Author Interviews, JAMA, Outcomes & Safety, University of Michigan / 03.02.2015

Nicholas Osborne, M.D., M.S Vascular Surgery Fellow University of Michigan, Ann Arbor MedicalResearch.com: What is the background for this study? Dr. Osborne: The American College of Surgeons launched the National Surgical Quality Improvement Program (ACS-NSQIP) in the early 2000s. This program collects and reports surgical outcomes to participating hospitals. One retrospective study of participating hospitals in the ACS-NSQIP reported improvements in risk-adjusted outcomes with participation. This study, however, did not compare ACS-NSQIP hospitals to control hospitals. The purpose of our study was to compare ACS-NSQIP to similar non-participating hospitals over time and determine whether participation in the ACS-NSQIP was associated with improved outcomes. MedicalResearch.com: What are the main findings? Dr. Osborne: When comparing hospitals participating in a national quality reporting program (ACS-NSQIP) to similar hospitals, there is no appreciable improvement in outcomes (mortality, morbidity, readmissions or cost)  outside of pre-existing trends across all hospitals. In other words, Hospitals nationwide were improving over this same time period and ACS-NSQIP hospitals did not improve above and beyond these existing trends. (more…)
Author Interviews, Diabetes, Nature, University of Michigan / 23.01.2015

MedicalResearch.com Interview with: Martin G. Myers, Jr., M.D., M.P.H. Director, Michigan Diabetes Research & Training Center Associate Professor of Internal Medicine - MEND Division Professor of Molecular & Integrative Physiology Marilyn H. Vincent Professor of Diabetes Research and Department of Pharmacology, University of Cambridge, Cambridge, UK.MedicalResearch.com Interview with: Martin G. Myers, Jr., M.D., M.P.H. Director, Michigan Diabetes Research & Training Center Associate Professor of Internal Medicine - MEND Division Professor of Molecular & Integrative Physiology Marilyn H. Vincent Professor of Diabetes Research and Department of Pharmacology, University of Cambridge, Cambridge Medical Research: What is the background for this study? What are the main findings? Dr. Myers: Diabetic people who take insulin to treat their diabetes are at risk of low blood sugar, which can cause serious consequences (including death).  This risk increases as blood sugar control improves, and so this risk limits the ability to control blood sugar.  The body has a system (the counter-regulatory response) that acts to prevent blood sugar from going too low, but this is often impaired in diabetic patients. We identified a brain circuit that senses and responds to falling blood sugar, and which acts to increase blood sugar.  Furthermore, we showed that the hormone leptin modulates the sensitivity of this circuit, and identified the neurotransmitter (CCK) that acts in this circuit to increase blood sugar.  Thus, we have identified several potential drug targets that could be used to prevent or treat low blood sugar in insulin-treated diabetics.  If we are able to pharmacologically modulate the activity of this brain circuit, it could improve the treatment of these patients. (more…)
Author Interviews, Endocrinology, Toxin Research, University of Michigan / 21.01.2015

Vasantha Padmanabhan, MS, PhD Professor, Departments of Pediatrics, Obstetrics and Gynecology, Molecular and Integrative Physiology, and Environmental Health Sciences University of Michigan Ann Arbor, Mi 48109MedicalResearch.com Interview with: Vasantha Padmanabhan, MS, PhD Professor, Departments of Pediatrics, Obstetrics and Gynecology, Molecular and Integrative Physiology, and Environmental Health Sciences University of Michigan Ann Arbor, Mi 48109 Medical Research: What is the background for this study? What are the main findings? Response: Controversy exists regarding the human health effects of bisphenol A (BPA), an endocrine-disrupting industrial chemical, present in plastic products, baby bottles, food can liners, and wide array of paper products including cash receipts. BPA has been linked to adverse metabolic effects, including obesity, diabetes and cardiac disease.  This study examined if exposure to bisphenol A during pregnancy, at levels humans are exposed to, induces oxidative stress, a major contributor to the development of insulin resistance, type 2 diabetes, metabolic syndrome, and cardiovascular disease. Findings from this multi species study show an association between higher maternal- and cord-blood BPA levels and 3-nitrotyrosine Y (NY), a marker of oxidative stress, in 24 pregnant women. Similar effect on oxidative stress was also found when human-comparable BPA doses were given to pregnant sheep and rats. Similarity of findings between BPA exposure and oxidative stress in the human association study and animals testing study raises concern about potential risk of BPA later in life. (more…)
Author Interviews, Cancer Research, University of Michigan / 04.12.2014

MedicalResearch.com Interview with: Silvana Papagerakis M.S., M.D., Ph.D. Research Assistant Professor, Department of Otolaryngology-Head and Neck SurgeryDirector, Oral, Head and Neck Cancer Invasion and Metastasis Laboratory Ann Arbor MI Silvana Papagerakis M.S., M.D., Ph.D. Research Assistant Professor, Department of Otolaryngology-Head and Neck Surgery Director, Oral, Head and Neck Cancer Invasion and Metastasis Laboratory, Ann Arbor MI MedicalResearch: What is the background for this study? What are the main findings? Dr. Papagerakis: We had suspicions that these medications somehow had a favorable impact on patient outcomes. This led us to review our large cohort of patients and screen them for common medications, focusing on antacids. In fact, our study did show that people taking antacids are doing better. What this study makes clear is that these medications may be more beneficial to the patients than just controlling side effects of chemotherapy or radiation treatment for head and neck cancer. (more…)
Author Interviews, Nutrition, University of Michigan, Weight Research / 19.11.2014

MedicalResearch.com Interview with: Yvonne M. Terry-McElrath, MSA Research Associate, Survey Research Center, Institute of Social Research University of Michigan Tobacco Research Center Medical Research: What is the background for this study? What are the main findings? Dr. Terry-McElrath: The United States Department of Agriculture (USDA) recently improved nutrition standards for federally-reimbursable school lunch and breakfast programs. Most lunch standards were implemented at the beginning of the 2012-13 school year and changes in breakfast began with the 2013-14 school year. Beginning in 2014, schools participating in federally-reimbursable meal programs were also required to improve nutrition standards for foods and beverages sold in vending machines, stores/snack bars/carts, and à la carte cafeteria lines. The new standards limit fats, sodium, sugar, and calories; and will eventually remove candy; regular-fat salty snacks/sugary treats; higher-fat milks; high-fat, high-calorie savory foods; and sugar-sweetened beverages, like regular soda, fruit drinks and high calorie sports drinks. They were developed in response to rising overweight/obesity among US children and adolescents. This study uses five years of data from nationally-representative samples of middle and high school students—and their school administrators—to examine three research questions: What percentage of US secondary students attended schools in 2008-2012 where foods and beverages met at least some of the USDA standards that were to begin phased implementation starting in 2012-13? Is there evidence that those standards were associated with student overweight/obesity? Is there evidence of the effect of those standards on racial/ethnic minorities and students from lower income families? Using data from schools even before the new USDA standards went into effect can indicate potential effect of the standards once they have been in effect for several years. The research was conducted through two studies: The Monitoring the Future study, supported by a grant from the National Institute on Drug Abuse, and the Youth, Education and Society study, part of a larger research initiative funded by the Robert Wood Johnson Foundation, titled “Bridging the Gap: Research Informing Policy and Practice for Healthy Youth Behavior.” Study findings show that from 2008-2012, few middle or high school students attended schools where food and beverage standards would be judged to meet at least some of the USDA school nutrition standards that began to be implemented in 2012-13. Significant increases in the number of standards over time were seen for middle but not high school students. Among high school students, having fruits and vegetables available wherever foods were sold, the absence of higher-fat milks, and increasing the number of positive nutrition standards were associated with significantly lower odds of overweight/obesity. Not having sugar-sweetened beverages was associated with lower overweight/obesity for middle and high school minority students. (more…)
Author Interviews, Esophageal, JAMA, University of Michigan / 01.10.2014

Megan A. Adams, MD Gastroenterology Fellow University of MichiganMedicalResearch.com Interview with Megan A. Adams, MD Gastroenterology Fellow University of Michigan   Medical Research: What are the main findings of the study? Dr. Adams: Surveys of doctors indicate that their fear of a malpractice lawsuit for missing a diagnosis of esophageal cancer might drive the overuse of tests called upper endoscopies in patients who are at low risk for the cancer. To examine whether this perception of medical liability risk accurately reflects the real likelihood of a malpractice claim, we looked at a national database of malpractice claims, and compared the rate of claims for delay in diagnosis of esophageal cancer in patients without alarm symptoms (weight loss, dysphagia, iron deficiency anemia), with the rate of claims alleging performance of an upper endoscopy without a good reason for performing the procedure. The database contained 278,220 claims filed against physicians in 1985-2012. The incidence of reported medical liability claims for failure to screen for esophageal cancer in patients without alarm features was quite low (19 claims in 11 years, 4 paid). In contrast, there were 17 claims in 28 years for complications of upper endoscopies with questionable indication (8 paid). (more…)
Author Interviews, Telemedicine, University of Michigan / 15.09.2014

Rashid Bashshur, PhD Senior Advisor for eHealth Professor Emeritus, Department of Health Management and Policy Executive Director, UMHS eHealth Center University of Michigan Health SystemMedicalResearch.com Interview with:  Rashid Bashshur, PhD Senior Advisor for eHealth Professor Emeritus, Department of Health Management and Policy Executive Director, UMHS eHealth Center University of Michigan Health System Medical Research: What are the Main findings of the study? Dr. Bashshur: The main findings can be summarized as follows:
  •  The prevalence of chronic disease is increasing due to the changing demographic composition of the population and unhealthy life styles. Chronic diseases are expensive, accounting for about 70% of health care expenditures;  but  they are amenable to telemedicine interventions.  These interventions consist of ongoing monitoring of patients living in their own home environments, engaging them in managing their health,  providing them with educational materials and the necessary tools to manage their life style mostly by avoiding risky behaviors and adopting healthy ones.
  • Telemedicine interventions consist of various configurations of technology (telephone, video, wired or wireless, automated or manual) , human resources (physicians, nurses, combinations, and patient populations at various levels risk levels or severity of illness, The interventions investigated to date also vary in terms of study design, duration of application (during the study period), and frequency of administration of the intervention.  Hence, the findings must be viewed from the perspective of the specific methodological attributes  of the studies that were performed.
  • Using only robust studies from 2000 to the near present, and limited to congestive heart failure, stroke and COPD.  With notable exceptions,  overall there is substantial and fairly consistent evidence of:
  • A decrease in use of service, including hospitalization, rehospitalization, and emergency depart visits as a result of the telemedicine intervention.
  • Improved health outcomes.
  • Improved event timing for stroke patients.
  • Reduced exacerbations of symptoms for COPD patients
  • Some interesting  trends  to be considered:
  • Frail and elderly patients, those with co-morbid conditions, and those in advanced stages of illness are not likely to benefit from telemedicine interventions, as compared to their counterparts.
  • Visual information as in videoconferencing proved superior to telephone only connection for the diagnosis and treatment of stroke patients.
  • There could be a tradeoff between extra nursing time versus reduced physician time in some settings, but the net effect is cost savings.
  • There seems to be a paradoxical telemedicine effect in terms of increasing longevity but no reduction in hospitalization, reported in few studies.
(more…)
Author Interviews, Cancer Research, CHEST, Critical Care - Intensive Care - ICUs, University of Michigan / 22.06.2014

Colin R. Cooke, MD, MSc, MS; Assistant Professor of Medicine, Division of Pulmonary & Critical Care Medicine Faculty, Center for Healthcare Outcomes & Policy University of MichiganMedicalResearch.com Interview with: Colin R. Cooke, MD, MSc, MS; Assistant Professor of Medicine, Division of Pulmonary & Critical Care Medicine Faculty, Center for Healthcare Outcomes & Policy University of Michigan MedicalResearch: What are the main findings of the study? Dr. Cooke: There were three primary findings from our study. First, we determined that between 1992 and 2005 there was almost a 40% increase in the number of admissions to an intensive care unit (ICU) among patients with lung cancer who were hospitalized for reasons other than surgical removal of their cancer. Second, most of this increase was because doctors were admitting these patients to intermediate intensive care units. These are units that provide greater monitoring and nurse staffing than typically available in general hospital wards, but usually also have less ability to provide life support measures than full service ICUs. Third, over the same period the reasons for ICU admission have changed. Although the most common reason for admission continues to be for problems related to the patients’ lung cancer, problems such as breathing difficulties requiring a ventilator and severe infections are increasingly common. These findings suggest that although overall use of the ICU for patients with lung cancer is increasing over time, providers may be shifting some of the intensive care for lung cancer patients toward less aggressive settings such as the intermediate care unit. (more…)
Author Interviews, Gastrointestinal Disease, NEJM, Pain Research, University of Michigan / 11.06.2014

William D. Chey, MD, AGAF, FACG, FACP, RFF Professor of Medicine Director, GI Physiology Laboratory Co-director, Michigan Bowel Control Program University of Michigan Health SystemMedicalResearch.com Interview with: William D. Chey, MD, AGAF, FACG, FACP, RFF Professor of Medicine Director, GI Physiology Laboratory Co-director, Michigan Bowel Control Program University of Michigan Health System MedicalResearch: What are the main findings of the study? Dr. Chey: Opiate analgesics are the most commonly prescribed medications in the US. GI side effects are common in patients who opiates. Constipation is the most common and most bothersome GI side effect of opiates. Peripherally acting mu opioid antagonists have been shown to benefit a subset of patients with opiate induced constipation. In 2 large, randomized, placebo controlled phase III trials, the peripherally acting, mu-opioid antagonist naloxegol was found to improve constipation in patients taking opioid analgesics for noncancer pain. Response rates were significantly higher with 25 mg of naloxegol than with placebo (intention-to-treat population: study 04, 44.4% vs. 29.4%, P = 0.001; study 05, 39.7% vs. 29.3%, P = 0.02) in both studies. Benefits were seen with the lower 12.5 mg dose in one of the studies (intention-to-treat population, 40.8% vs. 29.4%, P = 0.02). An interesting aspect of this study was the a priori inclusion of patients who had tried and failed to respond to other laxatives prior to enrollment. Response rates in this population were similar to the overall population (patients with an inadequate response to laxatives: study 04, 48.7% vs. 28.8%, P = 0.002; study 05, 46.8% vs. 31.4%, P = 0.01). Pain scores and daily opioid dosing were similar among the three groups before and after treatment. (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…)
Author Interviews, Genetic Research, Lipids, University of Michigan / 19.03.2014

dr_cristen_j_willerMedicalResearch.com Interview with: Cristen J. Willer, PhD Assistant Professor Division of Cardiovascular Medicine, Dept of Internal Medicine Dept of Human GeneticsDept of Computational Medicine and Bioinformatics University of Michigan Ann Arbor, MI 48109-5618 MedicalResearch.com: What are the main findings of the study? Dr. Willer: We wanted to find new genes related to heart disease, so we examined the DNA of approximately 10,000 Norwegian individuals and found 10 genes that are important regulators of blood cholesterol levels. Nine of these were well known to be related to lipids, but one gene was new.  It turned out to be in a region we'd previously noticed to be related to cholesterol, but it was a big region and we hadn't been able to pinpoint the gene yet.  Using this new approach, focusing on DNA differences that result in slightly different proteins in people, we zeroed in on the gene.  We then altered this gene in mice, and saw the predicted changes in cholesterol levels in mice. (more…)
Alzheimer's - Dementia, Author Interviews, PNAS, University of Michigan / 19.03.2014

Yanzhuang Wang, PhD Associate professor Dept. of Molecular, Cellular and Developmental Biology and Dept. of Neurology University of Michigan Ann Arbor, MI 48109-1048MedicalResearch.com Interview with: Yanzhuang Wang, PhD Associate professor Dept. of Molecular, Cellular and Developmental Biology and Dept. of Neurology University of Michigan Ann Arbor, MI 48109-1048  MedicalResearch.com: What are the main findings of the study? Dr. Wang: We learned how to repair a cellular structure called the Golgi apparatus that is broken in Alzheimer’s disease. This helps us understand how to reduce the formation of the toxic plaques that kill cells in the brain of Alzheimer's patients. The formation of amyloid plaques is a hallmark of Alzheimer’s disease; but exactly how much the plaques contribute to the disease is still not known. Our study found that the broken Golgi in the disease may be a major source of the toxicity of amyloid plaques. We showed in this study that repairing the Golgi can reduce the formation of the toxic plaques and thus may delay the disease development. (more…)
Author Interviews, Cost of Health Care, JAMA, Pain Research, Pharmacology, Radiology, University of Michigan / 17.03.2014

Dr. Brian C. Callaghan MD Department of Neurology University of Michigan Health System, Ann ArborMedicalResearch.com Interview Invitation with: Dr. Brian C. Callaghan MD Department of Neurology University of Michigan Health System, Ann Arbor MedicalResearch.com: What are the main findings of the study? Dr. Callaghan:  The main findings are that we order headache neuroimaging (MRIs and CTs) frequently, this accounts for approximately $1 billion dollars annually, and the number of tests ordered is only increasing with time. (more…)
AHA Journals, Author Interviews, Race/Ethnic Diversity, Stroke, University of Michigan / 14.03.2014

Lynda D. Lisabeth, PhD Interim Chair and Associate Professor Department of Epidemiology University of Michigan Ann Arbor, MichiganMedicalResearch.com Interview with: Lynda D. Lisabeth, PhD Interim Chair and Associate Professor Department of Epidemiology University of Michigan Ann Arbor, Michigan MedicalResearch.com: What are the main findings of the study? Dr. Lisabeth: The main findings were that Mexican Americans scored worse than non-Hispanic whites on all outcomes measured at 90 days following stroke, including neurologic, functional and cognitive outcomes, after adjustment for confounding factors. Further, we found that one-third of Mexican American stroke survivors have post-stroke dementia. Mexican Americans experienced more aphasia than non-Hispanic whites. Levels of functional impairment were substantial, with Mexican Americans on average experiencing moderate functional disability. Mexican Americans reported significantly greater difficulty than non-Hispanic whites with all activities of daily living (ADLs) and instrumental activities of daily living (IADLs) that were studied. (more…)
Author Interviews, BMJ, Cancer Research, University of Michigan / 04.03.2014

Sameer Saini MD Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USAMedicalResearch.com Interview with: Sameer Saini MD Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA MedicalResearch.com: What are the main findings of the study? Dr. Saini: The way that quality measures are defined can have important implications for how care is actually delivered. Current colorectal cancer screening quality measures use age to identify screen-eligible patients, encouraging screening in patients between 50 and 75 years of age. But they do not explicitly incorporate health status. In this context, our study had two main findings.
  • First, by focusing on age alone, we are not screening everyone who is likely to benefit. Specifically, many healthy people over 75 years of age (who are outside the target age range of the quality measure) may benefit from screening, but the current measure does not encourage screening in this population, leading to low screening use.
  • Second, some people who are NOT likely to benefit are being screened unnecessarily, like those with serious health problems. For example, people between ages 70-75 with serious health problems (who have limited life expectancy) are unlikely to benefit from screening, and may even be harmed by it. But the current quality measure encourages screening in such individuals due to their age, yielding relatively high screening rates. If the system focused on age and health status (rather than age alone), screening use would be more aligned with screening benefit, and we would have better health outcomes.
(more…)
General Medicine, JAMA, University of Michigan / 19.02.2014

Dr. David Hanauer, MD Associate Professor, University of Michigan Medical School 1500 East Medical Center Drive Ann Arbor, MI 48109-5940MedicalResearch.com Interview with: Dr. David Hanauer, MD Associate Professor, University of Michigan Medical School 1500 East Medical Center Drive Ann Arbor, MI 48109-5940 MedicalResearch.com: What are the main findings of the study Dr. Hanauer: From my perspective, the primary findings were that 65% of the general public is now aware of physician rating web sites and among those who are aware, about 36% had used them in the prior year.  Awareness and usage seems to be rapidly increasing compared to what has been reported in prior studies from just a few years ago.  We also found that patients consider word of mouth recommendations (from family/friends) to be almost twice as important as ratings sites are. (more…)
Author Interviews, Colon Cancer, General Medicine, PLoS, University of Michigan, Weight Research / 09.02.2014

Jenifer I Fenton Assistant Professor Department of Food Science and Human Nutrition Michigan State University East Lansing, MI 48824MedicalResearch.com Interview with: Jenifer I Fenton Assistant Professor Department of Food Science and Human Nutrition Michigan State University East Lansing, MI 48824 MedicalResearch.com: What are the main findings of the study? Dr. Fenton: This was a cross-sectional study, and thus, a snapshot in time. Although it cannot infer cause or temporality of obesity and colon polyp risk in men, it does show that obese men were more likely to have a polyp than their lean counterpart. In addition, there were serum biomarkers also associated with this risk. This could eventually lead to future blood tests to identify individuals at greater risk for polyps and inform screening recommendations. (more…)
Author Interviews, JAMA, Nutrition, Pediatrics, University of Michigan / 14.01.2014

Yvonne M. Terry-McElrath, MSA Institute for Social Research, University of Michigan, Ann ArborMedicalResearch.com Interview with: Yvonne M. Terry-McElrath, MSA Institute for Social Research, University of Michigan, Ann Arbor MedicalResearch.com: What are the main findings of the study? Answer: This study examined 2007-2012 commercialism trends in schools attended by nationally representative samples of US elementary and secondary students. While some measures showed significant decreases over time (especially beverage vending measures), most students at both elementary and secondary school levels continued to be exposed to school-based commercialism. Commercialism increased significantly with grade level. The most frequent type of commercialism varied by school level:  food coupons used as incentives was most common at the elementary school level, while exclusive beverage contracts were the most prevalent type of commercialism for middle and high school students. (more…)
Author Interviews, Breast Cancer, Nutrition, Pediatrics, University of Michigan / 01.12.2013

Richard Schwartz, Ph.D. Professor, Associate Dean for Graduate Academic and Student Affairs College of Natural Science Michigan State University Department of Microbiology and Molecular Genetics Michigan State University East Lansing, MI 48824-4320MedicalResearch.com Interview with: Richard Schwartz, Ph.D. Professor, Associate Dean for Graduate Academic and Student Affairs College of Natural Science Michigan State University Department of Microbiology and Molecular Genetics Michigan State University East Lansing, MI 48824-4320 MedicalResearch.com: What are the main findings of the study? Dr. Schwartz: The main finding is that exposure to a high fat diet from the age of puberty onwards hastened the development of chemical carcinogen-induced breast cancer in absence of weight gain. We also found that prior to the appearance of any tumors, we could detect changes in the mammary gland that included increased cellular proliferation, increased vascularity, and changes in immune function. (more…)
Antioxidants, Author Interviews, Hearing Loss, Nutrition, University of Michigan / 12.11.2013

http://ajcn.nutrition.org/content/early/2013/11/06/ajcn.113.068437.abstractMedicalResearch.com Interview with: Sung Kyun Park, Sc.D., M.P.H Assistant Professor, Epidemiology Assistant Professor, Environmental Health Sciences Departments of Epidemiology and Environmental Health Sciences University of Michigan School of Public Health Ann Arbor, MI MedicalResearch.com: What are the main findings of the study?
 Answer: This study reports that persons who eat more dietary antioxidants (beta carotene and vitamin C) or magnesium have a lower risk of hearing loss. This finding was seen in the levels currently observed in the general US population and independent of demographic and socioeconomic factors, noise exposures from workplaces, recreations or firearms, and other potential risk factors. (more…)
Author Interviews, Blood Pressure - Hypertension, University of Michigan / 05.11.2013

Jeremy Sussman, MD, MS Division of General Internal Medicine University of Michigan Staff Scientist, Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare SystemMedicalResearch.com Interview with: Jeremy Sussman, MD, MS Division of General Internal Medicine University of Michigan Staff Scientist, Center for Clinical Management Research Ann Arbor Veterans Affairs Healthcare System MedicalResearch.com: What are the main findings of the study? Dr. Sussman: We could prevent up to 180,000 more heart attacks and strokes in America every year using less medication overall. (more…)
Cost of Health Care, Emergency Care, Pediatrics, University of Michigan / 20.10.2013

Adrianne Haggins, MD, MS University of Michigan Health System Department of Emergency Medicine Ann Arbor, MI 48109-5303MedicalResearch.com Interview with: Adrianne Haggins, MD, MS University of Michigan Health System Department of Emergency Medicine Ann Arbor, MI  48109-5303 MedicalResearch.com: What are the main findings of the study? Dr. Haggins: Since the implementation of the Children’s Health Insurance Program (CHIP) in 1997, the last national health care reform that broadly expanded insurance coverage, adolescent use of primary care and specialty care has increased substantially in comparison to no change seen among the comparison group (young adults, who were not covered).  Broadening insurance coverage for adolescents did not result in a decrease in emergency department use, while ED use in the comparison group increased over time.   (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare, Race/Ethnic Diversity, University of Michigan, Weight Research / 25.09.2013

Dr. Lauren Hersch Nicholas Ph.D Research Affiliate, Population Studies Center. Faculty Research Fellow, Survey Research Center University of MichiganMedicalResearch.com Interview Invitation Dr. Lauren Hersch Nicholas Ph.D Research Affiliate, Population Studies Center. Faculty Research Fellow, Survey Research Center University of Michigan MedicalResearch.com: What are the main findings of the study? Dr. Nicholas: We found that a Medicare policy designed to improve the safety of bariatric surgery was associated with 17% decline in the share of Medicare patients from minority groups receiving bariatric surgery. (more…)
Author Interviews, CMAJ, Orthopedics, Pain Research, University of Michigan / 19.09.2013

Chad M. Brummett, M.D. Assistant Professor, University of Michigan Health System Department of Anesthesiology Division of Pain Medicine 1500 East Medical Center Drive, 1H247 UH, Box 5048 Ann Arbor, MI 48109MedicalResearch.com Interview with: Chad M. Brummett, M.D. Assistant Professor, University of Michigan Health System Department of Anesthesiology Division of Pain Medicine 1500 East Medical Center Drive, 1H247 UH, Box 5048 Ann Arbor, MI 48109 MedicalResearch.com:  What are the main findings of the study? Dr. Brummett: The study found that 42% of new patients presenting to a tertiary care pain clinic with a primary spine pain diagnosis met the American College of Rheumatology (ACR) survey criteria for fibromyalgia, which is a measure of widespread body pain and comorbid symptoms (e.g. trouble thinking, fatigue, mood symptoms, etc.).  Patients categorized as fibromyalgia-positive using the survey measure were distinctly different from those not meeting criteria.  In a multivariate regression model, independent predictors of being categorized as fibromyalgia-positive were female sex, higher neuropathic pain scores, anxiety, and lower physical function. (more…)
Case Western, Esophageal, Gastrointestinal Disease, University of Michigan / 11.09.2013

Joel H. Rubenstein, MD, MSc, FACG, FASGE Research Scientist, Veterans Affairs Center for Clinical Management Research Assistant Professor, Division of Gastroenterology, University of Michigan Medical School VA Medical Center 111-D 2215 Fuller Rd. Ann Arbor, MI 48105MedicalResearch.com Interview with: Joel H. Rubenstein, MD, MSc, FACG, FASGE Research Scientist, Veterans Affairs Center for Clinical Management Research Assistant Professor, Division of Gastroenterology, University of Michigan Medical School VA Medical Center Ann Arbor, MI 48105 MedicalResearch.com: What are the main findings of the study? Dr. Rubenstein: In a set of case-control studies within the same population, we found that H. pylori was inversely associated with erosive esophagitis, and with Barrett’s esophagus, but we did not find such a relation with symptoms of gastroesophageal reflux disease (GERD). (more…)
Author Interviews, Kidney Disease, University of Michigan / 03.09.2013

Afshinnia, Farsad, M.D., M.S. Research Fellow and Clinical Lecturer Department of Nephrology University of Michigan Health System MedicalResearch.com: What are the main findings of the study? Answer: Spontaneous Renal Artery Dissection (SRAD) is most commonly observed in middle aged individuals. Although SRAD can have no association with other comorbidities at the time of presentation, we have noticed association with a number of systemic disorders such as hypertension, cancer, congestive heart failure, and rheumatologic diseases. In particular clustering of Fibromascular dysplasia (FMD), Ehlers-Danlos syndrome, poly arteritis nodosa, Poland syndrome, and nail patella syndrome in our patients has been striking. The most commonly observed presenting symptom is sudden onset severe flank pain which may be spontaneous or following physical stress. Other presenting features may include uncontrolled hypertension, groin and/or testicular pain, headache, nausea, vomiting, fever, dysuria, hematuria and blurry vision. (more…)