Based on Genetic Profile, Longer Adjuvant Treatment Recommended for Some GIST Tumors

MedicalResearch.com Interview with:
Heikki Joensuu, MD

Department of Oncology
Helsinki University Hospital
University of Helsinki
Helsinki, Finland 

MedicalResearch.com: What is the background for this study?

Response: The randomized Scandinavian Sarcoma Group (SSG) XVIII trial compared three years of adjuvant imatinib to one year of adjuvant imatinib as adjuvant treatments of patients who had undergone macroscopically complete surgery for a GIST with a high risk for tumor recurrence. In this trial, patients treated with 3 years of imatinib had improved overall survival as compared to those who were allocated to one year of adjuvant imatinib. In 2 other randomized trials that compared either 1 year of adjuvant imatinib to one year or placebo, or 2 years of adjuvant imatinib to observation, no improvement in overall survival was found, although in all three trials adjuvant imatinib improved recurrence-free survival (RFS). The reasons for the discrepant findings with respect of overall survival in the 3 trials have been unclear.

Continue reading

Computerized Clinical Decision Support Systems Can Reduce Rate of Venous Thromboembolism

MedicalResearch.com Interview with:
Zachary Borabm, Research fellow

Hansjörg Wyss Department of Plastic Surgery
NYU Langone Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Recent studies have shown that health care providers perform poorly in risk stratifying their patients for venous thromboembolism (VTE) which leads to inadequate VTE prophylaxis delivery, especially in surgical patients. Computerized Clinical Decision Support Systems (CCDSSs) are programs integrated into an electronic health record that have the power to aid health care providers. Using a meta-analysis study technique we were able to pool data from 11 studies, including 156,366 patients that either had CCDSSs intervention or routine care without CCDSSs.

Our main outcome measures were the rate of prophylaxis for VTE and the rate of actual VTE events. We found that CCDSSs increased the rate of VTE prophylaxis (odds ratio 2.35, p<0.001) and decreased the risk of VTE events (risk ratio 0.78, p<0.001).

Continue reading

Diabetic Retinopathy: OCTA May Improve Staging, Diagnosis and Monitoring

MedicalResearch.com Interview with:

José Cunha-Vaz, M.D., Ph.D. Emeritus Professor of Ophthalmology University of Coimbra, Portugal President of AIBILI Association for Innovation and Biomedical Research on Light and Image Editor-in-Chief of Ophthalmic Research Coordinator, Diabetic Retinopathy and Retinal Vascular Diseases, European Vision Institute Clinical Research Network (EVICR.net)

Dr. Cunha-Vaz

José Cunha-Vaz, M.D., Ph.D.
Emeritus Professor of Ophthalmology
University of Coimbra, Portugal
President of AIBILI
Association for Innovation and Biomedical Research on Light and Image
Editor-in-Chief of Ophthalmic Research
Coordinator, Diabetic Retinopathy and Retinal Vascular Diseases,
European Vision Institute Clinical Research Network (EVICR.net) 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this study, we evaluated the clinical utility of quantitative measures of microvasculature in optical coherence tomographic angiography (OCTA). Although several studies have demonstrated the potential value of measures of microvasculature in the management of diabetic retinopathy (DR), our study uses the ROC curve to compare the overall value of different approaches. In this age matched population with a range of disease, the mean vessel density measured in the SRL had the highest AUC, indicating that it is best among the methods tested at differentiating normal eyes from eyes with diabetic retinopathy.

Continue reading

Neither Vitamin E or Selenium Found To Prevent Dementia

MedicalResearch.com Interview with:

Richard J. Kryscio, Ph.D. Statistics and Chair, Biostatistics and Sanders-Brown Center on Aging Sanders-Brown Center on Aging University of Kentucky

Dr. Richard Kryscio

Richard J. Kryscio, Ph.D.
Statistics and Chair, Biostatistics and Sanders-Brown Center on Aging
Sanders-Brown Center on Aging
University of Kentucky 

MedicalResearch.com: What is the background for this study?

Response: At the time the trial was initiated (2002), there was ample evidence that oxidative stress is an important mechanism in brain aging. Research showed that protein oxidation is linked to the brain’s response to the abnormal proteins seen in Alzheimer disease (amyloid beta plaques in particular) leading to inflammation, DNA repair problems, reduced energy production, and other cellular changes that are identified mechanisms in the Alzheimer brain.

Both vitamin E and selenium are antioxidants. Antioxidants, either through food or supplements, are believed to reduce oxidative stress throughout the body. In the brain, they may reduce the formation of amyloid beta plaques, reduce brain inflammation, and improve other brain processes. Studies in humans support these hypotheses. The Rotterdam study in the Netherlands, as an example, showed that initial blood levels of vitamin E could predict dementia risk. Those people with higher vitamin E levels were 25% less likely to develop dementia. Also, selenium deficiency results in cognitive difficulties and several population-based studies have shown an association between selenium level and cognitive decline (lower selenium levels are linked to thinking changes in the elderly).
Continue reading

High risks of mortality following bleeding and ischemic events occurring 1 year after coronary stenting

MedicalResearch.com Interview with:

Eric A. Secemsky, MD, MSc Interventional Cardiology Fellow Massachusetts General Hospital Harvard Medical School Baim Institute for Clinical Research

Dr. Eric Secemsky

Eric A. Secemsky, MD, MSc
Interventional Cardiology Fellow
Massachusetts General Hospital Harvard Medical School
Baim Institute for Clinical Research 

MedicalResearch.com: What is the background for this study?  What are the main findings?

Response: We know from previous trials that continuing dual antiplatelet therapy longer than 12 months after coronary stenting decreases ischemic events, including spontaneous myocardial infarction and stent thrombosis. However, extending dual antiplatelet therapy is also associated with some increase in bleeding risk. For instance, in the DAPT Study, more than 25,600 patients were enrolled and received both aspirin and a thienopyridine antiplatelet drug (clopidogrel or prasugrel) for one year after stenting. Of these patients, 11,648 participants who had followed the study protocol and had no serious cardiovascular or bleeding events during that first year were then randomized to either continue with dual therapy or to receive aspirin plus a placebo for another 18 months. The overall findings of the DAPT study were that, compared with switching to aspirin only after one year, continuing dual antiplatelet therapy for a total of 30 months led to a 1.6 percent reduction in major adverse cardiovascular and cerebrovascular events – a composite of death, myocardial infarction, stent thrombosis and ischemic stroke – and a 0.9 percent increase in moderate to severe bleeding events.

The prognosis following early ischemic and bleeding events has previously been well described. However, data for events occurring beyond 1 year after PCI are limited. As such, we sought to assess the cumulative incidence of death following ischemic and bleeding events occurring among patients in the DAPT Study beyond 1 year after coronary stenting.

Continue reading

Psychiatric Side Effects of 5 Alpha Reductase Inhibitors for BPH

MedicalResearch.com Interview with:

Blayne Welk, MD, FRCSC Assistant Professor of Surgery Western University

Dr. Blayne Welk

Blayne Welk, MD, FRCSC
Assistant Professor of Surgery
Western University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Concerns have been raised by regulatory agencies and patients about possible serious psychiatric side effects associated with the use of 5 alpha reductase inhibitors. These medications can be used for both enlarged prostates and alopecia.

We used administrative data to assess for potential psychiatric side effects associated with finasteride and dutasteride usage in older men with benign prostatic enlargement.

In our study we found that there was no increased risk of suicide associated with the use of these medications. However, there was a small increase in both self-harm and new onset depression associated with the use of 5 alpha reductase inhibitors.
Continue reading

Marked Increase in Premature Mortality After First Psychiatric Admission

MedicalResearch.com Interview with:
Florian Walter MSc
Centre for Mental Health and Safety
University of Manchester, Manchester, England
Dr Roger Webb PhD and
Reader in Mental Health Epidemiology
Senior Postgraduate Research Tutor
Division of Psychology and Mental Health
Faculty of Biology, Medicine and Health
The University of Manchester

MedicalResearch.com: What is the background for this study?

Response: Mental disorders are associated with an elevated risk of premature mortality, and risk is especially heightened soon after discharge from inpatient psychiatric services. Previous studies have focused on single causes of death, whereas our study considered a comprehensive array of cause-specific mortality outcomes.

We analysed over 1.7 million Danish residents in our national interlinked registry study, which was conducted collaboratively by the Centre of Mental Health and Safety, University of Manchester, UK and the National Centre for Register-based Research, Aarhus University, Denmark. We compared the risk of dying from specific natural and unnatural causes of death among patients following their first discharge from inpatient psychiatric care versus people not admitted.

Continue reading

Effect of Moderate-Intensity Exercise Training on Peak Oxygen Consumption in Patients With Hypertrophic Cardiomyopathy

MedicalResearch.com Interview with:

Sara Saberi, MD Assistant Professor Inherited Cardiomyopathy Program Frankel Cardiovascular Center University of Michigan Hospital and Health Systems

Dr. Sara Saberi

Sara Saberi, MD
Assistant Professor
Inherited Cardiomyopathy Program
Frankel Cardiovascular Center
University of Michigan Hospital and Health Systems 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Patients with hypertrophic cardiomyopathy are often told not to exercise or to significantly curb their exercise due to concern over the potential risk of increased ventricular arrhythmias and sudden cardiac death. There is no data regarding risks/benefits of exercise in HCM though. There is, however, data that shows that patients with HCM are less active and more obese than the general population AND a majority feel that exercise restrictions negatively impact their emotional well-being.

So, we devised a randomized clinical trial of a 16-week moderate-intensity aerobic exercise program versus usual activity with the primary outcome being change in peak VO2 (oxygen consumption). This exercise intervention resulted in a 1.27 mL/kg/min improvement in peak VO2 over the usual activity group, a statistically significant finding. There were no major adverse events (no death, aborted sudden cardiac death, appropriate ICD therapies, or sustained ventricular tachycardia). There was also a 10% improvement in quality of life as measured by the Physical Functioning scale of the SF-36v2.

Continue reading

Dermatology Physician Assistants Helping To Supplement Care in Underserved Areas

MedicalResearch.com Interview with:
Dr. Alex M. Glazer MD
National Society for Cutaneous Medicine
New York, New York 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We had previously studied the geographic distribution of dermatologists throughout the United States which revealed that dermatologists are unevenly geographically distributed throughout the country, with many regions having fewer than the 4 providers per 100,000 people needed to adequately care for a population. Because of the influx of PAs and NPs into the healthcare workforce throughout the past decade, we wanted to see how these providers were supplementing dermatologic care.

The main finding of our study is that dermatology PAs are helping to supplement dermatologists and together are providing broader, more uniform coverage across the United States

Continue reading

Laypeople Perceive Facelift To Give More Youthful, Healthier Appearance

MedicalResearch.com Interview with:
Lisa E. Ishii, MD, MHS
Associate Professor of Otolaryngology – Head and Neck Surgery
John Hopkins Medicine

Lisa Earnest Ishii, M.D. Associate Professor of Otolaryngology - Head and Neck Surgery Johns Hopkins Medicine

Dr. Ishii

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There was a gap in our knowledge about what the average lay person thought about the impact of a facelift.  We had information about what experts thought, and some about what patients themselves thought, but nothing about lay people.
Patients who choose to have a facelift are typically concerned about the opinions of:

1) Themselves when they look in the mirror, and

2) Laypeople they encounter socially in society.

Our study showed for the first time that laypeople find people who have had a facelift to appear more attractive, more youthful, healthier and more successful than they were before their facelift.

Continue reading

High Schools Less Likely To Adopt Sun Safety Practices

MedicalResearch.com Interview with:

Sherry Everett Jones PhD, MPH, JD, FASHA Health Scientist, Division of Adolescent School Health Centers for Disease Control & Prevention

Dr. Sherry Everett Jones

Sherry Everett Jones PhD, MPH, JD, FASHA
Health Scientist, Division of Adolescent School Health
Centers for Disease Control & Prevention

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Skin cancer is the most common form of cancer in the United States. Results from the School Health Policies and Practices Study found that in 2014, most schools lacked practices that could protect children and adolescents from sun exposure while at school. Positive attitudes and beliefs about sun safety behavior, which would make such behavior more likely, can be promoted and supported by school system policies and practices.

Continue reading

Military Physicians Say They Need More Education on Transgender Health Care

MedicalResearch.com Interview with:
David A. Klein, MD, MPH

Uniformed Services University of the Health Sciences (USUHS)
Bethesda, Maryland
Fort Belvoir Community Hospital (FBCH), Fort Belvoir, Virginia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In June 2016, the ban was lifted on transgender personnel serving openly in the military. Research suggests approximately 200 active-duty service members may request a gender transition annually.

The purpose of this study is to determine military family physician readiness to care for such patients. The majority (74 percent) of physicians have not received any formal education on the treatment of patients with gender dysphoria. Almost half of surveyed physicians are willing to prescribe cross-hormone therapy; of these, 99 percent report the need for additional training and/or assistance to do so. 53 report an unwillingness to prescribe even with additional education and assistance.

Continue reading