief narcotics and other super-frequent users.
19 May Pulmonary Embolism: Urine Fibrinopeptide B As Screening Tool
MedicalResearch.com Interview with
Timothy Fernandes, M.D., M.P.H.
University of California, San Diego
La Jolla, CA
MedicalResearch: What are the main findings of this study?
Dr. Fernandes: The fibrinopeptides are cleaved off of fibrinogen by thrombin during the generation of a new clot. These small molecules are excreted into the urine and we have developed a urine assay to measure the level of FPB. We examined the performance of urine FPB as a screening test for acute pulmonary embolism, blood clots that travel to the lungs.
The study group consisted of 344 patients: 61 (18%) with pulmonary embolism and 283 (83%) without. At a threshold of 2.5 ng/ml, urine FPB demonstrated sensitivity of 75.4% (95% CI: 62.4-85.2%), specificity of 28.9% (95% CI: 23.8-34.7%), and negative likelihood ratio of 0.18 (0.11-0.29), weighted by prevalence in the sample population. However, the thresholds of 5 ng/ml and 7.5 ng/ml had sensitivities of only 55.7% (95% CI: 42.5-68.2%), and 42.6% (30.3-55.9%), respectively.
The urine fibrinopeptide B assay at a cut-off of 2.5 ng/ml had a sensitivity of 75.4% for detecting pulmonary embolism. For diagnosis of PE, this sensitivity is comparable to previously published values for the first generation plasma latex and whole blood D-dimer assays (not as well and the D dimer ELISA assay).
19 May Atrial Fibrillation: Risk of Dementia with Non-Therapeutic Levels of Anticoagulation
MedicalResearch.com Interview with
T. Jared Bunch, MD
Medical director for Heart Rhythm Services
Director of Heart Rhythm research
Intermountain Medical Center, Utah
MedicalResearch: What are the main findings of the study?
Dr. Bunch: The main findings of the study are:
1) Atrial fibrillation patients treated with warfarin anticoagulation that have lower percentages of time in therapeutic range have significantly higher risks of all forms of dementia.
2) The dementia relative risk related to lower percentages of time in therapeutic range was higher than all other variables associated with stroke or risk of bleeding.
3) The risk of dementia related to lower percentages of time in therapeutic range was highest in younger patients in the study (<80 years).
19 May COPD: Benefits of high dose N-acetylcysteine
MedicalResearch.com Interview with:
Dr. Hoi Nam Tse, FCCP, MRCP, MBChB
Associate Consultant, Kwong Wah Hospital, Hong Kong
Life member and Council member of Hong Kong Thoracic Society
MedicalResearch: What are the main findings of the study?
Dr. Hoi Nam Tse: N-acetylcysteine (NAC) is an oral mucolytic containing anti-oxidative and anti-inflammatory property. Our study demonstrated that long term use of high-dose : N-acetylcysteine (600 mg twice daily for 1 year) was a well-tolerated treatment, and it reduced exacerbations and prolonged time to first exacerbation in ‘high-risk’ COPD patients--which was defined as patients who had 2 or more exacerbations per year, FEV1<50% or both. Such beneficial effect was not obvious in the ‘low-risk’ COPD patients.
18 May Pulmonary Embolism: Evaluation of Age-Adjusted Threshold of D-Dimer Blood Test
MedicalResearch.com Interview with
Scott C. Woller, MD
Co-Director Thrombosis Program
Intermountain Medical Center
Associate Professor of Internal Medicine
University of Utah School of Medicine
Murray, UT 84157-7000
Dr. Woller: By way of background, D-dimer, a simple blood test that is used to investigate the diagnosis of suspected pulmonary embolism (PE), and it increases with age. Recent research suggests that the use of an age-adjusted d-dimer threshold may improve diagnostic efficiency without compromising safety. We wished to assess the safety of using an age-adjusted d-dimer threshold in the work-up of patients with suspected pulmonary embolism.
MedicalResearch: What are the main findings of the study?
Dr. Woller: In this retrospective cohort study we identified 923 patients age > 50 years who presented to our emergency department with suspected pulmonary embolism, and had their pretest probability of PE calculated along with a d-dimer performed. All patients underwent computed tomography pulmonary angiography (CTPA). We observed that among patients unlikely to have PE, adoption of an age-adjusted D-dimer cut-off (compared with a conventional D-dimer cut-off) reduced the need for CTPA in an additional 18.3% of patients, and was associated with a low 90-day rate of failure to diagnose PE.
17 May Infertility in Men Linked to Mortality
MedicalResearch. com Interview with:
Michael Eisenberg, MD, PhD
Director, Male Reproductive Medicine and Surgery
Assistant Professor, Department of Urology
Assistant Professor, Department of Obstetrics and Gynecology
Stanford School of Medicine
MedicalResearch: What are the main findings of the study?
Dr. Eisenberg: There is an inverse relationship between semen quality and mortality so that as semen quality declines the likliehood of death increases.
17 May Two Large Meals May Be Better Than Six Small Meals For Weight, Diabetes Control
MedicalResearch.com Interview with:
Hana Kahleova, MD, PhD
Diabetes Centre, Institute for Clinical and Experimental Medicine
140 21 Prague
Czech Republic
MedicalResearch: What was the aim of your study?
Dr. Kahleova: The aim of the study was to compare the effect of six (A6 regimen) vs two meals a day, breakfast and lunch (B2 regimen), on body weight, hepatic fat content (HFC), insulin resistance and beta cell function.
MedicalResearch: What are the main findings of the study?
Dr. Kahleova: Comparison of the effect of six vs. two meals (breakfast and lunch) with the same daily caloric restriction (-500 kcal/day) and macronutrient content, each regimen lasting 12 weeks, demonstrated a superior effect of breakfast and lunch on body weight, hepatic fat content, fasting plasma glucose, C-peptide, glucagon and insulin sensitivity.
17 May Rheumatoid Arthritis: Obesity Impairs Disease Control
MedicalResearch.com Interview with:
Maria E.C. Sandberg, MSc PhD
Institutet för Miljömedicin / Institute of Environmental Medicine
Karolinska Institutet
Stockholm, Sweden
MedicalResearch: What are the main findings of the study?
Dr. Sandberg: Overweight at diagnosis significantly decreases the chance of achieving good disease control during the early phase of rheumatoid arthritis (RA).
17 May SLE: BAFF Antagonist For Treatment of Severely Active Disease
MedicalResearch.com Interview with: Dr Renee Martin Anthera Pharmaceuticals, Inc. 25801 Industrial Blvd, Suite B., Hayward, CA 94545, MedicalResearch: What are the main findings of the study? Dr. Martin: The PEARL-SC study identified many key elements that inform the further development of blisibimod for treatment of SLE: i. That patients with severely active disease responded well to blisibimod, ii. That a dose of 200mg blisibimod administered subcutaneously once per week improved measures of SLE disease activity, iii. That greater treatment effect was observed when the SRI-7 and SRI-8 endpoints were evaluated, presumably because the criteria for these endpoints (including 7- or 8- point improvements in SELENA-SLEDAI score, respectively, along with no new BILAG A or 2B scores, and no worsening of physician’s global assessment score) demand substantial improvement in disease activity compared with baseline, and are unlikely to be met by chance (e.g. in the placebo group), and iv. That blisibimod was safe and well-tolerated over 24-52 weeks of continuous therapy.16 May Antidepressants May Slow Growth of Brain Amyloid Plaques
MedicalResearch.com Interview with:
Yvette I. Sheline, M.D.
Professor of Psychiatry, Radiology, Neurology
Director, Center for Neuromodulation in Depression and Stress (CNDS)
University of Pennsylvania Perelman School of Medicine
Philadelphia, PA 19104
MedicalResearch: What are the main findings of this study?
Prof. Sheline: The main findings were that in transgenic mice who are genetically altered to develop Alzheimer's amyloid plaques, citalopram dramatically slowed the growth of plaques but did not cause existing plaques to shrink. In normal young people, it decreased the production of amyloid.
16 May Tdap Vaccine During Pregnancy: Safety and Efficacy
Posted at 10:36h
in Author Interviews, Baylor College of Medicine Houston, JAMA, OBGYNE, Vaccine Studies
MedicalResearch.com Interview with:
Flor M. Munoz, MD
Department of Pediatrics
Department of Molecular Virology and Microbiology
Baylor College of Medicine, Houston, Texas
MedicalResearch.com: What are the main findings of the study?
Dr. Munoz:
1. Tdap vaccine was safe and well tolerated during pregnancy
2. Women who are pregnant have adequate responses to the Tdap vaccine, similar to those of women who are not pregnant.
3. Antibodies to pertussis are efficiently transferred to the fetus through the placenta so that babies of mothers who were vaccinated during pregnancy had significantly higher concentrations of antibody at birth and up to 2 months of age, when compared to infants of mothers who were vaccinated post-partum.
4. Higher antibody concentrations in the first two months of life are likely to provide protection against pertussis during this period of high vulnerability
5. Infants of mothers who were vaccinated during pregnancy had adequate responses to their routine pertussis vaccines at 2, 4, and 6 months of age, and had expected and adequate responses to their 4th dose of vaccine at 1 year of age. The absolute concentration of antibodies to some of the pertussis antigens might be modestly lower after the primary series of vaccines in some infants of mothers who were vaccinated during pregnancy, but this difference does not persist after the 4th dose.
16 May Atrial Fibrillation: Risk With Intense Exercise Varies by Age
MedicalResearch.com Interview with: Dr Nikola Drca Department of Cardiology at the Karolinska Institute, Karolinska University Hospital Stockholm Sweden MedicalResearch: What are the main findings of the study? Dr. Nikola Drca: We found that intense physical activity like leisure-time exercise of more than five hours per week at the age of 30 increased the risk of developing atrial fibrillation later in life by 19%. In contrast, moderate-intensity physical activity like walking or bicycling of more than 1 hour per day at older age (age 60) decreased the risk by 13%.15 May US Health Care Age and Gender Spending Trends
MedicalResearch.com Interview with: David Lassman Statistician in the National Health Statistics Group, Office of the Actuary Centers for Medicare and Medicaid Services (CMS) Baltimore, Maryland. MedicalResearch: What types of health care spending are included in this report? Answer: In the past, the CMS Office of the Actuary provided periodic updates of health care spending by age and more recently by gender. This report, for the first time, provides a time series of spending by age (five categories – 0-18, 19-44, 45-64, 65-84, and 85+) and gender. We also show spending by three major age categories – children (0-18), working age adults (19-64), and the elderly (age 65 and over). We present data for personal health care only which consists of all the medical goods and services used to treat or prevent a specific disease or condition in a specific person. We provide estimates for the even years between 2002 and 2010. These age and gender estimates are controlled to the most recent Historical National Health Expenditure Accounts.15 May Migraines Associated With Increased Risk of Silent Stroke
MedicalResearch Interview with: Dr. Teshamae Monteith MD Assistant professor of Neurology Chief of the Headache Division University of Miami Miller School of Medicine. MedicalResearch: What are the main findings of the study? Dr. Monteith:- A doubling of silent brain infarctions in those with migraine even after adjusting for other stroke risk factors;
- No increase in the volume of white-matter hyperintensities (small blood vessel abnormalities) that have been associated with migraine in other studies;
- Migraines with aura — changes in vision or other senses preceding the headache — wasn’t common in participants and wasn’t necessary for the association with silent cerebral infarctions.
- High blood pressure, another important stroke risk factor, was more common in those with migraine. But the association between migraine and silent brain infarction was also found in participants with normal blood pressure.
14 May Mutated Gene Associated with Metabolic Syndrome
Posted at 21:25h
in Author Interviews, Endocrinology, Genetic Research, Metabolic Syndrome, Weight Research, Yale
MedicalResearch Interview with:
Arya Mani, M.D.
Department of Internal Medicine and Genetics
Yale Cardiovascular Research Center
Yale, New Haven CT
MedicalResearch: What are the main findings of the study?
Dr. Mani: Our group has identified a gene that when mutated it causes a form of truncal (central) obesity that is associated with a cluster of coronary artery disease risk factors, including high blood pressure, insulin resistance and possibly elevated blood lipids. These associated risk factors are collectively known as the metabolic syndrome, which may lead to development of diseases such as diabetes and coronary artery disease, both of which were very prevalent in the populations we studied. All identified mutations by our group have been so far gain of function mutations, which means they increased the activity of the gene in pathways related to adipogenesis and gluconeogenesis.
14 May Tackle Football Linked to Smaller Hippocampal Volume and Slower Reaction Times
MedicalResearch Interview with:
Patrick S. F. Bellgowan, PhD
Laureate Institute for Brain Research
Faculty of Community Medicine, The University of Tulsa,
Tulsa, Oklahoma
MedicalResearch: What are the main findings of the study?
Dr. Bellgowan: These results demonstrate 14% and 24% smaller hippocampal volumes in collegiate football players with and without a history of concussion relative to education-, sex- and age-matched controls participants. Further, the number of years of tackle football experience was correlated with smaller hippocampi and slower baseline reaction times. The hippocampus plays a key role in memory and emotional regulation. Volumetrics of other medial temporal lobe structures (I.e. The amygdala) did NOT show differences among groups suggesting that this effect is localized to the hippocampus.