MedicalResearch.com Interview with:
Shanthi Srinivasan, M.D. Associate Professor of Medicine
Division of Digestive Diseases Department of Medicine
Emory University Atlanta, GA 30322MedicalResearch.com: What are the main findings of the study?Dr. Srinivasan:The main findings of this study are that the neurotrophic factor GDNF is was able to protect against the weight gain induced by mice on a high fat diet. The mice that had overexpression of GDNF showed less weight gain while eating the same high fat diet as the control mice. GDNF seems to have effects on the genes regulating fat metabolism and energy expenditure and this could be the mechanism of prevention of weight gain.
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MedicalResearch.com Interview with: Daniel J. Elliott, M.D., MSCE, FACPAssociate Chair of Research
Department of Medicine and Research Scholar
Value Institute, Christiana Care Health System
MedicalResearch.com: What are the main findings of the study?Dr. Elliott:The optimal workload for hospitalists has been a question since the earliest days of hospital medicine. However there has been very little empirical evidence to understand the relationship between workload and outcomes.
The objective of our study was to determine the association of daily workload for hospitalists on the efficiency, quality, and cost of care. We analyzed data from a single private practice hospitalist group at a community-based health system between February 2008 and January 2011. Our research showed that both length of stay and cost increased for patients as hospitalist workload increased.
At the same time, our research showed that workload did not affect patient satisfaction as measured by HCAHPS scores or quality and safety outcomes including admissions, rapid response team activation and mortality.
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MedicalResearch.com Interview with:Dr Oyinlola Oyebode
Specialist Registrar in Public Health
Dept of Epidemiology & Public Health
University College London
MedicalResearch.com: What are the main findings of the study?Dr. Oyebode: We found that the more fruit and vegetables consumed, the lower the risk of death from any cause, from cancer or from heart disease or stroke. We found that vegetables were better than fruit at equivalent amounts.
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MedicalResearch.com Interview with: Jan Akervall, M.D., Ph.D.
Co-director, Head and Neck Cancer Multidisciplinary Clinic
Beaumont Hospital, Royal Oak
Clinical Director of Beaumont’s BioBank
MedicalResearch.com: What are the main findings of the study?Dr. Akervall: We identified biomarkers that can predict who will have an unfavorable response from radiation for head and neck cancer. These can be analyzed using standard laboratory techniques on biopsies that routinely are taken for diagnosis.
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MedicalResearch.com Invitation with:Dr Valerie Sung MBBS(Hons) FRACP MPH
NHMRC PhD Candidate, Department of Paediatrics, University of Melbourne, and Community Health Services Research, Murdoch Childrens Research Institute
Paediatrician, Centre for Community Child Health
The Royal Children’s Hospital
MedicalResearch.com: What are the main findings of the study?Dr. Sung: Lactobacillus reuteri was NOT effective in reducing crying or fussing in infants with colic, whether they are breast or formula fed. This is the largest and most rigorous trial to date to show this.
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MedicalResearch.com Interview with: Mary A.M. Rogers, PhD, MS
Research Associate Professor
Research Director, Patient Safety Enhancement Program
Department of Internal Medicine
University of Michigan Ann Arbor, MI 48109-2800
MedicalResearch.com: What are the main findings of the study?Dr. Rogers: The risk of serious infection is considerably elevated after receiving allogeneic (donor) red blood cell transfusions. For every 38 patients under consideration for transfusion, 1 patient could be spared an infection if more restrictive hemoglobin thresholds were used. When patients were given transfusions only after their hemoglobin fell below 7.0 g/dL, 1 patient avoided an infection of every 20 patients treated. The results were most consistent in elderly patients receiving hip and knee replacement surgeries. Their risk of infection decreased by 30% when lower hemoglobin thresholds were used.
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MedicalResearch.com Interview with:Dr. Thomas M. Pisansky MD
Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of the study?Dr. Pisansky:This patient-reported outcomes research did not identify a beneficial effect of once-daily tadalafil to prevent radiotherapy-related erectile dysfunction in men with prostate cancer.
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MedicalResearch.com Interview with: Rosebud O Roberts, M.B., Ch.B.
Professor of Epidemiology
Professor of Neurology
Mayo Clinic
MedicalResearch.com: What are the main findings of the study?
Dr. Roberts: We found that among persons 70 years and older, people with type 2 diabetes had a reduced glucose uptake (hypometabolism) in brain cells. We also found a similar association for people without type 2 diabetes but who had elevated hemoglobin A1c levels levels at the time of enrollment (HBA1c is a measure of glucose control, and represents the average blood glucose levels over a 3 month period). However, we did not find an association of diabetes with increased brain amyloid accumulation. Our findings were based on an investigation of the association of type 2 diabetes with markers of brain pathology: brain hypometabolism was assessed by 18F-fluorodeoxyglucose positron emission tomography [PET] and amyloid accumulation was assessed by 11-C Pittsburgh Compound B PET imaging.
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MedicalResearch.com Interview with:Karen E Lasser, MD MPH
Associate Professor of Medicine
Boston University School of Medicine, Boston, MA
MedicalResearch.com: What are the main findings of the study?Dr. Lasser: After controlling for variables that could affect the risk of readmission, we found that:
There was a slightly increased risk of all-cause readmission in Massachusetts (MA) relative to control states (New York and New Jersey) post-reform.
Racial and ethnic disparities in all-cause readmission rates did not change in MA relative to control states.
However, both blacks and whites in counties with the highest uninsurance rates had a decreased risk of readmission following MA health reform relative to blacks and whites in counties with lower uninsurance rates.
MedicalResearch.com Interview with: Evan A. Stein, M.D., Ph.D. FRCP(C), FCAP
Metabolic and Atherosclerosis Research Center
Cincinnati, OH 45225,
MedicalResearch.com: What are the main findings of the study?Dr. Stein:The study which is the first 52 week randomized double blind trial of a PCSK9 to report results (all others have been 12 weeks) demonstrated that the excellent LDL-C reductions of 55-60% seen at 12 weeks are maintained through 52 weeks, with no fall off in patient compliance, tolerability of efficacy. It also demonstrated that with longer treatment no new or unexpected side effects.
The study also had a unique design in that prior to randomization to the PCSK9 inhibitor (evolocumab) or placebo patients had a run in period during which time they were assigned, based on NCEP-ATP III criteria, to appropriated background therapy which ranged from diet only, to atorvastatin 10 mg a day, to atorvatatin 80 mg a day or atorvastatin 80 mg a day plus ezetimibe - reflecting how these patients are treated in practice. Only then if their LDL-C was still above 75 mg/dL were they randomized into the treatment part of the study with the new drug. The study showed that irrespective of background therapy the reduction with evolocumab was consistent.
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MedicalResearch.com Interview Invitation with: Timothy Hughes, PhD, MPH
Roena B. Kulynych Center for Memory & Cognition Research
Department of Internal Medicine
Division of Gerontology and Geriatric Medicine
Wake Forest School of Medicine
Medical Center Boulevard, Winston-Salem, NC 27157-1207
MedicalResearch.com: What are the main findings of the study?Dr. Hughes: This study is a follow-up to our recent paper that showed a novel relationship between arterial stiffness (commonly measured by pulse wave velocity) and the presence and extent of amyloid deposition in the brain, a hallmark of Alzheimer’s disease. For this study, we repeated brain amyloid imaging (using the Pittsburgh Compound B during PET imaging) in order to look for predictors of change in amyloid over two years in n=81 elderly adults aged 80+ and free from dementia. We observed that measures of systemic arterial stiffness (e.g. brachial ankle pulse wave velocity) was strongly associated with the extent of amyloid deposition in the brain at both baseline and follow-up. The change in brain amyloid accumulation over two years resulted in an increase in in the number of participants with Alzheimer’s-like (amyloid-positive) from 45% at baseline to a surprising 75% after just two years. This change in brain amyloid accumulation over two years was strongly related to having greater central stiffness (as measured by carotid femoral pulse wave velocity). These relationships between arterial stiffness and brain amyloid deposition were independent of the effects of age, gender, body mass index, antihypertensive medication use and even current blood pressure.
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MedicalResearch.com Interview with:M.S. Reimers, MD PhD Student
and
Dr. Jan Liefers MD
Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
MedicalResearch.com: What are the main findings of the study?Answer: Aspirin use was associated with an improved survival, as we have published before when investigating this cohort (Bastiaannet et al, Brit J Cancer 2012/ Reimers et al. J Am Geriatr Soc. 2012. In this study we have focused on investigating which patients will benefit from aspirin treatment by investigating some tumor markers, such as PTGS2 expression, HLA class I expression and PIK3CA mutation status. Interestingly, only patients with HLA class I expression on their tumor membrane will benefit from aspirin treatment and have a better outcome. We raise the hypothesize that aspirin inhibits platelet aggregation to circulating tumors cells. By interfering with this process, the metastatic potential of these circulating tumour cells is inhibited, thereby preventing metastasis and colon cancer death.HLA class I expression might be needed for signalling between platelets and circulating tumor cells. If this hypothesis is confirmed by others or in vitro studies, than this might explain the finding that aspirin seems not only beneficial as an adjuvant therapy for colorectal cancer patients, but also for patients with other malignancies (oesophagus, breast, etc). Interestingly, preliminary findings from our team investigating aspirin use in oesophageal cancer also showed that aspirin use in these tumors was associated with an improved survival.
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MedicalResearch.com Interview with:Eleftherios Mylonakis, M.D., Ph.D., FIDSA
Dean's Professor of Medical Science
Chief, Infectious Diseases Division
Alpert Medical School and Brown University
and Dr. Irene Kourbeti MD
Research Associate
Infectious Disease Division
Rhode Island Hospital, Providence, RI
MedicalResearch.com: What are the main findings of the study?Answer: There was high quality of evidence that biologic agents are associated with increased risk of all opportunistic infections, but there was no difference in mortality attributed to the opportunistic infections. Patients receiving biologics were twice more likely to develop opportunistic infections (OIs) compared to controls (OR 1.79; 95% CI, 1.17-2.74) with a number needed to harm (NNH) of 582 patients. That means that 1 opportunistic infection would occur in every 582 patients receiving biologics. The opportunistic infections usually occurred at the commencement of the use of the biological agent and they were not statistically more in patients with a previous exposure to anti-TNF agents as compared to the patients that had never received an anti-TNF agent..
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MedicalResearch.com Interview with:Hanna Sanoff MD, MPH
Lineberger Comprehensive Cancer Center
Department of Medicine
University of North Carolina, Chapel Hill, NC
MedicalResearch.com: What are the main findings of the study?Dr. Sanoff: We measured p16, a protein that increases with cellular aging, in blood cells of women receiving chemotherapy for breast cancer. We found that a standard course of chemotherapy led to an increase in p16 expression equivalent to what we have previous seen in people over the course of 10-15 years of chronological aging. This increase persisted in cancer survivors an average of three and half years after treatment.
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MedicalResearch.com Interview with:Beatrice A. Golomb MD, PhD
Professor of Medicine
Family and Preventive Medicine
University of California, San Diego
MedicalResearch.com: What are the main findings of the study?Dr. Golomb:The main finding is that veterans with Gulf War illness have bioenergetic defects -- dysfunction of mitochondria, the energy producing elements of cells -- that is evident in comparing affected veterans to matched healthy controls.
An estimated 1/4 to 1/3 of the ~700,000 US veterans from the 1990-1 Gulf War developed chronic multisymptom health problems that entail fatigue, cognitive and other CNS problems, muscle pain, weakness and exercise intolerance, with high rates of gastrointestinal (especially diarrhea) and neurological problems, and other symptoms - as well as autonomic dysfunction. Evidence suggests these problems have not abated with time. Veterans from other nations that have conducted epidemiological studies, including the UK, Canada, and Australia, also show elevated rates of problems.
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MedicalResearch.com Interview with:Dr. Paolo Fiorina, MD PhD
Assistant Professor, Division of Nephrology,
Harvard Medical School
and
Dr. Roberto Bassi
Post-doctoral research fellow
Nephrology Department at Children's Hospital Boston.
MedicalResearch.com: What are the main findings of the study?Dr. Fiorina: It is common knowledge that type 2 diabetes is a worldwide epidemic and that diabetic nephropathy has become the leading cause of renal failure in the western world. One of the main drivers and worsening factors for the diabetic kidney disease is proteinuria associated with various degrees of tubular damage, and unfortunately, therapies to halt or prevent this complication are not available so far. Our findings show that B7-1 when expressed on podocytes (a specific subset of renal cells) determines alterations in podocytes function and morphology, predisposing individuals with T2D to the loss of proteins into the urine. We also demonstrate that Abatacept, an immunomodulatory drug currently employed for the treatment of a variety of autoimmune diseases, is able to specifically target this malignant pathway, preventing podocytes cellular alterations in vitro and proteinuria development in two murine models of diabetic nephropathy in vivo.
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MedicalResearch.com Interview with:Ann Marie Navar-Boggan, MD, PhD
Division of Cardiology,
Duke University Medical Center
Durham, North Carolina
MedicalResearch.com: What are the main findings of the study?Dr. Navar-Boggan: Two groups of adults are really affected by the updated guidelines. First, 13.5 million adults, including one in five adults over the age of 60, were previously considered to have uncontrolled blood pressure but now meet new guideline goals.
Next, 14 million adults over the age of 60 (one in four adults in this age group) are currently on blood pressure lowering therapy and meeting the older, more stringent targets. The guidelines state that no changes are necessary in this group, but they may be eligible for reduced therapy, particularly if they have had side effects or difficulty with the therapies they are taking.
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MedicalResearch.com Interview with:Dr. Prof. Natalia N. Kudryavtseva
Head of Neurogenetics of Social Behavior Sector,
Institute of Cytology and Genetics SD RAS,
Novosibirsk, Russia
MedicalResearch.com: What are the main findings of the study?Answer: Hostile environment and social instability stress can have a significant impact on adolescents, causing the development of anxiety and depression.
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MedicalResearch.com Interview with:
Peter M. Rhee, MD, MPH
Chief, Division of Trauma, Critical Care, Burn and Emergency Surgery
Professor of Surgery, Medical Director,...
MedicalResearch.com Interview with: Michael J. Pencina, PhD
Professor of Biostatistics and Bioinformatics
Director of Biostatistics
Duke Clinical Research Institute
Durham, NC 27710
MedicalResearch.com: What motivated your research?Dr. Pencina: After the new guidelines were issued last November, we were intrigued by the change in treatment philosophy from that based on cholesterol levels (used by the “old guidelines” known as NCEP ATPIII) to one based on 10-year risk of cardiovascular disease (used by the new AHA-ACC guidelines). We were curious what the practical consequences of this shift would be.
Furthermore, the media quoted a lot of experts making educated guesses on the impact. We realized that this question can be answered much more precisely based on the NHANES data.
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MedicalResearch.com Interview with:Michael Laxy
Helmholtz Zentrum München
German Research Center for Environmental Health
Institute of Health Economics and Health Care Management
Neuherberg, Germany
MedicalResearch.com: What are the main findings of the study?Answer: In patients with type 2 diabetes a high level of self-management behavior was associated with a better glycemic control, i.e. a lower HbA1c level, in the cross-sectional perspective and a reduced mortality over a 12-year period. This effect remained robust after controlling for socio-demographic and disease related factors, including medication.
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MedicalResearch.com Interview with:Dr. Najma Ahmed
Trauma and Acute Care Surgeon, St. Michael's Hospital
Residency Training Director, General Surgery, University of Toronto
MedicalResearch.com: What are the main findings of this study:Dr. Ahmed: The main findings if the study were that the recent reduction of resident duty hours to much less than 80 hours decreases health outcomes in patients, has adverse educational outcomes for residents and does not improve wellness in surgery.
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MedicalResearch.com Interview with:Jeff Niederdeppe
Assistant Professor Department of Communication
Cornell University.
MedicalResearch.com: What are the main findings of the study?Answer: We conducted an Internet-based survey (N = 1319) with a nationally-representative sample of U.S. adults aged 18–64 during the fall of 2012. Americans voiced the highest levels of support for calorie labeling (65%) and removing drinks from schools (62%), and the lowest support for taxes (22%) or portion size restrictions (26%). Americans were evenly split on whether or not they support restricting sugary drink to children (50%) and requiring TV stations to air ads promoting healthy eating and exercise equal to the time used to advertise for sugary drinks (51%). Democrats and those with negative views of soda companies are more likely to support each of these policies.
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MedicalResearch.com Interview with:Barbara J. Rolls, PhD
Department of Nutritional Sciences
The Pennsylvania State University, 226 Henderson Building
University Park, PA 16802-6501
MedicalResearch.com: What are the main findings of the study?Dr. Rolls: We found that as we reduced the flake size of a breakfast cereal so that it filled a smaller volume, individuals ate a greater weight and more calories of the cereal. On four occasions, we served a popular wheat flake cereal, or the same weight of cereal crushed to 80%, 60%, or 40% of its volume, to 41 adults for breakfast. As the flake size was reduced, people made reductions in the volume of cereal they poured, but they still took a greater amount of weight and calories. They ended up eating 72 more calories at breakfast when they ate the cereal with the smallest flake size, an increase of 34%. These findings show that variations in food volume due to the size of individual food pieces affect the portion of food that people take, which in turn affects how much they eat.
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MedicalResearch.com Interview with: Florence K. Keane, MD
Harvard Radiation Oncology Program, Harvard Medical School
and Anthony V. D’Amico, MD, PhD
Department of Radiation Oncology,
Dana Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study:Answer: Patients with unfavorable intermediate-risk prostate cancer (PC) [1] have an increased risk of PC-specific mortality (PCSM) after radiotherapy (RT) with or without androgen suppression therapy (AST) compared to favorable intermediate-risk patients [2,3]. We provided validation for this prognostic subdivision using mature data with a median follow-up of 14.3 years from a prospective randomized trial comparing RT alone with RT and 6 months of AST [4]. We also assessed the risk of PCSM in patients with unfavorable intermediate-risk PC compared with high-risk prostate cancer.
Our main findings were as follows.
First, there were no prostate cancer deaths observed in favorable intermediate-risk patients, despite 50% receiving RT alone.
Second, there was not a statistically significant difference in the risk of PCSM in men with unfavorable intermediate-risk prostate cancer compared to men with high-risk PC after randomizing for age, comorbidities and treatment arm. While it is possible that a difference may emerge with longer follow-up, these results suggest that some men with unfavorable intermediate-risk PC may harbor occult GS 8-10 disease and could benefit from a 3.0-Tesla multiparametric MRI and targeted biopsy to rule out GS 8-10 disease.
MedicalResearch.com Interview with: Louise Pilote, MD, MPH, PhD
Department of Medicine, McGill University
Department of Epidemiology and Biostatistics, McGill University
MedicalResearch.com: What are the main findings of the study?Dr. Pilote: Our study found that in patients with atrial fibrillation (AF) undergoing dialysis, warfarin use, compared to no-warfarin use, did not reduce the risk for stroke (adjusted hazard ratio (HR): 1.14, 95% confidence interval (CI): 0.78 to 1.67) but it was associated with a 44% higher risk for bleeding event (adjusted HR: 1.44, 95% CI: 1.13 to 1.85). However, warfarin use in non-dialysis patients with AF was associated with a 13% lower risk for stroke (adjusted HR: 0.87, 95% CI: 0.85 to 0.90) and only a 19% higher risk for bleeding event (adjusted HR: 1.19, 95% CI: 1.16 to 1.22).
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MedicalResearch.com Interview with: Laureen Smith, PhD
Associate Professor
College of Nursing, The Ohio State University
Columbus, OH 43210
MedicalResearch.com: What are the main findings of the study?Dr. Smith: Daily sugar-sweetened beverage decreased significantly by about 1 serving per day. Also weekly consumption decreased from an average of over 4 days per week to about 2 ½ days per week. Generally, the teens were drinking the beverages fewer days per week and less servings on the days they did consume them. These changes were maintained on their own for a month after the intervention ended. Water consumption increased nearly 20 percent immediately post intervention and continued to increase at 30 days post-intervention.
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MedicalResearch.com Interview with: Dr. Hong-Mei Xiao M.D.,Ph.D.
Cognition Section
Professor of Gynecology,Reproductive Medicine
The Institute of Reproduction and Stem Cell Engineering
Xiangya School of Medicine, Central South University
Vice director, Reproduction and Genetics Hospital of CITIC-Xiangya
China, Changsha
MedicalResearch.com: What are the main findings of the study?Dr. Xiao:The study presents the first cases of human primary infertility due to mutation in a zona pellucida gene. We have identified a homozygous frameshift mutation in ZP1 ( GenBank accession number, KJ489454) resulting in the aberrant ZP1, which affects the formation of zona pellucida. We detected an autosomal-recessive pattern of inherited infertility.
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MedicalResearch.com Interview with:Dr Damian Hoy
University of Queensland
School of Population Health
Herston, Australia
MedicalResearch.com: What are the main findings of the study?Dr. Hoy: The study was part of the Global Burden of Disease 2010 study, which was conducted by the University of Queensland, Harvard University, Johns Hopkins University, University of Washington, and hundreds of disease experts throughout the globe. It is the largest ever public health study. It compared the overall burden (in terms of both death and disability) of the most common 291 diseases/conditions in the world. Low back pain was found to cause more global disability than any other disease/condition. If this is something you are going through, it may be worth knowing that marijuana strains for back pain is one of the most powerful remedies. You've possibly tried everything in the shop and over the counter medicine. So why not give this a go and see how you get on. There's no harm in trying.
Global disability from low back pain is increasing. There is an urgent need for global, regional and national agencies to pay far greater attention to the disability caused by low back pain. In the developed world there are low back pain therapy treatments available whereas, in the developing world things aren't as accessible.
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