MedicalResearch.com Interview with:
Gregory J. Tsongalis, PhD, HCLD, CC, FNACB
Professor of Pathology
Director, Molecular Pathology
Co-Director, Translational Research Program
Department of Pathology
Dartmouth Hitchcock Medical Center and
The Audrey and Theodor Geisel School of Medicine at Dartmouth Lebanon, NH 03756
MedicalResearch: What are the main findings of the study?
Dr. Tsongalis: This was the first study of its kind looking at multiple genes and multiple mutations in tumors of the appendix. Many of the identified mutations may be clinically actionable with respect to response to therapy or selection of therapy.
MedicalResearch.com Interview with:
Professor Jayashri Kulkarni MBBS, MPM, FRANZCP, PhD
Monash University
MedicalResearch.com: What are the main findings of the study?
Professor Kulkarni: Persistent schizophrenia is difficult and unfortunately common, despite advances over the past years in antipsychotic drug development. New treatment approaches are urgently needed. Also, a specific focus for women with schizophrenia is still somewhat lacking and there is a need to consider the special issues facing women with schizophrenia.
Over many years, we have been conducting clinical trials to develop the role of adjunctive estradiol use to treat symptoms of schizophrenia. This study is the largest clinical trial in the world of this type and we found that in an 8 week, three arm, double blind, placebo-controlled, adjunctive trial of transdermal estradiol (200mcg v 100mcg v placebo) in 183 women with schizophrenia, that the women who received either 200mcg or 100mcg transdermal estradiol made a better recovery. The women who received 200mcg transdermal estradiol made a slightly better recovery than women receiving 100mcg transdermal estradiol. Both estradiol groups were significantly better than the group who received adjunctive transdermal placebo.
MedicalResearch.com Interview with:
Alex Blum, MD MPH FAAP
Chief Medical Officer
Evergreen Health, Baltimore MD 21211
MedicalResearch.com: What are the main findings of the study?
Dr. Blum: Accounting for the social risk of patients using a measure of neighborhood socioeconomic status (SES), did not alter the hospital rankings for congestive heart failure (CHF) readmission rates.
MedicalResearch.com Interview with:
Aaron L. Leppin, MD
Knowledge and Evaluation Research Unit
Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of the study?
Dr. Leppin: We conducted a systematic review and meta-analysis of randomized trials assessing the effectiveness of hospital discharge interventions on reducing 30-day readmission rates. We identified 47 trials, 42 of which contributed to the primary meta-analysis.
Overall, the interventions that have been tested to reduce early hospital readmissions reduce them by about 20%.
The ones that are most effective, though, reduce them by almost 40% and use a consistent but complex approach. These interventions make a robust effort to fully understand the patient’s post-discharge context, often by visiting the patient’s home. They focus on identifying all the things the patient needs to do to be well—whether that’s organizing medications, getting a ride to the clinic, or paying the electric bill—and they determine whether the patient has the necessary resources and capacity to pull it all off. When limitations are found, these interventions have a strategy in place to support the patient through the post-discharge period.
MedicalResearch Interview with:
Charbel El Bcheraoui, PhD, MSc
Acting Assistant Professor, Global Health
Institute for Health Metrics and Evaluation
University of Washington
Seattle, WA 98121
MedicalResearch: What are the main findings of the study?
Dr. El Bcheraoui: We found a low rate of adverse events associated with male circumcision from U.S. hospital settings, especially if the procedure is performed within the first year of life. The rate of adverse events increased about 10 - 20 times if the procedure was performed later in life.
Dr. Donald Redelmeier, MD
Professor, Full SGS Member
Director, Clinical Epidemiology Unit
Sunnybrook Health Sciences Centre
Toronto, ON
MedicalResearch: What are the main findings of the study?
Dr. Redelmeier: We identified every woman in Ontario, Canada, who gave birth to a newborn baby between 2006 and 2011 and then evaluated each driver for the months before, during, and after pregnancy. This amounted to about half a million women who accounted for almost 8000 serious crashes that sent the driver to hospital. We found that the second trimester of pregnancy led to a 42% increase in the risk of a serious motor vehicle crash. The increased risk included diverse populations, distinct obstetrical cases, different crash characteristics. The risk equated to about twice the population norm but was still below male drivers at this age.
MedicalResearch.com interview with:
Dr Alexandra Pitman MBBS MRC Psych
MRC Clinical Research Fellow,
UCL Division of Psychiatry, UCL (University College London
MedicalResearch: What are the main findings of the study?
Answer: We conducted a systematic review of all published research comparing the experience of suicide bereavement with bereavement due to other causes, in which we considered the evidence from 57 studies evaluating the effect of bereavement on death, mental health, and social functioning of family members, friends, and other close contacts of the deceased. These studies showed that parents and children bereaved by suicide were at higher risk of mental health problems after the loss than parents and children bereaved by other causes, and that spouses and mothers bereaved by suicide were at higher risk of suicide than spouses and mothers bereaved by other causes. We also found some evidence that people from a range of kinship groups bereaved by suicide report more rejection and shame than people bereaved by other violent deaths, and that feeling stigmatised by the death is commonly experienced after any violent bereavement. It seemed that people bereaved by violent deaths, for example due to accidental death, homicide, drug-related death, motor vehicle crash, undetermined death or suicide, shared a sense of feeling blamed for the death or tainted by their association with the deceased.
MedicalResearch.com Interview with:
Dr. Julie Paik, MD MPH MSc
Instructor, Harvard Medical School
Brigham and Women's Hospital
MedicalResearch: What are the main findings of the study?
Dr. Paik: Many women in the United States take calcium supplements. One study found that over 60% of women aged 60 and over in the United States were taking calcium supplements. However, the medical community is still not certain of the effects of calcium supplements in women, particularly on cardiovascular disease risk. For this reason, we studied 74,245 women participating in the Nurses' Health Study over a 24-year follow-up period for their risk of developing cardiovascular disease (heart disease or stroke). We found that there was no increased risk of heart disease or stroke among women taking calcium supplements during the 24-year follow-up period. Our paper has several distinct strengths compared to prior studies including the large sample size, long follow-up period, cases of cardiovascular disease that were confirmed by medical record review, detailed and repeated assessment of calcium supplement use, and detailed information about other risk factors for cardiovascular disease.
MedicalResearch.com Interview with:
Richard D. Semba, MD MPH
W. Richard Green Professor of Ophthalmology
The Johns Hopkins University School of Medicine
Baltimore, MD 21287
MedicalResearch: What are the main findings of the study?
Dr. Semba: Resveratrol levels in older adults are not related to the risk of heart disease or cancer and are not related with lifespan. These findings were made in the InCHIANTI Study, a rigorously conducted study of human aging that is sponsored by the National Institute on Aging.
MedicalResearch.com Interview with:
Julie Wang, MD
Associate Professor of Pediatrics
Division of Allergy and Immunology
Icahn School of Medicine at Mount Sinai
New York, NY 10029
MedicalResearch: What are the main findings of the study?
Dr. Wang: The results of this study demonstrate that differences in prevalence of reported food allergies exist in elementary schools representing diverse socioeconomic and racial/ethnic characteristic. In this study, we conducted a survey at 4 elementary schools in New York City, 2 private schools that had a predominantly White student body with over 80% of families having paid a full tuition of over $35,000 per year and 2 public charter schools that had a primarily Black and Hispanic student body where over 90% of students qualified for free or reduced price school lunch. The results show a high rate of reported food allergy, with rates significantly higher in the private school population as compared to the public charter school population.
MedicalResearch.com Interview with:
Dr. Carlo Riccardo Rossi, MD
Melanoma and Sarcoma Unit, Veneto Institute of Oncology
Surgery Branch, Department of Surgery
Oncology, and Gastroenterology, University of Padova,
Padova, Italy
MedicalResearch: What are the main findings of the study?
Dr. Rossi: A total of 90% patients undergone lymph node dissection for melanoma had 12, 7, 14, 6 and 13 excised lymph nodes (10th percentile of the distribution) after 3 level axillary, 3 level or less neck, 4 level or more neck, inguinal, or ilio-inguinal dissections, respectively.
MedicalResearch.com Interview with:
Kwang-il Kim, MD, PhD
Associate Professor, Department of Internal Medicine,
Seoul National University College of Medicine,
Seoul National University Bundang Hospital,
Seoul, Republic of Korea
MedicalResearch: What are the main findings of the study?
Answer: There are few tools of preoperative risk stratification for the older adults. We found that not only disease itself but also frailty can lead to post-operative complication and mortality. So we made a scoring model to predict post-operative mortality and morbidity based on comprehensive geriatric assessment and it worked exactly.
MedicalResearch: Were any of the findings unexpected?
Answer: Under our predictive model, there was inflection point of mortality slope at point 5. Post-operative mortality of someone who scores 4~5 is below 10%, but it of other who scores 6~7 is about 30%. It was unexpected drastic change, so we think that there is physiologic threshold point.
MedicalResearch: What should clinicians and patients take away from your report?
Answer: Because the elderly are different from adults, clinicians have to focus on functional capacity, co-morbidity, and frailty for their older surgical patients. Make operative decision base on comprehensive geriatric assessment or our scoring model. If you depend on your own feeling, some older patients will suffer from post-operative complication and someone will forfeit his chance of surgery.
MedicalResearch.com Interview with:
Meagan F. Vaughn, PhD
Postdoctoral Trainee
Department of Epidemiology
Gillings School of Global Public Health
University of North Carolina at Chapel Hill
MedicalResearch: What are the main findings of the study?
Dr. Vaughn: Outdoor workers are at high-risk for tick-borne diseases. Adherence to recommended tick-bite prevention methods is poor. While permethrin treatment of clothing is highly protective against many arthropod vectors, the need for frequent reapplication lessens adherence. A double-blind randomized intervention was conducted to determine the effectiveness of long-lasting permethrin-impregnated uniforms for tick bite prevention among outdoor workers from North Carolina. Treatment group uniforms were factory-impregnated with long-lasting permethrin by Insect Shield, while control group uniforms received sham treatment. Participants completed weekly tick bite logs during two tick seasons. 130 participants reported 1,045 work-related tick bites over 5,251 person-weeks of follow-up. The effectiveness of long-lasting permethrin impregnated uniforms for prevention of work-related tick bites was 82% (p<0.001) for the first year and 34% (p=0.38) for the second year. These results indicate that long-lasting permethrin impregnated uniforms are highly effective for at least one year against tick bites among North Carolina outdoor workers.
MedicalResearch.com Interview with:
Zobair Younossi, MD, MPH
Chairman, Department of Medicine, Inova Fairfax Hospital
Vice President for Research, Inova Health System
Falls Church, Virginia, USA
MedicalResearch: What are the main findings of the study?
Dr. Younossi: We conducted the analysis of the patient reported outcomes (PROs) data that were systematically collected during clinical trials of sofosbuvir-containing regimens. The highlights of our findings are as follows:
MedicalResearch.com Interview with:
Mireille Serlie, MD PhD
Academic Medical Center
University of Amsterdam
Department of Endocrinology and Metabolism
Amsterdam, The Netherlands
MedicalResearch What are the main findings of the study?
Dr. Serlie: We studied the effects of hypercaloric high sugar or high fat/high sugar drinks consumed with the 3 main meals (representing an increase in meal size) or in between the 3 main meals (representing an increase in meal frequency or snacking). All subjects gained a similar amount of body weight but only the ones that snacked showed an increase in liver and abdominal fat. This suggests that besides caloric content and diet composition, eating pattern independently contributes to liver and abdominal fat accumulation. We also observed a trend for a decrease in hepatic insulin sensitivity in the high fat/high sugar frequency group only.
MedicalResearch.com Interview with:
Luisa Soares-Miranda, PhD
Research Center in Physical Activity, Health and Leisure
Faculty of Sport, University of Porto
Rua Dr. Plácido Costa,
Porto PORTUGAL
MedicalResearch: What are the main findings of the study?
Dr. Soares-Miranda: Modest physical activity, such as the distance and pace of walking, is important for the heart’s electrical well being of older adults. In our study, older adults that increased their walking pace or distance had a better heart rate variability when compared with those that decreased their walking pace or distance. Our results suggest not only that regular physical activity later in life is beneficial, but also that certain beneficial changes that occur may be reduced when physical activity is reduced. This supports the need to maintain modest physical activity throughout the aging process. Even small increases can lead to a better health, while reducing physical activity has the opposite effect. So, any physical activity is better than none, and more is better.
MedicalResearch.com Interview with:
Dr. Ignacio F. San Francisco
Departamento de Urología, Facultad de Medicina,
Pontificia Universidad Católica de Chile, Santiago, Chile
MedicalResearch: What are the main findings of the study?
Answer: Increasingly, men with low-risk prostate cancer are undergoing a close monitoring regimen called active surveillance, instead of moving forward immediately with treatment. However it is still unclear which men will develop evidence for worsening or more aggressive disease during active surveillance. In this study of 154 men with Gleason 6 prostate cancer followed for 38 months, we found that low levels of free testosterone were significantly associated with increased risk of developing more aggressive disease. We found no significant association with total testosterone concentrations, although there was a general trend towards increased risk with lower levels.
MedicalResearch.com Interview with:
Benjamin D. Sommers, MD, PhD
Assistant Professor of Health Policy & Economics
Harvard School of Public Health / Brigham & Women's Hospital
Boston, MA 02115
MedicalResearch.com: What are the main findings of the study?
Dr. Sommers: We find that over the first four years since Massachusetts' 2006 comprehensive health reform law, all-cause mortality in the state fell by 2.9%, compared to a similar population of adults living in counties outside Massachusetts that did not expand insurance during this period. We also found that the law reduced the number of adults in Massachusetts without insurance, reduced cost-related barriers to care, increased use of outpatient visits, and led to improvement in self-reported health. Overall, we estimate that the health reform law prevented over 320 deaths per year in the state - or one life saved per 830 adults gaining health insurance. Mortality rates declined primarily due to fewer deaths from causes amenable to health care, such as cancer, infections, and heart disease. We also found that the health benefits were largest for people living in poor counties in the state, areas with higher percentage of uninsured adults before the law was passed, and for minorities.
MedicalResearch.com Interview with: Niklas Mattsson MD, PhD University of California San Francisco Center for Imaging of Neurodegenerative Diseases VA Medical Center San Francisco, CA 94121, USA Clinical Neurochemistry Laboratory Institute of Neuroscience and Physiology Sahlgren’s University Hospital/Mölndal MedicalResearch.com: What are the main findings of the study? Dr. Mattsson: The main finding of this study was that cognitively healthy people with signs of...
MedicalResearch.com Interview with:
Amit Singal MD MS
Assistant Professor of Medicine
Medical Director, Liver Tumor Program
Dedman Scholar of Clinical Care
Division of Digestive and Liver Diseases
University of Texas Southwestern
Dallas TX 75201 - 8887
MedicalResearch: What are the main findings of the study?
Dr. Singal: We conducted a meta-analysis of current studies to characterize the association between hepatocellular carcinoma surveillance and early detection, curative treatment rates, and overall survival in patients with cirrhosis. We identified 47 studies with 15,158 patients, of whom 6,284 (41.4%) had hepatocellular carcinoma detected by surveillance. Hepatocellular carcinoma surveillance was associated with improved early stage detection (OR 2.08, 95% CI 1.80–2.37) and curative treatment rates (OR 2.24, 95% CI 1.99–2.52). These associations were robust to several sensitivity analyses, including study design, study location, and study period. Hepatocellular carcinoma surveillance was associated with significantly prolonged survival (OR 1.90, 95% CI 1.67–2.17), which remained significant in the subset of studies adjusting for lead-time bias. Three-year survival rates were 50.8% among patients who underwent surveillance, compared to only 28.2% among hepatocellular carcinoma patients with tumors detected outside of a surveillance program.
MedicalResearch.com Interview with:
Kejal Kantarci, M.D. M.S.
Professor of Radiology
Division of Neuroradiology
Mayo Clinic, Rochester, MN 55905
MedicalResearch: What are the main findings of the study?
Dr. Kantarci: Microinfarcts are one of the most common pathologies identified in the brains of older individuals and they impact cognition. However they are invisible lesions on MRI. We demonstrated that presence of microinfarcts in autopsied individuals are associated with the macroinfarcts identified on their MRI scans than they were alive. We also demonstrated that the presence of these invisible lesions are related to greater brain atrophy rates that are localized to watershed zones.
MedicalResearch.com Interview with:
Dana Dabelea, MD, PhD
Professor and Associate Dean, Faculty Affairs
Colorado School of Public Health
University of Colorado Denver
Aurora, CO 80045
MedicalResearch.com: What are the main findings of the study?
Dr. Dabelea: We found that the proportion of US youth living with Type 1 Diabetes has increased by at least 21% over a period of only 8 years. This increase was seen in both boys and girls, most age-groups and race/ethnic groups. While we do not completely understand the reasons for this increase, since the causes of Type 1 Diabetes are still unclear, it is likely that something has changed in our environment- both in the US and elsewhere in the world- causing more youth to develop the disease, maybe at increasingly younger ages.
MedicalResearch.com Interview with:
Jessica A. Grieger (BSc(hons), R Nutr, PhD)
Post-doctoral research fellow
Robinson Research Institute, University of Adelaide
MedicalResearch: What are the main findings of the study?
Dr. Grieger: The study aimed to identify associations between maternal dietary patterns in the 12 months before conception on fetal growth and preterm delivery. We report that a one standard deviation increase in the scores on the high-protein/fruit pattern was associated with decreased likelihood for preterm birth, whereas a one standard deviation increase on the high-fat/sugar/takeaway pattern was associated with increased likelihood for preterm birth as well as shorter gestation and birth length.