JAMA
19 Feb Online Physician Rating Sites: Public Awareness and Participation Increasing
MedicalResearch.com Interview with:
Dr. David Hanauer, MD
Associate Professor, University of Michigan Medical School
1500 East Medical Center Drive
Ann Arbor, MI 48109-5940
MedicalResearch.com: What are the main findings of the study
Dr. Hanauer: From my perspective, the primary findings were that 65% of the general public is now aware of physician rating web sites and among those who are aware, about 36% had used them in the prior year. Awareness and usage seems to be rapidly increasing compared to what has been reported in prior studies from just a few years ago. We also found that patients consider word of mouth recommendations (from family/friends) to be almost twice as important as ratings sites are.
19 Feb Pre-Op Vitamin D and Infection Risk Following Gastric Bypass Surgery
MedicalResearch.com Interview with:
Sadeq A. Quraishi, MD, MHA
Massachusetts General Hospital, Harvard Medical School
Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study?
Dr. Quraishi: Our retrospective study suggests that there is an association between pre-operative 25-hydroxyvitamin D [25(OH)D] levels and the risk of hospital-acquired infections after gastric bypass surgery. In particular, patients with 25(OH)D levels <30 ng/ml before surgery were almost 4 times more likely to develop a surgical site infection within 30 days of surgery than patients with pre-operative 25(OH)D levels at 30 ng/ml or higher.
19 Feb Alzheimer’s: Celexa Reduced Agitation, Has Modest Cognitive, Cardiac Side Effects
MedicalResearch.com Interview with:
Anton P. Porsteinsson M.D.
William B. and Sheila Konar Professor of Psychiatry
Director, Alzheimer's Disease Care, Research and Education Program (AD-CARE)
University of Rochester School of Medicine and Dentistry
Rochester, N.Y. 14620
MedicalResearch.com: What are the main findings of the study?
Dr. Porsteinsson: Identifying drugs outside the antipsychotic class with targeted anti-agitation effects that provide greater benefit or lower risk among patients with Alzheimer’s disease is a research priority. Citalopram, a selective serotonin reuptake inhibitor (SSRI), is frequently used in older individualsand has been suggested as an alternative to antipsychotic drugs for agitation and aggression in dementia. Among 186 patients with probable Alzheimer’s disease and agitation receiving psychosocial intervention, the addition of citalopram compared with placebo robustly and significantly reduced agitation and caregiver distress, but modest cognitive and cardiac adverse effects of citalopram may limit its practical application at the 30 mg/d dose studied in this trial. There are insufficient data on efficacy for agitation at lower doses of citalopram.
18 Feb Stroke: Intracranial Atherosclerosis as a Major Risk Factor
MedicalResearch.com Interview with:
M. Arfan Ikram, MD, PhD
Departments of Radiology, Epidemiology, and Neurology
Erasmus Medical Center,
Rotterdam, the Netherlands
MedicalResearch.com: What are the main findings of the study?
Dr. Ikram: The main finding of the study, carried out within the Rotterdam Study and led by drs. Daniel Bos and Arfan Ikram (both from the Erasmus Medical Center Rotterdam, the Netherlands), was that intracranial atherosclerosis is a major risk factor for stroke in the Western (white) population. Traditionally, intracranial atherosclerosis has not been considered of major importance to stroke risk in Western populations. In contrast, most research on intracranial atherosclerosis originates from Asian and African populations, where is was actually recognized as the most important risk factor of stroke. Our study demonstrates that also in the Western population intracranial atherosclerosis is a major risk factor for stroke and should get more focus in clinical practice. Moreover, our findings indicate that its contribution to the proportion of all strokes is greater than that of atherosclerosis in other vessel beds that are further away from the brain.
18 Feb Obesity: Linked to Genetics of Appetite and Satiety
MedicalResearch.com Interview with:
Dr Clare Llewellyn PhD Cpsychol
Lecturer in Behavioural Obesity Research
Health Behaviour Research Centre
Department of Epidemiology and Public Health
University College London, London
MedicalResearch.com: What are the main findings of the study?
Dr. Llewellyn:This study indicated that appetite – and, in particular, satiety sensitivity (how quickly you feel full during eating, or how long you remain full after eating) – could be one of the mechanisms through which ‘obesity genes’ influence body weight.
We know that body weight has a strong genetic basis, but the mechanisms through which ‘obesity genes’ influence weight are largely unknown.
We showed that children with a higher genetic predisposition to obesity (estimated from a score comprising 28 known obesity-related genes) not only had more body fat (a larger BMI and waist circumference), but importantly they were also less sensitive to satiety.
13 Feb Teledermatololgy As Triage Tool For Dermatology Hospital Consultation
MedicalResearch.com Interview with:
Dr. Misha A. Rosenbach
Assistant Professor of Dermatology Hospital of the University of Pennsylvania Section Editor,
JAMA Dermatology Patient Page
MedicalResearch.com: What are the main findings of the study? Dr. Rosenbach: There is strong agreement between teledermatologists and in-person dermatologists when evaluating inpatients at a tertiary care academic hospital. The primary aim of this study was to assess telederm as a triage tool. Many dermatologists are not full-time hospitalists, but work in private practice or clinics which may be remote from affiliated hospitals. The goal was to evaluate whether teledermatology could help those providers assess the acuity of inpatient consults. There was strong concordance.
12 Feb Genital Warts: Efficacy of Two Doses of HPV Vaccine
MedicalResearch.com Interview with:
Lisen Arnheim Dahlström
Associate Professor (Docent)
Institutionen för medicinsk epidemiologi och biostatistik
Department of Medical Epidemiology and Biostatistics
Karolinska Institutet Sweden
MedicalResearch.com: What are the main findings of the study?
Answer: The main finding, when studying HPV vaccine effectiveness against condyloma by dose level is that 3 doses offered the maximum protection, although 2 doses also offered a substantial protection.
11 Feb Most Women Remain Sexually Active into theirs 50s, 60s and Beyond.
MedicalResearch.com Interview with: Holly Thomas, MD General Internal Medicine Fellow, Women's Health and Clinical Research University of Pittsburgh Pittsburgh, PA 15213 MedicalResearch.com: What are the main findings of the study? Dr. Thomas: We found that, despite popular perception, the majority of women (85%) who are sexually active at midlife will remain sexually active four years later. We also found that the majority of women score low on a measure of sexual function. However, low sexual function scores did not mean women stopped having sex. In fact, the score on the sexual function measure did not predict whether women maintained sexual activity. Finally, we found that importance of sex was a strong predictor of whether women remained sexually active. Women who felt sex was moderately to extremely important in their lives were 3 times more likely to maintain sexual activity.03 Feb Cardiovascular Disease Risk and Sugar Intake
MedicalReseach.com Interview with: Quanhe Yang, PhD Division for Heart Disease and Stroke Prevention Centers for Disease Control and Prevention, Atlanta, GA 30341 MedicalReseach.com: What are the main findings of the study? Dr. Yang: The majority of US adults consume more added sugar than is recommended for a healthy diet. On average, Americans consume about 15% of daily calories from added sugar. About 70% of adults consume more than 10%of calories from added sugar and another 10% consume more than 25% of calories from added sugar. When you compare those who consume 7.5% (lowest quintile) of calories from added sugar with participants who consume between 17%-21% (quintile 4) of calories from added sugar, the latter group has a 38% higher risk of CVD mortality. But the risk of CVD death more than doubles for those who consume ≥21% (highest quintile) of calories from added sugar.27 Jan Alzheimer Disease and Elevated Pesticide DDT Levels
MedicalResearch.com Interview with: Jason R. Richardson MS, PhD, Associate Professor Department of Environmental and Occupational Medicine Robert Wood Johnson Medical School and Resident Member Environmental and Occupational Health Sciences Institute Piscataway, NJ 08854 MedicalResearch.com: What are the main findings of the study? Dr. Richardson: We had 3 main findings in our study. First, Alzheimer Disease patients had almost...
26 Jan Underserved Patients: Minority Physicians’ Role
MedicalResearch.com Interview with:
Dr. Lyndonna Marrast MD
Fellow in General Internal Medicine
Cambridge Health Alliance
Cambridge, MA 02139
MedicalResearch.com: What are the main findings of the study?
Dr. Marrast: We found that disadvantaged patients (categorized as racial and ethnic minorities, non-English home language speakers, being low income, having Medicaid, or reporting fair or poor health) were more likely than other patients to be cared for by a minority physician.
A majority, 54%, of black, Hispanic and Asian patients received care from a minority doctor and the vast majority, 70%, of those who report not speaking English at home got care from a minority physician.
23 Jan FDA Drug Approvals Have Variable Clinical Trial Evidence Record
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.22 Jan Concussions in Young Female Soccer Players
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.
17 Jan High Volume Hospitals and Discharge to Home after Colon Surgery
Posted at 19:17h
in Author Interviews, Baylor College of Medicine Houston, JAMA, Outcomes & Safety, Surgical Research
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
and
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.
17 Jan Safety Net Hospitals: Death Rates After Major Complications
Posted at 02:32h
in Author Interviews, Brigham & Women's - Harvard, Health Care Systems, JAMA, Medical Research Centers, Outcomes & Safety
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.
14 Jan Probiotics to Prevent Infantile Colic, Regurgitation and Functional Constipation
MedicalResearch.com Interview with:
Flavia Indrio, MD
Department of Pediatrics
Aldo Moro University of Bari
Bari, Italy
MedicalResearch.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.
14 Jan Cataracts: Quitting Smoking Decreases Risk
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.14 Jan Commercialism in School Food and Beverages
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.
12 Jan Age-Related Macular Degeneration: Ten Year Follow Up Study
[caption id="attachment_48090" align="alignleft" width="150"] Dr. Chew[/caption] MedicalResearch.com Interview Emily Y. Chew, M.D. Deputy Director, Division of Epidemiology and Clinical Applications National Eye Institute National Institutes of Health (NIH), Bethesda, MD MedicalResearch.com: What are the main findings of the study? Dr. Chew: We provided 10 year rates of development of advanced age-related macular degeneration (AMD), either neovascular...
10 Jan Alzheimer Disease: Effect of Vitamin E on Slowing Functional Decline
MedicalResearch.com Interview Invitation
Maurice Dysken, MD
Professor, School of Medicine
Department of Psychiatry
Minneapolis VA Health Care System,
Minneapolis, Minnesota
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.
10 Jan Severe Psychotic Disorders and Substance Use Patterns
 MedicalResearch.com Interview with:
Sarah M. Hartz, MD, PhD
Assistant Professor of Psychiatry
Washington University in St. Louis, Missouri
MedicalResearch.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.
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07 Jan Mindfulness Meditation to Improve Anxiety, Depression and Pain
Posted at 16:11h
in Author Interviews, Depression, JAMA, Johns Hopkins, Mental Health Research, Pain Research
MedicalResearch.com Interview with:
Madhav Goyal MD, MPH
Assistant Professor
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.
02 Jan High LDL, Low HDL Levels and Elevated Brain Amyloid
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.
31 Dec Adolescent Health: Sex Discussions During Office Visits
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.
31 Dec Hypothyroidism and Mild Cognitive Impairment Risk?
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.
29 Dec Peanut Allergy: Does Eating Peanuts During Pregnancy Reduce Allergies in Children?
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.29 Dec Antibiotic May Treat Dry Eye Disorder
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.
26 Dec Pediatric Migraines: Cognitive Therapy Plus Amitriptyline
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.
22 Dec Is Robotic Surgery Better than Traditional Colectomy?
Posted at 12:35h
in Author Interviews, Gastrointestinal Disease, JAMA, Johns Hopkins, Surgical Research
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.