Author Interviews, CMAJ, Sleep Disorders / 18.11.2013

Mohamed El Shayeb MD, MSc Health Technology and Policy Unit University of Alberta 3025 Research Transition Facility Edmonton, Alberta, Canada T6G2V2MedicalResearch.com Interview with: Mohamed El Shayeb MD, MSc Health Technology and Policy Unit University of Alberta 3025 Research Transition Facility Edmonton, Alberta, Canada T6G2V2 MedicalResearch.com: What are the main findings of the study? Dr. El Shayeb: Our study shows that limited channel level-3 portable devices, used at home, are of good diagnostic value compared to the comprehensive reference-standard level-1 sleep tests conducted in lab in the diagnosis of obstructive sleep apnea (the most common subtype of sleep disordered breathing.)

Were any of the findings unexpected? None of the findings were unexpected. Level-3 portable devices are commonly used in clinical practice; however, this technology has been widely disseminated, without solid evidence about their diagnostic performance or the subpopulation of sleep disordered breathing patients who are most appropriately diagnosed with them. Our research provides a high level of evidence on the diagnostic performance of these devices, and most importantly, defines the subgroup of patients who are eligible for this test (patients with simple obstructive sleep apnea, and without significant comorbidities.)
Author Interviews, JAMA, Lipids, Thyroid Disease / 18.11.2013

Angela M. Leung, MD, MSc Clinical Assistant Professor of Medicine Division of Endocrinology, Department of Medicine University of California Los AngelesMedicalResearch.com Interview with: Angela M. Leung, MD, MSc Clinical Assistant Professor of Medicine Division of Endocrinology, Department of Medicine University of California Los Angeles   MedicalResearch.com: What are the main findings of the study? Dr. Leung: Despite current guidelines to screen for thyroid dysfunction as a secondary cause of newly-diagnosed hyperlipidemia, this was performed only about 50% of the time by primary care providers in over 8,700 patients at a large, urban Boston academic medical center. Approximately 5% of patients who had thyroid function checked were found to have hypothyroidism. The majority of hypothyroid patients who received treatment with levothyroxine had successful correction of the initial hyperlipidemia within one year.
Accidents & Violence, Author Interviews, Pediatrics / 18.11.2013

Brad J. Bushman, PhD Professor of Communication and Psychology, Margaret Hall and Robert Randal Rinehart Chair of Mass Communication School of Communication, The Ohio State University, Columbus, Ohio; VU University Amsterdam, Amsterdam, NetherlandsGun Violence Trends in Movies Brad J. Bushman, PhD Professor of Communication and Psychology, Margaret Hall and Robert Randal Rinehart Chair of Mass Communication The Ohio State University, Columbus, Ohio; VU University Amsterdam, Amsterdam, Netherlands MedicalResearch.com: What are the main findings of the study? Dr. Bushman: Gun violence in PG-13 movies has tripled since 1985, the year the PG-13 rating was introduced. When the PG-13 rating was introduced, PG-13 films had about as much gun violence as G and PG films. Now PG-13 films have significantly more gun violence than R-rated films.
Author Interviews, PLoS, Weight Research / 16.11.2013

MedicalResearch.com Interview with: Guang Sun MD, PhD Professor, Discipline of medicine Faculty of medicine, Memorial University Canada MedicalResearch.com:  What are the main findings of the study? Dr. Sun: Plenty of anecdotal reports on how ‘Food Addiction’ may be a potential culprit of the rising prevalence of obesity. However to date no scientific study, based on a comprehensive criterion of the diagnosis of Food Addiction, has been performed at the population level. The main findings are in the following fours aspects: 1)         Food Addiction is indeed an important contributing factor in the development of obesity. 2)         The prevalence of Food Addition was 5.4% and increased concomitantly with obesity status defined by either body mass index (BMI) or body fat percentage (%BF). In another word, there is one food addict in every twenty adults (Newfoundland Province, Canada) 3)         Clinical Symptom Count(s) of Food Addiction is strongly associated with the severity of obesity. 4)         Women are twice as likely to be diagnosed with “Food Addiction” than men.
Allergies, Author Interviews, Heart Disease, Metabolic Syndrome, Pediatrics, Sleep Disorders, Surgical Research / 16.11.2013

MedicalResearch.com Interview with: Nina Berentzen Centre for Nutrition, Prevention and Health Services National Institute for Public Health and the Environment Bilthoven The Netherlands MedicalResearch.com: What are the main findings of the study? Answer: This study in 11-12 year old children shows that self-reported characteristics of sleep quality were not associated with blood pressure and HbA1c; and that in girls, but not in boys, some sleep characteristics were associated with anthropometric outcomes (BMI, waist circumference) and cholesterol levels. More specifically, in girls, longer time in bed was associated with lower BMI and waist circumference; having night-time awakenings with higher total cholesterol, going late to bed while rising early with higher total and HDL cholesterol; and feeling sleepy/tired during daytime with lower HDL cholesterol and with higher total-to-HDL cholesterol ratio. We report new findings for daytime outcomes of sleep quality that were not studied before in relation to cardiometabolic risk; e.g. difficulty with getting up in the morning, feeling rested after waking, and feeling sleepy or tired during the day. Our study therefore offers insight not only in characteristics of sleep at night, but also in consequences of sleep during the day.
Author Interviews, Health Care Systems, Long Term Care, Mental Health Research / 16.11.2013

Hugh C. Hendrie, MB ChB, DSc Professor, Department of Psychiatry, Indiana University School of Medicine Center Scientist, Indiana University Center for Aging Research Research Scientist, Regenstrief Institute, Inc.MedicalResearch.com Interview with: Hugh C. Hendrie, MB ChB, DSc  Professor, Department of Psychiatry, Indiana University School of Medicine Center Scientist, Indiana University Center for Aging Research Research Scientist, Regenstrief Institute, Inc. MedicalResearch.com: What are the main findings of the study? Answer: Our findings of higher rates of emergency care, longer hospitalizations and increased frequency of falls, substance abuse and alcoholism suggest that seriously mentally ill older adults remain a vulnerable population.
Author Interviews, Karolinski Institute, OBGYNE, Weight Research / 16.11.2013

MedicalResearch.com: Interview with: Olof Stephansson MD, PhD Associate professor, senior consultant in obstetrics and gynaecologyDepartment of Medicine, Clinical Epidemiology Unit, Karolinska InstitutetDepartment of Women’s and Children’s Health, Division of Obstetrics and Gynaecology Karolinska Institutet, Stockholm, Sweden MedicalResearch.com: What are the main findings of the study? Answer: Women with a history of bariatric surgery have an increased risk of preterm delivery, a doubled risk for small-for-gestational-age births and a reduction in large-for-gestational-age births. Also when considering maternal weight, education, age, parity and year of birth. There was no increased for stillbirth or neonatal mortality.
Author Interviews, Metabolic Syndrome, Obstructive Sleep Apnea, Weight Research / 15.11.2013

MedicalResearch.com Interview with: MedicalResearch.com Interview with: Dr. Emilia Mazzuca Biomedical Department of Internal and Specialistic Medicine (DIBIMIS) Section of Pneumology and Dr. Maria R Bonsignore, MD Associate Professor in Respiratory Medicine University of Palermo, Palermo, Italy MedicalResearch.com: What are the main findings of the study? Answer: Our main goal was to investigate gender-related interactions between obstructive sleep apnea (OSA) and obesity while taking associated metabolic abnormalities into account. We analyzed 423 men and 105 women previously studied for the association of OSA and the Metabolic Syndrome (MetS) (Bonsignore et al, Eur Respir J, 2012), to assess whether markers of general and visceral obesity were differently associated with OSA in men and women. Multivariate analysis showed that in men the apnea-hypopnea index (AHI), an indicator of OSA severity, was associated with waist circumference, a marker of visceral obesity, and body mass index (BMI); conversely, in women AHI was associated with hip circumference, a marker of subcutaneous fat deposition, and neck size.  The results were similar when patients without a diagnosis of MetS were analyzed; conversely, in patients with MetS, waist circumference was the only significant marker of OSA in both genders.
Author Interviews, NEJM, Urinary Tract Infections / 14.11.2013

Thomas M. Hooton M.D. Associate Chief of Staff, Medical Service, Miami VA Healthcare System Professor of Clinical Medicine and Vice Chair for VA Affairs, Department of Medicine, UMSOM Clinical Director, Division of Infectious Diseases, UMSOMMedicalResearch.com Interview with: Thomas M. Hooton M.D. Professor of Medicine and Vice Chair for VA Affairs, University of Miami Miller School of Medicine Associate Chief of Staff, Medical Service, Miami VA Healthcare System Clinical Director, Division of Infectious Diseases MedicalResearch.com: What are the main findings of the study? Dr. Hooten: The main findings from this study are: ·        Voided urine colony counts of E. coli as low as 101 to 102 cfu/mL are highly sensitive and specific for their presence in bladder urine in symptomatic women (growth of bacteria in bladder urine is the gold standard for the etiology of UTI). Moreover, even when E. coli is found along with other mixed flora in voided urine, it should not be considered a contaminant since it likely represents true bladder infection. ·        On the other hand, enterococci and Group B streptococci, which are frequently isolated from voided urine, are rarely isolated from paired catheter specimens, suggesting that these organisms only rarely cause acute uncomplicated cystitis. In our study, E. coli frequently grew from the urines of these women and is the likely cause for UTI symptoms in such episodes. ·        Organisms usually considered contaminants, such as lactobacilli, occasionally grow from catheter urines, but they are rarely found alone with pyuria, suggesting that these bacteria rarely cause acute uncomplicated cystitis. ·        The etiology of a quarter of acute uncomplicated cystitis episodes is unknown.  It is possible that some of these women have E. coli urethritis, which has been documented in some women with UTI symptoms, but we did not do further studies to evaluate this. It is possible also that enterococci and Group B streptococci may also cause urethritis, but there is no published evidence of this in young women with UTI symptoms. ·        Although voided urine cultures growing mixed flora are common in women with acute cystitis, true polymicrobic cystitis, as determined by sampling bladder urine, appears to be rare in this population.
Author Interviews, Blood Clots / 13.11.2013

MedicalResearch.com Interview with: Matteo Nicola Dario Di Minno, MD Dept. of Clinical Medicine and Surgery Regional Reference Center for Coagulation Disorders Federico II University, Naples, ItalyMedicalResearch.com: Matteo Nicola Dario Di Minno, MD Dept. of Clinical Medicine and Surgery Regional Reference Center for Coagulation Disorders Federico II University, Naples, Italy   MedicalResearch.com: What are the main findings of the study?
 Answer: In our study, patients with unprovoked VTE treated for a definite time with oral anticoagulants (ie, 3–12 months) had annual recurrence rates >5% in the presence of both overt and mild antithrombin deficiency and <5% with normal antithrombin levels, with these differences being statistically significant. Although these findings should be confirmed in further studies, a life-long oral anticoagulation might be considered in patients with unprovoked VTE.
Author Interviews, Chocolate, Nature, Nutrition, Pediatrics, Weight Research / 12.11.2013

Magdalena Cuenca García, PhD University of Granada Department of Physiology, School of Medicine Avd. Madrid 12; 18012 Granada (Spain)MedicalResearch.com Interview with: Magdalena Cuenca García, PhD University of Granada Department of Physiology, School of Medicine Avd. Madrid 12; 18012 Granada (Spain) MedicalResearch.com: What are the main findings of the study? Answer: In conclusion, the results of the present study showed that a higher chocolate consumption was associated with lower levels of central and total fatness in European adolescents. Of note is that the observed association was independent of total energy intake and saturated fat intake as well as objectively measured physical activity. In addition, results remained unchanged after adjusting for foods with high catechins concentration as fruit, vegetables and tea; as well as other products such as coffee that could influence the observed association between chocolate consumption and markers of total and central body fat.
Author Interviews, Flu - Influenza / 12.11.2013

MedicalResearch.com with: Dr Kate Mandeville MD MPH Clinical Research Fellow, London School of Hygiene and Tropical MedicineDr Kate Mandeville MD MPH Clinical Research Fellow, London School of Hygiene and Tropical Medicine   MedicalResearch.com: What is the background for your study? Dr. Mandeville: The UK spent nearly one billion pounds on pharmaceutical drugs during the swine flu pandemic, including vaccine and antiviral drugs. After the swine flu pandemic, it was revealed that some scientists on the World Health Organization’s advisory committee had links with the pharmaceutical industry. Scientists often provide commentary for journalists on emerging health risks and we set out to see whether scientists commentating on swine flu were also more likely to have links to pharmaceutical companies. We analysed UK newspaper coverage of the swine flu pandemic between April and July 2009. This was the period in which the UK government was making decisions on how best to respond to the emerging pandemic, including providing the public with vaccine and antiviral drugs. We looked for how often scientists were quoted in articles on the pandemic from a wide range of newspapers. We then examined these comments in more detail to see if scientists made an assessment of the risk to the public from swine flu, and compared these against assessments made by official agencies like the Department of Health. We also judged whether the scientists promoted or rejected the use of vaccines or antiviral drugs. For each scientist, we then looked for links with the pharmaceutical industry – or what we formally call competing interests - from a variety of sources, including scientific papers and the internet.
Author Interviews, Johns Hopkins, Stroke / 12.11.2013

Yogesh Moradiya MBBS From the Neurosciences Critical Care Division Johns Hopkins University, Baltimore, MD;MedicalResearch.com Interview with: Yogesh Moradiya MBBS From the Neurosciences Critical Care Division Johns Hopkins University, Baltimore, MD;   MedicalResearch.com: What are the main findings of the study? Answer: We studied 712,433 stroke cases in 6,839 hospital samples in United States over 11-year study period (2000-2010) and found that hospitals with neurology residency training program treated stroke patients with tissue plasminogen activator (tPA) more frequently than other teaching or non-teaching hospitals. The higher tPA utilization in hospitals with neurology residencies was independent of patient age, gender, ethnicity, insurance status, comorbidities, hospital geographic location, stroke case volume, calendar year and the Joint Commission Primary Stroke Center certification.
Author Interviews, Brain Injury, Cognitive Issues, Lancet / 12.11.2013

prof_david_menonMedicalResearch.com Interview with: Prof David K Menon MD PhD FRCP FRCA FFICM FMedSci Head, Division of Anaesthesia, University of Cambridge 
Consultant, Neurosciences Critical Care Unit 
BOC Professor, Royal College of Anaesthetists Professorial Fellow, Queens' College, Cambridge Senior Investigator, National Institute for Health Research Box 93, Addenbrooke's Hospital, 
Cambridge CB2 2QQ, UK MedicalResearch.com: What is the background for your study? Dr. Menon: We have known for some time that a history of traumatic brain injury (TBI) results in a significant (between 2 and 10 fold) increase in the likelihood of getting dementia in later life.  On possible mechanistic explanation for this comes from the finding that about a third of individuals who died of TBI, regardless of age, are found at autopsy to have deposits of β-amyloid in the brain, often Aβ42, which is the same variant of amyloid seen in the brain of patients who have Alzheimer’s Disease. However, such detection after death has made it impossible to examine the linkage of such early amyloid deposition to late dementia.  More recently, imaging with positron emission tomography (PET) and Pittsburgh compound B (PIB) has been used to image amyloid deposits in Alzheimer’s  Disease.  However, the technique had not been validated in traumatic brain injury.
Author Interviews, Diabetes, Gender Differences / 12.11.2013

MedicalResearch.com Interview with: Guy Fagherazzi, PhD Epidemiologist Scientific manager – E4N cohort study (www.e4n.fr) Inserm U1018 Team 9 Nutrition,hormones and women’s healthGuy Fagherazzi, PhD Epidemiologist Scientific manager – E4N cohort study (www.e4n.fr) Inserm U1018 Team 9 Nutrition,hormones and women’s health MedicalResearch.com: What are the main findings of the study?
 Dr. Fagherazzi: Our study of more than 60 000 French women from the E3N cohort study has shown that higher overall acidity of the diet, regardless of the individual foods making up that diet, was associated with a higher risk of type 2 diabetes.
Antioxidants, Author Interviews, Hearing Loss, Nutrition, University of Michigan / 12.11.2013

http://ajcn.nutrition.org/content/early/2013/11/06/ajcn.113.068437.abstractMedicalResearch.com Interview with: Sung Kyun Park, Sc.D., M.P.H Assistant Professor, Epidemiology Assistant Professor, Environmental Health Sciences Departments of Epidemiology and Environmental Health Sciences University of Michigan School of Public Health Ann Arbor, MI MedicalResearch.com: What are the main findings of the study?
 Answer: This study reports that persons who eat more dietary antioxidants (beta carotene and vitamin C) or magnesium have a lower risk of hearing loss. This finding was seen in the levels currently observed in the general US population and independent of demographic and socioeconomic factors, noise exposures from workplaces, recreations or firearms, and other potential risk factors.
General Medicine, PLoS / 12.11.2013

MedicalResearch.com Interview with: Jonas D. Finger and  Dr. Gert B.M. Mensink Jonas Finger, MPhil (Epidemiology) MA (Sports Sc) MA (Political Sc) Robert Koch-Institute - Department of Epidemiology and Health MonitoringDivision 24 - Interview surveys and European collaboration General-Pape-Straße 62-66, 12101 Berlin Germany MedicalResearch.com: What are the main findings of the study? Answer: People with a low level of education consume energy dense foods (sugar- and fat-rich foods) more frequently and low energy foods (fruit and vegetables) and alcohol less frequently compared to people with a high level of education. A new study aspect is that the role of physical activity level for the link between education and high energy food intake was also investigated. People with a low level of education have more frequently physically-demanding jobs leading to a higher level of total energy expenditure compared to sedentary office workers (mainly high educated). The latter are more active in their leisure time. The study provides some evidence to support the hypothesis that the low educated consumed more energy dense foods than the high educated because they expend more energy due to the physical work they do.
Author Interviews, Breast Cancer, Lancet, Radiation Therapy / 11.11.2013

Prof Jayant S Vaidya PhD Clinical Trials Group, Division of Surgery and Interventional Science University College London, London, UKMedicalResearch.com Interview with: Prof Jayant S Vaidya PhD Clinical Trials Group, Division of Surgery and Interventional Science University College London, London, UK MedicalResearch.com: What are the main findings of the study? Dr. Vaidya: The main findings are
  • a) these are longer term results that have confirmed our original publication in 201
  • (b) We found that when TARGIT intraoperative radiotherapy is given at the time of lumpectomy for breast cancer, the local control and survival from breast cancer is similar to several weeks of whole breast radiotherapy
  • c) we also found that with TARGIT there are significantly fewer deaths from other causes - i.e., fewer deaths from cardiovascular causes and other cancers
Author Interviews, Pediatrics, Toxin Research / 11.11.2013

Mark A D’Andrea, MD, FACRO University Cancer and Diagnostic Centers Houston, TexasMedicalResearch.com interview with: Mark A D’Andrea, MD, FACRO University Cancer and Diagnostic Centers Houston, Texas MedicalResearch.com: What are the main findings of the study? D’Andrea: Human exposure to benzene is associated with multiple adverse health effects leading to hematological malignancies including leukemia, lymphoma, aplastic anemia, pancytopenia and chromosomal aberrations. In addition, benzene exposure can affect a variety of organs such as the liver, kidney, and brain. Compared to adults, children have a higher susceptibility to environmental chemical exposures including benzene. In this study, we assessed the adverse health effects of the benzene exposure in children (< 17 years) following a flaring incident at the British petroleum refinery in the Texas City, Texas. The findings were compared with those children not exposed to the benzene. We found that white blood cell counts were significantly decreased in benzene exposed children compared with the unexposed children. Conversely, platelet counts were increased significantly in the benzene exposed group compared with the unexposed group. Similarly, benzene exposed children had significantly higher levels of serum creatinine levels than those unexposed to benzene. Furthermore, considered indicators of hepatic damage, the serum levels of alkaline phosphatase, aspartate amino transferase, and alanine amino transferase were elevated in the benzene exposed children compared with the unexposed children. Moreover, children exposed to benzene experienced somatic symptoms, with headache, unsteady gait, and memory loss being reported the most frequently occurring events, followed by upper respiratory symptoms cough, nausea/vomiting, skin rash, shortness of breath, wheezing, dizziness, chest pain, painful joints, and weight loss.
Author Interviews, Heart Disease, Pediatrics / 10.11.2013

MedicalResearch.com interview with: Martha Mullett, MD MPH Neonatology West Virginia Universty Ped&Neo 1 Medical Center Dr Morgantown, WV 26506Martha Mullett, MD MPH Neonatology West Virginia Universty Ped&Neo 1 Medical Center Dr Morgantown, WV 26506   MedicalResearch.com: What are the main findings of the study? Dr. Mullett: The unique findings in this study relate to differences in triglycerides (TG) in premature infants and small for gestational age (SGA) infants when in 5th grade, at which time the children are approximately 11 years old.  Premature infants have higher triglyceride levels in 5th grade than term infants.(p<.05)  This difference appears in those premature infants who become overweight/obese by this age, but this reaches only a trend level. (p=.058) SGA infants who become overweight/obese by 5th grade (BMI ≥ 85th percentile) have TG that are significantly higher than all other 5th grade groups.
Author Interviews, Calcium, Gender Differences, Heart Disease / 09.11.2013

Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital Hospital Avenue, Nedlands 6009MedicalResearch.com Interview with: Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital Hospital Avenue, Nedlands 6009 www.boneandvascularresearch.org.au MedicalResearch.com: What are the main findings of the study? Dr. Lewis: The paper reports the findings from an ancillary study of the effects of 1200 mg per day of calcium supplementation on a major predictor of heart disease risk, carotid artery intima-medial thickness and atherosclerosis. The principle study was a large five-year double blind randomized controlled trial of calcium supplements or a placebo. After 3 years of calcium supplementation or placebo measures of carotid artery intima-medial thickness were identical in the placebo and calcium treated patients.  Atherosclerotic plaque was reduced in calcium treated patients when analysed as total calcium intake. These findings argue strongly against an adverse effect of high dose calcium tablets on cardiovascular risk.
Author Interviews, Critical Care - Intensive Care - ICUs, Yale / 09.11.2013

MedicalResearch.com Interview with: John Ney, MD, MPH Clinical Assistant Professor, Department of Neurology, University of Washington neyj@uw.edu MedicalResearch.com: What are the main findings of the study? Dr. Ney: My colleagues and I used a large, publicly available dataset to examine the usage and effectiveness of electroencephalography (EEG) in adult intensive care units (ICUs) in the United States over a five year period.  We compared routine EEG, which consists of a portable machine hooked up to the patient to record brainwaves for a short duration, usually 20-40 minutes, with continuous EEG monitoring, where a patient’s brainwaves are recorded continuously for 24 hours or more and examined, ideally in real-time.  Because most patients in the ICU are comatose, we have generally poor and crude indicators of their brain function.  ICU patients are particularly at risk for non-convulsive seizures, where the brain is seizing, but there are few outward signs of a seizure.  EEG is the only means of detecting non-convulsive seizures, and is useful in determining the brain’s reactions to drugs, monitoring for stroke and other abnormal activity. Our main finding is that ICU patients receiving continuous EEG monitoring was associated with increased survival relative to those who received routine EEG only.    In our sample, 39% of ICU patients who received routine EEG died compared to only 25% of those with continuous EEG monitoring. This finding was both substantial and statistically significant, even after adjustment for age and other demographics, clinical disease comorbidity severity measures, and hospital factors.  Although continuous EEG monitoring was more expensive, the increase in hospital charges were not significant after adjustment.
Author Interviews, Cancer Research, OBGYNE, Pediatrics / 09.11.2013

Alastair Sutcliffe M.D., Ph.D. From the Institute of Child Health University College LondonMedicalResearch.com  Interview with: Alastair Sutcliffe M.D., Ph.D. From the Institute of Child Health University College London   MedicalResearch.com: What are the main findings of the study?   Dr. Sutcliffe: Good NEWS for couples who need assisted conception. All the births (106,000) from Great Britain over 18 years were linked to the National Childhood Cancer Registry from the Human Fertilisation and Embryology Authority (which has recorded all births sine 1991 by law.)Those children who showed up on both registries, had IVF conception and childhood cancer. We predicted the number we would expect from the known national childhood cancer rates. We found ALMOST IDENTICAL rates 108 in our group and 109 predicted. NO INCREASED RISK OF CANCER AFTER IVF CONCEPTION IN OFFSPRING.
AHA Journals, Author Interviews, Lancet, Stroke / 07.11.2013

Dr. Colin Derdeyn Mallinckrodt Institute of Radiology and the Departments of Neurology and Neurosurgery Washington University School of Medicine, St Louis, MO, USAMedicalResearch.com Interview with: Dr. Colin Derdeyn Mallinckrodt Institute of Radiology and the Departments of Neurology and Neurosurgery Washington University School of Medicine, St Louis, MO, USA MedicalResearch.com: What are the main findings of the study?  Dr. Derdeyn: The primary results indicate that medical management, consisting of dual antiplatelets for 3 months after a transient ischemic attack (TIA) or stroke, and rapid, effective control of blood pressure (systolic BP less than 140 mm Hg and 130 mm Hg if diabetic) and LDL-cholesterol (less than 70 mg/dl), in addition to management of other risk factors, is superior to angioplasty and stenting in addition to the same medical regimen for reducing the risk of future stroke in patients with severe atherosclerotic stenosis (>70%) of a major intracranial artery.    In addition, while there were subgroups at higher risk for stroke on medical treatment (older age, female gender, prior stroke in the territory),  none of these subgroups appeared to have a benefit from stenting (i.e. stroke rates in the stenting groups in these subgroups was higher too).
Author Interviews, Depression, JAMA / 07.11.2013

Richard L. Kravitz, MD, MSPH Professor and Co-vice Chair (Research) Interim Director, UC Center Sacramento Co-Editor in Chief, Journal of General Internal MedicineMedicalResearch.com Interview with: Richard L. Kravitz, MD, MSPH Professor and Co-vice Chair (Research) Interim Director, UC Center Sacramento Co-Editor in Chief, Journal of General Internal Medicine MedicalResearch.com: What is the background for your study? Dr. Kravitz: Depression in the United States is both undertreated and overtreated.  As the de facto mental health care system for many, primary care is at the nexus of this problem.  Up to 30% of patients with major depression in primary care go undiagnosed.  At the same time, partly as a result of marketing, lots of patients who don’t need meds are started on antidepressants.   So we were interested in finding ways to get more truly depressed patients into treatment without overtreating patients who don’t need it.
Author Interviews, Exercise - Fitness, Pediatrics / 07.11.2013

MedicalResearch.com Interview with: Chris Fritz BSs PEZZ Center for Pediatric Endocrinology Zurich, Zurich, Switzerland MedicalResearch.com: What are the main findings of the study? Answer: Targeted strength training significantly increases daily spontaneous physical activity (PA) behaviour in boys. The less active children showed the greatest increase. 102 healthy school children were randomly placed in two groups. The control group continued three PE classes per week, whereas the intervention group had two out of three PE classes replaced by an individualised strength training program. At baseline there was no difference in anthropometry, body composition and PAEE between the groups. At the end of the training intervention, we found a significant increase of upper and lower body strength in the intervention group in boys and in girls. Boys significantly increased their PA by 10%. Without taking into account the energy expenditure during the strength training, the 10% PAEE increase corresponds to a weekly bike ride of 28 miles for a child of 40 kg body weight. Or in other words, an individualised school based strength training program increases energy expenditure outside the intervention by an equivalent of about 7kg of body fat corresponding to 10kg of chocolate per year.
Author Interviews, Breast Cancer / 07.11.2013

Mila Donker, MD Resident in Radiation Oncology Study monitor EORTC 10981-22023 AMAROS trialMedicalResearch.com Interview with: Mila Donker, MD Resident in Radiation Oncology Study monitor EORTC 10981-22023 AMAROS trial The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Plesmanlaan 121, 1066 CX Amsterdam, Netherlands MedicalResearch.com: What are the main findings of the study?  Dr. Donker: Results of EORTC trial 10853 which were recently published in the Journal of Clinical Oncology showed that breast conserving treatment combined with radiotherapy reduces the risk of local recurrence in women with ductal carcinoma in situ (DCIS). Between 1986 and 1996, this phase III EORTC trial 10853 randomized 1010 women with complete local excision of DCIS to no further treatment (503 patients) or radiotherapy (507 patients). The risk of any local recurrence was found to be reduced by 48% in the patients who also received radiotherapy. The 15-year local recurrence-free rate was 69% for the group of patients receiving breast conserving surgery alone, but this increased to 82% for the group of patients who also received radiotherapy, and the 15-year invasive local recurrence-free rate was 84% versus 90%, respectively.
Author Interviews, JAMA, Pediatrics, Weight Research / 07.11.2013

Thomas H. Inge, M.D., Ph.D. Professor of Surgery and Pediatrics Director of the Surgical Weight Loss Program for Teens Director for the Center for Bariatric Research and Innovation Cincinnati Children’s Hospital Medical CenterMedicalResearch.com Interview with: Thomas H. Inge, MD, PhD, FACS, FAAP Surgical Director, Surgical Weight Loss Program for Teens Director, Center for Bariatric Research and Innovation Attending Surgeon, Cincinnati Children’s Hospital Medical Center Professor, UC Department of Surgery Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio MedicalResearch.com: What are the main findings of the study? Dr. Inge: The mean age of the 242 participants of this observational study was 17.1±1.6 years and the median BMI was 50.5 kg/m2.  Fifty-one percent demonstrated four or more major co-morbid conditions.  Laparoscopic Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and adjustable gastric banding were performed in 66%, 28%, and 6% of subjects, respectively.  There were no deaths during the initial hospitalization or within 30 days of surgery; major complications were seen in 19 subjects (8%). Minor complications were noted in 36 subjects (15%).  All re-operations and 85% of re-admissions were related to WLS.
Author Interviews, Cost of Health Care, Emergency Care / 06.11.2013

MedicalResearch.com Interview with: Jessica E. Galarraga, MD, MPH Resident Physician Department of Emergency Medicine George Washington University Hospital 2120 L. St. N.W. Suite 475 Washington D.C. Jessica E. Galarraga, MD, MPH Resident Physician Department of Emergency Medicine George Washington University Hospital 2120 L. St. N.W. Suite 475 Washington D.C.   MedicalResearch.com: What are the main findings of the study? Dr. Galarraga: This study examined how emergency department (ED) reimbursements for outpatient visits may be impacted by the insurance coverage expansion of the Patient Protection and Affordable Care Act as newly eligible patients gain coverage either through the Medicaid expansion or through health insurance exchanges. We conducted our analyses using the Medical Expenditure Panel Survey, a nationally representative survey managed by the Agency for Healthcare Research and Quality. We found that ED reimbursements for outpatient encounters by the previously uninsured who gain Medicaid insurance may increase by  17 percent and moving Medicaid-expansion ineligible patients to the private insurance market through insurance exchanges may increase reimbursements as high as 39 percent after the act is implemented.