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.
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MedicalResearch.com Interview with: Dr. Yang Liu
Preceptor and
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.
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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.
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MedicalResearch.com Interview with:Nita Ahuja, MD
Departments of Surgery and Oncology,
Johns Hopkins University School of Medicine
Baltimore, Maryland
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.
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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.
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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.
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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%.
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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.
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MedicalResearch.com Interview with: Dr. Miguel-Ángel Martínez-García
Respiratory Department, Hospital Universitario y Politécnico La Fe
Valencia, Spain
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.
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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.
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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.
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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.
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MedicalResearch.com Interview with Marzia Lazzerini, PhD
Institute for Maternal and Child Health IRCCS “Burlo Garofolo,”
Trieste, Italy
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.
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MedicalResearch.com Interview with Deanna Kepka, PhD, MPH
Assistant Professor
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.
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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.
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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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MedicalResearch.com Interview with: Prof. Prashanthan Sanders
Director, Centre for Heart Rhythm Disorders
University of Adelaide | Royal Adelaide Hospital | SAHMRI
NHMRC Practitioner Fellow
Centre for Heart Rhythm Disorders
Department of Cardiology | Royal Adelaide Hospital
Adelaide 5000 | Australia
MedicalResearch.com: What are the main findings of the study?Answer:Aggressive treatment of risk factors and weight reduced the symptom burden associated with atrial fibrillation. It is therefore important that in a similar manner to how we treat coronary artery disease, in atrial fibrillation there should be management directed at the reasons why these individuals got AF in the first place.
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MedicalResearch.com Interview with:Angela M. Leung, MD, MSc
Clinical Assistant Professor of Medicine
Division of Endocrinology, Department of Medicine
University of California Los Angeles
MedicalResearch.com: What are the main findings of the study?Dr. Leung:Despite current guidelines to screen for thyroid dysfunction as a secondary cause of newly-diagnosed hyperlipidemia, this was performed only about 50% of the time by primary care providers in over 8,700 patients at a large, urban Boston academic medical center. Approximately 5% of patients who had thyroid function checked were found to have hypothyroidism. The majority of hypothyroid patients who received treatment with levothyroxine had successful correction of the initial hyperlipidemia within one year.
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MedicalResearch.com Interview with:Richard L. Kravitz, MD, MSPH
Professor and Co-vice Chair (Research)
Interim Director, UC Center Sacramento
Co-Editor in Chief, Journal of General Internal Medicine
MedicalResearch.com: What is the background for your study?Dr. Kravitz: Depression in the United States is both undertreated and overtreated. As the de facto mental health care system for many, primary care is at the nexus of this problem. Up to 30% of patients with major depression in primary care go undiagnosed. At the same time, partly as a result of marketing, lots of patients who don’t need meds are started on antidepressants. So we were interested in finding ways to get more truly depressed patients into treatment without overtreating patients who don’t need it.
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MedicalResearch.com Interview with:Thomas H. Inge, MD, PhD, FACS, FAAP
Surgical Director, Surgical Weight Loss Program for Teens
Director, Center for Bariatric Research and Innovation
Attending Surgeon, Cincinnati Children’s Hospital Medical Center
Professor, UC Department of Surgery
Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
MedicalResearch.com: What are the main findings of the study?Dr. Inge: The mean age of the 242 participants of this observational study was 17.1±1.6 years and the median BMI was 50.5 kg/m2. Fifty-one percent demonstrated four or more major co-morbid conditions. Laparoscopic Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and adjustable gastric banding were performed in 66%, 28%, and 6% of subjects, respectively. There were no deaths during the initial hospitalization or within 30 days of surgery; major complications were seen in 19 subjects (8%). Minor complications were noted in 36 subjects (15%). All re-operations and 85% of re-admissions were related to WLS. (more…)
MedicalResearch.com Interview with: Nicholas J. Christian, PhD
Graduate School of Public Health
University of Pittsburgh
MedicalResearch.com: What are the main findings of the study?Dr. Christian: We found that the differences between measured and self-reported weights following bariatric surgery were small and did not systematically differ by measured body mass index or degree of postoperative weight change. The average degree of underreporting by self-report was 0.7 kg for women and 1.0 kg for men.
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MedicalResearch.com Interview with: Elsayed Z Soliman MD, MSc, MS, FAHA, FACC
Director, Epidemiological Cardiology Research Center (EPICARE)
Wake Forest School of Medicine
Medical Center Blvs, Winston Salem, NC 27157
Atrial Fibrillation and the Risk of Myocardial Infarction
MedicalResearch.com: What are the main findings of the study?Dr. Soliman: Using data from the REGARDS study, one of the largest US cohorts, we examined the risk of incident myocardial infarction (MI) associated with atrial fibrillation (AF). Overall, AF was associated with almost double the risk of MI. When we adjusted for common cardiovascular risk factors and potential confounders, the risk remained significantly high; about 70% increased risk. When we looked at women, men, blacks, and whites separately, we found significant differences between races and sex. AF in women and blacks was associated with more than double the risk of MI. This compares to less than 50% increased risk of heart attack associated with AF in men and whites . So AF is basically bad for all, but the risk of MI associated with AF is more pronounced in women and blacks.
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MediclResearch.com Interview with:John W. Ayers, PhD, MA
Graduate School of Public Health
San Diego State University, San Diego, California
MedicalResearch.com: What are the main findings of the study?Dr. Ayers: Our study, published today in the Journal of the American Medical Association, Internal Medicine was the first to describe daily rhythms in health behaviors.
Because trends in quitting contemplations are usually described annually using telephone surveys, we had to use a novel data source that could capture daily patterns. By monitoring aggregate Internet search queries we can see precisely what the population is thinking about by the content of their queries and that the population is engaged in the issue by searching. We therefore analyzed daily search volumes for smoking cessation queries (e.g., "quit smoking") in six languages across the entire globe.
We found that people search about quitting smoking more often early in the week, with the highest query volumes on Mondays, using a daily measure representing the proportion of quit smoking searches to all searches. This pattern was consistent across all six languages, suggesting a global predisposition to thinking about quitting smoking early in the week, particularly on Mondays.
English searches, for example, showed Monday query volumes were 11 percent greater than on Wednesdays, 67 percent greater than on Fridays, and 145 percent greater than on Saturdays. In total for all six languages, Monday query volumes were 25 percent higher than the combined mean number of searches for Tuesday through Sunday.
Practically these findings are very meaningful. For example, in English alone there are about 150,000 more quit smoking queries on Monday than on a typical day; about 8,000,000 over an entire year.
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MedicalResearch.com Interview with:Dr. Jennifer Fay Kawwaas MD
Department of Gynecology and Obstetrics
Emory University School of Medicine, Atlanta, GA, USA
MedicalResearch.com: What are the main findings of the study?Dr. Kawwaas: Using CDC National ART Surveillance System (NASS) data, we found an increasing trend from 2000 to 2010 in the number of donor egg cycles performed annually and in the percentage of donor cycles that resulted in a good outcome, defined as delivery of a full term infant weighing more than 5.5lbs. Donor and recipient ages remained relatively stable at 28 and 41, respectively, over the 11-year period.
Elective single embryo transfer is recommended when the donor is under 35 years old, regardless of recipient’s age; transfer of a single day 5 embryo was associated with an increased chance of good perinatal outcome.
Tubal or uterine factor infertility and non-Hispanic Black race were associated with a lower chance of good perinatal outcome.
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MedicalResearch.com Interview with:Dr. Elizabeth V. Asztalos, MD, M.Sc., FRCPC
Sunnybrook Health Sciences Centre
2075 Bayview Ave., Room M4 230
Toronto, ON M4N 3M5
MedicalResearch.com What are the main findings of the study?Answer: This study was focused to see if there were differences in the main neurodevelopmental outcomes of children whose mothers had participated in the original MACS trial. We found that there were no differences in the main outcomes of the trial as it related to the aspects of death and/or developmental. (more…)
MedicalResearch.com Interview with:Dr. Ali Rowhani-Rahbar PhD, MD, MPH
Kaiser Permanente Vaccine Study Center, Oakland, California
University of Washington
Department of Epidemiology Health Sciences
Seattle, WA 98195
MedicalResearch.com: What are the main findings of your study?Answer: We found that the magnitude of increased risk of fever and seizures
following immunization with the first dose of measles-containing
vaccines during the second year of life depends on age. Specifically,
the risk of seizures attributable to the vaccine during the 7 to 10 days
following vaccination was significantly greater among children 16-23
months of age (9.5 excess cases per 10,000 doses) than among children
12-15 months of age (4.0 excess cases per 10,000 doses). (more…)
MedicalResearch.com with:Professor Djillali Annane MD, PhD
Raymond Poincaré Hospital, Garches, France
CH d’Etampes, Etampes, France
MedicalResearch.com: What are the main findings of the study?Answer: The CRISTAL trial was designed in 2002 to clarify whether correction of acute hypovolemia in critically ill patients with colloids may increase the risk of death as compared to resuscitation with crystalloids. The trial has enrolled 2857 patients in 57 ICUs in France, Belgium, Canada and North Africa. The relative risk of death was at 28 day of 0.96 (95% CI: 0.88 to 1.04; P=0.26), and at 90 day of 0.92 (95%CI: 0.86 to 0.99; P=0.03) in favor of colloids. Colloids-treated patients had more days alive and off mechanical ventilation and off vasopressor both within 7 days and 28 days of randomization. There was no evidence for increased risk of kidney injury with colloids.
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MedicalResearch.com Interview with:Mila Ju, MD
Resident, Division of Vascular Surgery
Northwestern University
676 N. Saint Clair St., Ste 650
Chicago, IL 60611
MedicalResearch.com: What are the main findings of the study?Dr. Ju: By using combined data from Hospital Compare, American Hospital Association, and Medicare claims databases, we found that better hospital venous thromboembolism (VTE) prophylaxis adherence rates were weakly associated with worse risk-adjusted VTE event rates. Moreover, hospitals with higher intensity of detecting VTE with imaging studies (such as venous duplex, chest computer tomography, etc.) had more VTE events (13.5 in highest VTE imaging quartile vs 5.0 in lowest VTE imaging quartile) per 1000 discharges. Our study suggests that VTE rates might be influenced by surveillance bias and not reflecting the true quality of care provided by the hospitals.
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MedicalResearch.com Interview with:
Dr Valerie Sung MBBS(Hons) FRACP MPH NHMRC PhD Candidate
Department of Paediatrics, University of Melbourne, and
Community Health Services Research, Murdoch Childrens Research Institute Paediatrician, Centre for Community Child Health
The Royal Children’s Hospital
Parkville | 3052 | Victoria Australia
MedicalResearch.com: What are the main findings of the study?Dr. Sung: The systematic review identified 12 studies (1825 infants) that investigated the use of probiotics to treat or prevent infant colic (excessive crying of unknown cause in babies less than 3 months old). Three of the 5 treatment trials concluded probiotics effectively treat colic in breastfed babies; one suggested possible effectiveness in formula-fed babies with colic, and one suggested ineffectiveness in breastfed babies with colic. The three effective trials used the probiotic Lactobacillus reuteri in breastfed babies only; in two of these trials, the mothers were on a dairy-free diet. Five of the 7 prevention trials suggested probiotics to be ineffective in preventing colic.
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MedicalResearch.com Interview with: Zudin Puthucheary MBBS B.Med.Sci D.UHM EDICM MRCP FHEA
NIHR Research Fellow, Respiratory and Critical Care
Institute of Health and Human Performance, UCL
Post-CCT Fellow in Trauma and Critical Care,
Kings College Hospital
MedicalResearch.com: What are the main findings of the study?Answer: That muscle wasting occurs rapidly and early in critical illness, with up to 2-3% loss of muscle mass per day. This is related to the numbers of organs failed, and is made worse by the degree of acute lung injury, and increased protein delivery. Muscle wasting is the result of both decreased muscle protein synthesis and increased muscle protein breakdown. In addition 40% of these patients developed muscle necrosis over the study period.
(more…)
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