Author Interviews, Heart Disease, JAMA / 03.06.2014

MedicalResearch.com Interview with: Sana Al-Khatib, M.D. MHS Duke Clinical Research Institute Duke University School of Medicine Durham, NC, MedicalResearch.com Interview with: Sana Al-Khatib, M.D. MHS Duke Clinical Research Institute Duke University School of Medicine Durham, NC, MedicalResearch: What are the main findings of the study? Dr. Al-Khatib: Patients with an ejection fraction (measure of the pumping ability of the heart) of 30% to 35% who receive a prophylactic implantable cardioverter defibrillator have better survival than similar patients with no implantable defibrillator. (more…)
Accidents & Violence, JAMA, Pediatrics, Yale / 03.06.2014

Dr. Christopher Wildeman PhD Associate Professor of Sociology Faculty fellow at the Center for Research on Inequalities and the Life Course (CIQLE), and at the Institution for Social and Policy Studies (ISPS) at Yale University. MedicalResearch.com Interview with Dr. Christopher Wildeman PhD Associate Professor of Sociology Faculty fellow at the Center for Research on Inequalities and the Life Course (CIQLE), and at the Institution for Social and Policy Studies (ISPS) at Yale University. MedicalResearch.com: What are the main findings of the study? Dr. Wildeman: There are four key findings in the study. First, the cumulative risk of having a confirmed maltreatment report any time between birth and age 18 is much higher than most people would have thought. Fully 1 in 8 American children will experience this event at some point. Second, the risk of experiencing this event is highly unequally distributed, with Black and Hispanic experiencing it much more than Hispanic, White, and (especially) Asian children. Between 1 in 4 and 1 in 5 Black children will have a confirmed maltreatment report at any time in their childhood. For Native American, the risk is about 1 in 7. Third, the risk of maltreatment is quite similar for boys and girls. Finally, the highest risks of child maltreatment are in the first few years of life, suggesting that interventions aiming to diminish maltreatment should focus on parents with very young children. (more…)
Author Interviews, JAMA, Ophthalmology / 01.06.2014

Reed Jost, MS Retina Foundation of the Southwest 9600 N Central Expwy, Suite 200 Dallas, TX 75231 MedicalResearch.com Interview with: Reed Jost, MS Retina Foundation of the Southwest 9600 N Central Expwy, Suite 200 Dallas, TX 75231 MedicalResearch: What are the main findings of the study? Answer: Commercially available automated screening devices assess refractive risk factors, not amblyopia or strabismus, resulting in under-referral of affected children and over-referral of healthy children to pediatric eye care professionals. The Pediatric Vision Scanner is a binocular retinal birefringence scanner that directly detects strabismus and amblyopia by analyzing binocular scans for the presence or absence of birefringence, which is characteristic of steady, bifoveal fixation. We found that the Pediatric Vision Scanner outperformed an automated, refractive error screener (SureSight Autorefractor) in a cohort of 300 patients (2-6 years) tested in a pediatric ophthalmology setting. Compared to the SureSight, the Pediatric Vision Scanner had significantly higher sensitivity and higher specificity in the detection of strabismus and amblyopia. (more…)
Author Interviews, General Medicine, JAMA / 01.06.2014

Dr David A Hanauer MD MS Department of Pediatrics University of Michigan Medical School Ann Arbor, MI MedicalResearch.com Interview with: Dr David A Hanauer MD MS Department of Pediatrics University of Michigan Medical School Ann Arbor, MI MedicalResearch.com: What are the main findings of the study Dr. Hanauer: The main findings of our study were that: (1) Awareness and usage of rating sites for physicians appears to be growing, (2) The public is using these sites to make decisions about selecting (or avoiding) a physician, and (3) The percentage of people leaving ratings is still low (about 5%) suggesting that the results may not be representative of the majority of patient experiences. (more…)
Addiction, Author Interviews, JAMA, Pharmacology / 31.05.2014

Theodore J. Cicero, PhD Professor, Vice Chairman for Research Department of Psychiatry Washington University in St Louis St Louis, Missouri MedicalResearch.com Interview with: Theodore J. Cicero, PhD Professor, Vice Chairman for Research Department of Psychiatry Washington University in St Louis St Louis, Missouri MedicalResearch: What are the main findings of the study? Dr. Cicero: Heroin users nowadays are predominantly white men and women in their late 20s living outside large urban areas who were first introduced to opioids through prescription drugs compared to the 1960s when heroin users tended to be young urban men whose opioid abuse started with heroin. (more…)
Author Interviews, JAMA, Pediatrics, Pulmonary Disease / 29.05.2014

Susan Wu MD Division of Hospital Medicine, Children's Hospital Los Angeles Assistant Professor of Clinical Pediatrics, Keck School of Medicine of the University of Southern California MedicalResearch.com Interview with: Susan Wu MD Division of Hospital Medicine, Children's Hospital Los Angeles Assistant Professor of Clinical Pediatrics, Keck School of Medicine of the University of Southern California MedicalResearch: What are the main findings of the study? Dr. Wu: We performed a randomized trial at 2 urban free-standing children's hospitals, comparing inhaled 3% hypertonic saline to 0.9% normal saline in patients under 24 months with bronchiolitis. Patients with prematurity less than 34 weeks, cyanotic heart disease, chronic pulmonary disease, and previous episodes of wheezing or bronchodilator use were excluded. Patients were 4 mL of study medication nebulized up to 3 times in the emergency department; if admitted, patients continued to receive the assigned study medication three times a day until discharge. A total of 408 patients were analyzed. We found that 28.9% of patients treated with hypertonic saline required hospital admission, compared with 42.6% of patients in the normal saline group. (more…)
Author Interviews, JAMA, Neurological Disorders, Pediatrics / 29.05.2014

Kimford J. Meador, MD Professor Department of Neurology & Neurological Sciences Stanford Comprehensive Epilepsy Center Stanford University School of Medicine Stanford, CA 94305-5235. MedicalResearch.com Interview with: Kimford J. Meador, MD Professor Department of Neurology & Neurological Sciences Stanford Comprehensive Epilepsy Center Stanford University School of Medicine Stanford, CA 94305-5235. MedicalResearch: What are the main findings of the study? Dr. Meador: Breastfeeding while taking antiepileptic drugs does not appear to pose a risk to the child's development, and in fact the cognitive outcomes were better for those children who were breastfed vs. those were not. (more…)
Addiction, Author Interviews, JAMA, Neurological Disorders / 28.05.2014

MedicalResearch.com Interview with Dr. Edythe D.London PhD Professor, Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology David Geffen School of Medicine, UCLA Dr. Edythe D.London PhD Professor, Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology David Geffen School of Medicine, UCLA MedicalResearch: What are the main findings of the study? Dr. London: Brain function related to risky decision-making was different in stimulant users (methamphetamine users) than in healthy control subjects. In healthy controls, activation in the prefrontal cortex (right dorsolateral prefrontal cortex) during risk-taking in the laboratory was sensitive to the level of risk. This sensitivity of cortical activation was weaker in stimulant users, who instead had a stronger sensitivity of striatum activation. The groups also differed in circuit-level activity (network activity) when they were not performing a task but were “at rest.” Stimulant users showed greater connectivity within the mesocorticolimbic system, a target of abused drugs. This connectivity was negatively related to sensitivity in the prefrontal cortex to risk during risky decision-making. In healthy control subjects, connectivity between the right dorsolateral prefrontal cortex and striatum was positively related to sensitivity of prefrontal cortical activation to risk during risky decision-making. (more…)
Author Interviews, Cognitive Issues, Hearing Loss, JAMA, Pediatrics / 28.05.2014

William Kronenberger, Ph.D., HSPP Professor and Director, Section of Psychology Acting Vice Chair of Administration Department of Psychiatry Indiana University School of Medicine Riley Child and Adolescent Psychiatry Clinic MedicalResearch.com Interview with: William Kronenberger, Ph.D., HSPP Professor and Director, Section of Psychology Acting Vice Chair of Administration Department of Psychiatry Indiana University School of Medicine Riley Child and Adolescent Psychiatry Clinic MedicalResearch: What are the main findings of the study? Dr. Kronenberger: The main findings of the study are that children with cochlear implants had two to five times the risk of delays in executive functioning compared to children with normal hearing. Executive functioning is the ability to regulate and control thinking and behavior in order to focus and achieve goals; it is important for everything from learning to social skills. The areas of executive functioning that were most affected in children with cochlear implants were working memory, controlled attention, planning, and concept formation. Approximately one-third to one-half of the sample of children with cochlear implants had at least mild delays in these areas, compared to one-sixth or fewer of the normal-hearing sample. We think that reduced hearing experience and language delays cause delays in executive functioning to occur at higher rates in children with cochlear implants. (more…)
Author Interviews, Cancer Research, JAMA, Vaccine Studies / 27.05.2014

Scott A. Gruber, M.D., Ph.D., MBA, FACS, FCP, FACHE, CPE Chief of Staff, John D. Dingell VA Medical Center Associate Dean for Veterans Affairs & Professor of Surgery Wayne State University School of Medicine John D. Dingell VA Medical Center Chief of Staff Detroit, MI 48201 MedicalResearch.com Interview with: Scott A. Gruber, M.D., Ph.D., MBA, FACS, FCP, FACHE, CPE Chief of Staff, John D. Dingell VA Medical Center Associate Dean for Veterans Affairs & Professor of Surgery Wayne State University School of Medicine John D. Dingell VA Medical Center Chief of Staff Detroit, MI 48201 MedicalResearch: What are the main findings of the study? Dr. Gruber: We successfully addressed the problem of inadequate intracellular delivery of tumor- specific antigens (TSAs) to dendritic cells (DCs) by using synthetic cell-penetrating domains or peptides (CPPs) to create fusion tumor antigens (Ags) that readily penetrate through the plasma membrane. We demonstrated cloning and purification of the TSA melanoma-associated antigen 3 (MAGE-A3) in frame with CPP, producing enhanced cytosolic bioavailability in dendritic cells without altering cell functionality. Further, we showed that recombinant bacterial proteins can be easily engineered to purify large amounts of CPP-MAGE-A3. Use of full-length proteins circumvents the need to define HLA class I allele binding before vaccination and increases the number of epitopes recognized by CD8+ cytotoxic T lymphocytes (CTLs) when compared with peptide-pulsed dendritic cells. Finally, the use of proteins rather than plasmids or viral vectors for in vitro dendritic cell vaccine preparation avoids the practical and theoretical safety concerns regarding genomic modification. (more…)
Author Interviews, Breast Cancer, JAMA / 25.05.2014

Dr. Sarah Hawley PhD MPH Associate Professor in the Division of General Medicine University of Michigan Research Investigator, Ann Arbor VA Center of Excellence in Health Services Research & Development MedicalResearch.com Interview with: Dr. Sarah Hawley PhD MPH Associate Professor in the Division of General Medicine University of Michigan Research Investigator, Ann Arbor VA Center of Excellence in Health Services Research & Development   MedicalResearch: What are the main findings of the study? Dr. Hawley: There are a couple of main findings.
  • First, we found that nearly 20% of women in our population based sample of breast cancer patients reported strongly considering having contralateral prophylactic mastectomy (CPM, which means they had their unaffected breast removed at the same time as the breast with cancer), and about 8% received it. Of those who did receive contralateral prophylactic mastectomy, most (about 70%) did not have a clinical indication for it, which included a positive genetic mutation of BRCA1 or BRCA2 or a strong family history of breast or ovarian cancer.
  • However, most women (90%) who received it reported having a strong amount of worry about the cancer coming back (also called worry about recurrence).
  • We also found that when women had an MRI as part of their diagnostic work-up for breast cancer, they more often received contralateral prophylactic mastectomy than when they did not have an MRI.
(more…)
Author Interviews, Diabetes, JAMA, Yale / 24.05.2014

MedicalResearch.com Interview with: Neel M. Butala, AB Medical student at Yale School of Medicine New Haven, Connecticut MedicalResearch.com: What are the main findings of the study? Answer: We found that patients with diabetes had a disproportionate reduction in in-hospital mortality relative to patients without diabetes over the decade from 2000 to 2010. (more…)
Author Interviews, Compliance, JAMA, Pharmacology, Schizophrenia / 23.05.2014

Scott Stroup, MD, MPH Professor of Psychiatry Director, Program for Intervention Effectiveness Research, Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric Institute Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York MedicalResearch.com Interview with: Scott Stroup, MD, MPH Professor of Psychiatry Director, Program for Intervention Effectiveness Research, Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric Institute Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York MedicalResearch: What are the main findings of the study? Dr. Stroup: We conducted a study sponsored by the National Institute of Mental Health that compared long-acting injectable antipsychotics for people with schizophrenia. Long-acting injectable antipsychotics, also known as depot antipsychotics, are used to promote treatment adherence. We compared a newer injectable antipsychotic, paliperidone palmitate, to an older one, haloperidol decanoate. We did not find an advantage for the newer drug in overall effectiveness. The drugs performed very similarly, and were tolerated about the same. (more…)
Author Interviews, Diabetes, JAMA, OBGYNE / 22.05.2014

Wei Bao MD, PhD Postdoc fellow, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 MedicalResearch.com Interview with: Wei Bao MD, PhD Postdoc fellow, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 MedicalResearch: What are the main findings of the study? Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are: (1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI). (2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI. (3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI. (more…)
Author Interviews, JAMA, Neurological Disorders, Pediatrics / 21.05.2014

James Chamberlain, MD Division Chief, Emergency Medicine Children’s National Health System Washington, DC MedicalResearch.com Interview with: James Chamberlain, MD Division Chief, Emergency Medicine Children’s National Health System Washington, DC MedicalResearch: What are the main findings of the study? Dr. Chamberlain: Contrary to our hypothesis, lorazepam was not superior to diazepam for treating pediatric seizures. Both medications had similar effectiveness (72-73%) and safety (15-16% incidence of assisted ventilation). Lorazepam caused a longer period of sedation prior to waking up. The difference was approximately 15 minutes. (more…)
Author Interviews, Exercise - Fitness, General Medicine, JAMA, Rheumatology / 21.05.2014

Professor Kim Bennell ARC Future Fellow Department of Physiotherapy University of Melbourne Parkville, Vic 3010 Australia MedicalResearch.com Interview Professor Kim Bennell ARC Future Fellow Department of Physiotherapy University of Melbourne Parkville, Vic 3010 Australia MedicalResearch: What are the main findings of the study? Professor Bennell: In 102 people with painful hip osteoarthritis, we compared a 'real' physical therapy program involving exercise, manual therapy techniques,education and provision of a cane if appropriate to a sham physical therapy treatment that was made to look as though it was real but instead involved turned off ultrasound and gentle application of a hand crème to the hip region. Participants in both groups went to see a physical therapist on 10 occasions over 12 weeks and performed home exercises if in the 'real' physical therapy group or lightly applied the cream at home if in the sham group. Participants were followed for 9 months in total. We found that while both groups showed improvements in pain and physical function, the improvements were similar between the two groups. That is, the real physical therapy program did not show greater benefits over a sham treatment. (more…)
Author Interviews, JAMA, Kidney Stones, Urology / 21.05.2014

Charles D. Scales, Jr MD MSHS Assistant Professor of Surgery Division of Urologic Surgery Duke University Medical Center MedicalResearch Interview with: Charles D. Scales, Jr MD MSHS Assistant Professor of Surgery Division of Urologic Surgery Duke University Medical Center   MedicalResearch: What are the main findings of the study? Dr. Scales: When it comes to treating kidney stones, less invasive is not always better. We used the best method short of a randomized trial to balance out patients in terms of factors that might influence the success of treatment. In other words, we achieved a “statistical toss-up” for factors that could influence the outcome of the procedure. When we balanced out all of the factors that might influence the chance of a repeat procedure, we found that about 11% of patients treated with non-invasive SWL had a repeat procedure, as compared to <1% with minimally invasive URS. (more…)
Author Interviews, Baylor College of Medicine Houston, JAMA, OBGYNE, Vaccine Studies / 16.05.2014

Flor M. Munoz, MD Department of Pediatrics Department of Molecular Virology and Microbiology Baylor College of Medicine, Houston, Texas MedicalResearch.com Interview with: Flor M. Munoz, MD Department of Pediatrics Department of Molecular Virology and Microbiology Baylor College of Medicine, Houston, Texas MedicalResearch.com: What are the main findings of the study? Dr. Munoz: 1. Tdap vaccine was safe and well tolerated during pregnancy 2. Women who are pregnant have adequate responses to the Tdap vaccine, similar to those of women who are not pregnant. 3. Antibodies to pertussis are efficiently transferred to the fetus through the placenta so that babies of mothers who were vaccinated during pregnancy had significantly higher concentrations of antibody at birth and up to 2 months of age, when compared to infants of mothers who were vaccinated post-partum. 4. Higher antibody concentrations in the first two months of life are likely to provide protection against pertussis during this period of high vulnerability 5. Infants of mothers who were vaccinated during pregnancy had adequate responses to their routine pertussis vaccines at 2, 4, and 6 months of age, and had expected and adequate responses to their 4th dose of vaccine at 1 year of age. The absolute concentration of antibodies to some of the pertussis antigens might be modestly lower after the primary series of vaccines in some infants of mothers who were vaccinated during pregnancy, but this difference does not persist after the 4th dose. (more…)
Accidents & Violence, Author Interviews, Brain Injury, JAMA / 14.05.2014

Patrick S. F. Bellgowan, PhD Laureate Institute for Brain Research Faculty of Community Medicine, The University of Tulsa, Tulsa, Oklahoma MedicalResearch Interview with: Patrick S. F. Bellgowan, PhD Laureate Institute for Brain Research Faculty of Community Medicine, The University of Tulsa, Tulsa, Oklahoma MedicalResearch: What are the main findings of the study? Dr. Bellgowan: These results demonstrate 14% and 24% smaller hippocampal volumes in collegiate football players with and without a history of concussion relative to education-, sex- and age-matched controls participants. Further, the number of years of tackle football experience was correlated with smaller hippocampi and slower baseline reaction times. The hippocampus plays a key role in memory and emotional regulation. Volumetrics of other medial temporal lobe structures (I.e. The amygdala) did NOT show differences among groups suggesting that this effect is localized to the hippocampus. (more…)
Author Interviews, JAMA, Statins / 14.05.2014

Medidr_jennifer_robinson calResearch.com Interview with: Jennifer G. Robinson, MD, MPH Professor ,Departments of Epidemiology & Medicine Director, Prevention Intervention Center Department of Epidemiology College of Public Health University of Iowa Iowa City, IA 52242-2007 MedicalResearch: What are the main findings of the study? Dr. Robinson: The PCSK9 antibody, evolocumab, reduced LDL (or bad) cholesterol by about 65-70% regardless of the dose or type of statin used. This is a greater percentage reduction than ezetimibe, another drug used to lower LDL cholesterol in statin-treated patients, which lowered LDL cholesterol 15-20%. Side effects of evolocumab were similar to those for ezetimibe or placebo. (more…)
Author Interviews, Hospital Readmissions, JAMA, Mayo Clinic / 13.05.2014

Aaron L. Leppin, MD Knowledge and Evaluation Research Unit Mayo Clinic, Rochester, Minnesota MedicalResearch.com Interview with: Aaron L. Leppin, MD Knowledge and Evaluation Research Unit Mayo Clinic, Rochester, Minnesota MedicalResearch.com: What are the main findings of the study? Dr. Leppin: We conducted a systematic review and meta-analysis of randomized trials assessing the effectiveness of hospital discharge interventions on reducing 30-day readmission rates. We identified 47 trials, 42 of which contributed to the primary meta-analysis. Overall, the interventions that have been tested to reduce early hospital readmissions reduce them by about 20%. The ones that are most effective, though, reduce them by almost 40% and use a consistent but complex approach. These interventions make a robust effort to fully understand the patient’s post-discharge context, often by visiting the patient’s home. They focus on identifying all the things the patient needs to do to be well—whether that’s organizing medications, getting a ride to the clinic, or paying the electric bill—and they determine whether the patient has the necessary resources and capacity to pull it all off. When limitations are found, these interventions have a strategy in place to support the patient through the post-discharge period. (more…)
Author Interviews, JAMA, Pediatrics / 13.05.2014

Charbel El Bcheraoui, PhD, MSc Acting Assistant Professor, Global Health Institute for Health Metrics and Evaluation University of Washington Seattle, WA 98121 MedicalResearch Interview with: Charbel El Bcheraoui, PhD, MSc Acting Assistant Professor, Global Health Institute for Health Metrics and Evaluation University of Washington Seattle, WA 98121 MedicalResearch: What are the main findings of the study? Dr. El Bcheraoui: We found a low rate of adverse events associated with male circumcision from U.S. hospital settings, especially if the procedure is performed within the first year of life. The rate of adverse events increased about 10 - 20 times if the procedure was performed later in life. (more…)
Aging, Author Interviews, JAMA / 12.05.2014

Richard D. Semba, MD MPH W. Richard Green Professor of Ophthalmology The Johns Hopkins University School of Medicine Baltimore, MD 21287 MedicalResearch.com Interview with: Richard D. Semba, MD MPH W. Richard Green Professor of Ophthalmology The Johns Hopkins University School of Medicine Baltimore, MD 21287 MedicalResearch: What are the main findings of the study? Dr. Semba: Resveratrol levels in older adults are not related to the risk of heart disease or cancer and are not related with lifespan. These findings were made in the InCHIANTI Study, a rigorously conducted study of human aging that is sponsored by the National Institute on Aging. (more…)
Author Interviews, Cancer Research, JAMA, Surgical Research / 10.05.2014

Dr. Carlo Riccardo Rossi, MD Melanoma and Sarcoma Unit, Veneto Institute of Oncology Surgery Branch, Department of Surgery Oncology, and Gastroenterology, University of Padova, Padova, Italy MedicalResearch.com Interview with: Dr. Carlo Riccardo Rossi, MD Melanoma and Sarcoma Unit, Veneto Institute of Oncology Surgery Branch, Department of Surgery Oncology, and Gastroenterology, University of Padova, Padova, Italy MedicalResearch: What are the main findings of the study? Dr. Rossi: A total of 90% patients undergone lymph node dissection for melanoma had 12, 7, 14, 6 and 13 excised lymph nodes (10th percentile of the distribution) after 3 level axillary, 3 level or less neck, 4 level or more neck, inguinal, or ilio-inguinal dissections, respectively. (more…)
Author Interviews, Frailty, Geriatrics, JAMA, Surgical Research / 10.05.2014

MedicalResearch.com Interview with: Kwang-il Kim, MD, PhD Associate Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea MedicalResearch.com Interview with: Kwang-il Kim, MD, PhD Associate Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea MedicalResearch: What are the main findings of the study? Answer: There are few tools of preoperative risk stratification for the older adults. We found that not only disease itself but also frailty can lead to post-operative complication and mortality. So we made a scoring model to predict post-operative mortality and morbidity based on comprehensive geriatric assessment and it worked exactly. MedicalResearch: Were any of the findings unexpected? Answer: Under our predictive model, there was inflection point of mortality slope at point 5. Post-operative mortality of someone who scores 4~5 is below 10%, but it of other who scores 6~7 is about 30%. It was unexpected drastic change, so we think that there is physiologic threshold point. MedicalResearch: What should clinicians and patients take away from your report? Answer: Because the elderly are different from adults, clinicians have to focus on functional capacity, co-morbidity, and frailty for their older surgical patients. Make operative decision base on comprehensive geriatric assessment or our scoring model. If you depend on your own feeling, some older patients will suffer from post-operative complication and someone will forfeit his chance of surgery. (more…)
Author Interviews, Diabetes, JAMA, Pediatrics / 06.05.2014

Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045 MedicalResearch.com Interview with: Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045 MedicalResearch.com: What are the main findings of the study? Dr. Dabelea: We found that the proportion of US youth living with Type 1 Diabetes has increased by at least 21% over a period of only 8 years. This increase was seen in both boys and girls, most age-groups and race/ethnic groups. While we do not completely understand the reasons for this increase, since the causes of Type 1 Diabetes are still unclear, it is likely that something has changed in our environment- both in the US and elsewhere in the world- causing more youth to develop the disease, maybe at increasingly younger ages. (more…)
Author Interviews, JAMA, Statins, Weight Research / 29.04.2014

Takehiro Sugiyama, MD, MSHS, PhD Project Director, Diabetes Policy Planning Office Management and Planning Bureau Fellow, Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Shinjuku-ku, Tokyo Japan MedicalResearch.com Interview with: Takehiro Sugiyama, MD, MSHS, PhD Project Director, Diabetes Policy Planning Office Management and Planning Bureau Fellow, Department of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Shinjuku-ku, Tokyo Japan MedicalResearch.com: What are the main findings of the study? Dr. Sugiyama: In the US nationally representative sample from the National Health and Nutrition Examination Survey 1999-2010, we found that statin users in 2009-2010 eat 9.6% more calories and 14.4% more fat than statin users in 1999-2000. These increases were not observed in statin non-users; the trends of caloric and fat intake were statistically different between statin users and non-users. In 1999-2000, caloric and fat intake was significantly less for statin users compared with non-users, but the difference between the groups because smaller as time went by and there was no statistical difference in 2009-2010. Body mass index increased more rapidly for statin users compared to non-users. (more…)
Author Interviews, Cognitive Issues, JAMA / 28.04.2014

Tara Lagu MD PhD Assistant Professor of Medicine Tufts University School of Medicine MedicalResearch.com Interview with: Tara Lagu MD PhD Assistant Professor of Medicine Tufts University School of Medicine   MedicalResearch.com: What are the main findings of the study? Dr. Lagu: We found that use of mechanical ventilation in patients 65 and older is increasing rapidly. If current rates of increase continue, we expect that by 2020 there will be more than 600,000 hospitalizations per year that involve mechanical ventilation. This is a doubling in 20 years (2001-2020), and represents demand that could easily exceed the capacity of the US critical care system. We also found that increase in use among patients with dementia is 4 times faster than those without dementia. This is important because dementia is a terminal illness, and use of mechanical ventilation in patients with end-stage dementia is associated with poor 30-day and 1-year outcomes. (more…)
Author Interviews, Cost of Health Care, Diabetes, JAMA / 28.04.2014

Juliana C. N. Chan, MBChB MD FHKAM FRCP Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong. MedicalResearch.com Interview with: Juliana C. N. Chan, MBChB MD FHKAM FRCP Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong. MedicalResearch.com: What are the main findings of the study? Dr. Chan: In this 1-year randomized study, we asked the question whether type 2 diabetic patients receiving team-based integrated care augmented by information technology would further improve in their glycemic control if given additional peer support through the telephone. All patients underwent comprehensive risk assessment guided by the web-based JADE portal which generated personalized risk report with attained treatment targets and decision support. After 1 year, all patients improved significantly in all risk factors including A1c with improved treatment adherence, self efficacy and psychological wellbeing. Although the peer support group did not further improve in A1c, short-stay hospitalization rates were substantially reduced by 50% , especially amongst those with emotional distress. These patients accounted for 20% of the intervention group, in whom peer support further reduced psychological distress and treatment non-adherence. (more…)