Author Interviews, BMJ, Rheumatology / 15.04.2014

Zhang, Xuan MD Professor of Medicine Dept. of Rheumatology Peking Union Medical College Hospital Beijing,China,100730MedicalResearch.com Interview with: Zhang, Xuan MD Professor of Medicine Dept. of Rheumatology Peking Union Medical College Hospital Beijing,China,100730 and Dr. Peter E. Lipsky, MD Formerly National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institutes of Health, Bethesda, MD, MedicalResearch.com: What are the main findings of the study? Prof. Zhang & Lipsky--The results of this study indicate that TwHF is effective for the treatment of active rhematoid arthritis (RA). Importantly, these are the first data indicating that TwHF is effective in DMARD-naïve patients with active rheumatoid arthritis. At week 24, TwHF monotherapy resulted in significant improvement of disease activity, including pain assessment, the patient’s and physician’s global assessment, tender joint counts, swollen joint counts, ESR, CRP, and HAQ and SF-36 scores. MTX monotherapy and TwHF monotherapy had similar efficacy as shown by ACR20, ACR50 and ACR70 response criteria, EULAR and cDAI good response criteria, as well as DAS28 remission criteria and low disease activity(LDA) rate. The efficacy of TwHF was not inferior to that of MTX, and MTX +TwHF combination therapy was more effective than MTX monotherapy in treating active rhematoid arthritis. A safety evaluation of the study demonstrated that the frequency of total adverse events and severe adverse events of TwHF monotherapy was not significantly higher than that of MTX monotherapy, except for a slightly increased frequency of irregular menstruation. (more…)
Author Interviews, Blood Pressure - Hypertension, BMJ, Salt-Sodium / 15.04.2014

Dr. Feng He Wolfson Institute of Preventive Medicine Barts and The London School of Medicine and Dentistry Queen Mary University of London, London, UKMedicalResearch.com Interview with: Dr. Feng He Wolfson Institute of Preventive Medicine Barts and The London School of Medicine and Dentistry Queen Mary University of London, London, UK
MedicalResearch.com: What are the main findings of the study? Dr. He:
  • The UK salt reduction program has led to a fall in population blood pressure and thereby contributed to the reduction in stroke and heart disease deaths.
  •  In 2003, the UK Food Standards Agency and CASH (Consensus Action on Salt & Health) developed a salt reduction program. As approximately 80% of the salt in the diet is added to food by the food industry i.e. in processed foods, fast foods, canteen and restaurant foods etc, the public have no choice about eating it. Therefore progressive incremental targets to limit the amount of salt for each food category were set, which the industry had to achieve in a specified time. Reductions first started in 2003 and are continuing to this day.
  • The salt reduction program has been very successful and led to a 15% reduction in the average salt intake of the population, from 9.5g per day in 2003 to 8.1g per day in 2011 (P<0.05).
  • Over the same time period, blood pressure fell in the adult population by 3 mm Hg systolic and 1.4 mm Hg diastolic (P<0.0001). Stroke and heart disease deaths fell by 42% (P<0.0001) and 40% (P<0.0001) respectively.
  • It is possible that these falls in blood pressure and deaths from stroke and heart disease were attributable to various factors such as changes in diet, lifestyles and the improvement in the treatment of cardiovascular disease and its risk factors. Our further analysis showed that the reduction in salt intake played an important role, particularly in the falls in blood pressure.
  •  In a further analysis, we looked at individuals who were not on any drug treatment for blood pressure and a correction was made for all other variables that could have influenced blood pressure, apart from salt. There was still a fall in adult population blood pressure of 2.7mm Hg systolic/ 1.1mm Hg diastolic, (P <0.0001). This reduction in blood pressure could therefore be largely attributed to the fall in salt intake.
  •  It is well established that raised blood pressure throughout its range is a major cause of stroke and heart disease. The reduction in salt intake that led to a fall in blood pressure would have played an important role in both stroke and heart disease deaths.
  • Despite considerable progress being made on salt reduction, the average salt intake in England is still high. In 2011, it was 8.1 g/day which is over a third more salt than the recommended level of 6g/day. Therefore continuing and much greater efforts are needed to achieve further reductions in salt intake to prevent the maximum number of stroke and heart disease deaths. (more…)
Author Interviews, BMJ, Eating Disorders, Weight Research / 09.04.2014

Ulla Räisänen Senior Researcher HERG Health Experiences Research Group Department of Primary Care Health Sciences University of Oxford Oxford OX1 2ETMedicalResearch.com  Interview with Ulla Räisänen Senior Researcher HERG Health Experiences Research Group Department of Primary Care Health Sciences University of Oxford Oxford OX1 2ET MedicalResearch.com : What are the main findings of the study? Answer: We conducted a qualitative interview study exploring how young men (aged 16-25) recognise eating disorder symptoms and decide to seek help, and to examine their experiences of initial contacts with primary care in the UK. Our data suggest that the widespread perception of eating disorders as uniquely or predominantly a female problem led to an initial failure by young men to recognise their behaviours as symptoms of an eating disorder. Many presented late in their illness trajectory when eating disorder behaviours and symptoms were entrenched, and some felt that opportunities to recognise their illness had been missed because of others’ lack of awareness of eating disorders in men. In addition, the men discussed the lack of gender-appropriate information and resources for men with eating disorders as an additional impediment to making sense of their experiences, and some felt that health and other professionals had been slow to recognise their symptoms because they were men. (more…)
Author Interviews, BMJ, Heart Disease / 06.04.2014

Professor Ben He Department of Cardiology Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai China.MedicalResearch.com Interview with: Professor Ben He Department of Cardiology Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai China. MedicalResearch.com: What are the main findings of the study? Professor He: Elimination of PVCs by catheter ablation can improve LVEF and reverse LV dimensions. The pooled mean change in LVEF post-ablation meets the prespecified borderline (5%) and can be considered clinically effective. Beneficial effects of ablation of frequent PVCs in improving LV function are more significant in patients with reduced LVEF at baseline. (more…)
Author Interviews, BMJ, Nutrition / 02.04.2014

Dr Oyinlola Oyebode Specialist Registrar in Public Health Dept of Epidemiology & Public Health University College London London WC1E 6BTMedicalResearch.com Interview with: Dr Oyinlola Oyebode Specialist Registrar in Public Health Dept of Epidemiology & Public Health University College London MedicalResearch.com: What are the main findings of the study? Dr. Oyebode: We found that the more fruit and vegetables consumed, the lower the risk of death from any cause, from cancer or from heart disease or stroke. We found that vegetables were better than fruit at equivalent amounts. (more…)
Author Interviews, BMJ, Gastrointestinal Disease, Pediatrics, Probiotics / 02.04.2014

Dr Valerie Sung MBBS(Hons) FRACP MPH NHMRC PhD Candidate, Department of Paediatrics, University of Melbourne, and Community Health Services Research, Murdoch Childrens Research Institute Paediatrician, Centre for Community Child Health, The Royal Children’s HospitalMedicalResearch.com Invitation with: Dr Valerie Sung MBBS(Hons) FRACP MPH NHMRC PhD Candidate, Department of Paediatrics, University of Melbourne, and Community Health Services Research, Murdoch Childrens Research Institute Paediatrician, Centre for Community Child Health The Royal Children’s Hospital MedicalResearch.com: What are the main findings of the study? Dr. Sung: Lactobacillus reuteri was NOT effective in reducing crying or fussing in infants with colic, whether they are breast or formula fed. This is the largest and most rigorous trial to date to show this. (more…)
Author Interviews, BMJ, Health Care Systems, Hospital Readmissions / 01.04.2014

MedicalResearch.com Interview with: dr_karen_e_lasser Karen E Lasser, MD MPH Associate Professor of Medicine Boston University School of Medicine, Boston, MA MedicalResearch.com: What are the main findings of the study? Dr. Lasser: After controlling for variables that could affect the risk of readmission, we found that:
  1. There was a slightly increased risk of all-cause readmission in Massachusetts (MA) relative to control states (New York and New Jersey) post-reform.
  2. Racial and ethnic disparities in all-cause readmission rates did not change in MA relative to control states.
  3. However, both blacks and whites in counties with the highest uninsurance rates had a decreased risk of readmission following MA health reform relative to blacks and whites in counties with lower uninsurance rates.
(more…)
Author Interviews, BMJ, Gastrointestinal Disease, Pediatrics / 26.03.2014

MedicalResearch.com Interview with: Marie Lund MD, PhD student Department of Epidemiology Research København S | Denmark MedicalResearch.com: What are the main findings of the study? Dr. Lund: We found macrolide use in infants to be associated with a 30-fold increased risk of infantile hypertrophic pyloric stenosis (IHPS) with use during the first two weeks after birth and a lower, but significantly increased threefold risk with use during days 14 to 120. Similarly, there was a more than three-fold increased risk of IHPS associated with maternal macrolide use during the first two weeks after birth, but no increased risk with use thereafter. Finally, we found a possible modest association between maternal macrolide use during weeks 28 to birth and infantile hypertrophic pyloric stenosis. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Genetic Research, Medical Research Centers, Nutrition, Weight Research / 19.03.2014

Prof. Lu Qi, Assistant Professor, Department of Nutrition Harvard School of Public Health and Channing Division of Network Medicine Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MAMedicalResearch.com Interview with: Prof. Lu Qi, Assistant Professor, Department of Nutrition Harvard School of Public Health and Channing Division of Network Medicine Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA MedicalResearch.com: What are the main findings of the study? Dr. Lu Qi: In this study, we for the first time provide reproducible evidence from three large cohort studies to show that the association between regular consumption of fried foods and higher BMI was particularly pronounced among people with a greater genetic predisposition to obesity. On the other hand, the adverse genetic effects on BMI were also amplified by consuming more fried foods, the effects among those who ate fried foods more than four times a week was about twice as large compared with those who ate them less than once a week. (more…)
Author Interviews, BMJ, HPV, Vaccine Studies / 18.03.2014

MedicalResearch.com Interview with: Dr Rachel J Sacks Jefferiss Wing,  St Mary's Hospital Imperial College Healthcare NHS Trust, London UK MedicalResearch.com: What is the background of this study? Dr. Sacks: 2247 anonymous questionnaires were completed by young women, aged 13-19 years old, attending sexual health services across England, looking at their HPV vaccination outcomes and prevalence of risk factors associated with HPV acquisition and cervical cancer development, and comparing the survey results with national data where available. Known HPV acquisition and cervical cancer development risk factors include cigarette smoking, early age at first intercourse, increasing number of lifetime partners, co-infection with other sexually transmitted infections. MedicalResearch.com: What are the main findings of the study Dr. Sacks:
  •          Young women, aged 13  to 19 years old attending sexual health services across England had higher prevalence of known risk factors associated with HPV acquisition and cervical cancer development, compared with national data.
  •          Survey respondents had lower HPV vaccination offer and lower HPV vaccination completion rates than nationally.
  •          Subgroups within the survey respondents were identified as having a significantly lower offer and significantly lower completion rate of the HPV vaccination. These subgroups included respondents from London, those of non-white ethnicities, 17 to 19 year olds, smokers and those not in education, employment or training (NEETs).
  •          The highest risk individuals, in terms of HPV related risk factors, were the least likely to be offered and additional the least likely to complete the HPV vaccination course.
  •          Currently sexual health services in England are not involved in the delivery of the HPV vaccination programme and this is felt to be a huge missed opportunity for the primary prevention of HPV acquisition and its potential sequelae. Sexual health services should be included as a supplementary HPV vaccination delivery site in order to target these particularly vulnerable young women and to increase the success of the HPV vaccination programme in England.
(more…)
Author Interviews, BMJ, Heart Disease, Outcomes & Safety, Surgical Research / 17.03.2014

Dr Tahir Hamid MRCP (UK), FESC Department of Cardiology, Royal Albert Edward Infirmary NHS Trust, Wigan, UKMedicalResearch.com Interview with: Dr Tahir Hamid MRCP (UK), FESC Department of Cardiology, Royal Albert Edward Infirmary NHS Trust,  Wigan, UK MedicalResearch.com: What are the main findings of the study? Dr. Hamid: Traditionally patients undergoing diagnostic and interventional coronary artery procedures are kept Nil-by-mouth, but until yet there exists neither evidence nor clear guidance about the benefits of this practice in such patients. In our study performed at two National Health Services (NHS) institutes, we demonstrated in our 1916 patients, that such procedures could be undertaken without the need for being 4-6 hours fasting. None of our patients had major complications leading to pulmonary aspiration or emergency cardiac surgery. (more…)
Author Interviews, BMJ, OBGYNE / 12.03.2014

MedicalResearch.com Interview with: Dr Josefin Vikström Division of Obstetrics and Gynecology Department of Clinical and Experimental Medicine Faculty of Health Sciences Linköping University, Linköping, Sweden MedicalResearch.com: What are the main findings of the study? Dr. Vikström: Our study showed that women with a female infertility factor were more than two times more likely to have been born with a low birth weight (less than 2500g) or small for gestational age compared to women where the cause of infertility was unknown and/or male. (more…)
Alcohol, Author Interviews, BMJ, OBGYNE / 12.03.2014

Camilla Nykjaer, PhD Student School of Food Science and Nutrition University of Leeds, Leeds, UKMedicalResearch.com Interview with: Camilla Nykjaer, PhD Student School of Food Science and Nutrition University of Leeds, Leeds, UK   MedicalResearch.com: What are the main findings of the study? Answer: In our study, there was an association between the mother drinking alcohol during early pregnancy and being born preterm or small for gestational age. Babies of women who drank more than 2 units of alcohol per week in the first trimester were more likely to be born preterm, small for gestational age and with lower birth weight compared to non-drinkers, even after adjusting for a range of confounders including cotinine levels as a biomarker for smoking status. The association with preterm birth was present even in those mothers who reported drinking less than 2 units/week. (more…)
Author Interviews, BMJ, Mental Health Research, Pediatrics, Psychological Science / 11.03.2014

Mitch van Geel, PhD Institute of Education and Child Studies, Leiden University Leiden, the NetherlandsMedicalResearch.com Interview with: Mitch van Geel, PhD Institute of Education and Child Studies, Leiden University Leiden, the Netherlands MedicalResearch.com: What are the main findings of the study? Dr.van Geel: We performed a meta-analysis, which is a way to statistically summarize effect sizes from earlier studies. Individual studies often provide varying effect sizes, which makes it difficult to judge whether and how strong variables are related. Furthermore, study characteristics (sampling methods, response rates, controlling for certain confounders) might influence study results. By using a meta-analysis it can be analyzed to what extent study characteristics are related to results; if a particular result only tends to be established in studies with certain designs (for example a convenience sample), we might wonder whether such an effect really exists; but if we find that a particular outcome is unrelated to study characteristics or found in studies with relatively stronger designs, we might feel more certain in concluding that a relation between variables (bullying-suicide thoughts or attempts) exists. By using a meta-analysis we established a significant relation between bullying and thoughts about suicide, and bullying and suicide attempts, and we found that these results were unrelated to study characteristics. (more…)
Author Interviews, BMJ, Electronic Records / 07.03.2014

MedicalResearch.com Interview with: Stephanie Parks Taylor MD MS Associate Professor Director of Clinical Research Associate Division Director, Hospital Medicine USF Department of Internal Medicine MedicalResearch.com: What are the main findings of your study? Dr. Parks Taylor: The integration of electronic medical records has been proposed to have many benefits for the healthcare system. We investigated the effect of EMR implementation on communication between physicians and nurses in a hospital setting. The primary finding was that overall agreement about a patient's plan of care actually worsened after the implementation of EMR. This seemed to be related to a decrease in face-to-face communication between physicians and nurses. (more…)
Author Interviews, BMJ, Nutrition / 06.03.2014

Dr James J DiNicolantonio PharmD Ithaca, New York MedicalResearch.com Interview with: Dr James J DiNicolantonio PharmD Ithaca, New York   MedicalResearch.com: What are the main findings of the study? Dr. DiNicolantonio:  The increase in the prevalence of diabetes and obesity in the United States occurred with an increase in the consumption of carbohydrate not saturated fat.  There is no conclusive proof that a low-fat diet has any positive effects on health (good or bad).  The public fear that saturated fat raises cholesterol is completely unfounded as the low-density lipoprotein (LDL) particle size distribution is worsened when fat is replaced with carbohydrate. A public health campaign is drastically needed to educate on the harms of a diet high in carbohydrate/sugar. (more…)
Author Interviews, BMJ, Outcomes & Safety, Surgical Research / 06.03.2014

MedicalResearch.com Interview with: Mr. Aneel Bhangu West Midlands Research Collaborative, Academic Department of Surgery Queen Elizabeth Hospital Birmingham UK MedicalResearch.com: What are the main findings of the study?  Mr. Bhangu:  Out study was based on a novel collaborative approach, spanning 95 centres in the UK. It was led by surgical trainees, who form a natural network and work in a rotational pattern. These networks will mature to allow a future of clinical research to be embedded into routine NHS care. Our study found no increase in complications based on weekend operating. It’s possible that patients present differently at weekends, or that surgeons select less complex patients to operate upon. A key secondary finding is that patients operated on at weekends were less likely to undergo laparoscopy. This means that they are exposed to different processes of care, which may introduce risk. This may be a surrogate marker for other differences in weekend care that require exploration. (more…)
Author Interviews, BMJ, General Medicine, Outcomes & Safety / 06.03.2014

Karen Yeung Professor of Law Centre for Technology, Ethics Law & Society King's College London London WC2R 2LSMedicalResearch.com Interview with: Karen Yeung Professor of Law Centre for Technology, Ethics Law & Society King's College London London WC2R 2LS MedicalResearch.com: What are the main findings of the study? Professor Yeung: This study found a gap in existing legal regulation of healthcare quality in the UK.  While patients receiving treatment under mental health legislation are protected by the criminal law against wilful neglect or ill treatment, other patients are not subject to the same level of protection, although many such patients are just as vulnerable as those who are mentally incapacitated.  Hence we argue that a new criminal offence of 'wilful neglect or ill treatment' of patients in the healthcare sector is needed. (more…)
Author Interviews, BMJ, Nutrition, OBGYNE / 05.03.2014

MedicalResearch.com Interview with: Dr Linda Englund-Ögge Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Sahlgrenska Academy, Sahlgrenska University Hospital Gothenburg, SwedenDr Linda Englund-Ögge Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Sahlgrenska Academy, Sahlgrenska University Hospital Gothenburg, Sweden MedicalResearch.com: What are the main findings of the study? Answer: Women adhering to a prudent* or a traditional** dietary pattern during pregnancy had a significantly reduced risk of preterm delivery, even after adjusting for a range of confounders. The prudent pattern was also significantly associated to lower risk in the nulliparous, in spontaneous and in late preterm delivery. *, characterized by high intake of e.g. vegetables, fruit, whole grains and water to drink. **, characterized by high intake of e.g. boiled potatoes, fish and cooked vegetables. (more…)
Author Interviews, BMJ, Cancer Research, Chemotherapy, End of Life Care / 05.03.2014

Holly G. Prigerson, Ph.D. Irving Sherwood Wright Professor in Geriatrics Professor of Sociology in Medicine Co-Director, Center for End-of-Life Research Weill Cornell Medical College New York Presbyterian Hospital New York City, New York 10065MedicalResearch.com Interview with: Holly G. Prigerson, Ph.D. Irving Sherwood Wright Professor in Geriatrics Professor of Sociology in Medicine Co-Director, Center for End-of-Life Research Weill Cornell Medical College New York Presbyterian Hospital New York City, New York 10065 MedicalResearch.com: What are the main findings of the study? Dr. Prigerson: The main outcome of the research was end-of-life treatment and location of death with secondary outcomes being length of survival, late hospice referrals and attainment of preferred place of death. We found that 56 percent of patients receiving palliative chemotherapy in their final months.  Patients treated with palliative chemotherapy were five to 10 times more likely to receive intensive medical care and to die in an intensive care unit (ICU). Fewer than half died at home as compared with two-thirds of patients with metastatic cancer not treated with palliative chemotherapy. More specifically, we found that palliative chemotherapy was associated with:
  • Increased use of CPR and mechanical ventilation: 14% versus 2%
  • Late hospice referral: 54% versus 37%
  • Death in an ICU: 11% versus 2%
  • Death away from home: 47% versus 66%
  • Death away from their preferred place: 65% versus 80%
Survival did not differ significantly between patients who received palliative chemotherapy and those who did not (hazard ratio 1.11, 95% CI 0.90-1.38). Additionally, patients receiving palliative chemotherapy were less likely to acknowledge their illness as terminal (35% versus 49%, P=0.04), to have discussed end-of-life wishes with a physician (37% versus 48%, P=0.03), and to have completed a do-not-resuscitate order (36% versus 49%, P<0.05). (more…)
Author Interviews, BMJ, Cancer Research, HPV, Vaccine Studies / 05.03.2014

MedicalResearch.com Interview with: Dr Julia Brotherton Victorian Cytology Service, Melbourne, Victoria, Australia Dr Elizabeth Crowe The University of Queensland, School of Population Health, Brisbane, Australia NHS Borders, Department of Public Health, Melrose, Scotland, UK Prof. David Whiteman Group Leader / Department Coordinator QIMR Berghofer Medical Research Institute Royal Brisbane Hospital, QLD 4029 MedicalResearch.com: What are the main findings of the study? 1.       We conducted a case-control study in which we retrieved the HPV vaccination histories of young Australian women who were notified to the Pap smear registry with high-grade cervical lesions or with other types of cervical lesions, and compared them with the vaccination histories of women whose Pap smears showed only normal cytology. 2.       We found that women with high grade cervical lesions were significantly less likely than women with normal cytology to have received 3 doses of the quadrivalent HPV vaccine, equivalent to a vaccine effectiveness of 46%. 3.       The vaccine effectiveness among 15-19 year old women was even higher at 57%. We believe this reflects the fact that HPV16 causes an even higher proportion of high grade disease in young women due to its higher oncogenicity and shorter latent period. 4.       The HPV vaccine had 34% effectiveness against other cervical lesions (i.e. those not proven to be high grade lesions on histology). 5.       We also observed that 2 doses of the vaccine were 21% effective in preventing both high grade lesions and other grade lesions. (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…)
Author Interviews, BMJ, Mental Health Research, Smoking / 14.02.2014

MedicalResearch.com Interview with: Gemma Taylor MSc MBPsS Doctoral ResearcherGemma Taylor MSc MBPsS Doctoral Researcher and Paul Aveyard and PhD MRCP MRCGP FFPG Professor of Behavioral MedicinePaul Aveyard and PhD MRCP MRCGP FFPG Professor of Behavioral Medicine Fellow of Wolson College Primary Care Clinical Sciences The University of Birmingham Birmingham United Kingdom MedicalResearch.com: What are the main findings of the study? Answer: Smoking cessation is associated with improvements in mental health compared with continuing to smoke. The effect sizes seem as large for those with psychiatric disorders as those without and are equal or larger to effect estimates of antidepressant treatment for mood and anxiety disorders. (more…)
Author Interviews, BMJ, Endocrinology, General Medicine / 14.02.2014

Simon D. Brandt, PhD Reader in Bioactive Drug Chemistry School of Pharmacy & Biomolecular Sciences Liverpool John Moores University Liverpool, L3 3AF, UK Associate Editor "Drug Testing and Analysis" (Wiley)MedicalResearch.com Interview with: Simon D. Brandt, PhD Reader in Bioactive Drug Chemistry School of Pharmacy & Biomolecular Sciences Liverpool John Moores University Associate Editor "Drug Testing and Analysis" (Wiley) Author's background comment: This type of work represents one of our areas of activity related to multi-disciplinary approaches to harm reduction which combines public health work with research on various properties of bioactive substances. MedicalResearch.com: What are the main findings of the study? Answer: As part of our work related to so-called lifestyle and image-enhancing drugs and legal highs/bath salts, we became interested in a particular "food/dietary supplement" called "Esto Suppress" because it was discussed on some Internet forums dedicated to the topic of bodybuilding. Some forum members were speculating that tamoxifen might be present in this particular product. The reason for this speculation came from the chemical name that was written on the label which pointed in that direction. This particular product was also widely available from a number of online retailers and while some indications existed that the same chemical name was mentioned, others were seen to list a modified version of that name which did not always make much chemical sense. We test purchased four "Esto Suppress" samples in a local fitness store and confirmed that three of them contained the breast cancer drug tamoxifen. (more…)
Author Interviews, BMJ, Exercise - Fitness / 14.02.2014

Medical Research.com Interview with: James Woodcock Senior Research Associate UK CRC Centre for Diet and Activity Research MRC Epidemiology Unit, University of Cambridge MedicalResearch.com: What are the main findings of the study? Dr. Woodcock: The cycle hire scheme in London has benefited health through increasing physical activity. This reduces risk from a range of diseases including heart disease, type 2 diabetes, and depression. These benefits were at a population level bigger than the harms the cyclists faced from injury risk or air pollution exposure.  Looking at the harms air pollution did not make much difference.  The injury risk for users of the hire bikes appears to not be higher and may be lower than that for general cycling in the same area. However, the injury risks for general cycling in the cycle hire zone were quite high and benefits for cyclists would be greater if these risks were reduced. When we broke results for general cycling in the area down by age & gender we found two interesting findings. Firstly, that the risks faced by women were higher than for men and so benefits were less clear. Secondly, when we looked at results by age group the trade-off improved very considerably as people got older and for younger people (under 30) there may actually be harms. (more…)
Author Interviews, BMJ, Primary Care, Pulmonary Disease / 13.02.2014

Professor Chris van Weel Emeritus Professor of Family Medicine/General Practice Radboud University Nijmegen, The Netherlands Professor of Primary Health Care Research, Australian National University, Canberra Past President of WoncaMedicalResearch.com: Interview with: Professor Chris van Weel Emeritus Professor of Family Medicine/General Practice Radboud University Nijmegen, The Netherlands Professor of Primary Health Care Research, Australian National University, Canberra Background from Professor Chris van Weel Thank you for the opportunity to respond to your questions.  My paper was a commentary to the study of Jones and colleagues, Opportunities to diagnose chronic obstructive pulmonary disease in routine care in the UK: a retrospective study of a clinical cohort looking at the implications of the study findings. MedicalResearch.com: What are the main findings of the study? Answer: Jones and colleagues reported that in the UK, there are many missed opportunities to diagnose COPD. My comments are that this is not a unique UK problem, but a universal one: under-diagnosis or late diagnosis of COPD is a universal problem in most if not all countries in the world. To understand it, it is important to analyse more in-depth the diagnostic challenge in primary care, for general practitioners(GP)/family physicians (FP). The paper of Jones highlights this diagnostic problem - symptoms of COPD are initially insidious and may fluctuate over time. And from my earlier research it is also clear that patients 'adept' their daily activities (less physical activities) and therefore may underplay or even become unaware of, their symptoms. At the same time, this is a problem for the physician, when encountering these symptoms. As I highlighted in my commentary, GPs/FPs have to pay attention to other possible diseases that might cause these symptoms: pneumonia, heart failure, lung cancer. The 'low key symptoms' and the need of applying a broad diagnostic scope together cause what Jones and his colleagues called the 'missed opportunities' to diagnose COPD. (more…)
Author Interviews, BMJ, Breast Cancer, Mammograms / 13.02.2014

Anthony Miller, MD Director, Canadian National Breast Screening Study Professor Emeritus, Dalla Lana School of Public Health University of TorontoMedicalResearch.com Interview with: Anthony Miller, MD Director, Canadian National Breast Screening Study Professor Emeritus, Dalla Lana School of Public Health University of Toronto MedicalResearch.com: What are the main findings of the study? Prof. Miller:  The study involved 89,835 women aged 40 to 59. All underwent an annual physical breast examination, while half were randomly assigned to undergo annual mammograms for five years, beginning in 1980. During the five-year screening period, 666 invasive breast cancers were diagnosed in the mammography arm and 524 in the controls.  Over the 25 year follow-up 180 women in the mammography arm and 171 women in the control arm died of breast cancer.  The overall hazard ratio for death from breast cancer diagnosed during the screening period associated with mammography was 1.05 (95% CI: 0.85 – 1.30).  The findings for women aged 40-49 and aged 50-59 were almost identical. After 15 years of follow-up an excess of 106 cancers was observed in the mammography arm, attributable to over-diagnosis, i.e. 22% of screen-detected invasive breast cancers, half of those detected by mammography alone. This represents one over-diagnosed breast cancer for every 424 women screened by mammography. By 2005, 3,250 of the 44,925 women in the mammography arm of the study were diagnosed with breast cancer, and 500 had died of it. The control group of 44,910 women had 3,133 breast cancer diagnoses and 505 breast cancer deaths. We conclude that annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available. (more…)