MedicalResearch.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.
MedicalResearch.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.
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.
MedicalResearch.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.
MedicalResearch.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.
MedicalResearch.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.
MedicalResearch.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.
MedicalResearch.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.
MedicalResearch.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.
MedicalResearch.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.
MedicalResearch.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.
MedicalResearch.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.
Dr. 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.
MedicalResearch.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.
MedicalResearch.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.
MedicalResearch.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.
MedicalResearch.com Interview with:
Ekaterina Rogaeva, PhD
Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, CanadaDepartment of Medicine, University of Toronto, Toronto, Ontario, CanadaCambridge Institute for Medical Research and Department of Clinical Neurosciences, University of Cambridge, Cambridge, England
MedicalResearch.com: What are the main findings of the study?
Answer: We tested the hypothesis that late-onset Alzheimer disease (AD) might be in part explained by the homozygosity of unknown loci. In a genome-wide study of a Caribbean Hispanic population with noticeable inbreeding and high risk of AD we assessed the presence of long runs of homozygosity (ROHs) – regions where the alleles inherited from both parents are identical. Our results suggest the existence of recessive AD loci, since the mean length of the ROH per person was significantly longer in AD cases versus controls, and this association was stronger in familial AD.
MedicalResearch.com Interview with: Ann M. Sheehy, M.D., M.S. Associate Professor Division Head, Hospital Medicine University of Wisconsin Department of Medicine MedicalResearch.com: What are the main findings of the study? Answer: The Centers for Medicare and Medicaid Services (CMS) has changed their definition for observation status. Previously, observation status was determined by Interqual clinical criteria. The new...
MedicalResearch.com Interview with:
Lu Qi, MD, PhD, FAHA
Assistant Professor of Medicine
Harvard Medical School
Assistant Professor of Nutrition
Harvard School of Public Health
MedicalResearch.com Interview with:
Dr Pamela N Peterson MD
Denver Health Medical Center, CO
MedicalResearch.com: What are the main findings of the study?
Answer: We assessed the outcomes of mortality, rehospitalization, and procedural complications among 24,169 patients in the NCDR-ICD Registry with left ventricular systolic dysfunction receiving a cardiac resynchronization device in addition to an implantable defibrillator for the primary prevention of sudden cardiac death between 2006 and 2009. After stratification by the QRS complex morphology and duration on the ECG and adjustment for measured differences in other characteristics, patients with left bundle branch block (LBBB) and QRS durations of at least 150 msec had significantly lower rates of mortality and rehospitalization at 3 years compared with patients with non-LBBB QRS morphology and/or QRS duration of 120-149 msec. Rates of mortality and readmission were generally highest in patients with non-LBBB and QRS duration of 120-149 msec. Rates of procedural complications at 30- and 90-days were similar across strata of QRS morphology and duration.
MedicalResearch.com Interview with:
Bjarke Feenstra, Ph.D.
Senior Research Scientist
Statens Serum Institut
Artillerivej 5, 2300 Copenhagen S
Denmark
MedicalResearch.com: What are the main findings of the study?
Dr. Feenstra: We discovered a new genome-wide significant locus for infantile hypertrophic pyloric stenosis (IHPS) in a region on chromosome 11 harboring the apolipoprotein (APOA1/C3/A4/A5) gene cluster and also confirmed three previously reported loci. Characteristics of the new locus led us to propose the hypothesis that low levels of circulating lipids in infants are associated with increased risk of IHPS. We addressed this hypothesis by measuring plasma lipid levels in prospectively collected umbilical cord blood from a set of 46 IHPS cases and 189 matched controls. We found that levels were on average somewhat lower in the children who went on to develop the condition.
MedicalResearch.com Interview with:
Leora I. Horwitz, MD, MHS
Section of General Internal Medicine, Department of Medicine,
Yale School of Medicine,
Center for Outcomes Research and Evaluation,
Yale–New Haven Hospital, New Haven, Connecticut
MedicalResearch.com: What are the main findings of the study?
Answer: We interviewed nearly 400 older patients who had been admitted with heart failure, pneumonia or heart attack within one week of going home from the hospital. We also reviewed the medical records of 377 of the patients. We found, for example, that: