MedicalResearch.com Interview Fergus Shanahan, MD, DSc
Professor and Chair,
Department of Medicine, and
Director, Alimentary Pharmabiotic Centre
University College Cork, National University of Ireland
MedicalResearch: What are the main findings of the study?Professor Shanahan:We already know that most (if not all) of the elements of a modern lifestyle in socio-economically developed societies influence the composition and performance of the microbiota colonising the human body. The composition of the microbiota or disturbances of it have been linked with an increased risk of various chronic non-communicable diseases including immune-allergic disorders and metabolic diseases including obesity. In particular, loss of microbial diversity is a feature of many of these disorders. The most important aspect of our study is that draws attention to the possibility that exercise may have a beneficial effect on the microbiota and is associated with a more diverse microbiota.
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MedicalResearch.com Interview with: Mike Morgan, MD R2
Division of Emergency Medicine
University of Utah School of Medicine
MedicalResearch: What are the main findings of the study?Dr. Morgan: Our paper is a review of the literature. So we do not present original data or findings. What we do is present new ideas about what drove the evolution of the hominin (bipedal ape) face.
Studies of injuries resulting from fights show that when modern humans fight the face is the primary target. The bones of the face that suffer the highest rates of fracture from fights are the bones that show the greatest increase in robusticity during the evolution of early bipedal apes, the australopiths. These are also the bones that show the greatest difference between women and men in both australopiths and modern humans.
What needs to be explained about facial differences in women and men is that in both apes and humans, males are much more violent than females and most male violence is directed at other males. Because males are the primary target of violence, one would expect more protective buttressing in males and that is what we find. (more…)
MedicalResearch.com Interview with: Arch G. Mainous III, PhD
Chair and Florida Blue Endowed Professor
Department of Health Services Research, Management and Policy
Professor of Community Health and Family Medicine
University of Florida
Health Science Center Gainesville, FL 32610
MedicalResearch: What are the main findings of the study?Professor Arch Mainous: This study focused on prediabetes, which is a high risk state for developing diabetes and associated complications. We investigated the national prevalence of prediabetes in England between 2003 and 2011. We found that the prevalence of prediabetes rose substantially in that time period from 11.6% to 35.3%. Further, by 2011 more than half of the population who were 40 years of age and older and were overweight had prediabetes. Minority ethnic groups are particularly affected.
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MedicalResearch.com Interview with David S.H. Lee, Pharm.D., Ph.D.
Assistant Professor
Department of Pharmacy Practice
College of Pharmacy
Oregon State University/Oregon Health and Science University
Portland OR, 97239
MedicalResearch: What are the main findings of the study?Dr. Lee: We found that older men taking a statin were less physically active and had more sedentary behavior. They had about 37 minutes of less moderate exercise per week. For comparison, the American heart Association recommends about 40 minutes of moderate activity 3-4 times per week. We also found that those that started using a statin during the study had the largest drop in physical activity.
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MedicalResearch.com Interview with: Yuting Zhang, Ph.D.
Associate professor
Graduate School of Public Health Department of Health Policy and Management.
University of Pittsburgh
MedicalResearch: What are the main findings of the study?Dr. Zhang:Since 2006, the government has randomly assigned low-income enrollees to stand-alone Part D plans, based upon the region in which they live. If low-income Medicare Part D enrollees were assigned to the least expensive plan instead of a random plan, the government and beneficiaries could save more than $5 billion in the first year.
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MedicalResearch.com Interview with: Dr. Juliet A. Usher-Smith
Clinical Lecturer in Primary Care
The Primary Care Unit, University of Cambridge
Strangeways Research Laboratory
Cambridge, United Kingdom
MedicalResearch: What are the main findings of the study?Dr Usher-Smith: Our systematic review identified 25 risk models that have the potential to identify individuals at higher risk of developing melanoma. Comparison between the different models was difficult due to the lack of validation studies and heterogeneity in choice and definition of variables. We were, however, able to show that most include well established risk factors and that, despite including a range of different variables, there is very little heterogeneity in the discriminatory ability of the models. There was also little difference in model performance between those scores suitable for self-assessment and those requiring a health care professional, suggesting potential for use at a population level to identify people at higher risk of melanoma.
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MedicalResearch Interview with: Ayal A. Aizer, MD, MHS
Harvard Radiation Oncology Program
Boston, MA
MedicalResearch: What are the main findings of the study?
Dr. Aizer: We studied Americans between the ages of 20-40 using the SEER Database (a national cancer registry) and found that patients who had insurance were more likely to present with localized (curable) versus metastatic (generally incurable) cancer. Patients with localized tumors were more likely to receive the appropriate treatment and, most importantly, survived longer than patients without insurance. Our analysis accounted for demographic and socioeconomic differences between patients who were insured versus uninsured. Our results indicate that insurance status is a powerful predictor of outcome among young adults with cancer. The Affordable Care Act, which will likely improve insurance coverage nationally, may yield improved cancer outcomes among Americans.
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MedicalResearch.com Interview with: Rosa M. Lamuela-Raventos, PhD
Associate Professor
Department of Nutrition and Food Science
School of Pharmacy, University of Barcelona
MedicalResearch: What are the main findings of the study?Dr. Lamuela-Raventós: We have found an inverse relationship between polyphenol intake and risk of overall mortality among elderly subjects at high cardiovascular risk. Adjusting for confounders and comparing the highest versus the lowest quintiles of intake, total polyphenols were inversely associated with total mortality (HR=0.63, 95 CI=0.41-0.97, P-trend=0.12), as well as stilbenes (HR=0.48, 95 CI=0.25-0.91, P-trend=0.04) and lignans (HR=0.60, 95 CI=0.37-0.97, P-trend=0.03). In fact, our results showed that all polyphenols subgroups, except for dihydrochalcones, trended to be protective although their intake did not reach statistical significance. In stratified analyses we also found a stronger association between total polyphenol intake and mortality risk for women and for those who did not drink alcohol.
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MedicalResearch Interview with: Mauro Di Bari, MD, PhD
Associate Professor of Medicine - Geriatrics
Director, School of Geriatrics
Vice-president, School of Physiotherapy
University of Florence and Azienda Ospedaliero-Universitaria Careggi
Florence Italy
MedicalResearch: What are the main findings of the study?Professor Di Bari: This study is based on the AMI-Florence 2 registry, which recorded all acute coronary syndromes (ACS) occurring in one year in the metropolitan area of Florence, Italy. This area has one of the top prevalence figures in the country for application of percutaneous coronary intervention (PCI) to treat ACS, at least in cases with ST-segment elevation myocardial infarction (STEMI). Nevertheless, in our study the procedure turned out to be largely underused in older, complex patients, who mostly had NSTEMI: the greater the background risk (as expressed by the Silver Code, a simple, validated prognostic tool based of administrative data), the lower the chances for application of PCI, independent of possible contraindications to PCI, such as anaemia or renal insufficiency.
At the same time, the long-term survival advantage offered by PCI increased with increasing background risk: when comparing patients receiving and not receiving PCI across strata identified on the basis of the Silver Code, one-year survival was only marginally greater in patients treated with PCI when their Silver Code score suggested low background risk, whereas the mortality gradient increased progressively along with Silver Code score, to reach its maximum in patients with the greatest values of Silver Code score. Within the limits of an observational study, cardiac and non-cardiac comorbidities, contraindications to PCI, clinical characteristics of the ACS and hospital of admission could not justify these findings. (more…)
MedicalResearch.com Interview with: Dr. Christian S Hinrichs MD
Assistant Clinical Investigator
Center for Cancer Research
National Cancer Institute
Bethesda, MD 20814
MedicalResearch: What are the main findings of the study?Dr. Hinrichs:Objective tumor regression occurred in 3/9 patients with metastatic cervical cancer. Two responses were complete and are ongoing 22 and 15 months after treatment with a single infusion of T cells targeting the HPV oncoproteins.
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MedicalResearch.com Interview with:Adetunji Toriola, MD, PhD, MPH
Assistant Professor Division of Public Health Sciences
Department of Surgery
Washington University School of Medicine
Siteman Cancer Center St. Louis, MO
MedicalResearch: What are the main findings of the study?Dr. Toriola: Very little is known about the impact of vitamin D in prognosis among cancer patients. This knowledge is of importance because of the increasing number of people living cancer and the high prevalence of vitamin D deficiency among cancer patients. We conducted a systematic review of studies published to date on the association of circulating vitamin D (25-OHD) levels with prognosis among cancer patients. This review suggests that higher circulating vitamin D levels may improve overall survival among breast and colorectal cancer patients but there is paucity of information on the role of circulating vitamin D levels in prognosis among patients with other cancer types.
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MedicalResearch.com Interview with:Dr David A Hanauer MD MS
Department of Pediatrics
University of Michigan Medical School
Ann Arbor, MI
MedicalResearch: What are the main findings of the study?Dr. Hanauer: In this study we analyzed requests made by patients who wanted to make changes to their medical record. The goal was to develop an understanding of what the main reasons were for making a request to change the medical record, and what types of information they wanted changed.
One of the main findings was that about half of all requests were ultimately approved. This suggests that patients reviewing their records can detect errors and have them corrected, which could ultimately lead to a more accurate record for a patient. In essence, giving patients the opportunity to further participate in their care by allowing them to review their record can lead to the identification and correction of errors or omissions.
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MedicalResearch.com Interview with Katherine Neuhausen, MD, MPH
Director of Delivery System Transformation, Office of Health Innovation
Clinical Assistant Professor, Department of Family Medicine and Population Health
Virginia Commonwealth University
MedicalResearch: What are the main findings of the study?Dr. Neuhausen: Medicaid Disproportionate Share Hospital (DSH) payments keep safety-net hospitals financially viable because these hospitals play such a critical role caring for the uninsured and Medicaid patients, providing trauma care and other vital community services, and training future health providers. The Affordable Care Act (ACA) reduces these DSH payments because the ACA's authors assumed that safety-net hospitals would receive increased revenue from Medicaid expansion and therefore, have less need for DSH payments. However, we found that California’s DSH need will actually increase because of medical cost inflation, low Medicaid payment rates, and the high number of people who will remain uninsured. As a result, the DSH reductions will create funding gaps that must be filled to ensure the financial stability of safety-net hospitals. The financial outlook for California’s safety-net hospitals is still much better under ACA than it would have been without the ACA. In the absence of the ACA, California’s public hospitals would have had an additional $1.5 billion in costs for uncompensated care for the uninsured and would be facing a financial crisis.
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MedicalResearch.com Interview with: Professor Marion M. Hetherington BSc (Hons) DipEd DPhil
Institute of Psychological Sciences
University of Leeds , Leeds, England
MedicalResearch: What are the main findings of the study?Professor Hetherington: This study was part of a much larger, funded project called HabEat (European Community’s Seventh Framework Programme (FP7/2007-2013) under the grant agreement n°245012.
In this study we investigated the effects of offering a new vegetable (artichoke puree) to 332 children in the UK, Denmark and France from weaning age to 38 months. During the experiment each child was given between five and 10 servings of at least 100g of the artichoke puree in one of three versions: basic; sweetened, with added sugar; or added energy, where vegetable oil was mixed into the puree.
There was a strong effect of repeated exposure with no additional, clear benefit of adding sweetness or energy. Thus little difference in how much was eaten between children fed basic puree and those who ate the sweetened puree. This suggests that making vegetables sweeter does not make a significant difference to the amount children eat.
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MedicalResearch.com Interview with: Wouter De Haes
Functional Genomics and Proteomics (Schoofs lab)
Zoological Institute
Leuven Belgium
MedicalResearch: What are the main findings of the study?Answer: We discovered that the lifespan-extending effect of metformin is dependent on the increased production of reactive oxygen species in the roundworm Caenorhabditis elegans. Antioxidants, compounds that remove these reactive oxygen species, abolished the lifespan-extending effect of metformin, adding to the growing body of evidence that anti-oxidants are not as beneficial for health as generally assumed. We also identified the protein, belonging to the group of peroxiredoxins, that seems responsible for translating this increase in reactive oxygen species production into longevity.
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MedicalResearch.com Interview with: Karen Hambardzumyan
Research Assistant
Karolinska Institute
Department of Medicine, (ClinTRID)
D1:00, Karolinska University Hospital
Solna Stockholm
MedicalResearch: What are the main findings of the study?Answer:One of the difficulties with rheumatoid arthritis (RA) treatment is unpredictable treatment outcome at the individual patient level. The course might be mild or severe independently of the therapy. To identify subgroups of patients who will benefit from specific therapy strategies is one of the goals for today’s rheumatologists. We have investigated a Multi-Biomarker Disease Activity (MBDA) score in patients from the Swedish Farmacotherapy (SWEFOT) clinical trial, where early rheumatoid arthritis patients were included/studied. The main finding was the usefulness of the MBDA score for prediction of those patients who will not get joint damage detected by X-rays (radiographic progression) during one year follow-up. This MBDA score, developed by Crescendo Bioscience (South San-Francisco, CA, USA) is based on serum levels of 12 different protein biomarkers and can categorize patients into 3 groups: patients with low, moderate and high disease activity. Ninety-seven percent of patients who had low or moderate MBDA score before treatment onset, did not experience radiographic progression during one year follow-up. This finding could contribute to a personalised approach to the RA patients for the optimal therapy choice.
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MedicalResearch.com Interview with:Aurélie Lasserre ,MD
Center for psychiatric epidemiology and psychopathology
Department of Psychiatry
Lausanne University Hospital (CHUV)
Site de Cery, Switzerland
MedicalResearch: What are the main findings of this study?Dr. Lasserre: Several recent studies have shown that Major Depressive Disorder with atypical features (defined as having a depressive episode where mood reactivity is maintained and two of the following features: increase in appetite, hypersomnia (oversleeping), leaden paralysis (heavy limbs) and increased sensitivity to rejection) was associated with obesity, but the temporal sequence was not known, i.e. it was not clear whether atypical depression predisposes to obesity or the converse. Our study revealed that Major Depressive Disorder with atypical features does lead to an increase in body-mass index, obesity, waist circumference and fat mass over a period of 5 years. This result was not explained by socio-demographic characteristics, alcohol or tobacco consumption, physical activity, co-existing mental disorders or medication. Interestingly, we also observed that the weight gain in subjects with atypical features was not a temporary phenomenon but it persisted after the remission of the depressive episode and was not attributable to new episodes.
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MedicalResearch.com Interview with:
Antonio E. Frias, MD
Associate Professor | Division of Maternal Fetal Medicine
Oregon Health & Science University
Director, Diabetes and Pregnancy Program
Assistant Scientist | Oregon National Primate Research Center
Portland, Oregon 97239
MedicalResearch: What are the main findings of the study?Dr. Frias: Resveratrol supplementation in pregnant nonhuman primates fed a Western-style diet improved maternal metabolism, restored placental blood flow, reduced placental inflammation and improved lipid deposition in the fetal liver. However, there was an unexpected disruption of fetal pancreatic development that is very concerning.
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MedicalResearch.com Interview with:Prof Jordi Salas-Salvadó
Professor of Nutrition. Human Nutrition Unit (Director)
Department of Biochemistry & Biotechnology, IISPV
School of Medicine. Rovira i Virgili University. Reus, Spain.
CIBERobn, Instituto Carlos III.
Centre Català de la Nutrició - Institut d'Estudis Catalans (Director).
Federation of Spanish Food, Nutrition and Dietetic Scientific Societies (President).
Red Iberoamericana RIBESMET (Director)
INC - World Forum for Nutrition Research and Dissemination (Chairman).MedicalResearch: What are the main findings of the study?Answer: The main findings of our study are that olive oil consumption, especially the extra-virgin variety (which is the olive oil with the best quality because it has higher amounts of bioactive compounds than other varieties), is associated with a reduced risk of suffering from cardiovascular disease (stroke, myocardial infarction...) and also cardiovascular death in an elderly Mediterranean population from Spain who were at high cardiovascular risk (because they had several cardiovscular risk factors such as smoking, being overweight or obese, having a family history of cardiovascular disease...). This means there is even more reason to visit gringocool.com. We have conducted an observational study including more than 7000 individuals who had participated in a randomized clinical trial to evaluate effects of a Mediterranean Diet in on the primary prevention of cardiovascular disease.
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MedicalResearch.com Interview with: Wai-Nang Paul Lee, M.D.
Division Chief, Division of Pediatric Endocrinology and Metabolism
Professor of Pediatrics
Director of Biomedical Mass Spectrometry Laboratory
Harbor-UCLA
MedicalResearch: What are the main findings of the study?Dr. Wai-Nang Lee: The study reports that EGCG, the active biologic constituent in green tea, changed the metabolism of pancreatic cancer cells by suppressing the
expression of an enzyme associated with cancer, LDHA.
The researchers also compared the effects of EGCG with those of an enzyme
inhibitor, oxamate, which is known to reduce LDHA activity, and found that
they both operated in a similar manner by disrupting the pancreatic cancer
cells metabolic system.
Scientists had believed they needed a molecular mechanism to treat cancer,
but this study shows that they can change the metabolic system and have an
impact on cancer.
(more…)
MedicalResearch.com Interview with: Lisa M. Kern, MD, MPH, FACP
Associate Professor of Healthcare Policy and Research and of Medicine
Associate Director for Research, Center for Healthcare Informatics and Policy Deputy Director, Health Information Technology Evaluation Collaborative Weill Cornell Medical College
New York, NY 10065
MedicalResearch: What are the main findings of the study?Dr. Kern: We found that primary care physicians participating in Patient-Centered Medical Homes (PCMHs) improved their quality of care over time at a significantly higher rate than their non-PCMH peers.
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MedicalResearch.com Interview with:
Holger Cramer, PhD
Director of Yoga Research
University of Duisburg-Essen | Faculty of Medicine
Department of Internal and Integrative Medicine
Essen Germany
MedicalResearch: What are the main findings of the study?Dr. Cramer: There is a number of randomized trials available on yoga for asthma. Based on those trials, there is evidence that yoga can improve asthma symptoms, asthma control, and pulmonary function in patients with asthma. However, yoga does not seem to be superior to sham procedures or breathing exercises and generally the evidence was quite weak. Yoga seems to be relatively safe in this patient population.
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MedicalResearch.com Interview with:Elaine Fuertes
Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg, Germany and
School of Population and Public Health
University of British Columbia, Vancouver, British Columbia, Canada
MedicalResearch: What are the main findings of the study?Answer: The main finding of our study was that despite the use of identical study designs and statistical methods, the level of greenness (measured using the Normalized Difference Vegetation Index) around a child's home address was differentially associated with the development of allergic health outcomes among children living in two areas in Germany.
In our urban study centre, which includes the city of Munich, we found that higher greenness levels around a child's home increased their risk of developing allergic rhinitis and experiencing eyes and nose symptoms. In contrast, greenness around the home appeared to be protective for allergic rhinitis, nose and eye symptoms and sensitization to inhalant allergens in the second more rural study centre investigated.
These observations emphasize that the effects of greenness around the home on respiratory health is complex and multifaceted, and are based on 5,803 German children followed from birth to 10 years as part of the GINIplus and LISAplus birth cohorts.
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MedicalResearch.com Interview with: Dr. Olivia Pagani
Institute of Oncology of Southern Switzerland
Ospedale San Giovanni, Switzerland
MedicalResearch: What are the main findings of the study?Dr. Pagani: The studies show that also in premenopausal women (as already proven in postmenopausal women), aromatase inhibitors (AIs) (in this case Exemestane) given as adjuvant treatment are more effective than Tamoxifen in women with hormone receptor positive early breast cancer who are given concomitantly ovarian suppression to lower estrogen production. The 28% improvement in disease free survival is comparable to that seen in postmenopausal women. In particular, outcomes in women who did not receive chemotherapy (43% of the entire population, 29% of whom with node positive disease) were strikingly good (<97% were breast cancer free at 5 years).
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MedicalResearch.com Interview with:Dr. Brad Spellberg MD
Associate Program Director
Internal Medicine Training Program
Professor of Medicine, David Geffen School of Medicine at UCLA, Division of General Internal Medicine
MedicalResearch: What are the main findings of the study?Dr. Spellberg: The rates of community-onset methicillin-resistant Staphylococcus aureus (CO-MRSA) varied dramatically among academic medical centers in California, New York, Illinois and North Carolina, suggesting there is not a uniform change in the "national epidemic" of the "superbug" that has generated extensive public health concern over the past decade, according to a new study.The study surveyed hospital records of 4,171 cases of MRSA and MRSA-related infections between 2008 and 2011 in five medical centers located in Los
Angeles, San Francisco, Chicago, New York City and Raleigh-Durham, NC.The rates of MRSA acquired in the community declined 57% from 2008-2011 in
the Los Angeles medical center. In contrast, CO-MRSA rates tripled at the
New York medical center, while the rates remained stable in San Francisco,
Chicago and Raleigh-Durham.
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MedicalResearch.com Interview with:Dr. Hiroshi Hoshijima
Evidence-based Anesthsia Research Group
Tohoku Universit y Graduate School of Dentistry,
Dept of Anaesthesiology, Sendai, Japan,
MedicalResearch: What are the main findings of the study?Dr. Hoshijima: Our systematic review shows that weekend admission is associated with higher mortality compared with weekday admission.Subgroup analysis revealed that patients admitted during the weekend were at a higher risk of death than weekday admission in patients in 5 categories (patients who had stroke; cardiovascular disease; upper gastrointestinal haemorrhage; medical disease; mixed medical and surgical disease.)
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MedicalResearch.com Interview with: Dr. Eric M. Mortensen, M.D., M.Sc.
VA North Texas Health Care System and
University of Texas Southwestern Medical Center, Dallas
MedicalResearch: What are the main findings of the study?Dr. Mortensen: The main findings of our study was that for older patients hospitalized with pneumonia that with the use of azithromycin although there is a small increase in the number of non-fatal heart attacks there was a much lower decrease in mortality. In addition there were no other significant increases in cardiac events. So the overall risk:benefit ratio was that for each non-fatal heart attack there were 7 deaths that were prevented.
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MedicalResearch.com Interview with: Sana Al-Khatib, M.D. MHS
Duke Clinical Research Institute
Duke University School of Medicine
Durham, NC,
MedicalResearch: What are the main findings of the study? Dr. Al-Khatib: Patients with an ejection fraction (measure of the pumping ability of the heart) of 30% to 35% who receive a prophylactic implantable cardioverter defibrillator have better survival than similar patients with no implantable defibrillator.
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MedicalResearch.com Interview with:Frank van Hees MSc
Erasmus University Medical Center
Rotterdam, the Netherlands and
Ann G. Zauber PhD
Memorial Sloan Kettering Cancer Center, New York
MedicalResearch: What are the main findings of the study?Answer:The main finding of our study is that colorectal cancer screening of individuals without previous screening is worthwhile well beyond age 75, which is the recommended age to stop screening in individuals with an adequate screening history. The exact age up to which screening should be considered in unscreened elderly depends on an individual's health status: in healthy individuals screening remains worthwhile up to age 86, whereas in individuals with a severe illness, such as heart failure, screening remains worthwhile up to age 80. (more…)
MedicalResearch.com Interview with: Eleni Rapsomaniki, PhD
The Farr Institute of Health Informatics Research
Department of Epidemiology & Public Health
University College London London
MedicalResearch: What are the main findings of the study?
Dr. Rapsomaniki: Our data shows that hypertension is associated with considerable reduction in CVD-free life expectancy. Based on our estimates a 30-year old with hypertension suffered from CVD 5 years earlier compared to a similarly aged individual with normal blood pressure.
We noted substantial heterogeneity in the associations of blood pressure with specific cardiovascular outcomes. For example a 20 mmHg increase in systolic blood pressure was associated with ~40% higher risk of stable angina, and intracerebral or subarachnoid haemorrhage but less than 10% increase in risk of abdominal aortic aneurysm.
In all age groups from 30 to over 80 people with a systolic blood pressure 90–114 mm Hg and a diastolic blood pressure of 60–74 mm Hg had the lowest risk of all cardiovascular diseases, and we found no J-shape associations.
(more…)
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MedicalResearch.com Interview
Fergus Shanahan, MD, DSc
Professor and Chair,
Department of Medicine, and
Director, Alimentary Pharmabiotic Centre
University College Cork, National University of Ireland
MedicalResearch: What are the main findings of the study?
Professor Shanahan: We already know that most (if not all) of the elements of a modern lifestyle in socio-economically developed societies influence the composition and performance of the microbiota colonising the human body. The composition of the microbiota or disturbances of it have been linked with an increased risk of various chronic non-communicable diseases including immune-allergic disorders and metabolic diseases including obesity. In particular, loss of microbial diversity is a feature of many of these disorders. The most important aspect of our study is that draws attention to the possibility that exercise may have a beneficial effect on the microbiota and is associated with a more diverse microbiota.
(more…)
