Author Interviews, Hematology, NEJM, Sloan Kettering, Transplantation / 31.07.2014

MedicalResearch.com Interview with: Richard J. O'Reilly, MD Memorial Sloan Kettering Cancer Center Medical Research: What are the main findings of the study? Dr. O'Reilly: 1.       In a comparison of the results of HLA-matched sibling transplants with other established transplant approaches, including T-cell depleted half-matched parental marrow grafts, unmodified transplants from matched unrelated donors and cord blood transplants in the current era (2000-2009), transplants from donors other than HLA-matched siblings had 5 year survival outcomes similar to those of matched siblings when applied to young infants (≤ 3.5 months of age) or infants of any age that were not infected at the time of transplants. Thus any child born with SCID can now be successfully transplanted. 2.       Active infection at the time of transplant significantly reduced chances of long-term survival for all infants except those who received transplants from HLA-matched siblings. Thus, infection is a dominant determinant of transplant outcome.  Control of treatable infections prior to transplant should be a major clinical objective. 3.       Treatment with chemotherapy containing busulfan significantly enhances the likelihood of recovering a normal ability to make antibodies and fosters better recovery of T-cells that provide cell mediated immunity, and may be an acceptable risk in uninfected infants. However, use of any chemotherapy prior to transplant in an infant who is infected, greatly decreases chances of survival. In infected patients who lack a matched sibling, T-cell depleted transplants from half matched related donors had the best outcomes. (more…)
Author Interviews, Duke, General Medicine, Mental Health Research, Nature / 31.07.2014

Rainbo Hultman, PhD Postdoctoral Research Associate Laboratory for Psychiatric Neuroengineering, Principal Investigator Affective Cognitive and Addiction Disorders (ACAD) Research Group Department of Psychiatry and Behavioral Sciences Center for Neuroengineering Duke University Medical Center Durham, NC 27710MedicalResearch.com Interview with: Rainbo Hultman, PhD Postdoctoral Research Associate Laboratory for Psychiatric Neuroengineering, Principal Investigator Affective Cognitive and Addiction Disorders (ACAD) Research Group Department of Psychiatry and Behavioral Sciences Center for Neuroengineering Duke University Medical Center Durham, NC 27710 Medical Research: What are the main findings of the study? Dr. Hultman: Using a mouse model of stress-induced psychiatric dysfunction, we found that the brainwave patterns in two key brain regions (prefrontal cortex, PFC and amygdala, AMY) encode for susceptibility to such dysfunction. Furthermore, such susceptibility can be predicted from the brainwave patterns in these regions before the onset of stress. (more…)
Author Interviews, Dartmouth, Kidney Disease / 31.07.2014

MedicalResearch.com Interview with: Jeremiah R. Brown, PhD MS Assistant Professor of Health Policy and Clinical Practic The Dartmouth Institute Lebanon, NHMedicalResearch.com Interview with: Jeremiah R. Brown, PhD MS Assistant Professor of Health Policy and Clinical Practic The Dartmouth Institute Lebanon, NH   Medical Research: What are the main findings of the study? Dr. Brown: Using simple team-based quality improvement methods we prevented kidney injury in 20% of patients having a procedure in the cardiac catheterization lab.  Among patients with pre-existing kidney disease, we prevent kidney injury in 30% of patients. We believed that using a team-based approach and having teams at different medical centers in northern New England learn from one-another to provide the best care possible for their patients.  Some of the most innovative ideas came from these teams and identified simple solutions to protect patients from kidney injury from the contrast dye exposure; these included:
  • Getting patients to self-hydrate with water before the procedure (8 glasses of water before and after the procedure),
  • Allow patient to drink fluids up to 2-hours before the procedure (whereas before they were "NPO" for up to 12 hours and came in dehydrated),
  • Training the doctors to use less contrast in the procedure (which is good for the patient and saves the hospital money),
  • and creating stops in the system to delay a procedure if that patient had not received enough oral or IV fluids before the case (rather, they would delay the case until the patient received adequate fluids).Our success was really about hospital teams talking and innovating with one another instead of competing in the health care market, which resulted in simple, homegrown, easy to do solutions that improved patient safety.
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Author Interviews, JAMA, Psychological Science, University of Pittsburgh / 25.07.2014

John Blosnich, Ph.D., M.P.H., Post-doctoral fellow at the Center for Health Equity Research and Promotion Veterans Affairs Pittsburgh Healthcare System. MedicalResearch.com Interview with: John Blosnich, Ph.D., M.P.H., Post-doctoral fellow at the Center for Health Equity Research and Promotion Veterans Affairs Pittsburgh Healthcare System. Medical Research: What are the main findings of the study? Dr. Blosnich: I think there are two main findings from our study: First, since the beginning of the All-Volunteer U.S. military in 1973, there has been a shift in childhood experiences among men who have served in the military. Second, the childhood experiences of women who have served in the military have been largely similar across the Draft and All-Volunteer Eras. (more…)
Alzheimer's - Dementia, Author Interviews, Mayo Clinic / 25.07.2014

Dr. Bryan K. Woodruff Assistant Professor of Neurology Mayo Clinic, ArizonaMedicalResearch.com Interview Invitation Dr. Bryan K. Woodruff Assistant Professor of Neurology Mayo Clinic, Arizona Medical Research: What are the main findings of the study? Dr. Woodruff: There is evidence in the medical literature supporting a negative impact of losing a spouse for health conditions such as cancer or cardiovascular disease, but this has not been evaluated in terms of the impact of widowhood on the development of dementia.  We used the National Alzheimer’s Disease Coordinating Center (NACC) database, which pools data gathered by multiple federally-funded Alzheimer’s disease research centers to try to answer this question.  Specifically, we looked at the age at which individuals ultimately developed dementia in both individuals who lost their spouse and in those who remained married over the course of the study.  Surprisingly, the data we analyzed did not support a negative impact of losing a spouse in individuals who had no cognitive difficulties when they entered the study, and we saw a paradoxical effect of widowhood in those with mild cognitive impairment (MCI). (more…)
Author Interviews, Coffee, Mayo Clinic, Menopause / 24.07.2014

Stephanie Faubion, M.D Director of the Women’s Health Clinic Mayo Clinic in RochesterMedicalResearch.com Interview with: Stephanie Faubion, M.D Director of the Women’s Health Clinic Mayo Clinic in Rochester   Medical Research: What are the main findings of the study? Dr. Faubion: In this study that included over 1800 women, we found that caffeine intake was associated with more bothersome hot flashes and night sweats in postmenopausal women. (more…)
Education, HIV, Yale / 24.07.2014

Lynn E. Fiellin, M.D. Associate Professor of Medicine Director, play2PREVENT Lab Yale University School of Medicine New Haven, CT 06510MedicalResearch.com Interview with Lynn E. Fiellin, M.D. Associate Professor of Medicine Director, play2PREVENT Lab Yale University School of Medicine New Haven, CT 06510 Medical Research: What are the main findings of the study? Dr. Fiellin: The current findings are part of a larger study evaluating an interactive evidence-based video game, PlayForward: Elm City Stories, developed on the iPad and targeting risk reduction and HIV prevention in 333 young teens (ages 11-14). The larger study is examining a range of outcomes including knowledge, intentions, self-efficacy and actual behaviors and we are collecting at baseline, 6 weeks, 3, 6, 12, and 24 months. We are examining these outcomes in our experimental group compared with a control group playing a set of off-the-shelf games on the iPad. The current findings of the 196 teens who have completed the 6 weeks of gameplay and for whom we have baseline and 3 month data, reveal that, while the two groups had no differences in their baseline HIV risk knowledge, the PlayForward group had statistically significant gains in knowledge at 6 weeks (p<0.0001), sustained at 3 months (p<0.01). In addition, examining the association between exposure to the game and performance on the standardized assessments revealed that the number of game levels completed (a measure of exposure to the intervention) was positively correlated with knowledge gains measured at 3 months (r=0.42; p<0.001). (more…)
Author Interviews, Johns Hopkins / 23.07.2014

Eva DuGoff, PhD, MPP Graduate Student Department of Health Policy and Management Johns Hopkins Bloomberg School of Public HealthMedicalResearch.com Interview with: Eva DuGoff, PhD, MPP Graduate Student Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health   Medical Research: What are the main findings of the study? Dr. DuGoff: In this study we investigate average life expectancy in older adults living with one to 10 or more different chronic conditions. Our main finding is that life expectancy decreases with each additional chronic condition. (more…)
Author Interviews, Breast Cancer, Diabetes, Genetic Research, Nature, Vanderbilt / 23.07.2014

MedicalResearch.com Interview with: Qiuyin Cai, M.D., Ph.D. Associate Professor of Medicine Vanderbilt University Medical Research: What are the main findings of the study? Dr. Cai: We conducted a genome-wide association study in East Asians to search for additional genetic changes that are linked to breast cancer development. The study was conducted as part of the Asia Breast Cancer Consortium, which includes 22,780 women with breast cancer and 24,181 control subjects. We found DNA sequence changes in two genes, PRC1 and ZC3H11A, and a change near the ARRDC3 gene were associated with breast cancer risk. These results were also replicated in a large consortium, including 16,003 breast cancer cases and 41,335 control subjects of European ancestry. (more…)
Author Interviews, Cancer Research, General Medicine, Infections, Journal Clinical Oncology, Sloan Kettering / 23.07.2014

Allison Lipitz-Snyderman, PhD Assistant Attending Outcomes Research Scientist Center for Health Policy and Outcomes Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York, NY 10065MedicalResearch.com Interview with: Allison Lipitz-Snyderman, PhD Assistant Attending Outcomes Research Scientist Center for Health Policy and Outcomes Department of Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Center New York, NY  10065 Medical Research: What are the main findings of the study? Dr. Lipitz-Snyderman: Long-term central venous catheters are used to administer intravenous fluids and treatments such as chemotherapy.  These catheters can also be a source of bloodstream infections which can be harmful to cancer patients.  However, this risk is not well understood.  In our study, we found that the use of these catheters was associated with an increased risk of infections for patients with cancer.  We used a population-based dataset, SEER-Medicare, to study this issue in older adult cancer patients.  This dataset allowed us to study patients treated in different institutions and follow them over time. (more…)
Author Interviews, Education, JAMA, Surgical Research, UC Davis / 23.07.2014

  Erin Brown, MD General Surgery PGY6 UC Davis Medical CenterMedicalResearch.com Interview with: Erin Brown, MD General Surgery PGY6 UC Davis Medical Center Medical Research: What are the main findings of the study? Dr. Brown: This study sought to determine with childrearing during training put residents at increased risk of quiting.  We looked at both male and female surgical residents who chose to have children during residency and found that residents having children during training were not more likely to quit than those who did not have children.  We also found that there childrearing had no negative impact on surgical training based on total surgical case numbers, board pass rates, and annual exam scores.  Main findings of the study were that neither female gender nor childrearing during training were associated with residents quitting. (more…)
AHA Journals, Author Interviews, Gender Differences, Heart Disease, JACC, Yale / 22.07.2014

Aakriti Gupta, MD, MBBS Center for Outcomes Research and Evaluation Yale-New Haven Hospital, New Haven, ConnecticutMedicalResearch.com Interview with: Aakriti Gupta, MD, MBBS Center for Outcomes Research and Evaluation Yale-New Haven Hospital, New Haven, Connecticut Medical Research: What were the main findings? Dr. Gupta: Using a national database, we found that heart attack hospitalization rates for patients under the age of 55 have not declined in the past decade while their Medicare-age counterparts have seen a 20 percent drop. We also found that among younger patients below 55 years of age, women fare worse because they have longer hospital stays, and are more likely to die in the hospital after a heart attack. Young women were also more likely to have higher prevalence of co-existing medical conditions including diabetes, high blood pressure and higher cholesterol levels. Overall, all patient groups in the study saw increases in these conditions including diabetes and high blood pressure in the past decade. (more…)
Author Interviews, Brigham & Women's - Harvard, HIV, JAMA, Weight Research / 21.07.2014

Steven Grinspoon, MD Professor of Medicine, Harvard Medical School Director, MGH Program in Nutritional Metabolism Co-Director, Nutrition Obesity Research Center at Harvard Massachusetts General Hospital Boston, MA 02114MedicalResearch.com Interview with Steven Grinspoon, MD Professor of Medicine, Harvard Medical School Director, MGH Program in Nutritional Metabolism Co-Director, Nutrition Obesity Research Center at Harvard Massachusetts General Hospital Boston, MA 02114 Medical Research: What are the main findings of the study? Dr. Grinspoon: The primary finding is that tesamorelin, a hypothalamic peptide that increases the endogenous pulsatile secretion of growth hormone, reduced liver fat in HIV-infected patients with increased visceral (abdominal) fat.  Increased visceral fat is very closely linked with increased liver fat in HIV patients, but the effects on liver fat were not known.  Our data show that tesamorelin reduces liver fat in conjunction with decreasing visceral fat, which may be clinically important for patients with HIV-infection who have both increased abdominal fat and fatty liver disease. In addition the study demonstrated that this treatment strategy was neutral to glucose by the end of the 6 month study. (more…)
Author Interviews, Karolinski Institute, Red Meat / 18.07.2014

Andrea Bellavia From the Unit of Nutritional Epidemiology and the Unit of Biostatistics Institute of Environmental Medicine Karolinska Institutet, Stockholm, SwedenMedicalResearch.com Interview with: Andrea Bellavia From the Unit of Nutritional Epidemiology and the Unit of Biostatistics Institute of Environmental Medicine Karolinska Institutet, Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Bellavia: By evaluating together the consumption of processed and fresh red meat, we observed that processed red meat consumption was associated with shorter life, implying a potential negative effect on health. On the other hand, consumption of only fresh red meat was not associated with either shorter or longer survival. Therefore, the main finding of this work is that the negative effects of red meat consumption might only be due to meat processing, which counteract the positive effects of the beneficial nutrients of meat. (more…)
Author Interviews, Brigham & Women's - Harvard, Nutrition, Vitamin C / 14.07.2014

MedicalResearch Interview with: Dr. Lu Wang MD PhD Associate Epidemiologist, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Preventive Medicine Boston, MA 02115 Medical Research: What are the main findings of the study? Dr. Wang: We found that vitamin E supplement 400 IU every other day and vitamin C supplement 500 mg daily had no effect on total cancers, the incidence of prostate cancer and other site-specific cancers during periods of intervention, post-trial observation, or overall. (more…)
Author Interviews, Cancer Research, Lancet, Mayo Clinic, Radiation Therapy / 03.07.2014

Dr. Robert Foote MD Chair, Department of Radiation Oncology Mayo Clinic, Rochester, MNMedicalResearch.com Interview with: Dr. Robert Foote MD Chair, Department of Radiation Oncology Mayo Clinic, Rochester, MN MedicalResearch: What are the main findings of the study? Dr. Foote: Charged particle therapy (mainly protons and carbon ions) provide superior overall survival, disease-free survival and tumor control when compared to conventional photon therapy.  In particular, it appears that proton beam therapy provides superior disease-free survival and tumor control when compared to the state of the art intensity modulated radiation therapy using photons. (more…)
Author Interviews, Supplements, Wake Forest / 02.07.2014

MedicalResearch.com Interview with: Scott A. Davis, MA Research Administrative Coordinator Department of Dermatology Wake Forest School of Medicine MedicalResearch: What are the main findings of the study? Answer: St. John’s wort (SJW), a common complementary and alternative medicine (CAM) treatment for depression, is frequently used together with drugs that may interact dangerously with it. In data from the 1993-2010 National Ambulatory Medical Care Survey, a nationally representative survey of physician visits from the National Center for Health Statistics, SJW was prescribed together with drugs such as selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, warfarin, statins, digoxin, verapamil, and oral contraceptives. Using SJW together with other antidepressants may cause serotonin syndrome, a potentially fatal condition. (more…)
Author Interviews, Breast Cancer, JNCI, MD Anderson, Weight Research / 02.07.2014

Sai-Ching Jim Yeung, MD, PhD, FACP Professor of Medicine The University of Texas MD Anderson Cancer Center Department of Emergency Medicine Department of Endocrine Neoplasia & Hormonal Disorders Houston, Texas 77230-1402MedicalResearch.com Interview with Sai-Ching Jim Yeung, MD, PhD, FACP Professor of Medicine The University of Texas MD Anderson Cancer Center Department of Emergency Medicine Department of Endocrine Neoplasia & Hormonal Disorders Houston, Texas  77230-1402 MedicalResearch: What are the main findings of the study? Dr. Yeung: We believe that this study has bridged a significant gap in knowledge between epidemiological data (the association of obesity and poor breast cancer prognosis) and biological mechanisms mediating the impact of obesity on cancer. This study provides an important mechanistic insight into the causal relationship between obesity and breast cancer growth.
  1. Direct evidence for the links between obesity-associated changes in the biological processes and hallmarks of cancer in human estrogen receptor-positive (ER+) breast cancer. 
It is well known that obesity is associated epidemiologicaly with decreased survival in ER+ breast cancer patients. Although a body of experimental literature exists to suggest important roles for estrogen, insulin/IGF-1 and adipokine signaling and inflammation in the mechanisms mediating the impact of obesity on cancer, direct evidence for these mechanisms and their importance relative to one another is lacking in cancers from obese humans. Functional transcriptomic analysis of a prospective observation cohort with treatment-naïve ER+ breast cancer samples identified the insulin/PI3K signaling and secretion of cytokines among the top biological processes involved. Many of the obesity-associated changes in biological processes can be linked to cancer hallmarks.  Upstream regulator analysis identified estrogen (?-estradiol), insulin (INS1), insulin-like growth factor-1 (IGF1), and adipokines [vascular endothelial growth factor A (VEGFA), tissue necrosis factor (TNF), interleukin-6 (IL6), oncostatin-M (OSM), chemokine ligand 5 (CCL5), leptin (LEP), leukemia inhibitory factor (LIF), C-reactive protein (CRP), adiponectin (ADIPOQ), and interleukin-10 (IL10)] in mediating the impact of obesity on human ER+ breast cancer.
  1. Experimental evidence that obesity causes accelerated oncogene-driven ER+ breast cancer carcinogenesis.
While it is not possible to conduct a human experiment to prospectively examine the causal relationship between obesity and breast cancer, we created a transgenic mouse model with genetically induced obesity and oncogene-driven breast cancer.  With this model we found strong in vivo evidence using both longitudinal experiments and cross-sectional experiments that obesity accelerated oncogene-driven breast carcinogenesis. (more…)
Author Interviews, Cancer Research, Mayo Clinic / 27.06.2014

dr_john-coplandMedicalResearch.com Interview with: Dr. John A. Copland, PhD Associate Professor of Biochemistry/Molecular Biology Professor of Cancer Biology Cancer Basic Science Mayo Clinic, Jacksonville, Florida MedicalResearch: What are the main findings of the study? Dr. Copland: In our study we identified a pro-cancerous role for a novel protein- neuronal pentraxin 2 (NPTX2). This protein, normally found expressed in brain and nervous system tissues, is highly overexpressed in kidney tumors at all stages of disease. It has never previously been associated with kidney cancer, nor has it been associated with an oncogenic function in any other cancer. NPTX2 appears to play a significant role in not only tumor cell survival, but it also promotes tumor cell migration through activation of the ionotropic glutamate receptor 4 (GluR4). GluR4, also commonly associated with nervous system tissues, appears to be manipulating the flow of calcium into the tumor cell. Both NPTX2 and GluR4 are not components of normal kidney cell function. Because calcium is an important co-factor for many signaling pathways controlling cell growth, survival, and mobility, unconstrained calcium levels in a cell can promote malignancy. We show that calcium calmodulin kinase and AKT, two oncogenic signaling pathways are activated by NPTX2 via calcium influx. (more…)
Author Interviews, Dartmouth, Hospital Readmissions, Neurological Disorders, Neurology / 25.06.2014

MedicalResearch.com Interview with: Tracie A. Caller, MD , MPH Neurophysiology Fellow Dartmouth-Hitchcock Medical Center 1 Medical Center Dr., Lebanon NH 03756, USA MedicalResearch: What are the main findings of the study? Dr. Caller: We identified factors that appeared to increase the risk for a 30 day readmissions in the epilepsy population, which included refractory seizures but also coexistence of nonepileptic seizures and psychiatric comorbidities. (more…)
Author Interviews, Cancer Research, Exercise - Fitness, Mayo Clinic / 24.06.2014

Xuemei Sui, MD, MPH, PhD Assistant Professor Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208MedicalResearch.com Interview with:  Xuemei Sui, MD, MPH, PhD Assistant Professor, Department of Exercise Science Division of Health Aspects of Physical Activity Arnold School of Public Health University of South Carolina Columbia, SC 29208 MedicalResearch: What are the main findings of the study? Dr. Sui: In the present study, cancer survivors who reported performing resistance exercise (RE) at least 1 day of the week had a 33% lower risk of all-cause mortality compared with individuals who did not report participation in resistance exercise.  Further, there was an inverse relationship between resistance exercise and all-cause mortality in those who were physically active, but not in those who were physically inactive.  Although leisure-time physical activity was not associated with a lower risk of all-cause mortality, the present results support the benefits of resistance exercise and physical activity was during cancer survival. (more…)
Author Interviews, Cognitive Issues, JAMA, Mayo Clinic / 24.06.2014

Prashanthi Vemur, Ph.D. Mayo Clinic Rochester, MinnesotaMedicalResearch.com Interview with: Prashanthi Vemur, Ph.D. Mayo Clinic Rochester, Minnesota   MedicalResearch: What are the main findings of the study? Dr. Vemuri: Lifetime intellectual enrichment might delay the onset of cognitive impairment and be used as a successful preventive intervention to reduce the impending dementia epidemic. We studied two non-overlapping components of lifetime intellectual enrichment: education/occupation-score and mid/late-life cognitive activity measure based on self-report questionnaires. Both were helpful in delaying the onset of cognitive impairment but the contribution of higher education/occupation was larger. (more…)
Author Interviews, JAMA, Pediatrics, Stanford, Surgical Research / 24.06.2014

Kay W. Chang, MD Associate Professor of Otolaryngology and Pediatrics Stanford University Department of Otolaryngology Lucile Packard Children's Hospital at Stanford Division of Pediatric OtolaryngologyMedicalResearch.com Interview with: Kay W. Chang, MD Associate Professor of Otolaryngology and Pediatrics Stanford University Department of Otolaryngology Lucile Packard Children's Hospital at Stanford Division of Pediatric Otolaryngology MedicalResearch: What are the main findings of the study? Dr. Chang: At 18 months after surgery, weight percentiles in the study group increased by a mean of 6.3 percentile points, and body mass index percentiles increased by a mean of 8.0 percentile points. The greatest increases in weight percentiles were observed in children who were between the 1st and 60th percentiles for weight and younger than 4 years at the time of surgery. An increase in weight percentile was not observed in children who preoperatively were already above the 80th percentile in weight. (more…)
Author Interviews, Cancer Research, CHEST, Critical Care - Intensive Care - ICUs, University of Michigan / 22.06.2014

Colin R. Cooke, MD, MSc, MS; Assistant Professor of Medicine, Division of Pulmonary & Critical Care Medicine Faculty, Center for Healthcare Outcomes & Policy University of MichiganMedicalResearch.com Interview with: Colin R. Cooke, MD, MSc, MS; Assistant Professor of Medicine, Division of Pulmonary & Critical Care Medicine Faculty, Center for Healthcare Outcomes & Policy University of Michigan MedicalResearch: What are the main findings of the study? Dr. Cooke: There were three primary findings from our study. First, we determined that between 1992 and 2005 there was almost a 40% increase in the number of admissions to an intensive care unit (ICU) among patients with lung cancer who were hospitalized for reasons other than surgical removal of their cancer. Second, most of this increase was because doctors were admitting these patients to intermediate intensive care units. These are units that provide greater monitoring and nurse staffing than typically available in general hospital wards, but usually also have less ability to provide life support measures than full service ICUs. Third, over the same period the reasons for ICU admission have changed. Although the most common reason for admission continues to be for problems related to the patients’ lung cancer, problems such as breathing difficulties requiring a ventilator and severe infections are increasingly common. These findings suggest that although overall use of the ICU for patients with lung cancer is increasing over time, providers may be shifting some of the intensive care for lung cancer patients toward less aggressive settings such as the intermediate care unit. (more…)
Author Interviews, Stroke, Wake Forest / 22.06.2014

Cheryl Bushnell, MD, MHS Associate Professor of Neurology Director, Wake Forest Baptist Stroke Center Wake Forest Baptist School of Medicine Winston Salem, NC 27157MedicalResearch.com Interview with: Cheryl Bushnell, MD, MHS Associate Professor of Neurology Director, Wake Forest Baptist Stroke Center Wake Forest Baptist School of Medicine Winston Salem, NC  27157 MedicalResearch: What are the main findings of the study? Dr. Bushnell: We found that readmitted patients were significantly more likely to have more severe strokes, and to have been hospitalized two or more times during the year prior to the initial stroke admission, independent of other clinical factors, such as congestive heart failure, heart disease, or stroke complications (pneumonia, acute renal failure). (more…)
Author Interviews, Johns Hopkins, Pancreatic / 21.06.2014

Lei Zheng, M.D., Ph.D. Assistant Professor of Oncology and Surgery Gastrointestinal Cancer Program Division of Immunology The Sidney Kimmel Comprehensive Cancer Center and Department of Oncology Johns Hopkins University School of Medicine The Bunting-Blaustein Cancer Research Building (CRB1) Baltimore, MD 21231MedicalResearch.com Interview with: Lei Zheng, M.D., Ph.D. Assistant Professor of Oncology and Surgery Gastrointestinal Cancer Program Division of Immunology The Sidney Kimmel Comprehensive Cancer Center and Department of Oncology Johns Hopkins University School of Medicine The Bunting-Blaustein Cancer Research Building (CRB1) Baltimore, MD 21231 MedicalResearch: What are the main findings of the study? Dr. Zheng: This study shows for the first time that treatment with a vaccine-based immunotherapy directly re-programs the pancreatic cancer microenvironment, allowing the formation of lymphoid aggregates, which are organized, lymph node-like, functional immune structures and which convert an immunologically quiescent tumor into an immunologically active tumor.  (more…)
Author Interviews, Baylor College of Medicine Houston, Electronic Records / 21.06.2014

Dr. Hardeep Singh MD, MPH Chief the Health Policy, Quality & Informatics Program Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center in Houston, Texas Associate professor at Baylor College of MedicineMedicalResearch.com Interview with: Dr. Hardeep Singh MD, MPH Chief the Health Policy, Quality & Informatics Program Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center in Houston, Texas Associate professor at Baylor College of Medicine MedicalResearch: What are the main findings of the study? Dr. Singh: EHRs use can prompt new patient safety concerns, and many of these problems are complex and difficult to detect. We sought to better understand the nature of these patient safety concerns and reviewed 100 closed investigations involving 344 technology-related incidents arising between 2009 and 2013 at the Department of Veterans Affairs (VA). We evaluated safety concerns related to technology itself as well as human and operational factors such as user behaviors, clinical workflow demands, and organizational policies and procedures involving technology. Three quarters of the investigations involved unsafe technology while the remainder involved unsafe use of technology. Most (70%) investigations identified a mix of 2 or more technical and/or non-technical underlying factors. The most common types of safety concerns were related to the display of information in the EHR; software upgrades or modifications; and transmission of data between different components of the EHR system. (more…)
Author Interviews, Breast Cancer, JAMA, MD Anderson, Race/Ethnic Diversity / 20.06.2014

Dalliah Black, MD F.A.C.S. Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, HoustonMedicalResearch.com Interview with: Dalliah Black, MD F.A.C.S. Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, Houston   MedicalResearch: What are the main findings of the study? Dr. Black: This is a retrospective study from 2002 - 2007 using the SEER/Medicare database of over 31,000 women with node negative breast cancer evaluating the utilization of sentinel node biopsy (SNB) as it transitioned from an optional method for axillary staging to the standard of care instead of complete axillary lymph node dissection (ALND).  We found that SNB use increased each year in both white and black breast cancer patients throughout the study period.  However, SNB was less often performed in black patients (62.4%)compared to white patients (73.7%) and this disparity persisted through 2007 with a 12% difference.  Appropriate black patients more often had an ALND instead of the minimally invasive sentinel node biopsy which resulted in worse patient outcomes with higher lymphedema rates in black patients.  However, when black patients received the minimally invasive SNB, their rates of lymphedema were low and comparable to white patients who received SNB. (more…)
Diabetes, Scripps / 20.06.2014

Athena Philis-Tsimikas, M.D. Corporate Vice President Scripps Whittier Diabetes Institute, a subsidiary of Scripps HealthMedicalResearch.com Interview with: Athena Philis-Tsimikas, M.D. Corporate Vice President Scripps Whittier Diabetes Institute, a subsidiary of Scripps Health MedicalResearch: What are the main findings of the study? Dr. Philis-Tsimikas: Findings from the Dulce Digital study suggest that a text message-based self-management intervention improves glycemic control in high risk Latinos with type 2 diabetes. Researchers recruited 126 Latinos with type 2 diabetes and HbA1c greater than 7.5% from federally-qualified health centers (FQHCs) that serve disadvantaged populations to investigate the impact of a diabetes self-management intervention delivered via mobile text messaging. Cell phones were provided to patients who did not have them, along with text messaging instructions. Patients were randomized after completing clinical and self-reported measurements at baseline and these assessments were then repeated at 3 and 6 months. Both Dulce Digital and control groups received usual care.   The Dulce Digital group received three types of text messages — educational and motivational; medication reminders; and blood glucose monitoring prompts — two to three messages each day initially, with frequency tapering over 6 months. Project Dulce staff then monitored blood glucose responses, assessed reasons for hyperglycemia or hypoglycemia and encouraged follow up with providers as needed. Still ongoing, the current analyses included 106 completed participants (mean age= 49.25±9.49 years, 74% female), 52 of which were Dulce Digital participants. Findings showed significantly greater decreases in HbA1c with text messages compared with usual care only (9.4% to 8.4%, vs. 9.5% to 9.3%, P<.05) at 6 month follow-up. No significant group differences, however, have been observed for lipids, weight or blood pressure. (more…)