Annals Internal Medicine, Author Interviews, Compliance, Cost of Health Care, McGill, Pharmacology / 09.04.2014

Robyn Tamblyn BScN Msc PhD James McGill Chair Departments of Medicine and Epidemiology and Biostatistics McGill University Scientific Director Institute of Health Services and Policy Research Canadian Institutes of Health Research MedicalResearch.com Interview with: Robyn Tamblyn BScN Msc PhD James McGill Chair Departments of Medicine and Epidemiology and Biostatistics McGill University and Scientific Director Institute of Health Services and Policy Research Canadian Institutes of Health Research MedicalResearch.com: What are the main findings of the study? Dr. Tamblyn: Higher drug costs are associated with a higher probability of primary non-adherence, whereas better follow-up by the prescribing physician, and a policy to provide medication at no cost for the very poor increase the likelihood of adherence (more…)
Author Interviews, Gender Differences, Orthopedics, Race/Ethnic Diversity, UCLA / 08.04.2014

Dr. Carolyn Crandall, M.D. Division of General Internal Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, 90024, USAMedicalResearch.com Interview with: Dr. Carolyn Crandall, M.D. Division of General Internal Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, 90024, USA MedicalResearch.com: What are the main findings of the study? Dr. Crandall: We found that higher social class was linked with a lower risk of fractures among non-Caucasian women.  Compared with non-Caucasian women who had no more than a high school education, those with at least some postgraduate education had nearly 90% lower rates of non-traumatic fracture.  These results were present even after we accounted for income. (more…)
Author Interviews, Cognitive Issues, Medical Imaging, NIH / 07.04.2014

MedicalResearch.com Interview with: dr_Aalex_d_leowAlex Leow, MD PhD Psychiatric Institute Chicago, IL 60612 and   Tony J. Simon, PhD University of California, Davis MIND Institute Sacramento, CA 95817Tony J. Simon, PhD University of California, Davis MIND Institute Sacramento, CA 95817 MedicalResearch.com: What are the main findings of the study? Answer: Fragile X syndrome (FXS) is the most common inherited cause of intellectual disabilities and the most prevalent known single-gene cause of autism in males. The fragile X mental retardation 1 gene (FMR1) can be mutated with expanded numbers of CGG trinucleotide repeats in the 5’ untranslated region on the Xq27.3 site of the X chromosome. Normally, unaffected individuals have fewer than 45 CGG repeats in FMR1. When the size of the CGG repeat exceeds 200 FMR1 is silenced and the mutation is categorized as full, generating the FXS phenotype. If the expansion is between 55–200 repeats, then the individual is generally classified as a fragile X premutation carrier (fXPC). An estimated 40% of male and 8-16% of female premutation carriers later develop Fragile X-Associated Tremor/Ataxia Syndrome (FXTAS), which is a late-onset (usually 50-70 years old) neurodegenerative disorder. We recruited 46 neurologically symptomless young to middle aged carriers of the FMR1 gene mutation. They were age and gender matched with 42 unaffected control individuals without the gene mutation. Both groups were evaluated by cognitive testing as well as novel neuroimaging techniques termed “brain connectomics,” based on diffusion tensor imaging (DTI) whole-brain tractography.  A connectome is a comprehensive map, like a wiring diagram, of neural connections in the brain. Our study is the first-ever connectome study to compare fXPCs and controls. In short, brain connectomics enable scientists for the first time to study the global organizational properties of the human brain by applying cutting edge computational techniques, based on graph theory, to these comprehensive maps of neural connections (i.e., the brain graphs). Our main finding was that, in neurologically symptomless male carriers  we detected a correlation between brain graphs’ efficiency in processing information and the number of CGG repeats in the mutated region of FMR1 (we estimated that each additional CGG repeat that in these males represents an effective increase of ~1.5 years  of “brain aging”). The correlation may prove to be an effective marker of early brain aging in otherwise neurologically symptomless premutation carriers. The study also further confirmed previous findings of smaller brain stem volumes in male fXPCS than in male controls. (more…)
Mayo Clinic, Pain Research, Surgical Research / 05.04.2014

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. MedicalResearch.com:  What are the study’s main findings? Dr. Bingener-Casey:  “Patient-reported outcomes such as pain and fatigue are sensitive tools to detect how well patients recover from surgery. These patient-reported outcome results are different for men and women and for older versus younger people.” (more…)
Author Interviews, Biomarkers, Emergency Care, Heart Disease, JACC, Karolinski Institute / 04.04.2014

Martin J. Holzmann, MD, PHD Department of Emergency Medicine Karolinska University Hospital, HuddingeMedicalResearch.com Interview with: Martin J. Holzmann, MD, PHD Department of Emergency Medicine Karolinska University Hospital, Huddinge   MedicalResearch.com: What are the main findings of the study? Dr. Holzmann: In a cohort of 8900 consecutive patients who sought medical attention for chest pain, we found that an undetectable high-sensitivity cardiac troponin level (<5 ng/l), and an ECG with no ischemic changes has a negative predictive value of 99.8% (95%, 99.7-99.9%). Thus, this will rule out MI with nearly 100% accuracy, and independent of when the troponin was measured in relation to onset of chest pain, and independent of any risk factors for cardiovascular disease. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, NIH, Nutrition, Salt-Sodium / 03.04.2014

MedicalResearch.com Interview with: Niels Graudal, MD, DrMSc Senior Consultant Department of Internal medicine/Infectious Medicine/Rheumatology IR4242 Copenhagen University Hospital, Rigshospitalet Denmark Dr. Graudal: There are no studies, which show what happens with the risk of cardiovascular death or mortality if you change your sodium intake. Our study shows the association of sodium intake as it is with cardiovascular disease and mortality, which is only the second best way to consider the problem, but as the best way does not exist we have accepted this approach. There have been two different assumptions concerning the risks of sodium intake. One is that there is an increasing risk of heart disease, stroke and death of salt intake above 2300 mg, and one is that salt is not dangerous at all. Our study shows that both positions partially may be true, as a salt intake above 4900 mg is associated with increased risk of cardiovascular disease and mortality, whereas the present normal salt intake of most of the world’s populations between 2300 mg and 4900 mg is not associated with any increased risks. In addition our study shows that a low sodium intake below 2300 mg is also associated with increased risk of cardiovascular disease and death. (more…)
Mediterranean Diet, NIH, Nutrition, Weight Research / 02.04.2014

Dr. Milan K Piya NIHR Clinical Lecturer in Diabetes and Endocrinology Warwick Medical School, University of Warwick; University Hospitals Coventry and Warwickshire NHS Trust Coventry, UKMedicalResearch.com Interview with: Dr. Milan K Piya NIHR Clinical Lecturer in Diabetes and Endocrinology Warwick Medical School, University of Warwick; University Hospitals Coventry and Warwickshire NHS Trust Coventry, UK MedicalResearch.com: What are the main findings of the study? Answer: Our studies have identified two main findings: Firstly that the size or frequency of the meal doesn’t affect the calories we burn in a day, but what matters most for losing weight is counting calories. Secondly, by carrying more weight, more endotoxin enters the circulation to cause inflammation and eating more often will exacerbate this risk which has been linked to metabolic diseases such as type-2 diabetes. (more…)
Author Interviews, Infections, JAMA, University of Michigan / 01.04.2014

Mary A.M. Rogers, PhD, MS Research Associate Professor Research Director, Patient Safety Enhancement Program Department of Internal Medicine University of Michigan Ann Arbor, MI  48109-2800MedicalResearch.com Interview with: Mary A.M. Rogers, PhD, MS Research Associate Professor Research Director, Patient Safety Enhancement Program Department of Internal Medicine University of Michigan Ann Arbor, MI  48109-2800 MedicalResearch.com: What are the main findings of the study? Dr. Rogers: The risk of serious infection is considerably elevated after receiving allogeneic (donor) red blood cell transfusions.  For every 38 patients under consideration for transfusion, 1 patient could be spared an infection if more restrictive hemoglobin thresholds were used.  When patients were given transfusions only after their hemoglobin fell below 7.0 g/dL, 1 patient avoided an infection of every 20 patients treated.  The results were most consistent in elderly patients receiving hip and knee replacement surgeries.  Their risk of infection decreased by 30% when lower hemoglobin thresholds were used. (more…)
Alzheimer's - Dementia, Author Interviews, Diabetes, Mental Health Research, NIH, University of Pittsburgh / 01.04.2014

Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo ClinicMedicalResearch.com Interview with: Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo Clinic MedicalResearch.com: What are the main findings of the study? Dr. Roberts: We found that among persons 70 years and older, people with type 2 diabetes had a reduced glucose uptake (hypometabolism) in  brain cells.  We also found a similar association for people without type 2 diabetes but who had elevated hemoglobin A1c levels levels at the time of enrollment (HBA1c is a measure of glucose control, and represents the average blood glucose levels over a 3 month period). However, we did not find an association of diabetes with increased brain amyloid accumulation.  Our findings were based on an investigation of the association of type 2 diabetes with markers of brain pathology: brain hypometabolism was assessed by 18F-fluorodeoxyglucose positron emission tomography [PET] and amyloid accumulation was assessed by 11-C Pittsburgh Compound B PET imaging. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, University of Pittsburgh, Wake Forest / 31.03.2014

MedicalResearch.com Interview Invitation with: Timothy Hughes, PhD, MPH Roena B. Kulynych Center for Memory & Cognition Research Department of Internal Medicine Division of Gerontology and Geriatric Medicine Wake Forest School of Medicine Medical Center Boulevard, Winston-Salem, NC  27157-1207Timothy Hughes, PhD, MPH Roena B. Kulynych Center for Memory & Cognition Research Department of Internal Medicine Division of Gerontology and Geriatric Medicine Wake Forest School of Medicine Medical Center Boulevard, Winston-Salem, NC  27157-1207 MedicalResearch.com: What are the main findings of the study? Dr. Hughes: This study is a follow-up to our recent paper that showed a novel relationship between arterial stiffness (commonly measured by pulse wave velocity) and the presence and extent of amyloid deposition in the brain, a hallmark of Alzheimer’s disease. For this study, we repeated brain amyloid imaging (using the Pittsburgh Compound B during PET imaging) in order to look for predictors of change in amyloid over two years in n=81 elderly adults aged 80+ and free from dementia. We observed that measures of systemic arterial stiffness (e.g. brachial ankle pulse wave velocity) was strongly associated with the extent of amyloid deposition in the brain at both baseline and follow-up. The change in brain amyloid accumulation over two years resulted in an increase in in the number of participants with Alzheimer’s-like (amyloid-positive) from 45% at baseline to a surprising 75% after just two years. This change in brain amyloid accumulation over two years was strongly related to having greater central stiffness (as measured by carotid femoral pulse wave velocity). These relationships between arterial stiffness and brain amyloid deposition were independent of the effects of age, gender, body mass index, antihypertensive medication use and even current blood pressure. (more…)
Dartmouth, General Medicine / 31.03.2014

dr_james_d_sargentMedicalResearch.com Interview with James D. Sargent, MD, Professor of Pediatrics Professor of Community and Family Medicine Professor of The Dartmouth Institute Co-Director, Cancer Control Research Program Norris Cotton Cancer Center Norris Cotton Cancer Center, Department of Pediatrics Geisel School of Medicine at Dartmouth Lebanon, New Hampshire MedicalResearch.com: What are the main findings of the study? Dr. Sargent: We showed children aged 3-7 years depictions of healthy foods in McDonald’s and Burger King television advertisements that aired in 2010-11.  Children were asked what they saw in the images and not prompted to respond specifically to any aspect of the images.  All images contained the two healthy foods—apples and milk—the companies purported to be advertising through the Children’s Food and Beverage Advertising Initiative.  Only 52% and 70% of children correctly identified McDonald’s and Burger King images of milk.  Whereas 80% correctly identified McDonald’s image of apples, only 10% identified the Burger King apples as apples.  Instead, 81% mistook them as french fries. Please see the video of children responding to the BK apples depiction at http://cancer.dartmouth.edu/about_us/newsdetail/66129/ (more…)
Author Interviews, Infections, NIH, Rheumatology / 31.03.2014

MedicalResearch.com Interview with: Eleftherios Mylonakis, M.D., Ph.D., FIDSA Dean's Professor of Medical Science Chief, Infectious Diseases Division Alpert Medical School and Brown University and Dr. Irene Kourbeti MD Research Associate Infectious Disease Division Rhode Island Hospital, Providence, RI MedicalResearch.com: What are the main findings of the study? Answer : There was high quality of evidence that biologic agents are associated with increased risk of all opportunistic infections, but there was no difference in mortality attributed to the opportunistic infections. Patients receiving biologics were twice more likely to develop opportunistic infections (OIs) compared to controls (OR 1.79; 95% CI, 1.17-2.74) with a number needed to harm (NNH) of 582 patients. That means that 1 opportunistic infection  would occur in every 582 patients receiving biologics. The opportunistic infections usually occurred at the commencement of the use of the biological agent and they were not statistically more in patients with a previous exposure to anti-TNF agents as compared to the patients that had never received an anti-TNF agent.. (more…)
Author Interviews, PLoS, Toxin Research, UCSD / 30.03.2014

Beatrice A. Golomb MD, PhD Professor of Medicine Family and Preventive Medicine University of California, San DiegoMedicalResearch.com Interview with: Beatrice A. Golomb MD, PhD Professor of Medicine Family and Preventive Medicine University of California, San Diego MedicalResearch.com: What are the main findings of the study? Dr. Golomb: The main finding is that veterans with Gulf War illness have bioenergetic defects -- dysfunction of mitochondria, the energy producing elements of cells -- that is evident in comparing affected veterans to matched healthy controls. An estimated 1/4 to 1/3 of the ~700,000 US veterans from the 1990-1 Gulf War developed chronic multisymptom health problems that entail fatigue, cognitive and other CNS problems, muscle pain, weakness and exercise intolerance, with high rates of gastrointestinal (especially diarrhea) and neurological problems, and other symptoms - as well as autonomic dysfunction. Evidence suggests these problems have not abated with time. Veterans from other nations that have conducted epidemiological studies, including the UK, Canada, and Australia, also show elevated rates of problems. (more…)
Author Interviews, Blood Pressure - Hypertension, Duke, JAMA / 29.03.2014

MedicalResearch.com Interview with: Ann Marie Navar-Boggan, MD, PhD Division of Cardiology, Duke University Medical Center Durham, North Carolina MedicalResearch.com: What are the main findings of the study? Dr. Navar-Boggan: Two groups of adults are really affected by the updated guidelines. First, 13.5 million adults, including one in five adults over the age of 60, were previously considered to have uncontrolled blood pressure but now meet new guideline goals. Next, 14 million adults over the age of 60 (one in four adults in this age group) are currently on blood pressure lowering therapy and meeting the older, more stringent targets. The guidelines state that no changes are necessary in this group, but they may be eligible for reduced therapy, particularly if they have had side effects or difficulty with the therapies they are taking. (more…)
Author Interviews, Duke, Lipids, NEJM, Statins / 28.03.2014

Michael J. Pencina, PhD Professor of Biostatistics and Bioinformatics Director of Biostatistics Duke Clinical Research Institute Durham, NC 27710 MedicalResearch.com Interview with: Michael J. Pencina, PhD Professor of Biostatistics and Bioinformatics Director of Biostatistics Duke Clinical Research Institute Durham, NC 27710 MedicalResearch.com: What motivated your research? Dr. Pencina: After the new guidelines were issued last November, we were intrigued by the change in treatment philosophy from that based on cholesterol levels (used by the “old guidelines” known as NCEP ATPIII) to one based on 10-year risk of cardiovascular disease (used by the new AHA-ACC guidelines).  We were curious what the practical consequences of this shift would be. Furthermore, the media quoted a lot of experts making educated guesses on the impact.  We realized that this question can be answered much more precisely based on the NHANES data. (more…)
Author Interviews, Diabetes, Diabetes Care, NIH / 28.03.2014

Michael Laxy Helmholtz Zentrum München German Research Center for Environmental Health Institute of Health Economics and Health Care Management Neuherberg, GermanyMedicalResearch.com Interview with: Michael Laxy Helmholtz Zentrum München German Research Center for Environmental Health Institute of Health Economics and Health Care Management Neuherberg, Germany MedicalResearch.com: What are the main findings of the study? Answer: In patients with type 2 diabetes a high level of self-management behavior was associated with a better glycemic control, i.e. a lower HbA1c level, in the cross-sectional perspective and a reduced mortality over a 12-year period. This effect remained robust after controlling for socio-demographic and disease related factors, including medication. (more…)
Author Interviews, Heart Disease, Kidney Disease, McGill / 27.03.2014

Louise Pilote, MD, MPH, PhD Department of Medicine, McGill University Department of Epidemiology and Biostatistics, McGill UniversityMedicalResearch.com Interview with: Louise Pilote, MD, MPH, PhD Department of Medicine, McGill University Department of Epidemiology and Biostatistics, McGill University MedicalResearch.com: What are the main findings of the study? Dr. Pilote: Our study found that in patients with atrial fibrillation (AF) undergoing dialysis, warfarin use, compared to no-warfarin use, did not reduce the risk for stroke (adjusted hazard ratio (HR): 1.14, 95% confidence interval (CI): 0.78 to 1.67) but it was associated with a 44% higher risk for bleeding event (adjusted HR: 1.44, 95% CI: 1.13 to 1.85). However, warfarin use in non-dialysis patients with AF was associated with a 13% lower risk for stroke (adjusted HR: 0.87, 95% CI: 0.85 to 0.90) and only a 19% higher risk for bleeding event (adjusted HR: 1.19, 95% CI: 1.16 to 1.22). (more…)
Author Interviews, NIH, Nutrition, Sugar / 27.03.2014

Laureen Smith, PhD Associate Professor College of Nursing, The Ohio State University Columbus, OH 43210MedicalResearch.com Interview with: Laureen Smith, PhD Associate Professor College of Nursing, The Ohio State University Columbus, OH 43210 MedicalResearch.com: What are the main findings of the study? Dr. Smith: Daily sugar-sweetened beverage decreased significantly by about 1 serving per day. Also weekly consumption decreased from an average of over 4 days per week to about 2 ½ days per week. Generally, the teens were drinking the beverages fewer days per week and less servings on the days they did consume them. These changes were maintained on their own for a month after the intervention ended. Water consumption increased nearly 20 percent immediately post intervention and continued to increase at 30 days post-intervention. (more…)
Author Interviews, Disability Research, Johns Hopkins, Pain Research, Rheumatology / 27.03.2014

Dr Damian Hoy University of Queensland School of Population Health Herston, AustraliaMedicalResearch.com Interview with: Dr Damian Hoy University of Queensland School of Population Health Herston, Australia

MedicalResearch.com: What are the main findings of the study? Dr. Hoy: The study was part of the Global Burden of Disease 2010 study, which was conducted by the University of Queensland, Harvard University, Johns Hopkins University, University of Washington, and hundreds of disease experts throughout the globe. It is the largest ever public health study. It compared the overall burden (in terms of both death and disability) of the most common 291 diseases/conditions in the world. Low back pain was found to cause more global disability than any other disease/condition. If this is something you are going through, it may be worth knowing that marijuana strains for back pain is one of the most powerful remedies. You've possibly tried everything in the shop and over the counter medicine. So why not give this a go and see how you get on. There's no harm in trying. Global disability from low back pain is increasing. There is an urgent need for global, regional and national agencies to pay far greater attention to the disability caused by low back pain. In the developed world there are low back pain therapy treatments available whereas, in the developing world things aren't as accessible. (more…)
Author Interviews, Breast Cancer, Cancer, NIH / 26.03.2014

Yun Gong, M.D. Associate Professor Department of Pathology, Unit 53 M D Anderson Cancer Center Houston, TX 77030MedicalResearch.com Interview with: Yun Gong, M.D. Associate Professor Department of Pathology, Unit 53 M D Anderson Cancer Center Houston, TX 77030 MedicalResearch.com: What are the main findings of the study? Dr. Gong:  Androgen receptor (AR) was positive in 39% of the inflammatory breast cancer (IBC) tumors, approximately one-third of estrogen receptor (ER)-negative and progesterone receptor (PR)-negative tumors and 42.6% triple-negative tumors. AR positivity was significantly associated with lymphovascular invasion but not with other clinicopathologic parameters. There was a trend toward association between AR expression and PR expression. Univariate survival analysis indicated that patients with AR-negative/ER-negative tumors had significantly worse overall survival and disease-specific survival than the patients with tumors showing other combinations of AR/ER status (i.e., AR-negative/ER-positive, AR-positive/ER-negative,  or AR-positive/ER-positive). Notably, the study was performed using post-neoadjuvant IBC surgical specimens. (more…)
Autism, Genetic Research, NEJM, UCSD / 26.03.2014

MedicalResearch.com Interview with: Dr. Erik Courchesne PhD Professor, Department of Neurosciences UC San Diego School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Courchesne: “Building a baby’s brain during pregnancy involves creating a cortex that contains six layers,” Courchesne said. “We discovered focal patches of disrupted development of these cortical layers in the majority of children with autism.” The authors created the first three-dimensional model visualizing brain locations where patches of cortex had failed to develop the normal cell-layering pattern. The study found that in the brains of children with autism key genetic markers were absent in brain cells in multiple layers. “This defect,” Courchesne said, “indicates that the crucial early developmental step of creating six distinct layers with specific types of brain cells – something that begins in prenatal life – had been disrupted.”  The study gives clear and direct new evidence that autism begins during pregnancy. (more…)
Author Interviews, Gout, Mayo Clinic, Rheumatology / 26.03.2014

Tim Bongartz, M.D. Associate Professor of Medicine Department of Rheumatology Mayo Clinic, MinnesotaMedicalResearch.com Interview with: Tim Bongartz, M.D. Associate Professor of Medicine Department of Rheumatology Mayo Clinic, Minnesota MedicalResearch.com: What are the main study findings? Dr. Bongartz:  Dual-energy computed tomography (DECT) is an imaging methods that has been in use for many years to classify the material of renal stones. Our study demonstrates that this technology can be useful in identifying monosodium urate deposits in and around joint, allowing to diagnose patients with gout with overall high sensitivity and specificity. Importantly, a stratified analysis of patient subgroups revealed that DECT is less accurate in diagnosing patients with a first flare of gout, emphasizing the importance of careful patient selection when using this new technology. In a "diagnostic-yield" substudy, we explored the question how much DECT could contribute to correctly diagnose patients where clinicians did have a high level of suspicion for gout, but synovial fluid aspiration results came back negative. In about a third of these patients with negative routine testing, we could confirm a diagnosis of gout through use of DECT. (more…)
HPV, MD Anderson / 26.03.2014

Dr. Judith A. Smith is an Associate Professor in the Department of Gynecologic Oncology & Reproductive Medicine in the Division of Surgery at The University of Texas MD Anderson Cancer Center in Houston (UTMDACC),MedicalResearch.com Interview with: Dr. Judith A. Smith Pharm.D. Associate Professor Department of Gynecologic Oncology & Reproductive Medicine Division of Surgery The University of Texas MD Anderson Cancer Center in Houston MedicalResearch.com: What are the main findings of the study? Dr. Smith: This study first demonstrated in vitro suppression of HPV expression. After a single dose at 24 hours and with repeated dosing every 24 hours for 7 days followed by 7 days of no treatment, HPV eradication was achieved. These findings were confirmed with in vivo animal studies. HPV expression was eradicated with once daily AHCC dosing for 90 days and sustained after 30 day observation off treatment.  Immune modulation (increase) of IFNα (p < 0.03), IFNβ (p <0.03), and IFN (p< 0.03) and IgG1 (P < 0.05) was observed in AHCC treated mice compared to untreated controls. AHCC mechanism of immune modulation of the IFN pathways to eradicate HPV was particularly relevant because E6/E7 oncogenic activity in HPV infection is believed to be related to suppression of IFN expression/signaling.  These data suggest AHCC may help clear HPV infections and have a potential role in the prevention of HPV-related cancers. (more…)
Author Interviews, Endocrinology, Gastrointestinal Disease, JAMA, Johns Hopkins, Surgical Research / 24.03.2014

Elizabeth C. Wick, MD Assistant Professor,Department of Surgery The Johns Hopkins Hospital, Baltimore, MarylandMedicalResearch.com Interview with: Elizabeth C. Wick, MD Assistant Professor,Department of Surgery The Johns Hopkins Hospital, Baltimore, Maryland   MedicalResearch.com: What are the main findings of the study? Dr. Wick: The main finding is the high variability in physician practice for prescribing steroids and the lack of clear guidance as to best practice in the literature. (more…)
Author Interviews, Case Western, Chemotherapy, Genetic Research, Lung Cancer, UT Southwestern / 22.03.2014

Dr. Azi  Gazdar, MD UT Southwestern Medical Center W. Ray Wallace Distinguished Chair in Molecular Oncology Research Hamon Center for Therapeutic Oncology, PathologyMedicalResearch.com Interview with: Dr. Azi  Gazdar, MD UT Southwestern Medical Center W. Ray Wallace Distinguished Chair in Molecular Oncology Research Hamon Center for Therapeutic Oncology, Pathology MedicalResearch.com: What are the main findings of the study? Dr. Gazdar: We describe the characteristics of lung cancers arising in subjects who inherited a germline mutation that predisposes to lung cancer.  The mutation is rare in the general populations, and is inherited equally by both sexes.  However it is a potent predisposing gene, and one third of the never smoking carriers will develop lung cancer.  Thus, about 1% of patients who develop lung cancer carry the germline mutation.  This figure may rise as awareness of the condition and its link to lung cancer is raised among doctors diagnosing lung cancer. However, lung cancers mainly develop in women who are lifetime never smokers.  Lung cancer development is much less common among smokers and men, although accurate figures are not yet available. So the risk among carriers is somewhat similar to the BRCA genes predisposing to breast cancer, where a female carrier has about a 50% lifetime chance of developing breast cancer. The specific germline mutation (known as T790M) occurs in a gene known as epidermal growth factor receptor (EGFR) gene.  Sporadic mutations in this gene usually predict for effective responses to a class of drugs known as tyrosine kinase inhibitors (TKIs), which are widely used in the treatment of lung cancer.  However, the T790M mutation, when it occurs in sporadic tumors not associated with germline inheritance are resistant to TKI therapy.  Thus the prediction is that lung cancers arising in carriers with the germline mutation would also be resistant to TKI therapy. (more…)
Author Interviews, Mental Health Research, Neurology, NIH / 22.03.2014

Hannes Devos, PhD Assistant Professor Assistant Director Georgia Regents University Driving Simulator Lab Department of Physical Therapy College of Allied Health Sciences Georgia Regents University Augusta, GA 30912MedicalResearch.com Interview with: Hannes Devos, PhD Assistant Professor Assistant Director Georgia Regents University Driving Simulator Lab Department of Physical Therapy College of Allied Health Sciences Georgia Regents University Augusta, GA 30912 MedicalResearch.com: What are the main findings of the study? Dr. Devos: We compared on-road driving performance between 30 active drivers with Huntington disease and 30 age- and gender- matched control drivers. We found that Huntington disease affects all levels of driving skill due to motor and cognitive deficits and leads to unsafe driving, even in the early stages of the disease. Fourteen (47%) drivers with Huntington disease failed the road test compared with none of the controls. (more…)
Author Interviews, Diabetes, Mayo Clinic, Neurology / 20.03.2014

Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo ClinicMedicalResearch.com Interview with: Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo Clinic   MedicalResearch.com: What are the main findings of the study? Dr. Roberts: The onset of type two diabetes in midlife (before age 65 years)  is associated with brain pathology (subcortical brain infarctions, reduced hippocampal volume, reduced whole brain volume) in late-life. Early onset of diabetes also increases the risk of developing mild cognitive impairment  which is an intermediate stage between normal cognitive aging and dementia. Our findings suggest that loss of brain volumes may be an intermediate stage or a link between diabetes and cognitive impairment. We also found that diabetes onset in late-life (after age 65 years), is also associated with brain pathology (cortical infarctions, reduced whole brain volume). Finally, onset of hypertension in midlife, but not late-life, is associated with brain pathology in late- life. (more…)
Author Interviews, Diabetes, Diabetes Care, FDA, Pharmacology / 20.03.2014

Christian Hampp PhD Senior Staff Fellow/Epidemiologist at FDA Division of Epidemiology-I, Office of Pharmacovigilance and Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MDMedicalResearch.com Interview with: Christian Hampp PhD Senior Staff Fellow/Epidemiologist at FDA Office of Pharmacovigilance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD MedicalResearch.com: What are the main findings of the study? Dr. Hampp: Our study described U.S. market trends for antidiabetic drugs, focusing on newly approved drugs, concomitant use of antidiabetic drugs, and effects of safety concerns and restrictions on thiazolidinedione use. We found that since 2003, the number of adult antidiabetic drug users increased by approximately 43% to 18.8 million in 2012.  During 2012, 154.5 million prescriptions for antidiabetic drugs were filled in outpatient retail pharmacies.  Since 2003, metformin use increased by 97% to 60.4 million prescriptions dispensed in 2012.  Among antidiabetic drugs newly approved for marketing between 2003 and 2012, the dipeptidyl-peptidase-4 (DPP-4) inhibitor sitagliptin had the largest share with 10.5 million prescriptions in 2012. Possibly triggered by safety concerns, the use of pioglitazone declined in 2012 to approximately 52% of its peak in 2008, when 14.2 million prescriptions were dispensed in outpatient retail pharmacies and the use of rosiglitazone use decreased to fewer than 13,000 prescriptions dispensed in retail or mail-order pharmacies in 2012. (more…)
Author Interviews, CMAJ, Emergency Care, Gender Differences, Heart Disease, McGill / 20.03.2014

MedicalResearch.com Interview with: Roxanne Pelletier, PhD Postdoctoral Fellow Division of Clinical Epidemiology  McGill University Health Centre (MUHC) 687 Pine Avenue West, V Building, Room V2.17 Montreal, QcRoxanne Pelletier, PhD Postdoctoral Fellow Division of Clinical Epidemiology McGill University Health Centre (MUHC) 687 Pine Avenue West, V Building, Room V2.17 Montreal, Qc MedicalResearch.com: What made you want to study this disparity between men and women and heart attacks?  Dr. Pelletier:  Despite enhanced medical treatment and decrease in the incidence of heart diseases, important sex disparities persist in the risk of mortality following a cardiac event: the risk of mortality is higher in women compared to men, and this sex difference is even more important in younger adults. Therefore, we aimed to investigate potential mechanisms underlying this sex difference in mortality. (more…)