Author Interviews, CDC, Pediatrics / 24.09.2014

Dr. Lorraine Yeung Division of Birth Defects and Developmental Disabilities National Center on Birth Defects and Developmental Disabilities, CDCMedicalResearch.com Interview with: Dr. Lorraine Yeung Division of Birth Defects and Developmental Disabilities National Center on Birth Defects and Developmental Disabilities, CDC Medical Research: What are the main findings of the study? Dr. Yeung: In this report, we looked at the percentages of children who received various recommended clinical preventive services. We found that millions of infants, children, and adolescents in the U.S. did not receive key clinical preventive services. This report provides a baseline snapshot of the use of 11 key clinical preventive services before or shortly after the Affordable Care Act went into effect. A focus of the Affordable Care Act is on improving prevention of illness and disability and it does so by requiring new health insurance plans to provide certain clinical preventive services at no additional cost — with no copays or deductibles. This is important because we know increasing the use of these services can improve children’s health and promote healthy lifestyles that will enable them to reach their full potential. Some of the important findings in this report were:          In 2007, parents of almost eight in 10 (79 percent) children aged 10-47 months reported that they were not asked by healthcare providers to complete a formal screen for developmental delays in the past year.          In 2009, more than half (56 percent) of children and adolescents did not visit the dentist in the past year and nearly nine of 10 (86 percent) children and adolescents did not receive a dental sealant or a topical fluoride application in the past year.          Nearly half (47 percent) of females aged 13-17 years had not received their recommended first dose of HPV vaccine in 2011.          Approximately one in three (31 percent) outpatient clinic visits made by 11-21 year-olds during 2004–2010 had no documentation of tobacco use status; eight of 10 (80 percent) of those who screened positive for tobacco use did not receive any cessation assistance.          Approximately one in four (24 percent) outpatient clinic visits for preventive care made by 3-17 year olds during 2009-2010 had no documentation of blood pressure measurement. (more…)
Author Interviews, Heart Disease, JACC / 23.09.2014

Jerry D. Estep, M.D., FACC Assistant Professor of Medicine, Weill Cornell Medical College Medical Director, Heart Transplant & LVAD Program Methodist DeBakey Heart & Vascular Center Houston Methodist HospitalMedicalResearch.com Interview with: Jerry D. Estep, M.D., FACC Assistant Professor of Medicine, Weill Cornell Medical College Medical Director, Heart Transplant & LVAD Program Methodist DeBakey Heart & Vascular Center Houston Methodist Hospital Medical Research: What are the main findings of the study? Dr. Estep: There were two major findings: 1-Non-invasive Doppler echocardiographic and invasive measures of mean right atrial pressure (RAP) (r = 0.863; p < 0.0001), systolic pulmonary artery pressure (sPAP) (r=0.880; p<0.0001), right ventricular outflow tract stroke volume (r=0.660; p < 0.0001), and pulmonary vascular resistance (r = 0.643; p= 0.001) correlated significantly. 2-An algorithm integrating mitral inflow velocities, RAP, sPAP, and left atrial volume index was 90% accurate in distinguishing normal from elevated left ventricular filling pressures. (more…)
Author Interviews, General Medicine, Heart Disease, JACC, Karolinski Institute / 23.09.2014

Agneta Åkesson Associate professor, senior lecturer Photo by Anna Persson Nutritional Epidemiology IMM Institute of Environmental Medicine Karolinska Institutet Stockholm, SwedMedicalResearch.com Interview with Agneta Åkesson Associate professor, senior lecturer                                                  Nutritional Epidemiology IMM Institute of Environmental Medicine Karolinska Institutet Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Åkesson: Our study indicates that a healthy diet together with low-risk lifestyle practices such as being physically active, not smoking and having a moderate alcohol consumption, and with the absence of abdominal adiposity may prevent the vast majority of myocardial infarctions in men. (more…)
Author Interviews, Depression, JAMA / 23.09.2014

A001_C001_03160QMedicalResearch.com Interview with: Dr. Philippe Courtet MD PhD Centre Hospitalier Régional Universitaire de Montpellier, Institut National de la Santé et de la Récherche Médicale , Université Montpellier, Montpellier, France Fondation Fondamental, Créteil, France Medical Research: What are the main findings of the study? Dr. Courtet: Depressed outpatients who are beginning the treatment with a SSRI at higher dose than recommended present an increased risk (x2) of worsening of suicidal ideation during the first 6 weeks of treatment. This is consistent with the study by Miller et al published in the same journal few weeks ago, reporting a double risk of suicide attempt in young subjects (<24 yrs) who are begun an SSRI at higher dose than recommended. Our results showed that the increased suicide risk with the high dose of SSRI is not restricted to youngsters and is independent of the severity of the depression. (more…)
Author Interviews, JAMA / 23.09.2014

MedicalResearch.com Interview with: Todd C. Lee, MD, MPH Division of General Internal Medicine and Infectious Diseases Department of Medicine, McGill University Health Centre McGill Centre for Quality Improvement, Montreal, Quebec, Canada Medical Research: What are the main findings of the study? Dr. Lee: We found that in our cross-sectional study of six inpatient units in five hospitals that, in general, only 11% of patients were wearing lower body garments despite the fact that probably 55% of them could have been doing so.  The remainder were wearing open backed gowns.  When specifically asked, the majority of these patients would like to have been afforded the opportunity to wear more dignified attire and the patients were surprised that they were allowed to do so. (more…)
Author Interviews, Diabetes, Lipids, Statins / 22.09.2014

Prof. Moses Elisaf Professor of Internal Medicine University of Ioannina, GreeceMedicalResearch.com Interview with: Prof. Moses Elisaf Professor of Internal Medicine University of Ioannina, Greece Medical Research: What are the main findings of the study? Dr. Elisaf: We evaluated the effects of rosuvastatin in two groups of hyperlipidemic patients: one group had impaired fasting glucose (IFG) while the second group had normal fasting glucose. After study end, both groups had similar changes in their lipidemic profile. However, patients with IFG had a significant greater decrease in the cholesterol concentration of the more atherogenic small dense low-density lipoprotein (sdLDL) particles (-65.7%) compared with controls (-38.5%). Moreover, a greater increase in the mean LDL particle size was observed in the impaired fasting glucose group (+1.5% vs +0.4%). In addition, redistribution from the more atherogenic sdLDL to large buoyant LDL (lbLDL) subfractions was observed in the IFG group. (more…)
Author Interviews, Nursing / 22.09.2014

Dr. Peter Griffiths PhD, RN Centre for Innovation and Leadership in Health Sciences University of Southampton, Southampton, UK 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…)
Author Interviews, Occupational Health, Smoking / 22.09.2014

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…)
Author Interviews, Education, General Medicine / 22.09.2014

Chester G. Chambers PhD Armstrong Institute for Patient Safety and Quality Johns Hopkins Carey Business School, Baltimore, MarylandMedicalResearch.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…)
Author Interviews, Diabetes / 22.09.2014

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…)
Author Interviews, Ophthalmology / 22.09.2014

Dr. David O'Brart Keratoconus Research Institute, Department of Ophthalmology St. Thomas' Hospital, London, United KingdomMedicalResearch.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…)
Author Interviews, Blood Pressure - Hypertension, General Medicine, JAMA, Kidney Disease / 22.09.2014

Dr. Csaba P. Kovesdy, MD Professor of Medicine University of Tennessee Health Science Center Chief of Nephrology Memphis Veterans Affairs Medical CentMedicalResearch.com: Interview Invitation Dr. 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…)
Author Interviews, Melanoma / 21.09.2014

Mario Mandalà, MD Unit of Clinical Research Department of Oncology and Haematology Papa Giovanni XXIII Hospital Piazza OMS 1, 24100, Bergamo, ItalyMedicalResearch.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…)
Author Interviews, JAMA, Pulmonary Disease / 20.09.2014

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, OntarioMedicalResearch.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…)
Author Interviews, Blood Pressure - Hypertension, Protein / 20.09.2014

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 02118MedicalResearch.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…)
Author Interviews, Transplantation / 20.09.2014

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, NCMedicalResearch.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…)
Author Interviews, General Medicine, Heart Disease, JAMA / 20.09.2014

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…)
Accidents & Violence, Author Interviews, BMJ / 20.09.2014

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…)
Aging, Author Interviews, Blood Pressure - Hypertension / 20.09.2014

Xuemei Sui, MD, MPH, PhD Assistant Professor, Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208Xuemei Sui, MD, MPH, PhD Assistant 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…)
Author Interviews, Dermatology, JAMA, Metabolic Syndrome / 19.09.2014

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…)
Author Interviews, Ebola / 19.09.2014

Thomas House Warwick Mathematics Institute University of Warwick, Coventry. 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…)
Author Interviews, Pancreatic / 19.09.2014

MedicalResearch.com: Interview Bashir 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…)
Author Interviews, Genetic Research, Nature, Prostate Cancer / 18.09.2014

Dr. Jyotsna Batra QUT Institute of Health and Biomedical Innovation's Queensland University of Technology Queensland, AustraliaMedicalResearch.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…)
Author Interviews, Cancer Research, Lancet / 17.09.2014

Judith Trotman MBChB, FRACP, FRCPA Associate Professor Concord Hospital University of Sydney, AustraliaMedicalResearch.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…)
Author Interviews, Kidney Stones, NEJM, Radiology, UCSF / 17.09.2014

Rebecca Smith-Bindman, MD Professor in the Departments of Radiology; Epidemiology and Biostatistics; and Obstetrics, Gynecology and Reproductive Medicine UCSF San Francisco Calif.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…)
Addiction, Author Interviews, JAMA, PTSD / 17.09.2014

Susan Mason, PhD, MPH Assistant Professor Division of Epidemiology and Community Health Minneapolis, MN 55454MedicalResearch.com Interview with: Susan Mason, PhD, MPH Assistant 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…)
Author Interviews, JAMA, Surgical Research, Transplantation / 17.09.2014

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 97207MedicalResearch.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…)
Author Interviews, BMJ, HPV / 17.09.2014

Dr Neha Pathak, MBBS MA(Cantab) Academic Clinical Fellow in Obstetrics and Gynaecology Queen Mary University London.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…)
Author Interviews, Breast Cancer / 17.09.2014

Blake Cady MD Professor Emeritus of Surgery Brown UniversityMedicalResearch.com Interview with: Blake Cady MD Professor of Surgery (emeritus) at Harvard Medical School Partners 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…)