MedicalResearch.com Interview with: Prof John R Yarnold
Division of Radiotherapy and Imaging
The Royal Marsden NHS Foundation Trust
Sutton, Surrey SM2 5PT, UK
MedicalResearch.com: What are the main findings of the study?Prof. Yarnold: A 3-week schedule of curative post-operative radiotherapy for women with breast cancer involving 15 treatments (fractions) delivered Monday to Friday each week, is at least as safe and effective as historical schedules given over 5 or 6 weeks. In fact the 3-week schedule is gentler on the healthy tissues than earlier standard regimens.
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MedicalResearch.com Interview with: Prof Sally K Tracy DMid
Midwifery and Women's Health Research Unit
University of Sydney, Royal Hospital for Women
Randwick, NSW, Australia
MedicalResearch.com: What are the main findings of the study?
Prof. Tracy: We recruited 1748 pregnant women, of all risk types, from two tertiary teaching hospitals in different states in Australia and allocated them to receive either caseload midwifery care (871) or standard maternity care (877).
The study found more women in caseload midwifery experienced an unassisted vaginal birth without pharmacological analgesia, and fewer women experienced an elective caesarean. While the trial findings did not show a statistically significant difference in the rate of caesarean sections between either group, the overall rate fell by more than 20 percent from pre-trial levels.
Newborn infants in both groups achieved similar physical assessment scores (Apgar scores). A slightly lower number of pre-term births and neonatal intensive care admissions among the midwifery caseload group was not statistically significant.
Important secondary findings of the study include:
30 percent more spontaneous onset of labour
less induction of labour
less severe blood loss, and
stronger likelihood of breastfeeding at discharge from hospital.
These small differences accounted for an overall difference of AU$566.74 less with caseload midwifery than with standard care.
Caseload midwifery appeared to alter some of the pathways that recurrently contribute to increased obstetric intervention. Having this level of continuity of care works on the assumption that women will labour more effectively, need to stay in hospital less time and feel a stronger sense of satisfaction and personal control if they have the opportunity to get to know their midwife at the beginning of pregnancy. (more…)
MedicalResearch.com: Interview with:Michelle M. Mielke, Ph.D.
Associate Professor
Department of Health Sciences Research
Division of Epidemiology
Mayo Clinic 200 First Street SW
Rochester, MN 55905
MedicalResearch.com: What are the main findings of the study?Dr. Mielke: Among Parkinson’s disease (PD) patients, plasma levels of ceramides and monohexylceramides were higher in patients with cognitive impairment or dementia compared to patients who were cognitively normal. Levels of these lipids were also higher in the combined group of PD patients compared to non-PD controls but the number of controls were small.
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MedicalResearch.com Interview with:Jie He, PhD, MD
Director, Laboratory of Thoracic Surgery
President, Cancer Institute & Hospital, Chinese Academy of Medical Sciences
Chaoyang District, Beijing, 100021
MedicalResearch.com: What are the main findings of the study?Dr. Jie He: The main findings of the study is that we have identified IDH1 as an effective plasma biomarker for the diagnosis of NSCLCs, particularly with high sensitivity and specificity in the diagnosis of lung adenocarcinoma.
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MedicalResearch.com Interview with: Bruno Heleno, PhD fellow
Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, 1014 Copenhagen K, Denmark
MedicalResearch.com: What are the main findings of the study?Answer: In a literature review of cancer screening trials of a wide range of screening interventions, we found that trials seldom report the information necessary to weigh benefits against harms.
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MedicalResearch.com Interview with: Aasma Shaukat, M.D., M.P.H.
Dept. of Medicine
GI Division, MMC 36
University of Minnesota
Minneapolis, MN 55455
MedicalResearch.com: What are the main findings of the study?Dr. Shaukat: The study showed that screening for colon cancer using stool cards
consistently reduces risk of death from colon cancer by one-third through
thirty years. The benefit of screening in larger in men compared to women,
and for women the benefit seems to start at age 60. However, screening did
not make people live longer. (more…)
MedicalResearch.com Interview with:H. Blair Simpson, M.D., Ph.D.
Professor of Clinical Psychiatry, College of Physicians and Surgeons at Columbia University
Director of the Anxiety Disorders Clinic and the Center for OCD and Related Disorders at the New York State Psychiatric Institute
New York, NY 10032
MedicalResearch.com: What are the main findings of the study?Dr. Simpson: This is the first RCT to compare two recommended SRI augmentation strategies for adults with OCD. Adding EX/RP to SRIs was superior to risperidone and to pill placebo in reducing OCD symptoms and improving insight, functioning, and quality of life. Risperidone was not superior to placebo on any outcome.
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MedicalResearch.com Interview with: Chad M. Brummett, M.D.
Assistant Professor, University of Michigan Health System
Department of Anesthesiology
Division of Pain Medicine
1500 East Medical Center Drive, 1H247 UH, Box 5048
Ann Arbor, MI 48109
MedicalResearch.com: What are the main findings of the study?Dr. Brummett: The study found that 42% of new patients presenting to a tertiary care pain clinic with a primary spine pain diagnosis met the American College of Rheumatology (ACR) survey criteria for fibromyalgia, which is a measure of widespread body pain and comorbid symptoms (e.g. trouble thinking, fatigue, mood symptoms, etc.). Patients categorized as fibromyalgia-positive using the survey measure were distinctly different from those not meeting criteria. In a multivariate regression model, independent predictors of being categorized as fibromyalgia-positive were female sex, higher neuropathic pain scores, anxiety, and lower physical function.
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MedicalResearch.com Interview with:Mohamad Fakih, MD, MPH
Medical Director, Infection Prevention and Control
St John Hospital and Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Fakih: Urinary catheters are commonly used in the hospital. Although they help in the management of the sickest patients, they also present a risk for infection and other harms to the patient. The Centers for Medicaid and Medicare Services (CMS) have made catheter associated urinary tract infections (CAUTI) publicly reportable, and no longer reimburse hospitals for these infections if they occur in hospital setting. The definition of CAUTI is based on the surveillance definition of the National Healthcare Safety Network (NHSN) by the Centers for Disease Control and Prevention (CDC). We looked at clinician practice, including the Infectious Diseases specialist’s impression and compared them to the NHSN definition. We found a significant difference between what clinicians think is a urinary catheter infection and give antibiotics for it compared to the NHSN definition. The NHSN definition predicted clinical infection by the Infectious Diseases specialist in only about a third of the cases. We also found that Infectious Disease specialists considered patients to have true CAUTI in only half of what clinicians treated as CAUTI.
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MedicalResearch.com Interview with: Dr. Yunsheng MaMD, PHD, MPH
Division of Preventive and Behavioral Medicine
Department of Medicine
University of Massachusetts Medical School
55 Lake Avenue North, Worcester, MA 01655
MedicalResearch.com: What are the main findings of the study?Dr. Ma: Regardless of race/ethnicity, diabetes increases the risk of mortality the same compared to non-diabetes among different race/ethnicity. However, since there are higher prevalence of diabetes in Black and Hispanic, death rate due to diabetes is much higher in Black and Hispanic, this is because the diabetes prevalence rates are much higher in these population. Therefore, diabetes prevention is key to reduce diabetes related mortality disparities among racial/ethnic groups.
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MedicalResearch.com Interview with:
Daniel Belsky, PhD
NIA Postdoctoral Fellow
Center for the Study of Aging and Human Development
Duke University
Box 104410 Durham, NC 27708
Is Obesity...
MedicalResearch.com Interview with:Gianluca Gini, PhD and Tiziana Pozzoli, PhD
Department of Developmental and Social Psychology
University of Padua, Padua, Italy
MedicalResearch.com: What are the main findings of the study?Answer: Results of this meta-analysis show that bullied children are twice as likely as non-bullied children to experience psychosomatic symptoms (e.g., headache, stomachache, backache, abdominal pain, dizziness, sleeping problems, poor appetite, bedwetting, skin problems, vomiting), especially in samples that included an higher proportion of boys. Importantly, the same result was found not only with cross-sectional studies but also in a meta-analysis of six studies that employed a longitudinal design.
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MedicalResearch.com Interview with:Rodolfo Savica, MD, MSc
Department of Neurology, College of Medicine
Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of this study?Dr. Savica:This study is the first in North America to explore the incidence of DLB and PDD in a population based sample. We found that the overall incidence of dementia with Lewy bodies (DLB), considered the second leading cause of neurodegenerative dementia after Alzheimer`s disease, is lower than that of Parkinson`s disease (PD), increases steeply with age, and is markedly higher in men than in women.
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MedicalResearch.com Interview with:Matthew S. Pantell, MD, MS
Department of Pediatrics
University of California, San Francisco
MedicalResearch.com: What are the main findings of the study?Dr. Pantell:First of all, our study confirms the strong association between social isolation and mortality in a nationally representative sample from the US. Furthermore, it shows that, within the same national sample, social isolation is a similarly strong predictor of mortality as compared to smoking, obesity, high blood pressure, and high cholesterol. Examining individual components of social isolation, our study shows that, among both women and men, not living with a partner and not participating in religious activities frequently are strong individual predictors of mortality. Finally, our work shows that infrequent social contact is associated with mortality among women, and not participating in social clubs/organizations is associated with mortality among men.
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MedicalResearch.com Interview with:Ronald J. Iannotti, PhD
Prevention Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Trends in Physical Activity, Sedentary Behavior, Diet, and BMI Among US Adolescents, 2001–2009 MedicalResearch.com: What are the main findings of the study?Dr. Iannotti: Although average BMI percentile increased from 2001 to 2005 it did not increase from 2005 to 2009. This is consistent with some recent studies that suggest the increase in overweight and obesity may be leveling off. We suggest that we may be 'bending the curve'. During the same period, physical activity and consumption of fruits and vegetables increased while television watching and consumption of sweets and sweetened beverages decreased. We cannot say whether television watching was replaced with more time spent on computers but we did not find an increase in computer use from 2005 to 2009.
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MedicalResearch.com Interview with:Tobias Saam, MD
Institute of Clinical Radiology
Ludwig-Maximilians-Univ Hosp
Munich, Germany
MedicalResearch.com: What are the main findings of the study?Dr. Saam: The results of our meta-analysis suggest that despite a large degree of detected heterogeneity of the published studies, the presence of intraplaque hemorrhage by MRI in patients with carotid artery disease is associated with an approximately 5.6-fold higher risk for cerebrovascular events, such as TIA or stroke, as compared to subjects without intraplaque hemorrhage.
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MedicalResearch.com Interview with:Shoshana M. Rosenberg, ScD, MPH
Researcher, Susan F. Smith Center for Women's Cancers
Dana-Farber Cancer Institute
MedicalResearch.com: What are the main findings of the study?Answer: Rates of contralateral prophylactic mastectomy (CPM) have been increasing among all breast cancer patients, however this trend has been most pronounced among the youngest women with breast cancer. Because of this trend, we sought to better understand why the youngest women - those diagnosed at age 40 or younger - were deciding to have this surgery.
Many women not considered "high-risk", e.g., those without a cancer pre-disposing mutation, cited a desire to prevent the breast cancer from spreading as well as a desire to improve survival as reasons for undergoing the procedure, indicating they overestimate the benefit of having this surgery, as CPM does not affect these outcomes. While CPM does reduce the risk of developing breast cancer in the unaffected breast, in women who are not considered "high-risk", this risk is relatively low, however many women overestimated this risk as well. (more…)
MedicalResearch.com Interview with:Ze'ev Ronai, Ph.D.
Professor and scientific director of Sanford-Burnham Medical Research Institute La Jolla San Diego, Calif.
MedicalResearch.com: What are the main findings of the study?Answer:This study provides the first direct evidence of the importance of the PDK1 enzyme in the development of melanoma and in the metastasis of this aggressive tumor type. We demonstrate, with a genetic mouse melanoma model (harboring the Braf/Pten mutations commonly seen in human melanomas) and/or pharmacological inhibitors against PDK1, that melanoma requires this enzyme for its development, and more so – for its ability to metastasize. Since PDK1 is key kinase that regulates a number of protein kinases, which are currently being assessed in clinical trials (including AKT), our finding points to a new set of targets that could be more amenable for effective combination therapy in melanoma.
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Matthew Daubresse, MHS Research Data Analyst
Center for Drug Safety and Effectiveness
Johns Hopkins School of Public Health
615 N. Wolfe Street, Suite W6023
Baltimore, MD 21205
MedicalResearch.com: What are the main findings of the study?Answer: Over the past decade, prescriptions for non-opioid medications remained stable or declined among ambulatory pain visits in the United States. In visits for new-onset musculoskeletal pain, non-opioid prescribing decreased from 38% of visits in 2000 to 29% of visits in 2010. During this time, opioid prescriptions nearly doubled. Few patient, provider, and visit characteristics were associated with the likelihood of opioid receipt, suggesting increases in opioid prescribing have occurred generally across different groups of patients. (more…)
MedicalResearch.com Interview with:Faisal G. Bakaeen, MD FACS
Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, Texas
MedicalResearch.com: What are the main findings of the study?Dr. Bakaeen: The relative use of off-pump CABG peaked at 24% in 2003, followed by a slow decline after that to about 19%. In addition, the conversion rate from off- to on-pump decreased with time and has stayed below 3.5% in recent years. Perioperative mortality rates decreased over time for both on- and off-pump CABG and have stayed below 2% since 2006. The mortality associated with converted cases was high regardless of the surgery year.
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MedicalResearch.com Interview with:Mine Tezal, DDS, PhD
Oral Biology
University at Buffalo
NYS Center of Excellence in Bioinformatics and Life Sciences
MedicalResearch.com: What are the main findings of the study? Dr. Tezal: We observed an inverse association between dental caries and head and neck cancer (HNSCC), which persisted among never smokers and never drinkers. Besides untreated caries, two other objective measures of long-standing caries history (endodontic treatments and crowns) were also inversely associated with HNSCC with similar effect sizes, supporting the validity of the association. Missing teeth was associated with increased risk of HNSCC in univariate analyses, but after adjustment for potential confounders, its effect was attenuated and was no longer statistically significant.
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MedicalResearch.com Interview with:
Laura A. Petersen, MD, MPH
MEDVAMC Associate Chief of Staff, Research
Director, VA HSR&D Center of Excellence (152)
Houston TX 77030
Professor of Medicine
Chief, Section of Health Services Research
Baylor College of Medicine
HSR&D Center of Excellence
Michael E. DeBakey Veterans Affairs Medical Center
Houston, Texas 77030
MedicalResearch.com: What are the main findings of the study?Dr. Petersen: VA physicians randomized to the individual incentive group were more likely than controls to improve their treatment of hypertension. The adjusted changes over the study period in Veterans meeting the combined BP/appropriate response measure were 8.8 percentage points for the individual-level, 3.7 for the practice-level, 5.5 for the combined, and 0.47 for the control groups. Therefore, a physician in the individual group caring for 1000 patients with hypertension would have about 84 additional patients achieving blood pressure control or appropriate response after 1 year. The effect of the incentive was not sustained after the washout period. Although performance did not decline to pre-intervention levels, the decline was significant. None of the incentives resulted in increased incidence of hypotension compared with controls. While the use of guideline-recommended medications increased significantly over the course of the study in the intervention groups, there was no significant change compared to the control group. The mean individual incentive earnings over the study represented approximately 1.6% of a physician’s salary, assuming a mean salary of $168,000.
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MedicalResearch.com Interview with:Elisa Ebrille, MD
Department of Cardiology, School of Medicine
Fiorenzo Gaita, M.D.
Director Division of Cardiology Department of Medical Sciences
University of Turin, Turin, Italy
MedicalResearch.com What are the main findings of the study?
Answer: We evaluated 33 patients with long-standing atrial fibrillation and valvular heart disease who underwent valve surgery and concomitant cryoablation (pulmonary veins isolation, mitral isthmus and roof line lesions) from 2000 to 2002. The surgically created ablation lesion was validated with electroanatomic mapping. Percutaneous radiofrequency ablation was performed in cases with lesion incompleteness and these patients were followed for over 10 years.
A hybrid approach, combining surgical ablation procedure consisting of pulmonary veins isolation and creation of left atrial linear lesions (mitral isthmus and roof lines), along with endocardial ablation, when necessary, led to a significant clinical improvement in patients with long-standing atrial fibrillation and valvular heart disease during a long-term follow-up (> 10 years).
With the hybrid approach, pulmonary veins isolation and transmural left atrial linear lesions were obtained in a high percentage of patients (79%). When achieved and electrophysiologically demonstrated, the complete ablation scheme was effective in more than 80% of patients in maintaining sinus rhythm throughout follow-up. (more…)
MedicalResearch.com Interview with:Cori L. Ofstead, MSPH
President and CEO
OFSTEAD & ASSOCIATES
400 Selby Avenue, Suite V |Blair Arcade West
Saint Paul, MN 55102-4520
MedicalResearch.com: What are the main findings of the study?Dr. Ofstead: Our researchers found evidence that endoscope reprocessing lapses, which involved a failure to properly clean and disinfect endoscopes after patient use, were very common. These lapses occurred in hospitals, clinics, and ambulatory surgery centers, and involved various steps of the process. In many cases, the reprocessing problems persisted for months or years before being discovered. Over the past several years, thousands of patients have been exposed to contaminated endoscopes, which had significant implications for both patients and their medical providers. For example, we found quite a few cases where exposed patients had to be notified that proper procedures were not followed. In some cases, testing confirmed transmission of pathogens with an increase in morbidity and mortality.
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MedicalResearch.com Interview with:Fabian Bamberg, MD, MPH
Department of Clinical Radiology
Ludwig Maximilians University, Klinikum Grosshadern
Marchioninistrasse 15, 81377 Munich, Germany
MedicalResearch.com: What are the main findings of the study? Dr. Bamberg: Our study shows that there is a substantial and heterogenous degree of subclinical cardiovascular disease burden in patients with diabetes undergoing whole-body MRI. These whole-body MRI findings have significant prognostic relevance. For instance, our results show that patients without any pathologic findings experience no adverse cardiovascular event over a period of six years while the risk for a heart attack or stroke increases with the degree of disease burden.
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MedicalResearch.com Interview with:Svetlana Popova, M.D., M.P.H., Ph.D.
Senior Scientist, Social and Epidemiological Research,
Centre for Addiction and Mental Health
Assistant Professor, Epidemiology Division
Dalla Lana School of Public Health, University of Toronto
Assistant Professor, Factor-Inwentash Faculty of Social Work, University of Toronto
Graduate Faculty Associate Member, Institute of Medical Science, University of Toronto
CAMH, 33 Russell Street, Room # T507
Toronto Ontario, Canada M5S 2S1
MedicalResearch.com: What are the main findings of the study?Dr. Popova: We conducted a systematic literature review and meta-analysis of internationally published and unpublished studies that reported the prevalence of FAS and/or FASD in all types of child care systems (e.g., orphanage, foster care, boarding school, adoption centre, or child welfare system).
The primary objective was to estimate a pooled (combined) prevalence for FAS and FASD in various child care systems using data from existing studies that used an Active Case Ascertainment method (when researchers/clinicians actively seek and diagnose FASD cases).The available data was analyzed byusing a standard statistical technique (called meta-analysis).
This study revealed that the vast majority of existing studies report that the prevalence of Fetal Alcohol Spectrum Disorder (FASD) in the various child-care settings in the different countries is extremely high.
Our analysis of these studies demonstrated that the pooled prevalence of FAS in child care settings (6%) was found to be approximately 9-30 times higher than the prevalence of FAS in the general population of North America, which is reported to range from 2 to 7 cases per 1,000 individuals in the USA and 1 per 1,000 in Canada. Thus, children in care represent a high-risk population for FASD.
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MedicalResearch.com Interview with: Dr. Eung Y. Kim
Department of Radiology
Gachon University Medical Center
Incheon, South Korea.MedicalResearch.com: What are the main findings of the study?Answer: The extent of calcification involving intracranial artery significantly correlates with that of coronary artery in patients with ischemic stroke. The Agatston score measured in the intracranial arteries may be an independent predictor of asymptomatic coronary artery disease in patients with ischemic stroke. (more…)
MedicalResearch.com Interview with:Pranab K. Mukherjee, Ph.D.
Assistant Professor
Center for Medical Mycology
Department of Dermatology
University Hospitals Case Medical Center
Case Western Reserve University
Cleveland, OH 44106-5028
MedicalResearch.com: What are the main findings of the study?Answer: We performed a randomized double-blinded placebo-controlled pilot clinical trial to assess the safety, tolerability and effectiveness of a cetylpyridinium chloride (CPC)-based oral spray in the prevention of acute upper respiratory tract infections (URIs).
The tested CPC spray (ARMS-I, developed by Arms Pharmaceutical LLC, Cleveland, OH) was safe and exhibited high tolerability and acceptability among study participants
The product exhibited a trend to protect against URIs (55% relative reduction compared to the placebo), based on confirmed URIs, post-medication exit interviews, and daily electronic diaries completed by study participants
There was statistically significant reduction in frequency of cough and sore throat in the active group
The number of days (duration) of cough was significantly reduced in the active group compared to placebo arm
URI-associated viruses (influenza, rhinovirus and coronavirus) were detected in three individuals, all in the placebo arm. No virus was detected in the active arm/
No drug-related adverse events or oral lesions were observed
Previous vaccination status of the study participants did not affect the study outcome.
MedicalResearch.com Interview with:
Nasser Malyar, MD
Division of Vascular Medicine
Department of Cardiovascular Medicine
University Hospital Muenster
Albert-Schweitzer-Campus 1, A1
48149 Muenster, Germany
MedicalResearch.com: What are the main findings of the study?Dr. Malyar: The main findings of the study were that
1) PAD as a main or co-diagnosis is common among in-hospital treated patients
2) The prevalence of PAD among hospitalized patients is disproportionately increasing, particularly in the subset with critical limb ischemia
3) Despite all efforts and increasingly use of endovascular and surgical revascularization procedures PAD patients still have a poor in-hospital outcome in terms of limb amputation and in-hospital mortality
4) Last but not least the reimbursement costs for in-hospital treatment of patients with PAD are markedly increasing.
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MedicalResearch.com Interview with: Koji Ikeda, MD, PhD
Assistant Professor
Department of Cardiology
Graduate School of Medical Science,
Kyoto Prefectural University of Medicine
Kyoto, Japan
MedicalResearch.com: What are the main findings of the study? Dr. Ikeda: The main findings of this study is the identification of a novel mechanism that regulates glucose homeostasis and energy metabolism, provided by Ecscr. Consequently, Ecscr modifies the insulin sensitivity and the progression of obesity, indicating that Ecscr is a new target for the treatment of metabolic syndrome.
(more…)
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MedicalResearch.com Interview with:
Prof John R Yarnold
Division of Radiotherapy and Imaging
The Royal Marsden NHS Foundation Trust
Sutton, Surrey SM2 5PT, UK
MedicalResearch.com: What are the main findings of the study?
Prof. Yarnold: A 3-week schedule of curative post-operative radiotherapy for women with breast cancer involving 15 treatments (fractions) delivered Monday to Friday each week, is at least as safe and effective as historical schedules given over 5 or 6 weeks. In fact the 3-week schedule is gentler on the healthy tissues than earlier standard regimens.
(more…)
