Author Interviews, JAMA, Statins / 14.05.2014

Medidr_jennifer_robinsoncalResearch.com Interview with: Jennifer G. Robinson, MD, MPH Professor ,Departments of Epidemiology & Medicine Director, Prevention Intervention Center Department of Epidemiology College of Public Health University of Iowa Iowa City, IA 52242-2007 MedicalResearch: What are the main findings of the study? Dr. Robinson: The PCSK9 antibody, evolocumab, reduced LDL (or bad) cholesterol by about 65-70% regardless of the dose or type of statin used. This is a greater percentage reduction than ezetimibe, another drug used to lower LDL cholesterol in statin-treated patients, which lowered LDL cholesterol 15-20%. Side effects of evolocumab were similar to those for ezetimibe or placebo. (more…)
Author Interviews, Diabetes, Diabetologia, Exercise - Fitness, Sugar / 14.05.2014

MedicalResearch Interview with: Monique Francois Teaching Fellow & Research Assistant at the University of Otago School of Physical Education, Sport and Exercise Sciences University of Otago Dunedin, New Zealand MedicalResearch: What are the main findings of the study? Answer: We found that small 'snacks' of interval exercise before the three main meals lowered postprandial blood glucose and contributed to a lower blood glucose across the day. Whereas 30 minutes of continuous moderate exercise before dinner did not lower postprandial blood glucose nor mean glucose levels the exercise day or the following day, compared to exercise snacking. Six one minute intervals as walking or a combination of walking and resistance 3x per day (before the three main meals) improved glycaemic control in individuals with insulin resistance. (more…)
AHA Journals, Author Interviews, Nutrition, Stroke / 14.05.2014

MedicalResearch Interview with: Dr. Yan Qu Qingdao Municipal hospital Fruits and Vegetables Consumption and Risk of Stroke A Meta-Analysis of Prospective Cohort Studies MedicalResearch: What are the main findings of the study? Reply: First, both fruits and vegetables were found inversely associated with risk of stroke, and the relationships might be linear. Second, the inverse association of fruits and vegetables consumption with risk of stroke is consistent across subgroup analysis by outcome (stroke incidence and stroke mortality), location where the study was conducted (USA, Europe and Asia), sex (male and female), and stroke subtypes (ischemic and hemorrhagic). Third, citrus fruits, leafy vegetables and apples/pears were found inversely associated with risk of stroke. Fourth, very similar results were found in the subgroup analysis by status [yes: 0.78 (0.71-0.86) or no: 0.79 (0.74-0.85)] of adjusting for 6 or more of the 7 covariates (smoking, alcohol, blood pressure/hypertension, serum cholesterol, physical activity, body mass index, ≥3 dietary variables). These findings generally indicated that the association of fruits and vegetables consumption with the reduced risk of stroke may not be the result of confounding by the known factors. (more…)
Author Interviews, Diabetes, Heart Disease, Karolinski Institute, Lancet / 14.05.2014

MedicalResearch.com Interview with: Viveca Ritsinger MD Karolinska Institute, Department of Medicine, Cardiology Unit, Karolinska University Hospital, Stockholm Unit for Research and Development Kronoberg County Council, Växjö, Sweden MedicalResearch: What are the main findings of the study? Dr. Ritsinger: This is a long-term follow-up of the Swedish DIGAMI 1 study where patients with acute myocardial infarction and diabetes were randomized to either intensified insulin-based glycaemic control or to standard glucose lowering treatment. Patients and controls were followed for mortality for over 20 years and 90% of the patients died during follow up. Survival improved during a period of about 8 years. Intensified insulin-based glycaemic control increased survival time by an average of 2.3 years. (more…)
Author Interviews, General Medicine, Heart Disease, Statins / 14.05.2014

MedicalResearch.com Interview with Dr. Michael Johansen, MD, MS Department of Family Medicine The Ohio State University Columbus, OH 43201 MedicalResearch: What are the main findings of the study? Dr. Johansen: We found a surprisingly low number of people with coronary artery disease and diabetes (over age 40) were not reporting statin use. Of the people with coronary artery disease only 58% reported statin use while 52% of people with diabetes reported use. In addition, a reported diagnosis of hyperlipidemia was strongly correlated with statin use. In fact, individuals with hyperlipidemia and no coronary artery disease were more apt to be on a statin than people with coronary artery disease and no hyperlipidemia. Other high-risk conditions that have recently been included in the ACC/AHA high risk category were weakly or not associated with statin use including stroke and peripheral arterial disease. (more…)
Author Interviews, Cancer Research, Dartmouth / 14.05.2014

Gregory J. Tsongalis, PhD, HCLD, CC, FNACB Professor of Pathology Director, Molecular Pathology Co-Director, Translational Research Program Department of Pathology Dartmouth Hitchcock Medical Center and The Audrey and Theodor Geisel School of Medicine at Dartmouth Lebanon, NH 03756MedicalResearch.com Interview with: Gregory J. Tsongalis, PhD, HCLD, CC, FNACB Professor of Pathology Director, Molecular Pathology Co-Director, Translational Research Program Department of Pathology Dartmouth Hitchcock Medical Center and The Audrey and Theodor Geisel School of Medicine at Dartmouth Lebanon, NH 03756 MedicalResearch: What are the main findings of the study? Dr. Tsongalis: This was the first study of its kind looking at multiple genes and multiple mutations in tumors of the appendix. Many of the identified mutations may be clinically actionable with respect to response to therapy or selection of therapy. (more…)
Author Interviews, Mental Health Research, Schizophrenia / 13.05.2014

prof_jayashri_kulharniMedicalResearch.com Interview with: Professor Jayashri Kulkarni MBBS, MPM, FRANZCP, PhD Monash University MedicalResearch.com: What are the main findings of the study? Professor Kulkarni: Persistent schizophrenia is difficult and unfortunately common, despite advances over the past years in antipsychotic drug development. New treatment approaches are urgently needed. Also, a specific focus for women with schizophrenia is still somewhat lacking and there is a need to consider the special issues facing women with schizophrenia. Over many years, we have been conducting clinical trials to develop the role of adjunctive estradiol use to treat symptoms of schizophrenia. This study is the largest clinical trial in the world of this type and we found that in an 8 week, three arm, double blind, placebo-controlled, adjunctive trial of transdermal estradiol (200mcg v 100mcg v placebo) in 183 women with schizophrenia, that the women who received either 200mcg or 100mcg transdermal estradiol made a better recovery. The women who received 200mcg transdermal estradiol made a slightly better recovery than women receiving 100mcg transdermal estradiol. Both estradiol groups were significantly better than the group who received adjunctive transdermal placebo. (more…)
AHA Journals, Author Interviews, Health Care Systems, Hospital Readmissions, Medicare / 13.05.2014

Alex Blum, MD MPH FAAP Chief Medical Officer Evergreen Health, Baltimore MD 21211MedicalResearch.com Interview with: Alex Blum, MD MPH FAAP Chief Medical Officer Evergreen Health, Baltimore MD 21211 MedicalResearch.com: What are the main findings of the study? Dr. Blum: Accounting for the social risk of patients using a measure of neighborhood socioeconomic status (SES), did not alter the hospital rankings for congestive heart failure (CHF) readmission rates. (more…)
Author Interviews, Hospital Readmissions, JAMA, Mayo Clinic / 13.05.2014

Aaron L. Leppin, MD Knowledge and Evaluation Research Unit Mayo Clinic, Rochester, MinnesotaMedicalResearch.com Interview with: Aaron L. Leppin, MD Knowledge and Evaluation Research Unit Mayo Clinic, Rochester, Minnesota MedicalResearch.com: What are the main findings of the study? Dr. Leppin: We conducted a systematic review and meta-analysis of randomized trials assessing the effectiveness of hospital discharge interventions on reducing 30-day readmission rates. We identified 47 trials, 42 of which contributed to the primary meta-analysis. Overall, the interventions that have been tested to reduce early hospital readmissions reduce them by about 20%. The ones that are most effective, though, reduce them by almost 40% and use a consistent but complex approach. These interventions make a robust effort to fully understand the patient’s post-discharge context, often by visiting the patient’s home. They focus on identifying all the things the patient needs to do to be well—whether that’s organizing medications, getting a ride to the clinic, or paying the electric bill—and they determine whether the patient has the necessary resources and capacity to pull it all off. When limitations are found, these interventions have a strategy in place to support the patient through the post-discharge period. (more…)
Author Interviews, JAMA, Pediatrics / 13.05.2014

Charbel El Bcheraoui, PhD, MSc Acting Assistant Professor, Global Health Institute for Health Metrics and Evaluation University of Washington Seattle, WA 98121MedicalResearch Interview with: Charbel El Bcheraoui, PhD, MSc Acting Assistant Professor, Global Health Institute for Health Metrics and Evaluation University of Washington Seattle, WA 98121 MedicalResearch: What are the main findings of the study? Dr. El Bcheraoui: We found a low rate of adverse events associated with male circumcision from U.S. hospital settings, especially if the procedure is performed within the first year of life. The rate of adverse events increased about 10 - 20 times if the procedure was performed later in life. (more…)
Accidents & Violence, Author Interviews, CMAJ, OBGYNE / 13.05.2014

Professor, Full SGS Member Director, Clinical Epidemiology Unit Sunnybrook Health Sciences Centre G106-2075 Bayview Avenue Toronto, ON  Dr. Donald Redelmeier, MD Professor, Full SGS Member Director, Clinical Epidemiology Unit Sunnybrook Health Sciences Centre Toronto, ON MedicalResearch: What are the main findings of the study? Dr. Redelmeier: We identified every woman in Ontario, Canada, who gave birth to a newborn baby between 2006 and 2011 and then evaluated each driver for the months before, during, and after pregnancy.  This amounted to about half a million women who accounted for almost 8000 serious crashes that sent the driver to hospital.  We found that the second trimester of pregnancy led to a 42% increase in the risk of a serious motor vehicle crash.  The increased risk included diverse populations, distinct obstetrical cases, different crash characteristics. The risk equated to about twice the population norm but was still below male drivers at this age. (more…)
Author Interviews, Lancet, Mental Health Research / 13.05.2014

Dr Alexandra Pitman MBBS MRC Psych MRC Clinical Research Fellow, UCL Division of Psychiatry, UCL (University College LondonMedicalResearch.com interview with: Dr Alexandra Pitman MBBS MRC Psych MRC Clinical Research Fellow, UCL Division of Psychiatry, UCL (University College London MedicalResearch: What are the main findings of the study? Answer: We conducted a systematic review of all published research comparing the experience of suicide bereavement with bereavement due to other causes, in which we considered the evidence from 57 studies evaluating the effect of bereavement on death, mental health, and social functioning of family members, friends, and other close contacts of the deceased. These studies showed that parents and children bereaved by suicide were at higher risk of mental health problems after the loss than parents and children bereaved by other causes, and that spouses and mothers bereaved by suicide were at higher risk of suicide than spouses and mothers bereaved by other causes. We also found some evidence that people from a range of kinship groups bereaved by suicide report more rejection and shame than people bereaved by other violent deaths, and that feeling stigmatised by the death is commonly experienced after any violent bereavement. It seemed that people bereaved by violent deaths, for example due to accidental death, homicide, drug-related death, motor vehicle crash, undetermined death or suicide, shared a sense of feeling blamed for the death or tainted by their association with the deceased. (more…)
Author Interviews, Brigham & Women's - Harvard, Calcium, Heart Disease / 13.05.2014

Dr. Julie Paik, MD MPH Instructor, Harvard Medical School Brigham and Women's Massachusetts GeneralMedicalResearch.com Interview with: Dr. Julie Paik, MD MPH MSc Instructor, Harvard Medical School Brigham and Women's Hospital MedicalResearch: What are the main findings of the study? Dr. Paik: Many women in the United States take calcium supplements. One study found that over 60% of women aged 60 and over in the United States were taking calcium supplements. However, the medical community is still not certain of the effects of calcium supplements in women, particularly on cardiovascular disease risk. For this reason, we studied 74,245 women participating in the Nurses' Health Study over a 24-year follow-up period for their risk of developing cardiovascular disease (heart disease or stroke). We found that there was no increased risk of heart disease or stroke among women taking calcium supplements during the 24-year follow-up period. Our paper has several distinct strengths compared to prior studies including the large sample size, long follow-up period, cases of cardiovascular disease that were confirmed by medical record review, detailed and repeated assessment of calcium supplement use, and detailed information about other risk factors for cardiovascular disease. (more…)
Aging, Author Interviews, JAMA / 12.05.2014

Richard D. Semba, MD MPH W. Richard Green Professor of Ophthalmology The Johns Hopkins University School of Medicine Baltimore, MD  21287MedicalResearch.com Interview with: Richard D. Semba, MD MPH W. Richard Green Professor of Ophthalmology The Johns Hopkins University School of Medicine Baltimore, MD  21287 MedicalResearch: What are the main findings of the study? Dr. Semba: Resveratrol levels in older adults are not related to the risk of heart disease or cancer and are not related with lifespan. These findings were made in the InCHIANTI Study, a rigorously conducted study of human aging that is sponsored by the National Institute on Aging. (more…)
Allergies, Author Interviews, Pediatrics / 12.05.2014

dr_julie_wangMedicalResearch.com Interview with: Julie Wang, MD Associate Professor of Pediatrics Division of Allergy and Immunology Icahn School of Medicine at Mount Sinai New York, NY 10029   MedicalResearch: What are the main findings of the study? Dr. Wang: The results of this study demonstrate that differences in prevalence of reported food allergies exist in elementary schools representing diverse socioeconomic and racial/ethnic characteristic.  In this study, we conducted a survey at 4 elementary schools in New York City, 2 private schools that had a predominantly White student body with over 80% of families having paid a full tuition of over $35,000 per year and 2 public charter schools that had a primarily Black and Hispanic student body where over 90% of students qualified for free or reduced price school lunch.  The results show a high rate of reported food allergy, with rates significantly higher in the private school population as compared to the public charter school population. (more…)
Author Interviews, Endocrinology, Weight Research / 12.05.2014

MedicalResearch Interview with: Alicia J. Kowaltowski, MD, PhD Professor of Biochemistry Departamento de Bioquímica, IQ, Universidade de São Paulo São Paulo, SP, Brazil MedicalResearch: What are the main findings of the study? Dr. Kowaltowski: Intermittent fasting (24 hour cycles of all-you-can-eat followed by 24 fasting) is often used as a way to control excessive weight gain in laboratory animals, despite the fact that these animals overeat on the days they get food, and end up ingesting total quantities of food very similar to animals that eat every day. We show here that although lower weight gain occurs with intermittent fasting and there are some health benefits in adopting this diet, there are also some undesirable consequences. One such consequence is that this diet changes the control of hunger in the hypothalamus within the brain, making the rats hungry all the time, even when they are eating. (more…)
Author Interviews, Cancer Research, JAMA, Surgical Research / 10.05.2014

Dr. Carlo Riccardo Rossi, MD Melanoma and Sarcoma Unit, Veneto Institute of Oncology Surgery Branch, Department of Surgery Oncology, and Gastroenterology, University of Padova, Padova, ItalyMedicalResearch.com Interview with: Dr. Carlo Riccardo Rossi, MD Melanoma and Sarcoma Unit, Veneto Institute of Oncology Surgery Branch, Department of Surgery Oncology, and Gastroenterology, University of Padova, Padova, Italy MedicalResearch: What are the main findings of the study? Dr. Rossi: A total of 90% patients undergone lymph node dissection for melanoma had 12, 7, 14, 6 and 13 excised lymph nodes (10th percentile of the distribution) after 3 level axillary, 3 level or less neck, 4 level or more neck, inguinal, or ilio-inguinal dissections, respectively. (more…)
Author Interviews, Flu - Influenza, Vaccine Studies / 10.05.2014

MedicalResearch Interview: Dr Nicoline van der Maas MD Epidemiologist National Institute for Public Health and the Environment Centre for Infectious Disease Control Epidemiology and Surveillance The Netherlands MedicalResearch: What are the main findings of the study? Dr. van der Maas: The main finding, presented at the ESPID, is that we found no difference in growth, development and infection related contact rates with the general practitioner after the first year of life between infants of unvaccinated mothers and infants of mothers, vaccinated with an adjuvanted Influenza A (H1N1) vaccine during the second and third trimester of pregnancy. The offer of a H1N1 vaccination to pregnant women in their second and third trimester did not have a negative impact on infants’ health during the first year of life. (more…)
Author Interviews, Frailty, Geriatrics, JAMA, Surgical Research / 10.05.2014

MedicalResearch.com Interview with: Kwang-il Kim, MD, PhD Associate Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of KoreaMedicalResearch.com Interview with: Kwang-il Kim, MD, PhD Associate Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea MedicalResearch: What are the main findings of the study? Answer: There are few tools of preoperative risk stratification for the older adults. We found that not only disease itself but also frailty can lead to post-operative complication and mortality. So we made a scoring model to predict post-operative mortality and morbidity based on comprehensive geriatric assessment and it worked exactly. MedicalResearch: Were any of the findings unexpected? Answer: Under our predictive model, there was inflection point of mortality slope at point 5. Post-operative mortality of someone who scores 4~5 is below 10%, but it of other who scores 6~7 is about 30%. It was unexpected drastic change, so we think that there is physiologic threshold point. MedicalResearch: What should clinicians and patients take away from your report? Answer: Because the elderly are different from adults, clinicians have to focus on functional capacity, co-morbidity, and frailty for their older surgical patients. Make operative decision base on comprehensive geriatric assessment or our scoring model. If you depend on your own feeling, some older patients will suffer from post-operative complication and someone will forfeit his chance of surgery. (more…)
Author Interviews, Infections / 09.05.2014

Meagan F. Vaughn, PhD Postdoctoral Trainee Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel HillMedicalResearch.com Interview with: Meagan F. Vaughn, PhD Postdoctoral Trainee Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill MedicalResearch: What are the main findings of the study? Dr. Vaughn: Outdoor workers are at high-risk for tick-borne diseases. Adherence to recommended tick-bite prevention methods is poor.  While permethrin treatment of clothing is highly protective against many arthropod vectors, the need for frequent reapplication lessens adherence.  A double-blind randomized intervention was conducted to determine the effectiveness of long-lasting permethrin-impregnated uniforms for tick bite prevention among outdoor workers from North Carolina.  Treatment group uniforms were factory-impregnated with long-lasting permethrin by Insect Shield, while control group uniforms received sham treatment.  Participants completed weekly tick bite logs during two tick seasons.  130 participants reported 1,045 work-related tick bites over 5,251 person-weeks of follow-up.  The effectiveness of long-lasting permethrin impregnated uniforms for prevention of work-related tick bites was 82% (p<0.001) for the first year and 34% (p=0.38) for the second year. These results indicate that long-lasting permethrin impregnated uniforms are highly effective for at least one year against tick bites among North Carolina outdoor workers. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Mayo Clinic, Outcomes & Safety / 09.05.2014

MedicalResearch Interview with: Dr. David Cook MD Professor in the Department of Anesthesiology Division of Cardiovascular Anesthesiology Center for the Science of Health Care Delivery Mayo Clinic College of Medicine Rochester, Minnesota. MedicalResearch: What are the main findings of the study? Dr. Cook: The main finding of the study was that segmentation of a population of surgical patients into groups of higher and lower complexity allowed us to apply a standardized practice, focused factory model to surgical care delivery. A standardized care model improved care process measures such as time on mechanical ventilation or duration of a bladder catheter indwelling. The model reduced resource utilization, decreasing patient time in all care environments (operating room, ICU and on ?the floor?). The care model improved outcomes at 30 days and reduced the costs overall and in every care environment. In addition to the absolute improvements in quality and in cost, the standardized care model reduced variation in all measured variables. That reduction in variation may be even more important than the improved outcomes or reduced costs because we now know it is possible to make the health care experience predictable for these patients. That predictability is critically important to patients and providers, but it also has implications for health care metrics and payment models. (more…)
Author Interviews, Hepatitis - Liver Disease / 09.05.2014

Zobair Younossi, MD, MPH Chairman, Department of Medicine, Inova Fairfax Hospital Vice President for Research, Inova Health System Falls Church, Virginia, USAMedicalResearch.com Interview with: Zobair Younossi, MD, MPH Chairman, Department of Medicine, Inova Fairfax Hospital Vice President for Research, Inova Health System Falls Church, Virginia, USA   MedicalResearch: What are the main findings of the study? Dr. Younossi: We conducted the analysis of the patient reported outcomes (PROs) data that were systematically collected during clinical trials of sofosbuvir-containing regimens. The highlights of our findings are as follows:
  1. Patients with Hepatitis C (HCV)  have a significant impairment of their health related quality of life including those related to activity and fatigue. Their work productivity is also impaired.
  2. Cirrhosis can add additional negative impact on some of these patient reported outcomes.
  3. During treatment, patients with cirrhosis who were treated with an interferon-free sofosbuvir and ribavirin containing regimen did experience mild decline in their patient related outcome scores. However, this decline was similar for HCV patients with or without cirrhosis.
  4. On the other hand, patients with cirrhosis who were treated with an interferon-containing regimen showed a significant decline in their patient reported outcomes scores compared to those with Hepatitis C and without cirrhosis.
  5. Nevertheless, at the end of week 12 follow up, there was no longer a significant deficit in PROs noted regardless of the treatment arm for patients with cirrhosis.
  6. Furthermore, for the patients (HCV and cirrhosis) who achieved a sustained virologic response at 12 weeks, there were significant improvements (compared to baseline) in some PRO scores.
  7. During treatment, changes in patient reported outcomes scores were similar between cirrhotics and non-cirrhotics for both treatment regimens (all p>0.05).
(more…)
Author Interviews, Nutrition, Weight Research / 08.05.2014

Mireille Serlie, MD PhD Academic Medical Center University of Amsterdam Department of Endocrinology and Metabolism Amsterdam, The NetherlandsMedicalResearch.com Interview with: Mireille Serlie, MD PhD Academic Medical Center University of Amsterdam Department of Endocrinology and Metabolism Amsterdam, The Netherlands MedicalResearch What are the main findings of the study? Dr. Serlie: We studied the effects of hypercaloric high sugar or high fat/high sugar drinks consumed with the 3 main meals (representing an increase in meal size) or in between the 3 main meals (representing an increase in meal frequency or snacking). All subjects gained a similar amount of body weight but only the ones that snacked showed an increase in liver and abdominal fat. This suggests that besides caloric content and diet composition, eating pattern independently contributes to liver and abdominal fat accumulation. We also observed a trend for a decrease in hepatic insulin sensitivity in the high fat/high sugar frequency group only. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Geriatrics, Heart Disease / 08.05.2014

Luisa Soares-Miranda, PhD Research Center in Physical Activity, Health and Leisure Faculty of Sport, University of Porto Rua Dr. Plácido Costa, Porto PORTUGALMedicalResearch.com Interview with: Luisa Soares-Miranda, PhD Research Center in Physical Activity, Health and Leisure Faculty of Sport, University of Porto Rua Dr. Plácido Costa, Porto PORTUGAL MedicalResearch: What are the main findings of the study? Dr. Soares-Miranda: Modest physical activity, such as the distance and pace of walking, is important for the heart’s electrical well being of older adults. In our study, older adults that increased their walking pace or distance had a better heart rate variability when compared with those that decreased their walking pace or distance. Our results suggest not only that regular physical activity later in life is beneficial, but also that certain beneficial changes that occur may be reduced when physical activity is reduced. This supports the need to maintain modest physical activity throughout the aging process. Even small increases can lead to a better health, while reducing physical activity has the opposite effect. So, any physical activity is better than none, and more is better. (more…)
Author Interviews, BMJ, Prostate Cancer, Testosterone / 07.05.2014

dr_san_franciscoMedicalResearch.com Interview with: Dr. Ignacio F. San Francisco Departamento de Urología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile MedicalResearch: What are the main findings of the study? Answer: Increasingly, men with low-risk prostate cancer are undergoing a close monitoring regimen called active surveillance, instead of moving forward immediately with treatment. However it is still unclear which men will develop evidence for worsening or more aggressive disease during active surveillance. In this study of 154 men with Gleason 6 prostate cancer followed for 38 months, we found that low levels of free testosterone were significantly associated with increased risk of developing more aggressive disease. We found no significant association with total testosterone concentrations, although there was a general trend towards increased risk with lower levels. (more…)
Annals Internal Medicine, Author Interviews, Cost of Health Care, Health Care Systems / 07.05.2014

MedicalResearch.com Interview with: Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard School of Public Health / Brigham & Women's Hospital Boston, MA 02115MedicalResearch.com Interview with: Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard School of Public Health / Brigham & Women's Hospital Boston, MA 02115   MedicalResearch.com: What are the main findings of the study? Dr. Sommers: We find that over the first four years since Massachusetts' 2006 comprehensive health reform law, all-cause mortality in the state fell by 2.9%, compared to a similar population of adults living in counties outside Massachusetts that did not expand insurance during this period.  We also found that the law reduced the number of adults in Massachusetts without insurance, reduced cost-related barriers to care, increased use of outpatient visits, and led to improvement in self-reported health.  Overall, we estimate that the health reform law prevented over 320 deaths per year in the state - or one life saved per 830 adults gaining health insurance.  Mortality rates declined primarily due to fewer deaths from causes amenable to health care, such as cancer, infections, and heart disease.  We also found that the health benefits were largest for people living in poor counties in the state, areas with higher percentage of uninsured adults before the law was passed, and for minorities. (more…)
Author Interviews, Cancer Research, Hepatitis - Liver Disease, UT Southwestern / 07.05.2014

Amit Singal MD MS Assistant Professor of Medicine Medical Director, Liver Tumor Program Dedman Scholar of Clinical Care Division of Digestive and Liver Diseases University of Texas Southwestern Dallas TX 75201 - 8887MedicalResearch.com Interview with: Amit Singal MD MS Assistant Professor of Medicine Medical Director, Liver Tumor Program Dedman Scholar of Clinical Care Division of Digestive and Liver Diseases University of Texas Southwestern Dallas TX 75201 - 8887 MedicalResearch: What are the main findings of the study? Dr. Singal: We conducted a meta-analysis of current studies to characterize the association between hepatocellular carcinoma surveillance and early detection, curative treatment rates, and overall survival in patients with cirrhosis.  We identified 47 studies with 15,158 patients, of whom 6,284 (41.4%) had hepatocellular carcinoma  detected by surveillance. Hepatocellular carcinoma  surveillance was associated with improved early stage detection (OR 2.08, 95% CI 1.80–2.37) and curative treatment rates (OR 2.24, 95% CI 1.99–2.52). These associations were robust to several sensitivity analyses, including study design, study location, and study period. Hepatocellular carcinoma  surveillance was associated with significantly prolonged survival (OR 1.90, 95% CI 1.67–2.17), which remained significant in the subset of studies adjusting for lead-time bias. Three-year survival rates were 50.8% among patients who underwent surveillance, compared to only 28.2% among hepatocellular carcinoma  patients with tumors detected outside of a surveillance program. (more…)
Author Interviews, Mayo Clinic, Neurology, Stroke / 06.05.2014

Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 MedicalResearch.com Interview with: Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 MedicalResearch: What are the main findings of the study? Dr. Kantarci: Microinfarcts are one of the most common pathologies identified in the brains of older individuals and they impact cognition. However they are invisible lesions on MRI. We demonstrated that presence of microinfarcts in autopsied individuals are associated with the macroinfarcts identified on their MRI scans than they were alive. We also demonstrated that the presence of these invisible lesions are related to greater brain atrophy rates that are localized to watershed zones. (more…)
Author Interviews, Diabetes, JAMA, Pediatrics / 06.05.2014

Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045MedicalResearch.com Interview with:  Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045 MedicalResearch.com: What are the main findings of the study? Dr. Dabelea: We found that the proportion of US youth living with Type 1 Diabetes has increased by at least 21% over a period of only 8 years. This increase was seen in both boys and girls, most age-groups and race/ethnic groups.  While we do not completely understand the reasons for this increase, since the causes of Type 1 Diabetes are still unclear, it is likely that something has changed in our environment- both in the US and elsewhere in the world- causing more youth to develop the disease, maybe at increasingly younger ages. (more…)