MedicalResearch.com Interview with: Jason D. Wright, M.D.
Levine Family Assistant Professor of Women's Health
Florence Irving Assistant Professor of Obstetrics and Gynecology
Division of Gynecologic Oncology
Columbia University College of Physicians and Surgeons
161 Fort Washington Ave, New York, New York 10032
Medical Research: What are the main findings of the study?Dr. Wright:This study is one of the first large scale studies to examine the risk of cancer specifically in women who underwent hysterectomy with electric power morcellation. Among 32,000 women treated at over 500 hospitals across the US we noted cancer in 27 per 10,000 women.
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MedicalResearch.com Interview with: R Chris Williams PhD
Honorary Fellow, Musculoskeletal Division
The George Institute for Global Health
Sydney NSW 2000 Australia
Medical Research: What are the main findings of the study?Dr. Williams:We found that in addition to advice and reassurance, ‘regular’ or ‘as needed’ paracetamol did not improve recovery time for people with low back pain, compared to placebo. We also found the pain intensity and a range of other relevant measures, such as patient’s physical function was not different between the treatment groups.
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MedicalResearch.com Interview with: Eva DuGoff, PhD, MPP
Graduate Student
Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
Medical Research: What are the main findings of the study?Dr. DuGoff:In this study we investigate average life expectancy in older adults living with one to 10 or more different chronic conditions. Our main finding is that life expectancy decreases with each additional chronic condition.
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MedicalResearch.com Interview with: Qiuyin Cai, M.D., Ph.D.
Associate Professor of Medicine
Vanderbilt University
Medical Research: What are the main findings of the study?Dr. Cai: We conducted a genome-wide association study in East Asians to search for additional genetic changes that are linked to breast cancer development. The study was conducted as part of the Asia Breast Cancer Consortium, which includes 22,780 women with breast cancer and 24,181 control subjects. We found DNA sequence changes in two genes, PRC1 and ZC3H11A, and a change near the ARRDC3 gene were associated with breast cancer risk. These results were also replicated in a large consortium, including 16,003 breast cancer cases and 41,335 control subjects of European ancestry.
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MedicalResearch.com Interview with:Allison Lipitz-Snyderman, PhD
Assistant Attending Outcomes Research Scientist
Center for Health Policy and Outcomes
Department of Epidemiology and Biostatistics
Memorial Sloan Kettering Cancer Center New York, NY 10065
Medical Research: What are the main findings of the study?Dr. Lipitz-Snyderman:Long-term central venous catheters are used to administer intravenous fluids and treatments such as chemotherapy. These catheters can also be a source of bloodstream infections which can be harmful to cancer patients. However, this risk is not well understood. In our study, we found that the use of these catheters was associated with an increased risk of infections for patients with cancer. We used a population-based dataset, SEER-Medicare, to study this issue in older adult cancer patients. This dataset allowed us to study patients treated in different institutions and follow them over time.
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MedicalResearch.com Interview with:Dr. Dong-Xin Wang, MD, PhD
Department of Anesthesiology and Surgical Intensive Care
Peking University First Hospital
Beijing 100034, China
Medical Research: What are the main findings of the study?Answer: We found that use of epidural analgesia during labor is associated with decreased risk of postpartum depression.
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MedicalResearch.com Interview with:Agustin Ibanez, PhD
Laboratory of Experimental Psychology and Neuroscience
Institute of Cognitive Neurology and the National Scientific
and Technical Research Council and
Sandra Baez, MS;
Institute of Cognitive
Neurology and Institute of Neuroscience,
Favaloro University, Buenos Aires, Argentina
Medical Research: What are the main findings of the study?Answer: Both patients with the behavioral variant of frontotemporal dementia (bvFTD) and patients with frontal strokes presented moral judgment abnormalities. Their deficits were related to impairments in the integration of intentions and outcomes. Specifically, both patient groups judged moral scenarios by focusing on the actions' outcomes instead of the protagonists' intentions.
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MedicalResearch.com Interview with Dr Lim Weng Khong
Research Fellow, National Cancer Centre Singapore.
Medical Research: What are the main findings of the study?Dr Lim Weng Khong: This study uncovered the genetic cause fibroadenomas, which are very common benign breast tumours in women. The team from National Cancer Centre Singapore, Singapore General Hospital and Duke-NUS Graduate Medical School identified a critical gene called MED12 that has frequent durations in a remarkable 60 per cent of fibroadenomas studied. Their findings have been published in the top-ranked journal Nature Genetics.
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MedicalResearch.com Interview with:
Reza Robati, MD
Associate Professor of Dermatology
Deputy editor, Iranian Journal of Dermatology
Skin Research Center, Shahid Beheshti University of Medical Sciences
Tehran, Iran
Medical Research: What are the main findings of the study?Dr. Robati: In our study, increased levels of serum leptin and resistin and increased intima-media wall thickness of common carotid artery were observed in 60 psoriasis patients in comparison with 60 healthy controls. Moreover, we found positive correlation between these variables in psoriasis patients.
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MedicalResearch.com Interview with:Erin Brown, MD
General Surgery PGY6
UC Davis Medical Center
Medical Research: What are the main findings of the study?Dr. Brown: This study sought to determine with childrearing during training put residents at increased risk of quiting. We looked at both male and female surgical residents who chose to have children during residency and found that residents having children during training were not more likely to quit than those who did not have children. We also found that there childrearing had no negative impact on surgical training based on total surgical case numbers, board pass rates, and annual exam scores. Main findings of the study were that neither female gender nor childrearing during training were associated with residents quitting.
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MedicalResearch.com Interview with: Jennifer Keogh PhD, MSc, APD
Associate Professor Dietetics and Nutrition
Fellow of the South Australian Cardiovascular Research Development Program
School of Pharmacy and Medical Sciences
University of South Australia
Medical Research: What is the background for this study?Dr. Keogh:A variety of weight loss strategies are needed to help individuals lose weight and maintain weight loss. In this study we investigated the effects on weight loss of an intermittent energy restricted diet using a ‘week-on, week-off’ strategy compared to a continuous energy restricted diet after 8 weeks and on maintenance of weight loss at 12 months in healthy overweight and obese women. Using a group setting participants were advised to reduce their energy intake to approximately 5500 kJ per day when restricting their intake. The diet plan used was based on the previously published CSIRO Total Wellbeing Diet.
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MedicalResearch.com Interview with:Brian M. Wong, MD, FRCPC
Staff Physician, Division of General Internal Medicine
Assistant Professor, Department of Medicine
Director, Continuing Education & Quality Improvement
Associate Director, Centre for Quality Improvement & Patient Safety (C-QuIPS)
Sunnybrook Health Sciences Centre
Lisa Richardson, MD., MA, FRCPC
Department of Medicine, University of Toronto,
Division of General Internal Medicine, University Health Network,
HoPingKong Centre for Excellence in Education and Practice, University Health Network, Toronto, Ontario, Canada
Medical Research: What are the main findings of the study?Answer: Our study sought to characterize how many clinically important issues that occur during the overnight on-call period were handed over and discussed by the on-call resident with the daytime medical team. For example, if a patient developed chest pain in the middle of the night and the on-call resident evaluated the patient, did the resident then 'handover' this issue to the team the next morning so that they could follow up and make sure that the patient receives timely care? In our study, we found that approximately 40% of these issues did not get handed over. This finding was consistent across 2 major Canadian academic teaching hospitals.
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MedicalResearch.com Interview with:
Yang Hu
From the Division of Rheumatology, Immunology, and Allergy
Brigham and Women's Hospital and Harvard Medical School
Boston, MA
MedicalResearch.com: What are the main findings of the study?
Answer: We find regular (≥ 1 serving/day) consumption of sugar-sweetened soda, but not diet soda, is associated with increased risk of seropositive rheumatoid arthritis in women, independent of other dietary and lifestyle factor.
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MedicalResearch.com Interview with:
Donna Parker, Sc.D., FAHA
Director of Community Health and Research
Center for Primary Care and Prevention
Memorial Hospital of RI
Pawtucket, RI 02860
MedicalResearch: What are the main findings of the study?Answer: The main findings of the study are that women with a history of one or more miscarriages or one or more stillbirths appear to be at increased risk of cardiovascular disease. We found that the multivariable adjusted odds ratio for coronary heart disease for one or more stillbirths was 1.27 (95 percent CI, 1.07-1.51) compared with no stillbirth; for women with a history of one miscarriage, the odds ratio was 1.19 (95 percent CI, 1.08-1.32); and for women with a history of two or more miscarriages, the odds ratio was 1.18 (95 percent CI, 1.04-1.34) compared with no miscarriage. However, we did not find a significant association of ischemic stroke and pregnancy loss. The association between pregnancy loss and CHD appeared to be independent of hypertension, body mass index, waist-to-hip ratio and white blood cell count.
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MedicalResearch.com Interview with:
Aakriti Gupta, MD, MBBS
Center for Outcomes Research and Evaluation
Yale-New Haven Hospital,
New Haven, Connecticut
Medical Research: What were the main findings?
Dr. Gupta: Using a national database, we found that heart attack hospitalization rates for patients under the age of 55 have not declined in the past decade while their Medicare-age counterparts have seen a 20 percent drop.
We also found that among younger patients below 55 years of age, women fare worse because they have longer hospital stays, and are more likely to die in the hospital after a heart attack. Young women were also more likely to have higher prevalence of co-existing medical conditions including diabetes, high blood pressure and higher cholesterol levels. Overall, all patient groups in the study saw increases in these conditions including diabetes and high blood pressure in the past decade.
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MedicalResearch.com Interview with: Dr. Nelli Westercamp PhD, MPH, MBA
University of Illinois at Chicago
School of Public Health
Kenya, Epidemiology and Public Health
Medical Research: What are the main findings of the study?Dr. Westercamp: The three clinical control trials in Kenya, Uganda and South Africa found that male circumcision reduces the risk of female to male transmission by up to 60%, prompting the endorsement of medical male circumcision as an HIV prevention intervention by the WHO and UNAIDS. However, as medical male circumcision services for HIV prevention are being rolled out in the priority countries, questions remain whether the male circumcision promotion will actually translate into decreases in HIV infections. One factor that could reduce the effectiveness of male circumcision for HIV prevention at the population level is the behavioral risk compensation. In other words, if men who become circumcised believe that they are fully protected against HIV and engage in higher sexual risk taking behaviors as a result of this belief, this could reduce or even negate the protective effect of male circumcision against HIV.
To answer this question, we conducted a large prospective study concurrently with the scale up of male circumcision services in Western Kenya. We recruited 1,588 men seeking circumcision services as well as 1,598 men who decided to remain uncircumcised and assessed their sexual behaviors over 2 years, every 6 months. We then compared the behaviors of circumcised men before and after circumcision and also the behaviors of circumcised and uncircumcised men over time.
In the beginning of the study, we found that men choosing to become circumcised believed they were at higher risk of HIV than their uncircumcised counterparts. This perception of HIV risk declined significantly among the circumcised men after circumcision (from 30% at baseline to 14% at 24 months of follow up), while remaining relatively stable among the uncircumcised men (24% to 21%, respectively). Looking at sexual risk behaviors, we saw that the overall level of sexual activity increased equally in both groups, mostly driven by the youngest age group (18-24 year old). However, despite the decrease in risk perception among circumcised men and the increase in sexual activity among all men, all other risky behaviors decreased in both groups and protective behaviors – such as condom use – increased, particularly among circumcised men.
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MedicalResearch.com Interview with: Prof. Jean-Francois Rossignol, FRSC, FRCPath
Romark Laboratories, LC
MedicalResearch: What are the main findings of the study?Prof. Rossignol: Nitazoxanide, a new orally administered drug in development for treating influenza, reduced the duration of symptoms of uncomplicated influenza compared to a placebo. The drug also reduced viral shedding. Side effects were similar for the drug and placebo treatment arms. The study was designed and conducted in compliance with FDA guidelines for studying new drugs for influenza.
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MedicalResearch.com Interview withRiyaz Bashir MD, FACC, RVT
Associate Professor of Medicine
Director, Vascular and Endovascular Medicine
Department of Medicine, Division of Cardiovascular Diseases
Temple University Hospital
Philadelphia, PA 19140
Medical Research: What is the background for this study?Dr. Bashir : Blood clots of legs called deep vein thrombosis (DVT) is a very common disease that occurs in about 1.0 person per 1000 population per year. This condition is responsible for more than 600,000 hospitalizations each year in the United States and approximately 6% of these patients will die within 1 month of the diagnosis. Amongst these patients 20% - to 50% will go on to develop chronic leg pains, swelling, heaviness, skin discoloration, and ulcers, in spite of conventional treatment with Blood thinning medications (anticoagulation) and compression stockings.This condition, which is called Post-thrombotic syndrome PTS markedly impairs the quality of life of these patients and is a significant economic burden (2.4 billion dollars and 200 million work dayslost annually in US) on the society.In fact, many of these people lose their jobs because of the disability it causes.
Several small studies have shown that early clot removal by minimally invasive catheter-based clot busting procedure called Catheter-directed thrombolysis (CDT) leads to a significant reduction in Post-thrombotic syndrome along with improvements in quality of life. Unfortunately, due to the small number of patients in these studies, we did not have any data about the safety of this treatment option. This has led to conflicting recommendations by various medical societies like the American College of Chest Physicians recommending against its use while the American Heart Association recommends Catheter-directed thrombolysis as first-line treatment for these patients. In light of these conflicting directives, we reviewed the frequency and safety of CDT versus conventional treatment in these patients with blood clots above the knees in the United States using Nationwide Inpatient Sample database from 2005 to 2010.
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MedicalResearch.com Interview with:Kanako K. Kumamaru, MD PhD
Assistant Professor, Departments of Radiology
Brigham and Women’s Hospital & Harvard Medical School
Boston, MA 02115
Medical Research: What are the main findings of the study?Dr. Kumamaru: When a patient does not have diabetes and had no or ≤25% coronary stenosis in his/her previous coronary CT angiography (CCTA) performed within 3 years, the probability of newly developed coronary artery disease (CAD) is very low, suggesting no repeat CCTA necessary, even if the clinical scenario suggested CCTA to be appropriate. Especially, when coronary arteries were completely normal at the prior scan, no patient underwent subsequent revascularization during the study period.
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MedicalResearch.com Interview with Steven Grinspoon, MD
Professor of Medicine, Harvard Medical School
Director, MGH Program in Nutritional Metabolism
Co-Director, Nutrition Obesity Research Center at Harvard
Massachusetts General Hospital
Boston, MA 02114
Medical Research: What are the main findings of the study?Dr. Grinspoon:The primary finding is that tesamorelin, a hypothalamic peptide that increases the endogenous pulsatile secretion of growth hormone, reduced liver fat in HIV-infected patients with increased visceral (abdominal) fat. Increased visceral fat is very closely linked with increased liver fat in HIV patients, but the effects on liver fat were not known. Our data show that tesamorelin reduces liver fat in conjunction with decreasing visceral fat, which may be clinically important for patients with HIV-infection who have both increased abdominal fat and fatty liver disease. In addition the study demonstrated that this treatment strategy was neutral to glucose by the end of the 6 month study.
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MedicalResearch.com: Interview withDr. Sonia Singh
Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Medical Research: What are the main findings of the study?Dr. Singh: While there is a great deal of information about the epidemiology of HIV among MSM (men who have sex with men), there is much less information about a subset of MSM who also have sex with women – MSMW. In this article, CDC researchers examined HIV diagnoses among MSMW and MSM only (MSMO) from 2008 to 2011 to obtain a better understanding of the characteristics of men diagnosed with HIV who have ever had sex with both men and women. Of all MSM diagnosed with HIV during 2011, 26% also had sex with women with women in the past. From 2008 to 2011, HIV diagnoses among MSMW were relatively stable while there was an increase among young MSMO aged 13 to 29 years.
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MedicalResearch.com Interview with:Lisa A. McDonnell
Program Manager, Prevention & Wellness Centre,
Division of Prevention and Rehabilitation,
University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Medical Research: What are the main findings of the study?
Answer:The analysis focuses on a comparison of women’s perceptions of their heart disease knowledge and heart health risk with their self‐reported knowledge and heart health risk status. In summary, it gives insight into the Perceptions vs Reality when it comes to women and their heart health.
Heart disease knowledge:
For the purposes of measuring knowledge related to heart health, a scoring index was created on which women responding to the survey could score as low as 0 or as high as 40. The overall mean score among women in the survey was 15.0, which is fairly modest given the maximum of 40. In a comparison of actual and perceived heart disease knowledge, 80% of respondents with a low knowledge score perceived that they were moderately or well informed.
The risk factors that Canadian women most commonly associate with heart disease are being overweight/having abdominal obesity (ov/ob), physical inactivity, smoking, and lacking fruits/vegetables. Smoking, diabetes and high blood pressure account for up to 53% of MI’s, followed by Ov/Ob, psychosocial factors, a lack of physical activity, and a lack of fruits/vegetables. The limited awareness of high blood pressure, high cholesterol and diabetes as key risk factors is particularly surprising, given that these are key determinants of heart disease.
Low awareness of symptomology among women in our survey were noted when comparing the occurrence of symptoms versus their recognition of these symptoms as possibly being related to their heart. Only 4 in 10 women could name chest pain as a symptom of heart disease, and a smaller proportion could identify symptoms including dyspnea, radiating pain, or typical prodromal symptoms. Such shortcomings might contribute to the greater number of unrecognized myocardial infarctions in women than in men, not to mention inappropriate treatment of acute events and premature discharge from emergency care.
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MedicalResearch.com: Interview with: Anna Satcher Johnson MPH
Division of HIV/AIDS Prevention
Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia
Medical Research: What are the main findings of the study?Answer: The new analysis confirms historical trends suggesting that we’ve made significant progress in reducing HIV in the U.S. over time – overall and among several key populations, including injection drug users and heterosexuals. Overall, new HIV diagnoses from 2002 to 2011 declined 33 percent. However, these findings underscore continued concerns of a surging HIV epidemic among young gay and bisexual men. We found a significant increase in HIV diagnoses among young men who have sex with men between the ages of 13 and 24.
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MedicalResearch.com Interview with: Cheol Whan Lee andSeung-Jung Park
Division of Cardiology, Asan Medical Center,
University of Ulsan
Seoul, Korea
Medical Research: What are the main findings of the study?Answer: The time window of DES (drug-eluting stent) failure is widely variable from soon after DES implantation to several years after DES implantation. We observed patients with late DES failure are commonly presented with acute coronary syndrome. We hypothesized that temporal patterns of DES failure may be different, and analyzed all patients with first DES failure at our institution. We found that late drug-eluting stent failure is more likely to progress to acute myocardial infarction, aggressive angiographic patterns, and worse outcomes following retreatment.
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MedicalResearch.com Interview with:Dr Peter MacPherson MBChB PhD
Wellcome Trust Clinical Research Fellow
Liverpool School of Tropical Medicine
Department of Clinical Sciences
Liverpool School of Tropical Medicine
Pembroke Place, Liverpool L3 5QA
Medical Research: What are the main findings of the study?Dr. MacPherson: In 2012, an estimated 35 million individuals were infected with the human immunodeficiency virus (HIV) worldwide. Antiretroviral therapy (ART) substantially reduces the risk of HIV transmission as well as greatly reducing illness and death, raising hopes that high uptake of annual HIV testing and early initiation of ART could improve HIV prevention as well as care. Achieving high coverage of HIV testing and treatment is a major challenge however, with low rates of HIV testing and poor linkage into HIV care.
Self-testing for HIV infection (defined as individuals performing and interpreting their HIV test in private) is a novel approach that has seen high acceptance in Malawi and the United States, and is a process that could overcome barriers to conventional facility-based and community-based HIV testing, which lack privacy and convenience. However, no studies in high HIV prevalence settings have investigated linkage into HIV care after HIV self-testing.
Among 16,6660 adults in Blantyre, Malawi offered HIV self-testing, optional home initiation of HIV care (including two-weeks of ART for those eligible) compared with standard HIV care resulted in a substantial and significant increase in the proportion of adults initiating antiretroviral therapy.
HIV self-testing was also extremely popular, with 58% of the adult population self-testing with just 6-months.
To our knowledge, this is the first study to investigate a comprehensive home-based HIV testing, eligibility assessment and treatment initiation strategy.
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MedicalResearch.com Interview with: Sang-Beom Jeon, MD, PhD
From the Department of Neurology
Asan Medical Center
University of Ulsan College of Medicine
Seoul, Republic of Korea.
Medical Research: What are the main findings of the study?Dr. Sang-Beom Jeon: In this MRI study of 825 stroke patients, we demonstrated that high plasma concentrations of homocysteine, also known as hyperhomocysteinemia, were associated with small-vessel disease (lacunar infarcts and leukoaraiosis) and large-vessel atherosclerosis of cerebral arteries.
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MedicalResearch.com Interview with: Dr. Colette Smith: PhDResearch Department of Infection and Population Health
University College London, London, UKMedical Research: What are the main findings of the study?Dr. Smith: We followed a group of approximately 45,000 HIV-positive people from Europe, USA and Australia between 1999 to 2011. We found that the death rate approximately halved over the 12-year study period. For every 1,000 people, around 18 died per year in 1999-2001, reducing to 9 deaths per year in 2009-2011.
We also studied what people died of. We found that the death rate from AIDS and from liver disease decreased by around two-thirds. Deaths from heart disease approximately halved. However, the rate of cancer deaths (excluding cancers that are classified as AIDS events) remained constant over time.
One in three deaths were caused by AIDS in 1999 to 2011, and this decreased to one in five deaths in the last two years of the study. However, even in recent years it was the joint most common cause of death. The proportion of deaths from cancer increased over time. One in ten deaths were from cancer in 1999 to 2001, and this increased to one in five deaths in 2009 to 2011. By the end of the study it was the joint-most common cause of death.
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MedicalResearch.com Interview with: Jared Baeten, MD PhD
Professor, Departments of Global Health and Medicine
Adjunct Professor, Department of Epidemiology
University of Washington
Seattle, WA 98104
Medical Research: What are the main findings of the study?Dr. Baeten: Among heterosexual African couples in which the male was HIV positive and the female was not, receipt of antiretroviral pre-exposure preventive (PrEP) therapy did not result in significant differences in pregnancy incidence, birth outcomes, and infant growth compared to females who received placebo.
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MedicalResearch.com Interview with:Ling Zhao Ph. D.
Associate Professor
College of Acupuncture-Tuina,
Shanghai University of Traditional Chinese Medicine,
China
Medical Research: What are the main findings of the study?Dr. Zhao: In our study, we found that a 6-week course of moxibustion treatment (i.e., a modality of traditional acupuncture using burning moxa to warm and stimulate the acupoint) significantly reduced pain and improved function in patients with knee osteoarthritis compared to a credible placebo control. Our findings suggest that this ancient modality might be a useful adjunctive treatment for knee osteoarthritis. We also found that our sham device is credible for a double-blind randomized clinical trial assessing this traditional treatment modality.
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MedicalResearch.com Interview with: Dennis J. Cotter
President
Medical Technology and Practice Patterns Institute, Inc.
Bethesda, MD 20816
Medical Research: What are the main findings of the study?Answer: This is the first study to document anemia management practice patterns among predialysis CKD patients before and after publication of TREAT. Using a retrospective observational design based on a large US health plan database with over 1.2 million claims for predialysis CKD stage 3 and 4 patients, we report 4 main study findings.
1) For CKD stage 3 patients, the proportion prescribed ESA therapy declined from 17% pre-TREAT to 11% post-TREAT (a 38% decline) and for CKD stage 4 patients, from 34% to 27% (a 22% decline).
2) Prescribing of ESA therapy was declining even before TREAT, but the decline accelerated in the post-TREAT period.
3) ESA prescribing declined after TREAT regardless of anemia status; among patients with hemoglobin <10 g/dL, only 25% of stage 3 and 33% of stage 4 CKD were prescribed ESAs two years after TREAT, a notable 50% decline.
4) After adjusting for all covariates, the probability of prescribing ESAs was 35% less during a two year period after vs. before TREAT publication.
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MedicalResearch.com Interview with:
Jason D. Wright, M.D.
Levine Family Assistant Professor of Women's Health
Florence Irving Assistant Professor of Obstetrics and Gynecology
Division of Gynecologic Oncology
Columbia University College of Physicians and Surgeons
161 Fort Washington Ave, New York, New York 10032
Medical Research: What are the main findings of the study?
Dr. Wright: This study is one of the first large scale studies to examine the risk of cancer specifically in women who underwent hysterectomy with electric power morcellation. Among 32,000 women treated at over 500 hospitals across the US we noted cancer in 27 per 10,000 women.
(more…)
