MedicalResearch.com Interview with:Dr. Peter Griffiths PhD, RN
Centre for Innovation and Leadership in Health Sciences
University of Southampton, Southampton, UK
Medical Research: What are the main findings of the study?Dr. Griffiths: This study found that hospital nurses who are working on a 2 shift system, where care is provided by nurses working long shifts of 12-13 hours, report lower quality and safety of care than nurses who work a traditional three shift system where nurses typically work shifts of 8 hours. We also found that nurses who were working overtime reported lower quality and safety of care. We found that these shifts are common in some European countries – most notably Poland, Ireland and England.
(more…)
MedicalResearch.com: Interview with: Girija Syamlal MBBS, MPH , Epidemiologist
Division of Respiratory Disease Studies
National Institute for Occupational Safety and Health
CDC, Morgantown, West Virginia
CDC/NIOSH/DRDS
Morgantown,WV 26505
Medical Research: What are the main findings of the study?
Dr. Syamlal: During 2004–2011, of the 141 million U.S. adults, 20.7% were current cigarette smokers. Smoking prevalences were higher among men (22.8%) than women (18.3%). In both men and women, cigarette smoking prevalence varied widely by occupational group. In certain occupations, the prevalence of smoking was three times greater than the Healthy People 2020 goal that aims to reduce cigarette smoking prevalence to 12%.
(more…)
MedicalResearch.com Interview with:Chester G. Chambers PhD
Armstrong Institute for Patient Safety and Quality
Johns Hopkins Carey Business School, Baltimore, Maryland
Medical Research: What are the main findings of the study?
Dr. Chambers: The main findings of this study are that several metrics of system performance can be improved by using simple methods proven to be effective in many production settings.
Specifically, the idea of using “Pre-processing” as an aspect of medical education improves patient flow times, waiting times, system throughput, and system capacity.
When fixed costs are spread across more patients, we are effectively reducing the cost per patient as well.
In this context “Pre-processing” simply refers to the practice of having medical trainees present and review cases with the attending prior to patient clinic visits as opposed to doing it in the midst of the patient visit. This simple idea is common in many areas including surgery but tends to get omitted in other settings involving ambulatory care. Our simple experiment verified that this practice has real value in a wide array of settings.
(more…)
MedicalResearch.com Interview with: Yuli Huang and Yunzhao Hu
Department of Cardiology, the First People's Hospital of Shunde,
Shunde District, Foshan, PR China.
Medical Research: What are the main findings of the study?Response: “Prediabetes” is a general term that refers to an intermediate stage between normoglycaemia and overt type 2 diabetes mellitus (T2DM). It includes 2 groups of individuals, those with impaired glucose tolerance (IGT) and those with impaired fasting glucose (IFG). In 2003, the American Diabetes Association (ADA) redefined the fasting plasma glucose (FPG) concentration range for diagnosing IFG from 110 to 125 mg/dl to 100 to 125 mg/dl in order to better identify individuals at future type 2 diabetes mellitus risk. However, this change has been contentious and was not adopted by the World Health Organization (WHO) Expert Group or other international guidelines.
In this meta-analysis, we included data from 26 prospective cohort studies with for 280,185 participants and found that, after controlling for multiple cardiovascular risk factors, the presence of prediabetes at baseline, defined as defined as IFG of 110 to 125 mg/dL(IFG 110), IGT or combined IFG 110 and/or IGT, was associated with increased risk of all-cause and cardiovascular mortality. Specifically, IFG 110 was associated with 12% and 19% increase of all-cause and cardiovascular mortality, IGT was associated with 33% and 23% increase of all-cause and cardiovascular mortality, combination of IFG110 and/or IGT was associated with 21% and 21% increase of all-cause and cardiovascular mortality, respectively. Although IFG 100 was not associated with all-cause or cardiovascular mortality in the overall analysis, the risk was greater in young and middle age males according to subgroup analyses.
(more…)
MedicalResearch.com Interview with: Dr. David O'Brart
Keratoconus Research Institute, Department of Ophthalmology
St. Thomas' Hospital, London, United Kingdom
Medical Research: What are the main findings of the study?Dr. O'Brart: There was a slight but significant increase in myopic spherical equivalent refractive error after Photorefractive Keratectomy between 1 and 20 years, particularly in those under 40 at the time of treatment and female patients.
Corneal curvature/power remained unchanged but axial length increased over two decades. The procedure was safe with no long-term sight-threatening complications and improvements in CDVA (corrected distance visual acuity) and corneal transparency with time.
(more…)
MedicalResearch.com: Interview InvitationDr. Csaba P. Kovesdy, MD
Professor of Medicine
University of Tennessee Health Science Center
Chief of Nephrology
Memphis Veterans Affairs Medical Center
Medical Research: What are the main findings of the study?Dr. Kovesdy: We applied the structure of a clinical trial of hypertension management to our cohort of >600,000 patients with prevalent Chronic Kidney Disease (CKD). We first identified patients with baseline uncontrolled hypertension (using the definition applied by the SPRINT trial), then isolated the ones who had a decline in their baseline systolic blood pressure to two different levels (<120 and 120-139 mmHg) in response to a concomitant increase in prescribed antihypertensives, similar to what would happen in a trial examining two different systolic blood pressure targets. We then matched patients in the two groups to end up with identical baseline characteristics, similar to a randomized trial. When we examined the all-cause mortality of these two groups, we found that the group with follow-up systolic blood pressure of <120 had a 70% higher mortality.
(more…)
MedicalResearch.com Interview with: Mario Mandalà, MD
Unit of Clinical Research
Department of Oncology and Haematology
Papa Giovanni XXIII Hospital
Piazza OMS 1, 24100, Bergamo, Italy
Medical Research: What are the main findings of the study?Dr. Mandalà: We evaluated PD-L1 expression by IHC in 81 consecutive metastatic melanoma patients, with well-defined demographic and clinical characteristics. Protein expression levels were correlated with clinical outcome. PD-L1+ and PD-L1- subsets of the A375 cell line were stabilized in vitro and compared using gene expression profiling and functional assays. Results were confirmed using xenograft models. In our study PD-L1 membrane positivity was an independent negative prognostic marker. Furthermore PD-L1 expression defined a subset of the BRAF-mutated A375 cell line characterized by a highly invasive phenotype and by enhanced ability to grow in xenograft models. If confirmed, our clinical and experimental data suggest that PD-L1+ melanomas should be considered a disease subset with distinct genetic and morpho-phenotypic features, leading to enhanced aggressiveness and invasiveness.
(more…)
MedicalResearch.com Interview with: Andrea Gershon MD, MSc, FRCP(C)
Scientist, Institute for Clinical Evaluative Sciences
Respirologist, Division of Respirology, Sunnybrook Health Sciences Centre
Assistant Professor of Medicine, University of Toronto
ICES Central Bayview Avenue, Toronto, Ontario
Medical Research: What are the main findings of the study?Dr. Gershon: Within a large real world population of people with COPD, those who initiated combination long-acting beta-agonists (LABA) and inhaled corticosteroids (ICS) were less likely to die or be hospitalized for COPD than those who initiated LABA alone. Further those who initiated LABA/ICS combination therapy did not appear to have more pneumonia or osteoporotic fractures – side effects that have been associated with ICS use—than those initiating LABA alone.
A second interesting finding was that people with a co-diagnosis of asthma experienced a greater incremental benefit of LABA/ICS over LABA than people without a co-diagnosis of asthma.
Finally, we found that people who were not also taking an inhaled long-acting anticholinergic medication experienced a greater incremental benefit of LABA/ICS over LABA than people who were.
(more…)
MedicalResearch.com Interview with: Lynn L. Moore, DSc, MPH
Co-Director, Nutrition and Metabolism
Assoc Prof of Medicine
Preventive Medicine & Epidemiology Department of Medicine
Boston University School of Medicine
Boston, MA 02118
Medical Research: What are the main findings of the study?Response: Our data were derived from 1,361 adults (aged 30-54 years) enrolled in the Framingham Offspring Study and showed that men and women who consumed higher amounts of protein had lower blood pressures (both systolic and diastolic blood pressures) after four years of follow-up. We then followed them for an average of about 11 years and found that those who consumed the most protein (approximately 103 g/day) had about a 40% lower risk of developing high blood pressure than those consuming about half that amount. These beneficial effects were even more pronounced when higher protein intakes were combined with high fiber intakes.
(more…)
MedicalResearch.com Interview with: James J. Yoo, M.D., Ph.D.
Professor, Institute for Regenerative Medicine
Office of Women in Medicine and Science
Physiology & Pharmacology
Translational Science Institute
Wake Forest School of Medicine Winston-Salem, NC
Medical Research: What are the main findings of the study?Dr. Yoo: Our research is part of a long-term effort to engineer replacement kidneys in the lab to help solve the shortage of donor organs. In this particular report, we worked with human-sized kidneys and developed a method to help keep blood vessels in the new organs open and flowing with blood. Until now, lab-built kidneys had been rodent-sized and functioned for only one or two hours after transplantation because blood clots developed.
Our method to minimize clot formation involved two steps. First, we identified the most effective way to coat the vessels of the kidney scaffold with endothelial cells. We found that infusing cells with a syringe, followed by a period of pumping cells through the vessels at increasing flow rates, was most effective. Next, we looked for a way to ensure that the cells we introduced actually stayed in the vessels and did not wash away when blood flow was initiated. For this, we coated the vessel walls with an antibody to make them bind the endothelial cells.
(more…)
MedicalResearch.com Interview Dongyi (Tony) Du, MD, PhD
Division of Epidemiology
FDA/CDRH/OSB
Medical Research: What are the main findings of the study?Dr. Du: The risk for death on the date of surgery was 60% higher for recipients of mechanical aortic valves than recipients of bioprosthetic aortic valves (OR, 1.61 [95%CI, 1.27-2.04; P < .001]; risk ratio [RR], 1.60). The risk difference decreased to 16% during the 30 days after the date of surgery (OR, 1.18 [95%CI, 1.09-1.28; P < .001]; RR, 1.16). The risk for operative mortality was 19% higher for recipients of mechanical compared with bioprosthetic valves (OR, 1.21 [95%CI, 1.13-1.30; P < .001]; RR, 1.19). The number needed to treat with mechanical valves to observe 1 additional death on the surgery date was 290; to observe 1 additional death within 30 days of surgery, 121.
(more…)
MedicalResearch.com Interview with:Bindu Kalesan PhD MPH
Department of Epidemiology
Mailman School of Public Health
Columbia University
Medical Research: What are the main findings of the study?Dr. Kalesan:There were on average 84 gun deaths per day in the US between 2000 and 2010. The main message of the study is that the 11-year stable national firearm fatality rates mask the wide variation between states, racial and ethnic subgroups and intent of injury. Across 11 years, African-Americans had firearm fatality rates twice greater than Caucasians and 6-times greater than other minority races; the rates showing a decline only among other races. We found that the lowest rates are in HI while very high rates are observed in AK, LA and DC. Seven states (NY, IL, MD, NC, CA, AZ, NV) and DC showed declining rates while FL and MA had rising rates. The widely varying inter-state differences were driven by race specific differences within states.
(more…)
Xuemei Sui, MD, MPH, PhDAssistant Professor, Department of Exercise Science
Division of Health Aspects of Physical Activity
Arnold School of Public Health
University of South Carolina
Columbia, SC 29208
Medical Research: What are the main findings of the study?Dr. Sui:
First, blood pressure is inversely associated with cardiorespiratory fitness levels among men. People in higher fitness categories had lower blood pressure than those in lower fitness categories.
Second, fitness is a strong effect modifier for the systolic blood pressure aging trajectory.
A higher fitness level can significantly delay the natural age-associated increase in blood pressure.
(more…)
MedicalResearch.com Interview :
Iben Marie Miller, MD
Department of Dermatology
Roskilde Hospital, Roskilde
Department of Health and Medical Sciences,
University of Copenhagen, Copenhagen, Denmark
Medical Research: What are the main findings of the study?Dr. Miller: Using a cross-sectional design based on data from a Hidradenitis Suppurativa (HS) group recruited from the hospital (32 individuals), an HS group recruited from the general population (326 individuals) and 14,851 individuals without Hidradenitis Suppurativa, we investigated a possible association of Hidradenitis Suppurativa and the metabolic syndrome. We found that the HS groups had 2 to 4 times odds of having the metabolic syndrome when compared to individuals without HS leaving Hidradenitis Suppurativa patients at a high cardiovascular risk. Furthermore, we found that the odds were higher for the HS group from the hospital in comparison to the Hidradenitis Suppurativa group from the general population.
(more…)
Medical Research Interview with:
Thomas House
Warwick Mathematics Institute
University of Warwick, Coventry.
Medical Research: What are the main findings of this report?Dr House: I analysed the historic patterns of Ebola outbreaks, in particular their rate of introduction (about every 1.5 years), case fatality ratio (which varied between outbreaks but was typically high) and overall severity (which was very variable).
(more…)
MedicalResearch.com: InterviewBashir A. Lwaleed PhD, FRCPath, CBiol FSB, FIBMS Senior Lecturer
Faculty of Health Sciences
University of Southampton
Southampton General Hospital
Southampton United Kingdom
Medical Research: What are the main findings of the study?Dr. Lwaleed: That constituent(s) of Chokeberries has a supra-additive cytotoxic effect in combination with the drug gemcitabine, which is used clinically for this condition, when applied to a pancreatic carcinoma cell line in vitro.
(more…)
MedicalResearch.com Interview with:Dr. Jyotsna Batra
QUT Institute of Health and Biomedical Innovation's
Queensland University of Technology
Queensland, Australia
Medical Research: What are the main findings of the study?Dr Batra: Prostate cancer is a disease with upto 40% genetic component. Previous Genome-wide association studies have identified 77 risk loci associated with prostate cancer. This study is further extension of previous GWASs and also involved meta-analysis of multi-ethnic populations. Through this large study involving approximately 90,0000 individuals, 23 new susceptibility loci were identified to be associated with prostate cancer, 15 variants were identified among men of European ancestry, 7 were identified in multi-ancestry analyses and 1 was associated with early-onset prostate cancer.
(more…)
MedicalResearch.com Interview with: Judith Trotman MBChB, FRACP, FRCPA
Associate Professor Concord Hospital
University of Sydney, Australia
Medical Research: What are the main findings of the study?Dr. Trotman: That PET-CT (applying the cut-off of ≥4 on the now internationally recommended 5 Point Scale) is a more powerful predictor of both Progression Free and Overall Survival than conventional CT in patients responding to first line immunochemotherapy for advanced follicular lymphoma. It is also a much stronger predictor than the pre-treatment prognostic indices FLIPI and FLIP2. Patients who achieve PET-negative status have a median PFS over 6 years compared to only 17 months in those who remain PET-positive.
(more…)
MedicalResearch.com Interview with: Rebecca Smith-Bindman, MD
Professor in the Departments of Radiology;
Epidemiology and Biostatistics; and Obstetrics, Gynecology and Reproductive Medicine UCSF San Francisco Calif.
Medical Research: What are the main findings of the study?Dr. Smith-Bindman: New technology is rapidly developed in medicine, and its important to understand how that technology should be used to improve patient health outcomes. Sometimes the technology is far better than existing technology and it should replace the earlier technology, and sometimes it is not and therefore should not be used. In this clinical scenario – I e. patients who present to an emergency department with abdomen or back pain thought to possibly reflect kidney stones, ultrasound is a simpler, less expensive , and more readily available test in the emergency department setting and therefore if it is equal to CT with respect to patient outcomes, it should be used as the first test in these patients. Currently, CT is the test widely used for patients with suspected kidney stones.
We assessed a large number of patients with suspected kidney stones seen at one of 15 large academic emergency medicine departments across the country. Patients were assigned to point of care ultrasound performed by an ED physician, radiology ultrasound or radiology CT. We assessed a broad range of patient centered outcomes and found each of the three tests we studied were equivalent in terms of these outcomes including complications related to missed diagnoses, related serious adverse events, time spent in the emergency department and repeated ED visits and hospitalizations. However, the exposure to ionizing radiation was around half as high in patients who underwent ultrasound as their first test, and thus ultrasound should be used as the first imaging test in patients with suspected nephrolithiasis.
(more…)
MedicalResearch.com Interview with:
Susan Mason, PhD, MPHAssistant Professor
Division of Epidemiology and Community Health
Minneapolis, MN 55454
Medical Research: What are the main findings of the study?
Dr. Mason: We examined 49,408 women enrolled in the Nurses' Health Study II to see if those who had experienced PTSD symptoms at some point in their lives were more likely than those without PTSD symptoms to meet the criteria for food addiction, a measure of perceived dependence on food. We found that the 8% of women with the most lifetime PTSD symptoms were about 2.7 times as likely to meet the criteria for food addiction as women with no lifetime PTSD symptoms. This translates to an elevation in food addiction prevalence from about 6% among women with no PTSD symptoms to about 16% in women with the most PTSD symptoms.
(more…)
MedicalResearch.com Interview with: Darren J. Malinoski, MD, FACS
Assistant Chief of Surgery – Research and Education
Chief, Section of Surgical Critical Care
Portland VA Medical Center Associate Professor of Surgery
Oregon Health & Science University
Portland, OR 97207
Medical Research: What are the main findings of the study? Dr. Malinoski: Our two main findings are that the status of the DMG Bundle prior to organ recovery, at the end of the OPO donor management process, is the most predictive of the number of organs that will be transplanted per expanded criteria donor (ECD) and that the absolute increase in the number of individual DMG elements achieved over time also appears to be relevant. Taken together, these two findings suggest that the number of organs that will be transplantable from each donor is not necessarily predetermined by their age, comorbidities, and pre-neurologic death condition, but that active critical care management has the ability to affect outcomes and reassessing each donor’s condition over time is necessary.
(more…)
MedicalResearch.com Interview with: Dr Neha Pathak, MBBS MA(Cantab)
Academic Clinical Fellow in Obstetrics and Gynaecology
Queen Mary University London.
Medical Research: What are the main findings of the study?Dr. Pathak: Cervical testing for human papillomavirus (HPV) is being piloted as a more accurate method for cervical cancer screening than current cytology-based ("Pap smears"). However, cervical testing still requires gynaecological examination and a doctor or nurse to take the sample. This could be a deterrent to attending screening as it is invasive and time-consuming. Urine-based HPV testing would be a less invasive and more convenient alternative.
Our study was completed at the Queen Mary University London Women's Health Research Unit. We pooled the results of 14 studies from around the world which tested 1443 women for HPV in urine and cervical samples. We found that detection of HPV in urine seems to have good accuracy for the detection of HPV present in the cervix. We also found that using first void samples (the first part of the stream of urine) was twenty-two times more accurate than random or midstream urine samples.
(more…)
MedicalResearch.com Interview with: Blake Cady MDProfessor of Surgery (emeritus) at Harvard Medical SchoolPartners HealthCare, Harvard Medical
School institutions, Boston
Medical Research: What are the main findings of this study?Dr. Cady: Our findings support mammography screening, and our data is consistent
with the randomized trials. Breast cancer screening with mammography is the most extensively researched screening method ever studied. Only one “randomized" trial failed to show reduced mortality, (Canadian NCSS studies), and there were major flaws in its design and execution that negate their results, as noted in multiple critical publications (volunteers, not geographic assignment, palpable masses detected at examination assigned to “screening” arm, large contamination bias (control group got screened anyway), and very poor quality of mammography). Yet it is this NCSS study that is cited by critics and the press. “Failure Analyses” look backward from death, rather than forward from assignment in randomized trials. The concept of failure studies is well established as noted in recent reports of air-bag failures in cars, and many industrial studies. Seat belt prevention of deaths was discovered by police recording injuries and deaths in crashes after the fact - a failure analysis - not by randomized clinical trials. In breast cancer, failure analyses have advantages of little cost, early results, simplicity, and convenience, compared to randomized trials. Since our results support findings from randomized clinical trials (RCT), they can be accepted as reliable and accurate.
Our findings show that about 71% of deaths from breast cancer occur in the approximately 20% of our patients not in regular screening programs, while only 29% of deaths occur in the 80% of women who were regularly screened by mammography. By extrapolation, women regularly screened have only about a 5% breast cancer mortality, but women not screened have close to a 50% mortality.
(This is my extrapolation from our data, not direct data from our “Failure Analysis”)
(more…)
MedicalResearch.com Interview with: Aner Tal, PhD
Food and Brand Lab
Department of Applied Economics and Management
Cornell University, Ithaca, New York
Medical Research: What are the main findings of the study?Dr. Tal:Some TV programs might lead people to eat twice as much as other programs.
“We find that if you’re watching an action movie while snacking your mouth will see more action too!” says Aner Tal, Ph.D. lead author on the new article just published in the Journal of the American Medical Association: Internal Medicine. “In other words, the more distracting the program is the more you will eat.” In the study 94 undergraduates snacked on M&Ms, cookies, carrots and grapes while watching 20 minutes of television programming. A third of the participants watched a segment of the action movie The Island, a third watched a segment from the talk show, the Charlie Rose Show, and a third watched the same segment from The Island without sound. “People who were watching The Island ate almost twice as many snacks – 98% more than those watching the talk show!” says co-author Brian Wansink, author of Slim by Design (forthcoming) and Professor and Director of the Cornell Food and Brand Lab. “Even those watching “The Island” without sound ate 36% more.” People watching the more distracting content also consumed more calories, with 354 calories consumed by those watching The Island (314 calories with no sound) compared to 215 calories consumed by those watching the Charlie Rose Show. “More stimulating programs that are fast paced, include many camera cuts, really draw you in and distract you from what you are eating. They can make you eat more because you're paying less attention to how much you are putting in your mouth,” explains Tal. Because of this, programs that engage viewers more might wind up being worse for their diets.
(more…)
MedicalResearch.com Interview with: Professor Aubrey Sheiham
Emeritus Professor of Dental Public Health
Department of Epidemiology & Public Health,
University College London, WC1E 6BT. UK.
Medical Research: What are the main findings of the study?Prof Sheiham: There is a robust log-linear relationship of caries to sugar intakes from zero to 10% of sugars as a proportion of total energy intake. Furthermore our analyses showed that sugar intakes of 10%E sugars intake that is currently recommended as an upper limit for free sugars by the WHO and the Scientific Advisory Committee on Nutrition in England would induce a very costly burden of caries in most populations. Second, we found that free sugars* in the diet should make up no more than 3% of total energy intake. Above that level they cause a significant level of tooth decay across the lifecourse of most people in the developed world. Third, we were able to show that despite widescale fluoride use from both toothpastes and drinking water the mean numbers of decayed, missing and filled teeth (DMFT) and decayed and filled surfaces (DFS) for adults increased with sugar use despite the presence of fluoride.
*Free sugars are defined by the World Health Organisation Nutrition Guidance Adivisory Group as follows: “Free sugars include monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit concentrates.” (more…)
MedicalResearch.com Interview with:Alison M Gallagher PhD FHEA RNutr (Public Health)
Senior Lecturer in Human Nutrition
Northern Ireland Centre for Food and Health (NICHE)
School of Biomedical Sciences
University of Ulster Northern Ireland, UK
Medical Research: What are the main findings of the study?Dr. Gallagher: The main findings of the study were that overweight and obese males appeared to be more aware of food related images as compared to their normal weight counterparts. Individuals, regardless of weight status also appeared to be more visually ‘tuned in’ to high energy dense food-related visual stimuli as compared to low energy dense food-related stimuli. As high energy dense foods are overtly represented within the visual environment through food advertising, it may be of particular concern if certain individuals, in particular those who are overweight/obese, are demonstrating increased attention (an attentional bias) towards high energy dense food stimuli.
(more…)
MedicalResearch.com Interview with: Marc Nieuwenhuijse MD
Research fellow ICOR and FDA
Weill Cornell Medical College New York City
Medical Research: Why did you decide to study this topic?Dr. Nieuwenhuijse: The introduction of new orthopaedic implants and related technologies has been the focus of major scientific and policy discussions since the failures of articular surface replacement and large head size metal-on-metal articulations in total hip replacement were brought to light. However, scientists and policy makers seem to “run out of steam,” and the momentum for change generated by these recent high profile failures is waning. The consequences of uncontrolled device introduction worldwide may not be fully recognised by the scientific community and there is a high likelihood that current practice regarding device innovations will not change much. As such, there is a need to investigate whether the problems associated with the articular surface replacement and large head size metal-on-metal articulation are isolated events or if there is a systemic problem affecting the introduction of a much wider range of implantable devices.
In this study, we systematically evaluate the evidence concerning the introduction of five substantial, innovative, relatively recent, and already widely implemented device technologies used in major total joint replacement to determine the evidence of effectiveness and safety for introduction of five recent and ostensibly high value implantable devices in major joint replacement to illustrate the need for change and inform guidance on evidence based introduction of new implants into healthcare.
(more…)
MedicalResearch.com Interview with: Ankur Pandya, PhD
Assistant Professor of Healthcare Policy and Research
Departments of Healthcare Policy and Research
Weill Cornell Medical College
New York, NY 10065.
Medical Research: What are the main findings of the study?Dr. Pandya: Asymptomatic carotid stenosis is a highly prevalent condition that can lead to ischemic stroke, which is a leading cause of death and healthcare costs in the U.S. Revascularization procedures are often performed on asymptomatic carotid stenosis patients, but experts have questioned whether the stroke prevention benefits outweigh the risks and costs of revascularization in these patients. Imaging-based stroke risk assessment has traditionally focused on the degree of artery narrowing, but there has been growing interest in using cerebrovascular reserve (CVR) assessment to stratify these patients into those that are more likely to have a stroke, and thus better candidates for revascularization, and those that would be better off with less invasive management strategies (such as medical therapy). We therefore developed a simulation model to evaluate whether the CVR-based decision rule could be used efficiently select the right patients for revascularization. We found that the CVR-based strategy represented the best value for money compared to immediate revascularizations or medical therapy-based treatment for all patients.
(more…)
MedicalResearch.com Interview with:Dr. Marc Carrier, MD MSc
Scientist, Clinical Epidemiology, Ottawa Hospital Research Institute
Physician, Hematology, The Ottawa Hospital
Associate Professor, Department of Medicine, Faculty of Medicine, and Research Chair in Venous Thromboembolism and Cancer (Tier 2) at the University of Ottawa
MedicalResearch.com: What are the main findings of this study?
Dr. Carrier: Venous thromboembolism (VTE), comprised of deep vein thrombosis and pulmonary embolism, is the third leading cause of cardiovascular death. There are many anticoagulant treatments available but there is little guidance about which treatment is most effective and safe. This systematic review and network meta-analysis evaluated eight different treatment options for acute Venous thromboembolism. Forty-five trials were included in the analysis and there were no significant differences in clinical or safety outcomes associated with most treatment options when compared to the combination of LMWH-VKA..
(more…)
MedicalResearch.com Interview with: Lex W Doyle MD BS MSc FRACP
Professor of Neonatal Paediatrics
Department of Obstetrics and Gynaecology
The Royal Women’s Hospital
Parkville, Victoria, Australia
Medical Research: What are the main findings of the study?Dr. Doyle: From collectively pooling data from five large trials carried out around the world over the past 20 years, we know that magnesium sulfate given under strict medical protocols in hospital to women threatening to deliver preterm reduces the risk of cerebral palsy in their children in early childhood. Following from this knowledge, magnesium sulfate is now given routinely to women, under strict medical conditions, who are threatening to deliver very early in Australia, and in other parts of the world, to try to prevent cerebral palsy in their child. What we do not know is if magnesium sulfate used this way has any longer-term effects on the brain or on other important outcomes.
One of the initial studies that contributed to the overall evidence about cerebral palsy was carried out in Australia and New Zealand and completed more than 10 years ago. Over 1000 women and their babies were enrolled in that study and although the rate of cerebral palsy was not substantially reduced by magnesium sulfate in our study, we showed that there were fewer children at 2 years of age who were not walking in the group whose mothers were given magnesium compared with those whose mothers were given placebo. With this knowledge, and given the unknown longer-term benefits or risks, we re-evaluated the children from our study at school-age, between 6-11 years of age. We thoroughly evaluated their brain function, including movement and co-ordination, thinking ability, behaviour, and school progress, as well as general health and well-being. The basic message from our longer-term study is that magnesium sulfate, as used in our trial, does not have any substantial benefits or harms on brain or cognitive function, or any other outcome at school age.
(more…)
This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish.AcceptRejectRead More
Privacy & Cookies Policy
Privacy Overview
This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
MedicalResearch.com Interview with:
Dr. Peter Griffiths PhD, RN
Centre for Innovation and Leadership in Health Sciences
University of Southampton, Southampton, UK
Medical Research: What are the main findings of the study?
Dr. Griffiths: This study found that hospital nurses who are working on a 2 shift system, where care is provided by nurses working long shifts of 12-13 hours, report lower quality and safety of care than nurses who work a traditional three shift system where nurses typically work shifts of 8 hours. We also found that nurses who were working overtime reported lower quality and safety of care. We found that these shifts are common in some European countries – most notably Poland, Ireland and England.
(more…)
