Anemia, Author Interviews, Kidney Disease, Pharmacology, Stanford / 16.01.2017

MedicalResearch.com Interview with: Dr. Glenn M. Chertow, MD Professor Medicine, Nephrology Stanford University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Iron deficiency is common in persons with moderate to advanced (non-dialysis-dependent) chronic kidney disease (CKD), for a variety of reasons. Conventional iron supplements tend to be poorly tolerated and of limited effectiveness. In earlier studies of patients treated with ferric citrate for its effect as a phosphate binder, we saw increases in transferrin saturation and ferritin (markers of iron stores) and hemoglobin and hematocrit (the “blood count”). Therefore, we thought we should test the safety and efficacy of ferric citrate specifically for the treatment of iron deficiency anemia (IDA). With respect to the key findings, more than half (52%) of patients treated with ferric citrate experienced a sizeable (>=1 g/dL) increase in hemoglobin over the 16-week study period compared to fewer than one in five (19%) patients treated with placebo. Rates of adverse events (“side effects”) were similar to placebo; diarrhea in some patients and constipation in others were the most common. There were also favorable effects of ferric citrate on laboratory metrics of bone and mineral metabolism. (more…)
Author Interviews, Social Issues / 15.01.2017

MedicalResearch.com Interview with: PD Dr. René Proyer Martin-Luther-Universität Halle-Wittenberg Institut für Psychologie Abteilung Differentielle Psychologie und Psychologische Diagnostik MedicalResearch.com: What is the background for this study? Response: I got interested in the study of playfulness and adult playfulness in particular while I was working in the Psychology Department at the University of Zurich in Switzerland. There we worked with the so-called Values-in-Action (VIA) classification of strength and virtues (developed by Chris Peterson and Martin Seligman). In this classification humor and playfulness are being used synonymously. One of my first aims was testing whether this reflects their relation or whether they should be used separately. Overall, findings suggest that there is a relationship, but that the two are not redundant and should be studied separately. From there my interest in the field grew and I started reading more and more. It soon was clear that playfulness is an understudied individual differences variable and that current conceptualizations focus primarily on the facets of playfulness that are associated with fun and entertainment, while disregarding others. My research is aimed at narrowing some gaps in the literature and developing a structural model of how adult playfulness could be understood. (more…)
Author Interviews, Dermatology, Gastrointestinal Disease / 15.01.2017

MedicalResearch.com Interview with: Alexander Egeberg, MD PhD Gentofte Hospital Department of Dermatology and Allergy Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Inflammatory bowel disease (IBD) has been associated with increased prevalence of HS, but data has been limited to small studies and even less is known about the concurrence and risk of new-onset IBD in patients with pre-existing HS. In our study, we found a higher prevalence of Crohn’s disease and ulcerative colitis in patients with HS. Notably, there was a more than two-fold increased risk of new-onset Crohn’s disease and a 63% increased risk of new-onset ulcerative colitis in patients with Hidradenitis suppurativa compared with the general population. (more…)
Author Interviews, Biomarkers, Breast Cancer, Cancer Research / 14.01.2017

MedicalResearch.com Interview with: Ulrich Pfeffer, PhD Head of the Functional Genomics lab IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro Genova, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: In recent years our knowledge on genetic variants that are associated with the risk to develop breast cancer has grown substantially. In addition to the two breast cancer genes, BRCA1 and BRCA2 we know approximately 100 other genes that are present in the population in two variants. In the presence of a single of these variants the breast cancer risk is slightly increased and several variants together determine a significant increase in risk. We also know that certain variants are associated with specific subtypes of breast cancer such as the estrogen receptor positive breast cancer. We show in our work for the first time that some of these variants are more frequent in breast cancers that carry a specific somatic, non-inherited, mutation. In particular, we show this for the most frequent somatic mutation in breast cancer, PIK3CA, a gene involved in the control of tumor metabolism and many other aspects, a fundamental gene. The knowledge of this association tells us a lot on cancer biology. But most important, it might help to design specific prevention strategies. Since when you carry a germline allele that is associated with a specific somatic mutation you know your risk of a specific molecular type of breast cancer and eventually you can do something specific to prevent it. (more…)
Author Interviews, Exercise - Fitness / 14.01.2017

MedicalResearch.com Interview with: Dr Niels Vollaard Lecturer in Health and Exercise Science Faculty of Health Sciences and Sport Scotland's University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although the health benefits of regular exercise are undisputable, many people do not manage to achieve the minimum recommended amount of exercise. Because lack of time is a commonly identified reason for not doing enough exercise, over the past decade researchers have increasingly focussed on sprint interval training (SIT) as a time-efficient alternative to aerobic exercise. However, while most SIT protocols do indeed only include a short duration of sprint exercise, they also require recovery periods after each sprint. Therefore, the total training time commitment per session tends to be close to half an hour, which is no less than what is recommended for less strenuous moderate intensity exercise. To date, most sprint interval training studies have used the protocol that was employed in one of the first studies to look at aerobic adaptations following repeated sprints. This protocol consists of 6 repetitions of 30-second ‘all-out’ sprints. Very few studies have attempted to justify why this number of sprint repetitions would be optimal or even appropriate. Nonetheless, the number of sprint repetitions is of clear importance, as fewer sprints would result in more time-efficient training sessions. Thus, recent years have seen increasing interest in the benefits of SIT protocols with fewer sprints, which makes the protocol shorter and easier. However, up to now it remained unclear what the impact is of the number of sprint repetitions on key markers of health, such as maximal aerobic fitness (VO2max). This is of importance, as VO2max is the best predictor of risk of future disease and premature death. (more…)
Author Interviews, Diabetes, JAMA, Schizophrenia / 13.01.2017

MedicalResearch.com Interview with: Dr Toby Pillinger MA(Oxon) BM BCh MRCP Institute of Psychiatry, Psychology and Neuroscience King's College London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our meta-analysis has provided strong evidence that compared with healthy controls, individuals with early schizophrenia are at increased risk of developing type 2 diabetes mellitus, even when the effects of antipsychotic drugs, diet and exercise are taken out of the equation. Schizophrenia is associated with a dramatically reduced life expectancy, with individuals dying up to 30 years earlier than the general population. Approximately 60% of this excess mortality is due to physical health disorders such as heart attack or stroke, for which diabetes is a major risk factor. People with long-term schizophrenia are 3 times more likely than the general population to have diabetes, something that has previously been blamed on poor diet and exercise habits, as well as the use of antipsychotic medication. However, the link between schizophrenia and diabetes was first made back in the 19th century, long before the use of antipsychotics, and in an era where diets were less likely to cause diabetes. This could suggest that there is a causative link between schizophrenia and diabetes. Our meta-analysis examined whether diabetes risk is already raised in people at the onset of schizophrenia, before antipsychotics have been prescribed and before a prolonged period of illness that may be associated with poor diet and sedentary behaviour. We pooled data from 16 studies comprising 731 patients and 614 individuals from the general population. We collated blood data examining fasting blood glucose levels, blood glucose levels following the oral glucose tolerance test, fasting insulin levels and degree of insulin resistance. We demonstrated that compared with healthy controls, individuals with early schizophrenia had raised fasting glucose, raised levels of glucose following the oral glucose tolerance test, raised fasting insulin and elevated insulin resistance. Furthermore, these results remained statistically significant even when we restricted our analyses to studies where individuals with schizophrenia were matched to healthy controls with regards their diet, the amount of exercise they engaged in and their ethnic background. This suggests that our results were not wholly driven by differences in lifestyle factors or ethnicity between the two groups, and may therefore point towards a direct role for schizophrenia in increasing risk of diabetes. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Pain Research, Stroke / 13.01.2017

MedicalResearch.com Interview with: Dr. Matthias Eikermann, MD, PhD Associate Professor of Anaesthesia Harvard Medical School Clinical Director, Critical Care Division  MedicalResearch.com: What is the background for this study? Response: Up to one fifth of the general population have migraine, a primary, chronic-intermittent headache disorder affecting the neuronal and vascular systems and characterized by severe headache accompanied by nausea and/or sensory hypersensitivities such as photophobia and phonophobia. In approximately 20-30% of patients, the headache phase is preceded or accompanied by transient focal neurological disturbances presenting as visual symptoms but also sensory, aphasic, or motor symptoms known as migraine aura. Stroke is responsible for approximately 6.2 million deaths a year and is a leading global cause of long term disability. Considering that more than 50 million patients in hospital and 53 million ambulatory patients undergo surgical procedures in the United States every year. We found that patients with migraine, particularly migraine with aura, undergoing a surgical procedure are at increased risk of perioperative ischemic stroke and readmission to hospital within 30 days after discharge. (more…)
Author Interviews, Endocrinology, Gender Differences, JCEM / 13.01.2017

MedicalResearch.com Interview with: Caroline J. Davidge-Pitts, M.B., Ch.B Mayo Clinic Rochester, Minn. MedicalResearch.com: What is the background for this study? Response: The awareness of transgender healthcare issues has increased, leading to improved coverage of both hormonal and non-hormonal therapies. In endocrinology practices, there is an increased demand for providers who are competent in these areas. We wanted to assess the current status of knowledge and practice in transgender health amongst our current and future endocrinologists. (more…)
Author Interviews, Biomarkers, Cancer Research, ENT / 13.01.2017

MedicalResearch.com Interview with: Jacek Majewski PhD Associate Professor Department of Human Genetics McGill University and Genome Quebec Innovation Centre Montreal, Canada  MedicalResearch.com: What is the background for this study? Response: Our lab, in collaboration with Dr. Nada Jabado, has been investigating the molecular genetics of pediatric glioblastoma – a deadly brain cancer. Several years ago, in the majority of our patients’ tumors we discovered mutations in genes that encode histone proteins. Those mutations disrupt the epigenome - that is the way the DNA is modified, silenced, or activated in the cancer cells. It appears that epigenome-modifying mutations are particularly important in pediatric cancers, and our hypothesis is that they act by diverting the normal developmental pathways into unrestrained proliferation. Many other studies have highlighted the significance of epigenome disruption in a number of cancers. (more…)
Addiction, Author Interviews, Nutrition, Weight Research / 13.01.2017

MedicalResearch.com Interview with: Nicholas V. DiPatrizio, Ph.D. Assistant Professor of Biomedical Sciences University of California, Riverside School of Medicine Riverside, California, 92521 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Endocannabinoids are a group of lipid signaling molecules that serve many physiological roles, including the control of food intake, energy balance, and reward. Previous research by my group found that tasting specific dietary fats drives production of the endocannabinoids in the upper small intestine of rats, and inhibiting this signaling event blocked feeding of fats (DiPatrizio et al., Endocannabinoid signaling in the gut controls dietary fat intake, Proceedings of the National Academy of Sciences, 2011). Thus, gut-brain endocannabinoid signaling is thought to generate positive feedback to the brain that promotes the intake of foods containing high levels of fats. We now asked the question of what role peripheral endocannabinoid signaling plays in promoting obesity caused by chronic consumption of a western diet (i.e., high levels of fats and sugar), as well as the role for endocannabinoids in overeating that is associated with western diet-induced obesity. When compared to mice fed a standard low-fat/sugar diet, mice fed a western diet for 60 days rapidly gained body weight and became obese, consumed significantly more calories, and consumed significantly larger meals at a much higher rate of intake (calories per minute). These hyperphagic responses to western diet were met with greatly elevated levels of endocannabinoids in the small intestine and circulation. Importantly, blocking elevated endocannabinoid signaling with pharmacological inhibitors of cannabinoid receptors in the periphery completely normalized food intake and meal patterns in western diet-induced obese mice to levels found in control lean mice fed standard chow. This work describes for the first time that overeating associated with chronic consumption of a Western Diet is driven by endocannabinoid signals generated in the periphery. (more…)
Author Interviews, Biomarkers, JAMA, Prostate Cancer, Radiation Therapy / 13.01.2017

MedicalResearch.com Interview with: Trevor Royce MD MS Resident, Harvard Radiation Oncology Program MedicalResearch.com: What is the background for this study? What are the main findings? Response: Clinical trials in early prostate cancer take more than a decade to report on. Multiple early reporting endpoints have been proposed, but which one is best, remains unknown, until now. Of all the possible early endpoints examined, to date, how low a PSA blood test falls to, after treatment with radiation and hormonal therapy, appears to be the best, specifically, if the PSA doesn’t get below half a point, that patient is very likely to die of prostate cancer if given standard treatment for recurrence. Those men deserve prompt enrollment on clinical trials in order to properly save their life. (more…)
Author Interviews, Diabetes, Heart Disease / 13.01.2017

MedicalResearch.com Interview with: Dr. Abhinav Sharma MD Duke Clinical Research Institute, Duke University, Durham, NC Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada Renato D. Lopes, MD, PhD, MHS Duke Clinical Research Institute Durham, NC  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Impaired fasting glucose (IFG) has been demonstrated to be a risk factor for cardiovascular death; however, there is growing research suggesting that IFG also increases the risk of non-cardiovascular deaths such as cancer. The data on the distribution of causes of death among patients with impaired fasting glucose and cardiovascular risk factors have not been described. Our analysis used data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial. We identified that while myocardial death is the most common adjudicated cause of death, overall, non-cardiovascular deaths were more common that cardiovascular deaths. Among non-cardiovascular, cancer deaths were the most common cause of death. Furthermore, the burden of non-cardiovascular deaths increases relative to cardiovascular death over time. (more…)
Annals Internal Medicine, Author Interviews, Breast Cancer, Cancer Research, Prostate Cancer / 13.01.2017

MedicalResearch.com Interview with: Karsten Juhl Jørgensen, MD, Dr. MedSci The Nordic Cochrane Centre Rigshospitalet, Copenhagen  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our systematic Cochrane review of the original randomised breast screening trials showed substantial conflict between their estimates of the benefit. Some trials showed a large benefit, others none or a small benefit. This difference was related to the design of the trials. The most optimistic trials were those with suboptimal randomisation. The main findings of our current study support those of the most rigorously performed randomised trials: breast screening does not fulfill its fundamental premise, which is to reduce the occurrence of late stage disease. This means a mortality reduction is unlikely and that use of less invasive surgery due to breast screening is also unlikely. However, we did find very substantial increases in early stage breast cancer, which persisted over our 17 year observation period. This means that breast screening likely leads to substantial overdiagnosis of breast cancers that would otherwise not have caused health problems during a woman’s lifetime. We estimate that 1 in 3 breast cancers detected in a screened population is likely overdiagnosed. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 13.01.2017

MedicalResearch.com Interview with: Dr. Alex Kemper, MD, MPH, MS Member,US Preventive Services Task Force Professor of Pediatrics and Professor in Community Medicine Department of Pediatrics Duke University School of Medicine MedicalResearch.com: What is the background for this study? Response: Neural tube defects, where the brain or spinal cord do not develop properly in a baby, can occur early in pregnancy, even before a woman knows she is pregnant. Taking folic acid before and during pregnancy can help protect against neural tube defects. Most women do not get enough folic acid in their diets, so most clinicians recommend that any woman who could become pregnant take a daily folic acid supplement. (more…)
Author Interviews, Emergency Care, JAMA, Stroke, Surgical Research / 13.01.2017

MedicalResearch.com Interview with: Vitor Mendes Pereira MD MSc Division of Neuroradiology - Joint Department of Medical Imaging Division of Neurosurgery - Department of Surgery Toronto Western Hospital - University Health Network Associate Professor of Radiology and Surgery University of Toronto  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study is a pooled analysis of two large prospective stroke studies that evaluated the effectiveness of mechanical thrombectomy (MT) using one of the stent retrievers (Solitaire device ) in patients with acute ischemic stroke related to large vessel occlusion(LVO). It is known (after 5 randomized controlled trials in 2015) that IV rtPA alone failed to demonstrated benefit when compared to MT associated or not to rtPA. A question is still open: what it is the real benefit of IV rtPA in the context of LVO, particularly in centres that can offer mechanical thrombectomy within 60 minutes after qualifying imaging? (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Lancet, Medical Imaging, MRI, Social Issues / 12.01.2017

MedicalResearch.com Interview with: Dr Ahmed Tawakol MD Co-Director, Cardiac MR PET CT Program Massachusetts General Hospital and Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: While the link between stress and heart disease has long been established, the mechanism mediating that risk hasn’t been clearly understood. Animal studies showed that stress activates bone marrow to produce white blood cells, leading to arterial inflammation.  This study suggests an analogous path exists in humans. Moreover, this study identifies, for the first time in animal models or humans, the region of the brain (the amygdala) that links stress to the risk of heart attack and stroke. The paper reports on two complementary studies. The first analyzed imaging and medical records data from almost 300 individuals who had PET/CT brain imaging, primarily for cancer screening, using a radiopharmaceutical called FDG that both measures the activity of areas within the brain and reflects inflammation within arteries.  All participants in that study had no active cancer or cardiovascular disease at the time of imaging and each had information in their medical records on at least three additional clinical visits after imaging. The second study enrolled 13 individuals with a history of post-traumatic stress disorder, who were evaluated for their current levels of perceived stress and received FDG-PET scanning to measure both amygdala activity and arterial inflammation. (more…)
Accidents & Violence, Author Interviews, Pediatrics, University of Pennsylvania / 12.01.2017

MedicalResearch.com Interview with: Daniel Romer, PhD Annenberg Public Policy Center University of Pennsylvania Philadelphia, Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have been studying trends in health compromising behaviors in popular films that were released since 1950, and in 2013 we reported that films rated PG-13 had just passed the rate of portrayed gun violence shown in popular R-rated films in 2012. In this report, we updated the trends in gun violence through 2015 and found that the trend has continued. In addition, we noted the strong contribution to this trend of films with comic book heroes whose heavy use of guns omits the harmful and otherwise realistic consequences of blood and suffering. (more…)
Author Interviews, Education, Nature / 12.01.2017

MedicalResearch.com Interview with: Prof. Shulamit (Shu) Kahn Department of Markets, Public Policy and Law Questrom School of Business Boston University MedicalResearch.com: What is the background for this study? What are the main findings? Response: We started this research because Donna Ginther (Kansas) and I had an NIH R01 to study gender differences in biomedical careers. We quickly discovered that a major problem for women was the fact that between many years of graduate study and long postdocs, their biological clocks had almost expired before they would have a decent amount of time in their lives to think about having children. (more…)
Author Interviews, Heart Disease, Nutrition, Red Meat / 11.01.2017

MedicalResearch.com Interview with: Wayne W. Campbell PhD Center on Aging and the Life Course Purdue University MedicalResearch.com: What is the background for this study? Response: Organizations that promote healthy eating often recommend consuming no more than 3.5-4.5 2-3 ounce servings of red meat per week. This recommendation is mainly based on data from epidemiological studies that observe a cohort of peoples’ eating habits over time and relate those habits to whether or not they experience a cardiovascular event, such as a heart attack or stroke, or cardiovascular-related death. These studies show associations between dietary choices and health but are unable to determine if a dietary choice is actually causing the disease. Randomized controlled clinical trials are able to determine causality by isolating one dietary variable to see the effects of that variable on certain health risk factors. Therefore, our lab compiled data from randomized controlled trials assessing the consumption of ≤ vs >3.5 servings of total red meat per week on blood lipids and lipoproteins and blood pressures, since these are common measures taken by clinicians to determine the risk for developing cardiovascular disease. (more…)
Author Interviews, Biomarkers, Critical Care - Intensive Care - ICUs, Infections, JAMA, Pediatrics / 11.01.2017

MedicalResearch.com Interview with: Halden F. Scott MD, Assistant Professor Departments of Pediatrics and Emergency Medicine University of Colorado School of Medicine MedicalResearch.com: What is the background for this study? Response: Sepsis, a dysregulated immune response to infection, is a leading cause of death for children. Survival depends on rapid diagnosis and timely delivery of life-saving resuscitative care, including fluids and antibiotics. However, it can be challenging to make an early diagnosis of sepsis in children. Millions of children present for emergency care of infection and fever every year, most of whom will not develop sepsis. Tools that assist providers in distinguishing the sickest children with infection at an early stage could enable the early delivery of life-saving treatments. Lactate is a clinically-available laboratory test that has played a critical role in improving the diagnosis and treatment of sepsis in adults. Sepsis may cause lactate levels to rise in the blood during sepsis, through reduced delivery of oxygen to the tissues, as well as through changes in how energy is produced and in how lactate is cleared by the kidney and liver. Data about lactate in pediatric sepsis, particularly early levels and whether it is associated with mortality, have been limited. (more…)
Author Interviews, Diabetes, Diabetologia, Infections, Pediatrics / 11.01.2017

MedicalResearch.com Interview with: Dr. Hanna Honkanen PhD University of Tampere. MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association between enteroviruses and type 1 diabetes has been suggested for long and analyzed in several studies. However, only few studies have been able to study this association at the time when the disease process starts, which happens several months or years before type 1 diabetes is diagnosed. Our study made this possible since it was based on a large cohort of children who were followed from birth and samples were collected already before the disease process had started (prospective DIPP-study in Finland). Enterovirus infections were detected by analyzing the presence of viral nucleic acids in longitudinal stool sample series. Infections were found more frequently in case children who developed islet autoantibodies compared to control children. This excess was detected several months before islet autoimmunity appeared. This study is the largest such study carried out so far. The results suggest that enterovirus infections may contribute to the initiation of the disease process that eventually leads to type 1 diabetes. (more…)
Author Interviews, Blood Pressure - Hypertension, Global Health, JAMA / 11.01.2017

MedicalResearch.com Interview with: Dr. Gregory Roth MD Assistant Professor of Medicine Institute for Health Metrics and Evaluation and Division of Cardiology at the University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: The number of people in the world with high blood pressure has doubled in the past two decades, putting billions at an increased risk for heart disease, stroke, and kidney disease. In the current study, we aimed to estimate the association between systolic blood pressure (SBP) over 115 mm Hg, as well as SBP over 140 mm Hg, a condition known as hypertension, and the burden of different causes of death and health burden for 195 countries and territories over time. In 2015, an estimated 3.5 billion adults had systolic blood pressure of at least 110 to 115 mm Hg, and 874 million adults had SBP of 140 mm Hg or higher. In addition, the rate of elevated SBP increased substantially between 1990 and 2015, and disability-adjusted life-years (DALYs) and deaths associated with elevated systolic blood pressure also increased. Countries of lower developmental status – measured by the Socio-demographic Index (SDI) – saw greater increases in the number of deaths linked to elevated SBP than the most developed countries. The largest percent increase in elevated systolic blood pressure deaths between 1990 and 2015 occurred in low-middle countries (107%), and the most deaths occurred in high-middle SDI counties (2,844,499 deaths). (more…)
Author Interviews, Cost of Health Care, JAMA / 11.01.2017

MedicalResearch.com Interview with: Joel Segel, Ph.D. Assistant Professor Department of Health Policy and Administration The Pennsylvania State University University Park, PA 16802 MedicalResearch.com: What is the background for this study? Response: Americans’ health insurance plans increasingly include deductibles, which require patients to pay a certain amount out-of-pocket before the health plan will cover most services. In addition, the levels of these deductibles have been increasing with more and more Americans enrolling in high-deductible health plans (HDHP’s), which in 2013 were plans with a deductible of $1,250 or more for an individual or $2,500 or more for a family. Furthermore, nearly 40% of those with private insurance have a HDHP including most of the bronze and silver plans on the federal Marketplace. This trend has many worried that patients are facing greater financial risk and may delay or forego necessary care because of costs. A population that may be most vulnerable to these problems are Americans with common chronic conditions. (more…)
Annals Internal Medicine, Author Interviews, Cost of Health Care / 11.01.2017

MedicalResearch.com Interview with: Devan Kansagara MD, MCR Associate Professor of Medicine Oregon Health and Science University Director, Evidence-based Synthesis Program, Portland VA Medical Center Staff Physician, Portland VA Medical Center MedicalResearch.com: What is the background for this study? Response: Historically, the US health care system has been dominated by a fee-for-service payment structure in which health care providers are paid for discrete procedures and visits regardless of care quality. Pay for performance programs are part of the move towards value-based care. They tie a portion of payments to individual health care providers, institutions, or health care systems to performance on a discrete set of measures of health care quality. In theory, these programs are meant to encourage the right care at the right time and thereby improve the health of the patient population. Over the last decade, many studies in and outside the US have examined whether or not, in fact, these programs do result in improved care, reduced cost, and improved patient health. Our study is a systematic review of this literature. (more…)
Author Interviews / 11.01.2017

MedicalResearch.com Interview with: Heather F. Smith, Ph.D. Associate Professor of Anatomy Midwestern University Glendale, AZ 85308 MedicalResearch.com: What is the background for this study? Response: The appendix is a narrow pouch that projects off the cecum in the digestive system of many mammal species. Between 1-6% of humans will suffer from appendicitis (inflammation of the appendix) at some point in their lives. Although it is widely viewed as a vestigial organ with little known function, recent research suggests that the appendix may serve an important purpose. My research team gathered data on the presence or absence of the appendix and other gastrointestinal and environmental traits for 533 mammal species. We mapped the data onto a phylogeny (genetic tree) to track how the appendix has evolved through mammalian evolution, and to try to determine why some species have an appendix while others don’t. (more…)
Author Interviews, Exercise - Fitness, Rheumatology / 10.01.2017

MedicalResearch.com Interview with: Dorothy D. Dunlop Ph.D. Professor of Medicine and Preventive Medicine Northwestern University Feinberg School of Medicine Institute for Public Health and Medicine Center for Healthcare Studies Chicago, IL 60611  MedicalResearch.com: What is the background for this study?  
  • We know is being active is good for health.
  • Good evidence supports the current federal guidelines of doing 150 minutes of moderate physical activity each week to prevent serious conditions such as heart disease
  • But only 1 in 10 older US adults with arthritis in their lower limb joints (e.g., knees) meet federal physical activity guidelines
  • Inadequate physical activity is a major public health concern because It can lead to poor function, which threatens a person’s ability to live independently.
These issues motivated our study to investigate the minimum time commitment needed to improve function (or sustain high function) for adults with lower joint osteoarthritis. (more…)
Author Interviews, Hospital Acquired, Infections, Surgical Research, Technology / 10.01.2017

MedicalResearch.com Interview with: Alex Carignan, MD, MSc Department of Microbiology and Infectious Diseases Université de Sherbrooke, Quebec, Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although reports of iatrogenic transmission directly linked to surgical power tools (SPTs) are rare, the decontamination of such instruments is challenging due to their complex designs, which may restrict access to cleaning and sterilization agents, and because they often become contaminated after use. Most studies on infection risk with ultrasonic surgical power tools include patients who underwent phacoemulsification surgeries,but it is logical to assume that lumen contaminants, including bacteria and proteinaceous material from previous operations, may be found in neurosurgery SPTs as well. During June 2015, the infection control department at our institution was notified of an increase in the number of surgical site infection cases following craniotomy since January 2015. We investigated an outbreak of neurosurgical SSIs at a tertiary care hospital in Quebec, Canada, to identify the outbreak’s cause, and our investigation strongly suggests that modifying the reprocessing procedure of an ultrasonic surgical aspirator caused the outbreak. (more…)
Author Interviews, Dermatology, Environmental Risks, Melanoma / 10.01.2017

MedicalResearch.com Interview with: Sophie Seite, Ph. D La Roche-Posay Dermatological Laboratories Asnières, France. MedicalResearch.com: What is the background for this study? What are the main findings? Response: The survey included nearly 20,000 men and women in 23 countries, ages 16-65, and was primarily conducted online. The questionnaire collected data regarding demographics, sun exposure, behaviors regarding prevention and tanning, risk knowledge, self-examination, medical advice seeking, and social attitude. This unprecedented international survey on sun exposure behaviors and skin cancer detection found that there are many imperfections and geographical inequalities in primary and secondary prevention of skin cancer. The study was published in the Journal of the European Academy of Dermatology & Venereology by researchers from La Roche-Posay and the George Washington University (GW) Department of Dermatology. Survey results indicate that 88 percent of those questioned were aware of the risks of developing skin cancer when exposed without protection to the sun. However, just 1 in 2 respondents has ever consulted a dermatologist for a mole screening and 4 in 10 people don’t think to protect themselves from the sun outside of vacation. (more…)
Author Interviews, Cost of Health Care, Prostate Cancer / 10.01.2017

MedicalResearch.com Interview with: Tudor Borza, MD, MS Urologic Oncology and Health Service Research Fellow Department of Urology, University of Michigan MedicalResearch.com: What is the background for this study? Response: Starting in the late 2000’s studies began to identify overdiagnosis and overtreatment in men with prostate cancer. Because of the indolent nature of some prostate cancers many men who ended up diagnosed and treated would have never had any consequences from their prostate cancer. This led national organizations (like the American Urological Association and the National Comprehensive Cancer Network) to call for decreased prostate cancer screening (using the serum PSA test) and eventually led to the US Preventive Services Task Force to recommend against routine PSA screening, citing that the harms from diagnosis and treatment outweighed the harms from the disease. Over the same specialists treating the disease began to report on the safety of surveillance strategies in select men with prostate cancer. Watchful waiting (delaying any treatment until men become symptomatic from their cancer and then offering palliative treatment) was found to be comparable to initial treatment in men with a limited life expectance, either from advanced age or multiple comorbidities. Similarly, active surveillance (a technique employing intense monitoring with PSA testing, digital rectal exams, repeat biopsies and possible use of MRI or other biomarkers) was introduced with the goal of delaying treatment in some men with low risk cancer until the cancer becomes more aggressive and was shown to have similar outcomes to initial treatment in carefully selected men. We wanted to study the trends in initial prostate cancer treatment in this context of recommendations for decreased screening and recognition of the feasibility of surveillance in certain patients with prostate cancer. (more…)