Author Interviews, BMJ, Heart Disease / 09.07.2014

Philippe Pibarot, DVM, PhD, FAHA, FACC, FESC, FASE Professeur titulaire, Département de Médecine, Université Laval Professor, Department of Medicine, Laval University Directeur, Chaire de Recherche du Canada sur les Maladies Valvulaires Cardiaques Chair, Canada Research Chair in Valvular Heart Diseases Institut Universitaire de Cardiologie et de Pneumologie de QuébecQuébec Heart & Lung Institute - Local Y4165MedicalResearch.com Interview with : Philippe Pibarot, DVM, PhD, FAHA, FACC, FESC, FASE Professeur titulaire, Département de Médecine, Université Laval Professor, Department of Medicine, Laval University Directeur,  Chaire de Recherche du Canada sur les Maladies Valvulaires Cardiaques Chair,  Canada Research Chair in Valvular Heart Diseases Institut Universitaire de Cardiologie et de Pneumologie de QuébecQuébec Heart & Lung Institute - Local Y4165 Medical Research: What are the main findings of the study? Dr. Pibarot: The optimal timing of aortic valve replacement (AVR) in asymptomatic patients with severe aortic stenosis (AS) remains a matter of debates. Both the American and European guidelines recommend AVR for patients with severe AS who present with symptoms or left ventricular (LV) systolic dysfunction. However, patients with aortic stenosis are often older, less physically active and have more comorbidities, which make the assessment of AS-related symptoms challenging and unreliable. In this study by Capoulade et al, plasma levels of brain natriuretic peptide (BNP) were obtained in 157 patients with severe asymptomatic aortic stenosis and preserved LV ejection fraction at peak of exercise-stress echocardiography. Patients in the upper (>95 pg/ml) and mid (>45 pg/ml) tertiles of exercise BNP respectively had a 5- and 3- fold increase in the risk of events (i.e. AVR or death) compared to those in the lower tertile. Similar results were obtained in the subset of patients with low resting BNP. (more…)
Author Interviews, BMJ, Heart Disease / 07.07.2014

MedicalResearch.com Interview with: Dr Mohanraj K Karunanithi Research Team Leader | Integrated Mobile Health Systems The Australian e-Health Research Centre Digital Productivity and Services Flagship CSIRO Medical Research: What are the main findings of the study? Dr. Karunanithi:
  • 33% more clients completed the innovative home-based cardiac rehabilitation (CR) delivery using smartphone and the internet (Care Assessment Platform CR program) compared with the traditional centre-based cardiac rehabilitation program.
  • Care Assessment Platform-CR  was as effective as tradition CR program in improving physical activity, diet intake, and lowering depression
  • Care Assessment Platform -CR was also effective in reducing weight, and anxiety levels and more importantly, the overall health related quality of life.
(more…)
Author Interviews, BMJ, Heart Disease / 04.07.2014

MedicalResearch.com Interview with: Dr. Patrícia Lourenço Serviço de Medicina Interna, Centro Hospitalar São João Faculdade de Medicina da Universidade do Porto, Unidade I&D Cardiovascular do Porto Monteiro, Portugal; Medical Research: What are the main findings of the study? Dr. Lourenço: A low prealbumin at hospital discharge associates with morbidity and mortality in acute heart failure patients. The prognostic value of low prealbumin in heart failure is independent of other nutritional markers and of the inflammatory status. (more…)
Author Interviews, BMJ, Gender Differences, Mental Health Research / 01.07.2014

Dr. Flora I Matheson PhD Centre for Research on Inner City Health St. Michael's Hospital Toronto, ON, CanadaMedicalResearch.com Interview with: Dr. Flora I Matheson PhD Centre for Research on Inner City Health St. Michael's Hospital Toronto, ON, Canada MedicalResearch: What are the main findings of the study? Dr. Matheson:
  • We found that women were 10 per cent more likely to use mental health services than men.
  • And that within any 3-year period, women with physical illness used medical services for mental health treatment 6 months earlier than men.
(more…)
Allergies, Author Interviews, BMJ, Smoking / 29.06.2014

Dr. Wojciech Feleszko Department of Pediatric Respiratory Diseases and Allergy The Medical University of Warsaw Działdowska Warsaw, PolandMedicalResearch.com Interview with Dr. Wojciech Feleszko Department of Pediatric Respiratory Diseases and Allergy The Medical University of Warsaw Działdowska Warsaw, Poland MedicalResearch: What are the main findings of the study? Dr. Feleszko: We combined data from nineteen population-based cohort studies of 24 000 children and we found that household exposure to tobacco smoke after birth has immunomodulating effects.  We demonstrated an increased sensitivity to allergens, measured by serum IgE and skin testing which may contribute to the increased development of allergy in children exposed postnatally to household tobacco smoke. (more…)
Author Interviews, BMJ, Endocrinology, Weight Research / 27.06.2014

MedicalResearch.com Interview with: Mojca Jensterle Department of Endocrinology. Diabetes and Metabolic Diseases. University Medical Centre. Zaloska 7. Slovenia. MedicalResearch: What are the main findings of the study? Answer: This is the first report demonstrating that selective phosphodiesterase enzyme (PDE) 4 inhibitor roflumilast added to metformin (MET) was superior to metformin alone in reducing mean body weight after 12 weeks of treatment in obese women with polycystic ovary syndrome (PCOS), primarily due to a loss of fat mass. 31 women with PCOS diagnosed by the National Institute of Child Health and Human Development criteria aged 33.8 ± 7.4 years with BMI 36.4 ± 5.1 kg/m2concluded the study. They were randomized to MET 1000 mg BID or combined treatment (COM) with MET 1000 mg BID and roflumilast 500 mcg QD. The primary outcome were changes in anthropometric measures of obesity. At study endpoint subjects treated with COM lost on average 4.2 ± 2.8 kg compared to a 0.9± 2.5 kg weight gain in METgroup (p<0.001). BMI decreased for 1.6 ± 1.1 kg/m2 in COM arm compared to increase for 0.9 ± 2.4 kg/m2 in MET arm (p= 0.001). Total body fat decreased for 0.7±0.4 % in COM as opposed to 0.2 ± 0.1 % increase in MET and visceral adipose tissue (VAT) area as assessed by DXA decreased for 15.5 ± 1.6 cm2 in COM as opposed to 11.4 ± 5.3 cm2 increase in MET. The greater waist circumference reduction was noted in COM (4.2 ± 1 cm) compared with MET (0.8 ± 0.7 cm). The improvements of obesity measures were associated with beneficial effects on fasting glucose levels, insulin resistance and resolution of metabolic syndrome in affected women. The hypothesis behind the weight decrease and beneficial metabolic impact observed with roflumilast is based on the PDE4 regulation of signaling pathways linked to GLP-1 release. In experimental rodent model a single treatment with roflumilast enhanced plasma GLP-1 levels up to 2.5 -fold. (more…)
Author Interviews, BMJ, Disability Research / 27.06.2014

MedicalResearch:com Interview with: Stephen Honeybul FDS RCS (Eng), FRCS (SN), FRACS Consultant Neurosurgeon Sir Charles Gairdner Hospital HOD Royal Perth Hospital Perth WA Australia MedicalResearch: What are the main findings of this study?  Dr. Honeybul: Amongst those patients who had been adjudged severely disabled or in a vegetative state at 18 months, remained as such at the three years follow up. Most patients who were able to provide a response said that they would have provided consent to the "life saving" intervention even if they had known their final outcome (more…)
Author Interviews, BMJ, Infections, Pediatrics, Vaccine Studies / 25.06.2014

Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UKMedicalResearch.com: Interview with Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UK MedicalResearch: What are the main findings of the study? Dr. Wang: We have found evidence of recent whooping cough infection in 1 in 5 school age children who see their doctor with a persistent cough and in 1 in 6 children who have been fully vaccinated against whooping cough.  We have also shown that whooping cough can still cause clinically significant cough in fully vaccinated children. (more…)
Author Interviews, BMJ, Mental Health Research / 23.06.2014

Grégoire Rey Directeur du CépiDc CépiDc-Inserm Hopitâl Bicêtre FranceMedicalResearch.com Interview with: Grégoire Rey Directeur du CépiDc CépiDc-Inserm Hopitâl Bicêtre France MedicalResearch: What are the main findings of the study? Dr. Rey: We found that, between 2000 and 2010, unemployment and suicide rates were globally associatedin eight Western European countries (Austria, Finland, France, Germany, the Netherlands, Spain, Sweden, and the UK). However, this ecological association was weak (0.3% increase in suicide rate for a 10% increase in unemployment rate). Across countries, it was inconsistently confounded by the effect of other concomitant features of the economic crisis. MedicalResearch: Were any of the findings unexpected? (more…)
ADHD, Author Interviews, BMJ, Karolinski Institute / 19.06.2014

Dr. Henrik Larsson PhD Associate Professor Department of Medical Epidemiology and Biostatistics Karolinska Institute Stockholm, SwedenMedicalResearch.com Interview with: Dr. Henrik Larsson PhD Associate Professor Department of Medical Epidemiology and Biostatistics Karolinska Institute Stockholm, Sweden MedicalResearch: What are the main findings of the study? Dr. Larrson: We found no evidence for an overall increased rate of suicide related events associated with the use of stimulant or non-stimulant drug treatment for ADHD. If anything, the results pointed to a potential protective effect of drugs for ADHD on suicidal behaviour, particularly for stimulant drugs. (more…)
Author Interviews, BMJ, Heart Disease, Pharmacology / 17.06.2014

MedicalResearch.com Interview with: Professor June-Hong Kim, Division of Cardiology Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital Yangsan, South Korea; MedicalResearch: What are the main findings of the study? Dr. Kim: In vasospastic angina, the cilostazol group significantly reduced relative ireduction of of weekly incidence of chest pain compared with placebo group (−66.5±88.6% vs −17.6±140.1%, respectively, p=0.009).. Other clinical parameters such as a change in the frequency of chest pain (−3.7±0.5 vs −1.9±0.6, respectively, p=0.029), a change in the chest pain severity scale (−2.8±0.4 vs −1.1±0.4, respectively, p=0.003), and the proportion of chest pain-free patients (76.0% vs 33.3%, respectively, p=0.003) also significantly favored cilostazol. (more…)
Author Interviews, BMJ, Heart Disease / 17.06.2014

MedicalResearch.com Interview with Prof. Julia I. Newton: Dean of Clinical Medicine & Professor of Ageing and Medicine Clinical Academic Office The Medical School Newcastle University MedicalResearch: What are the main findings of the study? Prof. Newton: In this study we have explored for the first time the characteristics of patients with Postural tachycardia in the UK
  • Postural Tachycardia Syndrome  patients are predominantly female, young, well educated and have significant and debilitating symptoms that impact significantly upon their quality of life.
  • Despite this, there is no consistent treatment, high levels of disability and associated comorbidity.
  • Although individuals presented with symptoms at the same age, those attending a specialist clinic received a diagnosis quicker.
  • Symptom burden for those with Postural tachycardia is high and comparable to that seen in Chronic Fatigue Syndrome.
  • Chronic Fatigue Syndrome is recognized by the WHO as a neurological disorder and by the Disability Discrimination Act 2005 as a disability. At the current time those with Postural Tachycardia Syndrome  suffer to the same extent as those with Chronic Fatigue Syndrome but do not receive the same protection from the law.
  • It is important that more work is done to understand the underlying autonomic abnormality in those with Postural Tachycardia Syndrome in order to allow us to develop targeted treatments that are effective and go beyond the currently available simply symptomatic management.
(more…)
Author Interviews, BMJ, Weight Research / 16.06.2014

Gerard Ngueta Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre, Québec Québec, CanadaMedicalResearch.com Interview with: Gerard Ngueta Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre, Québec Québec, Canada MedicalResearch: What are the main findings of the study? Answer: The main findings of our study are as follows : 1- Contrary to body mass index (BMI), the waist circumference alone (which indicate central obesity or fat distribution) is not associated with cardiometabolic factors under study (i.e., insulin, triglycerides, systolic blood pressure and high-density lipoproteins levels). Thus, the apparent association –as found in previous studies- appears to be mediated through overall obesity (i.e., BMI). In the other words, the association observed in the previous studies between waist circumference and the cardiometabolic risk factors cited above could be mainly due to the strong correlation between waist circumference and BMI. 2- It is possible to estimate the independent contribution of overall fat and central fat on cardiometabolic risk factors by applying the residual model as previously suggested by Willet and Stampfer. (more…)
Author Interviews, BMJ, Mental Health Research / 12.06.2014

MedicalResearch.com Interview with: Emma Maund, PhD student Nordic Cochrane Centre Copenhagen, Denmark

MedicalResearch: What are the main findings of the study:

Answer: For statisticians to analyse adverse events recorded in a clinical trial, it is necessary that events described by the original investigators are coded to terms in a specialised medical coding dictionary. Our study assessed the effects of coding and coding conventions on summaries and tabulations of adverse events data on suicidality within clinical study reports of nine randomised controlled trials of duloxetine for the treatment of major depressive disorder. Trials used either the medical coding dictionary COSTART (Coding Symbols for a Thesaurus of Adverse Reaction Terms) or the larger and more recent dictionary MedDRA (Medical Dictionary for Regulatory Activities). We found suicides were clearly identifiable in all formats of adverse event data. Suicide attempts in tables included both definitive and provisional diagnoses. Suicidal ideation and preparatory behaviour were obscured in some tables owing to the lack of specificity of the medical coding dictionary, especially in trials using COSTART where the closest matching term available was depression. (more…)
Author Interviews, BMJ, End of Life Care / 12.06.2014

MedicalResearch.com: Interview with: Dr. Hsien Seow PhD Cancer Care Ontario Research Chair in Health Services Research Asst Professor, Dept of Oncology, McMaster University Hamilton, OntarioDr. Hsien Seow PhD Cancer Care Ontario Research Chair in Health Services Research Asst Professor, Dept of Oncology, McMaster University Hamilton, Ontario   MedicalResearch: Why did you conduct this study? Dr. Seow: While palliative care has gained recognition as a service that can improve patient outcomes and reduce health care costs at the end of life, especially in hospitals and hospices, much less attention has focused on providing inter-disciplinary palliative care in the community and home. There have been several randomized trials that showed mixed evidence that inter-disciplinary teams of specialist palliative care providers can reduce acute care utilization in the community; however team size and team composition varied in prior trials. This variation has not been researched as a cause for the mixed outcomes. (more…)
Author Interviews, BMJ, Breast Cancer, Brigham & Women's - Harvard, Nutrition / 11.06.2014

MedicalResearch.com Interview with Dr. Maryam Farvid MSc, Ph.D. Takemi fellow, and Associate ArofessorMedicalResearch.com Interview with Dr. Maryam Farvid MSc, Ph.D. Takemi fellow, and Associate Arofessor Senior author: Prof Walter Willett Department of Nutrition, Harvard School of Public Health, Boston, MA, MedicalResearch: What are the main findings of the study? Dr. Farvid: Compared to women who had one serving per week red meat, those who consumed 1.5 serving per day red meat had a 22 percent higher risk of breast cancer. Red meat intake is associated with breast cancer risk in a dose-response manner. Each additional serving/day increase in total red meat was associated with a 13% increase in risk of breast cancer. Furthermore, each additional serving/day of poultry was associated with a 25% lower risk of postmenopausal breast cancer. Substituting one serving/day of legumes for one serving/day of red meat was associated with a 15% lower risk of breast cancer, substituting one serving/day of poultry for one serving/day of red meat was associated with a 17% lower risk of breast cancer overall, and substituting one serving/day of combined legumes, nuts, poultry, and fish for one serving/day of red meat was associated with a 14% lower risk of breast cancer. (more…)
Author Interviews, BMJ, Diabetes / 10.06.2014

Arch G. Mainous III, PhD Chair and Florida Blue Endowed Professor Department of Health Services Research, Management and Policy Professor of Community Health and Family Medicine University of Florida Health Science Center Gainesville, FL 32610MedicalResearch.com Interview with: Arch G. Mainous III, PhD Chair and Florida Blue Endowed Professor Department of Health Services Research, Management and Policy Professor of Community Health and Family Medicine University of Florida Health Science Center Gainesville, FL 32610 MedicalResearch: What are the main findings of the study? Professor Arch Mainous: This study focused on prediabetes, which is a high risk state for developing diabetes and associated complications. We investigated the national prevalence of prediabetes in England between 2003 and 2011. We found that the prevalence of prediabetes rose substantially in that time period from 11.6% to 35.3%. Further, by 2011 more than half of the population who were 40 years of age and older and were overweight had prediabetes. Minority ethnic groups are particularly affected. (more…)
Author Interviews, BMJ, Electronic Records / 08.06.2014

Dr David A Hanauer MD MS Department of Pediatrics University of Michigan Medical School Ann Arbor, MIMedicalResearch.com Interview with: Dr David A Hanauer MD MS Department of Pediatrics University of Michigan Medical School Ann Arbor, MI   MedicalResearch: What are the main findings of the study? Dr. Hanauer: In this study we analyzed requests made by patients who wanted to make changes to their medical record. The goal was to develop an understanding of what the main reasons were for making a request to change the medical record, and what types of information they wanted changed. One of the main findings was that about half of all requests were ultimately approved.  This suggests that patients reviewing their records can detect errors and have them corrected, which could ultimately lead to a more accurate record for a patient. In essence, giving patients the opportunity to further participate in their care by allowing them to review their record can lead to the identification and correction of errors or omissions. (more…)
Author Interviews, BMJ, Karolinski Institute, Rheumatology / 06.06.2014

MedicalResearch.com Interview with: Karen Hambardzumyan Research Assistant Karolinska Institute Department of Medicine, (ClinTRID) D1:00, Karolinska University Hospital Solna Stockholm MedicalResearch: What are the main findings of the study? Answer: One of the difficulties with rheumatoid arthritis (RA) treatment is unpredictable treatment outcome at the individual patient level. The course might be mild or severe independently of the therapy. To identify subgroups of patients who will benefit from specific therapy strategies is one of the goals for today’s rheumatologists. We have investigated a Multi-Biomarker Disease Activity (MBDA) score in patients from the Swedish Farmacotherapy (SWEFOT) clinical trial, where early rheumatoid arthritis patients were included/studied. The main finding was the usefulness of the MBDA score for prediction of those patients who will not get joint damage detected by X-rays (radiographic progression) during one year follow-up. This MBDA score, developed by Crescendo Bioscience (South San-Francisco, CA, USA) is based on serum levels of 12 different protein biomarkers and can categorize patients into 3 groups: patients with low, moderate and high disease activity. Ninety-seven percent of patients who had low or moderate MBDA score before treatment onset, did not experience radiographic progression during one year follow-up. This finding could contribute to a personalised approach to the RA patients for the optimal therapy choice. (more…)
Allergies, Author Interviews, BMJ, Environmental Risks / 05.06.2014

Elaine Fuertes Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg, Germany and School of Population and Public Health University of British Columbia, Vancouver, British Columbia, CanadaMedicalResearch.com Interview with: Elaine Fuertes Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg, Germany and School of Population and Public Health University of British Columbia, Vancouver, British Columbia, Canada MedicalResearch: What are the main findings of the study? Answer: The main finding of our study was that despite the use of identical study designs and statistical methods, the level of greenness (measured using the Normalized Difference Vegetation Index) around a child's home address was differentially associated with the development of allergic health outcomes among children living in two areas in Germany. In our urban study centre, which includes the city of Munich, we found that higher greenness levels around a child's home increased their risk of developing allergic rhinitis and experiencing eyes and nose symptoms. In contrast, greenness around the home appeared to be protective for allergic rhinitis, nose and eye symptoms and sensitization to inhalant allergens in the second more rural study centre investigated. These observations emphasize that the effects of greenness around the home on respiratory health is complex and multifaceted, and are based on 5,803 German children followed from birth to 10 years as part of the GINIplus and LISAplus birth cohorts. (more…)
Accidents & Violence, Author Interviews, BMJ, Geriatrics / 29.05.2014

Mary W. Carter, Ph.D. Gerontology Program Director Towson University Towson, MD 21252-0001MedicalResearch.com Interview Invitation Mary W. Carter, Ph.D. Gerontology Program Director Towson University Towson, MD 21252-0001 MedicalResearch: What are the main findings of the study? Dr. Carter: Nearly 1 in 5 older adults experienced at least one severe medical injury during the five-year study period, and more than half of these occurred in an ambulatory care setting (i.e., not in the hospital).  Older adults that were in poorer health and who had greater levels of disability had the greatest risk.  Mortality rates were nearly twice as high among older adults experiencing a medical injury in comparison with otherwise similar older adults not experiencing a medical injury. Among survivors, the impact of medical injury was observed for extended periods of time, reflecting increased medical use and costs associated with medical injury. (more…)
Author Interviews, BMJ, Stroke / 26.05.2014

Michael T. C. Poon, MBChB, BMedSci (Hons) Junior Doctor, Wycombe General Hospital Buckinghamshire Healthcare NHS Trust, UKMedicalResearch.com Interview with: Michael T. C. Poon, MBChB, BMedSci (Hons) Junior Doctor, Wycombe General Hospital Buckinghamshire Healthcare NHS Trust, UK   MedicalResearch: What are the main findings of the study? Dr. Poon: At present, we know that the incidence and one-month case fatality of intracerebral haemorrhage (ICH) have remained static for the past two decades. However, any trend in long-term survival after ICH is less clear. Survivors face the risks of recurrent ICH as well as ischaemic events in the future. The balance between these risks has particular clinical implication on the decision about restarting antiplatelet/anticoagulant therapy after ICH. To address these questions, we undertook a systematic review and meta-analysis to determine whether long-term survival after intracerebral haemorrhage has changed over time, and to re-assess the balance between the risks of recurrent ICH and ischaemic events in studies quantifying both of these risks in the same population. The survival rates after ICH at 1 year and 5 years do not appear to have changed over time – 1 year survival was 46% and 5 year survival was 29%. The risk of recurrent ICH may be influenced by the ICH location, with lobar ICH having a higher rate of recurrence. In contrast to the previous systematic review, we found the risk of ischaemic stroke to be at least as high as the risk of recurrent ICH over 3 years after ICH. This reinforces the difficulty that clinicians and patients have in deciding about antithrombotic treatment after ICH. (more…)
Author Interviews, BMJ, Genetic Research, Heart Disease / 22.05.2014

Christopher Labos MD CM, FRCPC, MSc candidate Division of Epidemiology, Biostatistics and Occupational Health McGill University Montreal, Quebec CanadaMedicalResearch.com Interview with: Christopher Labos MD CM, FRCPC, MSc candidate Division of Epidemiology, Biostatistics and Occupational Health McGill University Montreal, Quebec Canada MedicalResearch: What are the main findings of the study? Dr. Labos: A higher genetic risk score (GRS) composed of a set of recently discovered genetic markers strongly linked to cardiovascular disease is associated with an earlier age of first acute coronary syndromes (ACS). We also found that other traditional risk factors such as smoking, obesity and male sex were also associated with an earlier ACS. Two medication classes were also associated with age of first ACS: hormone replacement therapy was associated with earlier ACS while aspirin was associated with ACS occuring at a later age. (more…)
Author Interviews, BMJ, Karolinski Institute, Rheumatology, Weight Research / 17.05.2014

Maria E.C. Sandberg, MSc PhD Institutet för Miljömedicin / Institute of Environmental Medicine Karolinska Institutet Stockholm, SwedenMedicalResearch.com Interview with: Maria E.C. Sandberg, MSc PhD Institutet för Miljömedicin / Institute of Environmental Medicine Karolinska Institutet Stockholm, Sweden   MedicalResearch: What are the main findings of the study? Dr. Sandberg: Overweight at diagnosis significantly decreases the chance of achieving good disease control during the early phase of rheumatoid arthritis (RA). (more…)
Author Interviews, BMJ, Prostate Cancer, Testosterone / 07.05.2014

dr_san_franciscoMedicalResearch.com Interview with: Dr. Ignacio F. San Francisco Departamento de Urología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile MedicalResearch: What are the main findings of the study? Answer: Increasingly, men with low-risk prostate cancer are undergoing a close monitoring regimen called active surveillance, instead of moving forward immediately with treatment. However it is still unclear which men will develop evidence for worsening or more aggressive disease during active surveillance. In this study of 154 men with Gleason 6 prostate cancer followed for 38 months, we found that low levels of free testosterone were significantly associated with increased risk of developing more aggressive disease. We found no significant association with total testosterone concentrations, although there was a general trend towards increased risk with lower levels. (more…)
Author Interviews, BMJ, Emergency Care, Heart Disease / 03.05.2014

Dr. Richard Body Emergency Department Manchester Royal Infirmary Manchester UKMedicalResearch.com Interview with:  Dr. Richard Body Emergency Department Manchester Royal Infirmary Manchester UK   MedicalResearch.com: What are the main findings of the study? Dr. Body: This paper actually reports the findings of two consecutive, separate studies.  We aimed to derive and then externally validate a clinical decision rule to risk stratify patients with suspected acute coronary syndromes in the Emergency Department (ED).  This rule could then be used to reduce unnecessary hospital admissions while also making judicious use of specialist high dependency resources. In the first study we derived a clinical decision rule that incorporates 8 variables: high sensitivity troponin T, heart-type fatty acid binding protein; ECG ischaemia; worsening angina; hypotension (systolic blood pressure <100mmHg on arrival); sweating observed in the ED; pain associated with vomiting; and pain radiating to the right arm or shoulder.  When we validated the rule at a different centre, we found that its use could have avoided hospital admission for over a quarter of patients while effectively risk stratifying others.  Of the 10% of patients who were identified as 'high risk', approximately 95% had a major adverse cardiac event within 30 days.  The findings suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule could be used to 'rule in' and 'rule out' acute coronary syndromes immediately, using information gathered at the time of initial presentation to the ED.  Before clinical implementation, we recommend that effect of using the MACS rule in practice should first be evaluated in a trial setting.  This will enable us to determine: (a) whether physicians and patients are likely to comply with (and be satisfied with) the MACS rule; (b) the safety of the MACS rule when used in practice; and (c) whether use of the MACS rule leads to cost savings for the health service. (more…)
Author Interviews, BMJ, Cancer Research, Surgical Research, Transplantation / 02.05.2014

MedicalResearch.com Interview with: Rajeev Desai SpR Gastroenterology, City Hospital Birmingham Honorary Clinical Research Fellow University Hospital Birmingham / NHS Blood and Transplant, Bristol MedicalResearch: What are the main findings of the study? Dr. Desai: This study of a large national cohort of organ donors shows that, following careful assessment and selection, organs from some donors with a previous history of cancer can be used safely for transplantation. The risks of accepting such organs for transplantation should be balanced with risks of non-acceptance and its consequences including delayed transplantation or non-transplantation. (more…)
Author Interviews, BMJ, Heart Disease, Nutrition / 02.05.2014

Shanshan Li, Doctoral candidate Department of Epidemiology Harvard School of Public Health, 655 Huntington Avenue Boston, MA 02115, USAMedicalResearch.com Interview with: Shanshan Li, Doctoral candidate Department of Epidemiology Harvard School of Public Health, 655 Huntington Avenue Boston, MA 02115, USA MedicalResearch.com: What are the main findings of the study? Answer: This is the first study to show that greater intake of dietary fiber, especially cereal fiber, was inversely associated with all-cause mortality. Participants increased their average dietary fiber intake after myocardial infarction (MI), and the greater the increase, the lower was the risk of subsequent all-cause and cardiovascular mortality. Overall, the benefits for increased fiber intake were strongest for fiber from cereal and grain sources. (more…)
Author Interviews, Blood Pressure - Hypertension, BMJ, OBGYNE / 30.04.2014

MedicalResearch.com Interview with: Dr Kate Bramham Division of Women's Health King's College London Women's Health Academic Centre KHP London, SE1 7ER MedicalResearch.com: What are the main findings of the study? Dr. Bramham: This meta-analysis of nearly 800,000 pregnancies from 55 studies has shown that women with chronic hypertension have a significantly increased incidence of pregnancy complications including superimposed pre-eclampsia, preterm delivery, low birth weight infants, perinatal loss and neonatal unit admission. (more…)
Author Interviews, BMJ, Gastrointestinal Disease, Transplantation / 29.04.2014

Mr. Thamara Perera FRCS Consultant Surgeon - Multi Organ Retrieval and Liver Transplant Liver Transplant - University Hospitals Birmingham NHS Foundation Trust Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, Birmingham, UKMedicalResearch.com Interview with: Mr. Thamara Perera FRCS Consultant Surgeon - Multi Organ Retrieval and Liver Transplant Liver Transplant - University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Queen Elizabeth Medical Centre, Birmingham, UK MedicalResearch.com: What are the main findings of the study? Answer: In this study we compared the basic energy metabolism of liver grafts obtained from conventional and widely practiced form of organ donation, the donation after brain death (DBD) donors, and recently revived form of organ donation called donation after circulatory death (DCD) donors. To introduce a background to this study - DCD liver grafts are perceived as marginal liver grafts, owing to the basic differences surrounding the organ donation. DCD organs suffer a period of warm ischemia from the time of treatment withdrawal in a potential donor up until the organs are actually recovered and preservation is initiated. Although the DCD liver grafts have supplemented the donor organ pool, the initial and short-term results following liver transplantation are comparatively poor and these differences are attributable to the donor warm ischemia. However there were no studies in the literature examining the energy status of DCD liver grafts and our study is the first such study. (more…)