Author Interviews, Brain Injury, University of Pittsburgh / 15.09.2014

Anthony P. Kontos, Ph.D. Assistant Research Director UPMC Sports Medicine Concussion Program Associate Professor Department of Orthopaedic Surgery University of PittsburghMedicalResearch.com Interview with: Anthony P. Kontos, Ph.D. Assistant Research Director UPMC Sports Medicine Concussion Program Associate Professor Department of Orthopaedic Surgery University of Pittsburgh Medical Research: What are the main findings of the study? Dr. Kontos: Our new Vestibular/Ocular Motor Screening (VOMS) examination was able to accurately identify nearly 90% of patients with a concussion. In our study of 64 concussed patients approximately five days post-injury and 78 healthy control-group patients who were administered VOMS by trained clinicians, we also found that more than 60% of patients with a concussion reported symptoms or had impairment on the VOMS following their injury. The VOMS, which was developed in conjunction with an interdisciplinary team of experts, assesses five areas of the vestibular ocular system: smooth pursuits, saccades (rapid eye movement), horizontal vestibular ocular reflex (VOR), visual motion sensitivity (VMS), and near-point-of-convergence (NPC) distance. (more…)
Author Interviews, Mental Health Research, NIH / 15.09.2014

MedicalResearch.com Interview with: Dr Oliver J Robinson Ph.D. Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, NIH, Bethesda, MD, Institute of Cognitive Neuroscience University College London, London, UK Medical Research: What are the main findings of the study? Dr. Robinson: This study is looking at a symptom of anxiety disorders known as “negative affective bias”. This describes the tendency of people with anxiety disorders to focus on negative or threatening information at the expense of positive information. We completed a number of previous studies looking at so called “adaptive” anxiety in healthy individuals – this is the normal, everyday anxiety that everyone experiences; walking home in the dark, for instance (in these prior studies we used unpredictable electrical shocks to make people anxious and stressed). When we made healthy people transiently anxious in this way we showed that this was also associated with negative affective bias and driven by a specific brain circuit: the dorsal medial prefrontal (anterior cingulate) cortex—amygdala aversive amplification circuit. In this study we showed that the same circuit that was engaged by transient anxiety in our healthy sample was actually engaged ‘at baseline’ (i.e. without stress) in our patient group. This suggests that this mechanism which can be temporarily activated in healthy controls becomes permanently ‘switched on’ in our patient group. This might explain why people with anxiety disorders show persistent ‘negative affective biases’. Furthermore, the extent to which this circuit was turned on correlated with self-reported anxiety. That is to say the more anxious an individual said they were, the greater the activity in this circuit. Therefore, there seems to be more of a dimension or scale of anxiety, rather than a simple well/unwell diagnosis. (more…)
Author Interviews, Multiple Sclerosis, Sleep Disorders, UC Davis / 14.09.2014

Steven D. Brass, M.D., M.P.H., M.B.A. PI and Lead Author on the study Director of Neurology Sleep Clinical Program Co-Medical Director of Sleep Medicine Laboratory Associate Clinical Professor in the Department of Neurology UC Davis Health System 4860 Y Street — Suite 3700 Sacramento, CA 95817 MedicalResearch.com Interview with: Steven D. Brass, M.D., M.P.H., M.B.A. PI and Lead Author on the study Director of Neurology Sleep Clinical Program Co-Medical Director of Sleep Medicine Laboratory Associate Clinical Professor in the Department of Neurology UC Davis Health System 4860 Y Street — Suite 3700 Sacramento, CA 95817 Medical Research: What was the primary finding of your study? Dr. Brass : Among the 11,400 surveys mailed out to all members of the Northern California Chapter of the National Multiple Sclerosis Society, 2,810 (24.6%) were returned. Of these, 2,375 (84.5%) met the inclusion criteria. Among the completed surveys, 898 (37.8%) screened positive for obstructive sleep apnea, 746 (31.6%) for moderate to severe insomnia, and 866 (36.8%) for restless legs syndrome.  In contrast, only 4%, 11%, and 12% of the cohort reported being diagnosed by a health care provider with obstructive sleep apnea, insomnia, and restless legs syndrome, respectively. Excessive daytime sleepiness was noted in 30% of respondents based on the Epworth Sleepiness Scale. More than 60% of the respondents reported an abnormal level of fatigue based on the Fatigue Severity Scale.  There was also an increased risk between complaints of Fatigue based on screening positive for the Fatigue Severity Scale  and screening positive for Obstructive Sleep Apnea  (1.850, with a 95% p-value < 0.001). (more…)
Author Interviews, Cancer Research, Dartmouth, Melanoma, Nature / 12.09.2014

Dr. Constance Brinckerhoff Professor of Medicine Professor of Biochemistry Geisel School of Medicine at DartmouthMedicalResearch.com Interview with: Dr. Constance Brinckerhoff Professor of Medicine Professor of Biochemistry Geisel School of Medicine at Dartmouth Medical Research: What are the main findings of the study? Dr. Brinckerhoff: The genetic mutation BRAFV600E , frequently found in metastatic melanoma, not only secretes a protein that promotes the growth of melanoma tumor cells, but can also modify the network of normal cells around the tumor to support the disease’s progression. Targeting this mutation with Vemurafenib reduces this interaction, and suggests possible new treatment options for melanoma therapy. (more…)
Author Interviews, Cancer Research, Genetic Research, University of Pennsylvania / 12.09.2014

Renata Afi Rawlings-Goss, Ph.D. Postdoctoral Fellow Tishkoff Lab, University of PennsylvaniaMedicalResearch.com Interview with: Renata Afi Rawlings-Goss, Ph.D. Postdoctoral Fellow Tishkoff Lab, University of Pennsylvania   Medical Research: What are the main findings of the study? Dr. Rawlings-Goss: We found genetic mutations in key gene regulators that have been linked to ethnic disparities in cancer. Our investigation identified more than 30 previously undescribed mutations in important regulatory molecules called microRNAs. Individual microRNA molecules can regulate large numbers of genes in some cases over 6000 genes at once. Therefore, mutations in these genes have been linked to numerous diseases. By and large, however, microRNA mutations have not been studied in people of diverse ethnic backgrounds. (more…)
Author Interviews, Dermatology, JAMA, NIH, Transplantation / 11.09.2014

MedicalResearch.com Interview with: Rena Zuo, BA MD Candidate at Duke University School of Medicine and Edward W. Cowen, MD, MHSc Senior Clinician Head, Dermatology Consultation Service Dermatology Branch Center for Cancer Research National Cancer Institute National Institutes of Health MedicalResearch: What are the main findings of the study?
 Answer: Chronic graft-vs-host disease (cGVHD) is a debilitating multisystem disease that occurs in patients receiving allogeneic hematopoietic stem cell transplantations as treatment for hematologic disorders. Although the diverse clinical presentations of cGVHD frequently mimic other autoimmune diseases such as Sjögren syndrome and systemic sclerosis, and low-titer antibodies are commonly found in patients with cGVHD, the exact pathogenesis and role of autoimmunity in cGVHD are incompletely understood. Our study is the first to characterize and identify risk factors associated with the development of two uncommon autoimmune phenomena, specifically alopecia areata and vitiligo, in the setting of cGVHD. Laboratory markers, including 11 antibodies, transplant-related factors, and other cGVHD systemic manifestations were analyzed. Several particularly interesting results were found:
  1. Among 282 patients with cGVHD, 15 demonstrated vitiligo (14 of 282; 4.9%) and/or alopecia areata (2 of 282; 0.7%).
  2. Female donor and female donor to male recipient sex mismatch, in particular, are significantly associated with the development of vitiligo and/or alopecia areata.
  3. Positive anti-cardiolipin (ACA) IgG was also significantly associated with development of vitiligo and/or alopecia areata.
(more…)
Author Interviews, Dermatology, Gastrointestinal Disease, JAMA, Mayo Clinic / 11.09.2014

Shadi Rashtak, MD Department of Dermatology Mayo Clinic College of Medicine Rochester, MinnesotaMedicalResearch.com Interview with: Shadi Rashtak, MD Department of Dermatology Mayo Clinic College of Medicine Rochester, Minnesota Medical Research:  What are the main findings of the study? Dr. Rashtak: We found that among a population of mainly acne patients those who received isotretinoin had a lower risk of inflammatory bowel disease as compared to those who did not take this medication. We carefully reviewed the medical records of patients to ensure that this finding was not simply because the drug was avoided in patients with a previous personal or family history of IBD. (more…)
Annals Internal Medicine, Author Interviews, Orthopedics, UCLA / 09.09.2014

Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at University of California, Los Angeles UCLA Medicine/GIM Los Angeles, CA  90024MedicalResearch.com Interview with: Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at University of California, Los Angeles   Medical Research: What are the main findings of the study? Dr. Crandall: 1.        We found high-strength evidence that several medications decrease fracture risk when used by persons with bone density in the osteoporotic range and/or with pre-existing hip or vertebral fracture.  While many of the medications (alendronate, risedronate, zoledronic acid, ibandronate, denosumab, teriparatide, and raloxifene) reduce vertebral fractures, a reduction in the risk of hip fracture is not demonstrated for all of the medications.  In particular, hip fracture reduction is only demonstrated for alendronate, risedronate, zoledronic acid, and denosumab.  Unfortunately, due to a lack of head-to-head trials, the comparative effectiveness of the medications is unclear. 2.       The adverse effects of the medications vary.  For example, raloxifene is associated with an increased risk of thromboembolic events, whereas denosumab and the bisphosphonate medications have been associated with increased risk of osteonecrosis of the jaw and atypical subtrochanteric femoral fractures. (more…)
Breast Cancer, MD Anderson, Surgical Research / 05.09.2014

sabelle Bedrosian, M.D., F.A.C.S. Associate Professor, Department of Surgical Oncology, Division of Surgery Medical Director, Nellie B. Connelly Breast Center The University of Texas MD Anderson Cancer Center, Houston, TXMedicalResearch.com: Interview with: Isabelle Bedrosian, M.D., F.A.C.S. Associate Professor, Department of Surgical Oncology, Division of Surgery Medical Director, Nellie B. Connelly Breast Center The University of Texas MD Anderson Cancer Center, Houston, TX Medical Research: What are the main findings of the study? Dr. Bedrosian: •       National BCT (breast conserving therapy) rates have increased during the last two decades. •       Disparities based on age, geographic facility location and type of cancer treatment facility have lessened over time. •       Insurance type and travel distance remain persistently associated with underutilization of breast conserving therapy. •       Annual income of less than $35K may be emerging as a new association with underutilization of breast conserving therapy. (more…)
Author Interviews, Cannabis, Disability Research, Karolinski Institute / 03.09.2014

Anna-Karin Danielsson, PhD Project Coordinator Karolinska Institutet Department of Public Health Sciences (PHS) Widerströmska huset| Stockholm, SwedenMedicalResearch.com Interview with: Anna-Karin Danielsson, PhD Project Coordinator Karolinska Institutet Department of Public Health Sciences (PHS) Widerströmska huset| Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Danielsson: Smoking cannabis in adolescence increases the risk of adverse social consequences later on in life. (more…)
Author Interviews, Mayo Clinic, Surgical Research / 03.09.2014

Dr. Juliane Bingener-Casey, M.D. Mayo Clinic in Rochester, Minn.MedicalResearch.com Interview with: Dr. Juliane Bingener-Casey, M.D. Mayo Clinic in Rochester, Minn Medical Research: What are the main findings of the study? Dr. Bingener: Other investigators have shown that preoperative quality of life is a predictor for postoperative survival in colon and pancreas cancer surgery. In this study we looked as preoperative quality of life as a predictor for postoperative complications. The main findings of the study were that patients who had a deficit in their quality of life before surgery had a 3 times higher risk of a serious complication before leaving the hospital than patients who had normal quality of life (16% vs 6 %), independent of gender, race, tumor stage or laparoscopic or open colectomy. Patients with serious complications before leaving the hospital also were older and had more other medical problems than patients without complications. Further, patients who had a complication stayed in the hospital longer and their postoperative quality of life was worse (more…)
Author Interviews, Case Western, Gender Differences / 01.09.2014

Melina Kibbe, MD, FACS, FAHA Professor and Vice Chair of Research Edward G. Elcock Professor of Surgical Research Department of Surgery Northwestern University Institute for BioNanotechnology in Medicine Deputy DirectorMedicalResearch.com Interview with: Melina Kibbe, MD, FACS, FAHA Professor and Vice Chair of Research Edward G. Elcock Professor of Surgical Research Department of Surgery,Northwestern University Institute for BioNanotechnology in Medicine Deputy Director Medical Research: What are the main findings of the study? Dr. Kibbe: We found that approximately 1/3 of all peer-reviewed published manuscripts in 5 top surgery journals did not state the sex of the animal or cell used for research. Of those that did state the sex, 80% used only males. (more…)
Author Interviews, Diabetes, Diabetologia, University of Pittsburgh / 31.08.2014

MedicalResearch.com Interview with: Dr. Sabita Soedamah-Muthu Division of Human Nutrition,Wageningen University Wageningen, the Netherlands and Prof Trevor Orchard Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA Medical Research: What are the main findings of the study? Answer: We present a new prognostic model combining information on age, glycated haemoglobin, waist-hip ratio, albumin/creatinine ratio and HDL (good) cholesterol to assess the 3, 5 and 7 year risk of developing major outcomes in patients with type 1 diabetes. (more…)
Author Interviews, Brigham & Women's - Harvard / 28.08.2014

Christopher D. Anderson, MD, MMSc Neurocritical Care | Acute Stroke Center for Human Genetic Research Massachusetts General Hospital Harvard Medical School Broad Institute of Harvard and MITMedicalResearch.com Interview with: Christopher D. Anderson, MD, MMSc Neurocritical Care | Acute Stroke Center for Human Genetic Research Massachusetts General Hospital Harvard Medical School Broad Institute of Harvard and MIT Medical Research: What are the main findings of the study? Dr. Anderson: Previous studies have linked Apolipoprotein E (APOE) epsilon variants with spontaneous intracerebral hemorrhage (ICH) particularly in the lobar (cortical and subcortical) regions of the brain, but it was not known whether this association would extend to warfarin-related ICH, or whether the risk of intracerebral hemorrhage on warfarin would be multiplicatively compounded by APOE epsilon allele status.  Our results demonstrate that APOE e2 and e4 variants are associated with more than a two-fold risk of lobar ICH for patients on warfarin, in comparison to warfarin-exposed individuals without ICH.  This observed association was strongest when analyzing subjects with definite or probable Cerebral Amyloid Angiopathy (CAA), as defined by the Boston Criteria.  No association between APOE e2 or e4 and non-lobar ICH was identified following our replication phase.  Furthermore, we did not detect an interaction between APOE status and warfarin status in ICH subjects using a case-only design. (more…)
Author Interviews, Dermatology, JAMA, UC Davis / 28.08.2014

MedicalResearch.com Interview with: Gayatri Patel, MD, MPH Division of General Medicine UC Davis Medical CenterMedicalResearch.com Interview with: Gayatri Patel, MD, MPH Division of General Medicine UC Davis Medical Center Medical Research: What are the main findings of the study? Dr. Patel: In this systematic review and meta-analysis, we sought to determine the effectiveness of photodynamic therapy (PDT) for the treatment of actinic keratoses relative to other common treatments. We included only randomized controlled trials and preformed a meta-analysis on homogenous studies. The primary finding of the study was that PDT has a better chance of removing actinic keratoses on the face or scalp than treatment with cryotherapy. (more…)
Author Interviews, Genetic Research, Hematology, Johns Hopkins, NEJM / 27.08.2014

Jerry Spivak, M.D Professor of Medicine and Oncology Director, Center for the Chronic Myeloproliferative Disorders John Hopkins MedicineMedicalResearch.com Interview with: Jerry Spivak, M.D Professor of Medicine and Oncology Director, Center for the Chronic Myeloproliferative Disorders John Hopkins Medicine Medical Research: What are the main findings of the study? Dr. Spivak: The main findings of this study are that polycythemia vera occurs in two clinical forms: an indolent form in which only phlebotomy may be necessary and a more aggressive form requiring myelosuppressive therapy and that these two forms of the disease can be distinguished genetically. (more…)
Author Interviews, Bipolar Disorder, JAMA, Stanford / 27.08.2014

MedicalResearch.com Interview with: Manpreet K. Singh, MD MS Assistant Professor of Psychiatry and Behavioral Sciences Akiko Yamazaki and Jerry Yang Faculty Scholar in Pediatric Translational Medicine Stanford University School of Medicine Medical Research: What are the main findings of the study? Dr. Singh: Our research team used a monetary incentive delay paradigm to measure fronto-limbic activity and connectivity associated with anticipation and receipt of reward and loss in healthy offspring of parents with bipolar I disorder. We found that compared to youth offspring without any family history of psychopathology, high-risk offspring had aberrant prefrontal and cingulate activations and connectivity during reward processing. Further, greater striatal, amygdalar, and insula activations while anticipating and receiving rewards and losses were associated with greater novelty-seeking and impulsivity traits in high-risk youth. (more…)
Author Interviews, Case Western, Lyme / 22.08.2014

Daniel Salkeld, PhD Lecturer & Research Associate Stanford Woods Institute for the Environment Professor Colorado State UniversityMedicalResearch.com Interview with: Daniel Salkeld, PhD Lecturer & Research Associate Stanford Woods Institute for the Environment Professor Colorado State University Medical Research: What are the main findings of the study that were just published in Ticks and Tick-borne Diseases? Dr. Salkeld: The primary findings of this new study show that western black-legged ticks, which can transmit Lyme disease, are active throughout the year in Northwest California, making the threat of Lyme disease year-round phenomenon. More specifically, my colleagues from California Department of Public Health Vector-borne Disease Section and University of California, Berkeley and I found that the activity of Western Black-legged ticks (Ixodes pacificus), which are the ticks most commonly known to carry Lyme disease (caused by Borrelia burgdorferi) in Northwest California, is largely predictable and year-round. In general, tick larvae (newly hatched immature ticks) are active April to June, and sometimes activity extends into October, while adult ticks are active from October to May. Nymphal ticks (the tick stage following larvae and preceding adults) are active from January to October but peak from April-June. This is important because nymphs are responsible for most Lyme disease infections. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease, Stanford / 21.08.2014

Marco Perez, MD Instructor in Cardiovascular Medicine Director, Inherited Cardiac Arrhythmia Clinic Stanford University Medical Center Cardiac Electrophysiology & Arrhythmia Service Stanford, CA 94305-5233MedicalResearch.com Interview with Marco Perez, MD Instructor in Cardiovascular Medicine Director, Inherited Cardiac Arrhythmia Clinic Stanford University Medical Center Cardiac Electrophysiology & Arrhythmia Service Stanford, CA 94305-5233 Medical Research: What are the main findings of the study? Dr. Perez: It was already known that obesity is an important risk factor for atrial fibrillation.  We studied over 80,000 postmenopausal women enrolled in the Women’s Health Initiative who were followed for the onset of atrial fibrillation, an irregular heart rhythm associated with stroke and death.  We found that those who exercised more than 9 MET-hours/week (equivalent to a brisk walk of 30 minutes six days a week) were 10% less likely to get atrial fibrillation than those who were sedentary.  Importantly, the more obese the women were, the more they benefited from the exercise in terms of atrial fibrillation risk reduction. (more…)
Author Interviews, Brigham & Women's - Harvard, Compliance, Kidney Disease, Primary Care / 20.08.2014

Mallika L. Mendu, M.D. Division of Renal Medicine Brigham and Women’s Hospital Boston, MA 02115.MedicalResearch.com Interview with: Mallika L. Mendu, M.D. Division of Renal Medicine Brigham and Women’s Hospital Boston, MA 02115. Medical Research: What are the main findings of the study? Dr. Mendu: Our study found that implementation of a chronic kidney disease (CKD) checklist, a tool that succinctly and clearly outlines CKD management guidelines, in a primary care clinic improved adherence to a number of significant management guidelines. We conducted a prospective study during a one year period among 13 primary care providers, four of whom were assigned to use a CKD checklist incorporated into the electronic medical record during visits with patients with CKD. Patients whose providers utilized a CKD checklist had higher rates of adherence to annual albuminuria testing, parathyroid hormone testing, phosphate testing, achieving a hemoglobin A1c target<7, documentation of avoidance of nonsteroidal anti-inflammatory drugs, use of an angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker and vaccination for annual influenza and 5-year pneumococcus. (more…)
Author Interviews, JAMA, Johns Hopkins, Outcomes & Safety / 20.08.2014

MedicalResearch.com Interview with: Sosena Kebede, MD, MPH Assistant Professor of Medicine, Department of Medicine Associate Faculty, the Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine Faculty, Department of Health Policy and Management and Baltimore, MD 21287Sosena Kebede, MD, MPH Assistant Professor of Medicine, Department of Medicine Associate Faculty, the Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine Faculty, Department of Health Policy and Management and Baltimore, MD 21287 Medical Research: What are the main findings of the study? Dr. Kebede: There were 3 main findings in this study: 1.       Patients’ understanding of aspects of their hospital care is suboptimal on the domains of knowledge of diagnoses, indications for the medications they take and the types of procedures/tests they get. Some forms of poor shared understanding could have potentially serious implications for their health and for future care such as identifying a prescribed antidepressant as a blood thinner or mistaking an echocardiogram a left heart catheterization or thinking a liver cyst is a liver cancer. Other forms of poor shared understanding such as not accurately identifying why a procedure is done or what the results of the procedure show (a finding not discussed in the research letter) may seem less consequential  but raise the issue of informed consent, patient empowerment and may alsoraise questions about patient and physician behavior towards appropriate use of in-patient procedures. Some of the questions we could ask here include: would patients demand more or less procedures if they had better understanding of what the procedures entail, and why they are beingordered? Conversely, would physicians recommend more or less of in-patient procedures, when they encounter patients whose understanding of procedure indications are optimal? (more…)
Author Interviews, JAMA, Karolinski Institute, Surgical Research / 20.08.2014

MedicalResearch.com Interview with: Mats Möller MD Department of Surgery, Ersta Hospital Department of Clinical Sciences Karolinska Institutet Danderyds Hospital, Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Möller: The natural course of common bile duct stones seem not as favorable as previous studies have suggested. Leaving stones with no measures taken has in our study a less favorable outcome compared to removing the stones. (more…)
Anesthesiology, Author Interviews, Karolinski Institute / 19.08.2014

MedicalResearch.com Interview with: Jan G. Jakobsson Institution for Clinical Science Karolinska Institutet, Danderyds Hospital Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Jakobsson:  We found that anaesthesiologists and nurse anaesthetists were concerned about the risk for neurocognitive side effects, but there routines and practice for preoperative identification of patients at risk, intraoperative management to minimise risk and assessment and management of patients showing signs and/or symptoms of neurocognitive side effects after anaesthesia was rarely at place. (more…)
Author Interviews, Cancer Research, Erasmus, JAMA / 19.08.2014

Frank van Hees, MSc Researcher, Department of Public Health, Erasmus MC Rotterdam, The NetherlandsMedicalResearch.com Interview with: Frank van Hees MSc Erasmus University Medical Center Rotterdam, the Netherlands   Medical Research: What are the main findings of the study? Answer: Many U.S. elderly are screened for colorectal cancer more frequently than recommended: One in every five elderly with a negative screening colonoscopy result undergoes another screening colonoscopy within 5 years’ time instead of after the recommended 10 years. Moreover, one in every four elderly with a negative screening colonoscopy result at age 75 or older receives yet another screening colonoscopy at an even more advanced age. Our study shows that, in average risk individuals, these practices are not only a waste of scarce health care resources: often they are also associated with a balance among benefits, burden, and harms that is unfavorable for those being screened. (more…)
Annals Internal Medicine, Author Interviews, Colon Cancer, Erasmus / 18.08.2014

Frank van Hees, MSc Researcher, Department of Public Health, Erasmus MC Rotterdam, The NetherlandsMedicalResearch.com Interview with: Frank van Hees, MSc Researcher, Department of Public Health, Erasmus MC Rotterdam, The Netherlands Medical Research:   What are the main findings of the study? Answer: Many U.S. elderly are screened for colorectal cancer more frequently than recommended: One in every five elderly with a negative screening colonoscopy result undergoes another screening colonoscopy within 5 years’ time instead of after the recommended 10 years. Moreover, one in every four elderly with a negative screening colonoscopy result at age 75 or older receives yet another screening colonoscopy at an even more advanced age. Our study shows that, in average risk individuals, these practices are not only a waste of scarce health care resources: often they are also associated with a balance among benefits, burden, and harms that is unfavorable for those being screened. (more…)
AHA Journals, Author Interviews, Heart Disease, UT Southwestern / 13.08.2014

MedicalResearch.com Interview with: Hurst M. Hall, MD and Sandeep Das, MD, MPH Division of Cardiology University of Texas Southwestern Medical Center Dallas, TX Medical Research: What are the main findings of the study? Answer: Most patients treated for a heart attack in the United States during this study period were discharged home on 325 mg of aspirin a day.  This was true even among subgroups expected to be at high bleeding risk. In addition, there was tremendous variability in the proportional use of this higher dose aspirin across hospitals, suggesting a prominent local influence on prescribing patterns. (more…)
Author Interviews, Mayo Clinic, Surgical Research / 11.08.2014

Dr. Juliane Bingener-Casey, M.D. Mayo Clinic in Rochester, Minn.MedicalResearch.com Interview with: Dr. Juliane Bingener-Casey, M.D. Mayo Clinic in Rochester, Minn.   Medical Research: What are the main findings of the study?   Dr. Bingener-Casey: “About half of patients seeking emergency care for gallbladder problems were immediately admitted and underwent urgent cholecystectomy, the other half went home. The half that went home was younger and had lower WBC counts, lower neutrophils and less people with elevated temperature than the patients immediately admitted. Of the half that went home, 31% returned at least once to the ED within 30 days and 20% were admitted to undergo urgent cholecystectomy after the return visit, 55% percent of those within 7 days of the initial ED visit. Patients who failed the elective treatment plan had similar WBC counts but were more likely to have an ASA >3, slightly higher creatinine and higher average maximum VAS pain score. Patients who were less than 40 years old or older than 60 years were more likely to fail the elective pathway.” (more…)
Author Interviews, Erasmus, Lancet, Prostate Cancer / 10.08.2014

Professor Fritz H Schröder Department of Urology, Erasmus University Medical Center Rotterdam, NetherlandsMedicalResearch.com Interview with: Professor Fritz H Schröder Department of Urology, Erasmus University Medical Center Rotterdam, Netherlands Medical Research: What are the main findings of the study? Professor Schröder: I consider as the main finding that we could report a continuing effect of PSA driven screening on prostate cancer mortality for men aged 55 – 69 years in the screen arm of our study after 13 years of follow-up. The absolute reduction in the risk of death from prostate cancer amounts to 1.28 per 1000 men randomized to the screening arm. This translated into numbers to be invited to screening and numbers needed to be diagnosed to save one prostate cancer death of 781 and 27. These figures show an increasing effect with increasing time of follow-up. The relative risk reduction related to the control arm has remained unchanged with respect to the 11 year follow-up period. For men who actually participated and were screened the relative risk reduction amounted to 27%, the figure most applicable to men who consider to be tested. (more…)
Author Interviews, Brigham & Women's - Harvard, Rheumatology, Weight Research / 01.08.2014

Dr. Bing Lu, M.D., Dr.P.H. Division of Rheumatology Immunology & Allergy Brigham & Women's Hospital and Harvard Medical School Boston, MA 02115MedicalResearch.com Interview with: Dr. Bing Lu, M.D., Dr.P.H. Division of Rheumatology Immunology & Allergy Brigham & Women's Hospital and Harvard Medical School Boston, MA 02115 Medical Research: What are the main findings of the study? Dr. Lu: In two large cohorts of women, we observed that being obese increased the risk of rheumatoid arthritis in women by 40–70% depending on age and serologic status. The highest risk for rheumatoid arthritis was among women who were overweight or obese at age 18 years, emphasizing the public health importance of combating the obesity epidemic at all ages. Our study implicates being overweight or obese throughout adult life as a risk factor in the development of seropositive and seronegative RA for women diagnosed with rheumatoid arthritis at age 55 years or younger. The attenuated association between BMI and rheumatoid arthritis diagnosed at older ages may reflect differences in the pathophysiology of RA diagnosed at earlier ages compared with that diagnosed at older ages, or may be a result of the limitations of BMI as a measure of total fat mass as women age. (more…)
Author Interviews, Gender Differences, Kidney Disease, Mayo Clinic, Weight Research / 31.07.2014

Dr. John C. Lieske, MD Mayo Clinic, Rochester, MNMedicalResearch.com Interview with Dr. John C. Lieske, MD Mayo Clinic, Rochester, MN Medical Research: What are the main findings of the study? Dr. Lieske: We followed 11 women before, 6 and 12 months after Roux en Y gastric bypass surgery.  The patients successfully lost weight as mean BMI fell from 46 kg/m2 preoperatively to 28 kg/m2 postoperatively.   Mean serum creatinine did not significantly change from baseline (0.8 mg/dl) to 12 months (0.7 mg/dl).  Hence mean GFR estimated by the CKD-EPI equation (eGFR) did not significantly change from 84 ml/min/1.73 m2 (baseline) to 90 ml/min/1.73 m2 (12 months).  However, GFR measured by iothalamate clearance (mGFR) significantly decreased from 108 ml/min/1.73m2 (121 ml/min) to 85 ml/min/1.73 m2 (90 ml/min). (more…)