Author Interviews, CMAJ, Opiods / 04.01.2016

[caption id="attachment_20406" align="alignleft" width="231"]Tara Gomes MHSc Tara Gomes[/caption] Medical Research: What is the background for this study? What are the main findings? Response: Surveillance of the harms associated with chronic opioid use is imperative for clinicians and policy-makers to rapidly identify emerging issues related to this class of medications.  However, data regarding opioid-related deaths is difficult to obtain in Canada as it is collected by local coroners and is not widely available to researchers.  We conducted a validation study to evaluate whether regularly collected vital statistics data collected by Statistics Canada can be used to accurately identify opioid-related deaths in Canada. We compared deaths identified from charts abstracted from the Office of the Chief Coroner of Ontario to those identified using several coding algorithms in the Statistics Canada Vital Statistics database.  We found that the optimal algorithm had a sensitivity of 75% and a positive predictive value of 90%. When using this algorithm, the death data obtained from the Vital Statistics database slightly underestimated the number of opioid-related deaths in Ontario, however the trends over time were similar to the data obtained from the coroner’s office.
Addiction, Author Interviews, CMAJ, Mental Health Research / 09.09.2015

Dr. Evan Wood MD, PhD, ABIM, FRCPC, ABAM Diplomat Professor of Medicine, UBC Canada Research Chair in Inner City Medicine Co-Director, Urban Health Research Initiative Medical Director for Addiction Services, Vancouver Coastal Health Physician Program Director for Addiction, Providence Health CareMedicalResearch.com Interview with: Dr. Evan Wood MD, PhD, ABIM, FRCPC, ABAM Diplomat Professor of Medicine, UBC Canada Research Chair in Inner City Medicine Co-Director, Urban Health Research Initiative Medical Director for Addiction Services, Vancouver Coastal Health Physician Program Director for Addiction Providence Health Care  Medical Research: What is the background for this study? What are the main findings? Dr. Wood: Drugs with the potential to produce altered states of consciousness were once the focus of intensive study in the 1950s and 1960s. While promising, this field of research has been dormant for decades but is now re-emerging as an area of intensive investigation and showing real potential as a new therapeutic paradigm in addiction medicine and mental health. While in its infancy, this is expected to be an area of much study in the coming years. Medical Research: What should clinicians and patients take away from your report? Dr. Wood: Psychedelic medicine is in its infancy and not ready for implementation in clinical practice. Clinicians and the community of individuals suffering from addiction and other concerns will hopefully support this area of research so that critical information on impacts and safety can be gathered.
Author Interviews, CMAJ, Infections, Vaccine Studies / 27.03.2015

MedicalResearch.com Interview with: Dr Fiona McQuaid Clinical Research Fellow University of Oxford, United Kingdom Medical Research: What is the background for this study? Response: Meningococcal B disease is a common cause of sepsis and meningitis with significant mortality and morbidity. A multicomponent vaccine against serogroup B meningococcus has been licensed for use in the Europe, Australia, Canada and recently the USA (though only in the 10-25 years age group) but questions remain about how long the bactericidal antibodies induced by infant vaccination persist and the likely breath of strain coverage. This was a follow on study looking at a group of children aged 5 years who had been vaccinated as infants and a different group who were vaccinated for the first time at 5 years of age. Medical Research: What are the main findings? Response: The percentage of children with protective antibody levels who had been immunized as infants fell in the 20 months since their last immunization but this varied by the strain of meingococcus B tested and by the different infant/toddler vaccination schedules. The children who were vaccinated for the first time at 5 years of age showed a good antibody response, but most reported pain and redness around the site of vaccination and 4-10% had a fever.
Author Interviews, CMAJ, Cognitive Issues / 28.02.2015

Optimized-dr-raza-naqviMedicalResearch.com Interview with: Dr. Raza M. Naqvi, MD, FRCPC Assistant Professor of Medicine Division of Geriatric Medicine Western University Victoria Hospital London, ON Medical Research: What is the background for this study? What are the main findings? Dr. Naqvi: The rates of dementia are rising worldwide. Currently we have over 35 million individuals with dementia in the world and this number will triple to over 100 million by 2050 according to the WHO. Many of these cases are in countries where English is not the first language and thus it is important to ensure that the diagnostic and assessment tools we use are valid in the populations being assessed. The Rowland Universal Dementia Assessment Scale (RUDAS) was developed in Australia in 2004 specifically to address the challenges of detecting cognitive impairment in culturally and linguistically diverse populations. This assessment tool is a brief questionnaire that clinicians can use as part of their initial assessment in those with memory loss or cognitive decline. It is freely available online (Search ‘RUDAS’) and takes less than 10 minutes for a clinician to complete with the individual being assessed. Our study was a systematic review and meta-analysis of the RUDAS which aimed to clarify the diagnostic properties of the test and see how it compares to other similar tests that are available. Through our detailed search of the literature we found 11 studies including over 1200 patients that assessed the RUDAS. The studies showed a combined sensitivity of 77.2% and specificity of 85.9%. This means that a positive test increases one’s likelihood of having dementia more than 5-fold and a negative test decreases their likelihood by 4-fold. Across the various studies, the Rowland Universal Dementia Assessment Scale performed similarly to the Mini-Mental State Examination (MMSE), the most commonly used cognitive assessment tool worldwide. The RUDAS appeared to be less influenced by language and education than the MMSE.
Author Interviews, Circadian Rhythm, CMAJ / 27.01.2015

Scott R. Garrison MD PhD Associate Professor, Department of Family Medicine Director, Pragmatic Trials Collaborative Faculty of Medicine University of Alberta EdmontonMedicalResearch.com Interview with: Scott R. Garrison MD PhD Associate Professor, Department of Family Medicine Director, Pragmatic Trials Collaborative Faculty of Medicine University of Alberta Edmonton MedicalResearch: What is the background for this study? What are the main findings? Dr. Garrison: Nocturnal leg cramps (also called rest cramps) are painful muscle tightenings, most often in the legs or feet, that are brought on by rest and often wake the sufferer from sleep. They are very common in older adults and can also occur during pregnancy. Having read anecdotal mention that the rest cramps of pregnancy appeared to be worse in summer we sought cohort level evidence to determine whether the more common presentation of age-related rest cramps was also seasonal. To do this we primarily looked at new quinine starts in the province of British Columbia over a period of several years. British Columbia has a publicly funded health care system and maintains electronic records on all health services, including prescription drugs, provided to its roughly 4.2 million residents. Quinine is approved for the treatment of acute malaria in Canada but is instead almost exclusively used off-label to prevent rest cramps. As such, new quinine starts are an excellent marker for new or escalating cramp burden. We also looked at Internet searches, geographically limited to the USA, for the term “leg cramps” (reflecting public interest) obtained from the Google Trends Search Volume Index Tool. Seasonality for both of these indicators of cramp burden was assessed by determining how well a least squares minimizing sinusoidal model predicted variability. We found that quinine starts and "leg cramp" related Internet queries were both strikingly sinusoidal with a 365-day periodicity (mid-summer high, mid-winter low) and a peak-to-peak variability that is approximately 2/3 of the mean. Seasonality accounted for 88% of the observed monthly variability (p < 0.0001) in quinine starts, and 70% of the observed variability (p < 0.0001) in “leg cramp” related internet searches.
Author Interviews, CMAJ, Pharmacology / 19.12.2014

MedicalResearch.com Interview with: Naveen Poonai MSc MD FAAP FRCPC Paediatric Emergency Physician Children's Hospital, London Health Sciences Center Assistant Professor Paediatrics and Internal Medicine Schulich School of Medicine and Dentistry London, Ontario, Medical Research: What is the background for this study? What are the main findings? Dr. Poonai: We found that in children discharged home with a fracture, both ibuprofen and oral morphine were effective at relieving pain. However, there were no significant differences in efficacy between the two agents and oral morphine was associated with more side effects. MedicalResearch.com: What was most surprising about the results? Dr. Poonai: The most surprising findings for us were that over 70% of children experienced pain significant enough to require analgesia once they were discharged home.  Furthermore, we were surprised to find that the anecdotally more potent agent morphine, was equivalent to ibuprofen for post-fracture pain relief in children.
Author Interviews, CMAJ, HPV, McGill, Vaccine Studies / 14.12.2014

Leah M. Smith PhD Department of Epidemiology, Biostatistics, and Occupational Health (Smith, Kaufman, Strumpf) McGill University, Montréal, QuebecMedicalResearch.com Interview with: Leah M. Smith PhD Department of Epidemiology, Biostatistics, and Occupational Health  (Smith, Kaufman, Strumpf) McGill University, Montréal, Quebec   Medical Research: What is the background for this study? What are the main findings? Dr. Smith: The human papillomavirus (HPV) vaccine protects against types of HPV that cause cervical cancer and anogenital warts. The vaccine first became available in 2006. Since then, it has faced a great deal of controversy surrounding, in part, some of the unanswered questions about the real-world effects of the vaccine, especially on the young girls targeted for immunization. One issue that has received a great deal of public attention has been the concern that HPV vaccination might give girls a false sense of protection against all sexually transmitted infections that might lead them to be more sexually active than they would otherwise. As a result, some parents have been reluctant to have their daughters vaccinated. It is also reason why some religious groups have spoken out against the vaccine. This question is further important from a public health perspective because increases in risky sexual behaviour would inevitably also lead to increases in teen pregnancy and sexually transmitted infections (excluding anogenital warts), which would of course undermine the potential health benefits of the vaccine.  In this study, we directly addressed the question of whether HPV vaccination has led to increases in pregnancy and non-HPV-related sexually transmitted infections (both of which are proxies for risky sexual behaviour) among adolescent girls. In our study of over 260,000 girls, we did not find any evidence that the HPV vaccine had a negative impact on these outcomes.
Author Interviews, CMAJ, Orthopedics, Surgical Research / 27.11.2014

MedicalResearch.com Interview with: NatNathan Evaniew MD Division of Orthopaedics McMaster Universityhan Evaniew MD Division of Orthopaedics McMaster University   Medical Research: What is the background for this study? Dr. Evaniew: Symptomatic cervical and lumbar spinal disc diseases affect at least 5% of the population and they cause a great deal of pain, disability, social burden, and economic impact. For carefully selected patients that fail to improve with nonsurgical management, conventional open discectomy surgery often provides good or excellent results. Minimally invasive techniques for discectomy surgery were introduced as alternatives that are potentially less destructive, but they require specialized equipment and expertise, and they may involve increased risks for technical complications.
Author Interviews, CMAJ, Diabetes, Electronic Records / 04.11.2014

Dr. Tim A. Holt PhD MRCP FRCGP NIHR Academic Clinical Lecturer University of Oxford Department of Primary Care Health Sciences Radcliffe Observatory Quarter Woodstock Road OxfordMedicalResearch.com Interview with: Dr. Tim A. Holt PhD MRCP FRCGP NIHR Academic Clinical Lecturer University of Oxford Department of Primary Care Health Sciences Radcliffe Observatory Quarter Woodstock Road Oxford Medical Research: What is the background for this study? Dr. Holt: Undiagnosed diabetes is a serious and very costly problem. Early diagnosis is important to reduce risk of long term complications. A structured approach to management at the practice level involves electronic diabetes registers, enabling audit of care, automated recall, and screen reminders. Such registers depend on the presence of an electronic code for diabetes in the record. 
Author Interviews, CMAJ, Stroke / 25.10.2014

MedicalResearch.com Interview with: Michael Douglas Hill, MD, MSc The Calgary Stroke Program, Department of Clinical Neurosciences Hotchkiss Brain Institute Associate Professor, University of Calgary Calgary, Alta MedicalResearch: What is the background for this study? Dr. Hill:  We conducted an audit of stroke admissions to Canadian hospitals in all provinces.  We examined key metrics of quality stroke care focusing on the acute treatment. Use of thrombolysis for stroke is a key quality metric in the Accreditation Canada standards for stroke care.  We found that the use of thrombolysis, while better than the past review (CMAJ. 2005 May 10;172(10):1307-12) remains low.  This is a marker for the overall quality of acute stroke care in Canada.  As expected, larger academic hospitals perform at a higher level than smaller community hospitals. Overall, this study serves to quantify the gaps in the delivery of acute stroke care to Canadians.
Author Interviews, CMAJ, Pediatrics, Vitamin D / 22.10.2014

Jonathon Maguire MD MSc FRCPC Pediatrician and Scientist Department of Pediatrics Li Ka Shing Knowledge Institute St. Michael’s Hospital University of TorontoMedicalResearch.com: Interview with: Jonathon Maguire MD MSc FRCPC Pediatrician and Scientist  Department of Pediatrics Li Ka Shing Knowledge Institute St. Michael’s Hospital University of Toronto   Medical Research: What is the background for this study? What are the main findings? Dr. Maguire: One of the main health benefits of cow’s milk is vitamin D.  We were interested to know if non-cow’s milk supports children’s vitamin D blood levels as well as cow’s milk.
Author Interviews, CMAJ, Mediterranean Diet, Metabolic Syndrome, Nutrition / 15.10.2014

Jordi Salas-Salvadó Professor of Nutrition Human Nutrition Unit Department of Biochemistry & Biotechnology IISPV School of Medicine. Rovira i Virgili University CIBERobn, Instituto Carlos IIIMedicalResearch.com Interview with: Jordi Salas-Salvadó Professor of Nutrition Human Nutrition Unit Department of Biochemistry & Biotechnology IISPV School of Medicine. Rovira i Virgili University CIBERobn, Instituto Carlos III Medical Research: What are the main findings of the study? Response: In this large, multicenter, randomized clinical trial conducted in Mediterranean individuals at high cardiovascular risk, Mediterranean-diet supplemented with extra-virgin olive oil was associated to a lower increase in the prevalence of metabolic syndrome compared to the advice on a control low-fat diet. However, no beneficial effect of Mediterranean-diet on the incidence of metabolic syndrome among participants free of this condition at baseline was observed. Therefore, the lower increase in prevalence was especially due to the reversion of metabolic syndrome in those individuals with metabolic syndrome at baseline.
Author Interviews, CMAJ, Diabetes, Thyroid Disease / 07.10.2014

MedicalResearch.com Interview with: Jean-Pascal Fournier, MD, PhD Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada and Laurent Azoulay, PhD Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Department of Oncology, McGill University, Montreal, Quebec, Canada Medical Research: What are the main findings of the study? Response: Patients with type II diabetes and treated hypothyroidism showed a 55% increased risk for low levels of thyroid stimulating hormone (TSH) (below 0.4 mIU/L) when initiating metformin, compared with those initiating sulfonylurea (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.09–2.20). In contrast, this effect of metformin was not observed in euthyroid patients, with an adjusted HR for low TSH of 0.97(95% CI 0.69–1.36).
Author Interviews, CMAJ / 12.09.2014

Annemarieke de Jonghe Academic Medical Center University of Amsterdam Departement of Internal Medicine Section of Geriatric Medicine F4-218 Amsterdam, The NetherlandsMedicalResearch.com Interview with: Annemarieke de Jonghe Academic Medical Center University of Amsterdam Departement of Internal Medicine Section of Geriatric Medicine F4-218 Amsterdam, The Netherlands Medical Research: What are the main findings of the study? Dr. de Jonghe: We investigated the preventive properties of melatonin versus placebo in a prospective cohort of elderly hip fracture patients (n=378). We found that 3mg melatonin vs placebo, given for 5 days from the day of admission, did not influence the incidence of delirium. However, in a posthoc analysis we found that more patients in the placebo group more often had a longer lasting delirium.
Author Interviews, CMAJ, Outcomes & Safety, Pediatrics / 20.08.2014

Dr Prakesh S Shah MSc, MBBS, MD, DCH, MRCP, FRCPC Professor, Departments of Paediatrics and HPME Mount Sinai Hospital and University of Toronto CIHR Applied Research Chair in Reproductive and Child Health Services and Policy Research Director, Canadian Neonatal Network Toronto Ontario Canada M5G 1X5MedicalResearch.com Interview with: Dr Prakesh S Shah MSc, MBBS, MD, DCH, MRCP, FRCPC Professor, Departments of Paediatrics and HPME Mount Sinai Hospital and University of Toronto CIHR Applied Research Chair in Reproductive and Child Health Services and Policy Research Director, Canadian Neonatal Network Toronto Ontario Canada M5G 1X5 Medical Research: What are the main findings of the study? Dr. Shah: The main findings of our study are that by embracing collaborative quality improvement program in 25 of 28 Neonatal ICUs in the country, we were able to show significant reduction in adverse outcomes of necrotizing enterocolitis, severe retinopathy of prematurity and nosocomial infections among preterm neonates born at less than 29 weeks of gestation. This resulted in significant overall reduction of composite outcome of mortality or severe morbidities and improved overall outcomes over 3 years of study period.
Author Interviews, Cancer Research, CMAJ / 08.08.2014

Tetyana Kendzerska MD, PhD Postdoctoral Fellow Institute for Clinical Evaluative Science, Sunnybrook Health Sciences Center, Toronto, ONMedicalResearch.com Interview with: Dr. Tetyana Kendzerska Institute for Clinical Evaluative Science Women's College Research Institute Women's College Hospital Department of Medicine University of Toronto Medical Research: What are the main findings of the study? Dr. Kendzerska: In a large cohort with varying degrees of obstructive sleep apnea (OSA), severity of obstructive sleep apnea was not found to be independently associated with either prevalent or incident cancer, except in one subgroup analysis in smoking-related cancer.
Author Interviews, CMAJ, Metabolic Syndrome, Pulmonary Disease, Weight Research / 14.07.2014

MedicalResearch.com Interview with: Dr Gundula Behrens Department of Epidemiology and Preventive Medicine University of Regensburg Franz-Josef-Strauss-Allee 11 93053 Regensburg, Germany Medical Research: What are the main findings of the study? Dr Behrens: We studied the relations of obesity and physical activity to the incidence of chronic obstructive pulmonary disease (COPD) among more than 100,000 middle-aged to elderly men and women living in the U.S. People with a large waist circumference (43.5 inches (110 cm) or over in women and 46.5 inches (118 cm) or over in men) had a 72% increased risk of COPD as compared to people with a normal waist circumference. In contrast, individuals who were physically active five times or more per week had a 29% decreased risk of COPD as compared to their physically inactive counter-parts.
Author Interviews, CMAJ, Compliance, Pharmacology, Statins / 25.06.2014

MedicalResearch.com Interview with: Dr. Heli Halava: Departments of Public Health and Pharmacology, Turku, Finland   MedicalResearch: What are the main findings of the study? Dr. Halava: The associations between lifestyle factors and nonadherence to statin therapy varied by cardiovascular comorbidity status. Of the participants without cardiovascular comorbidities (n = 6458), 3171 (49.1%) were nonadherent with their statin therapy. Of the participants with cardiovascular comorbidities (n = 2827), 1155 (40.9%) were nonadherent. People with cardiovascular comorbidities who had risky drinking behaviours or a cluster of lifestyle risks were at increased risk of nonadherence.
Accidents & Violence, Author Interviews, CMAJ, OBGYNE / 13.05.2014

Professor, Full SGS Member Director, Clinical Epidemiology Unit Sunnybrook Health Sciences Centre G106-2075 Bayview Avenue Toronto, ON Dr. Donald Redelmeier, MD Professor, Full SGS Member Director, Clinical Epidemiology Unit Sunnybrook Health Sciences Centre Toronto, ON MedicalResearch: What are the main findings of the study? Dr. Redelmeier: We identified every woman in Ontario, Canada, who gave birth to a newborn baby between 2006 and 2011 and then evaluated each driver for the months before, during, and after pregnancy.  This amounted to about half a million women who accounted for almost 8000 serious crashes that sent the driver to hospital.  We found that the second trimester of pregnancy led to a 42% increase in the risk of a serious motor vehicle crash.  The increased risk included diverse populations, distinct obstetrical cases, different crash characteristics. The risk equated to about twice the population norm but was still below male drivers at this age.
Author Interviews, CMAJ, OBGYNE / 28.04.2014

Professor Khalid Khan MMEd, MRCOG, MSc, FCPS, MBBS Women's Health Research Unit | Multi-disciplinary Evidence Synthesis Hub The Blizard Institute | 58 Turner Street | London | E1 2ABMedicalResearch.com Interview with: Professor Khalid Khan MMEd, MRCOG, MSc, FCPS, MBBS Women's Health Research Unit | Multi-disciplinary Evidence Synthesis Hub The Blizard Institute | 58 Turner Street | London | E1 2AB MedicalResearch.com: What are the main findings of the study? Prof. Khan: The risk of cesarean section was 12% lower among women undergoing induction of labor in comparison to the one that were managed expectantly. The subgroup comparison showed that the effect was significant in term and post-term however not in preterm gestations. Furthermore, induction of labor was associated with 50% and 14% reduction in risk of fetal death and admission to a neonatal intensive care unit, respectively.
Author Interviews, CMAJ, Cost of Health Care, Prostate Cancer / 26.04.2014

MedicalResearch.com Interview with: Alice Dragomir, MSc, PhD Assistant Professor, Urology/Surgery, McGill University Scientist, RI-MUHC MedicalResearch.com: What are the main findings of the study? Authors’ response: Our study demonstrates that for eligible patients, active surveillance could offer not only the known clinical advantages from the patient’s perspective, but also economic benefits from the health care system’s perspective. At the national level, the cost savings of an annual cohort of incident prostate cancers managed with active surveillance over a first year and 5 years of follow-up could be substantial. These are estimated at $96 million.
Author Interviews, Brain Injury, CMAJ / 26.04.2014

Jane Topolovec-Vranic, PhD Clinical Researcher, Trauma and Neurosurgery Program Associate Scientist, Li Ka Shing Knowledge Institute Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto Associate Member, Graduate Department of Rehabilitation Sciences, University of Toronto MedicalResearch.com Interview with: Jane Topolovec-Vranic, PhD Clinical Researcher, Trauma and Neurosurgery Program Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto Associate Member, Graduate Department of Rehabilitation Sciences, University of Toronto MedicalResearch.com What are the main findings of the study? Answer: In our study we found that almost half of the men interviewed in a homeless shelter in Toronto had experienced a traumatic brain injury in their past, and that most of them had experienced their first brain injury prior to becoming homeless, usually in the early teenage years.
Author Interviews, CMAJ, Cost of Health Care, Orthopedics / 23.04.2014

MedicalResearch.com Interview with: Susan Jaglal, PhD Senior Scientist Toronto Rehabilitation Institute University of Toronto, Toronto, Ontario MedicalResearch.com: What are the main findings of the study? Dr. Jaglal: Bone Mineral Density (BMD) tests are used to both diagnose osteoporosis and assess and individual’s risk of fracture. While the tests play an important role in bone health, they are sometimes ordered inappropriately. For example, while women age 40-44 are typically not at risk of fragility fracture or in need of Bone Mineral Density testing, these individuals received almost half the Bone Mineral Density tests performed in Ontario in 2007/2008. Policy changes have been made in recent years in an effort to curb unnecessary testing of low risk individuals in both the United States and Canada. Policy efforts in Ontario included a 2008 fee schedule change that limited repeated testing among low-risk patients and included a new fee code for a “baseline” tests. Patients were limited to 1 baseline test in their lifetime. The goal of the present study was to determine the impact of this fee schedule change on Bone Mineral Density testing rates. The study was based on an analysis of provincial administrative data including physician billings, hospital discharges, and emergency department visits. Results demonstrated that while fee schedule changes were associated with a decrease in BMD testing rates, the decreases affected both low and high-risk patients. Most decreases were seen in testing rates of low-risk women. However, the associated decrease in testing among high-risk patients (e.g., those over 65 or with a recent fracture) is concerning, as high-risk patients benefit from screening and monitoring of Bone Mineral Density.
Author Interviews, Blood Pressure - Hypertension, CMAJ, McGill, Stroke / 14.04.2014

Finlay A McAlister MD Division of General Internal Medicine Patient Health Outcomes Research and Clinical Effectiveness Unit Epidemiology Coordinating and Research (EPICORE) Centre McGill University, Montréal, QuebecMedicalResearch.com Interview with: Finlay A McAlister MD University of Alberta, Edmonton, Canada MedicalResearch.com: What are the main findings of the study? Dr. McAlister: We tested 2 systems of case management on top of usual care (note that at baseline more than 3/4 of our study patients were already taking medications to lower blood pressure (BP) and/or cholesterol but none were at guideline-recommended targets). The first (our "control" group) was a nurse seeing patients monthly x 6 months, measuring their blood pressure and LDL cholesterol, counseling them about risk factor reduction strategies (including lifestyle and medication adherence), and faxing results of BP/cholesterol to their primary care physicians with advice to patients who had blood pressure or cholesterol above guideline-recommended targets to see their primary care physician. The second (our "intervention" group) was a pharmacist seeing patients monthly x 6 months, measuring their blood pressure and LDL cholesterol, counseling them about risk factor reduction strategies (including lifestyle and medication adherence), and faxing results of BP/cholesterol to their primary care physicians.  However, if patients had blood pressure or cholesterol above guideline-recommended targets instead of just recommending that the patient see their primary care physician the pharmacist provided them with a prescription for medication (or up-titration of their current medications) to address the uncontrolled risk factor. Both groups improved substantially over usual care, but the intervention group improved even more (13% absolute improvement in control of BP/cholesterol levels compared to the nurse-led control arm) .
Author Interviews, CMAJ, Emergency Care, Gender Differences, Heart Disease, McGill / 20.03.2014

MedicalResearch.com Interview with: Roxanne Pelletier, PhD Postdoctoral Fellow Division of Clinical Epidemiology McGill University Health Centre (MUHC) 687 Pine Avenue West, V Building, Room V2.17 Montreal, QcRoxanne Pelletier, PhD Postdoctoral Fellow Division of Clinical Epidemiology McGill University Health Centre (MUHC) 687 Pine Avenue West, V Building, Room V2.17 Montreal, Qc MedicalResearch.com: What made you want to study this disparity between men and women and heart attacks?  Dr. Pelletier:  Despite enhanced medical treatment and decrease in the incidence of heart diseases, important sex disparities persist in the risk of mortality following a cardiac event: the risk of mortality is higher in women compared to men, and this sex difference is even more important in younger adults. Therefore, we aimed to investigate potential mechanisms underlying this sex difference in mortality.
Addiction, Author Interviews, CMAJ / 11.03.2014

MedicalResearch.com Interview with: Dr. Dagmar Haller, MD, PhD Médecin adjointe agrégée Unité Santé Jeunes Hôpitaux Universitaires de Genève Suisse MedicalResearch.com: What are the main findings of the study? Dr. Haller: One year after a consultation with a family doctor there was a 28% reduction in the proportion of excessive substance users among those who had reported excessive use at the start of the study but there was no significant difference between the group that received counseling and the one that did not.
Author Interviews, CMAJ, Weight Research / 04.03.2014

Dr. Laurie K. Twells, PhD School of Pharmacy, Memorial University, St. John’s Faculty of Medicine, Memorial University St. John’sNewfoundland and LabradorMedicalResearch.com Interview with: Dr. Laurie K. Twells, PhD School of Pharmacy, Memorial University, St. John’s Faculty of Medicine, Memorial University St. John’s Newfoundland and Labrador MedicalResearch.com: What are the main findings of the study? Dr. Twells: Obesity rates in Canada tripled between 1985 and 2011. Although class I obesity (BMI ≥ 30) appears to have increased at a slower rate, obese classes II (BMI ≥  35) and III (BMI ≥40) continued to increase disproportionately. Over the last decade, every province in Canada experienced increases in obesity rates. Overall obesity rates were lower in the west and higher in the eastern provinces and people over age 40 years were more likely to be overweight/obese than younger people. By 2019 it is projected that twenty-one per cent of Canadians will be obese but this will vary by province from 15.7% in British Columbia to 34.6% in Newfoundland and Labrador.
Author Interviews, CMAJ, Pulmonary Disease, Respiratory, Sleep Disorders / 03.03.2014

Dr. Vincent Yi-Fong Su Department of Chest Medicine Taipei Veterans General Hospital Taipei, TaiwanMedicalResearch.com Interview with: Dr. Vincent Yi-Fong Su Department of Chest Medicine Taipei Veterans General Hospital Taipei, Taiwan MedicalResearch.com: What are the main findings of the study? Answer: We found interestingly that patients with sleep apnea experienced a 1.20-fold (95% CI, 1.10-1.31; p <0.001) increase in incident pneumonia compared to patients without sleep apnea. We also demonstrated an “exposure-response relationship,” in that the patients with more severe sleep apnea might have a higher risk for pneumonia than did those of milder severity.
Author Interviews, CMAJ, OBGYNE / 10.02.2014

MedicalResearch.com Interview with: Dr. Sharon Daniel MD, MPH Physician, Intern in pediatrics at Soroka Medical Center, Beer-Sheva, Israel PhD Candidate and Prof. Amalia Levy (MPH, PhD Epidemiologist, Head of the Department of Public Health Principle Investigator. Ben-Gurion University of the Negev in Beer-Sheva, Israel, MedicalResearch.com: What are the main findings of the study? Answer: We tested the risk for miscarriage following the use of NSAIDs (ibuprofen, diclofenac, naproxen, indomethacin, etodolac) on the first trimester of pregnancy. We did not find increased risk among women who took those drugs during the first trimester of pregnancy, although we did find increased risk after the use of indomethacin. We found higher risk after the use of specific NSAIDs (Celecoxib, Rofecoxib, Etoricoxib) which are usually used to treat inflammatory diseases, only the exposure group was very small.
Aging, CMAJ / 21.01.2014

Professor Andrew Steptoe, MA, DPhil, DSc, FMedSci Director, Institute of Epidemiology and Health Care University College London British Heart Foundation Professor of Psychology Department of Epidemiology and Public Health London WC1E 6BTMedicalResearch.com Interview with: Professor Andrew Steptoe, MA, DPhil, DSc, FMedSci Director, Institute of Epidemiology and Health Care University College London British Heart Foundation Professor of Psychology Department of Epidemiology and Public Health London WC1E 6BT MedicalResearch.com: What are the main findings of the study? Dr. Steptoe: We are trying to understand whether positive well-being has beneficial effects as far as health and physical function is concerned.  The main findings are that the risk of developing impairments in activities of daily living (things life being able to bath or shower without help) over the next few years among older people is lower in people who enjoy life more. In addition, enjoyment of life predicted less decrease in walking speed over our 8 year study period in this sample of older men and women. Of course, these associations could be due to many things: the people with greater enjoyment of life could be more affluent, have less physical illness or disability to start with, or have healthier lifestyles at the outset, and these factors could predict the changes in physical function over time. But what we found is that baseline health, economic circumstances, and lifestyle explain only part of the association between enjoyment of life and deterioration in function. So the research suggests that enjoyment of life contributes to healthier and more active old age.