Author Interviews, Health Care Systems, Orthopedics / 05.08.2014

M. Susan Ridgely, JD Senior Policy Analyst RAND Corporation Santa Monica, CaliforniaMedicalResearch.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…)
Author Interviews, Dermatology, General Medicine, Surgical Research / 05.08.2014

Henry M. Spinelli, MD, PC Plastic & Reconstructive Surgery 875 Fifth Avenue New York, NY 10065MedicalResearch.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…)
Author Interviews, Prostate Cancer, Race/Ethnic Diversity / 04.08.2014

Isaac J. Powell MD Wayne State University/Karmanos Cancer Inst University Health Center Detroit, MI 48201.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. (more…)
Author Interviews, Gastrointestinal Disease, mBio / 04.08.2014

Dr. Sridhar Mani MD Departments of Genetics and Medicine Albert Einstein College of Medicine, Bronx, NY 10461MedicalResearch.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. (more…)
Annals Internal Medicine, Author Interviews, Heart Disease, Menopause / 03.08.2014

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 85012-1892MedicalResearch.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 (more…)
Author Interviews, Brigham & Women's - Harvard, Rheumatology, Weight Research / 01.08.2014

Dr. Bing Lu, M.D., Dr.P.H. Division of Rheumatology Immunology & Allergy Brigham & Women's Hospital and Harvard Medical School Boston, MA 02115MedicalResearch.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. (more…)
Author Interviews, Melanoma / 01.08.2014

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 87131MedicalResearch.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. (more…)
Author Interviews, Dermatology, Melanoma / 01.08.2014

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. (more…)
Anesthesiology, Author Interviews, Emergency Care / 01.08.2014

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…)
Author Interviews, Pediatrics, Vaccine Studies / 01.08.2014

Jana Shaw MD, MPH, FAAP Associate Professor of Pediatrics Pediatric Infectious Diseases SUNY Upstate Medical University 750 East Adams Street Syracuse, NY 13210MedicalResearch.com Interview with: Jana Shaw MD, MPH, FAAP Associate Professor of Pediatrics Pediatric Infectious Diseases SUNY Upstate Medical University 750 East Adams Street Syracuse, NY 13210 Medical Research: What are the main findings of the study? Dr. Shaw: In this study, we looked at exemptions to school immunization requirements in the US during 2009-2010 school year. We found that private schools have higher rates for all types of exemptions (medical, religious, and personal belief/philosophical). In addition, states that permitted personal belief exemptions had higher rates of exemptions overall compared to states that did not allow them. (more…)
Author Interviews, Electronic Records / 01.08.2014

MedicalResearch.com Interview Celeste Campos-Castillo PhD Assistant Professor Department of Sociology University of Wisconsin-Milwaukee Medical Research: What are the main findings of the study? Dr. Campos-Castillo: Approximately 13% of adults in the U.S. have held back information from doctors out of privacy or security concerns. When we compare adults with the same characteristics (e.g., age and education, overall health, and health care characteristics like having insurance and seeing a doctor in the past year) based on whether their doctor uses an electronic health record (EHR) system or not, we find that those with a doctor that uses an electronic health record were more likely to hold back information than those whose doctor does not use an electronic health record. Other studies have looked at whether electronic health records are related to withholding information out of privacy concerns, but the evidence was mixed: sometimes patients with EHRs were more likely to hold back information from doctors, other times there but sometimes there was no difference in withholding between patients of doctors who used EHRs and those who did not. What makes our study unique is that we consider a range of factors in the analysis that can disguise the real relationship between EHRs and withholding information because of privacy concerns. In particular, we take into account how patient ratings of quality of care play a complicated role in this situation. Patients with doctors who use EHRs often rate the quality of care they receive higher than those with doctors who are not using these systems. At the same time, higher quality ratings generally mean that patients feel comfortable sharing information with doctors, even the sensitive information that we tend to keep to ourselves. Because quality ratings are associated both with EHRs and with holding back information from doctors, it is necessary to consider this in the analysis. Otherwise – as we show in the study – we would mistakenly conclude that EHRs are unrelated to holding back information. Instead, we show that when we accurately compare patients with the same characteristics, including quality ratings, patients with EHRs are more likely to withhold information from their doctors out of concerns for privacy. (more…)
Allergies, Author Interviews / 01.08.2014

Supinda Bunyavanich, MD, MPH, MPhil Department of Pediatrics- Allergy/Immunology Department of Genetics and Genomic Sciences Icahn Institute for Genomics and Multiscale Biology Mindich Child Health and Development Institute Icahn School of Medicine at Mount Sinai New York, NY 10029 USAMedicalResearch.com Interview with: Supinda Bunyavanich, MD, MPH, MPhil Department of Pediatrics- Allergy/Immunology Department of Genetics and Genomic Sciences Icahn Institute for Genomics and Multiscale Biology Mindich Child Health and Development Institute Icahn School of Medicine at Mount Sinai New York, NY 10029 USA Medical Research: What are the main findings of the study? Dr. Bunyavanich: What is the prevalence of peanut allergy among US children? Given that 90% of US households consume peanut butter, this is an important question. We report and compare prevalence estimates of childhood peanut allergy according to varying criteria among 7-10 year-old children participating in a US birth cohort not selected for any disease. The prevalence of peanut allergy ranged from 2.0% to 5.0%, depending on definition. (more…)
Author Interviews, Diabetes, Mediterranean Diet, Nutrition, PLoS, Sugar / 01.08.2014

Effie Viguiliouk M.Sc. Candidate, Department of Nutritional Sciences University of TorontoMedicalResearch.com Interview with: Effie Viguiliouk M.Sc. Candidate, Department of Nutritional Sciences University of Toronto Medical Research: What are the main findings of the study? Effie Viguiliouk: This systematic review and meta-analysis of the totality of evidence from 12 randomized clinical trials in 450 participants with type 2 diabetes found that eating about 1/2 a cup of tree nuts per day (equivalent to about 60 g or 2 servings) significantly lowered the two key markers of blood sugar, HbA1c and fasting glucose, in comparison to calorically matched control diets without tree nuts. (more…)
Alcohol, Author Interviews, Social Issues / 31.07.2014

Magdalena Cerdá, DrPH MPH Assistant Professor, Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032-3727MedicalResearch.com Interview with: Magdalena Cerdá, DrPH MPH Assistant Professor, Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032-3727 Medical Research: What are the main findings of the study? Dr. Cerdá: We evaluated 1,095 Ohio National Guard soldiers, who had primarily served in Iraq and Afghanistan between 2008 and 2009 to determine the effect of civilian stressors and deployment-related traumatic events and stressors on post-deployment alcohol use disorder. Participants were interviewed three times over 3 years about alcohol use disorder, exposure to deployment-related traumatic events like land mines, vehicle crashes, taking enemy fire, and witnessing casualties, and about experiences of civilian life setbacks since returning from duty, including job loss, legal problems, divorce, and serious financial and legal problems. We found that having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders. In contrast, combat-related traumatic events were only marginally associated with alcohol problems. (more…)
Author Interviews, BMJ, Heart Disease, Nutrition / 31.07.2014

Prof. Frank B Hu Department of Nutrition Department of Epidemiology Harvard School of Public HealthMedicalResearch.com Interview Invitation Prof. Frank B Hu Department of Nutrition Department of Epidemiology Harvard School of Public Health Medical Research: What are the main findings of the study? Prof. Hu: We found that increasing consumption of fruits and vegetables is associated with reduced risk of mortality, especially cardiovascular mortality. The largest reduction in mortality can be achieved at 5 servings per day of fruits and vegetables. (more…)
Author Interviews, Genetic Research, JAMA, Schizophrenia / 31.07.2014

Dr Angelica Ronald Genes Environment Lifespan (GEL) laboratory Centre for Brain and Cognitive Development Department of Psychological Sciences Birkbeck, University of London London WC1E 7HXMedicalResearch.com Interview with: Dr Angelica Ronald Genes Environment Lifespan (GEL) laboratory Centre for Brain and Cognitive Development Department of Psychological Sciences Birkbeck, University of London London WC1E 7HX Medical Research: What are the main findings of the study? Dr. Ronald: Psychotic experiences, such as paranoia, hallucinations and disorganised thinking, are commonly reported by adolescents. Until now it has not been understood whether mild variations in psychotic experiences in the community are part of the same construct as more severe psychotic experiences in adolescence. Our findings suggest that they are. In our study, over 10,000 16-year-old adolescents in England and Wales were assessed on measures of psychotic experiences. The study identified a close link between normal, less frequent psychotic experiences and more severe and frequent experiences in the general population. A classic twin design was employed, which enabled us to conduct analyses investigating the role of genetic and environmental influences on psychotic experiences. The same genetic influences appeared to play a role across the spectrum of severity of psychotic experiences. The study found that psychotic experiences are moderately heritable in adolescence in the general population. This suggests it would be worth directing molecular genetic endeavours towards this area, which has so far received very little attention in terms of causal explanations. We also show that psychotic experiences have considerable environmental influence; in fact, environmental influence appears to play a larger role in causing psychotic experiences in adolescence than for diagnosed psychotic disorders in adults, such as schizophrenia. This result suggests a fruitful avenue will be to tackle what environmental risk factors influence adolescents to have psychotic experiences. (more…)
Author Interviews, Gender Differences, Kidney Disease, Mayo Clinic, Weight Research / 31.07.2014

Dr. John C. Lieske, MD Mayo Clinic, Rochester, MNMedicalResearch.com Interview with Dr. John C. Lieske, MD Mayo Clinic, Rochester, MN Medical Research: What are the main findings of the study? Dr. Lieske: We followed 11 women before, 6 and 12 months after Roux en Y gastric bypass surgery.  The patients successfully lost weight as mean BMI fell from 46 kg/m2 preoperatively to 28 kg/m2 postoperatively.   Mean serum creatinine did not significantly change from baseline (0.8 mg/dl) to 12 months (0.7 mg/dl).  Hence mean GFR estimated by the CKD-EPI equation (eGFR) did not significantly change from 84 ml/min/1.73 m2 (baseline) to 90 ml/min/1.73 m2 (12 months).  However, GFR measured by iothalamate clearance (mGFR) significantly decreased from 108 ml/min/1.73m2 (121 ml/min) to 85 ml/min/1.73 m2 (90 ml/min). (more…)
Author Interviews, Genetic Research, JCEM, Weight Research / 31.07.2014

Dr. Agatha van der Klaauw, PhD Wellcome Trust Postdoctoral Clinical Fellow Wellcome Trust-MRC Institute of Metabolic Science University of Cambridge Metabolic Research Laboratories Addenbrooke's Hospital Cambridge, United KingdomMedicalResearch.com Interview with: Dr. Agatha van der Klaauw, PhD Wellcome Trust Postdoctoral Clinical Fellow Wellcome Trust-MRC Institute of Metabolic Science University of Cambridge Metabolic Research Laboratories Addenbrooke's Hospital Cambridge, United Kingdom   Medical Research: What are the main findings of the study? Dr. van der Klaauw: Obesity occurs when we eat more calories than we burn which is often easy to do as many foods are highly palatable and high in calories. Highly palatable foods such as chocolate trigger signals in the brain that give a feeling of pleasure and reward (sometimes called cravings) which can contribute to overeating. These signals are processed in the reward centres in the brain, where sets of neurons release chemicals such as dopamine. However, very little is known about whether the reward centres of the brain work differently in some people who are overweight. In this study, we were interested in studying overweight people who had a problem with the melanocortin 4 receptor (MC4R) gene. About 1% of obese people have a problem in this gene which contributes to weight gain from a young age. We compared three groups of people: people who were overweight due to a problem in the MC4R gene, people who were overweight but the gene was normal and some people who were normal weight. We performed functional Magnetic Resonance Imaging (fMRI) scans to look at how the reward centres in the brain were activated by pictures of appetizing food such as chocolate cake compared to bland food such as rice or broccoli and non-food items such as staplers. We found that in normal weight people, the reward centres are activated (light up) when they are shown pictures of cake or chocolate and the same was seen in overweight people with a problem in the MC4R gene. But we found that the reward centres were underactive in overweight volunteers (in whom the gene was normal). (more…)
Author Interviews, Hematology, NEJM, Sloan Kettering, Transplantation / 31.07.2014

MedicalResearch.com Interview with: Richard J. O'Reilly, MD Memorial Sloan Kettering Cancer Center Medical Research: What are the main findings of the study? Dr. O'Reilly: 1.       In a comparison of the results of HLA-matched sibling transplants with other established transplant approaches, including T-cell depleted half-matched parental marrow grafts, unmodified transplants from matched unrelated donors and cord blood transplants in the current era (2000-2009), transplants from donors other than HLA-matched siblings had 5 year survival outcomes similar to those of matched siblings when applied to young infants (≤ 3.5 months of age) or infants of any age that were not infected at the time of transplants. Thus any child born with SCID can now be successfully transplanted. 2.       Active infection at the time of transplant significantly reduced chances of long-term survival for all infants except those who received transplants from HLA-matched siblings. Thus, infection is a dominant determinant of transplant outcome.  Control of treatable infections prior to transplant should be a major clinical objective. 3.       Treatment with chemotherapy containing busulfan significantly enhances the likelihood of recovering a normal ability to make antibodies and fosters better recovery of T-cells that provide cell mediated immunity, and may be an acceptable risk in uninfected infants. However, use of any chemotherapy prior to transplant in an infant who is infected, greatly decreases chances of survival. In infected patients who lack a matched sibling, T-cell depleted transplants from half matched related donors had the best outcomes. (more…)
Author Interviews, Duke, General Medicine, Mental Health Research, Nature / 31.07.2014

Rainbo Hultman, PhD Postdoctoral Research Associate Laboratory for Psychiatric Neuroengineering, Principal Investigator Affective Cognitive and Addiction Disorders (ACAD) Research Group Department of Psychiatry and Behavioral Sciences Center for Neuroengineering Duke University Medical Center Durham, NC 27710MedicalResearch.com Interview with: Rainbo Hultman, PhD Postdoctoral Research Associate Laboratory for Psychiatric Neuroengineering, Principal Investigator Affective Cognitive and Addiction Disorders (ACAD) Research Group Department of Psychiatry and Behavioral Sciences Center for Neuroengineering Duke University Medical Center Durham, NC 27710 Medical Research: What are the main findings of the study? Dr. Hultman: Using a mouse model of stress-induced psychiatric dysfunction, we found that the brainwave patterns in two key brain regions (prefrontal cortex, PFC and amygdala, AMY) encode for susceptibility to such dysfunction. Furthermore, such susceptibility can be predicted from the brainwave patterns in these regions before the onset of stress. (more…)
Author Interviews, Insomnia, Mental Health Research / 31.07.2014

MedicalResearch.com Interview with: Pasquale K Alvaro School of Psychology University of Adelaide South Australia, Australia Medical Research: What are the main findings of the study? Answer: In adolescents, insomnia is related to depression beyond chronotype (a classification system for circadian rhythms or body clock), anxiety and age. Insomnia is also related to Generalised Anxiety Disorder (GAD) beyond chronotype, depression and age. Depression accounts for the relationship between insomnia and Obsessive Compulsive Disorder (OCD), Separation Anxiety Disorder (SAD) and Social Phobia (SP). Furthermore, an evening chronotype  (delayed sleep phase, that is, preferring to go to bed in the early morning) predicts insomnia beyond depression, anxiety and age. Moreover, an evening chronotype predicts depression beyond insomnia, anxiety and age. Finally, insomnia and depression account for the relationships between an evening chronotype and panic disorder, OCD, SAD and SP. (more…)
Author Interviews, Dartmouth, Kidney Disease / 31.07.2014

MedicalResearch.com Interview with: Jeremiah R. Brown, PhD MS Assistant Professor of Health Policy and Clinical Practic The Dartmouth Institute Lebanon, NHMedicalResearch.com Interview with: Jeremiah R. Brown, PhD MS Assistant Professor of Health Policy and Clinical Practic The Dartmouth Institute Lebanon, NH   Medical Research: What are the main findings of the study? Dr. Brown: Using simple team-based quality improvement methods we prevented kidney injury in 20% of patients having a procedure in the cardiac catheterization lab.  Among patients with pre-existing kidney disease, we prevent kidney injury in 30% of patients. We believed that using a team-based approach and having teams at different medical centers in northern New England learn from one-another to provide the best care possible for their patients.  Some of the most innovative ideas came from these teams and identified simple solutions to protect patients from kidney injury from the contrast dye exposure; these included:
  • Getting patients to self-hydrate with water before the procedure (8 glasses of water before and after the procedure),
  • Allow patient to drink fluids up to 2-hours before the procedure (whereas before they were "NPO" for up to 12 hours and came in dehydrated),
  • Training the doctors to use less contrast in the procedure (which is good for the patient and saves the hospital money),
  • and creating stops in the system to delay a procedure if that patient had not received enough oral or IV fluids before the case (rather, they would delay the case until the patient received adequate fluids).Our success was really about hospital teams talking and innovating with one another instead of competing in the health care market, which resulted in simple, homegrown, easy to do solutions that improved patient safety.
(more…)
Author Interviews, Diabetologia, Weight Research / 31.07.2014

Joshua Bell, MSc Department of Epidemiology & Public Health University College LondonMedicalResearch.com Interview with: Joshua Bell, MSc Department of Epidemiology & Public Health University College London   Medical Research: What are the main findings of the study? Answer: We found that physical activity and leisure time sitting interact to affect the long-term risk of becoming obese, with protective effects of high physical activity depending upon low levels of leisure time sitting. Adults engaging in both high physical activity and low leisure time sitting showed nearly 4-fold lower odds of becoming obese after 5 years, compared with those engaging in both low physical activity and high leisure time sitting. (more…)
Author Interviews, Genetic Research, Mental Health Research / 30.07.2014

dr_zachary_kaminskyMedicalResearch.com Interview with: Zachary A. Kaminsky, Ph.D. Assistant Professor Johns Hopkins University School of Medicine Department of Psychiatry Baltimore, MD, 21205 Medical Research: What are the main findings of the study? Dr. Kaminsky: A DNA methylation increase at the SKA2 gene was identified and observed across three post mortem brain tissue cohorts and was associated with suicide. The DNA methylation at the SKA2 gene was associated with lower gene expression of the gene. The same association was found in blood allowing us to attempt to predict suicidal behaviors in living individuals. (more…)
Author Interviews, Diabetes, Diabetes Care, Kidney Disease / 30.07.2014

MedicalResearch.com Interview with: Petter Bjornstad, M.D. Children's Hospital Colorado University of Colorado Denver Aurora, CO 80045 Medical Research: What are the main findings of the study? Dr. Bjornstad: Type 2 diabetes is the most common cause of end-stage renal disease in the Western world. It is therefore of paramount importance to develop a better understanding of the determinants of diabetic nephropathy risk and progression, to improve outcome in adolescents with type 2 diabetes. We report high rates of microalbuminuria and renal hyperfiltration in adolescents with type 2 diabetes, which forecast early renal morbidity and mortality. In our observational study, insulin sensitivity measured by hyperinsulinemic-euglycemic clamp studies, rather than adiposity, blood pressure, lipid and glycemic control was associated with markers of renal health (albumin-to-creatinine ratio and estimated glomerular filtration rate). (more…)
Author Interviews, Neurology, Parkinson's / 30.07.2014

Associate Professor of Psychiatry and Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA 19104-2676 Parkinson's Disease Research, Education and Clinical Center (PADRECC) Mental Illness Research, Education and Clinical Center (MIRECC) Philadelphia Veterans Affairs Medical CenterMedicalResearch.com Interview with: Daniel Weintraub, M.D. Associate Professor of Psychiatry and Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA 19104-2676 Parkinson's Disease Research, Education and Clinical Center (PADRECC) Mental Illness Research, Education and Clinical Center (MIRECC) Philadelphia Veterans Affairs Medical Center Medical Research: What are the main findings of the study? Dr. Weintraub: That there is mixed evidence for the efficacy of naltrexone in the treatment of impulse control disorders in Parkinson’s disease, and the evidence is sufficient to support further study of this compound class for this indication.  In addition, the study demonstrates that it is possible to conduct a clinical trial in this area. (more…)
Author Interviews, BMJ, Mediterranean Diet, Nutrition / 30.07.2014

Dr Michelle Morris Research Fellow Nutritional Epidemiology Group School of Food Science & Nutrition University of LeedsMedicalResearch.com Interview with: Dr Michelle Morris Research Fellow Nutritional Epidemiology Group School of Food Science & Nutrition University of Leeds Medical Research: What are the main findings of the study? Dr. Morris: The healthiest diets consumed by UK Women are the most expensive. This study is UK centric, using dietary patterns consumed by UK women and scored for healthiness according to the UK Department of Health Eatwell Plate. Cost of diet was estimated using average prices taken from an evaluated UK food cost database. (more…)
Author Interviews, Diabetes, Diabetes Care, Weight Research / 30.07.2014

Grant Brinkworth PhD Associate Professor Senior Research Scientist CSIRO Animal, Food and Health Sciences Adelaide BC, South AustraliaMedicalResearch.com Interview with: Grant Brinkworth PhD Associate Professor Senior Research Scientist CSIRO Animal, Food and Health Sciences Adelaide BC, South Australia Medical Research: What are the main findings of the study? Dr. Brinkworth: Both a very low carbohydrate, high protein, high unsaturated fat diet and a high carbohydrate, low fat diet achieved similar weight loss, improvements in body composition and health risk markers. However, compared to the high carbohydrate, low fat diet, a very low carbohydrate high protein, high unsaturated fat diet had more favourable effects on blood lipid profile, glycemic control (indicated by greater reductions in glycosylated haemoglobin – primary clinical measure of blood glucose control and the requirements for blood glucose controlling drugs) and for reducing daily blood glucose fluctuations. The findings from this study suggests that a novel eating pattern that markedly limits carbohydrates, increases protein and unsaturated fat may have more favourable therapeutic potential for optimising the management of type 2 diabetes and reducing cardiovascular disease risk. (more…)
Addiction, Author Interviews, JAMA, Pediatrics / 29.07.2014

Sharon Levy, M.D., M.P.H. Director, Adolescent Substance Abuse Program Assistant Professor in Pediatrics Boston Children’s HospitaMedicalResearch.com Interview with: Sharon Levy, M.D., M.P.H. Director, Adolescent Substance Abuse Program Assistant Professor in Pediatrics Boston Children’s Hospital   Medical Research: What are the main findings of the study? Dr. Levy: We found that questions that asked about the frequency of alcohol, tobacco and drug use accurately triaged adolescents into "risk categories".  In other words, kids who reported using alcohol or marijuana "once or twice" last year were unlikely to have a substance use disorder, those who reported "monthly" use were very likely to meet diagnostic criteria for a "mild" or "moderate" substance use disorder while those who reported use weekly or more were very likely to meet diagnostic criteria for a "severe" substance use disorder. (more…)