MedicalResearch.com Interview with:Nicholas S. Downing, AB
Yale University School of Medicine
New Haven, Connecticut
MedicalResearch.com: What are the main findings of the study?Answer: In our systematic review of all new drugs approved by the FDA over an 8 year period, we found that there was real variability in the quality and quantity of clinical trial evidence used as the basis of the agency’s approval decisions. Some drugs were studied in multiple randomized, double-blinded, controlled clinical trials that provide very helpful information for patients and physicians. However, other drugs were studied in clinical trials that did not produce as much information about their safety and effectiveness.
MedicalResearch.com Interview with:John W. O'Kane M.D.
Associate Professor Family Medicine and Orthopaedics and Sports Medicine
Medical Coordinator, U.W. Intercollegiate Athletics
University of Washington Sports Medicine Clinic, Seattle
MedicalResearch.com: What are the main findings of the study?Dr. O’Kane: In 11 to 14 year old female elite soccer players the concussion incidence was 13% with a rate of 1.2 per 1000 athletic exposures. Symptoms lasted a median of 4 days and players with light or noise sensitivity, emotional lability, memory loss, nausea, and concentration problems took significantly longer to recover. Heading the ball accounted for 30.5% of concussions and the vast majority of concussions (86%) occurred in games. The majority of players (58.6%) reported playing with symptoms and less than half (44.1%) sought medical attention for their symptoms. Those seeking medical attention were symptomatic longer and were less likely to play with symptoms.
MedicalResearch.com Interview with:Daniel A. Anaya, MD, FACS
Associate Professor of Surgery - Surgical Oncology
Michael E. DeBakey Department of Surgery
Baylor College of Medicine
Chief, General Surgery & Surgical Oncology SectionDirector, Liver Tumor Program
Michael E. DeBakey VA Medical Center Houston, TX 77030
Dr. Courtney J. Balentine, MD
First author and surgical resident at Baylor College of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Anaya: That a good proportion of patients having colorectal operations will need additional assistance to recover during the postoperative period, resulting in being discharged to other facilities (nursing facilities, skilled care, etc) after surgery, and that hospitals where a higher-volume of colorectal operations are performed are more likely to discharge patients back to home after surgery.
MedicalResearch.com Interview with Elliot Wakeam MD
Center for Surgery and Public Health
Brigham and Women's Hospital
Boston MA 02115
MedicalResearch.com: What are the main findings of the study?Dr. Wakeam: Our study examined failure to rescue (FTR), or death after postoperative complications, in safety net hospitals. Prior work has shown that hospital clinical resources can improve rescue rates, however, despite having higher levels of technology and other clinical resources that should lead to better rates of patient rescue, safety net hospitals still had greater rates of death after major complications.
MedicalResearch.com Interview with: Flavia Indrio, MD
Department of Pediatrics
Aldo Moro University of Bari
Bari, ItalyMedicalResearch.com: What are the main findings of the study?Answer:The main finding is that for the first time the use in prevention instead of treatment with a probiotic for the colic regurgitation and constipation.
MedicalResearch.com Interview with: Birgitta Ejdervik Lindblad, MD PhD
Department of Ophthalmology
Örebro University Hospital Örebro, Sweden
MedicalResearch.com: What are the main findings of the study?
Answer: We have investigated the association between smoking cessation and risk of having a cataract extraction among 44 371 Swedish men aged 45-79 years. During 12 years of follow up we identified 5713 incident cases of cataract extraction.
Smoking cessation significantly decreased the risk with time.
Men who currently smoked more than 15 cigarettes per day had a 42 % increased risk of cataract extraction compared with men who had never smoked.
More than 20 years since quitting smoking, men who had smoked more than 15 cigarettes per day had a 21% increased risk of having a cataract extraction compared with men who had never smoked.
The effect of smoking cessation was observed earlier among men who smoked less than 15 cigarettes per day but more than 2 decades since smoking cessation the risk had not decreased to the level of never smokers.
MedicalResearch.com Interview with:Yvonne M. Terry-McElrath, MSA
Institute for Social Research, University of Michigan, Ann Arbor
MedicalResearch.com: What are the main findings of the study?Answer: This study examined 2007-2012 commercialism trends in schools attended by nationally representative samples of US elementary and secondary students.
While some measures showed significant decreases over time (especially
beverage vending measures), most students at both elementary and secondary
school levels continued to be exposed to school-based commercialism.
Commercialism increased significantly with grade level. The most frequent
type of commercialism varied by school level: food coupons used as
incentives was most common at the elementary school level, while exclusive
beverage contracts were the most prevalent type of commercialism for middle
and high school students.
MedicalResearch.com Interview InvitationMaurice Dysken, MD
Professor, School of Medicine
Department of Psychiatry
Minneapolis VA Health Care System,
MedicalResearch.com: What are the main findings of the study?Dr. Dysken: In patients with mild-to-moderate Alzheimer’s disease who were taking an acetylcholinesterase inhibitor, a dosage of 2000 IU/d of vitamin E significantly slowed functional decline compared to placebo by 6.2 months over the mean follow-up period of 2.27 years. Over this period of time caregiver time increased least in the vitamin E group compared to the other three groups (memantine alone, vitamin E plus memantine, and placebo) although the only statistically significant difference was between vitamin E alone and memantine alone. There were no significant safety concerns for vitamin E compared to placebo and mortality was lowest in the vitamin E alone group. It should be noted that patients who were on warfarin were excluded from the study because of a possible interaction with vitamin E that could have possibly increased bleeding events.
MedicalResearch.com Interview with:Sarah M. Hartz, MD, PhD
Assistant Professor of Psychiatry
Washington University in St. Louis, MissouriMedicalResearch.com: What are the main findings of this study?Dr. Hartz: This is the first large-scale study to comprehensively evaluate substance use in people with schizophrenia, bipolar disorder, and other severe mental illness.We found that people with severe mental illness have rates of smoking, alcohol use, and other substance use that are 3 to 5 times higher than people in the general population.
MedicalResearch.com Interview with:Madhav Goyal MD, MPH
General Internal Medicine
Johns Hopkins School of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Goyal:
The evidence is moderately strong that there is a small but consistent benefit for mindfulness meditation programs to improve 3 symptoms: anxiety, depression, and pain. We found low level evidence that mindfulness meditation helps with symptoms of stress and distress, as well as with the mental health dimension of quality of life.
For the symptoms of anxiety and depression for which we find moderate evidence of benefit, we need to keep in mind that most of the trials didn't study people with a clinical diagnosis of anxiety or depression (although a few did). Most were studying diverse patient populations who may have had a low level of these symptoms, such as those with breast cancer, fibromyalgia, organ transplant recipients, and caregivers of people with dementia.
We found about a 5-10% improvement in anxiety symptoms compared to placebo groups. For depression, we found a roughly 10-20% improvement in depressive symptoms compared to the placebo groups. This is similar to the effects that other studies have found for the use of antidepressants in similar populations.
While we found that the evidence was moderately strong that mindfulness meditation programs may improve pain, there weren't as many trials evaluating chronic pain, and so we don't understand what kinds of pain this type of meditation may be most useful for.
MedicalResearch.com Interview with:
Dr. Bruce Reed PhD
Professor of Neurology,
Associate Director UC Davis Alzheimer's Disease Center
Davis, CA 95616
MedicalResearch.com: What are the main findings of the study?Dr. Reed: We found that high LDL cholesterol and low HDL cholesterol in blood were both associated with higher amyloid deposition in the brain. This is potentially very important because the deposition of amyloid seems to be a critical step that kicks off a whole chain of events that eventually lead to Alzheimer's disease. It is widely believed (although not proven) that if this deposition of amyloid could be blocked that we could greatly decrease the incidence of Alzheimer's. The connection to cholesterol is exciting because we know a fair amount about how to change cholesterol levels. A great deal more research needs to be done, but this does suggest a potential new path toward trying to prevent AD.
MedicalResearch.com Interview with:Stewart C. Alexander, PhD
Department of Medicine
Duke University Medical Center
Durham, North Carolina
MedicalResearch.com: What are the main findings of the study?Dr. Alexander: Adolescents are reluctant to talk about sex with their doctors and won't raise the topic with their doctors. For physicians, there are common and valid barriers to talking about sexuality with adolescents, including time pressures and discomfort with the topic. Two-thirds of adolescents in our study had some sexuality talk during their annual visit, lasting 36 seconds long. Girls, African Americans, and older teens were more likely to receive sexuality talk. Additionally, longer visits and visits where the physician talked confidentially with their adolescent patient were more likely to have sexuality talk. Our study suggest that sexuality conversations in annual visits can be improved.
MedicalResearch.com Interview with:Ajay K Parsaik, MD, MS
Department of Psychiatry and Behavior Sciences
The University of Texas Medical School, Houston
Department of Neurology and Mayo Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of the study?Dr. Parsaik:Main findings of our study are that clinical and subclinical hypothyroidism is not associated with mild cognitive impairment in an elderly population after accounting for possible confounding factors and interactions.
MedicalResearch.com Interview with: Michael C. Young, M.D.
Associate Clinical Professor of Pediatrics
Harvard Medical School
Division of Allergy & Immunology
Children's Hospital Boston
MedicalResearch.com: What are the main findings of the study?Dr. Young: We found an association between increased maternal peripregnancy consumption of peanuts/ tree nuts and reduced risk of nut allergies in the offspring.
MedicalResearch.com Interview with: Dr. Yang Liu
Dr. David A. Sullivan, MS, PhD, FARVO
Senior Scientist, Schepens Eye Research Institute, Associate Professor, Department of Ophthalmology Harvard Medical School
Boston, MA, USA 02114
MedicalResearch.com: What is the main finding of the study?Answer:We discovered that azithromycin (AZM) can directly stimulate the function of human meibomian gland epithelial cells. Given this finding, it is possible that this antibiotic may prove beneficial as a treatment for meibomian gland dysfunction (MGD), which is the leading cause of dry eye disease in the world.
MedicalResearch.com Interview with:Scott W. Powers, PhD APBB
Division of Behavioral Medicine and Clinical Psychology and
Division of Neurology, Cincinnati Children’s Hospital Medical Center Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
MedicalResearch.com: What are the main findings of the study?Dr. Powers: Cognitive behavioral therapy plus amitriptyline resulted in greater reductions in days with headache and migraine-related disability compared with the use of headache education plus amitriptyline. Children and adolescents with chronic migraine began the study with an average of 21 days with headache per 28 days and disability measured in the severe range. After 20 weeks of treatment, 2 out of 3 participants in the CBT group had a 50% or greater reduction in headache days and 3 out of 4 had a reduction in disability to the mild to none range.
MedicalResearch.com Interview with:Nita Ahuja, MD
Departments of Surgery and Oncology,
Johns Hopkins University School of Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Ahuja: Across the nation, laparoscopic colectomy is performed about as frequently as open colectomy, despite being associated with a lower complication rate and a lower overall hospital cost. On the other hand, an exponentially growing prevalence was found with robotic colectomy, a procedure that has so far demonstrated only equivalent outcomes with laparoscopic colectomy but a higher overall cost.
MedicalResearch.com Interview with:Mitesh Patel, MD, MBA
RWJF Clinical Scholar, University of Pennsylvania
Mitesh Patel, MD, MBA is a Robert Wood Johnson Clinical Scholar the University of Pennsylvania and primary care physician at the Philadelphia VA Medical CenterMedicalResearch.com: What are the main findings of the study?Dr. Patel: We evaluated survey responses from nearly 300 internal medicine residency programs directors to assess whether residency programs were teaching residents the fundamental concepts of practicing high-value, cost-conscious care. We found that 85% of program directors feel that graduate medical education has a responsibility to help curtail the rising costs of health care. Despite this, about 6 out of every 7 internal medicine residency programs have not yet adopted a formal curriculum teaching new physicians these important concepts.
MedicalResearch.com Interview with:Elbert S. Huang, MD MPH FACP
Associate Professor of Medicine
University of Chicago
5841 S. Maryland Ave., MC 2007
Chicago, IL 60637
MedicalResearch.com: What did you find most surprising in these results?Dr. Huang: We did not expect hypoglycemia to rank as highly as it did among the diabetes complications.
We were also surprised to find that the rates of cardiovascular and microvascular complications are all dramatically lower than they were in the 1990s.
MedicalResearch.com Interview with:Dewleen G. Baker, MD
Department of Psychiatry
School of Medicine, University of California,
Veterans Affairs San Diego Healthcare System
Veterans Affairs Center of Excellence for Stress and Mental Health
San Diego, California
MedicalResearch.com: What are the main findings of the study?Dr. Baker: Pre-deployment psychiatric symptoms, combat intensity, and traumatic brain injury (TBI) were significant predictors of post-deployment PTSD symptom severity. However, the strongest predictor was deployment-related TBI; mild TBI increased symptom scores by 23%, and moderate to severe injuries increased scores by 71%.
MedicalResearch.com Interview with: Garrett M. Chinn, MD, MS
Division of General Medicine, Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston
MedicalResearch.com: What are the main findings of this study:Dr. Chinn: Despite the desire of most Americans facing terminal illness to spend their remaining time at home, only 24% of those aged 65 and older do so. Many spend their final days in an institutional setting such as an acute care hospital, often receiving aggressive care.
In the case of patients facing stage 4 lung cancer, many who would prefer to emphasize pain relief over extending life report not having discussed hospice with a physician. More than 25% indicate that they had not addressed advanced care directives such as do-not-resuscitate orders with their doctors but wanted to do so. This tells us that patients wish to better understand their illness and prognosis and might be interested in learning about hospice. And although the general trend for hospice utilization has increased over the past decade, a high percentage of hospice enrollment occurs quite late in the course of illness, often during an acute hospitalization.
MedicalResearch.com Interview with: Dr. Miguel-Ángel Martínez-García
Respiratory Department, Hospital Universitario y Politécnico La Fe
MedicalResearch.com: What are the main findings of this study:Answer: The main findings of the study are:
1. The treatment with CPAP
(continuous positive airway pressure) achieves a clinically and
statistically significant reduction of blood pressure in patients with
resistant hypertension (blood pressure that remains above goal in spite of
the use of at least three antihypertensive drugs) and obstructive sleep apnea.
MedicalResearch.com Interview with:J. Randall Curtis, MD, MPH
Professor of Medicine
Director, UW Palliative Care Center of Excellence
Section Head, Pulmonary and Critical Care Medicine, Harborview Medical CenterA. Bruce Montgomery, M.D. – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA 98104
MedicalResearch.com: What are the main findings of the study?Dr. Curtis: We examined the effect of a communication-skills intervention for internal medicine and nurse practitioner trainees on patient- and family-reported outcomes. The study was funded by the National Institutes of Nursing Research of the National Institutes of Heatlh. We conducted a randomized trial with 391 internal medicine and 81 nurse practitioner trainees at two universities. Participants were randomized to either an 8-session simulation-based, communication-skills intervention or to usual education. We collected outcome data from a large number of patients with life-limiting illness and their families, including 1866 patient ratings and 936 family ratings. The primary outcome was patient-reported quality of communication and, overall, this outcome did not change with the intervention. However, when we restricted our analyses to only patients who reported their own health status as poor, the intervention was associated with increased communication ratings. Much to our surprise, the intervention was associated with a small but significant increase in depression scores among post-intervention patients. Overall, this study demonstrates that among internal medicine and nurse practitioner trainees, simulation-based communication training compared with usual education improved communication skills acquisition, but did not improve quality of communication about end-of-life care for all patients. However, the intervention was associated with improved patient ratings of communication for the sickest patients. Furthermore, the intervention was associated with a small increase in patients’ depressive symptoms, and this appeared most marked among patients of the first-year residents.
MedicalResearch.com Interview with:James Guevara, MD, MPH
Associate Professor of Pediatrics & Epidemiology
Senior Diversity Search Advisor, Perelman School of Medicine
University of Pennsylvania,Director of Interdisciplinary Initiatives
PolicyLab: Center to Bridge Research, Practice, & Policy
The Children's Hospital of Philadelphia,Philadelphia, PA 19104
MedicalResearch.com: What did the study attempt to address?Dr. Guevara: Medical schools have sought to build more diverse faculty in their institutions through faculty development programs targeted to underrepresented minority faculty members. This study was conduct by THE CHILDREN'S HOSPITAL OF PHILADELPHIA'S POLICYLAB and The University of Pennsylvania and sought to determine if there was an association between minority faculty development programs and the representation, recruitment, and promotion of underrepresented minority faculty.
MedicalResearch.com Interview with:Ian Kronish, MD, MPH
Assistant Professor of Medicine
Center for Behavioral Cardiovascular Health
Division of General Medicine
Columbia University Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Kronish:Among primary care patients with persistently uncontrolled blood pressure despite medication treatment, we found that medication non-adherence was more than twice as common in patients with PTSD (68%) as compared to patients without PTSD (26%). The association between PTSD and medication non-adherence remained present after adjustment for key covariates including regimen complexity and depression. Recent research shows that PTSD not only contributes to psychological distress, but is also associated with increased risk for incident and recurrent cardiovascular disease. The data from our study suggest that medication non-adherence may be an important mechanism by which PTSD increases risk for cardiovascular disease.
MedicalResearch.com Interview with Marzia Lazzerini, PhD
Institute for Maternal and Child Health IRCCS “Burlo Garofolo,”
MedicalResearch.com: What are the main findings of the study?Answer: In children and adolescent with Crohn’s disease refractory to first and second line treatment, thalidomide was effective in inducing and maintaining clinical remission. About 60% of children achieved clinical remission, and clinical remission was maintained for a mean time of 180 weeks. The main reason to stop thalidomide was peripheral neuropathy.
MedicalResearch.com Interview with Deanna Kepka, PhD, MPH
College of Nursing & Huntsman Cancer Institute
University of Utah
MedicalResearch.com: What are the main findings of the study?
Dr. Kepka: Nearly two-thirds, 64.8% (95% CI: 62.2% - 67.3%) of women reporting a hysterectomy also reported a recent Pap test since their hysterectomy and more than half, 58.4% (95% CI: 55.3% - 61.4%) of women age 65 years and older without a hysterectomy reported a Pap test in the past three years. Together, this represents approximately 14 million in the United States.
MedicalResearch.com Interview with:Michael Ho, MD, PhD
Assistant Professor of Medicine, Division of Cardiology
Cardiology 111B 1055 Clermont Street
Denver CO 80220
MedicalResearch.com: What are the main findings of the study?Dr. Ho: We found that testosterone use was associated with a 29% increased risk of death, MI and stroke over a follow-up period of 27 months. The risk was similar among patients with or without coronary artery disease on coronary angiography.
MedicalResearch.com Interview with:Ilke Sipahi, MD
Department of Cardiology
Acibadem University Medical School, Istanbul, Turkey
Harrington Heart and Vascular Institute, University Hospitals Case Medical Cente, Case Western Reserve University School of Medicine, Cleveland, Ohio
MedicalResearch.com: Were you surprised at the extreme difference between these 2analyses?Answer: I was surprised. However, it is not unusual to find completely
contradictory results in medical studies. I was more surprised at the
fact that FDA paid more attention to it administrative observational
dataset rather than the huge large randomized clinical trials, all
showing excess GI bleeds with dabigatran (Pradaxa). Anyone who is even
slightly familiar with the medical literature knows that randomized trials are the gold standard in medical studies.
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