CMAJ
18 Nov Sleep Disorders: Accuracy of Portable Sleep Tests
MedicalResearch.com Interview with:
Mohamed El Shayeb MD, MSc
Health Technology and Policy Unit
University of Alberta
3025 Research Transition Facility
Edmonton, Alberta, Canada T6G2V2
MedicalResearch.com: What are the main findings of the study?
Dr. El Shayeb: Our study shows that limited channel level-3 portable devices, used at home, are of good diagnostic value compared to the comprehensive reference-standard level-1 sleep tests conducted in lab in the diagnosis of obstructive sleep apnea (the most common subtype of sleep disordered breathing.)
Were any of the findings unexpected?
None of the findings were unexpected. Level-3 portable devices are commonly used in clinical practice; however, this technology has been widely disseminated, without solid evidence about their diagnostic performance or the subpopulation of sleep disordered breathing patients who are most appropriately diagnosed with them. Our research provides a high level of evidence on the diagnostic performance of these devices, and most importantly, defines the subgroup of patients who are eligible for this test (patients with simple obstructive sleep apnea, and without significant comorbidities.)
19 Sep Cognitive Impairment and Hospital Readmissions
Posted at 13:17h
in CMAJ, Cognitive Issues, General Medicine, Hospital Readmissions, Outcomes & Safety
MedicalResearch.com Interview with:
Mark W. Ketterer, PhD, ABPP
Senior Bioscientific Staff
Henry Ford Hospital/A2
Detroit, MI 48202
Clinical Professor of Psychiatry & Behavioral Neurosciences
Department of Psychiatry Wayne State University
MedicalResearch.com: What are the main findings of the study:
Dr. Ketterer: A survey of 84 patients admitted to Henry Ford Hospital found 54% to have Moderate-Severe Cognitive Impairment (CI).
19 Sep Cancer Screening Trials: Weighing the Harms
MedicalResearch.com Interview with: Bruno Heleno, PhD fellow Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, 1014 Copenhagen K, Denmark MedicalResearch.com: What are the main findings of the study? Answer: In a literature review of cancer screening trials of a wide range of screening interventions, we found that trials seldom report the information necessary to weigh benefits against harms.19 Sep Colon Cancer: Screening and Mortality
MedicalResearch.com Interview with:
Aasma Shaukat, M.D., M.P.H.
Dept. of Medicine
GI Division, MMC 36
University of Minnesota
Minneapolis, MN 55455
MedicalResearch.com: What are the main findings of the study?
Dr. Shaukat: The study showed that screening for colon cancer using stool cards
consistently reduces risk of death from colon cancer by one-third through
thirty years. The benefit of screening in larger in men compared to women,
and for women the benefit seems to start at age 60. However, screening did
not make people live longer.
19 Sep Addiction: Does Chronic Care Management Improve Outcomes?
MedicalResearch.com Interview with:
Richard Saitz, MD MPH
Professor of Medicine and Epidemiology
Boston University Schools of Medicine and Public Health
Clinical Addiction Research and Education Unit, Boston Medical Center, Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study?
Dr. Saitz: Chronic care management in primary care did not improve health outcomes (abstinence from cocaine, opioids or heavy drinking; or any other clinical outcomes, like addiction consequences, emergency or hospital use, health-related quality of life, addiction severity) for people with alcohol or other drug dependence.
19 Sep Spine Pain Patients: Prevalence of Fibromyalgia in Tertiary Pain Clinic
MedicalResearch.com Interview with:
Chad M. Brummett, M.D.
Assistant Professor, University of Michigan Health System
Department of Anesthesiology
Division of Pain Medicine
1500 East Medical Center Drive, 1H247 UH, Box 5048
Ann Arbor, MI 48109
MedicalResearch.com: What are the main findings of the study?
Dr. Brummett: The study found that 42% of new patients presenting to a tertiary care pain clinic with a primary spine pain diagnosis met the American College of Rheumatology (ACR) survey criteria for fibromyalgia, which is a measure of widespread body pain and comorbid symptoms (e.g. trouble thinking, fatigue, mood symptoms, etc.). Patients categorized as fibromyalgia-positive using the survey measure were distinctly different from those not meeting criteria. In a multivariate regression model, independent predictors of being categorized as fibromyalgia-positive were female sex, higher neuropathic pain scores, anxiety, and lower physical function.
18 Sep Urinary Catheter Infections: Clinical Assessment vs National Safety Network Definition
Posted at 23:46h
in Author Interviews, CMAJ, Infections, Outcomes & Safety, Urinary Tract Infections
MedicalResearch.com Interview with:
Mohamad Fakih, MD, MPH
Medical Director, Infection Prevention and Control
St John Hospital and Medical Center
MedicalResearch.com: What are the main findings of the study?
Dr. Fakih: Urinary catheters are commonly used in the hospital. Although they help in the management of the sickest patients, they also present a risk for infection and other harms to the patient. The Centers for Medicaid and Medicare Services (CMS) have made catheter associated urinary tract infections (CAUTI) publicly reportable, and no longer reimburse hospitals for these infections if they occur in hospital setting. The definition of CAUTI is based on the surveillance definition of the National Healthcare Safety Network (NHSN) by the Centers for Disease Control and Prevention (CDC). We looked at clinician practice, including the Infectious Diseases specialist’s impression and compared them to the NHSN definition. We found a significant difference between what clinicians think is a urinary catheter infection and give antibiotics for it compared to the NHSN definition. The NHSN definition predicted clinical infection by the Infectious Diseases specialist in only about a third of the cases. We also found that Infectious Disease specialists considered patients to have true CAUTI in only half of what clinicians treated as CAUTI.
18 Sep Unhealthy Aging and Chronic Inflammation
MedicalResearch.com Interview with: Tasnime Akbaraly PhD Institut National de la Santé et de la Recherche Médicale Montpellier, France MedicalResearch.com: What are the main findings of the study? Dr. Akbaraly: The aim of this study was to examine the association between chronic inflammation and a range of aging phenotypes, assessed approximately 10 years later in a large British population of men and women -The Whitehall II Study-. As inflammation characterises a wide range of pathological processes, we considered several aging phenotypes, including cardiovascular disease (fatal and non-fatal), non-cardiovascular mortality and successful aging which encompasses optimal functioning across different physical, mental, and cognitive domains We found that chronic inflammation characterized by high levels of interleukin-6 (>2 pg/mL) twice over the 5-year exposure period nearly halved the odds of successful aging after 10–years of follow-up compared to maintaining low levels of interleukin-6 (<1pg/mL twice over the exposure period). Chronic inflammation was also associated with increased odds of future cardiovascular disease and non-cardiovascular mortality in a dose-response fashion. These associations were found to be independent of socio-economic factors, health behaviours (smoking, physical activity), and conditions such as obesity as well as the use of anti-inflammatory drugs and acute inflammation.18 Sep Diabetes: Increased Mortality Risk in Regardless of Race or Ethnicity
MedicalResearch.com Interview with:
Dr. Yunsheng Ma MD, PHD, MPH
Division of Preventive and Behavioral Medicine
Department of Medicine
University of Massachusetts Medical School
55 Lake Avenue North, Worcester, MA 01655
MedicalResearch.com: What are the main findings of the study?
Dr. Ma: Regardless of race/ethnicity, diabetes increases the risk of mortality the same compared to non-diabetes among different race/ethnicity. However, since there are higher prevalence of diabetes in Black and Hispanic, death rate due to diabetes is much higher in Black and Hispanic, this is because the diabetes prevalence rates are much higher in these population. Therefore, diabetes prevention is key to reduce diabetes related mortality disparities among racial/ethnic groups.
18 Sep Obesity: Low Childhood IQ Raises Risk of Midlife Obesity and Late-Life Dementia
MedicalResearch.com Interview with: Daniel Belsky, PhD NIA Postdoctoral Fellow Center for the Study of Aging and Human Development Duke University Box 104410 Durham, NC 27708 Is Obesity Associated With a Decline in Intelligence Quotient During the First Half of the Life Course? MedicalResearch.com: What are the main findings of the study? Dr. Belsky: Midlife obesity is linked with...
18 Sep MRIs of the Knee: How big a role is doctor’s financial stake?
MedicalResearch.com Interview with:
Matthew P. Lungren, MD
Duke University Medical Center
MedicalResearch.com: What are the main findings of the study?
Dr. Lungren: In the single center study, knee MRIs are more likely to be normal when the referring doctor has a financial stake in the imaging center or the equipment used; these data suggest that some of these examinations may be unnecessary.
18 Sep Pediatrics: Psychosomatic Problems in Bullied Children
MedicalResearch.com Interview with: Gianluca Gini, PhD and Tiziana Pozzoli, PhD Department of Developmental and Social Psychology University of Padua, Padua, Italy MedicalResearch.com: What are the main findings of the study? Answer: Results of this meta-analysis show that bullied children are twice as likely as non-bullied children to experience psychosomatic symptoms (e.g., headache, stomachache, backache, abdominal pain, dizziness, sleeping problems, poor appetite, bedwetting, skin problems, vomiting), especially in samples that included an higher proportion of boys. Importantly, the same result was found not only with cross-sectional studies but also in a meta-analysis of six studies that employed a longitudinal design.18 Sep Dementia: Lewy Body vs Parkinson’s Disease
MedicalResearch.com Interview with:
Rodolfo Savica, MD, MSc
Department of Neurology, College of Medicine
Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of this study?
Dr. Savica: This study is the first in North America to explore the incidence of DLB and PDD in a population based sample. We found that the overall incidence of dementia with Lewy bodies (DLB), considered the second leading cause of neurodegenerative dementia after Alzheimer`s disease, is lower than that of Parkinson`s disease (PD), increases steeply with age, and is markedly higher in men than in women.
18 Sep Social Isolation Linked to Mortality
MedicalResearch.com Interview with: Matthew S. Pantell, MD, MS Department of Pediatrics University of California, San Francisco MedicalResearch.com: What are the main findings of the study? Dr. Pantell: First of all, our study confirms the strong association between social isolation and mortality in a nationally representative sample from the US. Furthermore, it shows that, within the same national sample, social isolation is a similarly strong predictor of mortality as compared to smoking, obesity, high blood pressure, and high cholesterol. Examining individual components of social isolation, our study shows that, among both women and men, not living with a partner and not participating in religious activities frequently are strong individual predictors of mortality. Finally, our work shows that infrequent social contact is associated with mortality among women, and not participating in social clubs/organizations is associated with mortality among men.18 Sep Adolescents: Bending the Obesity Curve
MedicalResearch.com Interview with: Ronald J. Iannotti, PhD Prevention Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland Trends in Physical Activity, Sedentary Behavior, Diet, and BMI Among US Adolescents, 2001–2009 MedicalResearch.com: What are the main findings of the study? Dr. Iannotti: Although average BMI percentile increased from 2001 to 2005 it did not increase from 2005 to 2009. This is consistent with some recent studies that suggest the increase in overweight and obesity may be leveling off. We suggest that we may be 'bending the curve'. During the same period, physical activity and consumption of fruits and vegetables increased while television watching and consumption of sweets and sweetened beverages decreased. We cannot say whether television watching was replaced with more time spent on computers but we did not find an increase in computer use from 2005 to 2009.17 Sep Stroke Risk: Increased Risk with Intraplaque Carotid Artery Hemorrhage
MedicalResearch.com Interview with:
Tobias Saam, MD
Institute of Clinical Radiology
Ludwig-Maximilians-Univ Hosp
Munich, Germany
MedicalResearch.com: What are the main findings of the study?
Dr. Saam: The results of our meta-analysis suggest that despite a large degree of detected heterogeneity of the published studies, the presence of intraplaque hemorrhage by MRI in patients with carotid artery disease is associated with an approximately 5.6-fold higher risk for cerebrovascular events, such as TIA or stroke, as compared to subjects without intraplaque hemorrhage.
17 Sep Breast Cancer in Young Women: Decisions that Affect Contralateral Prophylactic Mastectomy
MedicalResearch.com Interview with:
Shoshana M. Rosenberg, ScD, MPH
Researcher, Susan F. Smith Center for Women's Cancers
Dana-Farber Cancer Institute
MedicalResearch.com: What are the main findings of the study?
Answer: Rates of contralateral prophylactic mastectomy (CPM) have been increasing among all breast cancer patients, however this trend has been most pronounced among the youngest women with breast cancer. Because of this trend, we sought to better understand why the youngest women - those diagnosed at age 40 or younger - were deciding to have this surgery.
Many women not considered "high-risk", e.g., those without a cancer pre-disposing mutation, cited a desire to prevent the breast cancer from spreading as well as a desire to improve survival as reasons for undergoing the procedure, indicating they overestimate the benefit of having this surgery, as CPM does not affect these outcomes. While CPM does reduce the risk of developing breast cancer in the unaffected breast, in women who are not considered "high-risk", this risk is relatively low, however many women overestimated this risk as well.
17 Sep Melanoma: PDK1 Kinase Required for Development and Metastasis
MedicalResearch.com Interview with:
Ze'ev Ronai, Ph.D.
Professor and scientific director of Sanford-Burnham Medical Research Institute La Jolla San Diego, Calif.
MedicalResearch.com: What are the main findings of the study?
Answer: This study provides the first direct evidence of the importance of the PDK1 enzyme in the development of melanoma and in the metastasis of this aggressive tumor type. We demonstrate, with a genetic mouse melanoma model (harboring the Braf/Pten mutations commonly seen in human melanomas) and/or pharmacological inhibitors against PDK1, that melanoma requires this enzyme for its development, and more so – for its ability to metastasize. Since PDK1 is key kinase that regulates a number of protein kinases, which are currently being assessed in clinical trials (including AKT), our finding points to a new set of targets that could be more amenable for effective combination therapy in melanoma.
16 Sep Opiod Prescriptions: Marked Increase in 10 Year Period
Matthew Daubresse, MHS Research Data Analyst Center for Drug Safety and Effectiveness Johns Hopkins School of Public Health 615 N. Wolfe Street, Suite W6023 Baltimore, MD 21205 MedicalResearch.com: What are the main findings of the study? Answer: Over the past decade, prescriptions for non-opioid medications remained stable or declined among ambulatory pain visits in the United States. In visits for new-onset musculoskeletal pain, non-opioid prescribing decreased from 38% of visits in 2000 to 29% of visits in 2010. During this time, opioid prescriptions nearly doubled. Few patient, provider, and visit characteristics were associated with the likelihood of opioid receipt, suggesting increases in opioid prescribing have occurred generally across different groups of patients.16 Sep Coronary Artery Bypass Grafting: On-Pump vs Off-Pump Trends and Mortality
Posted at 10:58h
in Author Interviews, Baylor College of Medicine Houston, CMAJ, Heart Disease, JAMA
MedicalResearch.com Interview with:
Faisal G. Bakaeen, MD FACS
Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, Texas
MedicalResearch.com: What are the main findings of the study?
Dr. Bakaeen: The relative use of off-pump CABG peaked at 24% in 2003, followed by a slow decline after that to about 19%. In addition, the conversion rate from off- to on-pump decreased with time and has stayed below 3.5% in recent years. Perioperative mortality rates decreased over time for both on- and off-pump CABG and have stayed below 2% since 2006. The mortality associated with converted cases was high regardless of the surgery year.