Author Interviews, Lancet, OBGYNE / 17.04.2014

MedicalResearch.com Interview with: Nestor E. Vain M.D. Professor of Pediatrics, School of Medicine, University of Buenos Aires Vice-President, FUNDASAMIN (Foundation for Maternal Infant Health), Argentina Director, Neonatology, Hospital Sanatorio de la Trinidad Palermo and San Isidro, Buenos Aires MedicalResearch.com: What is the background of this study? Prof. Vain: Delayed umbilical cord clamping (DCC) is currently recommended by many professional associations. The main reason is that it decreases the incidence of iron deficiency in infancy, a very serious public health problem in developing countries, but also prevalent in the USA and in western Europe. Besides it has other advantages in premature infants such as better adaptation of the cardiovascular system to extra-uterine life. How does Delayed umbilical cord clamping work?. Approximately 30% of the fetal blood volume is in the placenta at the time of delivery. Waiting for a couple of minutes before clamping the cord allows for a large part of that blood volume to return to the infant. (this process is known as placental transfusion) Despite of these well known facts, and the absence of serious complications, the compliance with the recommendation of delayed umbilical cord clamping is low. Why is that? There may be a variety of reasons but we are certain that one very important one is that the majority of obstetricians and neonatologists believe that to achieve an efficient placental transfusion and to avoid a negative effect from gravity, it is necessary to hold the infant at or below the level of the vagina during those 2 minutes. In that way the procedure is cumbersome and it prolongs unwillingly a separation between the infant and the mother. The believe that the infant needs to be at that low level is based on small studies performed more than 35 years ago. (more…)
Author Interviews, Hepatitis - Liver Disease / 17.04.2014

Jordan Feld MD MPH Toronto Western Hospital Liver Center University Health Network Sandra Rotman Centre for Global HealthMedicalResearch.com Interview with: Jordan Feld MD MPH Toronto Western Hospital Liver Center University Health Network Sandra Rotman Centre for Global Health MedicalResearch.com:  What are the main findings of the study? Dr. Feld: The SAPPHIRE 1 study was an international, large (631 patients) Phase 3 study of 3 direct acting antivirals combined with ribavirin for 12 weeks for the treatment of patients with genotype 1 hepatitis C virus (HCV) infection without cirrhosis.  The antivirals used were ABT-450, which is a protease inhibitor that is boosted with ritonovir to allow for once daily dosing along with ombitasvir (formally ABT 267), a potent NS5A inhibitor and dasabuvir (formerly known as ABT 333), a non-nucleoside polymerase inhibitor.  The ABT-450, ritonovir and ombitasvir were all co-formulated into a single tablet and dasabuvir was taken twice daily, as was ribavirin. The results of the study showed that the treatment is highly effective with 96% of patients achieving a sustained virological response (SVR) at 12 weeks after completing treatment.  SVR is a cure of HCV infection.  Importantly, patients with genotypes 1a and 1b had similar results with a rate of SVR12 of 95% in genotype 1a and 98% in genotype 1b.  These results were clearly superior to a historical control treatment with telaprevir combined with peginterferon and ribavirin.  Baseline factors were not predictive of outcome, including factors associated with non-response to interferon such as the IL28B genotype, baseline HCV viral load and older age. (more…)
Author Interviews, Nutrition, Weight Research / 16.04.2014

MedicalResearch.com Interview with: Jeffrey R. Parker Assistant Professor of Marketing Robinson College of Business - Georgia State University MedicalResearch.com: What are the main findings of the study? Mr. Parker: Recently, there has been quite a bit of debate about the effectiveness of providing dish-specific calorie information (a practice called “calorie posting”) on restaurant menus in terms of the healthiness of consumers’ food choices. Some results suggest that such labels lead to lower-calorie choices, while other research shows that there is no effect. We examined one factor that might impact the effectiveness of calorie posting: the practice of grouping low-calorie options on a menu and labeling this category accordingly (i.e., incorporating a low-calorie menu/category in the menu)—which we call “calorie organizing”—as opposed to simply allowing them to appear in their natural categories with the caloric content appearing in the dish descriptions (e.g., Sandwiches, Salads, Pastas, etc.). On the surface it seems obvious that making low-calorie options easier to find—by giving them their own labeled category on the menu—would bolster the positive effects of calorie posting. However, we found the opposite: additionally calorie organizing an already calorie-posted menu regularly eliminates the benefits that calorie posting can have. We argued and found evidence indicating that the underlying cause of this effect stems from how consumers make decisions. Restaurant menus are often too large for a consumer to seriously consider all of the dishes. Some consumers typically eliminate large portions of the menu on the basis of simple criteria (e.g., “I don’t like seafood.”, “It’s too early to eat pasta.”, etc. ). Since consumers generally make negative inferences about low-calorie dishes (e.g., “They don’t taste good.”, “They are small dishes.”, etc.) they are likely to summarily dismiss all of the low-calorie options early in the decision process when the menu is calorie-organized (i.e., has grouped the low-calorie dished and labeled the new category accordingly). Thus, they are likely to choose as poorly as they would were they given no calorie information. In contrast, when the menu is just calorie-posted, and the low-calorie dishes appear in their natural categories, these dishes are unlikely to be dismissed in the early choice-simplification stages. Thus, low-calorie dishes are likely to be seriously considered in the final decision process, during which the pros and cons of dishes can be more comprehensively traded off, and are therefore more likely to be chosen. (more…)
Author Interviews, Endocrinology, JCEM / 16.04.2014

Kai-Jen Tien, MD Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center Assistant Professor, Center of General Education Chia Nan University of Pharmacy and Science Tainan, TaiwanMedicalResearch.com Interview with: Kai-Jen Tien, MD Division of Endocrinology and Metabolism, Department of Internal Medicine,  Chi Mei Medical Center Assistant Professor, Center of General Education Chia Nan University of Pharmacy and Science Tainan, Taiwan MedicalResearch.com: What are the main findings of the study? Answer:  We conducted the first and largest population-based cohort study to evaluate the association of obstructive sleep apnea (OSA) and osteoporosis in a 6-year follow-up investigation of an Asian population. OSA is characterized by repetitive episodes of apnea/hypopnea and hypoxia in tissue, which might impact the bone metabolism. The results of the study showed that patients with obstructive sleep apnea had 2.74 times the risk of osteoporosis than patents without obstructive sleep apnea after adjustment for the patient`s characteristics and comorbidities. Across all age groups and sex groups, individuals with OSA had higher incidence rate of osteoporosis than individuals without obstructive sleep apnea. Subgroup analysis showed that older patients and female patients had a higher risk for osteoporosis than their younger and male counterparts. (more…)
Author Interviews, Colon Cancer, JAMA, Surgical Research / 16.04.2014

MedicalResearch.com Interview Invitation Dorna Jafari, M.D. and Michael J Stamos, MD Professor of Surgery John E. Connolly Chair, Department of Surgery University of California, Irvine Orange, CA 92868 MedicalResearch.com: What are the main findings of the study? Answer: Surgeons are faced with an aging population and data regarding outcomes is rare given that many studies preclude the elderly from the study population. Therefore, it is difficult to accurately discuss risk of surgical resection given the lack of data. Therefore we aimed to report the national trends and outcomes of colorectal cancer treatment in the elderly population. We demonstrated that the majority of resections are performed in patients >65yeras old. There is a trend towards a decrease in incidence of colorectal resection and a decrease in rate of mortality during 2001-2010.  However, the unique physiological changes associated with aging contribute to increase morbidity and morality as demonstrated by our findings. In fact patients >85 years have a 472% increase in risk-adjusted mortality during a hospital admission compared to younger patients. However, despite the substantially higher mortality and morbidity associated with age, there has been a marked improvement in surgical outcomes in the elderly population. (more…)
Author Interviews, BMJ, McGill, Pediatrics / 16.04.2014

MedicalResearch.com Interview with: Ethan K Gough, PhD candidate Department of Epidemiology Biostatistics and Occupational Health McGill University, Montreal, QC, Canada MedicalResearch.com: What are the main findings of the study? Answer: Antibiotic use produces significant gains toward expected growth in children, for their age and sex, from low- and middle-income countries. Children included in our study were generally smaller in height and weight than adequately nourished children of the same age, reflecting the spectrum of stunting and wasting malnutrition seen in low- and middle-income countries. Antibiotic use had a larger impact on weight than height, and the effect on weight was larger in populations who may be at greater risk of infections and early mortality, such as populations with a high prevalence of HIV infection or exposure, and a high prevalence of severe acute malnutrition. (more…)
Author Interviews, JAMA, Lung Cancer, Pulmonary Disease / 15.04.2014

Renda Soylemez Wiener, MD, MPH Assistant Professor of Medicine The Pulmonary Center Boston University School of Medicine Center for Healthcare Organization & Implementation Research Edith Nourse Rogers Memorial VA HospitalMedicalResearch.com Interview with: Renda Soylemez Wiener, MD, MPH Assistant Professor of Medicine The Pulmonary Center Boston University School of Medicine Center for Healthcare Organization & Implementation Research Edith Nourse Rogers Memorial VA Hospital MedicalResearch.com: What are the main findings of the study? Dr. Soylemez Wiener: The main finding is that evaluation of pulmonary nodules to determine whether or not they are cancerous is inconsistent with clinical practice guideline recommendations in almost half of cases, suggesting there is room for improvement in clinical care of these patients. Patients with pulmonary nodules are sometimes evaluated more aggressively than they should be (18%), which can cause harms to patients from unnecessary invasive tests (biopsies or surgery) or unneeded radiation exposure from imaging studies. Still more patients (27%) are followed less aggressively than they should be, which in the worst case scenario could lead to delays in the diagnosis and treatment of cancer. It is particularly important to improve care of these patients now, because new guidelines from the US Preventive Services Task Force recommend CT screening for lung cancer screening, which often finds pulmonary nodules that require evaluation. (more…)
Author Interviews, BMJ, Rheumatology / 15.04.2014

Zhang, Xuan MD Professor of Medicine Dept. of Rheumatology Peking Union Medical College Hospital Beijing,China,100730MedicalResearch.com Interview with: Zhang, Xuan MD Professor of Medicine Dept. of Rheumatology Peking Union Medical College Hospital Beijing,China,100730 and Dr. Peter E. Lipsky, MD Formerly National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institutes of Health, Bethesda, MD, MedicalResearch.com: What are the main findings of the study? Prof. Zhang & Lipsky--The results of this study indicate that TwHF is effective for the treatment of active rhematoid arthritis (RA). Importantly, these are the first data indicating that TwHF is effective in DMARD-naïve patients with active rheumatoid arthritis. At week 24, TwHF monotherapy resulted in significant improvement of disease activity, including pain assessment, the patient’s and physician’s global assessment, tender joint counts, swollen joint counts, ESR, CRP, and HAQ and SF-36 scores. MTX monotherapy and TwHF monotherapy had similar efficacy as shown by ACR20, ACR50 and ACR70 response criteria, EULAR and cDAI good response criteria, as well as DAS28 remission criteria and low disease activity(LDA) rate. The efficacy of TwHF was not inferior to that of MTX, and MTX +TwHF combination therapy was more effective than monotherapy in treating active rhematoid arthritis. A safety evaluation of the study demonstrated that the frequency of total adverse events and severe adverse events of TwHF monotherapy was not significantly higher than that of MTX monotherapy, except for a slightly increased frequency of irregular menstruation. (more…)
Author Interviews, JAMA, OBGYNE, Weight Research / 15.04.2014

MedicalResearch.com Interview with: Dagfinn Aune MS Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus Norfolk Place, Paddington, London W2 1PG, UK MedicalResearch.com: What are the main findings of the study? Answer: We conducted a systematic review and meta-analysis of studies examining the association between maternal body mass index (BMI) and risk of fetal death, stillbirth, neonatal, perinatal and infant death. We found that the risk of all these outcomes increased with greater BMI in a dose-response fashion. For example even within the high end of what is considered the normal BMI range (BMI of 24-25) there was a 10-20% increase in the relative risk, but the strongest relations were seen for those who were obese and morbidly obese with 30-60% and 2-3 fold increases in the relative risk respectively (depending on the outcome examined). (more…)
Author Interviews, Blood Pressure - Hypertension, BMJ, Salt-Sodium / 15.04.2014

Dr. Feng He Wolfson Institute of Preventive Medicine Barts and The London School of Medicine and Dentistry Queen Mary University of London, London, UKMedicalResearch.com Interview with: Dr. Feng He Wolfson Institute of Preventive Medicine Barts and The London School of Medicine and Dentistry Queen Mary University of London, London, UK
MedicalResearch.com: What are the main findings of the study? Dr. He:
  • The UK salt reduction program has led to a fall in population blood pressure and thereby contributed to the reduction in stroke and heart disease deaths.
  •  In 2003, the UK Food Standards Agency and CASH (Consensus Action on Salt & Health) developed a salt reduction program. As approximately 80% of the salt in the diet is added to food by the food industry i.e. in processed foods, fast foods, canteen and restaurant foods etc, the public have no choice about eating it. Therefore progressive incremental targets to limit the amount of salt for each food category were set, which the industry had to achieve in a specified time. Reductions first started in 2003 and are continuing to this day.
  • The salt reduction program has been very successful and led to a 15% reduction in the average salt intake of the population, from 9.5g per day in 2003 to 8.1g per day in 2011 (P<0.05).
  • Over the same time period, blood pressure fell in the adult population by 3 mm Hg systolic and 1.4 mm Hg diastolic (P<0.0001). Stroke and heart disease deaths fell by 42% (P<0.0001) and 40% (P<0.0001) respectively.
  • It is possible that these falls in blood pressure and deaths from stroke and heart disease were attributable to various factors such as changes in diet, lifestyles and the improvement in the treatment of cardiovascular disease and its risk factors. Our further analysis showed that the reduction in salt intake played an important role, particularly in the falls in blood pressure.
  •  In a further analysis, we looked at individuals who were not on any drug treatment for blood pressure and a correction was made for all other variables that could have influenced blood pressure, apart from salt. There was still a fall in adult population blood pressure of 2.7mm Hg systolic/ 1.1mm Hg diastolic, (P <0.0001). This reduction in blood pressure could therefore be largely attributed to the fall in salt intake.
  •  It is well established that raised blood pressure throughout its range is a major cause of stroke and heart disease. The reduction in salt intake that led to a fall in blood pressure would have played an important role in both stroke and heart disease deaths.
  • Despite considerable progress being made on salt reduction, the average salt intake in England is still high. In 2011, it was 8.1 g/day which is over a third more salt than the recommended level of 6g/day. Therefore continuing and much greater efforts are needed to achieve further reductions in salt intake to prevent the maximum number of stroke and heart disease deaths. (more…)
Author Interviews, Heart Disease, JAMA, Mental Health Research / 15.04.2014

https://archinte.jamanetwork.com/article.aspx?articleid=1860496MedicalResearch.com Interview with: Dr. Jeffery  C. Huffman, M.D. Harvard Medical School Department of Psychiatry Massachusetts General Hospital, Boston MedicalResearch.com: What are the main findings of the study? Dr. Huffman: Depression and anxiety in cardiac patients are associated with adverse cardiac outcomes.  We completed a very low-intensity care management intervention to identify depression and anxiety disorders during a cardiac admission and then to assist in the monitoring and management of the condition over the next 24 weeks. There have been other care management trials in cardiac patients, but ours was the first to co-manage depression and anxiety, the first to initiate treatment in the hospital, the first to take a broad population of cardiac patients rather than a single diagnosis, and the first to use such a low-resource strategy with only a single part-time social worker to coordinate care. We found that the care management intervention was associated with significant improvements in mental health treatment, mental health related quality of life, depression, and function at 24 weeks compared to enhanced treatment as usual.  We did not find differences in anxiety, adherence, or cardiac readmissions. (more…)
Annals Internal Medicine, Author Interviews / 14.04.2014

Sharon K. Inouye, MD, MPH Professor of Medicine, Harvard Medical School Director, Aging Brain Center, Institute for Aging Research Hebrew SeniorLife both in Boston, MAMedicalResearch.com Interview with: Sharon K. Inouye, MD, MPH Professor of Medicine, Harvard Medical School Director, Aging Brain Center, Institute for Aging Research Hebrew SeniorLife both in Boston, MA Study Co- Authors Cyrus Kosar, Douglas Tommet, Eva Schmitt, Margaret Puelle, Jane Saczynski, Edward Marcantonio and Richard Jones.  MedicalResearch.com: What are the main findings of the study?  Dr. Inouye: In this study, we developed and validated a new scoring system for delirium severity.  Delirium (acute confusional state) is a common and morbid complication of hospitalization for older persons, which often goes undetected.  Our new scoring system indicates that the severity of delirium is directly related to hospital outcomes, such as length of stay, nursing home placement, death, and healthcare costs. (more…)
Author Interviews, Genetic Research, Nature, Social Issues / 14.04.2014

MedicalResearch.com Interview with: Prof Dr Isabelle Mansuy Lab of Neuroepigenetics University/ETH Zürich Brain Research Institute Zürich SwitzerlandProf Dr Isabelle Mansuy Lab of Neuroepigenetics University/ETH Zürich Brain Research Institute Zürich Switzerland MedicalResearch.com: What are the main findings of the study? Prof. Mansuy: The mains findings are that the transmission of the effects of traumatic stress in early life involves small non-coding RNAs in sperm. The study shows that some microRNAs are in excess in the sperm of adult males subjected to trauma during early postnatal life, but are also altered in the brain and in blood, and that these alterations are associated with behavioral and metabolic symptoms including depressive behaviors, reduced risk assessment and altered glucose/insulin metabolism. Injecting sperm RNA in fertilized oocytes reproduces these symptoms and confirm that RNA are the responsible factors. (more…)
Author Interviews, Blood Pressure - Hypertension, CMAJ, McGill, Stroke / 14.04.2014

Finlay A McAlister MD Division of General Internal Medicine Patient Health Outcomes Research and Clinical Effectiveness Unit Epidemiology Coordinating and Research (EPICORE) Centre McGill University, Montréal, QuebecMedicalResearch.com Interview with: Finlay A McAlister MD University of Alberta, Edmonton, Canada MedicalResearch.com: What are the main findings of the study? Dr. McAlister: We tested 2 systems of case management on top of usual care (note that at baseline more than 3/4 of our study patients were already taking medications to lower blood pressure (BP) and/or cholesterol but none were at guideline-recommended targets). The first (our "control" group) was a nurse seeing patients monthly x 6 months, measuring their blood pressure and LDL cholesterol, counseling them about risk factor reduction strategies (including lifestyle and medication adherence), and faxing results of BP/cholesterol to their primary care physicians with advice to patients who had blood pressure or cholesterol above guideline-recommended targets to see their primary care physician. The second (our "intervention" group) was a pharmacist seeing patients monthly x 6 months, measuring their blood pressure and LDL cholesterol, counseling them about risk factor reduction strategies (including lifestyle and medication adherence), and faxing results of BP/cholesterol to their primary care physicians.  However, if patients had blood pressure or cholesterol above guideline-recommended targets instead of just recommending that the patient see their primary care physician the pharmacist provided them with a prescription for medication (or up-titration of their current medications) to address the uncontrolled risk factor. Both groups improved substantially over usual care, but the intervention group improved even more (13% absolute improvement in control of BP/cholesterol levels compared to the nurse-led control arm) . (more…)
Author Interviews, Hepatitis - Liver Disease, NEJM / 12.04.2014

Kris V. Kowdley, MD Director of Research & Director of the Liver Center of Excellence Digestive Disease Institute Virginia Mason Medical Center Seattle, WA 98111MedicalResearch.com Interview with: Kris V. Kowdley, MD Director of Research & Director of the Liver Center of Excellence Digestive Disease Institute Virginia Mason Medical Center Seattle, WA 98111 MedicalResearch.com: What are the main findings of the study? Dr. Kowdley:  A fixed-dose combination of ledipasvir and sofosbuvir in chronic Hepatitis C (HCV) genotype 1 patients without cirrhosis for 8 weeks without ribavirin was equally effective as the same combination with ribavirin added and also a 12 week combination of ledipasvir-sofosbuvir (without ribavirin). (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues / 12.04.2014

Ioannis Tarnanas M.Sc Senior Researcher Gerontechnology and Rehabilitation Research Group, ARTORG Centre for Biomedical Engineering, University of Bern, 3010 Bern, SwitzerlandMedicalResearch.com Interview with: Ioannis Tarnanas M.Sc Senior Researcher Gerontechnology and Rehabilitation Research Group, ARTORG Centre for Biomedical Engineering, University of Bern, 3010 Bern, Switzerland MedicalResearch.com: What are the main findings of the study? Answer: We examined 75 healthy older people and 134 patients with mild cognitive impairment. Our aim was to collect neuropsychological, neurophysiological, neuroimaging and behavioural data by means of a virtual reality serious game, in order to model the profile of the patients who will progress to dementia within the next 2-4 years. We found that the prediction based on the performance at the virtual reality based computerized assessment instrument is comparable to that of more established and widely accepted biomarkers, such as ERP and MRI. This can be explained by the cognitive fidelity and richness of behavioural data collected with virtual reality based measures, which directly reflect neurocognitive processes affected at a very early stage. (more…)
Author Interviews, Infections, Kaiser Permanente, Pediatrics, Vaccine Studies / 11.04.2014

Roger Paul Baxter, MD Co-Director Kaiser Permanente Vaccine Study Center Oakland, CA 94612.MedicalResearch.com Interview with: Roger Paul Baxter, MD Co-Director Kaiser Permanente Vaccine Study Center Oakland, CA 94612. MedicalResearch.com What are the main findings of the study? Dr. Baxter:  Menveo, the currently licensed CRM-conjugate meningococcal vaccine, showed an excellent booster response in adolescents, regardless of which conjugate vaccine they had received previously.  Also, although titers from the priming dose waned, at 3 years there were still protective antibodies in the majority of immunized individuals.  The other US-licensed meningococcal conjugate vaccine, Menactra, uses a different protein conjugate. (more…)
Author Interviews, Cost of Health Care, Medical Imaging, NIH / 11.04.2014

Jamie Hui, MD Center for Health Services Research Virginia Mason Medical Center Seattle, WashingtonMedicalResearch.com Interview with: Jamie Hui, MD Center for Health Services Research Virginia Mason Medical Center Seattle, Washington MedicalResearch.com: What are the main findings of the study? Dr. Hui: Through a quality improvement intervention aimed at how radiologists report on findings in female pelvic ultrasound examinations, we were able to decrease the number of unnecessary recommendations for follow-up imaging of benign adnexal cysts, preventing duress for these women. (more…)
Author Interviews, HIV, Infections, Social Issues / 11.04.2014

Amy Nunn, ScD, MS Assistant professor (research) of Behavioral and Social Sciences Brown University School of Public HealthMedicalResearch.com Interview with: Amy Nunn, ScD, MS Assistant professor (research) of Behavioral and Social Sciences Brown University School of Public Health MedicalResearch.com: What are the main findings of the study? Answer: The main findings are that people living in poor, mostly-minority urban neighborhoods, where health resources such as HIV testing and linkages to care are often lacking, are at a greater risk of contracting HIV and dying of AIDS. This is not because of differences in behavior. It's because they live in medically underserved areas where HIV incidence is very high and fewer people know their status. Fewer people knowing their status means fewer people on treatment. Fewer people on treatment means it's easier for people to come into contact with the virus, even if they don't engage in any higher risk behavior. In the paper, my colleagues and I call for increasing the focus of public health efforts on these neighborhoods where the epidemic is concentrated and contributing heavily to racial and economic disparities in AIDS mortality. (more…)
Author Interviews, Kidney Disease, Mayo Clinic, Rheumatology / 11.04.2014

Eric Matteson, M.D. Chairman of Rheumatology Mayo Clinic, Rochester, Minn MedicalResearch.com Interview with: Eric Matteson, M.D. Chairman of Rheumatology Mayo Clinic, Rochester, Minn MedicalResearch.com: What are the main findings of the study? Dr. Matteson: “The main points are that kidney disease is more common in patients with rheumatoid arthritis than in the general population and that moderate reduction in kidney function was more likely to be associated with cardiovascular disease in these patients as well. Patients with more active disease week are also at higher risk for kidney disease. “ (more…)
Author Interviews, HIV, Mental Health Research, University of Pennsylvania / 11.04.2014

Michael B. Blank, PhDMedicalResearch.com Interview with: Michael B. Blank, PhD Associate Professor of Psychology in Psychiatry Perelman School of Medicine University of Pennsylvania Philadelphia, PA 19104-3309 MedicalResearch.com: What are the main findings of the study? Dr. Blank:  We found that people in treatment for mental illnesses in inpatient and outpatient settings in Philadelphia and Baltimore were about times as likely to be infected with HIV as the general population in those cities and about 16 times as likely to be HIV infected as the general population of the US.  We also found that severity of psychiatric symptoms increased the likelihood of infection. (more…)
Author Interviews, Heart Disease, NEJM / 11.04.2014

Marc A. Pfeffer, M.D., Ph.D. Dzau Professor of Medicine Harvard Medical School Cardiovascular Division Brigham and Women's HospitalMedicalResearch.com Interview with: Marc A. Pfeffer, M.D., Ph.D. Dzau Professor of Medicine Harvard Medical School Cardiovascular Division Brigham and Women's Hospital MedicalResearch.com: What are the main findings of the study? Dr. Pfeffer: We randomized 3445 patients with symptomatic heart failure and a left ventricular ejection fraction greater than or equal to 45% (heart failure with preserved ejection fraction or diastolic heart failure) to spironolactone or placebo and followed them for over 3 years. Our primary outcome the composite of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for management of heart failure was not significantly reduced in the group randomized to spironolactone. We did, however, observe that fewer patients in the spironolactone group were hospitalized for the management of heart failure following randomization. Spironolactone therapy was associated with higher incidence of  hyperkalemia and rises in serum creatinine. (more…)
Author Interviews, Breast Cancer, JNCI, Nutrition / 11.04.2014

dr_sabina-sieriMedicalResearch.com Interview with: Sabina Sieri, PhD Epidemiology and Prevention Unit Department of Preventive & Predictive Medicine Fondazione IRCCS Istituto Nazionale dei Tumori 20133 Milan – Italy MedicalResearch.com: What are the main findings of this study? Dr. Sieri: In our study we found that there was an increased risk of developing breast cancer from high saturated fat intake. High total and saturated fat intake were associated with greater risk of ER PR positive breast cancer. High saturated fat intake was also associated with a greater risk of HER2 negative disease. So, a high-fat diet increases breast cancer risk and, most conspicuously, a high saturated fat intake increases the risk of developing hormone-sensitive diseases, suggesting saturated fat involvement in the etiology of hormone-sensitive breast cancer. (more…)
Author Interviews, JAMA / 11.04.2014

MedicalResearch.com Interview with: Wei-ping Zhou, MD, PhD Department of Hepatic Surgery Eastern Hepatobiliary Surgery Hospital Shanghai, China MedicalResearch.com: What are the main findings of the study?  Answer:  The main finding is that Quantitative HBsAg can be used as a new prognostic factor of Hepatocellular Carcinoma recurrence after partial hepatectomy in patients with a low HBV-DNA level. (more…)
Alzheimer's - Dementia, Author Interviews, Genetic Research, NIH / 10.04.2014

Prof. Dr. med. Piotr Lewczuk Head,Lab for Clinical Neurochemistry and Neurochemical Dementia Diagnostics, Universitätsklinikum Erlangen, Department of Psychiatry and Psychotherapy, 91054 Erlangen, GermanyMedicalResearch.com Interview with: Prof. Dr. med. Piotr Lewczuk Head,Lab for Clinical Neurochemistry and Neurochemical Dementia Diagnostics, Universitätsklinikum Erlangen, Department of Psychiatry and Psychotherapy, 91054 Erlangen, Germany MedicalResearch.com: What are the main findings of the study? Prof. Dr. med. Piotr Lewczuk: In our study, we investigated the concentrations of four isoforms of amyloid beta peptides in the blood of healthy young volunteers without memory complains. The participants were stratified into three groups according to their apolipoprotein E (APOE) genotype, which is the mostly investigated and generally accepted genetic risk factor for sporadic Alzheimer’s Disease (AD). It is known that the alterations of the amyloid beta metabolism are the earliest changes in the course of AD, occurring many years (or even decades) before the onset of the clinical symptoms, but it is actually not known how early these alterations start. Correspondingly, we wanted to investigate if healthy persons with genetic risk factor show changes in their amyloid beta metabolism already 30-40 years before the age when AD is usually diagnosed. We did not find any differences between the groups with and without APOE-driven risk, which might be carefully interpreted as no signs of Alzheimer’s Disease pathology in persons at risk at such an early life stage. Taken together, we think that the Alzheimer’s Disease pathology starts some 10-20 years before the beginning of the clinical symptoms, but not earlier. (more…)
Author Interviews, Breast Cancer, Mayo Clinic / 10.04.2014

Dr. Judy C. Boughey MD Professor of Surgery Mayo Clinic, Rochester MNMedicalResearch.com Interview with Dr. Judy C. Boughey MD Professor of Surgery Mayo Clinic, Rochester MN MedicalResearch.com: What are the main findings of the study?   Dr. Boughey: This study showed that the rate of reoperation after lumpectomy for breast cancer was significantly lower at Mayo Clinic in Rochester compared to national data. Mayo Clinic in Rochester uses frozen section analysis of margins at time of lumpectomy to direct any margin re-excisions during the surgery and therefore has a significantly lower rate of need for a second operation to ensure clean margins. The rate of reoperation was four times higher in the national data set than in the Mayo Clinic data set. (more…)
Author Interviews, Weight Research / 10.04.2014

MedicalResearch.com Interview witih: Dr. Constance Tom Noguchi, Ph.D. Molecular Medicine Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892  and Dr. Mawadda Al-Naeeli Department of Biological Sciences, Ohio University MedicalResearch.com: What are the main findings of the study? Answer: The main findings of our study are: 1) EPO treatment has an anti-inflammatory effect on white adipose tissue macrophage population during diet-induced obesity in addition to its associated metabolic improvements on glucose tolerance and insulin sensitivity in vivo. 2) In this model of obesity, EPO treatment was found to reduce M1-like [pro-inflammatory] and increased M2-like [anti-inflammatory] macrophages in visceral white adipose tissue depot. 3) In addition, EPO decreased circulating inflammatory monocytes. 4) These anti-inflammatory effects of EPO were found to be driven, at least in part, by direct EPO-R response in macrophages via Stat3 activation, where EPO effects on M2 but not M1 macrophages required interleukin-4 receptor/Stat6 axis. 5) The anti-inflammatory effects of EPO are not restricted to treatment with exogenous high dose EPO (1000U/kg), but also include endogenous physiological EPO levels as demonstrated by the series of studies conducted using ΔEpoR mice with EPO-R restricted to erythroid cells. (more…)
Author Interviews, Autism, JAMA / 10.04.2014

Bradley S. Peterson, MD Director of the Center for Developmental Neuropsychiatry Director of the Center for Developmental Neuropsychiatry, New York State Psychiatric Institute Suzanne Crosby Murphy Professor in Pediatric Neuropsychiatry, Columbia University, NYMedicalResearch.com Interview with: Bradley S. Peterson, MD Director of the Center for Developmental Neuropsychiatry Director of the Center for Developmental Neuropsychiatry, New York State Psychiatric Institute Suzanne Crosby Murphy Professor in Pediatric Neuropsychiatry, Columbia University, NY MedicalResearch.com: What are the main findings of the study? Dr. Peterson: We detected the presence of lactate in the brains of 13% of 75 participants who had ASD (Autism Spectrum Disorder), compared with 1% of the brains of 96 typically developing control participants. The presence of lactate was especially more common in adults who have ASD. Lactate is a product of anaerobic metabolism, which generally should not occur in healthy, living brains under normal circumstances. The presence of lactate in the brains of persons with Autism Spectrum Disorder therefore suggests the presence of deficient production of energy stores by a component of brain cells called “mitochondria”. We detected lactate most commonly in the cingulate gyrus, a region that supports the higher-order control of thought, emotion, and behavior, and that has been implicated previously in Autism Spectrum Disorder. (more…)