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…)
Annals Internal Medicine, Author Interviews, Compliance, Cost of Health Care, McGill, Pharmacology / 09.04.2014

Robyn Tamblyn BScN Msc PhD James McGill Chair Departments of Medicine and Epidemiology and Biostatistics McGill University Scientific Director Institute of Health Services and Policy Research Canadian Institutes of Health Research MedicalResearch.com Interview with: Robyn Tamblyn BScN Msc PhD James McGill Chair Departments of Medicine and Epidemiology and Biostatistics McGill University and Scientific Director Institute of Health Services and Policy Research Canadian Institutes of Health Research MedicalResearch.com: What are the main findings of the study? Dr. Tamblyn: Higher drug costs are associated with a higher probability of primary non-adherence, whereas better follow-up by the prescribing physician, and a policy to provide medication at no cost for the very poor increase the likelihood of adherence (more…)
Author Interviews, Lancet, OBGYNE / 09.04.2014

Enrique F. Schisterman, Ph.D. Chief and Senior Investigator Epidemiology Branch, DIPHR Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, MD 20854MedicalResearch.com Interview with: Enrique F. Schisterman, Ph.D. Chief and Senior Investigator Epidemiology Branch, DIPHR Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, MD 20854 MedicalResearch.com: What are the main findings of the study? Dr. Schisterman: Our results indicate that aspirin is not effective for reducing the chances of pregnancy loss in most cases. For the total number of women in the study, 13 percent of women who took aspirin and became pregnant subsequently experienced another loss, compared with 12 percent who took the placebo. Ultimately, 58 percent of women taking aspirin and 53 percent of the placebo group got pregnant and later gave birth. However, additional research is needed to investigate the finding that women who had experienced a single, recent pregnancy loss (before 4 1/2 months of pregnancy and within the past year) had an increased rate of pregnancy and live birth while on aspirin therapy. Among this group, 78 percent of those who took aspirin became pregnant, compared with 66 percent of those who took the placebo. For this subset of women, 62 percent of the aspirin group and 53 percent of the placebo group gave birth. (more…)
Author Interviews, BMJ, Eating Disorders, Weight Research / 09.04.2014

Ulla Räisänen Senior Researcher HERG Health Experiences Research Group Department of Primary Care Health Sciences University of Oxford Oxford OX1 2ETMedicalResearch.com  Interview with Ulla Räisänen Senior Researcher HERG Health Experiences Research Group Department of Primary Care Health Sciences University of Oxford Oxford OX1 2ET MedicalResearch.com : What are the main findings of the study? Answer: We conducted a qualitative interview study exploring how young men (aged 16-25) recognise eating disorder symptoms and decide to seek help, and to examine their experiences of initial contacts with primary care in the UK. Our data suggest that the widespread perception of eating disorders as uniquely or predominantly a female problem led to an initial failure by young men to recognise their behaviours as symptoms of an eating disorder. Many presented late in their illness trajectory when eating disorder behaviours and symptoms were entrenched, and some felt that opportunities to recognise their illness had been missed because of others’ lack of awareness of eating disorders in men. In addition, the men discussed the lack of gender-appropriate information and resources for men with eating disorders as an additional impediment to making sense of their experiences, and some felt that health and other professionals had been slow to recognise their symptoms because they were men. (more…)
Author Interviews, Eating Disorders, General Medicine, Social Issues / 09.04.2014

MedicalResearch.com Interview with Stephen M. Amrock, SM Department of Pediatrics New York University School of Medicine New York, NY 10016 MedicalResearch.com: What are the main findings of the study? Answer: We analyzed data from a nationally representative survey on youth risk behaviors. After adjusting for other risk taking behaviors, we found that high school adolescents who indoor tan were much more likely to also engage in behaviors typically associated with eating disorders. We also noted that the link between indoor tanning and such harmful weight control behaviors was even stronger among males than females. (more…)
Author Interviews, Gender Differences, Orthopedics, Race/Ethnic Diversity, UCLA / 08.04.2014

Dr. Carolyn Crandall, M.D. Division of General Internal Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, 90024, USAMedicalResearch.com Interview with: Dr. Carolyn Crandall, M.D. Division of General Internal Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, 90024, USA MedicalResearch.com: What are the main findings of the study? Dr. Crandall: We found that higher social class was linked with a lower risk of fractures among non-Caucasian women.  Compared with non-Caucasian women who had no more than a high school education, those with at least some postgraduate education had nearly 90% lower rates of non-traumatic fracture.  These results were present even after we accounted for income. (more…)
Author Interviews, Neurology / 08.04.2014

Xiang Gao, MD, PhD Assistant Professor in Medicine Harvard Medical School Associate Epidemiologist Brigham and Women's HospitalMedicalResearch.com Interview with: Xiang Gao, MD, PhD Assistant Professor in Medicine Harvard Medical School Associate Epidemiologist Brigham and Women's Hospital MedicalResearch.com: What are the main findings of the study? Dr. Gao: In this study including 12,556 men in the Health Professionals Follow-up Study, we found that the participants with Restless Legs Syndrome at baseline had significantly lower physical function (PF) score 6 years later than those without RLS, after adjusting for potential confounders. The magnitude of difference in physical function score for RLS symptoms ≥15 times/month vs no Restless Legs Syndrome was more than that of a 5-year increase of age or moderate amount of smoking. We also found that having daily daytime sleepiness and sleep duration ≥9 hours/day were associated with lower mean physical function value than not having these symptoms . (more…)
Alzheimer's - Dementia, Author Interviews, Coffee / 08.04.2014

Prof. Dr. Christa E. Müller University of Bonn Pharmaceutical Institute Pharmaceutical Chemistry I An der Immenburg 4 D-53121 Bonn (Endenich) Germany MedicalResearch.com Interview with: Prof. Dr. Christa E. Müller University of Bonn Pharmaceutical Institute Pharmaceutical Chemistry I An der Immenburg 4  D-53121 Bonn (Endenich) Germany MedicalResearch.com: What are the main findings of the study? Prof. Dr. Christa E. Müller: Genetically altered mice which show an aggregation of Tau protein and many symptoms of Alzheimer's Disease which progressively worsen with time was used. Caffeine was given to one group of mice at an early stage, when the symptoms were still moderate. The caffeine-treated mice showed better memory and less inflammation and brain damages in comparison to the non-treated control mice. This means that caffeine protected the mice to some extent. The side effects were moderate. (more…)
Author Interviews, CDC, Cost of Health Care, Diabetes, Diabetes Care / 08.04.2014

MedicalResearch.com Interview with: Dr. Rui Li Division of Diabetes Translation Centers for Disease Control and Prevention Atlanta, GA MedicalResearch.com: What are the main findings of the study? Answer: The proportion of people with diabetes facing high out-of-pocket (OOP) burden declined between 2001 and 2011. Although insurance and income related disparities have declined, almost one-fourth of all people with diabetes still face a high out-of-pocket burden. (more…)