Author Interviews, Genetic Research, Kidney Disease, Nature, University of Pennsylvania / 12.08.2013

MedicalResearch.com Interview with: Dr. Wen-Ya Ko, Ph.D. Postdoctoral Fellow, First author of the paper  Department of Genetics School of Medicine University of Pennsylvania 426 Clinical Research Building 415 Curie Boulevard Philadelphia, PA 19104-6145Dr. Wen-Ya Ko, Ph.D. Postdoctoral Fellow, First author of the paper Department of Genetics School of Medicine University of Pennsylvania 426 Clinical Research Building 415 Curie Boulevard Philadelphia, PA 19104-6145 Dr. Sarah Tishkoff, Ph.D., Senior author of the paper  David and Lyn Silfen University Professor Departments of Genetics and Biology School of Medicine School of Arts and Sciences University of PennsylvaniaDr. Sarah Tishkoff, Ph.D., Senior author of the paper David and Lyn Silfen University Professor Departments of Genetics and Biology School of Medicine School of Arts and Sciences University of Pennsylvania MedicalResearch.com: What are the main findings of the study?

 Answer: In humans the APOL1 gene codes for Apolipoprotein L1, a major component of the trypanolytic factor in serum.  The APOL1 gene harbors two risk alleles (G1 and G2) associated with chronic kidney disease (CKD) among individuals of recent African ancestry. We studied APOL1 across genetically and geographically diverse ethnic groups in Africa. We have discovered a number of novel variants at the APOL1 functional domains that are required to lyse trypanosome parasites inside human blood vessels. We further identified signatures of natural selection influencing the pattern of variation on chromosomes carrying some of these variants. In particular, we have identified a haplotype (a cluster of genetic variants linked along a short region of a chromosome), termed G3, that has evolved adaptively in the Fulani population who have been practicing cattle herding which has been historically documented as early as in the medieval ages (but which could have begun thousands of years earlier).  Many of the novel variants discovered in this study are candidates to play a role conferring protection against trypanosomiasis and/or to play a role in susceptibility of CKD in humans. (more…)
Annals Thoracic Surgery, Author Interviews, Heart Disease, Transplantation, Vanderbilt / 12.08.2013

Simon Maltais MD PhD Vanderbilt University Medical Center Division of Cardiovascular Surgery 1215 21st Ave S, MCE 5th Flr Nashville, TN 37232-8808.MedicalResearch.com Interview with: Simon Maltais MD PhD Vanderbilt University Medical Center Division of Cardiovascular Surgery 1215 21st Ave S, MCE 5th Flr Nashville, TN 37232-8808. MedicalResearch.com: What did your study evaluate and why is this important? Answer: We performed a rigorous, retrospective review of the Scientific Registry of Transplant Recipients (SRTR) data base to evaluate donor, recipient, and technical characteristics associated with graft survival in patients undergoing mechanical circulatory support (MCS) device explantation at the time of heart transplantation surgery. Donor and recipient characteristics has been well described in the medical literature for routine heart transplantation, however these characteristics in patients who were supported with a long term MCS device at the time of heart transplant was not known.  Additionally, due to chronic donor heart shortages, an increasing number of patients with advanced heart failure are being bridged with MSC devices until a suitable donor heart can be obtained. (more…)
Author Interviews, General Medicine, McGill, Sugar, Weight Research / 09.08.2013

MedicalResearch.com  Interview with: Caroline Franck, MSc Dvisions of Cardiology and Clinical Epidemiology McGill University, Montreal, Quebec, Canada MedicalResearch.com: What are the main findings of the study? Answer: We found that, although subsidies are needed to protect farmers from production risks, the current allocation of payments encourages the sustained overproduction of a handful of grains and oilseeds. Overproduction contributes to making the end products cheaper, which are then processed into energy-dense and high-fat/sugar foods. Obesity should be treated as a systems problem, in which farm production plays an important role. (more…)
Author Interviews, JNCI, Lung Cancer, Sloan Kettering / 09.08.2013

Prasad Adusumilli MD, FACS Associate Member, Thoracic Surgery Memorial Sloan-Kettering Cancer Center New YorkMedicalResearch.com Interview with: Prasad Adusumilli MD, FACS Associate Member, Thoracic Surgery Memorial Sloan-Kettering Cancer Center New York MedicalResearch.com: What are the main findings of the study? Answer: The current standard of care of for early-stage lung adenocarcinoma, the common form of lung cancer is curative-intent surgery either by limited resection, LR (removal of tumor with clear margins) or lobectomy, LO (removal of one-third to one-half of the lung harboring the tumor). Although lung-sparing LR is preferable, there is a reported incidence of 30-40% of recurrences within the same lung. The causative factor/s for these local recurrences is not known. In our study, we analyzed recurrence patterns and pathological features in patients who underwent 476 LO and 258 LR performed at the Memorial Sloan-Kettering Cancer Center, New York. We investigated the morphological patterns in pathology specimens utilizing the recently proposed International Association for the Study of Lung Cancer / European Respiratory Society / American Thoracic Society (IASLC/ERS/ATS) classification. We noticed that presence of micropapillary morphology was associated with three times higher recurrences in patients undergoing LR compared to LO, these recurrences were lower when there is an adequate margin (2 cm) resected beyond the tumor. In patients undergoing LO, the recurrences were 75% less. (more…)
Author Interviews, Gastrointestinal Disease, PNAS, University of Pennsylvania / 08.08.2013

MedicalResearch.com Interview with Frederic D. Bushman, Ph.D.  Professor, Department of Microbiology Department of Microbiology Perelman School of Medicine University of Pennsylvania 426A Johnson Pavilion 3610 Hamilton Walk Philadelphia, PA 19104MedicalResearch.com Interview with Frederic D. Bushman, Ph.D. Professor, Department of Microbiology Department of Microbiology Perelman School of Medicine University of Pennsylvania 426A Johnson Pavilion 3610 Hamilton Walk Philadelphia, PA 19104   MedicalResearch.com: What are the main findings of the study? Dr. Bushman: Viral populations in the human gut are huge, and some of the viruses change rapidly over time. (more…)
General Medicine, JAMA, University of Pennsylvania / 08.08.2013

MedicalResearch.com Interview with Edna B. Foa, PhD Department of Psychiatry, University of Pennsylvania, Philadelphia MedicalResearch.com: What are the main findings of the study? Dr. Foa: Naltrexone was effective in decreasing the percentage of days drinking in people with alcohol dependence and posttraumatic stress disorder during active treatment.  Six months after treatment discontinuation, participants who received prolonged exposure therapy for PTSD drank less than those who did not receive prolonged exposure.  Participants who received a combined treatment of prolonged exposure and naltrexone had the lowest drinking level after six-month treatment discontinuation. The main message of the study is that simultaneous treatment of alcohol dependence and PTSD yield superior outcome than each treatment alone. Importantly, the findings indicated that prolonged exposure therapy was not associated with increased drinking or alcohol craving, a concern that has been voiced by some investigators. In fact, reduction in PTSD severity and drinking was evident for all four treatment groups. This finding contradicts that common view that trauma-focuses therapy is contraindicated for individuals with alcohol dependence and PTSD, because it may exacerbate PTSD symptoms and thereby lead to increased alcohol use. (more…)
Author Interviews, JAMA, Mental Health Research, UT Southwestern / 07.08.2013

Carol S. North, MD, MPE  The Nancy and Ray L. Hunt Chair in Crisis Psychiatry Director, Program in Trauma and Disaster, VA North Texas Health Care System 4500 S. Lancaster Rd., Dallas, TX 75216 Professor of Psychiatry and Surgery/Division of Emergency Medicine UT Southwestern Medical Center 6363 Forest Park Rd. Dallas, TX 75390-8828MedicalResearch.com Interview with: Carol S. North, MD, MPE The Nancy and Ray L. Hunt Chair in Crisis Psychiatry Director, Program in Trauma and Disaster, VA North Texas Health Care System 4500 S. Lancaster Rd., Dallas, TX 75216 Professor of Psychiatry and Surgery/Division of Emergency Medicine UT Southwestern Medical Center 6363 Forest Park Rd. Dallas, TX 75390-8828 MedicalResearch.com: What are the main findings of the study? Answer: In post-disaster settings, a systematic framework of case identification, triage, and mental health interventions can guide overall mental health response and should be integrated into emergency medicine and trauma care responses. (more…)
Asthma, Author Interviews, Genetic Research, Smoking, UCLA / 06.08.2013

MedicalResearch.com Interview with: Virender Rehan, MD Professor of Pediatrics Chief, Division of Neonatology Director, Neonatal Intensive Care Unit Director, Neonatal-Perinatal Fellowship Training Program Co-Director Perinatal Research Center Harbor UCLA Medical Center, David Geffen School of Medicine at UCLA Torrance, CA, 90502 MedicalResearch.com: What are the main findings of the study? Dr. Rehan: The main findings of the study include the likelihood of transmission of asthma to third generation offspring following maternal smoking during pregnancy even when child’s mother didn’t smoke. And these effects seem to be more profound in the upper airways of males compared to that in females. (more…)
Author Interviews, Erasmus, Heart Disease, Tobacco Research / 03.08.2013

MedicalResearch.com Interview with: Dr. R.T. van Domburg Clinical epidemiologist, Associate Professor Erasmus Medical Center Department of Cardiology Ba561 ‘s-Gravendijkwal 230 3015 CE Rotterdam MedicalResearch.com: What are the main findings of your study? Answer: We collected data from the first patients who underwent coronary angioplasty in the early 1980s and followed them for 25 to 30 years. We found that patients who were able to quit smoking in the year following their PCI lived on average more than two years longer than those who continued to smoke. (more…)
Author Interviews, Hospital Acquired, Johns Hopkins / 31.07.2013

MedicalResearch.com Interview with: Bruce Y. Lee, MD MBA Associate Professor of International Health Director of Operations Research International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health 855 N. Wolfe Street Suite 600 Baltimore, MD 21205Bruce Y. Lee, MD MBA Associate Professor of International Health Director of Operations Research International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health 855 N. Wolfe Street Suite 600 Baltimore, MD 21205 MedicalResearch.com: What are the main findings of the study? Dr. Lee: Vancomycin resistant enterococci (VRE) is every hospital’s problem.  A VRE outbreak in one hospital, even if the hospital is relatively small or distant, can readily spread to other hospitals in a region because patients leaving one hospital often will go to other hospitals either directly or after an intervening stay at home.  These patients can then carry VRE with them to other hospitals.  Therefore, as long a single hospital has a problem with VRE or any other healthcare associated infection, all other hospitals are at risk.  Conquering VRE then requires cooperation among hospitals. (more…)
Author Interviews, Breast Cancer, Radiology, Yale / 30.07.2013

MedicalResearch.com Interview with Dr. Brian Haas MD Department of Diagnostic Radiology,Yale University School of Medicine, New Haven, CT Dr. Brian Haas MD Department of Diagnostic Radiology,Yale University School of Medicine, New Haven, CT MedicalResearch.com: What are the main findings of the study? Dr. Haas: We found that tomosynthesis helped to reduce the number of women who undergo a screening mammogram and are called back for additional imaging and testing. Specifically, the greatest reductions in patients being called back were seen in younger patients and those with dense breasts. Tomosynthesis is analogous to a 3D mammogram, and improves contrast of cancers against the background breast parenchyma. (more…)
Author Interviews, Cancer Research, Nature, University of Pennsylvania / 25.07.2013

MedicalResearch.com Interview with: Xiaolu Yang, Ph.D.MedicalResearch.com Interview with: Xiaolu Yang, Ph.D. Professor of Cancer Biology at the Perelman School of Medicine University of Pennsylvania and the Abramson Family Cancer Research Institute, MedicalResearch.com: What are the main findings of the study? Dr. Yang: TAp73 is a structural homologue of the preeminent tumor suppressor p53, but its role in tumorigenesis has been unclear. In this study, we show that TAp73 supports the proliferation of tumor cells. Mechanistically, TAp73 activates the expression of glucose-6-phosphate dehydrogenase (G6PD), a rate-limiting enzyme in the pentose phosphate pathway. This function of TAp73 is required for maintaining a robust biosynthesis and anti-oxidant defense in tumor cells. These finding connects TAp73 to oncogenic growth and suggest that G6PD may be a valuable target for tumor therapy. (more…)
Author Interviews, Cost of Health Care, JAMA, Mayo Clinic / 24.07.2013

Jon C. Tilburt, MD, MPH Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota Biomedical Ethics Program, Mayo Clinic Knowledge & Evaluation Research Unit, Mayo Clinic Healthcare Delivery Research Program, Center for the Science of Healthcare Delivery Division of Health Care Policy and Research, Mayo ClinicMedicalResearch.com Interview with: Jon C. Tilburt, MD, MPH Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota Biomedical Ethics Program, Mayo Clinic Knowledge & Evaluation Research Unit, Mayo Clinic Healthcare Delivery Research Program, Center for the Science of Healthcare Delivery Division of Health Care Policy and Research, Mayo Clinic What did you set out to find, what was your objective in this study?
  • We wanted to know physicians perceived roles and responsibilities in addressing health care costs as well as their enthusiasm for proposed strategies to contain health care spending.
Who did you study and what did you look at?
  • Practicing US physicians under age 65, we randomly selected 3900 physicians representing all specialties and mailed them an 8-page survey entitled “Physicians, Health Care Costs, and  Society.” We received 2,556 completed surveys (65% response rate). (more…)
Author Interviews, Cost of Health Care, Heart Disease, JAMA, Radiology, UT Southwestern / 24.07.2013

Susan Matulevicius, MD, MSCS  Department of Medicine, The University of Texas Southwestern Medical Center, DallasMedicalResearch.com Interview with: Susan Matulevicius, MD, MSCS Department of Medicine, The University of Texas Southwestern Medical Center, Dallas MedicalResearch.com: What are the main findings of the study? Dr. Matulevicius: In our cohort of 535 transthoracic echocardiograms performed at a single academic medical center, we found that the majority (92%) of echocardiograms were appropriate by the 2011 Appropriate Use Criteria; however, only 1 in 3 echocardiograms lead to an active change in patient care while 1 in 5 resulted in no appreciable change in patient care. (more…)
Author Interviews, Mayo Clinic, Outcomes & Safety / 23.07.2013

MedicalResearch.com Interview with Dr. Vinay Prasad, MD Medical Oncology Branch, National Cancer Institute National Institutes of Health, 10 Center Dr 10/12N226, Bethesda, MD20892. MedicalResearch.com: What are the main findings of the study? Dr. Prasad: We reviewed all original articles in the New England Journal of Medicine over ten years.  1344 articles tested some medical practice-- which is a screening or diagnostic test, medication, procedure or surgery.  Only 27% or 363 articles tested current medical practice.  And of these articles 146 (40%) contradicted current standard of care, constituting a medical reversal. (more…)
Anesthesiology, Author Interviews, Duke, Pain Research / 21.07.2013

Ru-Rong Ji, PhD Professor, Chief of Pain Research Department of Anesthesiology and Neurobiology Duke University Medical Center Durham, NC 27710MedicalResearch.com Interview with: Ru-Rong Ji, PhD Professor, Chief of Pain Research Department of Anesthesiology and Neurobiology Duke University Medical Center Durham, NC 27710 Neuroprotectin/Protectin D1 protects neuropathic pain in mice after nerve trauma MedicalResearch.com: What are the main findings of the study? Answer: We found the pro-resolution lipid mediator protectin D1 (PD1), derived from the fish oil DHA, can effectively prevent nerve injury-induced neuropathic pain. This treatment can also prevent nerve injury-induced neuroinflammation in the spinal cord (such as glial activation and expression of cytokines and chemokines, e.g., IL-1b, CCL2). These cytokines and chemokines are known to elicit pain. (more…)
Author Interviews, Diabetes, Johns Hopkins, Weight Research / 19.07.2013

MedicalResearch.com Interview with: Nisa M. Maruthur, MD, MHS Assistant Professor of Medicine & Epidemiology The Johns Hopkins University Early Response to Preventive Strategies in the Diabetes Prevention Program MedicalResearch.com: What are the main findings of the study? Dr. Maruther: For patients engaged in a lifestyle intervention to prevent diabetes, weight loss early on (at 6 months) is an extremely strong predictor of whether they will develop diabetes down the road.  Even in the setting of substantial weight loss (>10%) at 6 months, it is still beneficial to lower fasting glucose.  These results are unique in that we previously understood that weight loss over time (years) is important to prevent diabetes, but now we know the impact of early weight loss on longer-term diabetes risk. (more…)
Author Interviews, Duke, Fish, Nutrition, Pain Research / 18.07.2013

MedicalResearch.com Interview with: Ru-Rong Ji, PhD Professor, Chief of Pain Research Department of Anesthesiology and Neurobiology Duke University Medical Center Box DUMC 3094, Durham , NC 27710 MedicalResearch.com: What are the main findings of the study? Answer: We found the pro-resolution lipid mediator protectin D1 (PD1), derived from the fish oil DHA, can effectively prevent nerve injury-induced neuropathic pain. This treatment can also prevent nerve injury-induced neuroinflammation in the spinal cord (such as glial activation and expression of cytokines and chemokines, e.g., IL-1b, CCL2). These cytokines and chemokines are known to elicit pain. (more…)
Author Interviews, Cleveland Clinic, Heart Disease, Surgical Research / 17.07.2013

MedicalResearch.com Interview with Dr. Frank Sellke, MD Chief of cardiothoracic surgery and co-director of the Cardiovascular Institute at Rhode Island, The Miriam and Newport hospitals MedicalResearch.com: What are the main findings of the study? Dr. Sellke: The main findings of the study are that outcomes of repair of an ascending aortic dissection are improved under a full moon compared to other phases of the moon. This was with regard to both mortality and length of hospital stay. Interestingly, there was no correlation with season of the year. (more…)
Asthma, Author Interviews, Duke, Genetic Research, Lancet, NEJM / 10.07.2013

Daniel Belsky, PhD NIA Postdoctoral Fellow Center for the Study of Aging and Human Development Duke UniversityMedicalResearch.com Interview with: Daniel Belsky, PhD NIA Postdoctoral Fellow Center for the Study of Aging and Human Development Duke University Polygenic risk and the development and course of asthma: an analysis of data from a four-decade longitudinal study MedicalResearch.com: What are the main findings of the study? Dr. Belsky : We looked to the largest-ever genome-wide association study of asthma (that study by the GABRIEL Consortium included more than 26,000 individuals) to identify genetic variants that could be used to construct a genetic profile of asthma risk. We then turned to The Dunedin Multidisciplinary Health and Development Study, a unique cohort of 1,000 individuals who have been followed from birth through their fourth decade of life with extensive measurements of asthma and related traits. We computed a “genetic risk score” for each person based on the variants identified in GWAS.  Then, we looked at who developed asthma, when they developed asthma, and what that asthma looked like in terms of allergic response and impaired lung function. What we found: (1) People with higher genetic risk scores were more likely to develop asthma and they developed asthma earlier in life. (2) Among children who developed asthma, the ones at higher genetic risk were more likely to have persistent asthma through midlife. (3) Genetic risk was specifically associated with allergic asthma that resulted in chronic symptoms of impaired lung function. (4) People with higher genetic risk score developed more severe cases of asthma. As compared to people with a lower genetic risk, they were more often absent from school and work because of asthma and they were more likely to be hospitalized for asthma. (5) The genetic risk score provided new information about asthma risk that could not be obtained from a family history. (more…)
Author Interviews, Baylor College of Medicine Houston, Cost of Health Care, Heart Disease, JAMA / 03.07.2013

 MedicalResearch.com Interview with Salim S. Virani, MD, PhD Health Policy and Quality Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development Center of Excellence, and Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, Texas MedicalResearch.com: What are the main findings of the study? Dr. Virani: The main findings of the study are that despite having cholesterol levels at goal (LDL cholesterol <100 mg/dL), about one-third of patients (9200 out of 27947) with coronary heart disease had repeat cholesterol testing in 11 months from their last lipid panel. As expected, no intervention was performed as a response to these lipid panels. Collectively, 12686 additional lipid panels were performed in these patients.  Among 13,114 patients who met the optional treatment target of LDL-C<70 mg/dL, repeat lipid testing was performed in 8,177 (62.3% of those with LDL-C<70) during 11 months of follow-up. Patients with a history of diabetes mellitus (odds ratio [OR], 1.16; 95% CI, 1.10-1.22), a history of hypertension (OR, 1.21; 95%CI, 1.13-1.30), higher illness burden (OR, 1.39; 95%CI, 1.23-1.57), and more frequent primary care visits (OR, 1.32; 95%CI, 1.25-1.39) were more likely to undergo repeat testing, whereas patients receiving care at a teaching facility (OR, 0.74; 95%CI, 0.69-0.80) or from a physician provider (OR, 0.93; 95%CI, 0.88-0.98) and those with a medication possession ratio of 0.8 or higher (OR, 0.75; 95%CI, 0.71-0.80) were less likely to undergo repeat testing. (more…)
Author Interviews, Cancer Research, JAMA, Melanoma, Stanford / 03.07.2013

Susan Swetter, MD Professor of Dermatology Director, Pigmented Lesion & Melanoma Program Stanford University Medical Center & Cancer InstituteMedicalResearch.com Interview with: Susan Swetter, MD Professor of Dermatology Director, Pigmented Lesion & Melanoma Program Stanford University Medical Center & Cancer Institute  

Melanoma Survival Disadvantage in Young, Non-Hispanic White Males Compared With Females

MedicalResearch.com: What are the main findings of the study? Dr. Swetter: Women diagnosed with melanoma tend to fare better than men in terms of improved survival, and this has mostly been attributed to better screening practices and behaviors in women that result in thinner, more curable tumors, and/or more frequent physician visits in older individuals that result in earlier detection.  Our study focused on survival differences between young men and women (ages 15-39 years) diagnosed with cutaneous (skin) melanoma, who constitute a generally healthy population compared to the older adults that have usually been studied. We found that young men were 55% more likely to die of melanoma than age-matched women, despite adjustment for factors that may affect prognosis, such as tumor thickness, histology and location of the melanoma, as well as presence and extent of metastasis. Our results present further evidence that a biologic mechanism may contribute to the sex disparity in melanoma survival, since adolescent and young adults see physicians less frequently and are less likely to have sex-related behavior differences in skin cancer screening practices than older individuals. (more…)
Author Interviews, Nature, UCSF, Vitamin C / 02.07.2013

Interview with: Miguel Ramalho-Santos, Ph.D. University of California - San Francisco stem-cell scientist,MedicalResearch.com  Interview with: Miguel Ramalho-Santos, Ph.D. University of California - San Francisco stem-cell scientist, VitaminC induces Tet-dependent DNA demethylation and a blastocyst-like state in ES cells MedicalResearch.com: What are the main findings of the study? Answer: We found that Vitamin C has a profound effect in the regulation of gene activity in cultured mouse embryonic stem cells. Vitamin C specifically enhances the action of enzymes called Tet's, which remove certain chemical modifications to DNA (methylation). In this way, Vitamin C makes cultured mouse embryonic stem cells behave more like the early cells in the embryo that they represent. (more…)
Author Interviews, Breast Cancer, Cancer Research, Radiology, Yale / 01.07.2013

MedicalResearch.com Interview with: Sarah H. O'Connell M.D. PGY-4 Yale New Haven Hospital Yale School of Medicine Department of Diagnostic Radiology MedicalResearch.com:  What are the main findings of the study? Answer: The purpose of our study was to evaluate the visibility of cancers in women at high-risk for breast cancer on 2D mammography compared to digital breast tomosynthesis. In other words, how would the use of tomosynthesis contribute to cancer visualization in this population  of patients? We evaluated the cancers seen in both high-risk patients, those with a >20% lifetime risk of breast cancer, and intermediate risk  patients, those with a 15-20% lifetime risk of breast cancer, for a total of 56 cancers. We found that 41% (23/56) cancers were better seen on tomosynthesis and 4% (2/56) were only seen on tomosynthesis. The majority of the cancers seen better or only on tomosynthesis  presented as masses rather than as calcifications alone which were better seen on 2D mammography. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Medical Research Centers / 26.06.2013

Dr. Karen E. Joynt, MD MPH  Cardiovascular Division Brigham and Women's Hospital and VA Boston Healthcare System Department of Health Policy and Management, Harvard School of Public HealthMedicalResearch.com Interview with Dr. Karen E. Joynt, MD MPH Cardiovascular Division Brigham and Women's Hospital and VA Boston Healthcare System Department of Health Policy and Management, Harvard School of Public Health MedicalResearch.com: What are the main findings of the study? Dr. Joynt:  The main findings of the study were two-fold. First, high-cost patients in Medicare (the top decile of spenders) are responsible for about 80% of inpatient spending in the Medicare program, so understanding more about these patients' patterns of care is really important. Second, we found that only about 10% of acute-care spending for these high-cost Medicare patients were for causes that we generally think of as preventable in the short term, like uncontrolled diabetes, COPD, or heart failure. The rest of the spending was for acute conditions that we generally don't think of as preventable (at least in the short term), such as orthopedic procedures, sepsis, and cancer. (more…)
Author Interviews, Heart Disease, JAMA, Yale / 25.06.2013

Dr. Kumar Dharmarajan MD MBA  Yale School of Medicine Center for Outcomes Research & Evaluation (CORE)Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart FailureMedicalResearch.com  Interview with Dr. Kumar Dharmarajan MD MBA

Yale School of Medicine Center for Outcomes Research & Evaluation (CORE)Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart Failure MedicalResearch.com: What are the main findings of the study? We found that among a large contemporary cohort of heart failure hospitalizations, beta blockers are frequently started in patients with markers of clinical instability such as residence in an intensive care unit (ICU), volume overload requiring intravenous diuresis, and poor cardiac output requiring intravenous inotropes. Approximately 40% of patients in whom a beta blocker is started has at least one of these three potential contraindications to treatment. This finding is concerning, as recent performance measures for heart failure recommend that a beta blocker be started during hospitalization for heart failure among patients with left ventricular systolic dysfunction. However, these performance measures also state that persons in whom a beta blocker is started "should not be hospitalized in an ICU, should have no or minimal evidence of fluid overload or volume depletion, and should not have required recent treatment with an intravenous positive inotropic agent." Moving forward, we are concerned that the unselective application of the new performance measure may lead to the further use of beta blocker therapy in patients at higher risk for adverse consequences of therapy. (more…)
Brigham & Women's - Harvard, General Medicine, Medical Research Centers / 20.06.2013

Dr. Susan Redline M.D.,M.P.H. Peter C. Farrell Professor of Sleep Medicine at Harvard Medical School Brigham and Women's Hospital 221 Longwood Ave., Boston, MA 02115MedicalResearch.com Interview with: Dr. Susan Redline M.D.,M.P.H. Peter C. Farrell Professor of Sleep Medicine at Harvard Medical School Brigham and Women's Hospital 221 Longwood Ave., Boston, MA 02115 MedicalResearch.com: What are the main findings of the study? Dr. Redline: Among children with sleep apnea, early adenotonsillectomy  resulted in significant improvements in breathing during sleep, daytime behavior, sleep related symptoms, sleepiness and quality of life when we valuated 6 months after surgery. MedicalResearch.com:  Were any of the findings unexpected? (more…)
Author Interviews, McGill, Nutrition, Probiotics, Vitamin D / 20.06.2013

MedicalResearch.com Interview with: Dr. Mitchell Jones, MD, PhD Faculty of Medicine at McGill University in MontrealDr. Mitchell Jones, MD, PhD Faculty of Medicine at McGill University in Montreal MedicalResearch.com: What are the main findings of the study? Dr. Jones: We had previously reported on the cholesterol lowering efficacy of bile salt hydrolase active L. reuteri NCIMB 30242 due to reduced intestinal sterol absorption. However, the effects of bile salt hydrolase active L. reuteri NCIMB 30242 on fat soluble vitamins was previously unknown and was the focus of the study. (more…)
Author Interviews, Brigham & Women's - Harvard, Medical Research Centers, Sleep Disorders / 17.06.2013

MedicalResearch.com Interview with Yanping Li, PhD Brigham and Women's Hospital and Harvard Medical School Department of Medicine Channing Division of Network Medicine Boston, MA MedicalResearch.com: What are the main findings of the study? Answer: During 8 years of follow-up, we observed that men with RLS had a 30% increased risk of death. MedicalResearch.com: Were any of the findings unexpected? Answer: Based on our hypothesis, we would like to observed a higher risk of death from cardiovascular diseases, but we do not. (more…)
Author Interviews, Insomnia, Johns Hopkins, Sleep Disorders / 12.06.2013

Hemodialysis.com Interview with: Christopher Kaufmann, MHS Department of Mental Health, Johns Hopkins Bloomberg School of Public Health Hampton House, Room 800 624 North Broadway Baltimore, MD 21205 email: [email protected] MedicalResearch.com: What are the main findings of the study? Mr. Kaufmann:  The purpose of our study was to examine the association between insomnia and the use of a number of costly health services.  We used data from the Health and Retirement Study, a large nationally representative longitudinal population-based study of US middle-aged and older adults.  We found that individuals who reported a greater number of insomnia symptoms were more likely to report being hospitalized, using home healthcare services, and using nursing homes two years later.  After we accounted for a number of demographic and clinical characteristics, the association between number of reported insomnia symptoms and hospitalization remained statistically significant. (more…)