Author Interviews, General Medicine, Heart Disease, JACC, Karolinski Institute / 23.09.2014

Agneta Åkesson Associate professor, senior lecturer Photo by Anna Persson Nutritional Epidemiology IMM Institute of Environmental Medicine Karolinska Institutet Stockholm, SwedMedicalResearch.com Interview with Agneta Åkesson Associate professor, senior lecturer                                                  Nutritional Epidemiology IMM Institute of Environmental Medicine Karolinska Institutet Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Åkesson: Our study indicates that a healthy diet together with low-risk lifestyle practices such as being physically active, not smoking and having a moderate alcohol consumption, and with the absence of abdominal adiposity may prevent the vast majority of myocardial infarctions in men.
Author Interviews, Kidney Stones, NEJM, Radiology, UCSF / 17.09.2014

Rebecca Smith-Bindman, MD Professor in the Departments of Radiology; Epidemiology and Biostatistics; and Obstetrics, Gynecology and Reproductive Medicine UCSF San Francisco Calif.MedicalResearch.com Interview with: Rebecca Smith-Bindman, MD Professor in the Departments of Radiology; Epidemiology and Biostatistics; and Obstetrics, Gynecology and Reproductive Medicine UCSF San Francisco Calif. Medical Research: What are the main findings of the study? Dr. Smith-Bindman: New technology is rapidly developed in medicine, and its important to understand how that technology should be used to improve patient health outcomes. Sometimes the technology is far better than existing technology and it should replace the earlier technology, and sometimes it is not and therefore should not be used. In this clinical scenario – I e. patients who present to an emergency department with abdomen or back pain thought to possibly reflect kidney stones, ultrasound is a simpler, less expensive , and more readily available test in the emergency department setting and therefore if it is equal to CT with respect to patient outcomes, it should be used as the first test in these patients. Currently, CT is the test widely used for patients with suspected kidney stones. We assessed a large number of patients with suspected kidney stones seen at one of 15 large academic emergency medicine departments across the country. Patients were assigned to point of care ultrasound performed by an ED physician, radiology ultrasound or radiology CT. We assessed a broad range of patient centered outcomes and found each of the three tests we studied were equivalent in terms of these outcomes including complications related to missed diagnoses, related serious adverse events, time spent in the emergency department and repeated ED visits and hospitalizations. However, the exposure to ionizing radiation was around half as high in patients who underwent ultrasound as their first test, and thus ultrasound should be used as the first imaging test in patients with suspected nephrolithiasis.
Cleveland Clinic, Multiple Sclerosis / 16.09.2014

MedicalResearch.com: Interview with: Jeffrey A. Cohen, MD Hazel Prior Hostetler Endowed Chair Professor, Cleveland Clinic Lerner College of Medicine Director, Mellen Center for MS Treatment and Research Neurological Institute Cleveland Clinic Cleveland, OH  44195 Medical Research: What are the main findings of the study? Dr. Cohen: The primary objective of the GATE trial was to compare the efficacy and safety of generic glatiramer acetate to the approved form (Copaxone) in relapsing-remitting multiple sclerosis.  The study demonstrated equivalent efficacy of generic glatiramer acetate and Copaxone measured by gadolinium enhancing brain MRI lesions at months 7, 8, and 9 and a number of additional measures of MRI lesion activity.  The study also showed comparable safety (measured by adverse events) and injection site tolerability.
Author Interviews, Telemedicine, University of Michigan / 15.09.2014

Rashid Bashshur, PhD Senior Advisor for eHealth Professor Emeritus, Department of Health Management and Policy Executive Director, UMHS eHealth Center University of Michigan Health SystemMedicalResearch.com Interview with:  Rashid Bashshur, PhD Senior Advisor for eHealth Professor Emeritus, Department of Health Management and Policy Executive Director, UMHS eHealth Center University of Michigan Health System Medical Research: What are the Main findings of the study? Dr. Bashshur: The main findings can be summarized as follows:
  •  The prevalence of chronic disease is increasing due to the changing demographic composition of the population and unhealthy life styles. Chronic diseases are expensive, accounting for about 70% of health care expenditures;  but  they are amenable to telemedicine interventions.  These interventions consist of ongoing monitoring of patients living in their own home environments, engaging them in managing their health,  providing them with educational materials and the necessary tools to manage their life style mostly by avoiding risky behaviors and adopting healthy ones.
  • Telemedicine interventions consist of various configurations of technology (telephone, video, wired or wireless, automated or manual) , human resources (physicians, nurses, combinations, and patient populations at various levels risk levels or severity of illness, The interventions investigated to date also vary in terms of study design, duration of application (during the study period), and frequency of administration of the intervention.  Hence, the findings must be viewed from the perspective of the specific methodological attributes  of the studies that were performed.
  • Using only robust studies from 2000 to the near present, and limited to congestive heart failure, stroke and COPD.  With notable exceptions,  overall there is substantial and fairly consistent evidence of:
  • A decrease in use of service, including hospitalization, rehospitalization, and emergency depart visits as a result of the telemedicine intervention.
  • Improved health outcomes.
  • Improved event timing for stroke patients.
  • Reduced exacerbations of symptoms for COPD patients
  • Some interesting  trends  to be considered:
  • Frail and elderly patients, those with co-morbid conditions, and those in advanced stages of illness are not likely to benefit from telemedicine interventions, as compared to their counterparts.
  • Visual information as in videoconferencing proved superior to telephone only connection for the diagnosis and treatment of stroke patients.
  • There could be a tradeoff between extra nursing time versus reduced physician time in some settings, but the net effect is cost savings.
  • There seems to be a paradoxical telemedicine effect in terms of increasing longevity but no reduction in hospitalization, reported in few studies.
Author Interviews, Brigham & Women's - Harvard, Nature / 15.09.2014

MedicalResearch.com Interview with: MichDr. Michael Super, Ph.D.ael Super M.Sc., PhD Senior Staff Scientist Advanced Technology Team Wyss Institute at Harvard Center for Life Science, 2nd Floor Boston MA 02115 Medical Research: What is the background for this study? How big a problem is sepsis? Dr. Super:
  • Sepsis is a major problem and is the primary cause of death from infection. The incidence of sepsis is rising.
  • Sepsis affects more than 18 M people each year and at least 1/3 ( 6 million) die every year of sepsis.
  • Sepsis is a disease that affects the very young and old and it is estimated that 60-80% of childhood deaths in the developing world are due to sepsis.
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.
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.
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).
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.
Author Interviews, Cancer Research, Genetic Research, University of Pennsylvania / 12.09.2014

MedicalResearch.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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.