Author Interviews, JAMA, Pediatrics, Vaccine Studies / 15.10.2013

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 98195Dr. 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…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA / 14.10.2013

Professor Djillali Annane MD, PhD Raymond Poincaré Hospital, Garches, France CH d’Etampes, Etampes, FranceMedicalResearch.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. (more…)
Author Interviews, Blood Clots, JAMA / 13.10.2013

Mila Ju, MD Resident, Division of Vascular Surgery Northwestern University 676 N. Saint Clair St., Ste 650 Chicago, IL 60611MedicalResearch.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. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Pediatrics, Probiotics / 10.10.2013

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. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Nutrition, Protein / 10.10.2013

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 HospitalMedicalResearch.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…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 09.10.2013

Dr. Mary T Hawn MD Center for Surgical, Medical Acute Care Research and Transitions (C-SMART), Birmingham Veterans Administration Hospital, Birmingham, Alabama Section of Gastrointestinal Surgery, Department of Surgery University of Alabama at BirminghamMedicalResearch.com Interview with Dr. Mary T Hawn MD Center for Surgical, Medical Acute Care Research and Transitions (C-SMART), Birmingham Veterans Administration Hospital, Birmingham, Alabama Section of Gastrointestinal Surgery, Department of Surgery University of Alabama at Birmingham MedicalResearch.com: What are the main findings of the study? Dr. Hawn: The risk of adverse perioperative cardiac events is elevated in patients with recent coronary stenting, but the risk does not differ by stent type and stabilizes for surgery more than 6 months following stenting. (more…)
Author Interviews, JAMA, UT Southwestern / 08.10.2013

Roshni Rao, MD Division of Surgical Oncology, Department of Surgery University of Texas Southwestern Medical Center, DallasMedicalResearch.com Interview with: Roshni Rao, MD Division of Surgical Oncology, Department of Surgery University of Texas Southwestern Medical Center, Dallas MedicalResearch.com: What are the main findings of the study?  Dr. Rao: That in most women with small breast cancer (<3.0cm in size), it is not necessary to removal all the lymph nodes underneath the arm, even if those nodes do have cancer. Radiation therapy, which is required after a partial mastectomy for breast cancer, can prevent these nodes from growing or becoming clinically significant. (more…)
Author Interviews, Breast Cancer, JAMA, MD Anderson / 08.10.2013

Kelly K. Hunt, MD F.A.C.S. Professor, Department of Surgical Oncology, Division of Surgery Chief, Breast Surgical Oncology Section, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TXMedicalResearch.com Interview with: Kelly K. Hunt, MD F.A.C.S. Professor, Department of Surgical Oncology, Division of Surgery Chief, Breast Surgical Oncology Section, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX MedicalResearch.com: What are the main findings of the study? Dr. Hunt: We found that 40% of women who had node positive disease at initial presentation (confirmed by needle biopsy) had no evidence of residual cancer in the lymph nodes after chemotherapy. We performed sentinel lymph node (SLN) surgery followed by axillary lymph node dissection in all of the patients and found a false negative rate of 12.6% with the SLN procedure. The false negative rate was lower when surgeons used two mapping agents (blue dye and radioisotope) to identify the sentinel nodes and when they removed more than 2 sentinel nodes. (more…)
Author Interviews, Hand Washing, JAMA, MRSA / 07.10.2013

Anthony Harris, MD, MPH Department of Epidemiology and Public Health Professor University of Maryland School of Medicine Acting Medical Director of Infection Control University of Maryland Medical CenterMedicalResearch.com Interview with: Anthony Harris, MD, MPH Department of Epidemiology and Public Health Professor University of Maryland School of Medicine Acting Medical Director of Infection Control University of Maryland Medical Center     MedicalResearch.com: What are the main findings of the study? Dr. Harris: The aim of the study was to understand if wearing disposable gowns and gloves for all patient contact in the ICU could help prevent the spread of MRSA and similar antibiotic-resistant bacteria. Secondarily we wanted to make sure this type of patient isolation did not result in any harm to patients. The results of the study were that gowns and gloves worn by healthcare workers for contact with all patients in the ICU did not decrease the number of patients who acquired VRE but did decrease MRSA about 40 percent.  Also, wearing gloves and gowns did not adversely impact patient care.  For our goal of studying all types of infection, we did not find a benefit to universal gown and glove use. However, for transmission of MRSA alone, the intervention decreased transmission by about 40 percent. Although previous studies have showed isolation is associated with falls, bed sores and other adverse events, we found gowns and gloves did not produce more of these negative events. (more…)
Author Interviews, Blood Pressure - Hypertension, Exercise - Fitness, JAMA / 03.10.2013

MedicalResearch.com Interview Ma, Wei Department of Epidemiology and Health Statistics School of Public Health Shandong University Jinan, Shandong Province, 250012 China MedicalResearch.com: What are the main findings of the study? Answer: The results of this meta-analysis suggested that there was an inverse dose-response association between levels of recreational physical activity and risk of hypertension. Individuals who participated in high levels of recreational physical activity had a 19% lower risk of hypertension than those who didn’t exercise much. In addition, those with moderate levels of recreational physical activity had an 11% lower risk of hypertension. However, there was no significant association between occupational physical activity and risk of hypertension. (more…)
Author Interviews, Heart Disease, JAMA / 03.10.2013

Mads Wissenberg, MD Department of Cardiology Gentofte Hospital, University of Copenhagen Niels Andersens Vej 65 2900 Hellerup, Denmark Post 635MedicalResearch.com Interview with: Mads Wissenberg, MD Department of Cardiology Gentofte Hospital, University of Copenhagen Niels Andersens Vej 65 2900 Hellerup, Denmark Post 635 MedicalResearch.com: What are the main findings of the study? Answer: Our main findings from this nationwide study are that during a 10-year period where several national initiatives were taken to increase bystander CPR and improve advanced care, bystander CPR increased more than a two-fold from 21 % in 2001 to 45% in 2010. In the same period survival on arrival at the hospital increased more than a two-fold from 8% in 2001 to 22% in 2010, and 30-day survival more than a three-fold from 3.5% in 2001 to 11% in 2010. (more…)
Author Interviews, JAMA, Pediatrics / 02.10.2013

Shaon Sengupta, MD MBBS MPH Division of Neonatology, Department of Pediatrics Children’s Hospital of Philadelphia, Philadelphia, PennsylvaniaMedicalResearch.com Interview with: Shaon Sengupta, MD MBBS MPH Division of Neonatology, Department of Pediatrics Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania MedicalResearch.com: What are the main findings of the study? Dr. Sengupta: In this study we looked at all full-term neonates, which are defined as those born between 37 weeks 0 days to 41 weeks 6 days. Early term deliveries (37–38 weeks) are a significant part of all full-term deliveries, but are not the norm. In our study, 27% of neonates were born early term (37-38 weeks) while almost 62% were born at or after 39 weeks (term neonates). Similar data has been reported by other established sources of vital statistics. While traditionally, full term neonates are perceived to be a homogenous low-risk group, the findings from our study urge the pediatrics/neonatal provider to recognize early term (37-38 weeks) neonates as a higher risk group. They have significantly higher risk of NICU admission, respiratory morbidity, hypoglycemia, need for IV fluids and antibiotics. (more…)
Author Interviews, JAMA, Opiods, Pharmacology, Weight Research / 02.10.2013

Marsha A. Raebel, PharmD, BCPS, FCCP Investigator in Pharmacotherapy Institute for Health Research 10065 E. Harvard Ave Suite 300 Denver, CO 80231.MedicalResearch.com Interview with: Marsha A. Raebel, PharmD, BCPS, FCCP Investigator in Pharmacotherapy Institute for Health Research 10065 E. Harvard Ave Suite 300 Denver, CO 80231. MedicalResearch.com: What are the main findings of the study? Answer: We found that in a group of patients who took chronic opioids for non-cancer pain and who underwent bariatric surgery there was greater chronic use of opioids after surgery compared with before surgery, findings that suggest the need for proactive management of chronic pain in these patients after surgery. (more…)
Author Interviews, Hip Fractures, JAMA, Orthopedics / 25.09.2013

Sarah D. Berry MD MPH Institute for Aging Research, Hebrew Senior Life Boston, MassachusettsMedicalResearch.com Interview with: Sarah D. Berry MD MPH Institute for Aging Research, Hebrew Senior Life Boston, Massachusetts   MedicalResearch.com: What are the main findings of the study? Dr. Berry: Repeating a bone mineral density (BMD) screening test in 4 years provided little additional value beyond baseline BMD when assessing fracture risk. Also, the second BMD measure resulted in little change in risk classification that is commonly used in clinical management of osteoporosis. (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare, Race/Ethnic Diversity, University of Michigan, Weight Research / 25.09.2013

Dr. Lauren Hersch Nicholas Ph.D Research Affiliate, Population Studies Center. Faculty Research Fellow, Survey Research Center University of MichiganMedicalResearch.com Interview Invitation Dr. Lauren Hersch Nicholas Ph.D Research Affiliate, Population Studies Center. Faculty Research Fellow, Survey Research Center University of Michigan MedicalResearch.com: What are the main findings of the study? Dr. Nicholas: We found that a Medicare policy designed to improve the safety of bariatric surgery was associated with 17% decline in the share of Medicare patients from minority groups receiving bariatric surgery. (more…)
Author Interviews, JAMA, Pediatrics / 25.09.2013

Spencer P. Bass, MD Twenty-First Century Professor of Family Medicine Director, International Family Medicine Clinic Department of Family Medicine University of Virginia, PO Box 800729 Charlottesville, VA 22908-072MedicalResearch.com Interview with: Fern R. Hauck, MD, MS Spencer P. Bass, MD Twenty-First Century Professor of Family Medicine Director, International Family Medicine Clinic Department of Family Medicine University of Virginia, PO Box 800729 Charlottesville, VA  22908-072 Co-author of "14 Ways to Protect Your Baby from SIDS" (www.parentingpress.com/sids.html) MedicalResearch.com: What are the main findings of the study? Dr. Hauck: We looked at data from the Infant Feeding Practices Study II, which followed mother from pregnancy through the first year of infant life. Mothers received several surveys that asked about infant feeding and bedsharing (sleeping with their infant in the same bed or other sleep surface). We found that mothers who bedshared for the longest time had the longest duration of breastfeeding compared with mothers who did not bedshare or bedshared for shorter times. Breastfeeding duration was also longer among mothers who were better educated, were white, had previously breastfed another child, had planned to breastfeed this baby, and had not returned to work in the first year after the baby was born. (more…)
Author Interviews, JAMA / 19.09.2013

H. Blair Simpson, M.D., Ph.D. Professor of Clinical Psychiatry, College of Physicians and Surgeons at Columbia University Director of the Anxiety Disorders Clinic and the Center for OCD and Related Disorders at the New York State Psychiatric Institute 1051 Riverside Drive, Unit 69 New York, NY 10032MedicalResearch.com Interview with: H. Blair Simpson, M.D., Ph.D. Professor of Clinical Psychiatry, College of Physicians and Surgeons at Columbia University Director of the Anxiety Disorders Clinic and the Center for OCD and Related Disorders at the New York State Psychiatric Institute New York, NY 10032 MedicalResearch.com: What are the main findings of the study? Dr. Simpson: This is the first RCT to compare two recommended SRI augmentation strategies for adults with OCD. Adding EX/RP to SRIs was superior to risperidone and to pill placebo in reducing OCD symptoms and improving insight, functioning, and quality of life. Risperidone was not superior to placebo on any outcome. (more…)
Addiction, CMAJ, JAMA, Pharmacology, Primary Care / 19.09.2013

Richard Saitz, MD MPH Professor of Medicine and Epidemiology Boston University Schools of Medicine and Public Health Clinical Addiction Research and Education Unit, Boston Medical Center, Boston, MassachusettsMedicalResearch.com Interview with: Richard Saitz, MD MPH Professor of Medicine and Epidemiology Boston University Schools of Medicine and Public Health Clinical Addiction Research and Education Unit, Boston Medical Center, Boston, Massachusetts MedicalResearch.com: What are the main findings of the study? Dr. Saitz: Chronic care management in primary care did not improve health outcomes (abstinence from cocaine, opioids or heavy drinking; or any other clinical outcomes, like addiction consequences, emergency or hospital use, health-related quality of life, addiction severity) for people with alcohol or other drug dependence. (more…)
Alzheimer's - Dementia, Author Interviews, CMAJ, JAMA, Mayo Clinic, Parkinson's / 18.09.2013

Rodolfo Savica, MD, MSc Department of Neurology, College of Medicine Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MinnesotaMedicalResearch.com Interview with: Rodolfo Savica, MD, MSc Department of Neurology, College of Medicine Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, Minnesota   MedicalResearch.com: What are the main findings of this study? Dr. Savica: This study is the first in North America to explore the incidence of DLB and PDD in a population based sample. We found that the overall incidence of dementia with Lewy bodies (DLB), considered the second leading cause of neurodegenerative dementia after Alzheimer`s disease, is lower than that of Parkinson`s disease (PD), increases steeply with age, and is markedly higher in men than in women. (more…)
Author Interviews, Baylor College of Medicine Houston, CMAJ, Heart Disease, JAMA / 16.09.2013

Faisal G. Bakaeen, MD FACS Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, TexasMedicalResearch.com Interview with: Faisal G. Bakaeen, MD FACS Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, Texas   MedicalResearch.com: What are the main findings of the study? Dr. Bakaeen:  The relative use of off-pump CABG peaked at 24% in 2003, followed by a slow decline after that to about 19%. In addition, the conversion rate from off- to on-pump decreased with time and has stayed below 3.5% in recent years. Perioperative mortality rates decreased over time for both on- and off-pump CABG and have stayed below 2% since 2006. The mortality associated with converted cases was high regardless of the surgery year. (more…)
Author Interviews, Dental Research, JAMA / 16.09.2013

Mine Tezal, DDS, PhD Oral Biology University at Buffalo NYS Center of Excellence in Bioinformatics and Life SciencesMedicalResearch.com Interview with: Mine Tezal, DDS, PhD Oral Biology University at Buffalo NYS Center of Excellence in Bioinformatics and Life Sciences MedicalResearch.com: What are the main findings of the study?   Dr. Tezal: We observed an inverse association between dental caries and head and neck cancer (HNSCC), which persisted among never smokers and never drinkers. Besides untreated caries, two other objective measures of long-standing caries history (endodontic treatments and crowns) were also inversely associated with HNSCC with similar effect sizes, supporting the validity of the association.  Missing teeth was associated with increased risk of HNSCC in univariate analyses, but after adjustment for potential confounders, its effect was attenuated and was no longer statistically significant. (more…)
Author Interviews, Baylor College of Medicine Houston, Blood Pressure - Hypertension, Cost of Health Care, JAMA / 16.09.2013

Laura A. Petersen, MD, MPH MEDVAMC Associate Chief of Staff, Research Director, VA HSR&D Center of Excellence (152) 2002 Holcombe Blvd. Houston TX 77030 Professor of Medicine Chief, Section of Health Services Research Baylor College of Medicine www.houston.hsrd.research.va.govAshley Motter HSR&D Center of Excellence Michael E. DeBakey Veterans Affairs Medical CenterMedicalResearch.com Interview with: Laura A. Petersen, MD, MPH MEDVAMC Associate Chief of Staff, Research Director, VA HSR&D Center of Excellence (152) Houston TX 77030 Professor of Medicine Chief, Section of Health Services Research Baylor College of Medicine HSR&D Center of Excellence Michael E. DeBakey Veterans Affairs Medical Center Houston, Texas 77030 MedicalResearch.com: What are the main findings of the study? Dr. Petersen: VA physicians randomized to the individual incentive group were more likely than controls to improve their treatment of hypertension.  The adjusted changes over the study period in Veterans meeting the combined BP/appropriate response measure were 8.8 percentage points for the individual-level, 3.7 for the practice-level, 5.5 for the combined, and 0.47 for the control groups.  Therefore, a physician in the individual group caring for 1000 patients with hypertension would have about 84 additional patients achieving blood pressure control or appropriate response after 1 year.  The effect of the incentive was not sustained after the washout period. Although performance did not decline to pre-intervention levels, the decline was significant.  None of the incentives resulted in increased incidence of hypotension compared with controls.  While the use of guideline-recommended medications increased significantly over the course of the study in the intervention groups, there was no significant change compared to the control group.  The mean individual incentive earnings over the study represented approximately 1.6% of a physician’s salary, assuming a mean salary of $168,000. (more…)
Author Interviews, JAMA, Pediatrics, Weight Research / 11.09.2013

MedicalResearch.com Interview with: Dr. Elsie Taveras Massachusetts General Hospital for Children Division of General Pediatrics, Department of Pediatrics 100 Cambridge St, 15th Floor Boston, MA 02114Dr. Elsie Taveras Massachusetts General Hospital for Children Division of General Pediatrics, Department of Pediatrics 100 Cambridge St, 15th Floor Boston, MA 02114   MedicalResearch.com: What are the main findings of the study? Dr. Taveras: The main findings of the study were that, overall, the body mass index of children in the intervention group dropped an average of 0.18, while it rose 0.21 in the control group. Children in the intervention group were sleeping about 45 minutes longer than children in the control group. Time spent watching television on weekends dropped about an hour per day in the intervention group, leading to a significant difference from the control group, which increased weekend TV viewing. Both groups had a small reduction in weekday TV viewing, with a greater decrease in the intervention group, as well. (more…)
Author Interviews, Cost of Health Care, Critical Care - Intensive Care - ICUs, JAMA / 11.09.2013

Thanh N. Huynh, MD, MSHS Clinical Instructor UCLA Division of Pulmonary Critical CareMedicalResearch.com Interview with: Thanh N. Huynh, MD, MSHS Clinical Instructor UCLA Division of Pulmonary Critical Care MedicalResearch.com: What are the main findings of the study? Dr. Huynh: Our study shows that it is common for ICU doctors to recognize that futile treatment is provided to patients who cannot benefit from it.  In our study, 11% of ICU patients were perceived as receiving futile treatment.  The outcomes of these 123 patients were uniformly poor, with 85% dying within 6 months.  Advances in critical care medicine has allowed us to save lives, but it has also allowed us provide aggressive life-sustaining treatments that may not benefit all patients.  When aggressive treatment is poorly matched with a patient’s prognosis, doctors will consider such treatment as futile and our study shows that this is not an uncommon occurrence in our health system. (more…)
Author Interviews, JAMA, Mental Health Research / 10.09.2013

MedicalResearch.com Interview with: Ricardo E. Carrión, PhD Division of Psychiatry Research The Zucker Hillside Hospital, North Shore–Long Island Jewish Health System, Glen Oaks, New YorkCenter for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Manhasset, New York MedicalResearch.com: What are the main findings of your study: Answer: Reduced neurocognition, poor functioning, and other behavioral symptoms at baseline were associated with an increased risk of long-term social difficulties and school/work problems in adolescents and young adults at high clinical risk for psychosis. (more…)
Author Interviews, JAMA / 10.09.2013

Dr. Amy Sanderson MD Department of Anesthesiology Perioperative & Pain Medicine Boston Children’s Hospital Boston, MassachusettsMedicalResearch.com Interview with: Dr. Amy Sanderson MD Department of Anesthesiology Perioperative & Pain Medicine Boston Children’s Hospital Boston, Massachusetts MedicalResearch.com: What are the main findings of the study? Dr. Sanderson: There is substantial variability in the interpretation of a DNR order. 66.9% of clinicians believed that a DNR order indicates limitation of resuscitative measures only on cardiopulmonary arrest, whereas 33.1% considered a DNR order to be the threshold for the limitation of treatments not specifically related to resuscitation. 68.7% of clinicians reported that the care of a patient changes once a DNR order is written. Of those reporting changes in care, 11.2% reported that this happens only if a cardiopulmonary arrest occurs, while 36.7% believed that there is an increased attention to comfort. Finally, 52.1% reported that care changes beyond both resuscitative measures and focusing on comfort, including limitation or withdrawal of diagnostic and therapeutic interventions. Most clinicians reported that resuscitation status discussions happen later in the illness course than is ideal. (more…)
Author Interviews, Heart Disease, JAMA, Nutrition / 10.09.2013

MedicalResearch.com Interview with: Shanshan Li, MD, MSc, ScD Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts On behalf of Drs. Chuive, Flint, Pai, Forman, Hu, Willett, Mukamal and Rimm. MedicalResearch.com: What are the main findings of the study? Answer: In our prospective study of diet quality among MI survivors, we found that a higher diet quality post-MI, measured by Alternative Healthy Eating Index 2010, was associated with 24% lower death rate and 26% lower death rate from cardiovascular disease. Greater improvement of diet quality from pre- to post-MI was associated with 30% lower death rate and 40% lower cardiovascular disease death rate. In addition to reducing the bad fats intake, for example, saturated and transfat intake, MI patients also tended to reduce the good healthy polyunsaturated fats. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Kidney Disease, Medical Research Centers / 05.09.2013

MedicalResearch.com Interview with: Gearoid M. McMahon, MB, BCh Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Framingham Heart Study, National Heart, Lung, and Blood Institute, and Center for Population Studies, Framingham, Massachusetts MedicalResearch.com: What are the main findings of the study? Answer: This study examined the incidence, causes and outcomes of rhabdomyolysis in two large University Teaching hospitals. Rhabdomyolysis is a characterized by an increase in serum creatine phosphokinase (CPK) and results from muscle damage from a variety of causes. The most important complication of rhabdomyolysis is acute kidney injury which can result in a need for dialysis. Using a series of laboratory and clinical variables that are readily available on admission, we constructed a risk score that can predict with some accuracy the likelihood that a patient with rhabdomyolysis might die or need dialysis during an admission. The final variables included in the model were age, gender, the cause of rhabdomyolysis and the admission CPK, creatinine, phosphate, bicarbonate and calcium. One of the advantages of this study was, because we had access to data from two institutions, we were able to derive the risk score in one hospital and confirm its accuracy in the second institution. (more…)
Author Interviews, Cost of Health Care, JAMA / 04.09.2013

Seth A. Seabury, PhD Department of Emergency Medicine, University of Southern California Los Angeles Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los AngelesMedicalResearch.com Interview with: Seth A. Seabury, PhD Department of Emergency Medicine, University of Southern California, Los Angeles Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles   MedicalResearch.com: What are the main findings of the study? Dr. Seabury: We studied the trends in the earnings of male and female physicians in the US from 1987-2010 using nationally representative data from the Current Population Survey (CPS).  We found that, while the number of female physicians grew significantly, male physicians continue to have significantly higher earnings than female physicians.  The difference in the median earnings of male physicians compared to female physicians actually increased from $33,840 in 1987-1990 to $56,019 in 2006-2010, though the difference across years was not statistically significant.  Our approach controlled for differences in hours worked, so earnings gap was not driven by differences in work hours, though it could be explained by other factors we did not observe in our data (e.g., specialty choice). Looking at other occupations in the US health care industry, the male-female earnings gap was smaller for pharmacists and registered nurses and decreased over time, but was large and increased for physicians assistants.  On the other hand, our numbers indicate that outside of the health care industry, the male-female earnings gap fell by more than 45%.  Even though significant gender inequality persists across the US, female physicians do not appear to have benefited from the relative gains that female workers outside the health care industry have. (more…)