Author Interviews, Dermatology, JAMA, Metabolic Syndrome / 19.09.2014

MedicalResearch.com Interview : Iben Marie Miller, MD Department of Dermatology Roskilde Hospital, Roskilde Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Medical Research: What are the main findings of the study? Dr. Miller: Using a cross-sectional design based on data from a Hidradenitis Suppurativa (HS) group recruited from the hospital (32 individuals), an HS group recruited from the general population (326 individuals) and 14,851 individuals without Hidradenitis Suppurativa, we investigated a possible association of Hidradenitis Suppurativa and the metabolic syndrome. We found that the HS groups had 2 to 4 times odds of having the metabolic syndrome when compared to individuals without HS leaving Hidradenitis Suppurativa patients at a high cardiovascular risk. Furthermore, we found that the odds were higher for the HS group from the hospital in comparison to the Hidradenitis Suppurativa group from the general population. (more…)
Addiction, Author Interviews, JAMA, PTSD / 17.09.2014

Susan Mason, PhD, MPH Assistant Professor Division of Epidemiology and Community Health Minneapolis, MN 55454MedicalResearch.com Interview with: Susan Mason, PhD, MPH Assistant Professor Division of Epidemiology and Community Health Minneapolis, MN  55454   Medical Research: What are the main findings of the study? Dr. Mason: We examined 49,408 women enrolled in the Nurses' Health Study II to see if those who had experienced PTSD symptoms at some point in their lives were more likely than those without PTSD symptoms to meet the criteria for food addiction, a measure of perceived dependence on food. We found that the 8% of women with the most lifetime PTSD symptoms were about 2.7 times as likely to meet the criteria for food addiction as women with no lifetime PTSD symptoms. This translates to an elevation in food addiction prevalence from about 6% among women with no PTSD symptoms to about 16% in women with the most PTSD symptoms. (more…)
Author Interviews, JAMA, Surgical Research, Transplantation / 17.09.2014

Darren J. Malinoski, MD, FACS Assistant Chief of Surgery – Research and Education Chief, Section of Surgical Critical Care Portland VA Medical Center Associate Professor of Surgery Oregon Health & Science University Portland, OR 97207MedicalResearch.com Interview with: Darren J. Malinoski, MD, FACS Assistant Chief of Surgery – Research and Education Chief, Section of Surgical Critical Care Portland VA Medical Center Associate Professor of Surgery Oregon Health & Science University Portland, OR 97207 Medical Research: What are the main findings of the study?  Dr. Malinoski: Our two main findings are that the status of the DMG Bundle prior to organ recovery, at the end of the OPO donor management process, is the most predictive of the number of organs that will be transplanted per expanded criteria donor (ECD) and that the absolute increase in the number of individual DMG elements achieved over time also appears to be relevant.  Taken together, these two findings suggest that the number of organs that will be transplantable from each donor is not necessarily predetermined by their age, comorbidities, and pre-neurologic death condition, but that active critical care management has the ability to affect outcomes and reassessing each donor’s condition over time is necessary. (more…)
Author Interviews, JAMA, Weight Research / 17.09.2014

Aner Tal, PhD Food and Brand Lab Department of Applied Economics and Management Cornell University, Ithaca, New YorkMedicalResearch.com Interview with: Aner Tal, PhD Food and Brand Lab Department of Applied Economics and Management Cornell University, Ithaca, New York Medical Research: What are the main findings of the study? Dr. Tal: Some TV programs might lead people to eat twice as much as other programs. “We find that if you’re watching an action movie while snacking your mouth will see more action too!” says Aner Tal, Ph.D. lead author on the new article just published in the Journal of the American Medical Association: Internal Medicine. “In other words, the more distracting the program is the more you will eat.” In the study 94 undergraduates snacked on M&Ms, cookies, carrots and grapes while watching 20 minutes of television programming. A third of the participants watched a segment of the action movie The Island, a third watched a segment from the talk show, the Charlie Rose Show, and a third watched the same segment from The Island without sound. “People who were watching The Island ate almost twice as many snacks – 98% more than those watching the talk show!” says co-author Brian Wansink, author of Slim by Design (forthcoming) and Professor and Director of the Cornell Food and Brand Lab. “Even those watching “The Island” without sound ate 36% more.” People watching the more distracting content also consumed more calories, with 354 calories consumed by those watching The Island (314 calories with no sound) compared to 215 calories consumed by those watching the Charlie Rose Show. “More stimulating programs that are fast paced, include many camera cuts, really draw you in and distract you from what you are eating. They can make you eat more because you're paying less attention to how much you are putting in your mouth,” explains Tal. Because of this, programs that engage viewers more might wind up being worse for their diets. (more…)
Author Interviews, JAMA, Thromboembolism / 17.09.2014

Dr. Marc Carrier, MD MSc Scientist, Clinical Epidemiology, Ottawa Hospital Research Institute Physician, Hematology (Thrombosis), The Ottawa Hospital Associate Professor, Department of Medicine, Faculty of Medicine, and Research Chair in Venous Thromboembolism and Cancer (Tier 2) at the University of OttawaMedicalResearch.com Interview with: Dr. Marc Carrier, MD MSc Scientist, Clinical Epidemiology, Ottawa Hospital Research Institute Physician, Hematology, The Ottawa Hospital Associate Professor, Department of Medicine, Faculty of Medicine, and Research Chair in Venous Thromboembolism and Cancer (Tier 2) at the University of Ottawa MedicalResearch.com: What are the main findings of this study? Dr. Carrier: Venous thromboembolism (VTE), comprised of deep vein thrombosis and pulmonary embolism, is the third leading cause of cardiovascular death. There are many anticoagulant treatments available but there is little guidance about which treatment is most effective and safe. This systematic review and network meta-analysis evaluated eight different treatment options for acute Venous thromboembolism.  Forty-five trials were included in the analysis and there were no significant differences in clinical or safety outcomes associated with most treatment options when compared to the combination of LMWH-VKA.. (more…)
Author Interviews, General Medicine, JAMA, Pediatrics / 17.09.2014

Lex W Doyle MD BS MSc FRACP Professor of Neonatal Paediatrics Department of Obstetrics and Gynaecology The Royal Women’s Hospital Parkville, Victoria, AustraliaMedicalResearch.com Interview with: Lex W Doyle MD BS MSc FRACP Professor of Neonatal Paediatrics Department of Obstetrics and Gynaecology The Royal Women’s Hospital Parkville, Victoria, Australia Medical Research: What are the main findings of the study? Dr. Doyle: From collectively pooling data from five large trials carried out around the world over the past 20 years, we know that magnesium sulfate given under strict medical protocols in hospital to women threatening to deliver preterm reduces the risk of cerebral  palsy in their children in early childhood.  Following  from this knowledge, magnesium sulfate is now given routinely to women, under strict medical conditions, who are threatening to deliver very early in Australia, and in other parts of the world, to try to prevent cerebral palsy in their child.  What we do not know is if magnesium sulfate used this way has any longer-term effects on the brain or on other important outcomes. One of the initial studies that contributed to the overall evidence about cerebral palsy was carried out in Australia and New Zealand and completed more than 10 years ago.  Over 1000 women and their babies were enrolled in that study and although the rate of cerebral palsy was not substantially reduced by magnesium sulfate in our study, we showed that there were fewer children at 2 years of age who were not walking in the group whose mothers were given magnesium compared with those whose mothers were given placebo.  With this knowledge, and given the unknown longer-term benefits or risks, we re-evaluated the children from our study at school-age, between 6-11 years of age.  We thoroughly evaluated their brain function, including movement and co-ordination, thinking ability, behaviour, and school progress, as well as general health and well-being.  The basic message from our longer-term study is that magnesium sulfate, as used in our trial, does not have any substantial benefits or harms on brain or cognitive function, or any other outcome at school age. (more…)
Author Interviews, JAMA, Stroke / 16.09.2014

Silvia Koton, PhD, MOccH, RN Chair, Department of Nursing The Stanley Steyer School of Health Professions Tel Aviv University Tel Aviv, IsraelMedicalResearch.com Interview with: Silvia Koton, PhD, MOccH, RN Chair, Department of Nursing The Stanley Steyer School of Health Professions Tel Aviv University Tel Aviv, Israel Medical Research: What are the main findings of the study? Dr. Koton: Based on data on 14,357 participants in the Atherosclerosis Risk in Communities (ARIC) study who were free of stroke when the study began in 1987 and followed until the end of 2011, we found a 24 percent overall decline in first-time strokes in each of the last two decades and a 20 percent overall drop per decade in deaths after stroke. The results were similar across race and gender, but varied by age: the decline in stroke risk was concentrated mainly in the over-65 set, while the decrease in stroke-related deaths was primarily found among those under age 65. (more…)
Author Interviews, CDC, Gender Differences, JAMA, Weight Research / 16.09.2014

MedicalResearch.com Interview with:  Earl S. Ford, MD, MPH Medical officer, U.S Public Health Service Centers for Disease Control and Prevention Atlanta, GA 30341 Medical Research: What are the main findings of the study? Dr. Ford:  The main finding of the study is that mean waist circumference and the prevalence of abdominal obesity in US adults have increased since 1999-2000 and that these increases are being driven primarily by trends in women. Mean waist circumference and the percentage of abdominal obesity in men has been relatively stable since 2003-2004. (more…)
Author Interviews, JAMA, Ophthalmology, Telemedicine / 11.09.2014

Mary G. Lynch, MD Professor of Ophthalmology Atlanta Veterans Affairs Medical Center Decatur, Georgia. Department of Ophthalmology, Emory University School of Medicine, Atlanta, GeorgiaMedicalResearch.com Interview with: Mary G. Lynch, MD Professor of Ophthalmology Atlanta Veterans Affairs Medical Center Decatur, Georgia. Department of Ophthalmology, Emory University School of Medicine,  Atlanta, Georgia Medical Research: What are the main findings of the study? Dr. Lynch:
  • Since 2006, the VA has been systematically using teleretinal screening of patients with diabetes to screen for retinopathy in the Primary Care Clinics. Under this program, 90% of veterans with diabetes are evaluated on a regular basis. A number of patients who are screened have findings that warrant a face-to-face ophthalmic exam. No information exists on the effect of such a program on medical center resources.
  • 1,935 patients  underwent teleretinal screening through the Atlanta VA over a 6 month period.  We reviewed the charts of the 465 (24%) of the patients who were referred for a face to face exam in the Eye Clinic.
  • Data was collected for these patients to determine the reasons for referral, the accuracy of the teleretinal interpretation, the resources needed in the Eye Clinic of the Medical Center to evaluate and care for the referred patients over a two year period and possible barriers to patient care.
  • Of the 465 patients referred for an exam, 260 (55.9%) actually came in for an exam. Community notes were available for an additional 66 patients. Information was available for 326 (70.1%) of the referred patients.
  • The most common referring diagnoses were nonmacular diabetic retinopathy (43.2% of referrals), nerve related issues (30.8%), lens or media opacity (19.1%), age-related macular degeneration (12.9%) and diabetic macular edema (5.6%).
  • 16.9% of the referred patients had 2 or more concurrent problems that put them at high risk for visual loss.
  • The percentage agreement between teleretinal screening and the ophthalmic exam was high: 90.4%. Overall sensitivity was 73.6%. The detection of diabetic macular edema had the lowest sensitivity.
  • A visually significant condition was detected for the first time through teleretinal screening for 142 of the patients examined (43.6%).
  • The resource burden to care for referred patients was substantial.
  • 36% of patients required 3 or more visits over the ensuing 2 year period.
  • The treatment of diabetic macular edema had the highest resource use involving on average 5 clinic visits, 6 diagnostic procedures and 2 surgical procedures
  • The most common non-refractive diagnostic procedures were visual fields and optical coherence tomography.
  • The average cost to care for the referred patients (in Medicare dollars) in work RVUs alone was approximately $1,000 per patient. The cost to care for a patient with diabetic macular edema was $2673.36.
(more…)
Author Interviews, Dermatology, JAMA, NIH, Transplantation / 11.09.2014

MedicalResearch.com Interview with: Rena Zuo, BA MD Candidate at Duke University School of Medicine and Edward W. Cowen, MD, MHSc Senior Clinician Head, Dermatology Consultation Service Dermatology Branch Center for Cancer Research National Cancer Institute National Institutes of Health MedicalResearch: What are the main findings of the study?
 Answer: Chronic graft-vs-host disease (cGVHD) is a debilitating multisystem disease that occurs in patients receiving allogeneic hematopoietic stem cell transplantations as treatment for hematologic disorders. Although the diverse clinical presentations of cGVHD frequently mimic other autoimmune diseases such as Sjögren syndrome and systemic sclerosis, and low-titer antibodies are commonly found in patients with cGVHD, the exact pathogenesis and role of autoimmunity in cGVHD are incompletely understood. Our study is the first to characterize and identify risk factors associated with the development of two uncommon autoimmune phenomena, specifically alopecia areata and vitiligo, in the setting of cGVHD. Laboratory markers, including 11 antibodies, transplant-related factors, and other cGVHD systemic manifestations were analyzed. Several particularly interesting results were found:
  1. Among 282 patients with cGVHD, 15 demonstrated vitiligo (14 of 282; 4.9%) and/or alopecia areata (2 of 282; 0.7%).
  2. Female donor and female donor to male recipient sex mismatch, in particular, are significantly associated with the development of vitiligo and/or alopecia areata.
  3. Positive anti-cardiolipin (ACA) IgG was also significantly associated with development of vitiligo and/or alopecia areata.
(more…)
Author Interviews, Dermatology, Gastrointestinal Disease, JAMA, Mayo Clinic / 11.09.2014

Shadi Rashtak, MD Department of Dermatology Mayo Clinic College of Medicine Rochester, MinnesotaMedicalResearch.com Interview with: Shadi Rashtak, MD Department of Dermatology Mayo Clinic College of Medicine Rochester, Minnesota Medical Research:  What are the main findings of the study? Dr. Rashtak: We found that among a population of mainly acne patients those who received isotretinoin had a lower risk of inflammatory bowel disease as compared to those who did not take this medication. We carefully reviewed the medical records of patients to ensure that this finding was not simply because the drug was avoided in patients with a previous personal or family history of IBD. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA / 10.09.2014

Hayley Gershengorn MD Assistant Professor, Department of Medicine (Critical Care) Assistant Professor, The Saul R. Korey Department of Neurology Albert Einstein College of Medicine Bronx, NY 10461MedicalResearch.com Interview with: Hayley Gershengorn MD Assistant Professor, Department of Medicine (Critical Care) Assistant Professor, The Saul R. Korey Department of Neurology Albert Einstein College of Medicine Bronx, NY 10461 Medical Research:  What are the main findings of the study? Dr. Gershengorn: Using a large national database, we found there to be no association between the use of arterial catheters and mortality in mechanically ventilated medical intensive care unit patients. Similarly, we found no beneficial association between arterial catheters and mortality in any of the eight other critically ill subgroups evaluated. (more…)
Author Interviews, Cost of Health Care, JAMA / 09.09.2014

Michael Johansen, MD MS Assistant Professor Dept of Family Medicine Ohio State UniversityMedicalResearch.com Interview with: Michael Johansen, MD MS Assistant Professor Dept of Family Medicine Ohio State University Medical Research: What are the main findings of the study? Dr. Johansen: Between 2007-2011, the United States spent $63.4 billion on high-cost proton pump inhibitors of which $47.1 billion was in excess of using generic omeprazole. (more…)
Author Interviews, JAMA, Ophthalmology / 06.09.2014

Louis R. Pasquale, MD Channing Division of Network Medicine Department of Ophthalmology Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MassachusettsMedicalResearch.com Interview with: Louis R. Pasquale, MD Channing Division of Network Medicine Department of Ophthalmology Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Pasquale: We found that more time spent outdoors in summer was associated with increased risk of exfoliation syndrome. (more…)
Author Interviews, JAMA, Mental Health Research, Schizophrenia / 06.09.2014

MedicalResearch.com Interview with: Sandra M. Meier, PhD The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, National Centre for Register-Based Research Aarhus University, Aarhus, Denmark Medical Research: What are the main findings of the study? Dr. Meier: People with an obsessive-compulsive disorder are at a 6 to 7 times higher risk of developing schizophrenia than people without an obsessive-compulsive disorder. If the parents are diagnosed with an obsessive-compulsive disorder, their offspring experience a 3 to 4 times higher chance to develop schizophrenia. (more…)
Author Interviews, JAMA, Multiple Sclerosis / 05.09.2014

Jeffrey Cohen MD Department of Neurology Cleveland ClinicMedicalResearch.com Interview with: Jeffrey Cohen MD Department of Neurology Cleveland Clinic Medical Research: What are the main findings of the study? Dr. Cohen: This study assessed the relationship between walking speed, as measured by the Timed 25-foot Walk test, and patient-reported quality of life, as measured by the Physical Component Summary score of the 36-Item Short Form Health Survey (SF-36), in a pooled dataset from the AFFIRM, SENTINEL, and IMPACT multiple sclerosis Phase 3 trials.  It showed that slowed walking speed is associated with decreased quality of life.  It also showed that 20-25% slowing of walking speed is a clinically meaningful change. (more…)
Author Interviews, JAMA, Nutrition / 03.09.2014

MedicalResearch.com Interview with: Dong D. Wang, MD, MSc Department of Nutrition Harvard School of Public Health Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Wang:
  • The quality of the US diet improved modestly from 1999 to 2010, but the dietary quality of US population remains far from optimal and huge room exists for further improvements.
  • More than half of the improvement in diet quality was due to a large reduction in consumption of trans fat.
  • he improvement in dietary quality was greater among persons with higher socioeconomic status and healthier body weight, thus disparities that existed in 1999 increased over the next decade.
(more…)
Author Interviews, JAMA, Weight Research / 03.09.2014

Bradley Johnston, PhD Scientist | Child Health Evaluative Sciences Hospital for Sick Children Research Institute Assistant Professor | Department of Clinical Epidemiology & Biostatistics McMaster University Toronto, Ontario, Canada, M5G 0A4MedicalResearch.com Interview with: Bradley Johnston, PhD Scientist | Child Health Evaluative Sciences Hospital for Sick Children Research Institute Assistant Professor | Department of Clinical Epidemiology & Biostatistics McMaster University Toronto, Ontario, Canada Medical Research: What are the main findings of the study? Dr. Johnston:
  • Our findings represent the first meta-analysis using advanced epidemiological methods to summarize popular branded diets for weight loss, trials having been investigated using randomized trial methodology.
  • Among the 48 original RCTs included in our NMA, low to moderate quality evidence showed that both low-carbohydrate and low-fat diets were associated with an approximate 8 kg weight loss at 6 months when compared to no diet. Approximately 1-2 kg of this effect was lost by 12-months.
  • Although statistical differences existed among several of the diet macronutrient classes, the differences were small and unlikely to be important to those seeking to lose weight.
  • Similarly, our results showed that although there are statistically significant differences between some of the brand named diets, these differences are small and not likely patient important.
  • In terms of potential effect modifiers, behavioural support was significant at 6-months (enhancing weight-loss by 3.23 kg) and exercise was significant at 12-months (enhancing weight loss by 2.13 kg)
  • Regarding our sensitivity analyses, Differences in weight loss were not clinically important based on risk of bias, missing data, baseline weight, gender, and those with and without specific health conditions
  • Overall, our findings suggest that patients may choose, among those associated with the largest weight loss, the diet that gives them the least challenges with adherence.
(more…)
Author Interviews, Heart Disease, JAMA / 31.08.2014

Massimo Imazio. MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital and University of Torino Torino, ItaliaMedicalResearch.com Interview with: Massimo Imazio on behalf of the COPPS-2 Investigators Massimo Imazio. MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital and University of Torino Torino, Italia Medical Research: What is the background for this investigation? Dr. Imazio: Post-pericardiotomy syndrome, post-operative atrial fibrillation (AF), and post-operative effusions may be responsible for increased morbidity and healthcare costs after cardiac surgery. Postoperative use of colchicine prevented these complications in a single trial (the COPPS trial published on EHJ in 2010). Here all events occurred within 3 months and colchicine was given after cardiac surgery starting from postoperative day 3 for 1 month. However most postoperative AF events are reported in the first 3 days and thus pre-treatment with colchicine may give better outcomes. Thus we performed the COPPS-2 giving colchicine 48 to 72 hours before surgery for 1 month without a loading dose and weight adjusted doses (i.e. 0.5 mg twice daily for patients >70kg or 0.5 mg once for patients <70Kg) in order to improve patients compliance.The Colchicine for Prevention of the Post-pericardiotomy Syndrome and post-operative atrial fibrillation (COPPS-2 trial) is an investigator-initiated, double-blind, placebo-controlled, randomized clinical trial. A total of 360 consecutive candidates for cardiac surgery, 180 for each arm, were enrolled in 11 Italian centers between March 2012 and March 2014. Main exclusion criteria were absence of sinus rhythm at enrollment, cardiac transplantation, and contraindications to . (more…)
Author Interviews, Dermatology, JAMA, UC Davis / 28.08.2014

MedicalResearch.com Interview with: Gayatri Patel, MD, MPH Division of General Medicine UC Davis Medical CenterMedicalResearch.com Interview with: Gayatri Patel, MD, MPH Division of General Medicine UC Davis Medical Center Medical Research: What are the main findings of the study? Dr. Patel: In this systematic review and meta-analysis, we sought to determine the effectiveness of photodynamic therapy (PDT) for the treatment of actinic keratoses relative to other common treatments. We included only randomized controlled trials and preformed a meta-analysis on homogenous studies. The primary finding of the study was that PDT has a better chance of removing actinic keratoses on the face or scalp than treatment with cryotherapy. (more…)
Author Interviews, Hospital Acquired, JAMA, Surgical Research / 28.08.2014

Christopher Mantyh, M.D. Associate Professor of Surgery Chief of Colorectal Surgery NSQIP Surgical Champion Duke University Medical CenterMedicalResearch.com Interview with: Christopher Mantyh, M.D. Associate Professor of Surgery Chief of Colorectal Surgery NSQIP Surgical Champion Duke University Medical Center Medical Research: What are the main findings of the study?  Dr. Mantyh: Specific perioperative bundles can drastically reduce surgical site infections in colorectal surgery patients. (more…)
Author Interviews, Cancer Research, JAMA, Outcomes & Safety / 28.08.2014

MedicalResearch.com Interview with: Elizabeth Goodman BA Division of Oncology The Children’s Hospital of Philadelphia Philadelphia, Pennsylvania Medical Research: What are the main findings of the study? Answer: Weekend hospital admission for pediatric patients newly diagnosed with leukemia was associated with a longer length of stay, slightly longer wait to start chemotherapy and higher risk for respiratory failure; however, weekend admissions were not linked to an increased risk for death. (more…)
Author Interviews, Bipolar Disorder, JAMA, Stanford / 27.08.2014

MedicalResearch.com Interview with: Manpreet K. Singh, MD MS Assistant Professor of Psychiatry and Behavioral Sciences Akiko Yamazaki and Jerry Yang Faculty Scholar in Pediatric Translational Medicine Stanford University School of Medicine Medical Research: What are the main findings of the study? Dr. Singh: Our research team used a monetary incentive delay paradigm to measure fronto-limbic activity and connectivity associated with anticipation and receipt of reward and loss in healthy offspring of parents with bipolar I disorder. We found that compared to youth offspring without any family history of psychopathology, high-risk offspring had aberrant prefrontal and cingulate activations and connectivity during reward processing. Further, greater striatal, amygdalar, and insula activations while anticipating and receiving rewards and losses were associated with greater novelty-seeking and impulsivity traits in high-risk youth. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA / 27.08.2014

Prof Richard McManus MA PhD FRCGP NIHR School for Primary Care Research, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire United KingdomMedicalResearch.com Interview with Prof Richard McManus MA PhD FRCGP NIHR School for Primary Care Research, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire United Kingdom Medical Research: What are the main findings of the study? Prof. McManus: The TASMIN-SR clinical trial followed 552 patients with an average age of 70 and high blood pressure with pre-existing cardiovascular disease, diabetes or chronic kidney disease. After training in how to self-monitor blood pressuring using a readily available device, patients took readings twice each morning for the first week of each month, and following an individualised management plan were able to request additional medication from their general practitioner without the need for consultation. At the end of the study, patients who self-managed had significantly lower blood pressure (by 9.2 / 3.4 mmHg) than those who were visiting their GP for blood pressure monitoring, which would be expected to lower stroke risk by around 30% if sustained. (more…)
Author Interviews, Infections, JAMA, Pediatrics / 27.08.2014

Dr. Ralph Joseph Diclemente PhD Behavoral Sciences & Health School Of Public Health Emory University Atlanta GeorgiaMedicalResearch.com Interview with: Dr. Ralph Joseph Diclemente PhD Behavoral Sciences & Health School Of Public Health Emory University Atlanta Georgia   Medical Research: What are the main findings of the study?  Dr. DiClemente: In our study of 701 African American girls we observed significant and durable reductions in laboratory-confirmed sexually transmitted infections (50% reduction in chlamydial infections and a 60% reduction in gonorrhea) among girls in our intervention group relative to the comparison condition over a 36-month follow-up period.  In addition, we observed significant increases in condom use during sex and reductions in sex while using drugs or alcohol.  The key finding is the durability of the results - 3 years in the life of an adolescent is a long period. (more…)
Author Interviews, Heart Disease, JACC, JAMA / 26.08.2014

MedicalResearch.com Interview with: Dr. Peter Godsk Jørgensen Copenhagen City Heart Study Frederiksberg Hospital, Frederiksberg, Denmark Medical Research: What are the main findings of your study? Dr. Jørgensen: In the coming decades, a larger and larger proportion of the population will be aged 65 years or above. At present, no risk prediction models have been developed specifically for estimation of risk in this population. ECG changes are easily recognized and identify subclinical signs of end-organ disease. Our data reveal that not only are ECG changes a very frequent finding that independently predicts cardiovascular disease, they significantly improve risk prediction when added to the most used European and US risk models. Thus, our data demonstrate that adding ECG changes will correctly reclassify more than one third of the persons aged 65 years and above without cardiovascular disease. (more…)
Author Interviews, General Medicine, Heart Disease, JAMA / 26.08.2014

Steven M. Bradley, MD, MPH Veterans Affairs Eastern Colorado Health CareSystem Denver, ColoradoMedicalResearch.com Interview with Steven M. Bradley, MD, MPH Veterans Affairs, Eastern Colorado Health CareSystem Denver, Colorado Medical Research: What are the main findings of the study? Dr. Bradley: In 539 hospitals participating in the CathPCI Registry that performed elective coronary angiography on more than 500,000 patients, 22% of patients were asymptomatic at the time of coronary angiography. We observed marked variation in the hospital rate of angiography performed in asymptomatic patients, ranging from 0.2% to 66.5%, suggesting broad variation in the quality of patient selection for coronary angiography across hospitals.  Additionally, hospitals with higher rates of asymptomatic patients at diagnostic angiography also had higher rates of inappropriate PCI, due to greater use of PCI in asymptomatic patients. These findings suggest that patient selection for diagnostic angiography is associated with the quality of patient selection for PCI as determined by Appropriate Use Criteria. By addressing patient selection upstream of the catheterization laboratory, we may improve on the optimal use of both angiography and PCI. (more…)
Author Interviews, Heart Disease, JAMA / 26.08.2014

Michael B. Rothberg, MD, MPH Department of Internal Medicine Medicine Institute, Vice Chair for Research Cleveland Clinic, Cleveland, OhioMedicalResearch Interview with: Michael B. Rothberg, MD, MPH Department of Internal Medicine Medicine Institute, Vice Chair for Research Cleveland Clinic, Cleveland, Ohio Medical Research: What are the main findings of the study? Dr. Rothberg: In this randomized study we found that when people are presented with no information about the benefits of elective PCI, most assumed that it would prevent a heart attack. Unfortunately, this is incorrect, so people may choose to have the procedure based on false information.  We also found that simply telling them that PCI would not prevent a heart attack successfully dispelled this belief for most,  but not all, participants.  Explaining why PCI does not prevent heart attacks in this circumstance was the most effective way to change people's beliefs.  We also found that most people were willing to take medications, but when they were told that PCI does not prevent heart attacks, they were more likely to agree to medication. (more…)
Author Interviews, Frailty, Geriatrics, JAMA / 22.08.2014

Dr. Bellal Joseph MD FACS Associate Professor of Surgery Medical Director, Southern Arizona Telemedicine and Telepresence (SATT) Program Program Director, International Research Fellowship Liaison, Multi-Specialty Surgery Clinic at UAMCMedicalResearch.com Interview with Dr. Bellal Joseph MD FACS Associate Professor of Surgery Medical Director, Southern Arizona Telemedicine and Telepresence (SATT) Program Program Director, International Research Fellowship Liaison, Multi-Specialty Surgery Clinic at UAMC Medical Research: What are the main findings of the study? Dr. Joseph: Chronologic age is frequently used as the determinant of outcomes when treating elderly and treatments are tailored accordingly. However, the findings of our study challenge this dogma and suggest that it’s not the chronologic age rather frailty status of the individual that determines outcomes. We found frailty Index (quantitative measure of frailty) as a better predictor of in-hospital complications and discharge disposition in elderly compared to the chronologic age. (more…)