MedicalResearch.com Interview with: Dr. Judith Malmgren PhD
Affiliate Assistant Professor, Epidemiology
University of Washington
School of Public Health
Seattle, WA 98177
Medical Research: What are the main findings of the study?Dr. Malmgren: We found a significant shift to lower stage breast cancer at diagnosis with an observed increase in mammography detected breast cancer over time and a significant decrease in later stage cancers found by the patient or her doctor.
Mammography detected breast cancers were more often treated with lumpectomy and radiation and less likely to require mastectomy or adjuvant chemotherapy.
We also observed better 5 year invasive breast cancer specific survival among the mammography detected patients as opposed to the patient or physician detected breast cancer cases.
(more…)
MedicalResearch.com Interview with: Sahil Khera, MD and Dhaval Kolte, MD, PhD
Department of Medicine, Division of Cardiology
New York Medical College, NY
Medical Research: What are the main findings of the study?Answer: We used the publicly available Nationwide Inpatient Sample (NIS) databases for our study. We analyzed data on 6.5 million patients with heart attack (all types) from 2002 to 2011 in United States. Out of these 3.98 million were admitted with a diagnosis of non-ST elevation myocardial infarction (NSTEMI). Our objective was to describe how the care for patients with NSTEMI has changed over the past 10 years and whether this has resulted in better patient outcomes. We looked at the proportion of patients with NSTEMI who underwent cardiac catheterization each year. We also studied how many patients died in the hospital, how long was the hospital stay, and what was the total cost of hospitalization for this condition. Lastly, we determined if the changes in treatment and outcomes over the years were similar for different age- groups, men and women, and for different racial/ethnic groups.
In this analysis, we looked at cardiac catheterization trends after NSTEMI for both within 24 hours and within 48 hours. This is the first study of its kind to analyze two different time frames of early catheterization simultaneously. Although there was an increase in the proportion of patients with NSTEMI with increase in utilization of early cardiac catheterization and decrease in in-hospital death and length of stay, age-, sex-, and race/ethnicity-specific differences in the management and outcomes of NSTEMI were observed, and further studies are needed to develop strategies to ensure more equitable care for patients with this type of heart attack. (more…)
MedicalResearch.com: Interview Invitation Dr. Bente Glintborg:
Copenhagen Centre for Arthritis ResearchCentre for Rheumatology and Spine Diseases
Copenhagen University Hospital Glostrup
Copenhagen, Denmark
Medical Research: What are the main findings of the study?Dr. Glintborg: Current smoking had a negative impact among patients with psoriatic arthritis treated with TNFi. This was especially observed among male patients and among patients treated with infliximab and etanercept. Current smokers had a shorter treatment duration (=poorer treatment adherence rate) compared to non-smokers. And current smokers had poorer treatment response (measured as ACR20, ACR50 and ACR70 responses and EULAR good response) compared to non smokers. Especially among male smokers the EULAR good response and ACR20 response rates were nearly half of the rates among male non-smokers. The response rates among women did not seem to be affcted by smoking status. Current smokers had poorer self reported outcome measures (HAQ and VAS global and VAS fatigue) when they started treatment with TNFi.
(more…)
MedicalResearch.com Interview with: Professor Fritz H Schröder
Department of Urology, Erasmus University Medical Center
Rotterdam, Netherlands
Medical Research: What are the main findings of the study?Professor Schröder: I consider as the main finding that we could report a continuing effect of PSA driven screening on prostate cancer mortality for men aged 55 – 69 years in the screen arm of our study after 13 years of follow-up. The absolute reduction in the risk of death from prostate cancer amounts to 1.28 per 1000 men randomized to the screening arm. This translated into numbers to be invited to screening and numbers needed to be diagnosed to save one prostate cancer death of 781 and 27. These figures show an increasing effect with increasing time of follow-up. The relative risk reduction related to the control arm has remained unchanged with respect to the 11 year follow-up period. For men who actually participated and were screened the relative risk reduction amounted to 27%, the figure most applicable to men who consider to be tested.
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MedicalResearch.com Interview with: Dr. Gianni D'Egidio HBSc, MD, MEng
Academic Division of Internal Medicine
Ottawa Hospital, Canada
Medical Research: What are the main findings of the study?
Dr. D'Egidio: Baseline hand hygiene compliance at our main entrance in our study was 12.4%. We believe one of the main reasons for such an appalling low compliance was that individuals were distracted. Visitors entering are often preoccupied with acquiring information to help them navigate a large and confusing environment given the multitude of signs, lights, announcements and other people. Also, the majority of individuals entering have objects occupying their hands; keys, hand-held devices, coffee mugs, and during cold weather, gloves. All this together contributes to poor compliance at our front entrance.
We hypothesized that a conspicuous flashing red light at 3 Hz (3 flashed per second) attached to alcohol hand dispensers located at our front entrance would attract an individual’s attention and hopefully increase compliance. We measured hand hygiene compliance for 1-week periods from 07:30-08:30 before and after the implementation of our flashing lights. We found that compliance increased by more than double to 25.3% (p<0.0001).
(more…)
MedicalResearch.com Interview with: James T. Becker, Ph.D.
Professor of Psychiatry, Psychology, and Neurology
University of Pittsburgh
Medical Research: What are the main findings of the study?Dr. Becker: We found that people who eat baked or broiled (but not fried) fish at least once every week had significantly larger brain volumes in areas critical for memory and cognition, namely, hippocampus, precuneus, posterior cingulate cortex, and orbital frontal cortex.
(more…)
MedicalResearch.com Interview with: Kumar Bharat Rajan, PhD
Assistant Professor
Department of Internal Medicine
Section of Population Sciences
Chicago IL 60612
Medical Research: What are the main findings of the paper?Dr. Rajan: Lower levels of cognitive functioning was associated with incident stroke and the change in cognitive functioning was increased after incident stroke. Cognitive functioning was an independent marker of mortality even after accounting for incident stroke.
(more…)
MedicalResearch.com Interview with: Steven Ball
Telethon Kids Institute
University of Western Australia
West Perth, WA 6872, Australia
Medical Research: What are the main findings of the study?Answer:Our study suggests that the amount of time between pregnancies has less of an effect on birth outcomes than previously thought.
Relative to pregnancies that started 18-23 months after a previous birth, pregnancies that followed shorter spacing had very little increased risk of preterm birth, low birth weight or small-for-gestational-age. Longer pregnancy spacing showed increased risk of low birth weight and small-for-gestational-age, but not of preterm birth.
(more…)
MedicalResearch.com Interview with:Dr. Tetyana Kendzerska
Institute for Clinical Evaluative Science
Women's College Research Institute
Women's College Hospital
Department of Medicine
University of Toronto
Medical Research: What are the main findings of the study?Dr. Kendzerska: In a large cohort with varying degrees of obstructive sleep apnea (OSA), severity of obstructive sleep apnea was not found to be independently associated with either prevalent or incident cancer, except in one subgroup analysis in smoking-related cancer.
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MedicalResearch.com Interview with: Rakesh K. Mishra, MD
San Francisco Veterans Affairs Medical Center
San Francisco, CA 94121.
Medical Research: What are the main findings of the study?Dr. Mishra: Increased levels of both BNP and NT-proBNP are associated with elevated risk of adverse cardiovascular events in patients with stable coronary artery disease. However, when added to existing clinical models of risk, NT-proBNP is superior to BNP for risk reclassification.
(more…)
MedicalResearch.com Interview with: Brie Turner-McGrievy, Ph.D., M.S., R.D.
Assistant Professor, University of South Carolina
Arnold School of Public Health
Department of Health Promotion, Education, and Behavior Discovery
Columbia, SC 29208
Medical Research: What are the main findings of the study?Dr. Turner-McGrievy: This study assessed how closely crowdsourced ratings of foods and beverages contained in 450 pictures from the Eatery mobile app as rated by peer users using a simple “healthiness” scale were related to the ratings of the same pictures by trained observers. Our trained observers used a rating scale based on the U.S. Dietary Guidelines to assess the healthiness of the foods and beverages in each picture. Crowdsourcing uses the input of several users to provide feedback and information. We found that all three trained raters’ scores was highly correlated with the peer healthiness score for all the photos. In addition, we found that peer ratings were in the expected direction for both foods/beverages the Dietary Guidelines say to increase and ones to limit. Photos with fruit, vegetables, whole grains, and legumes, nuts, and seeds were all associated with higher peer healthiness scores and processed, food from fast food restaurants, refined grains, red meat, cheese, savory snacks, sweets/desserts, and sugar sweetened beverages were associated with lower peer healthiness scores.
(more…)
MedicalResearch.com Interview with: Claudio Soto, PhD
Professor of Neurology
Director Mitchell Center for Alzheimer's disease and related Brain Disorders
University of Texas Medical School at Houston
Medical Research: What are the main findings of the study?Dr. Soto:In this study we describe for the first time the highly sensitive detection of prions in human urine, specifically in samples from patients affected by the variant form of Creutzfeldt-Jakob disease (vCJD), which is the disease produced by infection with prions associated with bovine spongiform encephalopathy, also known as mad cow disease. For detection we used the protein misfolding cyclic amplification (PMCA) technique which amplifies the amount of abnormal prion protein in a cyclical manner conceptually analogous to the polymerize chain reaction. We detected prions in 13 of the 14 vCJD cases analyzed, and the only negative was a sample coming from a patient under treatment with a experimental drug injected directly into the brain. No false positive were observed in the more than 200 cases analyzed. The concentration of abnormal prion protein in urine was estimated at 1x10^-16 g/ml, or 3x10^-21 moles/ml, which extrapolates to ~40-100 particles per ml of urine.
(more…)
Medical Research Interview with:
Lara J. Akinbami, MD
Infant, Child and Women's Health Statistics Branch
National Center for Health Statistics
Centers for Disease...
MedicalResearch.com Interview with:Dr Marc Tischkowitz MD PhD
University Lecturer (Associate Professor) and
Honorary Consultant Physician in Medical Genetics
Department of Medical Genetics, University of Cambridge
Medical Research: What are the main findings of the study?Dr. Tischkowitz: The PALB2 gene was first identified in 2006 and linked to breast cancer in 2007 but until now we have not had good breast cancer risk estimates for women who have inherited PALB2 mutations. This study was started in 2009 by an group of research institutions (The PALB2 Interest Group) in Canada, US, Europe (UK, Belgium, Greece, Italy, Finland) and Australia. We studied 362 individuals with PALB2 mutations from 154 families. We found that awomen with a PALB2 mutation will on average have a 35% risk of developing breast cancer by the age of 70, rising to 58% if there is a strong family history. Our study will help clinicians to better advise and manage such women.
There are several new aspects.
It is by far the largest study to date and provides the most accurate risk estimates for PALB2 mutation carriers.
MedicalResearch.com Interview Cristina B. Geltzeiler, MD
Knight Cancer Institute
Oregon Health & Science University
Portland, OR 97239-3098
Medical Research: What are the main findings of the study?Dr. Geltzeiler: The main findings of the study are that implementing an Enhanced Recovery After Surgery (ERAS) program at a community hospital can be successfully implemented and can allow patients to recover quicker from their surgery with ongoing safety.
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MedicalResearch.com Interview with: Dr. Richard Saitz MD MPHDepartment of Community Health Sciences
Boston University School of Public Health
Boston, Massachusetts
Medical Research: What are the main findings of the study?Dr. Saitz: We found that brief counseling interventions had no efficacy for reducing the frequency of illicit drug use or drug use consequences among primary care patients identified by screening as using drugs.
(more…)
MedicalResearch.com Interview with: James Fisher BSc (Hons) MSc PGCLT(HE)
Senior Lecturer Sports Conditioning and Fitness
IFBB Certified Weight Training Prescription Specialist
Centre for Health, Exercise and Sport Science
Faculty of Business, Sport and Enterprise
Southampton Solent University, Southampton
Medical Research: What are the main findings of the study?Answer: The study reports that pre-conceived ideas about exercise order, and rest intervals are not substantiated by evidence, and that advanced training routines such as pre-exhaustion appear to induce no greater strength adaptations than simpler training methods. Ultimately, that a single set of each exercise performed at a repetition duration which maintains muscular tension is all that is necessary to induce significant increases in strength in even trained persons.
(more…)
MedicalResearch.com Interview with: Sara Tartof, PhD, MPH
Post-doctoral research fellow
Kaiser Permanente Southern California Department of Research & Evaluation.
Medical Research: What are the main findings of the study?Dr. Tartof: Our study found that the herpes zoster vaccine continues to be effective in protecting older adults against shingles, even after they undergo chemotherapy. In particular, we found that those patients who were previously vaccinated with the vaccine were 42 percent less likely to develop shingles following chemotherapy treatment. We also found that none of our vaccinated patients underwent hospitalization for shingles, while six unvaccinated patients were hospitalized with the disease.
(more…)
MedicalResearch Interview with: Maurizio Gasparini MD
Humanitas Research Hospital
Rozzano, Italy
Medical Research: What are the main findings of the study?Dr. Gasparini: We found that a strategic programming of implantable cardioverter defibrillators which allows the non-sustained arrhythmias to self-terminate is associated with reductions in hospitalizations, length of hospital stay and cost per patient-year and an increase in the time to first hospitalization. These results were mainly driven by reduction in cardiovascular-related events.
(more…)
MedicalResearch.com Interview withJagpreet Chhatwal, Ph.D.
Assistant Professor
Department of Health Services Research
Houston, TX 77098
Medical Research: What are the main findings of the study?Dr. Chhatwal:The recent updates in hepatitis C virus (HCV) screening policy and ongoing therapeutic advances can make hepatitis C a rare disease in the US by 2036. However, more aggressive screening strategies are needed to further reduce the burden of disease. For example, 1-time universal screening further identify 487,000 chronic hepatitis C virus cases in the next 10 years, and can make hepatitis C a rare disease in the next 12 years.
(more…)
upcoming JAMA publication:
MedicalResearch.com Interview with:Shuen-Iu Hung, PhD, for the Taiwan SCAR consortium
Associate Professor, Department of Pharmacology,
National Yang-Ming University, Taipei, 112 Taiwan
Medical Research: What are the main findings of the study?Reply: Phenytoin, a widely prescribed antiepileptic drug, can cause severe cutaneous adverse reactions (SCAR) (e.g., Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) ), which carry high mortality and morbidity. The genomic basis of phenytoin-induced SCAR has not been known. This study identifies CYP2C variants, including CYP2C9*3 known to reduce drug clearance, as the key genetic factors associated with phenytoin-related severe cutaneous adverse reactions. These findings have potential to improve the safety profile of phenytoin in clinical practice and offer the possibility of prospective testing for preventing phenytoin-related SCAR.
(more…)
MedicalResearch.com: Interview with: M. Susan Ridgely, JD
Senior Policy Analyst
RAND Corporation
Santa Monica, California
Medical Research: What are the main findings of the study?Answer: We evaluated a three-year effort, coordinated by the Integrated Healthcare Association, to determine whether bundled payment could be an effective payment model for California. The pilot focused on bundled payment for orthopedic procedures for commercially insured adults under age 65. Bundled payment is a much-touted strategy that pays doctors and hospitals one fee for performing a procedure or caring for an illness. The strategy is seen as one of the most-promising ways to curb health care spending. Unfortunately, the project failed to meet its goals, succumbing to recruitment challenges, regulatory uncertainty, administrative burden and concerns about financial risk.
At the outset of the project, participants included six of the state’s largest health plans, eight hospitals and an independent practice association. Eventually, two insurers dropped out because they believed the bundled payment model in this project would not lead to a redesign of care or lower costs. Another decided that bundled payment was incompatible with its primary type of business (health maintenance organization). Just two hospitals eventually signed contracts with the three remaining health plans to use bundled payments. Hospitals that dropped out cited concerns about the time and effort involved.
The project was hurt by a lack of consensus about what types of cases to include and which services belonged in the bundle. In the end, most stakeholders agreed that the bundle definitions were probably too narrow to capture enough procedures to make bundled payment viable.
(more…)
MedicalResearch.com Interview with:Henry M. Spinelli, MD, PC
Plastic & Reconstructive Surgery
875 Fifth Avenue
New York, NY 10065
Medical Research: What are the main findings of the study?
Dr. Spinelli: Briefly, we polled approximately 26,000 plastic surgeons by way of membership in the International Society of Aesthetic Plastic Surgeons (ISAPS), American Society for Aesthetic Plastic Surgery (ASAPS) and American Society of Plastic Surgeons (ASPS) and collated this data and published it in Aesthetic Plastic Surgery (the Blue Journal), the official journal of ISAPS. This preliminary study was initiated given the current and past healthcare and cosmetic medical/surgical care climate both in the United States and worldwide. As a background, when it comes to injectables (botox and fillers) there is not a united consensus on a state by state basis in the USA and from country to country worldwide. Additionally, the regulations and laws governing the administration of botox and injectables is in a constant flux. For instance, the UK allowed beauticians in the past to administer these substances however they are now banned from legal administration of these products. Alabama, only allows physicians (dermatologists and plastic surgeons) to purchase and administer botox and injectables whereas the medical board of California states that physicians can perform the procedure or oversee licensed registered nurses, licensed vocational nurses, or physicians assistants. Similarly, dentists in some states are permitted to administer these agents. It would be a bad idea for any physician working with botox to take Advanced Botox Training to reduce the possibility of medical misdemeanors.
At the present time few studies have directly assessed the capability of various providers to administer cosmetic injections. When people schedule a consultation for plastic surgery, they are often looking for things like a younger face or a nicer body. The answer to the previous question will become more important as the demand for these procedures continues to grow and an increasing number of practitioners and different Plastic Surgeon from a variety of backgrounds enter the field to meet demand. This study aimed to help define the role of various practitioners in an increasingly more competitive environment for injectables and to explore the relationship between patient and injectable provider in order to improve patient satisfaction and outcomes.
When asked to rank patients’ perceptions of various providers according to their expertise in administering Botox and dermal fillers, responders ranked plastic surgeons and dermatologists as most capable (96%) then nurses in plastic surgery and dermatology (3%). Gynecologists (<1%), dentists (<1%) and nurses in other fields (<1%) all received nearly equivalent numbers of “most capable” rankings. When asked to rank patients’ perception of various providers according to their inability to administer Botox and dermal fillers, nurses in other fields were most frequently ranks as least capable (63%) followed by dentists (26%), gynecologists (12%), plastic surgeons and dermatologists (2%) and nurses in plastic surgery and dermatology (1%).
(more…)
MedicalResearch.com Interview with:Isaac J. Powell MD
Wayne State University/Karmanos Cancer Inst
University Health Center
Detroit, MI 48201.
Medical Research: What is the background for your study?Dr. Powell: During the PSA testing era for prostate cancer, which is responsible for early treatment, survival disparity between African Americans and European Americans has been eliminated.
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MedicalResearch.com Interview with: Dr. Sridhar Mani MD
Departments of Genetics and Medicine
Albert Einstein College of Medicine
Bronx, NY 10461
Medical Research: What are the main findings of the study?Dr. Mani: In a series of studies using cells grown in the lab and mouse studies, the researchers found that a metabolite called indole 3-propionic acid (IPA)—produced exclusively by so-called commensal bacteria —both strengthens the intestinal epithelium’s barrier function and prevents its inflammation by activating an orphan nuclear receptor, Pregnane X Receptor (PXR). Specifically, PXR activation suppresses production of an inflammatory protein called tumor necrosis factor alpha (TNF-á) while increasing levels of a protein that strengthens the junctions between intestinal epithelial cells (makes the intestines less permeable to noxious substances). Loss of PXR protein and/or IPA results in a disrupted intestinal barrier and increased propensity towards intestinal inflammation and/or toxin induced injury to the intestines.
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MedicalResearch.com Interview with: S. Mitchell Harman, M.D., Ph.D.
CAPT US Public Health Service, retired
Professor, Clinical Medicine, U of AZ College of Medicine
Interim Chief, Dept. of Internal Medicine
Chair, IRB Subcommitee
Phoenix VA Health Care System
Phoenix, AZ 85012-1892
Medical Research: What are the main findings of the study?Dr. Harman: The major findings are:
1. Neither transdermal nor oral estrogen treatment significantly accelerates or decelerates rate of change of carotid artery intimal medial thickness (CIMT) in healthy recently menopausal women.
2. Both estrogen treatments have some potentially beneficial effects on markers of CVD risk, but these differ depending on the route of estrogen delivery with improvements in LDL and HDL cholesterol seen with oral, and reduced insulin resistance with transdermal.
3. No significant effects were observed on rate of accumulation of coronary artery calcium.
4. Women reported significant relief of vasomotor (hot flush) symptoms with both estrogen treatments
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MedicalResearch.com Interview with: Dr. Bing Lu, M.D., Dr.P.H.
Division of Rheumatology
Immunology & Allergy
Brigham & Women's Hospital and Harvard Medical School
Boston, MA 02115
Medical Research: What are the main findings of the study?Dr. Lu: In two large cohorts of women, we observed that being obese increased the risk of rheumatoid arthritis in women by 40–70% depending on age and serologic status. The highest risk for rheumatoid arthritis was among women who were overweight or obese at age 18 years, emphasizing the public health importance of combating the obesity epidemic at all ages. Our study implicates being overweight or obese throughout adult life as a risk factor in the development of seropositive and seronegative RA for women diagnosed with rheumatoid arthritis at age 55 years or younger. The attenuated association between BMI and rheumatoid arthritis diagnosed at older ages may reflect differences in the pathophysiology of RA diagnosed at earlier ages compared with that diagnosed at older ages, or may be a result of the limitations of BMI as a measure of total fat mass as women age.
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MedicalResearch.com Interview with:Marianne Berwick, PhD, MPH for the GEM Study Team
Professor, Division of Epidemiology
University of New Mexico, Department of Internal Medicine
New Mexico Cancer Research Facility
University of New Mexico, Albuquerque, NM 87131
Medical Research: What are the main findings of this study?Dr. Berwick: In our study of Sun Exposure and Melanoma Survival: A GEM Study we found that there is little strong evidence that sun exposure at any time in life influences melanoma-specific survival. This study took place in Australia, Italy, Canada and the United States among 3,578 individuals newly diagnosed with melanoma, who we followed for a mean of 7.4 years.
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MedicalResearch.com Interview with: Estee L. Williams, MD
SUNY Downstate Medical Center, Brooklyn, New York
Madfes Integrated Dermatology, New York, New York
[email protected]Medical Research: What are the main findings of the study?
Dr. Williams: In our retrospective review of all melanomas diagnosed at the Veterans’ Affairs Hospital in Brooklyn since 2000, we discovered that although a majority of the melanomas (63%) were found by the dermatologist during a yearly “full body” screening examination (versus detection by the patient), melanomas found by the dermatologist were not necessarily thinner (hence, earlier, more curable) than those found by the patient.
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MedicalResearch.com Interview with: Lindsay Cohen MD
Department of Emergency Medicine
University of British Columbia
Medical Research: What are the main findings of the study?Dr. Cohen: In our systematic review of the literature, we sought to synthesize the available evidence on the effect of ketamine on clinical outcomes as compared to other sedative agents in intubated patients. Our outcomes of interest included intracranial and cerebral perfusion pressures, neurologic outcomes, ICU length of stay, and mortality. We included only randomized controlled trials and prospective controlled studies, and identified a total of ten studies that met our inclusion criteria. Due to the lack of homogeneity in the studies, data was analyzed in a qualitative manner. None of the studies reported significant differences between ketamine and other sedative agents for any of our outcomes of interest.
(more…)
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MedicalResearch.com Interview with:
Dr. Judith Malmgren PhD
Affiliate Assistant Professor, Epidemiology
University of Washington
School of Public Health
Seattle, WA 98177
Medical Research: What are the main findings of the study?
Dr. Malmgren: We found a significant shift to lower stage breast cancer at diagnosis with an observed increase in mammography detected breast cancer over time and a significant decrease in later stage cancers found by the patient or her doctor.
Mammography detected breast cancers were more often treated with lumpectomy and radiation and less likely to require mastectomy or adjuvant chemotherapy.
We also observed better 5 year invasive breast cancer specific survival among the mammography detected patients as opposed to the patient or physician detected breast cancer cases.
(more…)
Research.com Interview with
Jagpreet Chhatwal, Ph.D.
Assistant Professor
Department of Health Services Research
Houston, TX 77098
Medical Research: What are the main findings of the study?
Dr. Chhatwal: The recent updates in hepatitis C virus (HCV) screening policy and ongoing therapeutic advances can make hepatitis C a rare disease in the US by 2036. However, more aggressive screening strategies are needed to further reduce the burden of disease. For example, 1-time universal screening further identify 487,000 chronic 
