MedicalResearch.com Interview with: William Kronenberger, Ph.D., HSPP
Professor and Director, Section of Psychology
Acting Vice Chair of Administration
Department of Psychiatry
Indiana University School of Medicine
Riley Child and Adolescent Psychiatry Clinic
MedicalResearch: What are the main findings of the study?Dr. Kronenberger: The main findings of the study are that children with cochlear implants had two to five times the risk of delays in executive functioning compared to children with normal hearing. Executive functioning is the ability to regulate and control thinking and behavior in order to focus and achieve goals; it is important for everything from learning to social skills. The areas of executive functioning that were most affected in children with cochlear implants were working memory, controlled attention, planning, and concept formation. Approximately one-third to one-half of the sample of children with cochlear implants had at least mild delays in these areas, compared to one-sixth or fewer of the normal-hearing sample. We think that reduced hearing experience and language delays cause delays in executive functioning to occur at higher rates in children with cochlear implants.
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MedicalResearch.com Interview with:David T. Gilbertson, Ph.D.
Chronic Disease Research Group
Center for Observational Research, Amgen, Inc, Thousand Oaks, CA
MedicalResearch: What were the main findings of the study?Dr. Gilbertson: Since transfusion avoidance is important in patients receiving maintenance hemodialysis, development of a measure of red blood cell transfusion use to assess dialysis facility anemia management is reasonable. Because dialysis facility size varies widely, calculation of a standardized transfusion ratio (STfR) using standard methods is possible, but these methods result in significant instability in estimates for small dialysis facilities. Use of more advanced statistical methods results in standardized transfusion ratio estimates that are considerably more stable and more consistently precise across dialysis facilities of all sizes.
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MedicalResearch.com Interview with:Dr. Duncan M. Chanda MD
Institute for Medical Research & Training and UNZA-UCLMS
Research and Training Project
University Teaching Hospital
Lusaka, Zambia
MedicalResearch: What are the main findings of the study?Dr. Chanda:The main findings are that in this cohort of relatively healthy patients, with a median CD4 of 367, ART can be delayed till the end of TB short course chemotherapy without deleterious effects. This differs from studies that looked at cohorts with very low median CD4 ( around 25-150 in most cases) in which early cART was found to reduce mortality and other AIDS defining events.
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MedicalResearch.com Interview with Dr. Derek Radisky PhD
Associate Professor and Consultant
Mayo Clinic Cancer Center
MedicalResearch: What are the main findings of the study? Dr. Radisky: The study used human tissue biopsies to find that production of matrix metalloproteinse-3 (MMP3) in pancreatic cancer biopsies was associated with poorer patient prognosis, and showed through transgenic animal and cell culture experiments that this was due to activation of the oncogenic protein Rac1b. The study thus identifies an MMP3-Rac1b signaling axis that drives pancreatic cancer progression.
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MedicalResearch.com Interview with: Scott A. Gruber, M.D., Ph.D., MBA, FACS, FCP, FACHE, CPE
Chief of Staff, John D. Dingell VA Medical Center
Associate Dean for Veterans Affairs & Professor of Surgery
Wayne State University School of Medicine
John D. Dingell VA Medical Center Chief of Staff
Detroit, MI 48201
MedicalResearch: What are the main findings of the study?Dr. Gruber: We successfully addressed the problem of inadequate intracellular delivery of tumor- specific antigens (TSAs) to dendritic cells (DCs) by using synthetic cell-penetrating domains or peptides (CPPs) to create fusion tumor antigens (Ags) that readily penetrate through the plasma membrane. We demonstrated cloning and purification of the TSA melanoma-associated antigen 3 (MAGE-A3) in frame with CPP, producing enhanced cytosolic bioavailability in dendritic cells without altering cell functionality. Further, we showed that recombinant bacterial proteins can be easily engineered to purify large amounts of CPP-MAGE-A3. Use of full-length proteins circumvents the need to define HLA class I allele binding before vaccination and increases the number of epitopes recognized by CD8+ cytotoxic T lymphocytes (CTLs) when compared with peptide-pulsed dendritic cells. Finally, the use of proteins rather than plasmids or viral vectors for in vitro dendritic cell vaccine preparation avoids the practical and theoretical safety concerns regarding genomic modification.
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MedicalResearch.com Interview with:Michael T. C. Poon, MBChB, BMedSci (Hons)
Junior Doctor, Wycombe General Hospital
Buckinghamshire Healthcare NHS Trust, UK
MedicalResearch: What are the main findings of the study?Dr. Poon: At present, we know that the incidence and one-month case fatality of intracerebral haemorrhage (ICH) have remained static for the past two decades. However, any trend in long-term survival after ICH is less clear. Survivors face the risks of recurrent ICH as well as ischaemic events in the future. The balance between these risks has particular clinical implication on the decision about restarting antiplatelet/anticoagulant therapy after ICH. To address these questions, we undertook a systematic review and meta-analysis to determine whether long-term survival after intracerebral haemorrhage has changed over time, and to re-assess the balance between the risks of recurrent ICH and ischaemic events in studies quantifying both of these risks in the same population.
The survival rates after ICH at 1 year and 5 years do not appear to have changed over time – 1 year survival was 46% and 5 year survival was 29%. The risk of recurrent ICH may be influenced by the ICH location, with lobar ICH having a higher rate of recurrence. In contrast to the previous systematic review, we found the risk of ischaemic stroke to be at least as high as the risk of recurrent ICH over 3 years after ICH. This reinforces the difficulty that clinicians and patients have in deciding about antithrombotic treatment after ICH.
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MedicalResearch.com Interview with:Seok-Yong Lee, Ph.D.
Assistant Professor of Biochemistry and
Ru-Rong Ji, Ph.D.
Distinguished Professor of Duke University
Professor of Anesthesiology and Neurobiology
Chief of Pain Research
Duke University Medical Center
Durham, NC 27710
MedicalResearch: What are the main findings of the study? Answer:We have developed an antibody that can block the pain and itching sensations in mice simultaneously with high efficacy. We would like to point out that our discovery has the potential to be applied to human once the antibody is humanized. Given the high selectivity, general safety profile, and long half-lives of monoclonal antibodies, this method we developed to raise antibodies against therapeutic targets (e.g., ion channels) can have broad applications to other diseases.
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MedicalResearch.com Interview with:Dr. Sarah Hawley PhD MPH
Associate Professor in the Division of General Medicine
University of Michigan
Research Investigator, Ann Arbor VA Center of Excellence in Health Services Research & Development
MedicalResearch: What are the main findings of the study?Dr. Hawley: There are a couple of main findings.
First, we found that nearly 20% of women in our population based sample of breast cancer patients reported strongly considering having contralateral prophylactic mastectomy (CPM, which means they had their unaffected breast removed at the same time as the breast with cancer), and about 8% received it. Of those who did receive contralateral prophylactic mastectomy, most (about 70%) did not have a clinical indication for it, which included a positive genetic mutation of BRCA1 or BRCA2 or a strong family history of breast or ovarian cancer.
However, most women (90%) who received it reported having a strong amount of worry about the cancer coming back (also called worry about recurrence).
We also found that when women had an MRI as part of their diagnostic work-up for breast cancer, they more often received contralateral prophylactic mastectomy than when they did not have an MRI.
MedicalResearch.com Interview with:Bríain ó Hartaigh, Ph.D.
Assistant Research Professor of Epidemiology
Dalio Institute of Cardiovascular Imaging
NewYork-Presbyterian Hospital and the Weill Cornell Medical College
Belfer Research Building New York, NY 10021
MedicalResearch: What are the main findings of the studyDr. Hartaigh: Elevated resting heart rate (RHR) during childhood and midlife are associated with an increased risk of all-cause mortality.
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MedicalResearch.com Interview with:
MedicalResearch.com Interview with:
Albert L. Siu, MD, MSPH
Co-Vice Chair
Mount Sinai School of Medicine, New York
MedicalResearch: What are the main...
MedicalResearch.com Interview with:Edward Giovannucci, MD, ScD
Department of Nutrition
Harvard School of Public Health
Boston, MA
MedicalResearch: What are the main findings of the study?Dr. Giovannucci: In 50,000 men followed over 24 years, we found that those regularly consuming tomato products, which are high in lycopene, had a 30% lower risk of developing lethal prostate cancer. Among men being screened regularly with PSA, the risk reduction from high tomato consumption was 50%. We also examined the prostate cancer tissue and found that higher dietary lycopene intake was associated with less new blood vessel formation, which may help explain why the cancers were less likely to progress.
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MedicalResearch.com Interview with:Neel M. Butala, AB
Medical student at Yale School of Medicine
New Haven, Connecticut
MedicalResearch.com: What are the main findings of the study?
Answer: We found that patients with diabetes had a disproportionate reduction in in-hospital mortality relative to patients without diabetes over the decade from 2000 to 2010.
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MedicalResearch.com Interview with:
Unab I. Khan, M.B.,B.S., M.S.
Assistant Professor of Pediatrics and Family & Social Medicine
Division of Adolescent Medicine
The Children’s Hospital at Montefiore
The Pediatric Hospital for Albert Einstein College of Medicine
Bronx, NY 10467
MedicalResearch: What are the main findings of the study?Dr. Khan: We wanted to find factors that lead to either an increase or decrease in risk of developing cardiovascular disease. We found that in middle aged overweight and obese women, who may not have any medical problems like diabetes, high blood pressure, high cholesterol, an increase in weight over time and the development of any of the conditions stated above, increased the risk of cardiovascular disease significantly.
On the other hand, even moderate physical activity decreased the risk of heart disease, even in the presence of the above stated conditions.(more…)
MedicalResearch.com Interview with:Scott Stroup, MD, MPH
Professor of Psychiatry
Director, Program for Intervention Effectiveness Research,
Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric InstituteDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
MedicalResearch: What are the main findings of the study?Dr. Stroup:We conducted a study sponsored by the National Institute of Mental Health that compared long-acting injectable antipsychotics for people with schizophrenia. Long-acting injectable antipsychotics, also known as depot antipsychotics, are used to promote treatment adherence. We compared a newer injectable antipsychotic, paliperidone palmitate, to an older one, haloperidol decanoate. We did not find an advantage for the newer drug in overall effectiveness. The drugs performed very similarly, and were tolerated about the same.
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MedicalResearch.com Interview with:Susan Farr, Ph.D.
Research Professor of Geriatrics
Saint Louis University
MedicalResearch: What are the main findings of the study?Dr. Farr:We found that reducing the conversion of amyloid precursor protein (APP) to beta amyloid with an antisense targeting the beta amyloid portion of amyloid precursor protein in the Tg2576 mouse which overexpresses human beta amyloid, improves learning and memory and reduces neuroinflammatory cytokine (inflammation in the brain).
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MedicalResearch.com Interview with: Dr. Robin Voigt PhD
Department of Internal Medicine
Division of Gastroenterology
Rush University Medical Center
Chicago, Illinois
MedicalResearch: What are the main findings of the study? Dr. Voigt:We found that chronic circadian rhythm disruption has no effect on the intestinal microbiota when mice are fed a standard chow diet but when combined with a high-fat, high-sugar diet circadian rhythm disruption results in intestinal dysbiosis and an increase in pro-inflammatory bacteria.
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MedicalResearch.com Interview with:Jonathon D. Truwit, MD, MBA
Enterprise Chief Medical Officer
Sr. Administrative Dean
Froedtert-Medical College of Wisconsin
Milwaukee, WI 53226
MedicalResearch.com: What are the main findings of the study?Dr. Truwit: Rosuvastatin did not reduce mortality, nor days free of the breathing machine, in patients with sepsis-associated acute respiratory distress syndrome (ARDS). One in four patients with ARDS die.
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MedicalResearch.com Interview with: Christopher Labos MD CM, FRCPC,MSc candidate
Division of Epidemiology, Biostatistics and Occupational Health
McGill University
Montreal, Quebec Canada
MedicalResearch: What are the main findings of the study?Dr. Labos:A higher genetic risk score (GRS) composed of a set of recently discovered genetic markers strongly linked to cardiovascular disease is associated with an earlier age of first acute coronary syndromes (ACS). We also found that other traditional risk factors such as smoking, obesity and male sex were also associated with an earlier ACS. Two medication classes were also associated with age of first ACS: hormone replacement therapy was associated with earlier ACS while aspirin was associated with ACS occuring at a later age.
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MedicalResearch.com Interview with:Wei Bao MD, PhD
Postdoc fellow, Epidemiology Branch
Division of Intramural Population Health Research
NICHD/National Institutes of Health
Rockville, MD 20852
MedicalResearch: What are the main findings of the study?Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are:
(1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI).
(2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI.
(3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI.
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MedicalResearch.com Interview with: Malene Nøhr Demant
Department of Cardiology
Copenhagen University Hospital Gentofte
Hellerup, Denmark
MedicalResearch: What are the main findings of the study?Dr. Demant:Our study shows that increasing severity of heart failure is associated with an increased risk of developing diabetes. Increasing loop-diuretic dosage was used as a proxy for heart failure severity. Patients with the most severe heart failure were three times more likely to develop diabetes than those with the least severe. Patients who were also being treated with ACE inhibitors (angiotensin-converting-enzyme inhibitors) had a less pronounced increase in diabetes risk.
Patients who developed diabetes were 16% more likely to die than those who did not develop diabetes.
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MedicalResearch.com Interview with:Nileshkumar J. Patel MD
Staten Island University Hospital
Staten Island, NY, 10304 and
Abhishek J. Deshmukh MD
University of Arkansas
Little Rock, AR
MedicalResearch: What are the main findings of the study?Answer: We analyzed data from almost 4 million hospitalizations for atrial fibrillation (AF) from more than 1,200 hospitals across 45 states in last decade, and found that
- Hospitalization rates for atrial fibrillation have increased exponentially among US adults during the past 10 years, particularly in those 65 years or older.
- The most frequent coexisting conditions were hypertension (59.99%), diabetes (21.47%) and chronic pulmonary disease (20.01%).
- In terms of geographic distribution of admissions, the hospitals in the South constitute (38.5%) the highest percentage of atrial fibrillation hospitalizations, followed by Midwest (24.9%), Northeast (22.2%) and West (14.4%).
- Overall in-hospital mortality was 1%. The mortality rate was highest in >80 years age group (1.93%) and patients with concomitant heart failure (8.2%).
- The percentage of patients discharged to nursing facility increased from 8.1% in 2000 to 11.5% in 2010 and need for home health care increased from 6.7% to 13.1%. Approximately one fourth of the patients (25.83%) were discharged to long-term care institution if atrial fibrillation hospitalization was complicated by acute ischemic stroke.
- Mean cost of AF hospitalization increased significantly from $6,410 in 2001 to $8,439 in 2010 (24.04% increase, p <0.001) even after adjusting for inflation. This represents an absolute increment in annual national cost from approximate 2.15 billion dollars in 2001 to 3.46 billion dollars in 2010. The mean cost of care was highest if AF hospitalization was associated with heart failure ($33,161) and valvular disorders ($28,030).
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MedicalResearch.com Interview with:James Chamberlain, MD
Division Chief, Emergency Medicine
Children’s National Health System
Washington, DC
MedicalResearch: What are the main findings of the study?Dr. Chamberlain: Contrary to our hypothesis, lorazepam was not superior to diazepam for treating pediatric seizures. Both medications had similar effectiveness (72-73%) and safety (15-16% incidence of assisted ventilation). Lorazepam caused a longer period of sedation prior to waking up. The difference was approximately 15 minutes.
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MedicalResearch.com Interview Professor Kim Bennell
ARC Future Fellow
Department of Physiotherapy
University of Melbourne
Parkville, Vic 3010 Australia
MedicalResearch: What are the main findings of the study?Professor Bennell: In 102 people with painful hip osteoarthritis, we compared a 'real' physical therapy program involving exercise, manual therapy techniques,education and provision of a cane if appropriate to a sham physical therapy treatment that was made to look as though it was real but instead involved turned off ultrasound and gentle application of a hand crème to the hip region. Participants in both groups went to see a physical therapist on 10 occasions over 12 weeks and performed home exercises if in the 'real' physical therapy group or lightly applied the cream at home if in the sham group. Participants were followed for 9 months in total. We found that while both groups showed improvements in pain and physical function, the improvements were similar between the two groups. That is, the real physical therapy program did not show greater benefits over a sham treatment. (more…)
MedicalResearch.com Interview with:Vicki Fung, Ph.D.
Assistant Professor
Department of Medicine, Harvard Medical School
Mongan Institute for Health Policy, Massachusetts General Hospital
MedicalResearch: What are the main findings of the study?Dr. Fung: We found that lower income parents of children with asthma were more likely to delay or avoid taking their children to a doctor's office visit or to the emergency room if they had to pay higher out-of-pocket costs for care; they were also more likely to report borrowing money to pay for asthma care.
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MedicalResearch Interview with: Charles D. Scales, Jr MD MSHS
Assistant Professor of Surgery
Division of Urologic Surgery
Duke University Medical Center
MedicalResearch: What are the main findings of the study?Dr. Scales:When it comes to treating kidney stones, less invasive is not always better.
We used the best method short of a randomized trial to balance out patients in terms of factors that might influence the success of treatment. In other words, we achieved a “statistical toss-up” for factors that could influence the outcome of the procedure.
When we balanced out all of the factors that might influence the chance of a repeat procedure, we found that about 11% of patients treated with non-invasive SWL had a repeat procedure, as compared to <1% with minimally invasive URS.
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MedicalResearch.com Interview with:
Nathalie E. Holz, MA
Department of Child and Adolescent Psychiatry and Psychotherapy
Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany MedicalResearch: What are the main findings of the study?Dr. Holz: Using data from a prospective community sample followed since birth, we investigated the impact of prenatal maternal smoking on lifetime Attention-Deficit/ Hyperactivity Disorder (ADHD) symptoms and on brain structure and inhibitory control assessed with Magnetic Resonance Imaging in the adult offspring. Those who were prenatally exposed to tobacco not only exhibited more ADHD symptoms, but also showed decreased activity in the inhibitory control network encompassing the inferior frontal gyrus as well as the anterior cingulate cortex. Activity in these regions was inversely related to lifetime ADHD symptoms and novelty seeking, respectively. In addition volume in the inferior frontal gyrus was decreased in these participants.
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MedicalResearch.com Interview with:Colleen K. McIlvennan, DNP, ANP
Assistant Professor of Medicine
University of Colorado, Division of Cardiology
Section of Advanced Heart Failure and Transplantation
MedicalResearch: What are the main findings of the study?Answer: We interviewed 22 patients who were offered destination therapy left ventricular assist devices (DT LVAD), 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an overriding desire to live as long as possible: [LVAD] was the only option I had…that or push up daisies…so I automatically took this. In contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: There are worse things than death. Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually.
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MedicalResearch.com Interview with:Dr. Price Kerfoot MD, EdM
Rabkin Fellow in Medical Education
Associate Professor of Surgery, Harvard Medical School
MedicalResearch: What are the main findings of the study?Dr. Kerfoot:
(1) An online spaced education game improved clinicians' knowledge of hypertension intensification and generated a modest but significant improvement in time to blood pressure target among their patients with hypertension.
(2) As a method to increase clinicians' long-term knowledge, the spaced education game was significantly more effective than providing the identical content via a traditional method (online posting with e-mail reminders).
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MedicalResearch.com Interview with: Adnan Custovic DM MD PhD FRCP
Professor of Allergy
Institute of Inflammation and Repair
University of Manchester
University Hospital of South Manchester
Manchester M23 9LT, UK
MedicalResearch: What are the main findings of the study?Dr. Custovic: In a longitudinal analysis of the data from our birth cohort study collected from birth to age eleven years, we demonstrated an association between early-life antibiotic prescription and development of wheezing, but not atopy. Furthermore, amongst children with wheezing, antibiotic prescription in infancy increases the risk of subsequent severe wheeze/asthma exacerbations and hospital admissions. This is the first demonstration that children who receive antibiotics in infancy have impaired antiviral immunity later in life, and that early-life antibiotic prescription is associated with variants on chromosome 17q21 locus (which is an asthma susceptibility locus).
Our findings suggest that the association between antibiotics and childhood asthma reported in previous studies arises through a complex confounding by indication, in which hidden factors which increase the likelihood of both antibiotic prescription in early life and subsequent asthma development are increased susceptibility to virus infections consequent to impaired antiviral immunity, and genetic variants on 17q21. Our results raises an important issue that effects which are often attributed to environmental exposures may be a reflection of genetic predisposition.
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MedicalResearch Interview with:Dr. Gerard J. CrinerMD, FACP, FACCP
Professor, Medicine
Director, Medical Intensive Care Unit and Ventilator Rehabilitation Unit
Co-Director, Center for Inflammation, Translational and Clinical Lung Research, Temple University Hospital in Philadelphia, PA
MedicalResearch: What are the main findings of the study?Dr. Criner: The STATCOPE Trial (Simvastatin in the Prevention of COPD Exacerbations) found that a statin drug commonly used to lower cholesterol is not effective in reducing the number and severity of flare ups from chronic obstructive pulmonary disease (COPD). The study rigorously tested the hypothesis that statin drugs may be beneficial to persons with COPD because of the drugs’ purported anti-inflammatory effect. However, researchers found that:
40 mg. of daily simvastatin (statin drug) added to usual care did not reduce exacerbation rate or prolong the time to exacerbation in patients with moderate to severe COPD.
Simvastatin had no effect on lung function, quality of life, severe adverse events or mortality.
The data do not demonstrate a therapeutic benefit from statins in patients with moderate to severe COPD.
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