Author Interviews, Critical Care - Intensive Care - ICUs, Infections, Outcomes & Safety / 20.01.2014

Allan J. Walkey, M.D., M.Sc Boston University School of Medicine Pulmonary Center Boston, MassachusettsMedicalResearch.com Interview with: Allan J. Walkey, M.D., M.Sc Boston University School of Medicine Pulmonary Center Boston, Massachusetts MedicalResearch.com: What are the main findings of the study? Dr. Walkey: Thank you for the interest in our study.  Current evidence-based treatments for severe sepsis (ie, infection+systemic inflammatory response+ end organ dysfunction) include specific processes of care rather specific therapeutics.  These processes include early administration of antibiotics, early fluid resuscitation, and lung protective ventilation strategies.  We hypothesized that hospitals with more ‘practice’ at treating patients with severe sepsis may have more effective care processes leading to improved patient outcomes.  We examined more than 15,000 severe sepsis admissions from 124 US academic medical centers. Our findings supported our hypothesis. After adjustment for patient severity of illness and hospital characteristics, mortality in the highest quartile severe sepsis case volume hospitals was 22% and  mortality in lowest severe sepsis case volume hospitals was 29%.  The 7% absolute mortality difference would result in an estimated number needed to treat in high severe sepsis volume hospitals to prevent one death in low case volume hospitals of 14 (though we advise caution in interpretation of a number needed to treat in an observational study). Costs and length of stay were not different across levels of severe sepsis case volume.  Results were robust to multiple subgroup and sensitivity analyses. (more…)
Author Interviews, Baylor College of Medicine Houston, JAMA, Outcomes & Safety, Surgical Research / 17.01.2014

MedicalResearch.com Interview with: Daniel A. Anaya, MD, FACS Associate Professor of Surgery - Surgical Oncology Michael E. DeBakey Department of Surgery Baylor College of Medicine Chief, General Surgery & Surgical Oncology SectionDirector, Liver Tumor Program Michael E. DeBakey VA Medical Center Houston, TX 77030 and Dr. Courtney J. Balentine, MD First author and surgical resident at Baylor College of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Anaya:  That a good proportion of patients having colorectal operations will need additional assistance to recover during the postoperative period, resulting in being discharged to other facilities (nursing facilities, skilled care, etc) after surgery, and that hospitals where a higher-volume of colorectal operations are performed are more likely to discharge patients back to home after surgery. (more…)
Author Interviews, Breast Cancer, Surgical Research / 17.01.2014

MedicalResearch.com Interview with: Dr. R.A. Badwe, MS Director,  Tata Memorial Centre E. Borges Marg, Parel Mumbai 400 012 MedicalResearch.com: What are the main findings of the study? Answer: The trial was a randomized control study involving 350 women with per primum metastatic breast cancer. These women were divided into two groups from February 2005 to May 2013. One group underwent surgery and radiotherapy (LRT) (n=173) while another group of 177 women were spared these (no LRT). Both groups had undergone six successful rounds of chemotherapy before their recruitment into the trial. Women who underwent surgery had the primary breast tumour and lymph nodes removed, followed by locoregional radiation therapy. The primary endpoint of the study was overall survival (OS). At a median follow-up of 17 months, no difference was observed in OS between the groups; the OS rates were 19.2% and 20.5%, respectively, (HR = 1.04; 95%CI, 0.80-1.34; P = 0.79).  The lack of a survival benefit is due to a trade-off between local control and distant disease progression. The results indicated that women who underwent surgery and had improved locoregional control and significantly worse distant progression-free survival compared with women who did not undergo surgery (HR = 1.41; 95% CI, 1.08-1.85; P = .01). Progression of distant disease was 42% more likely (P = .01) in the LRT arm whereas the risk of local progression was 84% lower with LRT. (more…)
Author Interviews, Exercise - Fitness / 17.01.2014

Rebecca Seguin, PhD, CSCS Cornell University, Division of Nutritional Sciences Ithaca NY 14853MedicalResearch.com Interview with: Rebecca Seguin, PhD, CSCS Cornell University, Division of Nutritional Sciences Ithaca NY 14853 MedicalResearch.com: What are the main findings of the study? Answer: The main findings of the study are that regardless of demographic factors and physical activity levels, women who spent the most time engaged in sedentary behaviors had higher risk of death and women who spent the least amount of time engaged in sedentary behaviors. (more…)
Author Interviews, Exercise - Fitness / 17.01.2014

MedicalResearch.com Interview with: Maike Neuhaus, MPsych Australian Postgraduate Award PhD Candidate Cancer Prevention Research Centre School of Population Health The University of Queensland Herston, QLD 4006 Australia MedicalResearch.com: What are the main findings of the study? Answer: Substantial epidemiological evidence shows that high volumes of sedentary behaviour – simply put  too much sitting- are linked to detrimental health outcomes such as overweight and obesity, type 2 diabetes, some cancers, and all-cause mortality. Desk-based office workers typically spend around 75% of their work hours sitting at their desks or in meetings. Furthermore, they are unlikely to compensate for these high volumes of sitting time at work with less sedentary activities outside of work. Office workers are thus a high-risk group and an important target for intervention. The Stand Up UQ study examined best-practice approaches to reduce excessive sitting in office workers. Three separate groups of administrative office workers from The University of Queensland in Brisbane, Australia, participated in this study: One group received height-adjustable workstations only; another group received the same height-adjustable workstations plus additional individual (e.g. face-to-face coaching) and organisational strategies (e.g. management consultation, staff information session) to reduce workplace sitting; the third group served as control group and maintained their usual work-practice. Results showed that relative to the control group, the group receiving height-adjustable workstations and additional strategies had a three-fold greater reduction in sitting time than the group receiving height-adjustable workstations only. These findings have important practical and financial implications for workplaces targeting sitting time reductions. (more…)
Alcohol, Author Interviews, General Medicine, Karolinski Institute / 17.01.2014

Andrea Bellavia MSc Institute of Environmental Medicine, Karolinska Institutet Stockholm, SwedenMedicalResearch.com Interview with: Andrea Bellavia MSc Institute of Environmental Medicine, Karolinska Institutet Stockholm, Sweden Dr. Montgomery: What are the main findings of the study? Answer: We evaluated for 15 years a cohort of Swedish men and women and observed, after taking into account various socio-demographic, dietary, and lifestyle factors, that a low daily consumption of alcoholic beverages is tied with longer survival. (more…)
Allergies, Author Interviews / 17.01.2014

MedicalResearch.com Interview with: Katja M Hakkarainen, M.Sc.Pharm. Doctoral researcher Nordic School of Public Health NHV Guest teacher, Doctoral studentSection for Social Medicine Department of Public Health and Community Medicine, Institute of Medicine Sahlgrenska Academy, University of Gothenburg Gothenburg, SwedenKatja M Hakkarainen, M.Sc.Pharm. Doctoral researcher Nordic School of Public Health NHV Guest teacher, Doctoral studentSection for Social Medicine Department of Public Health and Community Medicine, Institute of Medicine Sahlgrenska Academy, University of Gothenburg Gothenburg, Sweden MedicalResearch.com: What are the main findings of the study? Answer: In total 12% of the adult general public was found to experience harm from medicines, i.e. adverse drug events (ADEs), when we scrutinised the medical and dispensing records of 4970 adults in Sweden during three months, including 29 inpatient care departments in three hospitals, 110 specialised outpatient clinics, and 51 primary care units. Most ADEs were adverse drug reactions (also called side effects) and sub-therapeutic effects. Commonly used drugs caused most ADEs, with a high frequency of adverse drug reactions from antidepressants and cardiovascular drugs as well as sub-therapeutic effects of analgesics and cardiovascular drugs. Of all ADEs, 39% were potentially preventable, because the drug therapy or use was judged suboptimal. (more…)
Author Interviews, Brigham & Women's - Harvard, Health Care Systems, JAMA, Medical Research Centers, Outcomes & Safety / 17.01.2014

Elliot Wakeam MD Center for Surgery and Public Health Brigham and Women's Hospital Boston MA 02115MedicalResearch.com Interview with Elliot Wakeam MD Center for Surgery and Public Health Brigham and Women's Hospital Boston MA 02115 MedicalResearch.com: What are the main findings of the study? Dr. Wakeam: Our study examined failure to rescue (FTR), or death after postoperative complications, in safety net hospitals. Prior work has shown that hospital clinical resources can improve rescue rates, however, despite having higher levels of technology and other clinical resources that should lead to better rates of patient rescue, safety net hospitals still had greater rates of death after major complications. (more…)
Author Interviews, Pediatrics / 17.01.2014

Dr. Daniel S.  Budnitz MD MPH CAPT, USPHS Division of Healthcare Quality Promotion Director of the Centers for Disease Control and Prevention’s Medication Safety Program Atlanta, GeorgiaMedicalResearch.com Interview with: Dr. Daniel S.  Budnitz MD MPH CAPT, USPHS Division of Healthcare Quality Promotion Director of the Centers for Disease Control and Prevention’s Medication Safety Program Atlanta, Georgia MedicalResearch.com: What are the main findings of the study? Dr. Budnitz: To reduce dosing errors when administering orally ingested over-the-counter (OTC) liquid medications, especially among children, the US Food and Drug Administration (FDA) released and the Consumer Healthcare Products Association (CHPA) released recommendations for how to display dosing directions and markings on dosing devices. This study assessed recommendation adherence for national brand name orally ingested OTC liquid pediatric analgesics/antipyretics and cough, cold, and allergy products available after the FDA guidance was finalized in 2011.  To identify and prioritize specific areas for improvement, recommendations were categorized as ‘top tier’ (potential to address ≥3-fold errors) or ‘low tier’ (intended to improve clarity and consistency). Of 68 products, 91% of dosing directions and 62% of dosing devices adhered to all top tier recommendations; 57% of products adhered to every top tier recommendation, and 93% adhered to all or all but one. A dosing device was included with all products (e.g., oral syringe, dosing cup). No dosing directions used atypical volumetric units (e.g., drams), and no devices used volumetric units that did not appear in dosing directions. Six products used trailing zeros or failed to use leading zeros with decimal doses; eight did not use small font for fractions.  Appropriate use of zeros and decimals is important to avoid 10-fold overdoses; using small font for fractions (½ vs. 1/2) helps avoid potential  4-fold errors if 1/2 interpreted as 1 or 2.  Product adherence to low tier recommendations ranged from 26% to 91%. (more…)
Author Interviews, BMJ, OBGYNE, Pediatrics / 16.01.2014

Sophie Grigoriadis, MD, MA, PhD, FRCPC Head, Women's Mood and Anxiety Clinic:  Reproductive Transitions, Fellowship Director, Sunnybrook Health Sciences Centre, Scientist, Sunnybrook Research Institute Adjunct Scientist, Women's College Research Institute, Associate Professor, Faculty of Medicine, University of TorontoMedicalResearch.com Interview with: Sophie Grigoriadis, MD, MA, PhD, FRCPC Head, Women's Mood and Anxiety Clinic:  Reproductive Transitions, Fellowship Director, Sunnybrook Health Sciences Centre, Scientist, Sunnybrook Research Institute Adjunct Scientist, Women's College Research Institute, Associate Professor, Faculty of Medicine, University of Toronto MedicalResearch.com: What are the main findings of the study? Dr. Grigoriadis: Infants of women exposed to selective serotonin reuptake inhibitors (SSRIs) during late pregnancy (but not early) are at risk for developing persistent pulmonary hypertension of the newborn (PPHN). PPHN is a condition in which blood pressure remains high in the lungs following birth and which results in breathing difficulties.  The symptoms can range from mild to severe, but the condition can be managed successfully typically after SSRI exposure. It is important to note that the baseline risk for PPHN in the general population is low (about 2 per 1,000 live births), and so the increase in risk with SSRIs still represents a low overall risk for developing PPHN following SSRI exposure in late pregnancy (increasing to approximately 5 per 1,000 live births). This increased risk means that 286 to 351 women would have to be treated with an SSRI during late pregnancy in order to result in 1 additional case of PPHN. (more…)
Author Interviews, BMJ, Outcomes & Safety / 16.01.2014

Sunita Vohra MD MSc FRCPC FCAHS Director, CARE Program Director, PedCAM Network, AIHS Health Scholar Professor, Dept of Pediatrics Faculty of Medicine & Dentistry University of Alberta Edmonton Continuing Care Centre, Edmonton, Alberta CanadaMedicalResearch.com Interview with: Sunita Vohra MD MSc FRCPC FCAHS Director, CARE Program Director, PedCAM Network, AIHS Health Scholar Professor, Dept of Pediatrics Faculty of Medicine & Dentistry University of Alberta Edmonton Continuing Care Centre, Edmonton, Alberta Canada MedicalResearch.com: What are the main findings of the study? Dr. Vohra: Our main findings were: (i) relative to how often systematic reviews evaluate the effectiveness of health interventions, the systematic review of harms is quite neglected; and (ii) even when systematic reviews do aim to evaluate harms, there is considerable room for improvement in reporting. (more…)
Alcohol, Author Interviews / 16.01.2014

Professor Karen Hughes Professor in Behavioural Epidemiology Centre for Public Health Liverpool John Moores University Liverpool L3 2ETMedicalResearch.com Interview with: Professor Karen Hughes Professor in Behavioural Epidemiology Centre for Public Health Liverpool John Moores University Liverpool L3 2ET MedicalResearch.com: What are the main findings of the study? Answer: We used trained actors to test whether servers in pubs, bars and nightclubs would sell alcohol to people showing signs of extreme intoxication, despite this being illegal in the UK. In over four fifths (83.6%) of purchase attempts, bar servers sold alcohol to the pseudo-drunk actors – even though many clearly identified the actors as being drunk. We also collected data on bar environments, looking specifically at ten factors that have been associated with alcohol-related harm in previous studies: low levels of seating, loud noise, crowding, poor lighting, dirtiness, cheap drink promotions, young bar staff, young customers, rowdiness, and customer drunkenness. We found that the more of these characteristics bars had, the more likely they were to sell alcohol to drunks, with 100% of bars with 8 or more of these characteristics serving the pseudo-drunk actors. However, even in bars with none of these characteristics, two thirds of purchase attempts resulted in an alcohol sale. Having security staff managing entrance to the premises was also associated with alcohol service; possibly suggesting that bar servers in premises with door staff believe responsibility for vetting customers lies with such staff. (more…)
Allergies, Asthma, Author Interviews, Lancet / 15.01.2014

Mariona Pinart, PhD CREAL-Centre for Research in Environmental Epidemiology ISGlobal alliance Parc de Recerca Biomèdica de Barcelona Doctor Aiguader, 88 | 08003 BarcelonaMedicalResearch.com Interveiw with: Mariona Pinart, PhD CREAL-Centre for Research in Environmental Epidemiology ISGlobal alliance Doctor Aiguader, 88 | 08003 Barcelona MedicalResearch.com: What are the main findings of the study? Answer: The study examined 23.434 children at 4 and 8 years from 12 ongoing European population-based birth cohort studies that recorded information on current eczema, rhinitis, and asthma from questionnaires and serum-specific IgE to six allergens. We wanted to assess how often eczema, rhinitis and asthma coexist in the same children (comorbidity) and whether the occurrence of comorbidities was due to causality or casualty and finally we wanted to examine whether the occurrence of comorbidity was modified by IgE sensitization. We found that comorbidity affects about 4% of children aged 4–8 years and that about 50% of this comorbidity is due to causality, suggesting that these diseases share common pathophysiological mechanisms. In addition, we found that children comorbidity at age 4 are 30 to 60 times more likely to have comorbidity at age 8 years, suggesting that the presence of comorbidity at age 4 years is a strong determinant of comorbidity at age 8 years. Even children with one single disease are also at high risk of developing comorbidity by age 8 years. Interestingly, we found that not only comorbidity is present in children both sensitized and not sensitized to IgE but also that only 38% of incident comorbidity at age 8 years is explained by the presence of IgE sensitization at age 4 years. (more…)
Author Interviews, Diabetes, Diabetes Care, Ophthalmology / 15.01.2014

MedicalResearch.com Interview with: Dr. Eelco van Duinkerken Vrije Universiteit Medical Center, Amsterdama MedicalResearch.com: What are the main findings of the study? Answer: In our study we assessed the relationship between cerebral small vessel disease and peripheral microvascular function in type 1 diabetes patients. By MRI cerebral small vessel disease was assessed as white matter hyperintensities and lacunar infarcts (markers of ischemia) and cerebral microbleeds (expression of vascular leakage). We hypothesized that subgroups, i.e. those with (proliferative) retinopathy, are more at risk to develop cerebral small vessels disease. To this end, we selected type 1 diabetes patients with proliferative retinopathy, type 1 diabetes patients without microvascular complications and healthy controls. The main finding of our study was that only cerebral microbleeds, but not ischemic markers of cerebral small vessel disease were more prevalent in type 1 diabetes patients with proliferative retinopathy relative to the other groups. Cerebral microbleeds were also related to microvascular function in skin. This suggest that cerebral microbleeds are part of generalized microangiopathy in patients with type 1 diabetes. (more…)
Author Interviews, BMJ, Heart Disease, Nutrition / 15.01.2014

Dr Victoria J Burley Senior Lecturer in Nutritional Epidemiology School of Food Science and Nutrition University of Leeds Biostatistics, University of Leeds, UKMedicalResearch.com Interview with: Prof. Victoria J Burley Senior Lecturer in Nutritional Epidemiology School of Food Science and Nutrition University of Leeds Biostatistics, University of Leeds, UK MedicalResearch.com: What are the main findings of the study? Prof. Burley: Although it’s been suggested for a long time that foods rich in dietary fiber may protect individuals from having a heart attack or stroke because they lower some of the risk factors for these diseases, trying to determine how much dietary fibre might be beneficial and whether these benefits are apparent in all populations around the world has been less easy to research. Our research at the University of Leeds has pooled the results of published large-scale follow-up studies and has demonstrated a consistent lowering of risk of cardiovascular and coronary heart disease with increasing dietary fiber intake. This dose-response trend suggests that even small additional increments in intake may be beneficial in the long term. (more…)
Author Interviews, Gastrointestinal Disease, NEJM, Pediatrics, Vaccine Studies / 15.01.2014

W. Katherine Yih Ph.D., M.P.H Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care InstituteMedicalResearch.com Interview with: W. Katherine Yih Ph.D., M.P.H Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute MedicalResearch.com:  What are the main findings of the study? Dr. Yih: The main findings are that vaccination with the first dose of RotaTeq is associated with a small increase in the risk of intussusception, which is concentrated in the first week after vaccination.  The estimated risk is about 1.5 excess cases per 100,000 first doses administered.  This risk is fairly small, amounting to roughly 1/10 of the risk seen after the original rotavirus vaccine (called Rotashield) that was used in 1998-1999, before it was withdrawn from the market. We also found evidence that Rotarix increases the risk of intussusception.  However, the number of infants receiving Rotarix and the number getting intussusception after Rotarix were too small to allow us to estimate the risk after Rotarix with any precision. (more…)
Author Interviews, Diabetes, Diabetes Care, Fish / 15.01.2014

Jyrki Virtanen, PhD Adjunct Professor of Nutritional Epidemiology University of Eastern Finland Institute of Public Health and Clinical Nutrition Kuopio, FinlandMedicalResearch.com Interview with: Jyrki Virtanen, PhD Adjunct Professor of Nutritional Epidemiology University of Eastern Finland Institute of Public Health and Clinical Nutrition Kuopio, Finland MedicalResearch.com: What are the main findings of the study? Dr. Virtanen: The main finding was that serum long-chain omega-3 polyunsaturated fatty acid (PUFA) concentration, an objective biomarker of fish and long-chain omega-3 PUFA intake, was associated with a lower risk of incident type 2 diabetes during the average follow-up of 19.3 years in middle-aged and older men from Eastern Finland. The risk was 33% lower in the highest vs. the lowest quartile after adjustment for potential confounders. In contrast, hair mercury, a marker for long-term exposure to mercury, was not associated with the risk. Previously in this study population, high hair mercury content has been associated with higher risk of cardiovascular diseases and attenuation of the beneficial impact of long-chain omega-3 PUFA on the risk. Also, we did not find associations with the intermediate-chain length omega-3 PUFA alpha-linolenic acid, either, which is a plant-based omega-3 PUFA. This suggests that the findings were specific to the long-chain omega-3 PUFAs from fish. (more…)
Author Interviews, Gastrointestinal Disease, Infections, NEJM, Vaccine Studies / 15.01.2014

MedicalResearch.com Interview with Eric S. Weintraub, M.P.H. Epidemiologist at Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? Mr. Weintraub: While current rotavirus vaccines were not associated with intussusception in large pre-licensure trials, recent post-licensure data (from international settings) suggest the possibility of a low risk of intussusception occurrence after receipt of monovalent rotavirus vaccination (RV1).  We examined the risk of intussusception following RV1 vaccination in a U.S. population.  In this study of more than 200,000 doses of RV1, a slight increased risk of intussusception was observed after vaccination, which should be considered in light of the benefits of preventing rotavirus associated illness. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Nutrition, Pediatrics / 14.01.2014

Flavia Indrio, MD Department of Pediatrics Aldo Moro University of Bari Bari, ItalyMedicalResearch.com Interview with: Flavia Indrio, MD Department of Pediatrics Aldo Moro University of Bari Bari, Italy MedicalResearch.com: What are the main findings of the study? Answer: The main finding is that for the first time the use in prevention instead of treatment with a probiotic for the colic regurgitation and constipation. (more…)
Author Interviews, Emergency Care / 14.01.2014

Dr. Michael A. LaMantia Regenstrief Institute, Inc. Investigator and Assistant Professor of Medicine Indiana University School of MedicineMedicalResearch.com Interview with: Dr. Michael A. LaMantia Regenstrief Institute, Inc. Investigator and Assistant Professor of Medicine Indiana University School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. LaMantia: We conducted a systematic review of existing studies on delirium in emergency departments and found that neither completely validated delirium screening instruments nor an ideal schedule to perform delirium assessments exist there. (more…)
Author Interviews, JAMA, Ophthalmology, Smoking / 14.01.2014

MedicalResearch.com Interview with: Birgitta Ejdervik Lindblad, MD PhD Department of Ophthalmology Örebro University Hospital Örebro, Sweden MedicalResearch.com: What are the main findings of the study? Answer: We have investigated the association between smoking cessation and risk of having a cataract extraction among 44 371 Swedish men aged 45-79 years. During 12 years of follow up we identified 5713 incident cases of cataract extraction. Smoking cessation significantly decreased the risk with time. Men who currently smoked more than 15 cigarettes per day had a 42 % increased risk of cataract extraction compared with men who had never smoked. More than 20 years since quitting smoking, men who had smoked more than 15 cigarettes per day had a 21% increased risk of  having a cataract extraction compared with men who had never smoked. The effect of smoking cessation was observed earlier among men who smoked less than 15 cigarettes per day but more than 2 decades since smoking cessation the risk had not decreased to the level of never smokers. (more…)
Author Interviews, JAMA, Nutrition, Pediatrics, University of Michigan / 14.01.2014

Yvonne M. Terry-McElrath, MSA Institute for Social Research, University of Michigan, Ann ArborMedicalResearch.com Interview with: Yvonne M. Terry-McElrath, MSA Institute for Social Research, University of Michigan, Ann Arbor MedicalResearch.com: What are the main findings of the study? Answer: This study examined 2007-2012 commercialism trends in schools attended by nationally representative samples of US elementary and secondary students. While some measures showed significant decreases over time (especially beverage vending measures), most students at both elementary and secondary school levels continued to be exposed to school-based commercialism. Commercialism increased significantly with grade level. The most frequent type of commercialism varied by school level:  food coupons used as incentives was most common at the elementary school level, while exclusive beverage contracts were the most prevalent type of commercialism for middle and high school students. (more…)
Author Interviews, Prostate Cancer, Race/Ethnic Diversity / 14.01.2014

David M. Albala, MD Associated Medical Professionals of NY, PLLC Syracuse, NY 13210MedicalResearch.com Interview with: David M. Albala, MD Associated Medical Professionals of NY, PLLC Syracuse, NY 13210 MedicalResearch.com: What are the main findings of the study? Dr. Albala: Prostate cancer is the second leading cause of cancer death and American man. Prostate cancer diagnosis and mortality differences between African American and Caucasian populations have been highlighted in the literature. Research has shown that African American males are at a biological predisposition for prostate cancer and that additional socioeconomic and physician-patient educational factors may contribute to a higher mortality rate among this group - over two times greater than that of Caucasian American males. At present the most commonly used to detection tools for prostate cancer are the serum prostatic specific antigen test (PSA) and a digital rectal examination (DRE). These complementary tests provide physicians with an indication of whether to proceed with biopsy for a definitive pathological diagnosis. Despite ongoing disputes regarding the effectiveness of PSA screening as an indicator for prostate cancer, a superior alternative test as yet to become available for men at risk. The American Urological Association (AUA) emphasizes the value of early detection and that sheared decision-making should not be overlooked and that shared decision making should be integral to screening decisions. The AUA urges individuals to personally assess, with their physicians, whether a PSA screen is necessary. Emphasis should be placed on the proper education of African American men who are at increased risk for the disease, as well as on their participation in repeated screening practices for the earliest possible detection of prostate cancer. (more…)
Author Interviews, Cancer Research, Lancet / 14.01.2014

MedicalResearch.com Interview with: Dr Jonathan Banks  Programme Manager: The Discovery Research Programme  Centre for Academic Primary Care  NIHR School for Primary Care Research  School of Social and Community Medicine  University of Bristol  Bristol BS8 2PSDr Jonathan Banks Programme Manager: The Discovery Research Programme Centre for Academic Primary Care NIHR School for Primary Care Research School of Social and Community Medicine University of Bristol  Bristol BS8 2PS MedicalResearch.com: What are the main findings of the study? Dr. Banks: We asked members of the public attending their local general practice or primary care centre to consider a series of hypothetical scenarios or vignettes which depicted cancer symptoms, their risk of cancer and the investigative processes involved in testing for cancer. We wanted to measure the point at which the risk of cancer outweighed the burden and inconvenience of testing in relation to lung, colorectal and pancreas cancers. Most people, around 88%, opted for testing even at the lowest risk of cancer which in our vignettes was 1%. Further analyses showed variation between cancers with fewer people opting for testing for colorectal cancer at a low (1%) risk and more people choosing to be tested for all cancers in the 60-69 age group. (more…)
Author Interviews, Geriatrics, MRSA / 11.01.2014

Courtney Reynolds, PhD Medical Scientist Training Program University of California Irvine, School of MedicineMedicalResearch.com Interview with: Courtney Reynolds, PhD Medical Scientist Training Program University of California Irvine, School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Reynolds: Our survey of factors influencing admission to 13 nursing homes in Orange County, California showed that MRSA carriers are denied admission more often than non-carriers, even after accounting for other important factors such as insurance status, required level of care and previous experience at the facility. In 80% of cases where MRSA carriage was responsible for denial of admission, nursing home administrators cited a lack of available single or cohort (MRSA only) rooms to accommodate these potential residents. (more…)
Author Interviews, Education, Exercise - Fitness, Infections / 11.01.2014

MedicalResearch.com Interview with: Anna-Christina Lauer, MD Department of Audiology and Phoniatrics Charité-University Medicine Berlin Berlin, Germany MedicalResearch.com: What are the main findings of the study? Dr. Gross: We could show that the injury rates depend on the undergraduate medical training the students attended. This demonstrates that medical undergraduatue education, especially a hands-on training, is critical in the prevention of needlestick- and sharps injuries. Also the use of safety devices has proven to reduce injury rates significantly. Given the large size of our study we could not only comfirm that needlestick and sharps injuries are still a common problem, looking at an injury rate of about 20% per year, we also learned a lot about the accident circumstances: Most accidents occur at bedside during venepuncture and intravenous cannulation. The second most common setting is the operating room, where suturing and instrument transfers can lead to injuries. Since we analyzed official reports and the anonymous surveys at the same time we could affirm an underreporting rate of more than 50%. (more…)
Author Interviews, Diabetes, Diabetes Care, Pediatrics, Stanford / 11.01.2014

Naama Barnea-Goraly M.D. Center for Interdisciplinary Brain Sciences Research Stanford UniversityMedicalResearch.com Interview with: Naama Barnea-Goraly M.D. Center for Interdisciplinary Brain Sciences Research Stanford University MedicalResearch.com: What are the main findings of the study? Answer: Our main findings showed that compared with age and sex matched controls, children with type 1 diabetes have significant differences in white matter structure in widespread brain regions. Within the type 1 diabetes group, earlier onset of diabetes and longer duration were associated with greater alterations in white matter structure. In addition, measures of hyperglycemia and glucose variability, but not hypoglycemia were associated with white matter structure; however, hypoglycemia exposure and the number of severe hypoglycemia events in our sample were too small to identify statistically meaningful differences. Finally, we observed a significant association between white matter structure and cognitive ability in children with type 1 diabetes, but not in controls. (more…)
Annals Internal Medicine, Author Interviews, Electronic Records / 10.01.2014

Robert S. Rudin, Ph.D. Associate Policy Researcher RAND Corporation 20 Park Plaza, Suite 920 Boston, MA 02116MedicalResearch.com Interview with: Robert S. Rudin, Ph.D. Associate Policy Researcher RAND Corporation Boston, MA 02116 MedicalResearch.com: What are the main findings of the study? Dr. Rudin: We found that most published health IT implementation studies report positive effects on quality, safety, and efficiency. Most evaluations focus on clinical decision support and computerized provider order entry. However, not all studies report equally positive results, and differences in context and implementation are one likely reason for these varying results, yet details of context and implementation are rarely reported in these studies. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA / 10.01.2014

Maurice Dysken, MD Professor, School of Medicine Department of Psychiatry Minneapolis VA Health Care System, Minneapolis, MinnesotaMedicalResearch.com Interview Invitation Maurice Dysken, MD Professor, School of Medicine Department of Psychiatry Minneapolis VA Health Care System, Minneapolis, Minnesota MedicalResearch.com: What are the main findings of the study? Dr. Dysken: In patients with mild-to-moderate Alzheimer’s disease who were taking an acetylcholinesterase inhibitor, a dosage of 2000 IU/d of vitamin E significantly slowed functional decline compared to placebo by 6.2 months over the mean follow-up period of 2.27 years.  Over this period of time caregiver time increased least in the vitamin E group compared to the other three groups (memantine alone, vitamin E plus memantine, and placebo) although the only statistically significant difference was between vitamin E alone and memantine alone.  There were no significant safety concerns for vitamin E compared to placebo and mortality was lowest in the vitamin E alone group.  It should be noted that patients who were on warfarin were excluded from the study because of a possible interaction with vitamin E that could have possibly increased bleeding events. (more…)