Author Interviews

MedicalResearch.com Interview with: Philip Gorelick, M.D., M.P.H, F.A.C.P. Medical Director of the Hauenstein Neuroscience Center Saint Mary’s Health Care, Grand Rapids, MI; Professor, Translational Science and Molecular Medicine Michigan State University College of Human Medicine; Board member of the National Stroke AssociationPhilip Gorelick, M.D., M.P.H, F.A.C.P. Medical Director of the Hauenstein Neuroscience Center Saint Mary’s Health Care, Grand Rapids, MI; Professor, Translational Science and Molecular Medicine Michigan State University College of Human Medicine; Board member of the National Stroke Association and Judy Lenane, R.N., M.H.A. Chief Clinical Officer of iRhythm Technologies, Inc. Judy Lenane, R.N., M.H.A. Chief Clinical Officer of iRhythm Technologies, Inc.   Medical Research: What is atrial fibrillation and how common a problem is it among US adults? Dr. Gorelick: Nearly 3 million people in the US suffer from Atrial Fibrillation or “Afib,” an abnormal heart rhythm that causes the heart to beat rapidly and irregularly. While Afib can occur at any age, the incidence increases with age and the number of cases is expected to increase significantly in the coming years as the population ages. Approximately 5 percent of people 65 years and older and one in every 10 people over 80 years of age have Afib. It is more common in those with high blood pressure, heart disease or lung disease.

MedicalResearch.com Interview with: Jorge F. Saucedo MD Allstate Foundation, Judson B. Branch Chair of Cardiology Head, Division of Cardiology Co-Director Cardiovascular Institute NorthShore University HealthSystem Clinical Professor of Medicine University of Chicago Pritzker School of Medicine Talla A. Rousan, MD Oklahoma City, OK. First author of study. Medical Research: What are the main findings of the study? Answer: It was found that patients with diabetes mellitus (DM) presenting with acute myocardial infarction (AMI) have a higher in-hospital mortality rate compared to patients without DM. Patients with insulin-requiring diabetes mellitus presenting with non-ST-segment elevation myocardial infarction had higher in-hospital mortality rate than patients with non-insulin requiring diabetes mellitus.

Eric Macy, MS, MS Allergy & Immunology Kaiser Permanente Medical Group-AllergyMedicalResearch.com Interview with: Eric Macy, MS, MS Allergy & Immunology Kaiser Permanente Medical Group-Allergy   Medical Research: What are the main findings of the study? Dr. Macy:
  • Cephalosporins are currently widely and relatively safely used in individuals with a history of a penicillin "allergy" in their medical record.
  • Cephalosporin associated anaphylaxis is very rare, even in individuals with a history of penicillin "allergy".
  • Cephalosporin associated serious cutaneous adverse reactions are extremely rare.
  • Cephalosporin associated Clostridium difficile and serious nephropathy are relatively common.

dr_iffat_rahmanMedicalResearch.com Interview Invitation with: Dr. Iffat Rahman Ph.D. Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Rahman: Our study suggests that moderate to high level of physical activity could protect against heart failure in women.

MedicalResearch.com Interview with: Professor Usha Menon,  Evangelia-Ourania Fourkala PhD and Matthew Burrell PhD Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, University College London, UK Medical Research: What are the main findings of the study? Response: Our study has shown that skirt size is a good proxy for central obesity. Each unit increase in UK skirt size every ten years between the age of 20 and 60 was associated with a 33% increase in postmenopausal breast cancer in our cohort.

MedicalResearch.com Interview with: Prof. Dr. med. Alain Nordmann Innere Medizin FMH Basel, Switzerland Medical Research: What are the main findings of the study? Dr. Nordmann: Based on available randomised controlled trials, garlic preparations seem to lower blood pressure in individuals with hypertension in the short term. However, the quality of the studies and the lack of long-term data preclude the routine use of garlic preparations to lower blood pressure in individuals qualifying for antihypertensive drug therapy.

MedicalResearch.com Interview with: Katharina Mayer MD Deutsches Herzzentrum München, Technische Universität München, Munich, Germany Medical Research: What are the main findings of the study? Dr. Mayer: Patients whose platelets do not respond well to aspirin carry a higher risk of death or stent thrombosis. Platelet response to aspirin is an independent predictor of ischemic events in patients undergoing percutaneous coronary interventions (PCI).

Dr. Aaron P. Thrift PhD Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle, WA.MedicalResearch.com: Interview with: Dr. Aaron P. Thrift PhD Public Health Sciences Division Fred Hutchinson Cancer Research Center Seattle, WA. Medical Research: What are the main findings of the study? Dr. Thrift: We conclude that height is inversely associated with risk of esophageal adenocarcinoma, both in men and women. The association is not due to confounding from known risk factors or bias.

Stewart Agras, M.D. Professor of Psychiatry Emeritus Stanford University School of MedicineMedicalResearch.com Interview with: Stewart Agras, M.D. Professor of Psychiatry Emeritus Stanford University School of Medicine MedicalResearch: What was the study about? Dr. Agras: Family-based treatment (FBT) has been shown to be more effective than individual psychotherapy for the treatment of adolescent anorexia nervosa. This treatment focuses on helping the family to re-feed their child. The question posed in this study was whether Family-based treatment would have any advantages over Systemic family therapy (SyFT) focusing on family interactions that may affect the maintenance of the disorder. The participants were 164 adolescents with anorexia nervosa and their families – one of the largest studies of its type.

Dr. Song Hee Hong PhD Associate Professor, Health Outcomes and Policy Research Dept. Clinical Pharmacy University of Tennessee Health Science Center Memphis, TN 38163MedicalResearch.com Interview with: Dr. Song Hee Hong PhD Associate Professor, Health Outcomes and Policy Research Dept. Clinical Pharmacy University of Tennessee Health Science Center Memphis, TN 38163 Medical Research: What are the main findings of the study? Dr. Hong: Use of GDDP (generic drug discount programs) increased to 23.1% in 2010 from 3.6% of patients receiving any prescription drugs in 2007. Generic drug discount programs were more valued among the elderly, sicker and uninsured populations. The lower use of Generic drug discount programs among racial/ethnic minorities observed when the program was deployed no longer existed when the program matured.

Pietro Manuel Ferraro, MD PhD Candidate Division of Nephrology Catholic University of the Sacred Heart Rome ItalyMedicalResearch.com Interview with: Pietro Manuel Ferraro, MD PhD Candidate Division of Nephrology Catholic University of the Sacred Heart Rome Italy Medical Research: What are the main findings of the study? Dr. Ferraro: We analyzed the association between physical activity and energy intake and the risk of developing kidney stones in three large cohorts of U.S. health professionals. The 215,133 participants included did not have any history of kidney stones when follow-up began. During 20 years of follow-up, 5,355 of them developed a kidney stone. Initially, we found that participants with higher physical activity levels had a reduced risk of developing stones in two of the three cohorts. However, after accounting for a number of factors that could potentially confound the association such as age, body mass index and dietary intake, the association was no longer significant. Similarly, energy intake was not associated with a reduced risk of developing kidney stones.

Richard J. Kryscio, PhD, Professor Sanders-Brown Center on Aging University of KentuckyMedicalResearch.com Interview with: Richard J. Kryscio, PhD, Professor Sanders-Brown Center on Aging University of Kentucky Medical Research: What are the main findings of the study? Dr. Kryscio:  We followed 531 elderly over time assessing their cognition annually; of these 105 (about 20%) eventually were diagnosed with a serious cognitive impairment (either a mild cognitive impairment or a dementia) and 77% of the latter declared a subjective memory complaint prior to the diagnosis of the impairment.  In brief, declaration of a memory problem put a subject at three times the risk of a future impairment.

MedicalResearch.com Interview with: Tuomo Tompuri, MD Clinical Physiology and Nuclear Medicine Kuopio University Hospital, Finland Medical Research: What are the main findings of the study? Dr. Tompuri: Measures of the cardiorespiratory fitness should be scaled by lean mass instead of body weight, while aiming to enable comparison between the subjects. Our result is physiologically logical and confirms earlier observations of the topic. Scaling by body weight has been criticized, because body fat, per se, does not increase metabolism during exercise. We did observe that scaling by body weight introduces confounding by adiposity.

Rebecca J. Schmidt, M.S., Ph.D. Assistant Professor Department of Public Health Sciences The MIND Institute School of Medicine University of California Davis Davis, California 95616-8638MedicalResearch.com Interview with: Rebecca J. Schmidt, M.S., Ph.D. Assistant Professor Department of Public Health Sciences The MIND Institute School of Medicine University of California Davis Davis, California 95616-8638 MedicalResearch: What are the main findings of the study? Dr. Schmidt: Women who had children with autism reported taking iron supplements during pregnancy and breastfeeding less often than women who children who were typically developing.  Mothers of children with autism also had lower average iron intake.

Dennis Kim, MD Los Angeles Biomedical Research Institute Researcher MedicalResearch.com Interview with: Dennis Kim, MD Los Angeles Biomedical Research Institute Researcher Medical Research: What are the main findings of the study? Dr. Kim: Laparoscopic cholecystectomy, a minimally invasive procedure to remove the gallbladder, is one of the most common abdominal surgeries in the U.S. Yet medical centers around the country vary in their approaches to the procedure with some moving patients quickly into surgery while others wait. Our study found gallbladder removal surgery can wait until regular working hours rather than rushing the patients into the operating room at night. The gallbladder is a pear-shaped organ on the upper right side of the abdomen that collects and stores bile, a digestive fluid produced by the liver. Gallbladders may need to be removed from patients who suffer pain from gallstones that block the flow of bile. In a laparoscopic cholecystectomy, surgeons insert a tiny video camera and special surgical tools through small incisions in the abdomen to remove the gallbladder. Occasionally, surgeons may need to create a large incision to remove the gallbladder, and this is known as an open cholecystectomy. We conducted a retrospective study of 1,140 patients at two large urban referral centers who underwent gallbladder removal surgeries. We found 11% of the surgical procedures performed at night (7 a.m.-7 p.m.) were converted to the more invasive procedure, open cholecystectomies. Only 6% of those who underwent the surgery during the day required the more invasive form of surgery.

Prof. Bin He M.S. Ph.D University of Minnesota’s College of Science and Engineering Director of the University’s Institute for Engineering in Medicine.MedicalResearch.com Interview with: Prof. Bin He M.S. Ph.D University of Minnesota’s College of Science and Engineering Director of the University’s Institute for Engineering in Medicine. MedicalResearch: What are the main findings of the study? Prof. He: It is found that people with long term mind body awareness training including yoga and meditation can learn much faster and better the brain-computer interface skills to control a computer cursor by their minds.

MedicalResearch.com Interview with: Dr. MichaelD. Keall PhD Otago University, Wellington, New Zealand Medical Research: What are the main findings of the study? Dr. Keall: We found that home injuries from falls could be reduced by 26% by making some simple modifications to people’s homes, consisting of handrails for steps and stairs, grab rails for bathrooms, outside lighting, edging for outside steps and slip-resistant surfacing for outside surfaces such as decks and porches.

Prof Mika Kivimäki PhD Department of Epidemiology and Public Health, University College London, London, UK Hjelt Institute, Medical Faculty, University of Helsinki, Helsinki, FinlandMedicalResearch.com Interview with: Prof Mika Kivimäki PhD Department of Epidemiology and Public Health, University College London, London, UK Hjelt Institute, Medical Faculty, University of Helsinki, Helsinki, Finland Medical Research: What are the main findings of the study? Prof. Kivimäki: In our study, we pooled published and unpublished data from 222 120 men and women from the USA, Europe, Japan, and Australia. Of them, 4963 individuals developed type 2 diabetes during the mean follow-up of 7.6 years. This is the largest study to date on this topic. In an analysis stratified by socioeconomic status, the association between long working hours and diabetes was evident in the low socioeconomic status group, but was null in the high socioeconomic status group. The association in the low socioeconomic status group did not change after taking into account age, sex, obesity, physical activity, and shift working. So, the association was very robust. In brief, the main finding of our meta-analysis is that the link between longer working hours and type 2 diabetes was apparent only in individuals in the low socioeconomic status groups.

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

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

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

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

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

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

Dr. Peter Griffiths PhD, RN Centre for Innovation and Leadership in Health Sciences University of Southampton, Southampton, UK MedicalResearch.com Interview with: Dr. Peter Griffiths PhD, RN Centre for Innovation and Leadership in Health Sciences University of Southampton, Southampton, UK Medical Research: What are the main findings of the study? Dr. Griffiths: This study found that hospital nurses who are working on a 2 shift system, where care is provided by nurses working long shifts of 12-13 hours, report lower quality and safety of care than nurses who work a traditional three shift system where nurses typically work shifts of 8 hours. We also found that nurses who were working overtime reported lower quality and safety of care. We found that these shifts are common in some European countries – most notably Poland, Ireland and England.

MedicalResearch.com: Interview with: Girija Syamlal MBBS, MPH , Epidemiologist Division of Respiratory Disease Studies National Institute for Occupational Safety and Health CDC, Morgantown, West Virginia CDC/NIOSH/DRDS Morgantown,WV 26505 Medical Research: What are the main findings of the study? Dr. Syamlal: During 2004–2011, of the 141 million U.S. adults, 20.7% were current cigarette smokers. Smoking prevalences were higher among men (22.8%) than women (18.3%). In both men and women, cigarette smoking prevalence varied widely by occupational group. In certain occupations, the prevalence of smoking was three times greater than the Healthy People 2020 goal that aims to reduce cigarette smoking prevalence to 12%.

Chester G. Chambers PhD Armstrong Institute for Patient Safety and Quality Johns Hopkins Carey Business School, Baltimore, MarylandMedicalResearch.com Interview with: Chester G. Chambers PhD Armstrong Institute for Patient Safety and Quality Johns Hopkins Carey Business School, Baltimore, Maryland Medical Research: What are the main findings of the study? Dr. Chambers: The main findings of this study are that several metrics of system performance can be improved by using simple methods proven to be effective in many production settings. Specifically, the idea of using “Pre-processing” as an aspect of medical education improves patient flow times, waiting times, system throughput, and system capacity. When fixed costs are spread across more patients, we are effectively reducing the cost per patient as well. In this context “Pre-processing” simply refers to the practice of having medical trainees present and review cases with the attending prior to patient clinic visits as opposed to doing it in the midst of the patient visit. This simple idea is common in many areas including surgery but tends to get omitted in other settings involving ambulatory care. Our simple experiment verified that this practice has real value in a wide array of settings.

MedicalResearch.com Interview with: Yuli Huang and Yunzhao Hu Department of Cardiology, the First People's Hospital of Shunde, Shunde District, Foshan, PR China. Medical Research: What are the main findings of the study? Response: “Prediabetes” is a general term that refers to an intermediate stage between normoglycaemia and overt type 2 diabetes mellitus (T2DM). It includes 2 groups of individuals, those with impaired glucose tolerance (IGT) and those with impaired fasting glucose (IFG). In 2003, the American Diabetes Association (ADA) redefined the fasting plasma glucose (FPG) concentration range for diagnosing IFG from 110 to 125 mg/dl to 100 to 125 mg/dl in order to better identify individuals at future type 2 diabetes mellitus risk. However, this change has been contentious and was not adopted by the World Health Organization (WHO) Expert Group or other international guidelines. In this meta-analysis, we included data from 26 prospective cohort studies with for 280,185 participants and found that, after controlling for multiple cardiovascular risk factors, the presence of prediabetes at baseline, defined as defined as IFG of 110 to 125 mg/dL(IFG 110), IGT or combined IFG 110 and/or IGT, was associated with increased risk of all-cause and cardiovascular mortality. Specifically, IFG 110 was associated with 12% and 19% increase of all-cause and cardiovascular mortality, IGT was associated with 33% and 23% increase of all-cause and cardiovascular mortality, combination of IFG110 and/or IGT was associated with 21% and 21% increase of all-cause and cardiovascular mortality, respectively. Although IFG 100 was not associated with all-cause or cardiovascular mortality in the overall analysis, the risk was greater in young and middle age males according to subgroup analyses.

Dr. David O'Brart Keratoconus Research Institute, Department of Ophthalmology St. Thomas' Hospital, London, United KingdomMedicalResearch.com Interview with: Dr. David O'Brart Keratoconus Research Institute, Department of Ophthalmology St. Thomas' Hospital, London, United Kingdom   Medical Research: What are the main findings of the study? Dr. O'Brart: There was a slight but significant increase in myopic spherical equivalent refractive error after Photorefractive Keratectomy between 1 and 20 years, particularly in those under 40 at the time of treatment and female patients. Corneal curvature/power remained unchanged but axial length increased over two decades. The procedure was safe with no long-term sight-threatening complications and improvements in CDVA (corrected distance visual acuity) and corneal transparency with time.