Accidents & Violence, JAMA, Pediatrics, Yale / 03.06.2014

Dr. Christopher Wildeman PhD Associate Professor of Sociology Faculty fellow at the Center for Research on Inequalities and the Life Course (CIQLE), and at the Institution for Social and Policy Studies (ISPS) at Yale University.MedicalResearch.com Interview with Dr. Christopher Wildeman PhD Associate Professor of Sociology Faculty fellow at the Center for Research on Inequalities and the Life Course (CIQLE), and at the Institution for Social and Policy Studies (ISPS) at Yale University. MedicalResearch.com: What are the main findings of the study? Dr. Wildeman: There are four key findings in the study. First, the cumulative risk of having a confirmed maltreatment report any time between birth and age 18 is much higher than most people would have thought. Fully 1 in 8 American children will experience this event at some point. Second, the risk of experiencing this event is highly unequally distributed, with Black and Hispanic experiencing it much more than Hispanic, White, and (especially) Asian children. Between 1 in 4 and 1 in 5 Black children will have a confirmed maltreatment report at any time in their childhood. For Native American, the risk is about 1 in 7. Third, the risk of maltreatment is quite similar for boys and girls. Finally, the highest risks of child maltreatment are in the first few years of life, suggesting that interventions aiming to diminish maltreatment should focus on parents with very young children. (more…)
Annals Internal Medicine, Author Interviews, Cancer Research, University of Pittsburgh / 30.05.2014

Yael Schenker, MD, MAS Assistant Professor Division of General Internal Medicine Section of Palliative Care and Medical Ethics University of Pittsburgh Pittsburgh, PA 15213 MedicalResearch.com Interview with: Yael Schenker, MD, MAS Assistant Professor Division of General Internal Medicine Section of Palliative Care and Medical Ethics University of Pittsburgh Pittsburgh, PA  15213 MedicalResearch: What are the main findings of the study?  Dr. Schenker: We analyzed the content of cancer center advertisements placed in top TV and magazine media markets in 2012.  Out of 1427 advertisements that met our initial search criteria, we found 409 unique advertisements that promoted clinical services at 102 cancer centers across the country.  These advertisements promoted cancer treatments (88%) more often than cancer screening (18%) or supportive services (13%).  Provision of information about clinical services was scant. For example, 27% of advertisements mentioned a benefit of advertised services and 2% quantified these benefits.  2% mentioned a risk of advertised services and no advertisements quantified these risks.  5% mentioned costs or insurance coverage and no advertisements mentioned availability under specific insurance plans.  In contrast, use of emotional appeals was frequent (85%).  Emotional appeals commonly evoked hope for survival, focused on treatment advances, used fighting language, and/or evoked fear.  Nearly half of all advertisements included patient testimonials, overwhelmingly focused on stories about survival or cure.  Only 15% of testimonials included a disclaimer (for example, “most patients do not experience these results”) and none described the outcome that a typical patient may expect. (more…)
Baylor College of Medicine Houston, Heart Disease, Testosterone / 27.05.2014

Robert S. Tan MD, MBA, AGSFMedicalresearch.com Interview with: Robert S. Tan MD, MBA, AGSF Clinical Director & Chief Geriatrics, Michael DeBakey VAMC Director, Opal Medical, LLC Clinical Professor of Family & Community Medicine, UTHSC-Houston Associate Professor of Medicine (Geriatrics), Baylor College Medicine Medicalresearch: What are the main findings of the study? Dr. Tan: Our findings¹ are similar to that of an early study by Shores et al ² and other studies on endogenous testosterone that found testosterone lowered mortality. In the analysis of 39,937 patients at the Low T Centers up to 5 years, the rate ratios of new MI and strokes on testosterone as compared to general community based data sets (3,4) was 0.12 (C.I. 0.08-0.18, p<0.0001) and 0.05 (C.I 0.02-0.13, p<0.0001) respectively. Thus, there appears to be a lower risk of heart attacks and strokes with patients on testosterone. While the compared population sets are not identical or real controls; our study does suggest that rates of MI and strokes in real life practice with testosterone treated patients are even lower than the general population registries (which may include older patients). (more…)
Author Interviews, Mayo Clinic, Pancreatic / 27.05.2014

Dr. Derek Radisky PhD Associate Professor and Consultant Mayo Clinic Cancer CenterMedicalResearch.com Interview with Dr. Derek Radisky PhD Associate Professor and Consultant Mayo Clinic Cancer Center MedicalResearch: What are the main findings of the study?  Dr. Radisky: The study used human tissue biopsies to find that production of matrix metalloproteinse-3 (MMP3)  in pancreatic cancer biopsies was associated with poorer patient prognosis, and showed through transgenic animal and cell culture experiments that this was due to activation of the oncogenic protein Rac1b.  The study thus identifies an MMP3-Rac1b signaling axis that drives pancreatic cancer progression. (more…)
Author Interviews, Dermatology, Duke, Pain Research / 26.05.2014

MedicalResearch.com Interview with: Seok-Yong Lee, Ph.D. Assistant Professor of BiochemistrySeok-Yong Lee, Ph.D. Assistant Professor of Biochemistry and Ru-Rong Ji, Ph.D. Distinguished Professor of Duke University Professor of Anesthesiology and Neurobiology Chief of Pain ResearchRu-Rong Ji, Ph.D. Distinguished Professor  of Duke University Professor of Anesthesiology  and Neurobiology Chief of Pain Research Duke University Medical Center Durham, NC 27710 MedicalResearch: What are the main findings of the study?

 Answer: We have developed an antibody that can block the pain and itching sensations in mice simultaneously with high efficacy. We would like to point out that our discovery has the potential to be applied to human once the antibody is humanized. Given the high selectivity, general safety profile, and long half-lives of monoclonal antibodies, this method we developed to raise antibodies against therapeutic targets (e.g., ion channels) can have broad applications to other diseases. (more…)
Author Interviews, Diabetes, JAMA, Yale / 24.05.2014

MedicalResearch.com Interview with: Neel M. Butala, AB Medical student at Yale School of Medicine New Haven, Connecticut MedicalResearch.com: What are the main findings of the study? Answer: We found that patients with diabetes had a disproportionate reduction in in-hospital mortality relative to patients without diabetes over the decade from 2000 to 2010. (more…)
Mayo Clinic, Urology / 20.05.2014

Daniel S. Elliott, M.D MAYO Clinic, Associate Professor Department of Urology Section of Pelvic and Reconstructive Surgery Rochester, MinnesotaMedicalResearch.com Interview with: Daniel S. Elliott, M.D MAYO Clinic, Associate Professor Department of Urology Section of Pelvic and Reconstructive Surgery Rochester, Minnesota MedicalResearch: What are the main findings of the study?  Dr. Elliott: The biggest issue is that we were able to devise a new procedure that is a simple outpatient anti-incontinence surgery for women that does NOT use any synthetic meshes.  The importance of this is that all traditional (meaning NON-mesh) surgeries for female incontinence have been large surgeries with fairly significant risks such as pain, bleeding and prolonged recovery.  When the meshes came out in the late ‘90’s, their big benefit was that they were outpatient and quick procedures.  But now that we are discovering all the long term complications from meshes such as chronic pain, scarring, painful intercourse, vaginal extrusion of the meshes, and organ injury, patients have become VERY reluctant and fearful to undergo any mesh type surgery.    Therefore, we devised a new procedure that used a very small piece of the patient’s own tissue (from the rectus fascia) and placed this via the “transobturator route.”  In the process, we melded together the “best” of both worlds---a NON-mesh, outpatient anti-incontinence procedure that is safe (no long term problems as seen with meshes) . (more…)
Mayo Clinic, Urology / 20.05.2014

MedicalResearch.com Interview with: Sarah P. Psutka, MD Fellow in Urologic Oncology Department of Urology, Mayo Clinic MedicalResearch: What are the main findings of each study?  Dr. Psutka: In this study, we analyzed 1335 patients who underwent radical cystectomy at the Mayo clinic between 1996 and 2006. We categorized patients who stayed in the hospital longer than 10 days, putting them in the top 25th percentile of the length of stay, as having a prolonged hospital stay. We noted that prolonged hospital stay was associated with adverse postoperative outcomes, including serious complications and early postoperative death. Patients who had a prolonged length of stay had a higher burden of comorbidities, American Society of Anesthesiologist score, and their Eastern Cooperative Oncology Group Score. A multivariable analysis, holding these factors and other clinically relevant potential confounders constant, revealed that only the ECOG performance score independently predicted whether or not a patient had a prolonged hospital course following radical cystectomy. (more…)
Blood Clots, General Medicine, UCSD / 19.05.2014

MedicalResearch.com Interview withTimothy Fernandes, M.D., M.P.H. University of California, San Diego - La Jolla, CA Timothy Fernandes, M.D., M.P.H. University of California, San Diego La Jolla, CA MedicalResearch: What are the main findings of this study? Dr. Fernandes: The fibrinopeptides are cleaved off of fibrinogen by thrombin during the generation of a new clot. These small molecules are excreted into the urine and we have developed a urine assay to measure the level of FPB. We examined the performance of urine FPB as a screening test for acute pulmonary embolism, blood clots that travel to the lungs. The study group consisted of 344 patients: 61 (18%) with pulmonary embolism and 283 (83%) without. At a threshold of 2.5 ng/ml, urine FPB demonstrated sensitivity of 75.4% (95% CI: 62.4-85.2%), specificity of 28.9% (95% CI: 23.8-34.7%), and negative likelihood ratio of 0.18 (0.11-0.29), weighted by prevalence in the sample population. However, the thresholds of 5 ng/ml and 7.5 ng/ml had sensitivities of only 55.7% (95% CI: 42.5-68.2%), and 42.6% (30.3-55.9%), respectively. The urine fibrinopeptide B assay at a cut-off of 2.5 ng/ml had a sensitivity of 75.4% for detecting pulmonary embolism. For diagnosis of PE, this sensitivity is comparable to previously published values for the first generation plasma latex and whole blood D-dimer assays (not as well and the D dimer ELISA assay). (more…)
Author Interviews, Fertility, Stanford / 17.05.2014

Michael Eisenberg, MD, PhD Director, Male Reproductive Medicine and Surgery Assistant Professor, Department of Urology Assistant Professor, Department of Obstetrics and GynecologyMedicalResearch. com Interview with: Michael Eisenberg, MD, PhD Director, Male Reproductive Medicine and Surgery Assistant Professor, Department of Urology Assistant Professor, Department of Obstetrics and Gynecology Stanford School of Medicine
MedicalResearch:   What are the main findings of the study? Dr. Eisenberg: There is an inverse relationship between semen quality and mortality so that as semen quality declines the likliehood of death increases. (more…)
Author Interviews, BMJ, Karolinski Institute, Rheumatology, Weight Research / 17.05.2014

Maria E.C. Sandberg, MSc PhD Institutet för Miljömedicin / Institute of Environmental Medicine Karolinska Institutet Stockholm, SwedenMedicalResearch.com Interview with: Maria E.C. Sandberg, MSc PhD Institutet för Miljömedicin / Institute of Environmental Medicine Karolinska Institutet Stockholm, Sweden   MedicalResearch: What are the main findings of the study? Dr. Sandberg: Overweight at diagnosis significantly decreases the chance of achieving good disease control during the early phase of rheumatoid arthritis (RA). (more…)
Alzheimer's - Dementia, Author Interviews, University of Pennsylvania / 16.05.2014

Yvette I. Sheline, M.D. Professor of Psychiatry, Radiology, Neurology Director, Center for Neuromodulation in Depression and Stress (CNDS) University of Pennsylvania Perelman School of Medicine Philadelphia, PA 19104MedicalResearch.com Interview with: Yvette I. Sheline, M.D. Professor of Psychiatry, Radiology, Neurology Director, Center for Neuromodulation in Depression and Stress (CNDS) University of Pennsylvania Perelman School of Medicine Philadelphia, PA 19104 MedicalResearch: What are the main findings of this study? Prof. Sheline: The main findings were that in transgenic mice who are genetically altered to develop Alzheimer's amyloid plaques, citalopram dramatically slowed the growth of plaques but did not cause existing plaques to shrink. In normal young people, it decreased the production of amyloid. (more…)
Author Interviews, Baylor College of Medicine Houston, JAMA, OBGYNE, Vaccine Studies / 16.05.2014

Flor M. Munoz, MD Department of Pediatrics Department of Molecular Virology and Microbiology Baylor College of Medicine, Houston, Texas MedicalResearch.com Interview with: Flor M. Munoz, MD Department of Pediatrics Department of Molecular Virology and Microbiology Baylor College of Medicine, Houston, Texas MedicalResearch.com: What are the main findings of the study? Dr. Munoz: 1. Tdap vaccine was safe and well tolerated during pregnancy 2. Women who are pregnant have adequate responses to the Tdap vaccine, similar to those of women who are not pregnant. 3. Antibodies to pertussis are efficiently transferred to the fetus through the placenta so that babies of mothers who were vaccinated during pregnancy had significantly higher concentrations of antibody at birth and up to 2 months of age, when compared to infants of mothers who were vaccinated post-partum. 4. Higher antibody concentrations in the first two months of life are likely to provide protection against pertussis during this period of high vulnerability 5. Infants of mothers who were vaccinated during pregnancy had adequate responses to their routine pertussis vaccines at 2, 4, and 6 months of age, and had expected and adequate responses to their 4th dose of vaccine at 1 year of age. The absolute concentration of antibodies to some of the pertussis antigens might be modestly lower after the primary series of vaccines in some infants of mothers who were vaccinated during pregnancy, but this difference does not persist after the 4th dose. (more…)
Author Interviews, Exercise - Fitness, Heart Disease, Karolinski Institute / 16.05.2014

MedicalResearch.com Interview with: Dr Nikola Drca Department of Cardiology at the Karolinska Institute, Karolinska University Hospital Stockholm Sweden MedicalResearch: What are the main findings of the study? Dr. Nikola Drca: We found that intense physical activity like leisure-time exercise of more than five hours per week at the age of 30 increased the risk of developing atrial fibrillation later in life by 19%. In contrast, moderate-intensity physical activity like walking or bicycling of more than 1 hour per day at older age (age 60) decreased the risk by 13%. (more…)
Author Interviews, Endocrinology, Genetic Research, Metabolic Syndrome, Weight Research, Yale / 14.05.2014

MedicalResearch Interview with: Arya Mani, M.D. Department of Internal Medicine and Genetics Yale Cardiovascular Research Center Yale, New Haven CT Arya Mani, M.D. Department of Internal Medicine and Genetics Yale Cardiovascular Research Center Yale, New Haven CT MedicalResearch: What are the main findings of the study? Dr. Mani: Our group has identified a gene that when mutated it causes a form of truncal (central) obesity that is associated with a cluster of coronary artery disease risk factors, including high blood pressure, insulin resistance and possibly elevated blood lipids. These associated risk factors are collectively known as the metabolic syndrome, which may lead to development of diseases such as diabetes and coronary artery disease, both of which were very prevalent in the populations we studied. All identified mutations by our group have been so far gain of function mutations, which means they increased the activity of the gene in pathways related to adipogenesis and gluconeogenesis. (more…)
Author Interviews, Diabetes, Heart Disease, Karolinski Institute, Lancet / 14.05.2014

MedicalResearch.com Interview with: Viveca Ritsinger MD Karolinska Institute, Department of Medicine, Cardiology Unit, Karolinska University Hospital, Stockholm Unit for Research and Development Kronoberg County Council, Växjö, Sweden MedicalResearch: What are the main findings of the study? Dr. Ritsinger: This is a long-term follow-up of the Swedish DIGAMI 1 study where patients with acute myocardial infarction and diabetes were randomized to either intensified insulin-based glycaemic control or to standard glucose lowering treatment. Patients and controls were followed for mortality for over 20 years and 90% of the patients died during follow up. Survival improved during a period of about 8 years. Intensified insulin-based glycaemic control increased survival time by an average of 2.3 years. (more…)
Author Interviews, Cancer Research, Dartmouth / 14.05.2014

Gregory J. Tsongalis, PhD, HCLD, CC, FNACB Professor of Pathology Director, Molecular Pathology Co-Director, Translational Research Program Department of Pathology Dartmouth Hitchcock Medical Center and The Audrey and Theodor Geisel School of Medicine at Dartmouth Lebanon, NH 03756MedicalResearch.com Interview with: Gregory J. Tsongalis, PhD, HCLD, CC, FNACB Professor of Pathology Director, Molecular Pathology Co-Director, Translational Research Program Department of Pathology Dartmouth Hitchcock Medical Center and The Audrey and Theodor Geisel School of Medicine at Dartmouth Lebanon, NH 03756 MedicalResearch: What are the main findings of the study? Dr. Tsongalis: This was the first study of its kind looking at multiple genes and multiple mutations in tumors of the appendix. Many of the identified mutations may be clinically actionable with respect to response to therapy or selection of therapy. (more…)
Author Interviews, Hospital Readmissions, JAMA, Mayo Clinic / 13.05.2014

Aaron L. Leppin, MD Knowledge and Evaluation Research Unit Mayo Clinic, Rochester, MinnesotaMedicalResearch.com Interview with: Aaron L. Leppin, MD Knowledge and Evaluation Research Unit Mayo Clinic, Rochester, Minnesota MedicalResearch.com: What are the main findings of the study? Dr. Leppin: We conducted a systematic review and meta-analysis of randomized trials assessing the effectiveness of hospital discharge interventions on reducing 30-day readmission rates. We identified 47 trials, 42 of which contributed to the primary meta-analysis. Overall, the interventions that have been tested to reduce early hospital readmissions reduce them by about 20%. The ones that are most effective, though, reduce them by almost 40% and use a consistent but complex approach. These interventions make a robust effort to fully understand the patient’s post-discharge context, often by visiting the patient’s home. They focus on identifying all the things the patient needs to do to be well—whether that’s organizing medications, getting a ride to the clinic, or paying the electric bill—and they determine whether the patient has the necessary resources and capacity to pull it all off. When limitations are found, these interventions have a strategy in place to support the patient through the post-discharge period. (more…)
Author Interviews, Brigham & Women's - Harvard, Calcium, Heart Disease / 13.05.2014

Dr. Julie Paik, MD MPH Instructor, Harvard Medical School Brigham and Women's Massachusetts GeneralMedicalResearch.com Interview with: Dr. Julie Paik, MD MPH MSc Instructor, Harvard Medical School Brigham and Women's Hospital MedicalResearch: What are the main findings of the study? Dr. Paik: Many women in the United States take calcium supplements. One study found that over 60% of women aged 60 and over in the United States were taking calcium supplements. However, the medical community is still not certain of the effects of calcium supplements in women, particularly on cardiovascular disease risk. For this reason, we studied 74,245 women participating in the Nurses' Health Study over a 24-year follow-up period for their risk of developing cardiovascular disease (heart disease or stroke). We found that there was no increased risk of heart disease or stroke among women taking calcium supplements during the 24-year follow-up period. Our paper has several distinct strengths compared to prior studies including the large sample size, long follow-up period, cases of cardiovascular disease that were confirmed by medical record review, detailed and repeated assessment of calcium supplement use, and detailed information about other risk factors for cardiovascular disease. (more…)
Erasmus, General Medicine / 12.05.2014

Dr. Adriaan J van der Meer Department of Gastroenterology and Hepatology Erasmus MC, University Medical Center Rotterdam, The NetherlandsMedicalResearch.com Interview with: Dr. Adriaan J van der Meer Department of Gastroenterology and Hepatology Erasmus MC, University Medical Center Rotterdam, The Netherlands MedicalResearch: What are the main findings of the study? Dr. J van der Meer: The main finding of our study is that the prognosis of patients with compensated HCV-induced advanced liver disease can be adequately assessed by risk scores which merely include objective variables that are readily available in daily practice. Our analyses resulted in two separate prognostic scores by which the individual patient's risk of mortality or clinical disease progression (defined as occurence of Hepatitis C Cirrhosis (HCC), liver failure, liver transplantation or death) can be assessed. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Mayo Clinic, Outcomes & Safety / 09.05.2014

MedicalResearch Interview with: Dr. David Cook MD Professor in the Department of Anesthesiology Division of Cardiovascular Anesthesiology Center for the Science of Health Care Delivery Mayo Clinic College of Medicine Rochester, Minnesota. MedicalResearch: What are the main findings of the study? Dr. Cook: The main finding of the study was that segmentation of a population of surgical patients into groups of higher and lower complexity allowed us to apply a standardized practice, focused factory model to surgical care delivery. A standardized care model improved care process measures such as time on mechanical ventilation or duration of a bladder catheter indwelling. The model reduced resource utilization, decreasing patient time in all care environments (operating room, ICU and on ?the floor?). The care model improved outcomes at 30 days and reduced the costs overall and in every care environment. In addition to the absolute improvements in quality and in cost, the standardized care model reduced variation in all measured variables. That reduction in variation may be even more important than the improved outcomes or reduced costs because we now know it is possible to make the health care experience predictable for these patients. That predictability is critically important to patients and providers, but it also has implications for health care metrics and payment models. (more…)
Breast Cancer, Mayo Clinic, Weight Research / 08.05.2014

Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn.MedicalResearch.com Interview with: Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn. MedicalResearch.com: What are the main findings of the study? Dr. Boughey: Rates of bilateral mastectomy are higher in hospitals with immediate breast reconstruction available. Bilateral mastectomy rates were highest in hospitals with high volumes of immediate breast reconstruction. Large, teaching, urban, and Northeastern hospitals were more likely to have higher immediate breast reconstruction volumes. (more…)
Author Interviews, Cancer Research, Hepatitis - Liver Disease, UT Southwestern / 07.05.2014

Amit Singal MD MS Assistant Professor of Medicine Medical Director, Liver Tumor Program Dedman Scholar of Clinical Care Division of Digestive and Liver Diseases University of Texas Southwestern Dallas TX 75201 - 8887MedicalResearch.com Interview with: Amit Singal MD MS Assistant Professor of Medicine Medical Director, Liver Tumor Program Dedman Scholar of Clinical Care Division of Digestive and Liver Diseases University of Texas Southwestern Dallas TX 75201 - 8887 MedicalResearch: What are the main findings of the study? Dr. Singal: We conducted a meta-analysis of current studies to characterize the association between hepatocellular carcinoma surveillance and early detection, curative treatment rates, and overall survival in patients with cirrhosis.  We identified 47 studies with 15,158 patients, of whom 6,284 (41.4%) had hepatocellular carcinoma  detected by surveillance. Hepatocellular carcinoma  surveillance was associated with improved early stage detection (OR 2.08, 95% CI 1.80–2.37) and curative treatment rates (OR 2.24, 95% CI 1.99–2.52). These associations were robust to several sensitivity analyses, including study design, study location, and study period. Hepatocellular carcinoma  surveillance was associated with significantly prolonged survival (OR 1.90, 95% CI 1.67–2.17), which remained significant in the subset of studies adjusting for lead-time bias. Three-year survival rates were 50.8% among patients who underwent surveillance, compared to only 28.2% among hepatocellular carcinoma  patients with tumors detected outside of a surveillance program. (more…)
Breast Cancer, Mayo Clinic, Pain Research, Pharmacology / 06.05.2014

Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn.MedicalResearch.com Interview with: Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn. MedicalResearch.com: What are the main findings of the study? Dr. Boughey: Use of paravertebral block (a form of regional anesthesia) in women undergoing mastectomy results in less need for opioid medications and less frequent use of anti-nausea medication after surgery. (more…)
Author Interviews, Mayo Clinic, Neurology, Stroke / 06.05.2014

Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 MedicalResearch.com Interview with: Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 MedicalResearch: What are the main findings of the study? Dr. Kantarci: Microinfarcts are one of the most common pathologies identified in the brains of older individuals and they impact cognition. However they are invisible lesions on MRI. We demonstrated that presence of microinfarcts in autopsied individuals are associated with the macroinfarcts identified on their MRI scans than they were alive. We also demonstrated that the presence of these invisible lesions are related to greater brain atrophy rates that are localized to watershed zones. (more…)
Author Interviews, Breast Cancer, Mayo Clinic, Surgical Research, Weight Research / 02.05.2014

Tina Hieken, M.D. Associate Professor of Surgery Mayo Clinic,Rochester, MinnMedicalResearch.com Interview with: Tina Hieken, M.D. Associate Professor of Surgery Mayo Clinic,Rochester, Minn   MedicalResearch.com: What are the main findings of the study? Dr. Hieken: Among more than 1,300 newly diagnosed invasive breast cancer patients, 36 percent of whom were obese (BMI ≥ 30), preoperative axillary ultrasound with fine needle aspiration biopsy of suspicious lymph nodes identified metastasis to the lymph nodes in 36 percent of patients found to be node-positive at operation.  For all BMI categories (normal, overweight, obese) axillary ultrasound was predictive of pathologic nodal status (p<0.0001).  The sensitivity of axillary ultrasound did not differ across BMI categories while specificity and accuracy were better for overweight and obese patients, respectively, than for normal weight patients.  Furthermore, patients across all BMI categories who had suspicious axillary lymph nodes on ultrasound and had a positive fine needle aspiration biopsy had significantly more positive lymph nodes at operation, an average of five metastatic nodes, and an overall higher nodal disease burden at operation. (more…)
Author Interviews, Erasmus, Neurology, Stroke / 25.04.2014

M. Arfan Ikram, MD, PhD Assistant professor in Neuroepidemiology Erasmus Medical Center Rotterdam, the NetherlandsMedicalResearch.com Interview with: M. Arfan Ikram, MD, PhD Assistant professor in Neuroepidemiology Erasmus Medical Center Rotterdam, the Netherlands MedicalResearch.com: What are the main findings of this study? Dr. Ikram: We show that the risk of stroke might be increased due to an increased risk of ischemic stroke or increased risk of hemorrhagic stroke. Because these subtypes of stroke require different -often opposite- clinical management, currently available prediction rules for any stroke are insufficient. We propose a novel prediction rule that provides separate risks for ischemic stroke and hemorrhagic stroke. (more…)
Author Interviews, JAMA, Stroke, UCLA / 24.04.2014

Dr. Gregg C. Fonarow MD Director, Ahmanson-UCLA Cardiomyopathy Center UCLA CHAMP - Cholesterol, Hypertension, and Atherosclerosis Management Program Professor, Department of Medicine Associate Chief, Cardiology David Geffen School of Medicine Los Angeles, CAMedicalResearch.com Interview with: Dr. Gregg C. Fonarow MD Director, Ahmanson-UCLA Cardiomyopathy Center Professor, Department of Medicine Associate Chief, Cardiology David Geffen School of Medicine Los Angeles, CA MedicalResearch.com: What are the main findings of the study? Dr. Fonarow: This study examined data from hospitals that have adopted the American Heart Association/ American Stroke Association’s national quality initiative, Target: Stroke, which aims to increase the number of stroke patients treated with clot-busting drugs for ischemic stroke within 60 minutes or less after hospital arrival.  Initiated nationwide in 2010, Target: Stroke provided 10 key strategies as well as tools to facilitate timely tPA administration, as well as additional approaches to improve stroke care and outcome. Data from 71,169 tPA-treated stroke patients at 1,030 hospitals participating in Target: Stroke were analyzed to compared the time to treatment and incidence of complications before implementation, from 2003 to 2009, to the post-implementation years, from 2010 to 2013. This study found that the percentage of patients treated within the recommended timeframe increased from less than one-third before Target: Stroke to more than half afterwards. The Target: Stroke program goal of 50 percent or more of patients having door-to-needle times within 60 minutes was successfully achieved. In addition, the average time to treatment dropped by 15 minutes, from 74 to 59 minutes. Faster treatment was associated with lower rates of complications, including death. Before Target: Stroke, 9.9% of stroke patients died in the hospital, compared to 8.3% of patients treated after the initiative started, a difference which was statistically significant. In addition, patients treated by Target: Stroke strategies were less likely to develop the complication of symptomatic intracranial hemorrhage. (more…)
Author Interviews, Dengue, Ebola, Genetic Research, Infections, NEJM, NIH / 24.04.2014

Sergio D. Rosenzweig, MD, PhD Director, Primary Immunodeficiency Clinic (PID-C) LHD, NIAID, NIH Head of the Infectious Diseases Susceptibility Unit at the Laboratory of Host Defenses, National Institutes of Allergy and Infectious Diseases National Institutes of Health Bethesda, MD, 20892MedicalResearch.com Interview with: Sergio D. Rosenzweig, MD, PhD Director, Primary Immunodeficiency Clinic (PID-C) Head of the Infectious Diseases Susceptibility Unit at the Laboratory of Host Defenses, National Institutes of Allergy and Infectious Diseases National Institutes of Health Bethesda, MD, 20892 MedicalResearch.com: What are the main findings of the study? Dr. Rosenzweig: We diagnosed a disease called CDG-IIb in two siblings with severe development issues and very low levels of immunoglobulins, which include infection-fighting antibodies. These children were referred to the NIAID Primary Immunodeficiency Clinic through the NIH Undiagnosed Diseases Program. CDG-IIb is an extremely rare congenital disorder of glycosylation (CDG), with only one other case reported. The genetic defect of the disease disrupts glycosylation, the process for attaching and trimming sugars from proteins. Almost 50% of our proteins have sugars attached, and these are called glycoproteins. They include immunoglobulins and also some viral glycoproteins that are made when cells are infected by a virus. The spread of some viruses, including HIV and influenza, depend on viral glycoproteins in order to infect additional cells and form viral protective shields. We found that this type of virus was less able to replicate, infect other cells, or create adequate protective shields in CDG-IIb patient cells because of the glycosylation defect. In comparison, adenovirus, poliovirus, and vaccinia virus, which either do not rely on glycosylation or do not form protective glycoprotein shields, replicated normally when added to both CDG-IIb and healthy cells. (more…)
Author Interviews, Autism, JAMA, Johns Hopkins / 22.04.2014

Li-Ching Lee, PhD, ScM Associate Scientist, Departments of Epidemiology and Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205MedicalResearch.com Interview with: Li-Ching Lee, PhD, ScM Associate Scientist, Departments of Epidemiology and Mental Health Johns Hopkins Bloomberg School of Public Health Baltimore MD 21205 MedicalResearch.com: What are the main findings of the study? Dr. Li-Ching Lee: This population-based case-control study in young children provides evidence that prenatal selective serotonin reuptake inhibitor (SSRI) use may be a risk factor for autism and other developmental delays (DD). Among boys, prenatal SSRI exposure was nearly 3 times as likely in children with autism spectrum disorder (ASD) relative to children with typical development; the strongest association occurred with first-trimester exposure. Exposure was also elevated among boys with DD and was strongest in the third trimester. (more…)