MedicalResearch.com Interview with:Vanja Douglas, MD
Sara & Evan Williams Foundation
Endowed Neurohospitalist Chair
Assistant Professor of Clinical Neurology
UCSF Department of Neurology
Neurology Clerkship Director
Editor in Chief, The NeurohospitalistMedicalResearch.com: What are the main findings of the study?Answer: The study found that a simple 2-minute assessment performed at the time of hospital admission can accurately predict an adult medical inpatient's risk of developing delirium during that hospitalization.
MedicalResearch.com Interview with:Saul Blecker, MD, MHS
Department of Population Health
NYU School of Medicine
227 East 30th St., #648
New York, NY 10016
MedicalResearch.com: What are the main findings of the study?Dr. Blecker:We tracked utilization of the inpatient electronic health record (EHR) as a proxy for hospital intensity of care. EHR utilization was found to have variations over time, particularly when comparing days to nights and weekdays to weekends.
MedicalResearch.com Interview with:Brian D. Glass
Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary, University of London, London, United Kingdom
Bradley C. Love
Department of Cognitive, Perceptual and Brain Sciences, University College London, London, United Kingdom
MedicalResearch.com: What are the main findings of the study?Answer: We had 72 non-gaming participants play 40 hours of video games over 6 to 8 weeks. We tested them on psychological tests before and after. The participants either played The Sims (a life simulator game), or one of two versions of StarCraft (a real-time strategy game) -- one which had a higher level of complexity. We found that the StarCraft players (especially on the higher complexity version) performed better on specifically the psychological tasks which tested cognitive flexibility. Cognitive flexibility is the ability to adapt to a changing environment by keeping multiple things in mind and switch between tasks effectively. This sort of ability is considered a higher level psychological ability because it requires strategic thinking and creativity.
MedicalResearch.com Interview with:Xiaohui Zhuo PhD
Division of Diabetes Translation
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
MedicalResearch.com: What are the main findings of the study?First, someone diagnosed with type 2 diabetes may pay an average of about $85,500 treating the disease over his or her lifetime. Lifetime cost is higher for women, and for patients who developed the disease earlier in life.
Second, treating diabetic complications account for more than half of lifetime costs, and a majority of which is attributed by damage to large blood vessels, which can lead to coronary heart disease and stroke.
MedicalResearch.com Interview with: Dr. Axel Bauer, MD, FESC, F-ISHNE
Prof. Dr. med. Axel Bauer is head of the coronary care and chest pain unit and primary investigator in the research group of biosignal analysis and sudden death of the cardiology department of the Eberhard-Karls-Universität Tübingen, Germany.
MedicalResearch.com: What are the main findings of the study?Dr. Bauer: Catheter-based renal sympathetic denervation is a promising treatment option in patients with resistant arterial hypertension. However, it is invasive and might have presently unknown adverse side effects in the long-term. Therefore, identification of patients who benefit from RDN and, equally importantly, those who do not is of great importance. With assessment of baroreflex sensitivity (BRS) we found a way to do that. Patients with resistant hypertension and impaired BRS at baseline benefited the most from RDN in terms of reduction of mean systolic BP on (ABPM) while RDN had no effect in patients with preserved BRS.
MedicalResearch.com Interview with: Bjarke Feenstra, Ph.D.
Senior Research Scientist
Statens Serum Institut
Artillerivej 5, 2300 Copenhagen S
MedicalResearch.com: What are the main findings of the study?Dr. Feenstra: We discovered a new genome-wide significant locus for infantile hypertrophic pyloric stenosis (IHPS) in a region on chromosome 11 harboring the apolipoprotein (APOA1/C3/A4/A5) gene cluster and also confirmed three previously reported loci. Characteristics of the new locus led us to propose the hypothesis that low levels of circulating lipids in infants are associated with increased risk of IHPS. We addressed this hypothesis by measuring plasma lipid levels in prospectively collected umbilical cord blood from a set of 46 IHPS cases and 189 matched controls. We found that levels were on average somewhat lower in the children who went on to develop the condition.
MedicalResearch.com Interview with:Xuemei Sui, MD, MPH, PhD
Department of Exercise Science
Arnold School of Public Health
University of South Carolina
921 Assembly Street Room 226
Columbia, SC 29208
MedicalResearch.com: What are the main findings of the study?Answer: Coffee intake was a risk factor with higher mortality in men, but not in women. Men who drank more than 28 cups of coffee weekly had a 21% higher risk of dying when comparing with their non-coffee-consuming peers. In addition, younger men (age<55 years) who drank more than 28 cups of coffee weekly had a 56% increase in mortality from all-cause and younger women had a greater than 2-fold higher risk of all-cause mortality than those who did not drink coffee.
MedicalResearch.com Interview with:Ruifeng Cao, MD,PhD
Laboratory of Nahum Sonenberg
Department of Biochemistry
Montreal, QC H3A 1A3, Canada
MedicalResearch.com: What are the main findings of the study?Answer: Circadian (~24h) timing is a fundamental biological process, underlying cellular physiology in animals, plants, fungi, and cyanobacteria. In mammals, including humans, a circadian clock in the brain drives daily rhythms in sleep and wakefulness, feeding and metabolism, and many other essential processes. We studied how protein synthesis, which is a fundamental process underlying many biological activities, is controlled in the brain clock in mice and identified a protein that functions as a clock repressor. By removing the repressor protein, the clock function is improved.
MedicalResearch.com Interview with: Matthew Parkes
Research in Osteoarthritis Manchester (ROAM)
Arthritis Research UK Epidemiology Unit
Centre for Musculoskeletal Research
Institute of Inflammation and Repair
The University of Manchester
Manchester Academic Health Science Centre
Manchester M13 9PT
MedicalResearch.com: What are the main findings of the study?Answer: Looking at all trials of lateral wedge insoles, they seem to reduce pain slightly.
However, looking at trials which compare lateral wedges to flat wedges, they don’t appear to differ in terms of pain reduction.
MedicalResearch.com: Interview with Sirimon Reutrakul MD
Section of Endocrinology Department of Medicine
Rush University Medical Center
Chicago, Illinois 60612
MedicalResearch.com: What are the main findings of the study?Answer: We found a strong association between obstructive sleep apnea and gestational diabetes mellitus. In pregnant women diagnosed with gestational diabetes, the risk of obstructive sleep apnea is increased nearly 7-fold compared to those without gestational diabetes. In addition, we found that in non-diabetic women, pregnancy is associated with more disrupted sleep.
MedicalResearch.com Interview with Dr. Anthony Bavry, MD MPH
Assistant Professor of Medicine
University of Florida
1600 SW Archer Road
Gainesville, FL 32610
MedicalResearch.com: What are the main findings of the study?Dr. Bavry: Among individuals with chronic stable coronary artery disease, it is possible to define a group who are at relatively low risk for adverse cardiovascular events.
MedicalResearch.com:Were any of the findings unexpected?(more…)
Medical Research.com Interview with:
Katrin Streckfuss-Boemeke, PhD
Department of Cardiology and Pneumology
Heart Research Center Göttingen (HRCG)
University Medical Center Göttingen
37075 Göttingen Germany
Medical ResearcH.com: What are the main findings of the study?Answer: The main finding is that human induced pluripotent stem cells (hiPSCs) can be generated from different somatic cell sources including bone marrow mesenchymal stem cells (MSCs), hair keratinocytes, and skin fibroblasts, but MSCs and fibroblasts are more easily reprogrammed than keratinocytes.
All generated hiPSCs can differentiate into cardiomyocytes with an efficiency ranging from 3 to 42%. However, the highest cardiac differentiation efficiency was achieved from MSC-derived hiPSCs.
Although the cardiac differentiation efficiency varied among different cell lines, there is no significant difference in the functionalities of cardiomyocytes derived from different hiPSC lines.
MedicalResearch.com: Interview withLeonardo Trasande, MD, MPP
Departments of Pediatrics, Environmental Medicine, Population Health, and Medicine, School of Medicine, and Wagner School of Public Service, and Steinhardt School of Culture, Education, and Human Development, Department of Nutrition
MedicalResearch.com: What are the main findings of the study?Answer: We detect associations of urinary phthalate metabolites in a cross-sectional study of US adolescents. The association is highly robust to multiple sensitivity analyses, and specific to phthalates commonly found in food. Further, longitudinal study of dietary phthalate exposures is needed.
MedicalResearch.com: Interview with: Therese Koops Grønborg PhD student/ph.d.-studerende, MSc
Section of Biostatistics/Sektion for Biostatistisk
Department of Public Health/Institut for Folkesundhed
Bartholins Allé 2, DK-8000 Aarhus C, Denmark
MedicalResearch.com: What are the main findings of the study?Answer: There are three important findings in our study.
We estimated a population-based Autism Spectrum Disorder (ASD) sibling recurrence risk relative to the background population and found an almost seven-fold increase. While this indeed is an increased risk, it is also lower than what other recent studies have suggested.
We also compared the relative recurrence risk for full and maternal/paternal half siblings and found a lower relative recurrence risk in half siblings than in full siblings, which supports the genetic pathway to ASD. The recurrence risk for maternal half siblings is still higher than for the background population suggesting that factors unique to the mother, such as the intrauterine environment and perinatal history, may contribute to ASD.
Last, but not least, we estimated the time trends in the relative recurrence risk. While the ASD prevalence has been increasing for several years, we found no time trends in the relative recurrence risk, suggesting that the factors contributing to the risk for ASDs recurrence in siblings (perhaps a combination of genes and environment) have not changed over time.
MedicalResearch.com Interview with:
Dr.Csaba P. Kovesdy MD FASN.
The Fred Hatch Professor of Medicine
Director, Clinical Outcomes and Clinical Trials Program in Nephrology
University of Tennessee Health Science Center
Chief of Nephrology
Division of Nephrology, Memphis VA Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Kovesdy: In this study of >650,000 US veterans with CKD we found that categories of lower SBP/DBP combinations are associated with lower mortality only as long as the DBP component remains above a threshold of approximately 70 mmHg, and that patients with BP values in the range of 130-159/70-89 mmHg had the lowest mortality. Patients who might be considered to have “ideal” blood pressure (<130/80) actually had increased mortality due to the inclusion of individuals with low systolic and diastolic blood pressures.
MedicalResearch.com Interview with:Leora I. Horwitz, MD, MHSSection of General Internal Medicine, Department of Medicine,
Yale School of Medicine,
Center for Outcomes Research and Evaluation,
Yale–New Haven Hospital, New Haven, Connecticut
MedicalResearch.com: What are the main findings of the study?Answer: We interviewed nearly 400 older patients who had been admitted with heart failure, pneumonia or heart attack within one week of going home from the hospital. We also reviewed the medical records of 377 of the patients. We found, for example, that:
40% of patients could not understand or explain the reason they were in the hospital in the first place;
A fourth of discharge instructions were written in medical jargon that a patient was not likely to understand;
Only a third of patients were discharged with scheduled follow-up with a primary care physician or cardiology specialist;
Only 44% accurately recalled details of their appointments.
In other words, we didn't do a very good job of preparing patients for discharge, and perhaps as a result, patients were pretty confused about important things they needed to know after they were home.
We just published a companion paper in the Journal of Hospital Medicine last week in which we looked at the discharge summaries for the same patients - that is, the summary of the hospitalization that is meant to help the outpatient doctor understand what happened in the hospital. Turns out we were just as bad at communicating with doctors as with patients - we focused on details of the hospitalization rather than what needed to happen next or what needed to be followed up, and in a third of cases, we didn't even send the summary to the outpatient doctor. In fact out of 377 discharge summaries, we didn't find a single one that was done on the day of discharge, sent to the outpatient doctor, and included all key content recommended by major specialty societies.
MedicalResearch.com Interview with:
Sandra Ryeom, PhD,
Assistant professor of Cancer Biology,
Perelman School of Medicine, University of Pennsylvania
MedicalResearch.com: What are the main findings of the study?Answer: We identified an important pathway (calcineurin-NFAT-Angiopoeitin2) in the vasculature of early metastatic lung lesions that is critical for promoting lung metastases.
MedicalResearch.com: Were any of the findings unexpected?Answer: Since there is limited understanding of regulation of tumor angiogenesis at metastatic sites, identification of the calcineurin pathway and a newly identified target of calcineurin-NFAT signaling was all unexpected.
MedicalResearch.com Interview with: Dr. Finlay McAlister
Division of General Internal Medicine
Patient Health Outcomes Research and Clinical Effectiveness Unit
University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ont.
MedicalResearch.com: What are the main findings of the study?Answer: Heart Failure carries a high risk of readmission/death in the first 30 days after hospital discharge (approximately 20%) - even in this cohort of patients with first time diagnosis of heart failure who were discharged home to the community. Patients who do not have an outpatient physician follow-up visit in the first 30 days after discharge have poorer outcomes at 30 days, 3 months, 6 months, and 12 months. Although outcomes are similar for patients who see an unfamiliar or a familiar physician in that first 30 days, over the longer term follow-up with a familiar physician is associated with better outcomes than follow-up with unfamiliar physician(s).
MedicalResearch.com Interview with:John P. Cooke MD PhD
Chair, Department of Cardiovascular Sciences
Director, Center for Cardiovascular Regeneration
Houston Methodist Research Institute
6670 Bertner St MS: R6-414, Houston, TX 77030
MedicalResearch.com: What are the main findings of the study?Answer: We discovered that the proton pump inhibitors PPIs), as a class, impair vascular relaxation. The PPIs have this effect by suppressing the activity of a key enzyme required for cardiovascular health. The enzyme is known as DDAH (for dimethylarginine dimethylaminohydrolase). This enzyme is critical in clearing ADMA (asymmetric dimethylarginine) from tissues and the circulation. Because ADMA is an endogenous inhibitor of nitric oxide synthase, accumulation of ADMA impairs vascular relaxation and vascular homeostasis. Previously, we and others have found that, by inhibiting endothelium-derived nitric oxide, ADMA accelerates vascular disease in preclinical models. In humans, ADMA is linked to the severity of vascular disease, and is an independent risk factor for major adverse cardiovascular events (MACE). Thus, the effect of PPIs to inhibit DDAH would be anticipated to impair cardiovascular health, and to increase the risk of MACE.
MedicalResearch.com Author Interview:
Steven A. Narod, MD Women’s College Research Institute
790 Bay St, 7th Floor
Toronto, ON, M5G 1N8 Canada
MedicalResearch.com: What are the main findings of the study?Answer:We found that the survival of women with breast cancer and a brca1 mutation was similar to that of women with breast cancer and no mutation.
MedicalResearch.com: Orly Vardeny, PharmD, MS
Associate Professor of Pharmacy and Medicine
University of Wisconsin-Madison
MedicalResearch.com What are the main findings of the study?Answer: We performed a post-hoc analysis of the RALES study to assess rates of hyperkalemia and hypokalemia among African American (AA) and non-AA study participants, and examined clinical outcomes by race. We found that AA had less overall increases in potassium compared to non-AA, and exhibited less hyperkalemia with spironolactone. AA subjects were also found to have higher rates of hypokalemia, even among those randomized to spironolactone. Moreover, AA participants appeared to derive less clinical benefit from spironolactone. While non-AA demonstrated reduced risk for death and the combined endpoint of death or heart failure hospitalizations when randomized to spironolactone, African Americans did not derive benefit, and the risk of these outcomes were not different between spironolactone and placebo among AA.
MedicalResearch.com Interview with: Michiyo Yamakawa MHSc
Department of Epidemiology
Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences,
MedicalResearch.com: What are the main findings of the study?Answer: We found that breastfeeding was associated with decreased risk of overweight and obesity at the age of 7 and 8 years compared with formula feeding. Moreover, the protective associations for obesity were greater than those for overweight.
MedicalResearch.com Interview with: Dr. Ramon Trullas
CSIC Institute of Biomedical Research of Barcelona
MedicalResearch.com: What are the main findings of the study?Answer: The findings reported in this manuscript that we consider can be underscored are:
1) Asymptomatic subjects at risk of developing sporadic Alzheimer’s disease (AD), as well as symptomatic patients diagnosed with probable sporadic AD show a low concentration of circulating cell free mitochondrial DNA (mtDNA) in cerebrospinal fluid (CSF).
2) Pre-symptomatic subjects carrying pathogenic PSEN1 gene mutations which cause early onset familial AD, also exhibit low mtDNA content in CSF.
3) Reduced mtDNA content in CSF occurs in preclinical PSEN1 mutation carriers at least one decade before patients are expected to manifest clinical signs of dementia and well before any alteration in currently known AD biomarkers.
4) Low mtDNA content in CSF distinguishes patients diagnosed with AD from either controls or patients with fronto-temporal lobar degeneration.
These findings indicate that the amount of circulating cell-free mtDNA content in CSF may be a novel biomarker for the early detection of AD in the preclinical stage of AD. Moreover, the observation that low mtDNA content in the CSF is associated with both sporadic and familial forms of AD suggests that, independently of the etiology, regulation of mtDNA content is a converging factor in the pathophysiology of AD.
MedicalResearch.com Interview with: Steve Estus PhD
Dept. of Physiology University of Kentucky
Office: Room 332 Sanders-Brown Building
800 S. Limestone Street
Lexington, KY 40536-0230
MedicalResearch.com: What are the main findings of the study?Answer: We report evidence for the function of a Alzheimer's genetic risk factor. This protective allele of the polymorphism decreases the splicing efficiency of exon 2 in CD33, a receptor protein that regulates microglial activation. Loss of exon 2 appears to produce a dormant CD33 protein, resulting in increased microglial phagocytosis activity. Overall, these findings confirm and extend recent papers in Neuron and Nature Neuroscience (discussed further in our report) that described decreased CD33 activity with the protective SNP allele.
MedicalResearch.com Interview with: Rakesh M. Suri MD, D.Phil.
Mayo Clinic College of Medicine, Rochester, Minnesota
MedicalResearch.com: What might clinicians “take home” from this study?
a. The contemporary outcomes of surgical correction of mitral regurgitation are excellent based upon results observed in this large multinational, multi-institutional study, Mitral valve surgery now has a low peri-operative risk of death or complications, and a very high likelihood of saving a patient’s own heart valve (>90% - repair); thereby avoiding the need for replacement with an artificial valve substitute.
b. All patients with severe degenerative mitral regurgitation are at risk for heart failure and/or death when surgical correction is delayed. A safe period of “watchful waiting” in those with severe mitral regurgitation due to flail leaflets, even in the absence of traditional Class I triggers for surgery (symptoms or left ventricular dilation/dysfunction) does not exist.
c. Prompt mitral valve surgery within months following the diagnosis of severe degenerative mitral regurgitation, even in those without symptoms, is associated with important and sustained long term benefits including a 40% decrease in death and 60% less heart failure risk, sustained many years following surgical intervention
MedicalResearch.com Interview with:Dr. Takahisa Fujikawa, MD, PhD, FACS.
Director, Dept of Surgery, Kokura Memorial Hospital,
3-2-1 Asano, Kokurakita-ku, Kitakyushu, Fukuoka 802-8555, JAPAN.
MedicalResearch.com: What are the main findings of the study?Answer:
A total of consecutive 1,075 patients undergoing abdominal laparoscopic surgery between 2005 and 2011, including 715 basic and 360 advanced laparoscopic surgeries, were reviewed. The perioperative management protocol consists of interruption of antiplatelet therapy (APT) one week before surgery and early postoperative re-institution in low thromboembolic risk patients (n=160, iAPT group), whereas preoperative APT was maintained in patients with high thromboembolic risk or emergent situation (n=52, cAPT group). Perioperative and outcome variables of cAPT and iAPT groups, including bleeding and thromboembolic complications, were compared to those of patients without APT (non-APT group, n=863).
No case suffering excessive intraoperative bleeding due to continuation of APT was observed. There were 10 postoperative bleeding complications (0.9%) and 3 thromboembolic events (0.3%), but surgery was free of both complications in cAPT group. No significant differences were found between the groups in operative blood loss, blood transfusion rate, and the occurrence of bleeding and thromboembolic complications.
Multivariable analyses showed that multiple antiplatelet agents (p=0.015) and intraoperative blood transfusion (p=0.046) were significant prognostic factors for postoperative bleeding complications. Increased thromboembolic complications were independently associated with high New York Heart Association class (p=0.019) and history of cerebral infarction (p=0.048), but not associated with APT use. (more…)
MedicalResearch.com Interview with: Daniela Di Giuseppe
Division of Nutritional Epidemiology
Institute of Environmental Medicine
Stockholm 171 77, Sweden
MedicalResearch.com: What are the main findings of the study?Answer: Women whose long-term intake of omega 3 PUFAs exceeded 0.21 g a day, equivalent to at least one serving of fatty fish or four servings of lean fish a week, had half the risk (52% lower) of rheumatoid arthritis of women who consumed less.
MedicalResearch.com Interview with:Marina Klein, MD, MSc, FRCP(C)
Associate Professor of Medicine
McGill University Health Centre
Division of Infectious Diseases and Chronic Viral Illness Service
3650 Saint Urbain
Montreal, Quebec H2X 2P4
Disease in HIV–Hepatitis C Coinfection: A Longitudinal Cohort Analysis MedicalResearch.com: What are the main findings of the study?Dr. Klein: We showed that people with HIV and hepatitis C infection who smoked marijuana did not tend to progress more rapidly to liver fibrosis, liver cirrhosis or end-stage liver disease, even with increasing numbers of joints smoked per week. Previous studies that reported that marijuana was harmful to the liver were likely biased because they did not ensure that marijuana smoking occurred before the development of liver problems.
Prof. Steve Allen
Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow
Room 314, The College of Medicine, Swansea University,
Swansea, SA2 8PP, UK.
MedicalResearch.com: What are the main findings of the study?Answer: Overall, diarrhoea occurred in just over 10% participants and diarrhoea caused by C. difficile in about 1%. These outcomes were equally common in those taking the microbial preparation and those taking placebo.
Other outcomes (e.g. common GI symptoms, length of hospital stay, quality of life) were also much the same in the two groups. So, there was no evidence that the microbial preparation had prevented diarrhoea or had led to any other health benefit.
In agreement with previous research, serious adverse events were also similar in the two groups – so we found no evidence that the microbial preparation caused any harm.
MedicalResearch.com Interview with: Rebecca M Reynolds, Professor of Metabolic Medicine
Endocrinology Unit, BHF/University Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh EH14 6TJ, UK
MedicalResearch.com: What are the main findings of the study?Answer: We found that the adult offspring of women who were obese at the start
of pregnancy were 35% more likely to die prematurely than offspring of
normal-weight women. We also found that children born to mothers who
were overweight when they became pregnant had an 11% increased risk of
premature death. Adult offspring of mothers who were obese were also
at increase risk of hospital admissions for cardiovascular events.
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