MedicalResearch.com Interview with:Dr. Takatoshi Kasai, MD, PhD
Department of Cardiology and Cardio-Respiratory Sleep Medicine,
Juntendo University School of Medicine, Tokyo, Japan
MedicalResearch.com: What are the main findings of the study?
Dr. Kasai: Sleep disordered breathing, determined using predischarge nocturnal pulse oximetry, is prevalent and is an independent predictor of the combined end point of readmission and mortality in hospitalized patients with left ventricular systolic dysfunction after acute decompensated heart failure.
MedicalResearch.com Interview with:Dr. Meghan Azad, PhD
Banting Postdoctoral Fellow
Department of Pediatrics
University of Alberta
MedicalResearch.com: What are the main findings of the study?Dr. Azad: In this study, our goal was to evaluate the clinical evidence for using probiotics (live "healthy bacteria") to prevent childhood asthma. We reviewed the results of 20 clinical trials involving over 4000 infants, where probiotics were administered during pregnancy or the first year of life, and found no evidence to support the use of probiotics for asthma prevention. Children receiving probiotics were just as likely to develop asthma as children receiving placebo. Similarly, there was no effect of probiotic supplementation on the development of wheezing.
MedicalResearch.com Interview with:Aniket D. Kulkarni, M.B., B.S., M.P.H
Women's Health and Fertility Branch
Centers for Disease Control and Prevention
MedicalResearch.com: What are the main findings of the study?Dr. Kulkarni: Our study estimates the contribution of fertility treatments and natural conception to multiple births. Fertility treatments include IVF and non-IVF treatments. Non-IVF treatments primarily include ovulation induction and ovarian stimulation coupled with timed intercourse or intrauterine insemination (IUI). All estimated proportions were adjusted for maternal age which makes this study unique.
The incidence of twin births nearly doubled and the incidence of triplet and higher-order births quadrupled over the last 4 decades.
Our study estimates that by 2011, a total of 36% of twin births and 77% of triplet and higher-order births resulted from conception assisted by fertility treatments, after adjusting for maternal age.
After initial increase, the incidence of triplet and higher order births decreased by 29% from 1998 to 2011. The decrease in triplet and higher order births has coincided with a 70% reduction in the transfer of 3 or more embryos during IVF and a 33% decrease in the proportion of triplet and higher order births attributable to IVF. The decline in the number of embryos transferred during IVF became possible due to monitoring of ART treatments and outcomes and the work of professional societies, which have repeatedly revised practice guidelines to include recommendations for lowering the number of embryos transferred.
In contrast, non-IVF fertility treatments of ovulation induction and ovarian stimulation are estimated to contribute the increasing number of multiple births. Hence there is a need for surveillance of births from non-IVF fertility treatments.
MedicalResearch.com Interview with:Dr Kirstin R Mitchell PhD
Lecturer in Sexual and Reproductive Health
Dept of Social and Environmental Health Research
Faculty of Public Health & Policy
London School of Hygiene and Tropical Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Mitchell: We explored the distribution of sexual function in the British population using a probability sample survey (the third National Survey of Sexual Attitudes and Lifestyles [Natsal-3]) of 15 162 individuals aged 16–74 years. We measured sexual function using the Natsal-SF, a novel validated measure, which assessed problems with individual sexual response, sexual function in a relationship context, and self-appraisal of sex life.
Men and women in the oldest age groups surveyed (55 – 74) were more likely to have low overall sexual function than those in the youngest age group (16 – 24). After taking account of age differences, low sexual function was associated in both men and women with being unemployed, with current depression, and with poor general health. It was also associated with higher numbers of lifetime partners (women only), paying for sex (men only), and reporting same-sex partners, as well as with other aspects of sexual health, such as being diagnosed with an STI and experiencing sex against their will.
Low sexual function was associated with relationship breakdown, and with people not being happy with their relationship. Within relationships, the most common problem was an imbalance in level of interest in sex between partners, which affected around a quarter of both men and women. Just under one in five men and women said their partner had experienced sexual difficulties in the last year, and this proportion increased with age, particularly among women.
Lack of interest in sex was one of the most commonly reported problems for both men and women, affecting three in every twenty (15%) men, and with women twice as likely as men to say that this had been an issue in the last year. Difficulty reaching climax (16%) and vaginal dryness (13%) were among common problems for women; and reaching a climax more quickly than desired (15%), and difficulty getting or keeping an erection (13%) among men.
MedicalResearch.com Interview with:J. Randall Curtis, MD, MPH
Professor of Medicine
Director, UW Palliative Care Center of Excellence
Section Head, Pulmonary and Critical Care Medicine, Harborview Medical CenterA. Bruce Montgomery, M.D. – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA 98104
MedicalResearch.com: What are the main findings of the study?Dr. Curtis: We examined the effect of a communication-skills intervention for internal medicine and nurse practitioner trainees on patient- and family-reported outcomes. The study was funded by the National Institutes of Nursing Research of the National Institutes of Heatlh. We conducted a randomized trial with 391 internal medicine and 81 nurse practitioner trainees at two universities. Participants were randomized to either an 8-session simulation-based, communication-skills intervention or to usual education. We collected outcome data from a large number of patients with life-limiting illness and their families, including 1866 patient ratings and 936 family ratings. The primary outcome was patient-reported quality of communication and, overall, this outcome did not change with the intervention. However, when we restricted our analyses to only patients who reported their own health status as poor, the intervention was associated with increased communication ratings. Much to our surprise, the intervention was associated with a small but significant increase in depression scores among post-intervention patients. Overall, this study demonstrates that among internal medicine and nurse practitioner trainees, simulation-based communication training compared with usual education improved communication skills acquisition, but did not improve quality of communication about end-of-life care for all patients. However, the intervention was associated with improved patient ratings of communication for the sickest patients. Furthermore, the intervention was associated with a small increase in patients’ depressive symptoms, and this appeared most marked among patients of the first-year residents.
MedicalResearch.com Interview with:James Guevara, MD, MPH
Associate Professor of Pediatrics & Epidemiology
Senior Diversity Search Advisor, Perelman School of Medicine
University of Pennsylvania,Director of Interdisciplinary Initiatives
PolicyLab: Center to Bridge Research, Practice, & Policy
The Children's Hospital of Philadelphia,Philadelphia, PA 19104
MedicalResearch.com: What did the study attempt to address?Dr. Guevara: Medical schools have sought to build more diverse faculty in their institutions through faculty development programs targeted to underrepresented minority faculty members. This study was conduct by THE CHILDREN'S HOSPITAL OF PHILADELPHIA'S POLICYLAB and The University of Pennsylvania and sought to determine if there was an association between minority faculty development programs and the representation, recruitment, and promotion of underrepresented minority faculty.
MedicalResearch.com Interview with:Michael D. April, MD, DPhil
San Antonio Uniformed Services Health Education Consortium.Department
Harvard Medical School
The Medical Practice Evaluation Center
MedicalResearch.com: What are the main findings of this study?Dr. April: Using a mathematical model, this study quantified the survival benefits associated with antiretroviral therapy to HIV-infected people in South Africa since 2004. Our results highlight the astounding benefits of treatment. In short, antiretroviral therapy has saved 2.8 million years of life in South Africa to date and is projected to save an additional 15.1 million years of life by 2030.
MedicalResearch.com Interview with:Alessandra d’Azzo PhD
Department of Genetics, St Jude Children’s Research Hospital
262 Danny Thomas Place, Memphis, Tennessee 38105
MedicalResearch.com: What are the main findings of the study?Dr. d’Azzo: We have discovered a connection between a rare childhood disorder and Alzheimer’s disease that usually affects older people.
The culprit is a metabolic enzyme called NEU1 that normally controls the recycling or disposal of proteins in a specific cell compartment, the lysosome.
When NEU1 is defective, children develop the severe metabolic disease, sialidosis.
Our study suggests that NEU1 also plays an important role in the development of Alzheimer’s disease. Based on this discovery, we decided to increase NEU1 enzyme activity in the brain of an Alzheimer’s disease mouse model that shows features characteristic of the human disease, namely the accumulation of toxic protein aggregates or plaques. Remarkably, we could significantly diminish the number of plaques in the brain of these mice by increasing NEU1 enzyme activity.
MedicalResearch.com Interview with: Brian Grunau MD
Emergency Physician, St. Paul's Hospital
Clinical Assistant Professor, UBC Department of Emergency Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Grunau: Among 2819 consecutive Emergency Department visits of patients with allergic reactions or anaphylaxis, five clinically important biphasic reactions were identified (0.18%; 95% confidence interval [CI] 0.07% to 0.44%), with two occurring during the ED visit and three post-discharge. There were no fatalities. When examining patients who satisfied the definition for anaphylaxis and those who did not separately, clinically important biphasic reactions occurred in 2 patients (0.40%; 95% CI 0.07% to 1.6%) and 3 patients (0.13%; 95% CI 0.03% to 0.41%), respectively.
MedicalResearch.com Interview with:Dr. Morten Sejer Hansen
Department of Anaesthesia 4231
Centre of Head and Orthopaedics, Rigshospitalet
Copenhagen University Hospital, Copenhagen, Denmark
MedicalResearch.com: What are the main findings of the study?Answer: Out-of-hospital administration of intranasal fentanyl in doses of 50 and 100 microgram appears to be safe and well tolerated, with a low incidence of side effects
Secondly, intranasal fentanyl appeared effective in a wide range of patients, although no firm conclusions on analgesic efficacy can be provided due to the lack of a placebo control.
MedicalResearch.com Interview with:Ian Kronish, MD, MPH
Assistant Professor of Medicine
Center for Behavioral Cardiovascular Health
Division of General Medicine
Columbia University Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Kronish:Among primary care patients with persistently uncontrolled blood pressure despite medication treatment, we found that medication non-adherence was more than twice as common in patients with PTSD (68%) as compared to patients without PTSD (26%). The association between PTSD and medication non-adherence remained present after adjustment for key covariates including regimen complexity and depression. Recent research shows that PTSD not only contributes to psychological distress, but is also associated with increased risk for incident and recurrent cardiovascular disease. The data from our study suggest that medication non-adherence may be an important mechanism by which PTSD increases risk for cardiovascular disease.
MedicalResearch.com Interview with:Dr. Lianne Jeffs PhD
Nurse and researcher at St. Michael's Hospital
University of Toronto
MedicalResearch.com: What are the main findings of the study?Dr. Jeffs: The main findings of the study include:
1. Patients described the bedside nursing handover as engaging, personal and informative. The bedside nursing handover created a a space to connect with their nurses in a more personal manner (e.g., provided an introduction between patient and nurse at the beginning of the shift)
2. Patients found the experience increased their engagement in their own care, and kept them informed about their health status and care plan. It also gave the patient an opportunity to identify important needs to the nurse (e.g., daily activities)
3. Not all patients wanted to participate in the bedside nursing handover. This was typically exemplified by long-term-stay patients.
MedicalResearch.com Interview with:Hans-Willem Snoeck MD, PhD
Columbia University Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Snoeck: We were, for the first time, able to differentiate human embryonic stem cells and induced pluripotent stem cells into at least 6 different types of lung and airway epithelial cells. Furthermore, we could demonstrate function of surfactant-producing type II alveolar epithelial cells, and the lung progenitors we generated could generate airway after transplantation under the kidney capsule of immunodeficient mice.
MedicalResearch.com Interview with:Dr Nigel Field MBPhD
Research Department of Infection and Population Health
University College London, London, UK
MedicalResearch.com: What are the main findings of the study? Dr. Field:This study, published in The Lancet on Tuesday 26 November, reports data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal), interviewing over 15,000 participants aged 16-74 years, to systematically assess the association between people’s health and their sexual lifestyles in Britain. The key findings from the study are that close to one in six (17%) of men and women feel that their health had affected their sex life in the past year. This rises to three fifths (60%) among men and women who say that they are in bad health. However, only a quarter of men (24%) and under a fifth of women (18%) who say that ill-health affects their sex life had sought help from a health profession, usually a family doctor.
MedicalResearch.com Interview with:Jakob Christensen
Department of Neurology, Aarhus University Hospital, Aarhus, Denmark;
Merete Juul Sørensen
Regional Centre of Child and Adolescent Psychiatry, Aarhus University Hospital
MedicalResearch.com: What are the main findings of the study?Answer: We found that the risk of autism spectrum disorder was increased by 50% in children of mothers who took antidepressants during pregnancy. However, when we controlled for other factors related to the medication, by comparing with children of mothers with a diagnosis of depression or with un-exposed siblings, the risk was smaller and not significantly increased.
MedicalResearch.com Interview with: Richard Schwartz, Ph.D.
Professor, Associate Dean for Graduate Academic and Student Affairs College of Natural Science Michigan State University
Department of Microbiology and Molecular Genetics
Michigan State University East Lansing, MI 48824-4320
MedicalResearch.com: What are the main findings of the study?Dr. Schwartz: The main finding is that exposure to a high fat diet from the age of puberty onwards hastened the development of chemical carcinogen-induced breast cancer in absence of weight gain. We also found that prior to the appearance of any tumors, we could detect changes in the mammary gland that included increased cellular proliferation, increased vascularity, and changes in immune function.
MedicalResearch.com Interview with:Dr. Victor W. Henderson MD
Professor of Health Research and Policy and of Neurology and Neurological Sciences
Stanford University, Stanford, CA 94305
MedicalResearch.com: What are the main findings of the study?Dr. Henderson: Estrogen or hormone therapy effects on some health outcomes differ by age, harmful at one age and beneficial at another.
This difference is sometimes referred to as the “critical window” or “timing” theory. It is controversial whether the so-called critical-window applies to memory or other cognitive skills.
In assessing the critical window hypothesis, we found that the relation between blood levels of estrogen and memory or reasoning skills is the same in younger postmenopausal women as in older postmenopausal women. Essentially, there is no association at either age.
MedicalResearch.com Interview with Marzia Lazzerini, PhD
Institute for Maternal and Child Health IRCCS “Burlo Garofolo,”
MedicalResearch.com: What are the main findings of the study?Answer: In children and adolescent with Crohn’s disease refractory to first and second line treatment, thalidomide was effective in inducing and maintaining clinical remission. About 60% of children achieved clinical remission, and clinical remission was maintained for a mean time of 180 weeks. The main reason to stop thalidomide was peripheral neuropathy.
MedicalResearch.com Interview with:Ida C. Svege PhD student / Physical Therapist NAR
Norwegian research centre for Active Rehabilitation Department of Orthopaedics, Oslo University Hospital / NIMI / Norwegian School of Sports Sciences
MedicalResearch.com: What are the main findings of the study?Answer: The main finding of the study was that exercise therapy in addition to patient education resulted in significantly higher 6-year cumulative survival of the native hip to total hip replacement compared with patient education only. Over the 6 year follow-up period the need for total hip replacement was reduced by 44% in the group who received both exercise therpay and patient education. Also, better self-reported physical function was demonstrated in the group who received exercise therapy and patient education, suggesting that the lower surgery rate in this group were due to better hip function, with or without the presence of pain.
MedicalResearch.com Interview with:Craig A Umscheid, MD, MSCE, FACP
Assistant Professor of Medicine and Epidemiology
Director, Center for Evidence-based Practice
Medical Director, Clinical Decision Support
Chair, Department of Medicine Quality Committee
Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center
University of Pennsylvania Philadelphia, PA 19104
MedicalResearch.com: What are the main findings of the study?Dr. Umscheid: We developed and successfully deployed into the electronic health record of the University of Pennsylvania Health System an automated prediction tool which identifies newly admitted patients who are at risk for readmission within 30 days of discharge. Using local data, we found that having been admitted to the hospital two or more times in the 12 months prior to admission was the best way to predict which patients are at risk for being readmitted in the 30 days after discharge. Using this finding, our automated tool identifies patients who are “high risk” for readmission and creates a “flag” in their electronic health record (EHR). The flag appears next to the patient’s name in a column titled “readmission risk.” The flag can be double-clicked to display detailed information relevant to discharge planning. In a one year prospective validation of the tool, we found that patients who triggered the readmission alert were subsequently readmitted 31 percent of the time. When an alert was not triggered, patients were readmitted only 11 percent of the time. There was no evidence for an effect of the intervention on 30-day all-cause readmission rates in the 12-month period after implementation.
MedicalResearch.com Interview with:Thomas D. Sequist, MD, MPH,
MedicalResearch.com: What are the main findings of the study?Dr. Sequist: Our study, the Impact of Cost Displays on Primary Care Physician Laboratory Test Ordering published in the Journal of General Internal Medicine found that when the costs of certain lab tests were displayed electronically in real time, the rate at which physicians ordered tests decreased. It was conducted among 215 primary care physicians working for Atrius Health, an alliance of six non-profit medical groups and a home health and hospice agency in Massachusetts, where an integrated electronic health record system is used. Physicians in the intervention group received real-time information on laboratory costs for 27 individual tests when they placed their electronic orders, while the control group did not. What we found was a significant decrease in the ordering rates of both high and low cost range tests by physicians to whom the costs of the tests were displayed electronically in real-time. This included a decrease in ordering rates for four of the 21 lower cost laboratory tests, and one of six higher cost laboratory tests.
In addition, physicians were generally very receptive to the intervention. A majority (81 percent) reported that the exercise increased their knowledge regarding costs of care and requesting real-time cost information on an expanded set of health care services.
MedicalResearch.com Interview with Deanna Kepka, PhD, MPH
College of Nursing & Huntsman Cancer Institute
University of Utah
MedicalResearch.com: What are the main findings of the study?
Dr. Kepka: Nearly two-thirds, 64.8% (95% CI: 62.2% - 67.3%) of women reporting a hysterectomy also reported a recent Pap test since their hysterectomy and more than half, 58.4% (95% CI: 55.3% - 61.4%) of women age 65 years and older without a hysterectomy reported a Pap test in the past three years. Together, this represents approximately 14 million in the United States.
MedicalResearch.com Interview with:Bledar Daka MD, PhD-student.
University of Gothenburg in Sweden
MedicalResearch.com: What are the main findings of your study?Answer:The main finding of our study was that low testosterone levels were associated with MI in both men and women but the association was stronger in men with type 2 diabetes.
This finding was in concert with findings that could associate the CVD death with low levels of testosterone especially in elder men.
MedicalResearch.com Interview with:Elin Ekblom Bak | Doktorand
Institutionen för Medicin, Enheten för klinisk epidemiologi,
Karolinska universitetssjukhuset Solna
114 86 Stockholm
MedicalResearch.com: What are the main findings of the study?
Answer: That we, in a large sample of 60 y old men and women, found that a generally active day life (compared with an inactive daily life) was significantly associated with a better metabolic health at baseline, and a reduced risk with 27% for a first time cardiovascular event and 30% for all-cause mortality during 12.5 years of follow up. This was seen regardless of intentional exercise. Why this is important is because the focus is often of just exercise for health benefits and longevity. Exercise is still important, but, as we saw in this study, the activity that we do during the extended hours of daily living is as important and has a significant effect on cardiovascular health and longevity. These results are in a reversed way in line with the detrimental effects of prolonged sitting (regardless exercise habits) now frequently reported in an increasing amount of research studies. This is because sedentary time mainly replaces time in daily activity, and vice versa (daily activity replace time spent sitting).
MedicalResearch.com InterviewDr. Michael Shevell
Chair of the Pediatrics Department at the McGill Faculty of Medicine and Pediatrician-in-Chief at the Montreal Children’s Hospital and the McGill University Health Centre
MedicalResearch.com: What are the main findings of the study?Dr. Shevell: At risk term infants who have spent some time in a Level III NICU after birth are at substantially increased later risk for an autistic spectrum disorder. Frequently this disorder occurs in conjunction with substantial co-morbidity.
MedicalResearch.com Interview with:Dr Julia Wade PhD
University of Bristol, Clifton, Bristol
MedicalResearch.com: What are the main findings of the study?Dr. Wade:We hope that our study provides men with more information about diagnosing prostate cancer. A diagnosis of prostate cancer can only be confirmed through prostate biopsies after the finding of a raised PSA. This biopsy process requires 10 or so samples to be taken rectally, with a local anaesthetic, and this has some side effects. Most men describe prostate biopsies as uncomfortable, but around 40% report pain and many experience bleeding; a small number, 1%, are admitted to hospital and 10% need to see a doctor because of post-biopsy symptoms. We found that the men who experienced post-biopsy symptoms as ‘problematic’ at 7 days post biopsy also experienced raised anxiety compared to men who experienced symptoms as non-problematic
MedicalResearch.com Interview with: Mehwish Qasim
PhD Candidate, Research & Teaching Assistant
Department of Health Management and Policy
University of Iowa, College of Public Health
MedicalResearch.com: What are the main findings of the study?Answer:This study focused on two questions: Do patients living in the poorest communities have worse post-surgical outcomes than those in the wealthiest communities? And has the level of these differences in post-surgical outcomes changed over time?
We found that although post-surgical outcomes improved in general from 2000-2009, (significant decreases in nine of twelve mortality and patient safety measures), patients from low-income areas had worse surgical outcomes than those from high-income areas for nine of twelve measures in both 2000 and 2009. The disparities in outcomes between low- and high-income groups did not change significantly for nine of the twelve measures.
MedicalResearch.com Interview with:Professor Clive Page
Director, Sackler institute of Pulmonary Pharmacology
Joint Head, Institute of Pharmaceutical Science
King's College London
150 Stamford Street Waterloo Campus
London SE1 9NH
MedicalResearch.com: What are the main findings of the study?Prof. Page: RPL 554 was shown to cause bronchodilation and anti-inflammatory activity at the same dose. The drug showed benefit in both patients with COPD and asthma.
MedicalResearch.com Interview with:Prof Ype Elgersma PhD
Neuroscience Institute, Erasmus University Rotterdam
MedicalResearch.com: What are the main findings of the study?Answer: Research in genetic mouse models suggested that inhibition of HMG-CoA-reductase by statins might ameliorate the cognitive and behavioral phenotype of children with Neurofibromatosis type 1 (NF1), an autosomal dominant disorder. In a 12-month randomized placebo-controlled study including 84 children with NF1, we found that simvastatin, an inhibitor of the HMG-CoA-reductase pathway had no effect on full-scale intelligence, attention problems or internalizing behavioral problems, or on any of the secondary outcome measures.
MedicalResearch.com Interview with:Michael Ho, MD, PhD
Assistant Professor of Medicine, Division of Cardiology
Cardiology 111B 1055 Clermont Street
Denver CO 80220
MedicalResearch.com: What are the main findings of the study?Dr. Ho: We found that testosterone use was associated with a 29% increased risk of death, MI and stroke over a follow-up period of 27 months. The risk was similar among patients with or without coronary artery disease on coronary angiography.
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