Author Interviews, Baylor College of Medicine Houston, Electronic Records / 21.06.2014

Dr. Hardeep Singh MD, MPH Chief the Health Policy, Quality & Informatics Program Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center in Houston, Texas Associate professor at Baylor College of MedicineMedicalResearch.com Interview with: Dr. Hardeep Singh MD, MPH Chief the Health Policy, Quality & Informatics Program Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center in Houston, Texas Associate professor at Baylor College of Medicine MedicalResearch: What are the main findings of the study? Dr. Singh: EHRs use can prompt new patient safety concerns, and many of these problems are complex and difficult to detect. We sought to better understand the nature of these patient safety concerns and reviewed 100 closed investigations involving 344 technology-related incidents arising between 2009 and 2013 at the Department of Veterans Affairs (VA). We evaluated safety concerns related to technology itself as well as human and operational factors such as user behaviors, clinical workflow demands, and organizational policies and procedures involving technology. Three quarters of the investigations involved unsafe technology while the remainder involved unsafe use of technology. Most (70%) investigations identified a mix of 2 or more technical and/or non-technical underlying factors. The most common types of safety concerns were related to the display of information in the EHR; software upgrades or modifications; and transmission of data between different components of the EHR system. (more…)
Author Interviews, Cancer Research, End of Life Care / 20.06.2014

Daniel Rocke, MD Medical School University of Michigan Medical School Ann Arbor, 2009.MedicalResearch.com Interview with Daniel Rocke, MD Duke Medicine Department Otolaryngology MedicalResearch: What are the main findings of the study? Dr. Rocke: I think the main point is that, to quote the paper, "end-of-life decision making by patients with cancer and their caregivers is significantly affected by their preference for quality of life or quantity of life, but OHNS physicians’ decision making is not." This is important because physicians counseling patients making end-of-life decisions are coming at these decisions from a different perspective that may not line up with their patients. If physicians recognize this, I think that these end-of-life discussions can be more productive (more…)
AHA Journals, Alcohol, Author Interviews, Heart Disease / 20.06.2014

Dr. Darryl P. Leong MBBS(Hons) MPH PhD FRACP FESC Hamilton General Hospital 237 Barton Street East CanadaMedicalResearch.com: Interview with: Dr. Darryl P. Leong MBBS(Hons) MPH PhD FRACP FESC Hamilton General Hospital 237 Barton Street East Canada   MedicalResearch: What are the main findings of the study? Dr. Leong: The main findings of this study are that while low-moderate levels of alcohol use are associated with a reduced risk of myocardial infarction, this protective association was not seen in peoples of all ethnicities. Secondly, heavy alcohol use (≥6 drinks) within a 24 hour period was associated with a significant increase in the immediate risk of myocardial infarction. (more…)
Author Interviews, Breast Cancer, JAMA, MD Anderson, Race/Ethnic Diversity / 20.06.2014

Dalliah Black, MD F.A.C.S. Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, HoustonMedicalResearch.com Interview with: Dalliah Black, MD F.A.C.S. Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, Houston   MedicalResearch: What are the main findings of the study? Dr. Black: This is a retrospective study from 2002 - 2007 using the SEER/Medicare database of over 31,000 women with node negative breast cancer evaluating the utilization of sentinel node biopsy (SNB) as it transitioned from an optional method for axillary staging to the standard of care instead of complete axillary lymph node dissection (ALND).  We found that SNB use increased each year in both white and black breast cancer patients throughout the study period.  However, SNB was less often performed in black patients (62.4%)compared to white patients (73.7%) and this disparity persisted through 2007 with a 12% difference.  Appropriate black patients more often had an ALND instead of the minimally invasive sentinel node biopsy which resulted in worse patient outcomes with higher lymphedema rates in black patients.  However, when black patients received the minimally invasive SNB, their rates of lymphedema were low and comparable to white patients who received SNB. (more…)
Author Interviews, Endocrinology, JCEM / 20.06.2014

Mette Andersen Nexø Psychologist, Ph.D. student at The National Research Center for the Working Environment Copenhagen Area, DenmarkMedicalResearch.com: Interview with Mette Andersen Nexø Psychologist, Ph.D. student at The National Research Center for the Working Environment Copenhagen Area, Denmark MedicalResearch: What is the background for this study? Answer: The present study is a systematic assessment of the influence of a spectrum of thyroid diseases on ability to work. By presenting new information on the possible socioeconomic consequences of thyroid diseases, the results can help bring awareness to important needs for rehabilitation of thyroid patients. (more…)
Author Interviews, Cancer Research / 20.06.2014

John L. VandeBerg PhD Southwest National Primate Research Center Texas Biomedical Research Institute San Antonio, TX 78245-0549MedicalResearch.com Interview with: John L. VandeBerg PhD Southwest National Primate Research Center Texas Biomedical Research Institute San Antonio, TX 78245-0549 MedicalResearch: What are the main findings of this study? Dr. VandeBerg: Despite the increasing use of sunscreen in recent decades, the incidence of melanoma continues to rise by 3% annually, leading to concerns that sunscreen may not be effective in preventing melanoma despite its efficacy in preventing sunburn.  Our results established in the laboratory opossum, which is the only natural mammalian model of UVB-induced melanoma, that SPF 15 sunscreen applied to infants prior to low dose UVB radiation leads later in life to a 10-fold reduction in pre-melanotic lesions, which are known to progress to malignant melanoma. (more…)
Author Interviews, Diabetes, Weight Research / 19.06.2014

Benjamin D. Horne, PhD, MPH, FAHA, FACC Director, Cardiovascular and Genetic Epidemiology, Intermountain Heart Institute Adjunct Assistant Professor, Genetic Epidemiology Division, Department of Medicine, University of UtahMedicalResearch.com Interview with: Benjamin D. Horne, PhD, MPH, FAHA, FACC Director, Cardiovascular and Genetic Epidemiology, Intermountain Heart Institute Adjunct Assistant Professor, Genetic Epidemiology Division, Department of Medicine, University of Utah MedicalResearch: What is the background for this study? Dr. Horne: The Fasting II trial was a single-arm interventional trial of 24-hour water-only fasting among pre-diabetics with metabolic syndrome. The participants were adults with fasting blood glucose >100 mg/dL and at least two other components of the metabolic syndrome, including high triglycerides, low HDL cholesterol (the “good” cholesterol), high blood pressure, or high waist circumference. The participants were asked to fast once per week for 6 weeks, with multiple goals in this pilot study. This is the first interventional trial of fasting in people with pre-diabetes or diabetes. (more…)
Author Interviews, BMC, Cost of Health Care / 19.06.2014

MedicalResearch.com Interview with: Natasha K Brusco Manager of Physiotherapy Services, Cabrini Health PhD Candidate, Physiotherapy Department, Faculty of Health Science, La Trobe University, Bundoora, Victoria, Australia MedicalResearch: What are the main findings of the study? Answer: This economic evaluation reports that providing additional Saturday rehabilitation, compared to Monday to Friday rehabilitation alone, is likely to be cost saving per quality adjusted life year gained and for a minimal clinically important difference in functional independence. This builds on previous literature that reports that additional Saturday rehabilitation can improve functional independence and health related quality of life at discharge and may reduce patient length of stay. (more…)
Author Interviews, Depression, Heart Disease / 19.06.2014

Dr. Amit J.Shah MD Assistant Research Professor Assistant Professor, Department of Epidemiology Emory, Rollins School of Public HealthMedicalResearch.com: Interview with Dr. Amit J.Shah MD Assistant Research Professor Assistant Professor, Department of Epidemiology Emory, Rollins School of Public Health MedicalResearch: What are the main findings of the study? Dr. Shah: We discovered that in a group of patients who were undergoing heart evaluation with coronary angiography, symptoms of depression predicted increased risk of coronary artery disease and death in women aged 55 years or less. This relationship was stronger in these women than older women, as well as in men aged 55 years or less. Over 1 in 4 women aged 55 years or less had moderate to severe depression, which was higher than any other group; these women had over twice the risk of having heart disease or dying over the next 3 years compared to those with none or mild depression. (more…)
Author Interviews, Depression, Heart Disease, NEJM, OBGYNE / 19.06.2014

Dr. Krista Huybrechts MD PhD Brigham & Women’s Hospital Department of Medicine Division of Pharmacoepidemiology & Pharmacoeconomics Boston, MA 02120MedicalResearch.com Interview Invitation Dr. Krista Huybrechts MD PhD Brigham & Women’s Hospital Department of Medicine Division of Pharmacoepidemiology & Pharmacoeconomics Boston, MA 02120 MedicalResearch: What are the main findings of the study? Dr. Huybrechts: In this cohort study including 949,504 pregnant women enrolled in Medicaid, we examined whether the use of selective serotonin reuptake inhibitors (SSRIs) and other antidepressants during the first trimester of pregnancy is associated with increased risks for congenital cardiac defects. In order to control for potential confounding by depression and associated factors, we restricted the cohort to women with a depression diagnosis and used propensity score adjustment to control for depression severity and other potential confounders. We found no substantial increased risk of cardiac malformations attributable to SSRIs. Relative risks for any cardiac defect were 1.25 (95%CI, 1.13-1.38) unadjusted, 1.12 (1.00-1.26) depression-restricted, and 1.06 (0.93-1.22) depression-restricted and fully-adjusted. We found no significant associations between the use of paroxetine and right ventricular outflow tract obstruction (1.07, 0.59-1.93), or the use of sertraline and ventricular septal defects (1.04, 0.76-1.41); two potential associations that had been of particular concern based on previous research findings. (more…)
Author Interviews, Opiods, Pharmacology / 19.06.2014

Nicholas B. King, PhD, Biomedical Ethics Unit McGill University Montreal QC CanadaMedicalResearch.com Interview with: Nicholas B. King, PhD, Biomedical Ethics Unit McGill University Montreal QC Canada MedicalResearch: What are the main findings of the study? Dr. King: Unintentional overdoses from prescription opioid painkillers have been rising sharply in the US and Canada during the past two decades, killing thousands of people every year. A lot has been written about the subject in both popular media and scholarly literature, but we still don't have a very good idea of why this has happened. So we tried to objectively and systematically assess evidence for what has contributed to increasing mortality. We found the following: (1) The evidence base for why mortality has increased is very thin, and more research is urgently required. (2) We found evidence for at least 17 different causes of increased mortality. We found the most evidence for the following factors: dramatically increased prescription and sales of opioids; increased use of strong, long-acting opioids like oxycodone and methadone; combined use of opioids and other (licit and illicit) drugs and alcohol; and social and demographic characteristics. We found little evidence that internet sales of pharmaceuticals and errors by doctors and patients--factors commonly cited in the media--have played a significant role. (more…)
ADHD, Author Interviews, Genetic Research, Nature / 19.06.2014

Michele Jacob, Ph.D. Professor of Neuroscience Sackler School of Graduate Biomedical Sciences Tufts UniversityMedicalResearch.com Interview with Michele Jacob, Ph.D. Professor of Neuroscience Sackler School of Graduate Biomedical Sciences Tufts University MedicalResearch: What are the main findings of the study? Dr. Jacob: Autistic-like behaviors and cognitive impairments associate with loss of the Adenomatous Polyposis Coli (APC) gene.  We deleted APC chiefly from excitatory neurons in the mouse developing forebrain; the mice exhibited changes in synapse maturation and density, reduced social interest, increased repetitive behaviors, and learning deficits.  In addition, we found  molecular changes that define a novel role for APC in linking to and regulating the levels of particular proteins that function in synaptic adhesion complexes and signaling pathways that are required for normal learning and memory consolidation. (more…)
ADHD, Author Interviews, BMJ, Karolinski Institute / 19.06.2014

Dr. Henrik Larsson PhD Associate Professor Department of Medical Epidemiology and Biostatistics Karolinska Institute Stockholm, SwedenMedicalResearch.com Interview with: Dr. Henrik Larsson PhD Associate Professor Department of Medical Epidemiology and Biostatistics Karolinska Institute Stockholm, Sweden MedicalResearch: What are the main findings of the study? Dr. Larrson: We found no evidence for an overall increased rate of suicide related events associated with the use of stimulant or non-stimulant drug treatment for ADHD. If anything, the results pointed to a potential protective effect of drugs for ADHD on suicidal behaviour, particularly for stimulant drugs. (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA / 19.06.2014

Carlos J. Rodriguez, MD, MPH Department of Medicine and Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North CarolinaMedicalResearch.com Interview with Carlos J. Rodriguez, MD, MPH Department of Medicine and Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina MedicalResearch: What are the main findings of the study? Dr. Rodriguez: As a clinician there is a notion suggesting that lower blood pressure is better but our current research to date is controversial and not conclusive. We wanted to study a large group of people with hypertension and see whether over 20 years of follow up, if a lower systolic blood pressure would be associated with lower cardiovascular events (heart attack, stroke, heart failure, angina). We hypothesized that there would be a linear association between blood pressure and events, that lower blood pressure would be associated with lower events and that as the blood pressure went up there would be more events. We found this was not the case but that hypertensives with a blood pressure between 120-138mmhg have the greatest benefit and those with a blood pressure less than 120mmhg did not have additional benefit. (more…)
Accidents & Violence, Author Interviews / 19.06.2014

Alva O. Ferdinand, DrPH, JD School of Public Health College Station, TX   77843MedicalResearch.com Interview with: Alva O. Ferdinand, DrPH, JD Texas A&M Health Science Center School of Public Health College Station, TX   77843   MedicalResearch: What are the main findings of the study? Answer: Over the last decade, several states have enacted legislating making it illegal to text while driving. However, little is known about the impact that state texting-while-driving bans have had on roadway crash-related fatalities. Some states have banned all drivers from texting while driving while others have banned only young drivers from this activity. Furthermore, some states’ texting bans entail secondary enforcement, meaning an enforcement officer must have another reason to stop a vehicle before citing a driver for texting while driving, and other states’ texting bans entail primary enforcement, meaning an enforcement officer does not have to have another reason for stopping a vehicle. We conducted a longitudinal panel analysis examining within-state changes in roadway fatalities after the enactment of state texting-while-driving bans using roadway fatality data as captured in the Fatality Analysis Reporting System between 2000 and 2010. To further examined the impact of these bans on various age groups, as younger individuals are thought to engage in texting while driving more often than older individuals. States that had enacted texting-while-driving bans during the study period were considered “treatment” states and states that had not passed texting-while-driving bans were considered “control” states. We found that states with primary laws banning young drivers only saw an average of an 11% reduction in roadway following the enactment of such bans during the study period. States with primary laws banning all drivers were also associated with significant reductions for those aged 15 to 21 and those who were 65 years old or older. States with secondarily enforced bans, whether banning all drivers or young drivers only, did not see any significant reductions in roadway fatalities. (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease / 18.06.2014

Nynne Nyboe Andersen, MD, PhD student Department of Epidemiology Research Statens Serum Institut 2300 Copenhagen, Denmark MedicalResearch.com Interview with: Nynne Nyboe Andersen, MD, PhD student Department of Epidemiology Research Statens Serum Institut 2300 Copenhagen, Denmark MedicalResearch: What are the main findings of the study? Dr. Andersen: Previous studies evaluating the risk of cancer associated with the use of TNF-α antagonists are mainly based on data from randomized clinical trials with a short follow up time. Consequently, we used the national Danish registries to conduct a nationwide population-based cohort study assessing the risk of cancer in patients with inflammatory bowel disease (IBD) exposed to these drugs from their introduction in 1999 until 2012. We included more than 56.000 patients with IBD and among those 4500 were exposed to TNF-α antagonists, contributing with almost 20.000 person-years of follow-up. Our main results revealed that the risk of overall cancer was significantly increased in the analysis adjusted for propensity score and potential confounders except for azathioprine, however, when we additionally adjusted for azathioprine use the relative risk decreased markedly leaving no significant increased risk of cancer. Given the upper limit of the confidence intervals, this study could rule out a more than 36% relative increase in the risk of overall cancer over a median follow-up of 3.7 years among TNF-α antagonist-exposed patients with 25% of these followed for 6 years or longer. We also did some stratified analyses according to cumulative number of TNF-α inhibitor doses, and time since first TNF-α inhibitor dose, but these results did not reveal any significantly increased risk of cancer nor did the analyses on site-specific cancers. (more…)
Author Interviews, Clots - Coagulation, Genetic Research / 18.06.2014

MedicalResearch.com Interview with: David Ldr_david_l_brown. Brown, MD, FACC Professor of Medicine Cardiovascular Division Washington University School of Medicine St. Louis, MO 63110 MedicalResearch: What are the main findings of the study? Dr. Brown: This meta-analysis of randomized controlled trials showed that using a genotype-based warfarin dosing algorithm did not improve the process or outcomes of anticoagulation compared to using a clinical dosing algorithm. (more…)
Author Interviews, Cancer Research, Journal Clinical Oncology / 18.06.2014

MedicalResearch.com Interview with: Yosuke Uchitomi, MD, PhD Professor and Chairman, Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan MedicalResearch: What are the main findings of the study? Dr. Uchitomi: This study demonstrated the effect of communication skills training (CST) consisted of didactic lecture, role-plays, and peer discussion for oncologists with extensive experience in comprehensive cancer center hospitals in improving the psychological distress of cancer patients as well as oncologist performances and confidence in communicating with patients, using a randomized design.  Reasons for this positive result might include that the communication skills training program had been developed based on patient preferences regarding the communication of bad news and oncologists’ needs. (more…)
Author Interviews, Case Western, Sleep Disorders / 18.06.2014

Ronnie Fass, M.D., FACG, Professor of Medicine Case Western Reserve University Director, Division of Gastroenterology and Hepatology, Head, Esophageal and Swallowing Center, Metro Health Medical Center Cleveland, OHMedicalResearch.com Interview with: Ronnie Fass, M.D., FACG, Professor of Medicine Case Western Reserve University Director, Division of Gastroenterology and Hepatology, Head, Esophageal and Swallowing Center, Metro Health Medical Center Cleveland, OH MedicalResearch: What are the main findings of the study? Dr. Fass: This is the first study to compare the extent of acid reflux between nighttime sleep and daytime naps in patients with Gastroesophageal reflux disease. The results of our study show that naps are associated with significantly greater esophageal acid exposure compared to sleep. Acid reflux events were more frequent and their total duration was longer during naps when compared with acid reflux events during nighttime sleep. Additionally, the fraction of time that the subjects were experiencing acid reflux with pH < 4 was significantly higher during naps than nighttime sleep and subjects experienced more symptoms due to acid reflux during their nap than their sleep. (more…)
Accidents & Violence, Author Interviews, Lancet, Mental Health Research / 18.06.2014

Professor Louis Appleby Professor of Psychiatry C.B.E The University of Manchester in the UKMedicalResearch.com Interview with: Professor Louis Appleby Professor of Psychiatry C.B.E The University of Manchester in the UK   MedicalResearch: What are the main findings of the study? Professor Appleby: “Patients with mental illness are two and a half times more likely to be victims of homicide than people in the general population according to our research published in The Lancet Psychiatry today. “In this study, the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCI), based at The University of Manchester, examined data on the victims and perpetrators of all homicides in England and Wales between January, 2003 and December, 2005. We found that during the 3-year study period, 1496 people were victims of homicide, and 6% (90) of them had been under the care of mental health services in the year before their death. A third (29) of these patient victims were killed by other patients with mental illness. In 23 homicides in which the victim was a mental health patient killed by another mental health patient, the victim and the perpetrator were known to each other either as partners (9, 35%), family members (4, 15%), or acquaintances (10, 38%). In 21 of these 23 cases, both the victims and perpetrators were undergoing treatment at the same National Health Service Trust. Alcohol and drug misuse (victims 66%, perpetrators 93%) and a history of violence (victims 24%, perpetrators 24%) were common among both patient victims and perpetrators. The study also found that in the 3 years to 2005, 213 mental health patients were convicted of homicide—accounting for 12% of all homicide convictions.” (more…)
Author Interviews, Endocrinology, OBGYNE / 17.06.2014

Sergio R. Ojeda, D.V.M. Division Head and Senior Scientist Division of Neuroscience Division of Neuroscience, OR National Primate Research Center/Oregon Health and Science University, Beaverton OR 97006MedicalResearch.com Interview with: Sergio R. Ojeda, D.V.M. Division Head and Senior Scientist Division of Neuroscience Division of Neuroscience, OR National Primate Research Center/Oregon Health and Science University, Beaverton OR 97006 MedicalResearch: What are the main findings of the study? Dr. Ojeda: The study shows that a receptor for two growth factors (brain-derived neurotrophic factor [BDNF] and neurotrophin 4/5  [NT4/5]) that are known to be important for development of the nervous system is also essential for maintaining oocyte integrity and survival in the mammalian ovary. Intriguingly, the full-length form of this receptor (known as NTRK2-FL) is not expressed in oocytes until the time of the first ovulation. At this time,  the pre-ovulatory gonadotropin discharge stimulates granulosa cells of ovarian follicles to produce not only more BDNF, but also more of a peptide known as kisspeptin, to induce the formation of NTRK2-FL in oocytes. To date, kisspeptin was known to be  only critical for the hypothalamic control of reproduction. To induce NTRK2-FL, BDNF binds to truncated NTRK2 receptors (NTRK2-T1), which are abundant in oocytes throughout prepubertal development.  Kisspeptin, on the other hand, does so by activating its receptor KISS1R, also expressed in oocytes. Once present after the first ovulation, NTRK2-FL is able to activate a survival pathway in oocytes following gonadotropin stimulation, presumably at every cycle. In the absence of NTRK2-FL, oocytes die, follicular structure disintegrates and a condition of premature ovarian failure ensues. (more…)
Author Interviews, JAMA, Mental Health Research / 17.06.2014

Monika Waszczuk 1+3 PhD Student MRC SGDP Research Centre Institute of Psychiatry, King's College London DeCrespigny Park London UKMedicalResearch.com Interview with: Monika Waszczuk 1+3 PhD Student MRC SGDP Research Centre Institute of Psychiatry, King's College London DeCrespigny Park London UK MedicalResearch: What are the main findings of the study? Answer: Little is known about the genetic influences on the relationship between depression and anxiety disorders across development. We used two population-based prospective longitudinal twin and sibling studies to investigate phenotypic associations between the symptoms of these disorders, and tested genetic structures underlying these symptoms across three developmental stages: childhood, adolescence and early adulthood. We found that depression and anxiety disorder symptoms are largely distinct in childhood and are influenced by largely independent genetic factors. Depression and anxiety symptoms become more associated and shared most of their genetic etiology from adolescence. An overarching internalizing genetic factor influencing depression and all anxiety subscales emerged in early adulthood. These results provide preliminary evidence for different phenotypic and genetic structures of internalizing disorder symptoms in childhood, adolescence and young adulthood, with depression and anxiety becoming more associated from adolescence. (more…)
Author Interviews, Breast Cancer / 17.06.2014

Jack Cuzick PhD Centre for Cancer Prevention Wolfson Institute of Preventive Medicine Queen Mary University of London, London UKMedicalResearch.com Interview with: Jack Cuzick PhD Centre for Cancer Prevention Wolfson Institute of Preventive Medicine Queen Mary University of London, London UK Dr. Cuzick offers the manuscript below to put the results of the Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial in focus for MedicalResearch.com.

The Prevention of Breast Cancer

The first human evidence that drug treatment might reduce the incidence of breast cancer was reported in 19851, where it was found that use of tamoxifen in a trial of women with breast cancer to reduce recurrence of existing tumours also had a major impact on new tumours in the opposite breast, reducing them from 10 to 3. That observation has subsequently been confirmed in several other adjuvant trials and an overview of all such trials indicates that after an average of about 8 years of follow up, 5 years of tamoxifen reduced new contralateral tumours by 39%, with similar effects in years 0-5 and 5-10 in women with oestrogen receptor positive or unknown primary tumours2. These observations and positive results from animal studies3, led to the evaluation of 5 years of tamoxifen in women without breast cancer, but at high risk in 4 large trials. A recent overview4 indicates a 33% reduction in all breast cancer after a 10 years follow up, with a larger reduction in years 0-5 (48%), when treatment was given, and a continuing (22%) effect in years 5-10. Reductions were seen for oestrogen receptor positive invasive cancer (44%) and DCIS (28%), but no effect was seen for both oestrogen receptor negative invasive cancer, where in fact a non-significant 13% (P=0.4) increase was observed. Somewhat larger effects were seen for these other selective estrogen receptor modulators (SERMs) – raloxifene, lasofoxifene and arzoxifene – in trials of osteoporotic women, where the primary endpoint was fracture reduction4. A subsequent head-to-head trial of raloxifene vs tamoxifen, showed tamoxifen to be about 20% more effective, but raloxifene had fewer side effects5. Lasofoxifene not only showed benefits for breast cancer reduction but also reduced fracture rates and heart disease6, and this multi-dimensional set of benefits makes it an attractive candidate for prevention. (more…)
Author Interviews, JAMA, Thromboembolism / 17.06.2014

Jay Giri, MD MPH Assistant Professor, Perelman School of Medicine Director, Peripheral Intervention Interventional Cardiology & Vascular Medicine Cardiovascular Division University of PennsylvaniaMedicalResearch Interview with: Jay Giri, MD MPH Assistant Professor, Perelman School of Medicine Director, Peripheral Intervention Interventional Cardiology & Vascular Medicine Cardiovascular Division University of Pennsylvania MedicalResearch: What are the main findings of the study? Dr. Giri: Use of thrombolytics was associated with lower all-cause mortality and increased rates of intracranial hemorrhage.  These results were also seen in intermediate-risk pulmonary embolism.  Finally, it appeared that patients under age 65 might be at less bleeding risk from thrombolytics. (more…)
Author Interviews, BMJ, Heart Disease, Pharmacology / 17.06.2014

MedicalResearch.com Interview with: Professor June-Hong Kim, Division of Cardiology Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital Yangsan, South Korea; MedicalResearch: What are the main findings of the study? Dr. Kim: In vasospastic angina, the cilostazol group significantly reduced relative ireduction of of weekly incidence of chest pain compared with placebo group (−66.5±88.6% vs −17.6±140.1%, respectively, p=0.009).. Other clinical parameters such as a change in the frequency of chest pain (−3.7±0.5 vs −1.9±0.6, respectively, p=0.029), a change in the chest pain severity scale (−2.8±0.4 vs −1.1±0.4, respectively, p=0.003), and the proportion of chest pain-free patients (76.0% vs 33.3%, respectively, p=0.003) also significantly favored cilostazol. (more…)
Author Interviews, BMJ, Heart Disease / 17.06.2014

MedicalResearch.com Interview with Prof. Julia I. Newton: Dean of Clinical Medicine & Professor of Ageing and Medicine Clinical Academic Office The Medical School Newcastle University MedicalResearch: What are the main findings of the study? Prof. Newton: In this study we have explored for the first time the characteristics of patients with Postural tachycardia in the UK
  • Postural Tachycardia Syndrome  patients are predominantly female, young, well educated and have significant and debilitating symptoms that impact significantly upon their quality of life.
  • Despite this, there is no consistent treatment, high levels of disability and associated comorbidity.
  • Although individuals presented with symptoms at the same age, those attending a specialist clinic received a diagnosis quicker.
  • Symptom burden for those with Postural tachycardia is high and comparable to that seen in Chronic Fatigue Syndrome.
  • Chronic Fatigue Syndrome is recognized by the WHO as a neurological disorder and by the Disability Discrimination Act 2005 as a disability. At the current time those with Postural Tachycardia Syndrome  suffer to the same extent as those with Chronic Fatigue Syndrome but do not receive the same protection from the law.
  • It is important that more work is done to understand the underlying autonomic abnormality in those with Postural Tachycardia Syndrome in order to allow us to develop targeted treatments that are effective and go beyond the currently available simply symptomatic management.
(more…)
Author Interviews, Hospital Readmissions, JAMA / 17.06.2014

Greg D. Sacks, MD, MPH Department of Surgery, David Geffen School of Medicine at UCLA MedicalResearch.com Interview with: Greg D. Sacks, MD, MPH Department of Surgery, David Geffen School of Medicine at UCLA MedicalResearch: What are the main findings of this study? Dr. Sacks: This study evaluated the all-cause readmissions measure developed by the Centers for Medicare and Medicaid Services to penalize hospitals for unplanned readmissions. By evaluating readmissions of surgical patients at a single academic medical center, we found that the readmissions measure was able to identify only a third of the planned readmissions and mislabeled the remaining two thirds of planned readmissions as unplanned. This discrepancy was a result of the measure’s reliance on administrative claims data, which disagreed in 31% of cases with clinical data abstracted from the patient’s chart. Also, almost a third (27%) of the readmissions in this study were for reasons unrelated to the original hospitalization. (more…)
Author Interviews, Diabetes, Diabetes Care, Mediterranean Diet, Nutrition / 17.06.2014

 David J.A. Jenkins Professor and Canada Research Chair in Nutrition and Metabolism, Dept. of Medicine and Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, CanadaMedicalResearch.com Interview with: David J.A. Jenkins Professor and Canada Research Chair in Nutrition and Metabolism, Dept. of Medicine and Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada   MedicalResearch: What are the main findings of the study? Prof. Jenkins: The main findings were that inclusion of just over an once (31g) of canola oil in low glycemic index diets of type 2 diabetes study participants, to further reduce the glycemic load (GL), reduced HbAIC more than a high cereal fiber diet, as predicted. However the Canola oil low GL diet also reduced serum TG and LDL-C and thus Framingham risk score for cardiovascular disease. The effect was seen most clearly in those at highest CHD risk and those with features of the metabolic syndrome. (more…)
Author Interviews, Pediatrics, Weight Research / 17.06.2014

Michelle A. Mendez, PhD Assistant Professor Department of Nutrition University of North Carolina at Chapel Hill Gillings School of Public Health Chapel Hill, NMedicalResearch.com Interview with: Michelle A. Mendez, PhD Assistant Professor Department of Nutrition University of North Carolina at Chapel Hill Gillings School of Public Health Chapel Hill, NC MedicalResearch: What are the main findings of the study? Dr. Mendez: Using national surveillance data to examine trends in energy intake among children, we found that there was an initial decline in intakes from 2003-4 through 2007-08, which mirrored evidence that child obesity in the US may have begun to decline in that period. Subsequently, however, in 2009-10, energy intake increased in older children aged 12-19y, and reached a plateau in children aged <11y. This shift is consistent with reports that, particularly in older children, the downward trend in obesity levels may have been reversed in recent years. (more…)
Author Interviews, BMJ, Weight Research / 16.06.2014

Gerard Ngueta Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre, Québec Québec, CanadaMedicalResearch.com Interview with: Gerard Ngueta Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre, Québec Québec, Canada MedicalResearch: What are the main findings of the study? Answer: The main findings of our study are as follows : 1- Contrary to body mass index (BMI), the waist circumference alone (which indicate central obesity or fat distribution) is not associated with cardiometabolic factors under study (i.e., insulin, triglycerides, systolic blood pressure and high-density lipoproteins levels). Thus, the apparent association –as found in previous studies- appears to be mediated through overall obesity (i.e., BMI). In the other words, the association observed in the previous studies between waist circumference and the cardiometabolic risk factors cited above could be mainly due to the strong correlation between waist circumference and BMI. 2- It is possible to estimate the independent contribution of overall fat and central fat on cardiometabolic risk factors by applying the residual model as previously suggested by Willet and Stampfer. (more…)