Author Interviews, CHEST, Critical Care - Intensive Care - ICUs / 27.06.2014

MedicalResearch.com Interview with: James R. Klinger, MD, FCCP Professor of Medicine, Brown University Darren Taichman, MD, PhD, FCCP Adjunct Associate Professor of Medicine, University of Pennsylvania Greg Elliott, MD, MACP, FCCP Professor of Medicine, University of Utah School of Medicine Background: The authors discuss the June 17, 2014 CHEST publication: Pharmacological Therapy for Pulmonary Arterial Hypertension in Adults: CHEST Guideline MedicalResearch: How widespread is the problem of Pulmonary Arterial Hypertension (PAH)? Greg Elliott: PAH is an uncommon, but important disorder because untreated it is usually progressive and fatal, AND there are effective treatments. This makes the guidelines important for physicians, patients and insurers. MedicalResearch: What are the most common causes of PAH? Greg Elliott: Common causes are connective tissues diseases like scleroderma, toxins like methamphetamine and cases for which the cause is not known, i.e. idiopathic. Some (about 20 %) idiopathic cases are caused by gene mutations. (more…)
Author Interviews, Cancer Research, Mayo Clinic / 27.06.2014

dr_john-coplandMedicalResearch.com Interview with: Dr. John A. Copland, PhD Associate Professor of Biochemistry/Molecular Biology Professor of Cancer Biology Cancer Basic Science Mayo Clinic, Jacksonville, Florida MedicalResearch: What are the main findings of the study? Dr. Copland: In our study we identified a pro-cancerous role for a novel protein- neuronal pentraxin 2 (NPTX2). This protein, normally found expressed in brain and nervous system tissues, is highly overexpressed in kidney tumors at all stages of disease. It has never previously been associated with kidney cancer, nor has it been associated with an oncogenic function in any other cancer. NPTX2 appears to play a significant role in not only tumor cell survival, but it also promotes tumor cell migration through activation of the ionotropic glutamate receptor 4 (GluR4). GluR4, also commonly associated with nervous system tissues, appears to be manipulating the flow of calcium into the tumor cell. Both NPTX2 and GluR4 are not components of normal kidney cell function. Because calcium is an important co-factor for many signaling pathways controlling cell growth, survival, and mobility, unconstrained calcium levels in a cell can promote malignancy. We show that calcium calmodulin kinase and AKT, two oncogenic signaling pathways are activated by NPTX2 via calcium influx. (more…)
Author Interviews, Pulmonary Disease / 27.06.2014

MedicalResearch.com Interview with: Dr. Juan P de Torres Pulmonary Department Clínica Universidad de Navarra Pamplona, Spain;MedicalResearch.com Interview with: Dr. Juan P de Torres Pulmonary Department Clínica Universidad de Navarra Pamplona, Spain; MedicalResearch: What are the main findings of the study? Dr. Torres: The BODE Index (BMI, Obstruction, Dyspnea, Exercise ) predicts mortality better than the GOLD ABCD (The Global Obstructive Lung Disease) grading and adding the COTE (Copd cO-morbidity TEst ) comorbidity Index to the BODE Index is complementary and provides an excellent predictive capacity for all-cause mortality in COPD patients. (more…)
Author Interviews, BMJ, Endocrinology, Weight Research / 27.06.2014

MedicalResearch.com Interview with: Mojca Jensterle Department of Endocrinology. Diabetes and Metabolic Diseases. University Medical Centre. Zaloska 7. Slovenia. MedicalResearch: What are the main findings of the study? Answer: This is the first report demonstrating that selective phosphodiesterase enzyme (PDE) 4 inhibitor roflumilast added to metformin (MET) was superior to metformin alone in reducing mean body weight after 12 weeks of treatment in obese women with polycystic ovary syndrome (PCOS), primarily due to a loss of fat mass. 31 women with PCOS diagnosed by the National Institute of Child Health and Human Development criteria aged 33.8 ± 7.4 years with BMI 36.4 ± 5.1 kg/m2concluded the study. They were randomized to MET 1000 mg BID or combined treatment (COM) with MET 1000 mg BID and roflumilast 500 mcg QD. The primary outcome were changes in anthropometric measures of obesity. At study endpoint subjects treated with COM lost on average 4.2 ± 2.8 kg compared to a 0.9± 2.5 kg weight gain in METgroup (p<0.001). BMI decreased for 1.6 ± 1.1 kg/m2 in COM arm compared to increase for 0.9 ± 2.4 kg/m2 in MET arm (p= 0.001). Total body fat decreased for 0.7±0.4 % in COM as opposed to 0.2 ± 0.1 % increase in MET and visceral adipose tissue (VAT) area as assessed by DXA decreased for 15.5 ± 1.6 cm2 in COM as opposed to 11.4 ± 5.3 cm2 increase in MET. The greater waist circumference reduction was noted in COM (4.2 ± 1 cm) compared with MET (0.8 ± 0.7 cm). The improvements of obesity measures were associated with beneficial effects on fasting glucose levels, insulin resistance and resolution of metabolic syndrome in affected women. The hypothesis behind the weight decrease and beneficial metabolic impact observed with roflumilast is based on the PDE4 regulation of signaling pathways linked to GLP-1 release. In experimental rodent model a single treatment with roflumilast enhanced plasma GLP-1 levels up to 2.5 -fold. (more…)
Author Interviews, BMJ, Disability Research / 27.06.2014

MedicalResearch:com Interview with: Stephen Honeybul FDS RCS (Eng), FRCS (SN), FRACS Consultant Neurosurgeon Sir Charles Gairdner Hospital HOD Royal Perth Hospital Perth WA Australia MedicalResearch: What are the main findings of this study?  Dr. Honeybul: Amongst those patients who had been adjudged severely disabled or in a vegetative state at 18 months, remained as such at the three years follow up. Most patients who were able to provide a response said that they would have provided consent to the "life saving" intervention even if they had known their final outcome (more…)
Author Interviews, Autism, Lancet, Mental Health Research / 26.06.2014

Dr Sarah Cassidy PhD Autism Research Centre,Department of Psychiatry University of Cambridge, Cambridge, UKMedicalResearch.com Interview with: Dr Sarah Cassidy PhD Autism Research Centre,Department of Psychiatry University of Cambridge, Cambridge, UK MedicalResearch.com: What are the main findings of the study? Dr. Cassidy: We found that adults with late diagnosis of Asperger Syndrome (31 years on average), were at significantly higher risk of contemplating suicide during their lifetime (66%) than those from the general UK population (17%), and a sample of patients with Psychosis (59%). We also found that adults diagnosed with Asperger Syndrome with a history of depression, were significantly more likely to experience suicidal thoughts, and suicide plans or attempts, than those with Asperger Syndrome without a history of depression.  A higher level of autistic traits was also a significant risk factor for having planned or attempted suicide. (more…)
Author Interviews, JAMA, Pediatrics, Surgical Research / 26.06.2014

Frank H. Morriss, Jr., MD, MPH Professor of Pediatrics - Neonatology University of Iowa Carver College of MedicineMedicalResearch.com Interview with: Frank H. Morriss, Jr., MD, MPH Professor of Pediatrics  - Neonatology University of Iowa Carver College of Medicine   MedicalResearch: What are the main findings of the study? Dr. Morriss: Our aim was to assess the association between surgery performed during the initial hospitalization of very low- birth-weight infants and subsequent death or neurodevelopmental impairment at 18-22 months’ corrected age. We conducted a retrospective cohort analysis of patients who were prospectively enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998 to 2009. Surgery was classified by the expected anesthesia type as either major surgery that likely would have been performed under general anesthesia; or minor surgery, that is, procedures that could have been performed under non-general anesthesia and in general were shorter in duration. There were 2,186 major surgery patients and 784 minor surgery patients and more than 9,000 patients who did not undergo surgery. We found that any surgical procedure  increased the adjusted risk of death or neurodevelopmental impairment in low birth weight infants by about 30%. Not all surgical procedures were associated with increased risk, however. Compared with those who did not undergo surgery, patients  who were classified as having major surgery had a risk-adjusted odds ratio of death or neurodevelopmental impairment of 1.52 (95% confidence interval 1.24-1.87). However, those who were classified as having minor surgery had no increased adjusted risk. Among survivors who had major surgery compared with those who did not undergo surgery the risk-adjusted odds ratio for neurodevelopmental impairment was 1.56 (95% confidence interval 1.26-1.93), and the risk-adjusted mean Bayley II Mental Developmental Index and mean Psychomotor Developmental Index values were significantly lower. (more…)
Author Interviews, Dartmouth, Hospital Readmissions, Neurological Disorders, Neurology / 25.06.2014

MedicalResearch.com Interview with: Tracie A. Caller, MD , MPH Neurophysiology Fellow Dartmouth-Hitchcock Medical Center 1 Medical Center Dr., Lebanon NH 03756, USA MedicalResearch: What are the main findings of the study? Dr. Caller: We identified factors that appeared to increase the risk for a 30 day readmissions in the epilepsy population, which included refractory seizures but also coexistence of nonepileptic seizures and psychiatric comorbidities. (more…)
Author Interviews, BMJ, Infections, Pediatrics, Vaccine Studies / 25.06.2014

Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UKMedicalResearch.com: Interview with Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UK MedicalResearch: What are the main findings of the study? Dr. Wang: We have found evidence of recent whooping cough infection in 1 in 5 school age children who see their doctor with a persistent cough and in 1 in 6 children who have been fully vaccinated against whooping cough.  We have also shown that whooping cough can still cause clinically significant cough in fully vaccinated children. (more…)
Author Interviews, Dermatology / 25.06.2014

MedicalResearch.com Interview with Chenjie Xu PhD Assistant Professor of Bioengineering Nanyang Technological University Singapore 637457 MedicalResearch: What are the main findings of the study? Answer: Keloid is a long-term dermatological scarring disease characterized by disfiguring lesions resulting from overgrowth of dense fibrous tissue. It is also unsightly and can even lead to disfigurement and psychological problems of affected patients. This study investigated the use of microneedle technology in the self-management of keloid lesions. Briefly, we have developed a “wearable” microneedle device for transdermal delivery of an anti-metabolite drug (5-FU) to inhibit the proliferation activity of keloid fibroblast. This study has provided evidence for effective inhibition of keloid fibroblasts in vitro and successful translation of this platform can significantly reduce the cost of keloid treatment and improve the patient compliance. (more…)
Author Interviews, CMAJ, Compliance, Pharmacology, Statins / 25.06.2014

Dr. Heli Halava: Departments of Public Health and Pharmacology, Turku, FinlandMedicalResearch.com Interview with: Dr. Heli Halava: Departments of Public Health and Pharmacology, Turku, Finland MedicalResearch: What are the main findings of the study? Dr. Halava: The associations between lifestyle factors and nonadherence to statin therapy varied by cardiovascular comorbidity status. Of the participants without cardiovascular comorbidities (n = 6458), 3171 (49.1%) were nonadherent with their statin therapy. Of the participants with cardiovascular comorbidities (n = 2827), 1155 (40.9%) were nonadherent. People with cardiovascular comorbidities who had risky drinking behaviours or a cluster of lifestyle risks were at increased risk of nonadherence. (more…)
AHA Journals, Author Interviews, Race/Ethnic Diversity, Stroke / 25.06.2014

Wuwei (Wayne) Feng MD MS FANA Assistant Professor, Department of Neuroscience Department of Health Science & Research Medical University of South Carolina Stroke Center The Center of Rehabilitation Research in Neurological ConditionsMedicalResearch.com Interview with: Wuwei (Wayne) Feng MD MS FANA Assistant Professor, Department of Neuroscience Department of Health Science & Research Medical University of South Carolina Stroke Center The Center of Rehabilitation Research in Neurological Conditions MedicalResearch: What are the main findings of the study? Dr. Feng: Stroke hospitalization rate is decreasing in the elderly, but increasing in the young/middle aged population, but this increase is mainly driven by the increase in blacks (not in whites) which incurred persistent racial disparity in stroke. It has tremendous economic impact as outlined in the paper. Of hospital charges totaling $2.8 billion over 10-year period, $453.2 million (16.4%) are associated with racial disparity (79.6% from patients <65 years). By way of background: 84,179 stroke hospitalizations occurred in South Carolina from 2001 to 2010. Blacks accounted for 29,846 (35.5%) and whites accounted for 54,333 (64.5%) of the strokes. Among blacks, 50.4% were <65 years of age compared to 29.6% among whites. The overall stroke hospitalization rate decreased over the 10-year period. There was a significant reduction in stroke hospitalization rate in the older (≥65 years old) populations, for both blacks and whites. Whereas, in the younger populations (<65 years old), the overall rate of stroke hospitalizations actually increased significantly; however this increase was only associated with black patients. For example, the hospitalization rate per 100,000 for young blacks was 121 in 2001, 139 in 2005 and 142 in 2010 (a 17.3% increase from 2001). This racial disparity was more severe in the younger group with the highest disparity seen in the 45-54 year age groups for both ischemic strokes (having a clot) and intra-cerebral hemorrhagic strokes. (more…)
Author Interviews, Gender Differences, Heart Disease, JAMA / 25.06.2014

MedicalResearch.com Interview with: David Strauss, M.D., Ph.D., Senior Author Medical Officer Center for Devices and Radiological Health U.S. Food and Drug Administration, Silver Spring, Md MedicalResearch: What are the main findings of the study? Dr. Strauss: The underrepresentation of women in clinical trials for cardiac resynchronization therapy (CRT) devices, as with other devices, has made it difficult to assess differences in the safety and effectiveness of these devices for women vs. men. The FDA is exploring the potential of pooling and analyzing data from multiple trials to bridge the knowledge gap for certain subpopulations (such as women) often underrepresented in medical device clinical trials. By conducting one such meta-analysis, the FDA found that women benefit from cardiac resynchronization therapy (CRT) significantly more than men do. (more…)
Author Interviews, Cancer Research, Exercise - Fitness, Mayo Clinic / 24.06.2014

Xuemei Sui, MD, MPH, PhD Assistant Professor Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208MedicalResearch.com Interview with:  Xuemei Sui, MD, MPH, PhD Assistant Professor, Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208 MedicalResearch: What are the main findings of the study? Dr. Sui: In the present study, cancer survivors who reported performing resistance exercise (RE) at least 1 day of the week had a 33% lower risk of all-cause mortality compared with individuals who did not report participation in resistance exercise.  Further, there was an inverse relationship between resistance exercise and all-cause mortality in those who were physically active, but not in those who were physically inactive.  Although leisure-time physical activity was not associated with a lower risk of all-cause mortality, the present results support the benefits of resistance exercise and physical activity was during cancer survival. (more…)
Author Interviews, Heart Disease, Lancet / 24.06.2014

Professor Lixin Jiang MD, PhD, F.A.C.C. National Clinical Research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular Disease Fuwai Hospital, National Center for Cardiovascular Diseases Beijing , ChinaMedicalResearch.com Interview with: Professor Lixin Jiang MD, PhD, F.A.C.C. National Clinical Research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular Disease Fuwai Hospital, National Center for Cardiovascular Diseases Beijing , China MedicalResearch: What are the main findings of the study? Professor Jiang: In this first representative nationwide assessment of quality of care in China, we studied 13,815 hospital admissions for STEMI in 162 hospitals across China over the past decade. We found that the incidence of hospital admission for STEMI quadrupled from 3.7 per 100,000 in 2001 to 15.8 per 100,000 in 2011. There were substantial changes in testing and treatment patterns. Over the study period, the rate of testing for troponin increased from 21.4% in 2001 to 66.5% in 2011. Additionally, based at the ideal patients’ analysis, the use of several highly effective treatments for STEMI, including aspirin, clopidogrel and statins, improved over the study period. However, other therapies known to reduce mortality in STEMI patients – such as β-blockers and ACE inhibitors – were underused with only 57.7% of patients receiving beta-blockers and 66.1% ACE inhibitors respectively in 2011. While the proportion of patients receiving reperfusion therapy remained constant, there was a notable shift away from fibrinolysis, which was the primary means of reperfusion in 2001, towards primary PCI. However, in 2011, only 27.6% of patients admitted to Chinese hospitals for STEMI received primary PCI, the gold standard of treatment, while 27.4% received fibrinolytic therapy in the ideal patients. Despite increasing overall intensity of treatment, procedure use, and testing, no significant change in the rate of in-hospital death from STEMI was seen over the study period. (more…)
Author Interviews, Hospital Readmissions, JAMA, Surgical Research / 24.06.2014

Benjamin S. Brooke, M.D., Ph.D. Assistant Professor of Surgery Division of Vascular Surgery University of Utah School of MedicineMedicalResearch.com Interview with: Benjamin S. Brooke, M.D., Ph.D. Assistant Professor of Surgery Division of Vascular Surgery University of Utah School of Medicine MedicalResearch: What are the main findings of the study? Dr. Brooke: This study was designed to evaluate whether high-risk surgical patients who visit a primary care provider (PCP) during the early period following hospital discharge are less likely to be readmitted within 30-days.  We examined this question by performing a retrospective cohort analysis of Medicare beneficiaries (2003-2010) who underwent a high risk surgery (open thoracic aortic aneurysm repair) as well as a control group of patients who underwent a lower risk surgical procedure (open ventral hernia repair), and then determining whether there was evidence of early PCP follow-up. In risk-adjusted analyses, we found that early primary care provider-follow-up was associated with a significant lower likelihood of 30-day readmission for high-risk patients undergoing open thoracic aortic aneurysm repair, particularly if a post-operative complication had occurred.  In comparison, early primary care provider follow-up did not have a significant effect on lowering readmissions in uncomplicated patients and those undergoing lower-risk operations such as ventral hernia repair. (more…)
Author Interviews, Cognitive Issues, JAMA, Mayo Clinic / 24.06.2014

Prashanthi Vemur, Ph.D. Mayo Clinic Rochester, MinnesotaMedicalResearch.com Interview with: Prashanthi Vemur, Ph.D. Mayo Clinic Rochester, Minnesota   MedicalResearch: What are the main findings of the study? Dr. Vemuri: Lifetime intellectual enrichment might delay the onset of cognitive impairment and be used as a successful preventive intervention to reduce the impending dementia epidemic. We studied two non-overlapping components of lifetime intellectual enrichment: education/occupation-score and mid/late-life cognitive activity measure based on self-report questionnaires. Both were helpful in delaying the onset of cognitive impairment but the contribution of higher education/occupation was larger. (more…)
Author Interviews, JAMA, Pediatrics, Stanford, Surgical Research / 24.06.2014

Kay W. Chang, MD Associate Professor of Otolaryngology and Pediatrics Stanford University Department of Otolaryngology Lucile Packard Children's Hospital at Stanford Division of Pediatric OtolaryngologyMedicalResearch.com Interview with: Kay W. Chang, MD Associate Professor of Otolaryngology and Pediatrics Stanford University Department of Otolaryngology Lucile Packard Children's Hospital at Stanford Division of Pediatric Otolaryngology MedicalResearch: What are the main findings of the study? Dr. Chang: At 18 months after surgery, weight percentiles in the study group increased by a mean of 6.3 percentile points, and body mass index percentiles increased by a mean of 8.0 percentile points. The greatest increases in weight percentiles were observed in children who were between the 1st and 60th percentiles for weight and younger than 4 years at the time of surgery. An increase in weight percentile was not observed in children who preoperatively were already above the 80th percentile in weight. (more…)
Author Interviews, Cognitive Issues, Long Term Care / 23.06.2014

Regina Shih PhD Senior Behavioral Scientist at the RAND Corporation.MedicalResearch.com Interview with: Regina Shih PhD Senior Behavioral Scientist at the RAND Corporation.   MedicalResearch: What are the main findings of the study? Dr. Shih: RAND identified 25 high-impact policy options to improve the delivery, workforce, and financing of long term care, with a specific eye toward those with dementia and their caregivers. Undertaking these 25 policy options would achieve five goals: increasing public awareness of dementia and its signs and symptoms; improving access to long-term care; promoting high-quality, person-centered care like that offered at Lakeside Manor; providing better support for family caregivers; and reducing the burden of dementia costs on individuals and their families. Of these 25 policy options, we identified four unique options that have never been identified in any national plan on dementia or long-term care. This is likely because we focused on the intersection between dementia and long-term care, rather than just one or the other. And, rather than only focusing on actions that federal agencies can take, we identified policy options by interviewing 30 different stakeholders in the public and private sectors at the local, state, and national levels. These unique, high-impact policy options have to do with
  • Linking private health insurance with private long-term care insurance;
  • Including home and community-based services in state Medicaid plans;
  • Establishing cross-setting teams focused on returning the person with dementia to the community;
  • Expanding financial compensation to family caregivers.
(more…)
Author Interviews, Biomarkers, OBGYNE / 23.06.2014

MedicalResearch.com Interview with: Dr. Ali Abbara Imperial College London, United Kingdom Dr. Abbara: What are the main findings of the study? MedicalResearch: We found that a novel blood test for kisspeptin was able to identify asymptomatic pregnant women who were at increased risk of subsequent miscarriage. Blood kisspeptin performed better than the more commonly measured pregnancy hormone BHCG in identifying women at increased risk of miscarriage.  (more…)
Author Interviews, BMJ, Mental Health Research / 23.06.2014

Grégoire Rey Directeur du CépiDc CépiDc-Inserm Hopitâl Bicêtre FranceMedicalResearch.com Interview with: Grégoire Rey Directeur du CépiDc CépiDc-Inserm Hopitâl Bicêtre France MedicalResearch: What are the main findings of the study? Dr. Rey: We found that, between 2000 and 2010, unemployment and suicide rates were globally associatedin eight Western European countries (Austria, Finland, France, Germany, the Netherlands, Spain, Sweden, and the UK). However, this ecological association was weak (0.3% increase in suicide rate for a 10% increase in unemployment rate). Across countries, it was inconsistently confounded by the effect of other concomitant features of the economic crisis. MedicalResearch: Were any of the findings unexpected? (more…)
Accidents & Violence, Author Interviews, Race/Ethnic Diversity / 23.06.2014

Krim K. Lacey, PhD Research Fellow, Research Center for Group Dynamics Program for Research on Black Americans (PRBA) Institute for Social Research University of Michigan Ann Arbor, MIMedicalResearch.com Interview with: Krim K. Lacey, PhD Research Fellow, Research Center for Group Dynamics Program for Research on Black Americans (PRBA) Institute for Social Research University of Michigan Ann Arbor, MI MedicalResearch: What are the main findings of the study? Dr. Lacey: The main findings from this nationally representative study were that U.S. Black women abused by a domestic partner, on a whole were vulnerable to various negative physical and mental health problems. While the findings of the study support the few previous studies conducted on women within this population, this study was the first population-based, predominantly black sample that used structured clinical assessments. Importantly, the study substantiates other arguments that the Black population is not culturally monolithic, that African American and Caribbean Black women are affected differently by severe intimate partner violence. Another key finding was the association identified between eating disorders and intimate partner violence, which in general, has been largely underexplored. Finally, the study provided national information on the health outcomes of Caribbean Black women; one of the fastest growing subgroups within the Black population. (more…)
Author Interviews, Blood Pressure - Hypertension, Geriatrics / 23.06.2014

Dr. Michele Callisaya Faculty of Medicine, Nursing & Health Sciences Monash University, ClaytonMedicalResearch.com Interview with:  Dr. Michele Callisaya Faculty of Medicine, Nursing & Health Sciences Monash University, Clayton MedicalResearch: What are the main findings of the study? Dr. Callisaya: Falls are common in older people and can lead to hip fracture and loss of mobility.  Blood pressure reducing medications are commonly taken by older people to protect against heart attacks and stroke, but may have some unwanted side effects such as light-headedness and loss of balance.  We found that older people who were on large doses of such medications were at increased risk of falling. (more…)
Author Interviews, Cancer Research, CHEST, Critical Care - Intensive Care - ICUs, University of Michigan / 22.06.2014

Colin R. Cooke, MD, MSc, MS; Assistant Professor of Medicine, Division of Pulmonary & Critical Care Medicine Faculty, Center for Healthcare Outcomes & Policy University of MichiganMedicalResearch.com Interview with: Colin R. Cooke, MD, MSc, MS; Assistant Professor of Medicine, Division of Pulmonary & Critical Care Medicine Faculty, Center for Healthcare Outcomes & Policy University of Michigan MedicalResearch: What are the main findings of the study? Dr. Cooke: There were three primary findings from our study. First, we determined that between 1992 and 2005 there was almost a 40% increase in the number of admissions to an intensive care unit (ICU) among patients with lung cancer who were hospitalized for reasons other than surgical removal of their cancer. Second, most of this increase was because doctors were admitting these patients to intermediate intensive care units. These are units that provide greater monitoring and nurse staffing than typically available in general hospital wards, but usually also have less ability to provide life support measures than full service ICUs. Third, over the same period the reasons for ICU admission have changed. Although the most common reason for admission continues to be for problems related to the patients’ lung cancer, problems such as breathing difficulties requiring a ventilator and severe infections are increasingly common. These findings suggest that although overall use of the ICU for patients with lung cancer is increasing over time, providers may be shifting some of the intensive care for lung cancer patients toward less aggressive settings such as the intermediate care unit. (more…)
Author Interviews, Stroke, Wake Forest / 22.06.2014

Cheryl Bushnell, MD, MHS Associate Professor of Neurology Director, Wake Forest Baptist Stroke Center Wake Forest Baptist School of Medicine Winston Salem, NC 27157MedicalResearch.com Interview with: Cheryl Bushnell, MD, MHS Associate Professor of Neurology Director, Wake Forest Baptist Stroke Center Wake Forest Baptist School of Medicine Winston Salem, NC  27157 MedicalResearch: What are the main findings of the study? Dr. Bushnell: We found that readmitted patients were significantly more likely to have more severe strokes, and to have been hospitalized two or more times during the year prior to the initial stroke admission, independent of other clinical factors, such as congestive heart failure, heart disease, or stroke complications (pneumonia, acute renal failure). (more…)
Author Interviews, NEJM, Rheumatology / 21.06.2014

Bethanie Wilkinson, Ph.D. Pfizer 445 Eastern Point Rd. Groton, CT 06340MedicalResearch.com Interview with Bethanie Wilkinson, Ph.D. Pfizer 445 Eastern Point Rd. Groton, CT 06340   MedicalResearch: What are the main findings of the study? Dr. Wilkinson: ORAL Start showed that XELJANZ (tofacitinib citrate) 5 and 10 mg twice daily (BID), taken by itself without methotrexate (MX), inhibited the progression of structural damage and reduced the signs and symptoms of rheumatoid arthritis (RA), and was statistically significantly superior to methotrexate on these measures at Month 6 (primary endpoint) and at all measured time points up to 24 months in patients with rheumatoid arthritis who had not previously received methotrexate or therapeutic doses of methotrexate.  XELJANZ is not indicated in patients who had not previously received methotrexate.
  •  Both doses of XELJANZ met the study’s co-primary efficacy endpoints of mean change from baseline in van der Heijde modified Total Sharp Score (mtss) [0.18 and 0.04 (both P<0.001) for tofacitinib 5 and 10 mg BID, respectively, versus 0.84 for MTX], and ACR70 response rates [25.5% and 37.7% for tofacitinib 5 and 10 mg BID (both P<0.001) versus 12.0% for MTX], at Month 6.
  • These results were sustained at all measured time points up to 24 months.
(more…)
Author Interviews, Johns Hopkins, Pancreatic / 21.06.2014

Lei Zheng, M.D., Ph.D. Assistant Professor of Oncology and Surgery Gastrointestinal Cancer Program Division of Immunology The Sidney Kimmel Comprehensive Cancer Center and Department of Oncology Johns Hopkins University School of Medicine The Bunting-Blaustein Cancer Research Building (CRB1) Baltimore, MD 21231MedicalResearch.com Interview with: Lei Zheng, M.D., Ph.D. Assistant Professor of Oncology and Surgery Gastrointestinal Cancer Program Division of Immunology The Sidney Kimmel Comprehensive Cancer Center and Department of Oncology Johns Hopkins University School of Medicine The Bunting-Blaustein Cancer Research Building (CRB1) Baltimore, MD 21231 MedicalResearch: What are the main findings of the study? Dr. Zheng: This study shows for the first time that treatment with a vaccine-based immunotherapy directly re-programs the pancreatic cancer microenvironment, allowing the formation of lymphoid aggregates, which are organized, lymph node-like, functional immune structures and which convert an immunologically quiescent tumor into an immunologically active tumor.  (more…)
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…)