Aging, Author Interviews, Genetic Research / 26.08.2014

Dr. Manuel Serrano PhD Tumour Suppression Group CNIO, Melchor Fernandez Almagro 3, 28029 Madrid, Spain.MedicalResearch.com Interview with: Dr. Manuel Serrano PhD Tumour Suppression Group CNIO, Melchor Fernandez Almagro 3, 28029 Madrid, Spain. Medical Research: What are the main findings of the study? Dr. Serrano: We investigated the contribution of rare genetic variation to human exceptional longevity (EL, individuals with ≥100 years of age) by exome-sequencing long-lived siblings in three different families where exceptional longevity clustered. We found only one gene that harbored rare variants that was likely to contribute to human longevity across all three families and this gene was the Apolipoprotein B gene (APOB). We further found that the frequency of these rare APOB variants associated with familial exceptional longevity was greater in a cohort of 206 nonfamilial cases of exceptional longevity compared to the control population, though this association did not reach statistical significance. In addition, we found rare variants in many genes within individual families that are likely to contribute to human longevity given previous studies in animals. (more…)
Author Interviews, Infections, Ophthalmology / 26.08.2014

Ronald C Gentile, MD, FACS, FASRS Professor of Ophthalmology Chief, Ocular Trauma Service (Posterior Segment) Surgeon Director The New York Eye and Ear Infirmary of Mount Sinai New York, NY 10003 President: operationrestorevision.orgMedicalResearch.com Interview with Ronald C Gentile, MD, FACS, FASRS Professor of Ophthalmology Chief, Ocular Trauma Service (Posterior Segment) Surgeon Director The New York Eye and Ear Infirmary of Mount Sinai New York, NY 10003 President: operationrestorevision.org Medical Research: What are the main findings of the study? Dr. Gentile: We had three main findings in our study on the microbiological spectrum and antibiotic sensitivity in endophthalmitis over the past twenty- five years at the New York Eye and Ear Infirmary of Mount Sinai. First Finding: The first main finding of the study was that there has not been any major change in the types of organisms causing endophthalmitis over the past 25 years. The most common cause of endophthalmitis in the study was bacteria, 95%, with most, 85%, being Gram-positive bacteria. The most prevalent organisms isolated were coagulase-negative staphylococcus, making up about 40% of the cases. This was followed by Streptococcus viridans species in about 12% and Staphylococcus aureus in about 11%. Gram-negative organisms accounted for about 10% and fungi for about 5%. Second Finding: The second main finding of the study was that the current empiric intravitreal antibiotics used for treating endophthalmitis, vancomycin and ceftazidime, continue to be an excellent choice. The overwhelming majority of microorganisms causing endophthalmitis are susceptible to this combination. Over 99% of the Gram-positive isolates were susceptible to the vancomycin and about 92 percent of the Gram-negative isolates were susceptible to ceftazidime. Third Finding: The third main finding of the study was that there was increasing microbial resistance to eight antibiotics including cefazolin, cefotetan, cephalothin, clindamycin, erythromycin, methicillin/oxacillin, ampicillin, ceftriaxone and decreasing microbial resistance to three antibiotics including gentamicin, tobramycin, and imipenem. For example, Staph Aureus isolates resistant to methicillin increased from 18% in the late 1980s to just over 50% this past decade while gentamicin-resistance endophthalmitis isolates decreased during the same time period from 42% to 6%. (more…)
Author Interviews, Nursing, Outcomes & Safety / 26.08.2014

dr_susan_millerMedicalResearch.com Interview with: Susan Miller, PhD Professor of Health Services, Practice and Policy (Research) at the Center for Gerontology and Health Care Research The Warren Alpert Medical School of Brown University Medical Research: What are the main findings of the study? Prof. Miller:  Upon introduction of culture change, the nursing homes that implemented culture change most extensively produced statistically significant improvements in the percent of residents on bladder training programs, the percent of residents who required restraints, the proportion of residents with feeding tubes, and the percent with pressure ulcers. They also showed a nearly significant reduction in resident hospitalizations. No quality indicator became significantly worse. Among homes that implemented less culture change, the only significant improvement occurred in the number of Medicare/Medicaid health-related and quality of life survey deficiencies. Urinary tract infections and hospitalizations got slightly worse. (more…)
Author Interviews, Heart Disease, JACC, JAMA / 26.08.2014

MedicalResearch.com Interview with: Dr. Peter Godsk Jørgensen Copenhagen City Heart Study Frederiksberg Hospital, Frederiksberg, Denmark Medical Research: What are the main findings of your study? Dr. Jørgensen: In the coming decades, a larger and larger proportion of the population will be aged 65 years or above. At present, no risk prediction models have been developed specifically for estimation of risk in this population. ECG changes are easily recognized and identify subclinical signs of end-organ disease. Our data reveal that not only are ECG changes a very frequent finding that independently predicts cardiovascular disease, they significantly improve risk prediction when added to the most used European and US risk models. Thus, our data demonstrate that adding ECG changes will correctly reclassify more than one third of the persons aged 65 years and above without cardiovascular disease. (more…)
Author Interviews, General Medicine, Heart Disease, JAMA / 26.08.2014

Steven M. Bradley, MD, MPH Veterans Affairs Eastern Colorado Health CareSystem Denver, ColoradoMedicalResearch.com Interview with Steven M. Bradley, MD, MPH Veterans Affairs, Eastern Colorado Health CareSystem Denver, Colorado Medical Research: What are the main findings of the study? Dr. Bradley: In 539 hospitals participating in the CathPCI Registry that performed elective coronary angiography on more than 500,000 patients, 22% of patients were asymptomatic at the time of coronary angiography. We observed marked variation in the hospital rate of angiography performed in asymptomatic patients, ranging from 0.2% to 66.5%, suggesting broad variation in the quality of patient selection for coronary angiography across hospitals.  Additionally, hospitals with higher rates of asymptomatic patients at diagnostic angiography also had higher rates of inappropriate PCI, due to greater use of PCI in asymptomatic patients. These findings suggest that patient selection for diagnostic angiography is associated with the quality of patient selection for PCI as determined by Appropriate Use Criteria. By addressing patient selection upstream of the catheterization laboratory, we may improve on the optimal use of both angiography and PCI. (more…)
Author Interviews, General Medicine, Infections, NEJM / 26.08.2014

Medical Research Interview with: Brian Dannemann, MD, FACP Senior Director, JNJ Pharmaceutical Research and Development Titusville, NJ 08560 MedicalResearch: What are the main findings of the study? Dr. Dannemann : The final investigational 120-week results from the TMC207-C208 Phase 2 study demonstrated that bedaquiline (SIRTURO®) showed nearly twice an many patients in the bedaquiline group as in the placebo group were cured on the basis of the World Health Organization (WHO) outcome definitions for Multidrug-Resistant Tuberculosis which was statistically significant (38 of 66 patients  [58%] and 21 of 66 patients [32%] respectively; p = 0.003). (more…)
Author Interviews, Heart Disease, JAMA / 26.08.2014

Michael B. Rothberg, MD, MPH Department of Internal Medicine Medicine Institute, Vice Chair for Research Cleveland Clinic, Cleveland, OhioMedicalResearch Interview with: Michael B. Rothberg, MD, MPH Department of Internal Medicine Medicine Institute, Vice Chair for Research Cleveland Clinic, Cleveland, Ohio Medical Research: What are the main findings of the study? Dr. Rothberg: In this randomized study we found that when people are presented with no information about the benefits of elective PCI, most assumed that it would prevent a heart attack. Unfortunately, this is incorrect, so people may choose to have the procedure based on false information.  We also found that simply telling them that PCI would not prevent a heart attack successfully dispelled this belief for most,  but not all, participants.  Explaining why PCI does not prevent heart attacks in this circumstance was the most effective way to change people's beliefs.  We also found that most people were willing to take medications, but when they were told that PCI does not prevent heart attacks, they were more likely to agree to medication. (more…)
Author Interviews, End of Life Care, Race/Ethnic Diversity / 25.08.2014

Holly G. Prigerson, Ph.D. Irving Sherwood Wright Professor in Geriatrics Professor of Sociology in Medicine Director, Center for Research on End of Life Care Weill Cornell Medical College 1404 Baker Pavilion, New York Presbyterian Hospital New York City, New York 10065MedicalResearch.com Interview with: Holly G. Prigerson, Ph.D. Irving Sherwood Wright Professor in Geriatrics Professor of Sociology in Medicine Director, Center for Research on End of Life Care Weill Cornell Medical College New York Presbyterian Hospital  New York City, New York 10065 Medical Research: What are the main findings of the study? Dr. Prigerson: That there are strikingly different preferences for end-of-life care based on a patient's race/ethnicity and in rates of do not resuscitate order completion.  Regardless of what those preferences are, however, they significantly influence the likelihood of completing a do not resuscitate order (dnr) across racial/ethnic groups. (more…)
Author Interviews / 25.08.2014

Cologuard® is designed to detect DNA alternations and blood released from cancerous and precancerous colon lesions.Exact Sciences Corp announced the introduction of a new home test, Cologuard®, for the detection of colon polyps and colon cancer. The test will be first offered to patients through the Mayo Clinic, whose researchers helped develop the new screening technology. Cologuard® is designed to detect DNA alternations and blood released from cancerous and precancerous colon lesions. The test requires a prescription and express mail access. The Cologuard® kit is mailed to the patient who completes the test at home, and then is mailed back to a laboratory for processing. The patient should receive the results within two weeks. Patients who have a positive (abnormal) test result will require follow up colonoscopy. (more…)
Author Interviews, General Medicine, Heart Disease, JACC, Vitamin D / 25.08.2014

MedicalResearch.com Interview with Esther Ooi & Børge G Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Herlev Hospital, Copenhagen University Hospital Dept. Clinical Biochemistry Herlev Ringvej 75, DK-2730 Herlev, Denmark Medical Research: What are the main findings of the study? Answer: Our findings suggest that low 25(OH)D levels observationally is simply a marker for elevated atherogenic lipoproteins, and thus question a role for vitamin D supplementation in the prevention of cardiovascular disease. (more…)
Author Interviews, Pediatrics, Vaccine Studies, Vitamin K / 25.08.2014

dr_shannon_macdonaldMedicalResearch.com interview with: Dr. Shannon MacDonald PhD Department of Pediatrics, University of Calgary, Calgary and Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada Medical Research: What are the main findings of the study? Dr. MacDonald: We found that vitamin K was refused by only a very small number of parents in our study population (0.3%) but that the number appears to be increasing (almost doubling in the past 7 years). The parents that refused vitamin K for their child were more likely to be those that delivered at home and/or with a midwife. We also found that parents who refused vitamin K for their child were also much more likely to go on to refuse all vaccinations by 15 months of age. (more…)
Author Interviews, Diabetes, Diabetes Care, Race/Ethnic Diversity / 24.08.2014

Satyesh K Sinha, PhD Assistant Professor Charles R Drew University of Medicine and Science Los Angeles, CA-90059MedicalResearch.com Interview with: Satyesh K Sinha, PhD Assistant Professor Charles R Drew University of Medicine and Science Los Angeles, CA-90059 Medical Research: What are the main findings of the study? Dr. Sinha: Our main finding is that compared to Whites, African Americans (AAs) and Hispanics, with diabetes, have a higher prevalence of early chronic kidney disease (CKD) which is significantly associated with urinary albumin excretion (UAE) and/or C-reactive protein (CRP). (more…)
Author Interviews, Neurological Disorders, Neurology / 23.08.2014

Mahyar Etminan PharmD, MSc Scientist I Pharmaceutical Outcomes Programme (POPi) Faculty of Medicine | Assistant Professor, Department of Pediatrics The University of British Columbia | Child and Family Research Institute (CFRI) Vancouver, BC V5Z 4H4MedicalResearch.com Interview with: Mahyar Etminan PharmD, MSc Scientist I Pharmaceutical Outcomes Programme (POPi) Faculty of Medicine | Assistant Professor, Department of Pediatrics The University of British Columbia | Child and Family Research Institute (CFRI) Vancouver, BC Medical Research: What are the main findings of the study? Dr. Eiminan: Current users of Fluoroquinolones are at a twice their risk of developing peripheral neuropathy than non users. (more…)
Author Interviews, Urinary Tract Infections, Urology / 23.08.2014

Steve J. Hodges MD Associate Professor, Department of Urology Wake Forest University School of Medicine Medical Center Blvd, Winston-Salem, NCMedicalResearch.com Interview with: Steve J. Hodges MD Associate Professor, Department of Urology Wake Forest University School of Medicine Medical Center Blvd, Winston-Salem, NC Medical Research: What are the main findings of this study? Dr. Hodges: The main findings of this study were that skin irritants (typically urine) may cause vulvitis in prepubertal girls, which leads to an alteration of their perineal microbiome, with increased colonization by uropathogenic bacteria, increasing the risk of UTI. (more…)
Author Interviews, Transplantation / 22.08.2014

Alvaro Rojas-Pena, MD Research Investigator, Laboratory Coordinator Robert H. Bartlett – Extracorporeal Life Support Laboratory Department of Surgery, Section of Transplantation Surgery Ann Arbor, MI 48109MedicalResearch.com Interview with:  Alvaro Rojas-Pena, MD Research Investigator, Laboratory Coordinator Robert H. Bartlett – Extracorporeal Life Support Laboratory Department of Surgery, Section of Transplantation Surgery Ann Arbor, MI 48109 Medical Research: What are the main findings of the study? Dr. Rojas-Pena: During the first 10 years’ experience of the University of Michigan using Extracorporeal Support (ECS) for organ donation in controlled donors after circulatory determination of death (cDCDD) we were able to increase the pool of organs suitable for transplantation by 20%. A total of 48 renal grafts, 13 livers and 1 pancreas were successfully transplanted from 37 cDCDD. Kidneys transplanted after extracorporeal support assisted donation had a delayed graft function (DGF) rate of 31%, compared to the rate of renal grafts procured without extracorporeal support (64%).  DGF was defined as the need of hemodialysis within the first 7 days post transplantation Finally, the 3-year survival rate of the renal transplant recipients is within the national standard for all renal recipients of cDCD at our institution. (more…)
Author Interviews, Diabetes, Diabetes Care / 22.08.2014

Mark A. EspelandMedicalResearch.com Interview with: Mark A. Espeland PhD Professor Department of Biostatistics Sticht Center on Aging Center for Diabetes Research WFU Primate Center Center for Integrative Medicine Translational Science Institute Wake Forest School of Medicine, Winston-Salem, NC Medical Research: What are the main findings of the study? Dr. Espeland : Over 10 years, overweight and obese adults with type 2 diabetes who were provided a lifestyle intervention targeting sustained weight loss and increased physical activity, lowered their rates of hospitalizations and medication use and reduced the costs of their health care by over $5,000. (more…)
Author Interviews, Case Western, Lyme / 22.08.2014

Daniel Salkeld, PhD Lecturer & Research Associate Stanford Woods Institute for the Environment Professor Colorado State UniversityMedicalResearch.com Interview with: Daniel Salkeld, PhD Lecturer & Research Associate Stanford Woods Institute for the Environment Professor Colorado State University Medical Research: What are the main findings of the study that were just published in Ticks and Tick-borne Diseases? Dr. Salkeld: The primary findings of this new study show that western black-legged ticks, which can transmit Lyme disease, are active throughout the year in Northwest California, making the threat of Lyme disease year-round phenomenon. More specifically, my colleagues from California Department of Public Health Vector-borne Disease Section and University of California, Berkeley and I found that the activity of Western Black-legged ticks (Ixodes pacificus), which are the ticks most commonly known to carry Lyme disease (caused by Borrelia burgdorferi) in Northwest California, is largely predictable and year-round. In general, tick larvae (newly hatched immature ticks) are active April to June, and sometimes activity extends into October, while adult ticks are active from October to May. Nymphal ticks (the tick stage following larvae and preceding adults) are active from January to October but peak from April-June. This is important because nymphs are responsible for most Lyme disease infections. (more…)
Author Interviews, Frailty, Geriatrics, JAMA / 22.08.2014

Dr. Bellal Joseph MD FACS Associate Professor of Surgery Medical Director, Southern Arizona Telemedicine and Telepresence (SATT) Program Program Director, International Research Fellowship Liaison, Multi-Specialty Surgery Clinic at UAMCMedicalResearch.com Interview with Dr. Bellal Joseph MD FACS Associate Professor of Surgery Medical Director, Southern Arizona Telemedicine and Telepresence (SATT) Program Program Director, International Research Fellowship Liaison, Multi-Specialty Surgery Clinic at UAMC Medical Research: What are the main findings of the study? Dr. Joseph: Chronologic age is frequently used as the determinant of outcomes when treating elderly and treatments are tailored accordingly. However, the findings of our study challenge this dogma and suggest that it’s not the chronologic age rather frailty status of the individual that determines outcomes. We found frailty Index (quantitative measure of frailty) as a better predictor of in-hospital complications and discharge disposition in elderly compared to the chronologic age. (more…)
Author Interviews, NEJM, Respiratory / 22.08.2014

John DeVincenzo, M.D. Professor of Pediatrics Division of Infectious Diseases Professor of Microbiology, Immunology and Biochemistry University of Tennessee School of Medicine. University of Tennessee. Medical Director, Molecular Diagnostics and Virology Laboratories Le Bonheur Children's Hospital Memphis, TennesseeMedicalResearch.com Interview with: John DeVincenzo, M.D. Professor of Pediatrics Division of Infectious Diseases Professor of Microbiology, Immunology and Biochemistry University of Tennessee School of Medicine. Le Bonheur Children's Hospital Memphis, Tennessee Medical Research: What are the main findings of the study? Dr. DeVincenzo: The main findings are
  • a) This is the first time that anyone has shown that the infection caused by the RSV virus can be effectively reduced in a human after the infection has already started.
  •  b) We also show for the first time that once we reduce the amount of virus in the patient, that very quickly, they start to feel better. This clinical improvement was not expected to occur so rapidly.
  • c) The antiviral appeared safe and it was easy to give.
(more…)
Author Interviews, Heart Disease, Stem Cells / 21.08.2014

Antonis Hatzopoulos, PhD, FAHA Associate Professor of Medicine- Division of Cardiovascular Medicine Associate Professor of Cell & Developmental Biology Vanderbilt Center for Stem Cell Biology Vanderbilt University Nashville, TN 37232-6300MedicalResearch.com Interview with: Antonis Hatzopoulos, PhD, FAHA Associate Professor of Medicine- Division of Cardiovascular Medicine Associate Professor of Cell & Developmental Biology Vanderbilt Center for Stem Cell Biology Vanderbilt University Nashville, TN 37232-6300 Medical Research: What are the main findings of the study? Dr. Hatzopoulos: Using cell tracking in the normal adult mouse heart, we found that endothelial cells can function as cardiac stem cells to generate new heart muscle.  Our results show that besides heart muscle, endothelial cells produce quiescent and proliferating cardiac progenitor cells that reside in the media and adventitia layers of the coronary arteries, respectively. (more…)
Author Interviews, Psychological Science / 21.08.2014

MedicalResearch.com Interview with: Ashley Merianos, PhD, CHES Health Promotion & Education Program University of Cincinnati Cincinnati, Ohio   45221-0068 Medical Research: What are the main findings of the study? Dr. Merianos: Our study found that college students are unhappy and have difficulty with stress management. Specifically, the majority (61.0%) of participants reported having high stress, and were most stressed about school, lack of time, and with their future career. Although high levels of stress were reported, most (72.0%) students reported low frequency in using stress management techniques. Our study shows that students who reported low happiness reported higher stress levels and lower emotional closeness to others. (more…)
Author Interviews, Diabetes, Kidney Disease, Neurology, Stroke / 21.08.2014

MedicalResearch.com Interview with: Prof. Chia-Huang Kao From the Graduate Institute of Clinical Medical Science Department of Radiation Oncology and Nuclear Medicine and PET Center Graduate Institute of Clinical Medical Science China Medical University Hospital, Taichung, Taiwan. Medical Research: What are the main findings of the study? Prof. Kao: Patients with chronic kidney disease (CKD) are at high risk for hypoglycemia; several factors are reported to contribute to hypoglycemia in these patients. However, most previous studies were limited by the relatively small number of patients with CKD included in the study by the exclusion of cases with CKD. In the present study, the incidence rate of hypoglycemia in patients with CKD was 4.5%, which is approximately twice the value noted in previous reports and multivariate analysis revealed a 2.53-fold increase in the risk of death for CKD patients with hypoglycemia after adjusting for related confounding factors including hypertension, hyperlipidemia, diabetes, and antidiabetic drugs. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease, Stanford / 21.08.2014

Marco Perez, MD Instructor in Cardiovascular Medicine Director, Inherited Cardiac Arrhythmia Clinic Stanford University Medical Center Cardiac Electrophysiology & Arrhythmia Service Stanford, CA 94305-5233MedicalResearch.com Interview with Marco Perez, MD Instructor in Cardiovascular Medicine Director, Inherited Cardiac Arrhythmia Clinic Stanford University Medical Center Cardiac Electrophysiology & Arrhythmia Service Stanford, CA 94305-5233 Medical Research: What are the main findings of the study? Dr. Perez: It was already known that obesity is an important risk factor for atrial fibrillation.  We studied over 80,000 postmenopausal women enrolled in the Women’s Health Initiative who were followed for the onset of atrial fibrillation, an irregular heart rhythm associated with stroke and death.  We found that those who exercised more than 9 MET-hours/week (equivalent to a brisk walk of 30 minutes six days a week) were 10% less likely to get atrial fibrillation than those who were sedentary.  Importantly, the more obese the women were, the more they benefited from the exercise in terms of atrial fibrillation risk reduction. (more…)
Author Interviews, BMJ, End of Life Care / 21.08.2014

MedicalResearch.com Interview with: Dr. Julian Mausbach RA Geschäftsführer Kompetenzzentrum Medizin - Ethik - Recht Helvetiae Zürich, Switzerland Medical Research: What are the main findings of the study? Answer: 611 cases of suicide tourism were found in the canton of Zurich between 2008 and 2012. More than half of the suicide tourists were women with a median age of 69 years. After an initial decrease in 2009, cases of suicide tourism increased from then on onwards and doubled in 2012. The underlying diseases varied considerably. Main reasons for the assisted suicide were neurological diseases, followed by cancer, rheumatic diseases. Approximately one third of the study population had more than one disease. (more…)
Author Interviews, Mediterranean Diet, Nutrition, OBGYNE / 21.08.2014

MedicalResearch.com Interview with: Audrey J. Gaskins, Sc.D. Postdoctoral Research Fellow Department of Nutrition Harvard School of Public Health Medical Research: What are the main findings of the study? Answers: In our  large prospective cohort study, we found that higher adherence to several healthy dietary patterns (e.g. the Alternate Healthy Eating Index 2010, Alternate Mediterranean Diet, and Fertility Diet) prior to pregnancy was not associated with risk of pregnancy loss. (more…)
Author Interviews, Brain Injury / 21.08.2014

Li-Shan Chou, Ph.D Professor and Department Head Department of Human Physiology University of Oregon Eugene, OR 97403-124MedicalResearch.com Interview with: Li-Shan Chou, Ph.D Professor and Department Head Department of Human Physiology University of Oregon Eugene, OR 97403-1240 Medical Research: What are the main findings of the study? Prof. Li-Shan Chou: The findings from this study indicate that pre return-to-activity (RTA), the adolescents with concussion reduced their medial/lateral displacement and velocity during dual-task walking, suggesting an improvement in gait balance control, while significantly increasing these frontal plane motion variables during dual-task walking post RTA, suggesting a worsening of frontal plane COM control following RTA. These data suggest that frontal plane motion during dual-task walking are sensitive to the effects of return to activity following concussion and may reveal a possible regression in gait stability following return to activity. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, Disability Research / 20.08.2014

Karen Margolis, M.D., M.P.H. Senior Investigator (Director of Clinical Research) HealthPartners Institute for Education and Research Minneapolis, MN, 55440-1524MedicalResearch.com Interview with Karen Margolis, M.D., M.P.H. Senior Investigator (Director of Clinical Research) HealthPartners Institute for Education and Research Minneapolis, MN, 55440-1524 Medical Research: What are the main findings of the study? Dr. Margolis: The study compared falls and fractures in patients aged 40-79 with diabetes who were treated for high blood pressure.  One group received treatment that aimed at getting systolic blood pressure under 120, while the other group received treatment to achieve systolic blood pressure under 140. The results show that patients who received intensive blood pressure treatment did not fall more than less intensively treated patients, nor did they incur more fractures over an average follow-up of about five years. (more…)
Author Interviews, Brigham & Women's - Harvard, Compliance, Kidney Disease, Primary Care / 20.08.2014

Mallika L. Mendu, M.D. Division of Renal Medicine Brigham and Women’s Hospital Boston, MA 02115.MedicalResearch.com Interview with: Mallika L. Mendu, M.D. Division of Renal Medicine Brigham and Women’s Hospital Boston, MA 02115. Medical Research: What are the main findings of the study? Dr. Mendu: Our study found that implementation of a chronic kidney disease (CKD) checklist, a tool that succinctly and clearly outlines CKD management guidelines, in a primary care clinic improved adherence to a number of significant management guidelines. We conducted a prospective study during a one year period among 13 primary care providers, four of whom were assigned to use a CKD checklist incorporated into the electronic medical record during visits with patients with CKD. Patients whose providers utilized a CKD checklist had higher rates of adherence to annual albuminuria testing, parathyroid hormone testing, phosphate testing, achieving a hemoglobin A1c target<7, documentation of avoidance of nonsteroidal anti-inflammatory drugs, use of an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker and vaccination for annual influenza and 5-year pneumococcus. (more…)
Author Interviews, JAMA, Johns Hopkins, Outcomes & Safety / 20.08.2014

MedicalResearch.com Interview with: Sosena Kebede, MD, MPH Assistant Professor of Medicine, Department of Medicine Associate Faculty, the Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine Faculty, Department of Health Policy and Management and Baltimore, MD 21287Sosena Kebede, MD, MPH Assistant Professor of Medicine, Department of Medicine Associate Faculty, the Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine Faculty, Department of Health Policy and Management and Baltimore, MD 21287 Medical Research: What are the main findings of the study? Dr. Kebede: There were 3 main findings in this study: 1.       Patients’ understanding of aspects of their hospital care is suboptimal on the domains of knowledge of diagnoses, indications for the medications they take and the types of procedures/tests they get. Some forms of poor shared understanding could have potentially serious implications for their health and for future care such as identifying a prescribed antidepressant as a blood thinner or mistaking an echocardiogram a left heart catheterization or thinking a liver cyst is a liver cancer. Other forms of poor shared understanding such as not accurately identifying why a procedure is done or what the results of the procedure show (a finding not discussed in the research letter) may seem less consequential  but raise the issue of informed consent, patient empowerment and may alsoraise questions about patient and physician behavior towards appropriate use of in-patient procedures. Some of the questions we could ask here include: would patients demand more or less procedures if they had better understanding of what the procedures entail, and why they are beingordered? Conversely, would physicians recommend more or less of in-patient procedures, when they encounter patients whose understanding of procedure indications are optimal? (more…)