Author Interviews, Cost of Health Care, Outcomes & Safety / 04.06.2013

James D. Chambers, PhD, MPharm Assistant Professor The Center for the Evaluation of Value and Risk in Health Institute for Clinical Research and Health Policy Studies TuftsMedicalCenter www.cearegistry.org MedicalResearch.com: What are the main findings of the study? Dr. Epstein: Using cost-effectiveness evidence to help inform the allocation of expenditures for medical interventions in Medicare has the potential to generate substantial aggregate health gains for the Medicare population with no increases in spending. Reallocating expenditures for interventions in Medicare using cost-effectiveness evidence led to an estimated aggregate health gain of 1.8 million quality-adjusted life years (QALYs), a measure of health gain that accounts for both quality and quantity of life. (more…)
Author Interviews, Brain Injury, Depression, Mental Health Research, UT Southwestern / 04.06.2013

MedicalResearch.com eInterview with: John Hart, M.D. Medical Science Director at the Center for BrainHealth Jane and Bud Smith Distinguished Chair Cecil Green Distinguished Chair The University of Texas at DallasJohn Hart, M.D. Medical Science Director at the Center for BrainHealth Jane and Bud Smith Distinguished Chair Cecil Green Distinguished Chair The University of Texas at Dallas MedicalResearch.com: What are the main findings of the study? Dr. Hart: Football players often sustain numerous concussive and subconcussive impacts—head impacts that do not elicit neurologic symptoms that may lead to white matter damage. We evaluated a population of retired NFL players in order to study the relationship between white matter integrity and the manifestation of depressive symptoms. We identified, for the first time, a correlation between depression and white matter abnormalities in former players with a remote history of concussion using diffusion tensor imaging (DTI). Our data demonstrated a significant association between white matter integrity, as measured by DTI Fractional Anisotropy (FA), and the presence as well as severity of depressive symptoms in retired NFL athletes with a history of concussive or subconcussive impacts. We also found that dysfunction of the anterior aspect of the corpus callosum (forceps minor) and its projections to the frontal lobe can identify those with depression with 100% sensitivity and 95% specificity. (more…)
Author Interviews, Heart Disease, Lifestyle & Health / 04.06.2013

MedicalResearch.com eInterview with: Haitham Ahmed, MD, MPH The Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Hospital MedicalResearch.com: What were the main findings of the study? Dr. Ahmed: Everyone knows that healthy lifestyle habits are major factors that protect you from heart disease. What we don’t know is which habits are most important, and how exactly these habits prevent disease progression along the causal biological pathway over years and years. So we followed 6,200 men and women of various ethnic backgrounds from 6 university locations across the US. We looked at their eating habits, exercise, weight, and smoking history. We did CT scans on them at the start of the study and then a few years later (mean 3 years) and found that healthier people had lower calcium deposition in their coronaries. We then kept following them and found that these same healthy people had a trend towards less cardiovascular events. We then kept following them further and found that these same healthy people died less, by an 80% lower rate, compared to people that were unhealthy, which was incredible. So what we took away from this is that you have enormous power in changing your risk of atherosclerosis, heart disease, and death by changing your lifestyle behaviors. (more…)
Author Interviews, Memory, Mental Health Research / 04.06.2013

Dr Sunjeev Kamboj Lecturer in Clinical Psychology Co-ordinator for International DClinPsy Trainees http://www.ucl.ac.uk/clinical-psychology/index.htm MedicalResearch.com: What are the main findings of the study? Dr. Kamboj: Using a fairly standard approach for this type of research, we measured the frequency of intrusive memories in normal, healthy women after they watched a series of video clips containing distressing scenes. We also measured baseline levels of progesterone and estrogen. We tested three groups of women who, while similar in all respects such age, education level, as well as how they responded to the film, differed in terms of the stage of the menstrual cycle they were in. Our key finding was that women in the 'early luteal phase' - which occurs in the third week of the cycle - had three times as many intrusive memories about the video than women in the first two weeks or fourth week of the cycle. (more…)
Author Interviews, Diabetes / 03.06.2013

Dr. Fumiaki Imamura, Ph.D. Research Fellow Harvard School of Public Heath Department of Epidemiology 677 Huntington Ave, Kresge-913C Boston, MA

MedicalResearch.com: What are the main findings of the study? Dr. Imamura: Among older adults, risk factors for type 2 diabetes mellitus (DM) were differentially associated with DM preceded predominantly by IR or β-cell dysfunction. MedicalResearch.com:Were any of the findings unexpected? Dr. Imamura: For subsets of incident DM, some conventional DM risk factors, including body-mass index and HDL-cholesterol, could not predict incident DM. (more…)
Author Interviews, Diabetes, Exercise - Fitness, Weight Research / 31.05.2013

Martin Sénéchal, Ph.D. Postdoctoral Researcher The Manitoba Institute of Child Health University of Manitoba 511E- 715 McDermot Ave Winnipeg, ManitobaMedicalResearch.com eInterview with Martin Sénéchal, Ph.D. Postdoctoral Researcher The Manitoba Institute of Child Health University of Manitoba 511E- 715 McDermot Ave Winnipeg, Manitoba MedicalResearch.com: What are the main findings of the study? Answer: The main finding of this study is that reducing central adiposity and increasing fitness in men and women with Type 2 diabetes are key components for successfully improving glycemic control. A secondary finding of the study is that improvement in both central adiposity (reduction) and fitness (increasing) simultaneously; increase the likelihood of reducing HbA1c, one of the most widely used indicators of glucose control, and/or Type 2 diabetes medications. (more…)
Author Interviews, Infections, Lancet, Vaccine Studies / 31.05.2013

MedicalResearch.com eInterview with: Fengcai Zhu Deputy Director of the Jiangsu Provincial Center for Disease Prevention and Control, Jiangsu provincial center for disease prevention and control

Fengcai Zhu

Deputy Director of the Jiangsu Provincial Center for Disease Prevention and Control, Jiangsu provincial center for disease prevention and control

MedicalResearch.com Editor's Note: HFMD = Hand Foot and Mouth Disease Hand Foot and Mouth Disease

MedicalResearch.com: What are the main findings of the study? Answer: From this trial, the inactivated alum-adjuvant EV71 vaccine showed a good protection for both the EV71-associated HFMD and EV71-associated disease. The vaccine gave 90% protection against clinical EV71-associated HFMD and 80.4% against EV71-associated disease (including neurological complications) for at least 12 months. The safety profile and immunogenicity of this vaccine is proved to be clinical acceptable. We also proposed a titre (1:32) of neutralization antibody as surrogate of protection against EV71-associated disease.

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Author Interviews, Endocrinology, Thyroid Disease / 31.05.2013

Pauline Mendola, PhD Investigator Epidemiology Branch Division of Epidemiology, Statistics and Prevention Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH Rockville, MD 20852MedicalResearch.com eInterview with Pauline Mendola, PhD Investigator Epidemiology Branch Division of Epidemiology, Statistics and Prevention Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH Rockville, MD 20852 MedicalResearch.com: What are the main findings of the study? Dr. Mendola: Women with thyroid disease during pregnancy had more obstetric complications including preeclampsia and preterm birth.  They were also more likely to be admitted to an intensive care unit during their delivery admission. (more…)
Author Interviews, Emergency Care, NEJM / 30.05.2013

MedicalResearch.com eInterview with: Adam Z. Tobias, MD, MPH Assistant Professor of Emergency Medicine University of Pittsburgh School of Medicine Pittsburgh, PA 15261Adam Z. Tobias, MD, MPH Assistant Professor of Emergency Medicine University of Pittsburgh School of Medicine Pittsburgh, PA  15261 MedicalResearch.com: What are the main findings of the study? Answer: We reviewed records of 11,920 in-flight medical emergency calls from five domestic and international commercial airlines to a physician-staffed medical communications center at the University of Pittsburgh.  We found that during the study period, there was one medical emergency per 604 flights (16 per 1 million passengers).  The most common problems were syncope or pre-syncope, respiratory symptoms, and nausea and vomiting.  Aircraft diversion to an alternative landing site occurred just over 7% of the time. About one quarter of patients were transported to a hospital and only 8.6% were admitted. (more…)
Author Interviews, Cancer Research, Stanford / 30.05.2013

MedicalResearch.com eInterview with Ronald Levy, M.D. Professor and Chief Division of Oncology Stanford University, 269 Campus Drive Stanford, California 94305, USA MedicalResearch.com: What are the main findings of the study? Dr. Levy: Injection of antibodies that deplete Treg cells directly into a tumor can evoke an immune response that cures  the animal of distant, untreated tumors. This effect eliminates cancer even in the brain. The dose of antibodies locally injected can be as low as 1/100 the dose used for systemic injection and therefore should avoid the usual autoimmune side effects of these antibodies. The antibodies used are directed against CTLA4 and OX40 antigens. (more…)
ADHD, Author Interviews, JAMA, Mental Health Research, Pediatrics / 30.05.2013

Kathryn L. Humphreys, M.A., Ed.M. Clinical Psychology Doctoral Student UCLA Department of Psychology 1285 Franz Hall, Box 951563 Los Angeles, CA 90095MedicalResearch.com eInterview with Kathryn L. Humphreys, M.A., Ed.M. Clinical Psychology Doctoral Student UCLA Department of Psychology 1285 Franz Hall, Box 951563 Los Angeles, CA 90095 MedicalResearch.com: What are the main findings of the study? Response: Our primary question was to answer whether the use of stimulant medication in the treatment of ADHD was associated with increased or decreased risk for a variety of substance use (ever tried) and substance use disorder (abuse or dependence) outcomes (alcohol, cocaine, marijuana, nicotine, and non-specific drug use). Prior research from individual studies of children have provided mixed evidence (i.e., some found medication increased later risk, some found medication decreased risk, and still others found no difference in risk). We examined available longitudinal studies (i.e., medication treatment preceded measurement of substance outcome) together using meta-analysis, a technique that aggregates findings from a number of studies, in order to examine this question in a much larger sample of individuals. Our main finding was that children with ADHD who received medication treatment did not differ in risk for lifetime substance use or abuse or dependence compared to those children with ADHD who did not receive medication treatment. (more…)
Author Interviews, Neurological Disorders, Parkinson's / 29.05.2013

MedicalResearch.com eInterview with Dr. Emanuele Cereda Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo Viale Golgi 19, 27100 Pavia, Italy MedicalResearch.com: What are the main findings of the study? Dr. Cereda: A large analysis of more than 100 studies shows that exposure to pesticides, or bug and weed killers, and solvents is likely associated with a higher risk of developing Parkinson’s disease. MedicalResearch.com: Were any of the findings unexpected? Dr. Cereda: In first instance I can say no as in every day clinical practice we frequently see patients reporting such exposure. Accordingly, it appears quite obvious to look at these exposures as risk factors. Unfortunately, from an epidemiologic point of view this is not enough! That's why we did this study. Amazing rather than surprising was the fact that commonly the sources of funding in the studies we retrieved and included in meta-analysis were health or health-related institutions, private foundations (mainly Parkinosn’s disease foundations), or government or para-government companies. No study acknowledged the involvement of any chemicals manufacturer! (more…)
Author Interviews, Cancer Research, Prostate Cancer, Stanford / 29.05.2013

MedicalResearch.com eInterview with Timothy J. Daskivich, MD Robert Wood Johnson Foundation Clinical Scholars® University of California Los Angeles Division of General Internal Medicine and Health Services Research 10940 Wilshire Blvd, 7th Floor Suite 710, Room 721 Los Angeles, California 90024 MedicalResearch.com: What are the main findings of the study?  Were any of the findings unexpected? Dr. Daskivich:  We found that age and a simple count of comorbidities were strongly predictive of likelihood of dying of causes other than prostate cancer.  When we put numbers to it, it was surprising how often older men with multiple comorbidities were dying of something else than their prostate cancer within 14 years of diagnosis.  For example, a 75-year old man with 3 or more comorbidities—diabetes, high blood pressure, and history of heart attack—had a probability of death from something other than CaP of 71% at 10 years.  For a 71-year old man with 3 or more comorbidities, the probability was 60%.  We compared that to the amount of time they were dying of prostate cancer, which was 3% for low-risk disease and 7% for intermediate-risk disease. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Kidney Disease, Medical Research Centers, Mediterranean Diet, Nutrition / 29.05.2013

MedicalResearch.com eInterview with Iris Shai, RD, PhD PI of the DIRECT trial Ben Gurion University of the Negev, Israel MedicalResearch.com: What are the main findings of the study? Dr. Shai: Low-carbohydrate is as effective as Mediterranean or low-fat diets in improving renal function among moderately obese participants with or without type 2 diabetes, with baseline serum creatinine<176µmol/L (not sever renal stage).  The effect is likely to be mediated by weight-loss induced improvements in insulin sensitivity and blood pressure. (more…)
Author Interviews, Blood Pressure - Hypertension, Diabetes, Kidney Disease, Pediatrics / 28.05.2013

MedicalResearch.com eInterview with: Dr. Jane L Lynch MD School of Medicine Pediatrics University of Texas Health Science Center at San AntonioDr. Jane L Lynch MD School of Medicine Pediatrics University of Texas Health Science Center at San Antonio MedicalResearch.com: What are the main findings of the study? Dr. Lynch: American youth with type 2 diabetes who received the best currently available treatment and close monitoring of their diabetes experienced a more rapid progression of co-morbidities far more aggressive than what is typically seen in adults with type 2 diabetes. MedicalResearch.com: Were any of the findings unexpected? Dr. Lynch: Youth with type 2 diabetes enrolled in the TODAY study developed early and rapidly progressing signs of heart and kidney disease, poor glycemic control and diabetes-related eye disease; even in the group receiving more intensive two-drug therapy, shown in previously released results to be the most effective treatment for maintenance of glycemic control. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Cancer Research, CT Scanning, Medical Imaging, Medical Research Centers / 27.05.2013

prof_john_d_mathewsJohn D. Mathews, MBBS, MD, PhD, DSc Hon, DMedSc Hon, Professor of epidemiology at the School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians MedicalResearch.com: What are the main findings of the study? Prof Mathews: We found that for persons having at least one CT scan before the age of 20 years, and followed for an average period of 10 years, the average risk of cancer was increased by 24% compared with unexposed persons matched for age, sex and year of birth. The cancer risk increased by 16% for each CT scan that preceded the cancer by more than one year. The proportional increase in risk was greater for persons exposed at younger ages. (more…)
Asthma, Author Interviews / 26.05.2013

MedicalResearch.com eInterview with: Stefan Worgall Ph.D., M.D
Department of Genetic Medicine and 4Department of Pediatrics Weill Cornell Medical College, New York, NY 10021, USA.
MedicalResearch.com: What are the main findings of the study? Dr. Worgall: Asthma is a common disease and large genome-wide association studies  found variation in the gene for ORMDL3, in to up to 30 percent of asthma cases. The over-production ORMDL3 was connected to childhood asthma. ORMDL3 protein inhibits the new production of sphingolipids. Our study connects sphingolipid metabolism mechanistically to human asthma for the first time. We found that inhibition of the enzyme that is critical to sphingolipid synthesis, serine palmitoyl-CoA transferase (SPT),  produced asthmatic lungs in mice and in human bronchi, as it did in mice that had a genetic defect in SPT. When these mice were given methacholine their airways constricted further. We further determined that the airway hyperactivity seen in the mice was not linked to increased inflammation, which is a target for most asthma therapies. (more…)
Author Interviews, Cancer Research, Genetic Research, Lung Cancer / 26.05.2013

MedicalResearch.com Authors’ Interview: Sophie Rousseaux and Saadi Khochbin INSERM, U823; Université Joseph Fourier, Grenoble 1; Institut Albert Bonniot, Grenoble F-38700, France. MedicalResearch.com: What are the main findings of the study? Answer: We first discovered that all cancer cells lose the ability to maintain gene silencing and therefore activate genes that should normally remain silent. Although present in all cells, some genes are normally expressed (or “active”) only in one cell type. For example, normal lung cells do not express genes that are only active in germ cells (i. e., cells that will become spermatozoa), but lung cancerous cells activate some of these germ cells-specific genes. In this work we designed a specific approach to detect these aberrant gene expressions and found that they occur in all cancers of all origins. We then decided to exploit this phenomenon to help the detection of cancers and predict their evolution. For this purpose, we chose to focus on lung cancer to establish “a proof of principle”. We found that, among all the genes wrongly expressed in the tumour cells, the activation of 26 of them enabled us to identify the most aggressive lung cancers. Compared with the existing information currently available for doctors (i.e.; tumour size, its pathological subtype…), our approach brings much more precision in predicting the evolution of the tumours and the prognosis of the patients. (more…)
Author Interviews / 23.05.2013

MedicalResearch.com eInterview with  William A. Bauman, MD Veterans Affairs Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury Suite 7A-13, James J. Peters Veterans Affairs Medical Center 130 West Kingsbridge Road, Bronx, NY 10468; Dr. William A. Bauman, MD Veterans Affairs Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury Suite 7A-13, James J. Peters Veterans Affairs Medical Center 130 West Kingsbridge Road, Bronx, NY 10468; MedicalResearch.com: What are the main findings of the study? Dr. Bauman: In a prospective, randomized two-group, double-blind, placebo-controlled, intention-to-treat clinical trial, we determined whether SCI in-patients with a full thickness (Stage III or IV) pressure ulcers of the pelvic region who received 24 weeks or less of optimized clinical care and an oral anabolic steroid agent, oxandrolone, have a greater percent of healed target pressure ulcers than those who received placebo and the same clinical care. There was no significant difference in proportion of pressure ulcers that healed between the treatment and placebo groups [treatment recipients 24.1% (95% CI, 16.0% to 32.1%) and placebo recipients 29.8% (CI, 21% to 38.6%) with a difference, -5.7 percentage points (CI, -17.5 to 6.8 percentage points)]. Also, the rate of healing of wounds at 28 days was not significantly different between the groups (50.9% of the oxandrolone group and 43.3% of the placebo group had healing of ≥30.0%), nor was the number of wounds that remained closed at 8 weeks significantly different (16.7% of the oxandrolone group and 15.4% of the placebo group). No serious adverse events were related to drug administration but a significantly greater proportion of patients had elevated liver enzymes in the treatment group [treatment recipients 32.4% (95% CI, 23.6% to 41.2%) and placebo recipients 2.9%% (CI, 0.0% to 6.1%). Thus, oxandrolone showed no benefit over placebo for improving healing of chronic pressure ulcers of the pelvic region or the proportion that remained closed after 8 weeks of treatment. (more…)
Author Interviews, JAMA, Stroke / 22.05.2013

Dr. Rishi Gupta, MD Associate Professor of Neurology, Neurosurgery and Radiology Emory University School of Medicine Director, Vascular Neurology Fellowship Program Director, Multi-Hospital Acute Stroke Network Marcus Stroke and Neuroscience Center Grady Memorial Hospital MedicalResearch.com: What are the main findings of the study? Dr. Gupta: The main findings of this study are that patients with more proximal cerebral arterial occlusion involving the middle cerebral artery and internal carotid artery appear to be the targets for endovascular reperfusion therapy trials. Moreover, previous clinical trials have used a NIHSS > 8 or > 10 threshold to include patients into randomzed trials comparing endovascular therapy versus IV tPA. The threshold may need to be higher and in our analysis we found that threshold to be 14 or greater. (more…)
Author Interviews, Mental Health Research, Sleep Disorders, University of Pennsylvania / 18.05.2013

MedicalResearch.com eInterview with: Linden Oliver, MA, Clinical Research Coordinator University of Pennsylvania Behavioral Sleep Medicine Research Program Philadelphia, Pa MedicalResearch.com: What are the main findings of the study? Answer: We found that less sleep is associated with greater suicide risk in those with insomnia. Specifically, we looked at suicide risk in people with insomnia, and also asked how much sleep they got in the past month. In those with some suicide risk, the likelihood of being high risk (versus low risk) decreased by 72% for every hour of sleep that person reported getting at night. (more…)
Author Interviews, JAMA, Nutrition / 14.05.2013

MedicalResearch.com eInterview with: Mary Scourboutakos PhD student at the University of Toronto Mary R. L'Abbe, PhD Earle W. McHenry Professor, and Chair, Department of Nutritional Sciences Faculty of Medicine, University of Toronto FitzGerald Building, 150 College Street, Rm 315 Toronto, ON, Canada M5S 3E2 MedicalResearch.com: What are the main findings of the study? Answer: We found that chain restaurant meals on average contained half a day's worth of calories, almost a full day's worth of fat and saturated fat, and more than a day's worth of sodium. (more…)
Allergies, Author Interviews / 09.05.2013

MedicalResearch.com eInterview with Author Peter S. Creticos, M.D. (corresponding author) Dr. Creticos' Comments: This paper reports the first successful randomized, double-blind, pivotal trial of sublingual immunotherapy with a ragweed tablet. The relevance of this lies in the recognition that ragweed is the dominant seasonal allergen in North America (~26% of US population is allergic to this noxious weed which pollinates from early August to early October). An alternate (sublingual) approach to immunotherapy for allergic respiratory disease would be a welcome addition to our armamentarium, as the current mode of treatment in the U.S., that of subcutaneous injection immunotherapy, is saddled with a burdensome injection regimen that requires frequent office visits over a 4-5 year course of treatment. (more…)
Author Interviews, Diabetes, Race/Ethnic Diversity, Stroke / 08.05.2013

MedicalResearch.com eInterview with Jane C Khoury, PhD

Associate Professor Division of Biostatistics and Epidemiology Cincinnati Children’s Hospital Medical Center MLC 5041, 3333 Burnet Avenue Cincinnati, Ohio 45229-3039 MedicalResearch.com: What are the main findings of the study? Dr. Khoury: Over all age groups, those with diagnosed diabetes have at least 3-fold increased risk of incident ischemic stroke compared to those without diabetes. This is even more pronounced in those less than 65 years of age, with 5-fold and 12-fold increase for those of black and white race respectively.  All rates are adjusted to the 2000 population. (more…)
Author Interviews, Hematology, Surgical Research, Transfusions / 08.05.2013

MedicalResearch.com eInterview with Luca Weltert, MD Cardiac Surgery Department of the European Hospital in Rome, Presentation during the Plenary Scientific Session of the 93rd AATS Annual Meeting in Minneapolis. MedicalResearch.com: What are the main findings of the study? Dr. Luca Weltert: This study illustrates the efficacy of Human Recombinant Erythropoietin (HRE) in avoiding blood transfusions in the heart surgery setting. And aside from complicated number, tables and statistics tells that HRE can reduce Blood Transfusions as much as 65%, while at the same time not exposing patients to any substantial added risk. (more…)
Author Interviews, Race/Ethnic Diversity / 08.05.2013

MedicalResearch.com eInterview with Annette Langer-Gould, MD, PhD From the Department of Research and Evaluation Kaiser Permanente, Southern California, Pasadena; and Neurology Department Kaiser Permanente, Southern California Los Angeles Medical Center, CA. MedicalResearch.com: What are the main findings of the study? Dr. Langer-Gould: The main findings of the study were that multiple sclerosis is more common in black women than in white women, which run contrary to the widely accepted belief that blacks are less susceptible to MS. In particular, we found that black patients had a 47 percent higher risk of MS than white patients, while Hispanic and Asian patients had a 50 percent and 80 percent lower risk compared to white patients, respectively. We also found that 70 percent of MS cases occurred in females, but this preponderance of females diagnosed was more pronounced among black patients than white patients. In addition, black women had a higher incidence of MS than white patients of both genders, while black men had a similar risk of being diagnosed with MS compared to white men. The lower risk among Hispanic and Asian patients was true for both sexes. (more…)