MedicalResearch.com Interview with: Miles D. Witham, PhD
Aging and Health, University of Dundee, Dundee, United Kingdom
MedicalResearch.com: What are the main findings of the study?
Answer: We gave high dose vitamin D3 (100,000 units) or placebo every 3 months to people aged 70 or over, who all had isolated systolic hypertension (ISH). The main focus of the trial was to test whether vitamin D supplementation could reduce blood pressure in this group of patients – this pattern of blood pressure, whether the systolic (top number) is high, and the diastolic (bottom number) is normal, is very common in older people. Previous studies have suggested a link between low vitamin D levels and higher blood pressure, but no trial has yet tested this idea in older patients with ISH.
Despite the treatment causing a significant increase in circulating vitamin D levels, we saw no significant reduction in blood pressure with vitamin D supplementation, despite the trial running for a year. We tested whether certain groups might still benefit – e.g. those with very high blood pressure or very low vitamin D levels, but even these groups did not show a reduction in blood pressure.
We also tested whether vitamin D supplementation reduced the health and stiffness of arteries – both important predictors of future heart attack or stroke. Unfortunately, vitamin D did not affect these measures either, and didn’t reduce cholesterol or glucose levels.
On the more positive side, vitamin D supplements did appear safe, and the number of falls in the vitamin D group was slightly lower than in those people who received placebo. This is reassuring, as an earlier study (Sanders et al) had suggested that very high doses of vitamin D might make falls more likely, in contrast to previous low dose studies that show a protective effect of vitamin D against falls.
MedicalResearch.com Interview with:
Carol S. North, MD, MPE
The Nancy and Ray L. Hunt Chair in Crisis Psychiatry
Director, Program in Trauma and Disaster,
VA North Texas Health Care System
4500 S. Lancaster Rd., Dallas, TX 75216
Professor of Psychiatry and Surgery/Division of Emergency Medicine
UT Southwestern Medical Center
6363 Forest Park Rd. Dallas, TX 75390-8828
MedicalResearch.com: What are the main findings of the study?
Answer: In post-disaster settings, a systematic framework of case identification, triage, and mental health interventions can guide overall mental health response and should be integrated into emergency medicine and trauma care responses.
MedicalResearch.com Interview with Dr. Pietro Manuel Ferraro
Division of Nephrology–Renal Program, Department of Internal Medicine and Medical Specialties, Columbus-Gemelli Hospital, Rome, Italy
MedicalResearch.com: What are the main findings of the study?
Dr. Ferraro: We analyzed three large cohorts over time to see if those with prevalent or incident kidney stones might have a higher risk of developing coronary heart disease (fatal or non fatal myocardial infarction or the need for coronary revascularization). The cohorts consisted of over 200,000 participants without any prior history of coronary heart disease. After a median follow-up of over 8 years, we observed that women affected with stones seem to have a greater risk of developing coronary heart disease independent of a number of other known cardiovascular risk factors such as diabetes or high blood pressure. We did not observe a significant association among men.
MedicalResearch.com Interview with:
Jon C. Tilburt, MD, MPH
Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
Biomedical Ethics Program, Mayo Clinic
Knowledge & Evaluation Research Unit, Mayo Clinic
Healthcare Delivery Research Program, Center for the Science of Healthcare Delivery
Division of Health Care Policy and Research, Mayo Clinic
What did you set out to find, what was your objective in this study?
MedicalResearch.com Interview with:
Susan Matulevicius, MD, MSCS
Department of Medicine, The University of Texas Southwestern Medical Center, Dallas
MedicalResearch.com: What are the main findings of the study?
Dr. Matulevicius: In our cohort of 535 transthoracic echocardiograms performed at a single academic medical center, we found that the majority (92%) of echocardiograms were appropriate by the 2011 Appropriate Use Criteria; however, only 1 in 3 echocardiograms lead to an active change in patient care while 1 in 5 resulted in no appreciable change in patient care.
MedicalResearch.com Interview with:
Aneel Bhangu, MBChB, MRCS and Douglas M. Bowley, FRCS
Royal Centre for Defense Medicine, Birmingham, England
MedicalResearch.com: What are the main findings of the study?
Answer: Our study was a meta-analysis, which combined the findings from 8 randomized controlled trials that included a total of 623 patients. The key finding was that delayed primary skin closure (DPC) for contaminated and dirty abdominal incisions may reduce the rate of surgical site infection. However, due to high risk of bias from the included studies, including flaws in study design, definitive evidence is lacking.
We believe that this meta-analysis represents an exciting development in biomedical publishing; this was a true collaboration between US and UK military surgeons to examine an area of major concern and interest to surgeons everywhere. This work uses experience hard-won on the battlefields of Iraq and Afghanistan, combined with published surgical trials, to inform both future research activity as well as military and civilian surgical practice. This cross-fertilization of ideas is one positive consequence of all the sacrifice and suffering of recent conflicts.
MedicalResearch.com Interview with: Andreas Beyerlein, PhD
Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, Germany
MedicalResearch.com What are the main findings of the study?
Dr. Beyerlein: We identified respiratory infections in early childhood, especially in the first year of life, as a risk factor for islet autoimmunity, which is known as a precursor of type 1 diabetes (T1D). We also found some evidence for short term effects of infectious events on development of autoimmunity.
MedicalResearch.com Interview with:
Maarten C. Bosland, DVSc, PhD
Professor of Pathology
Department of Pathology
University of Illinois at Chicago
College of Medicine
Chicago, IL 60612
MedicalResearch.com: What are the main findings of the study?
Dr. Bosland: Daily consumption of a supplement containing soy protein isolate for two years following radical prostatectomy did not reduce recurrence of prostate cancer in men at high risk for this (radical prostatectomy is surgical removal of the prostate to treat prostate cancer). The study showed that this soy supplementation was safe. It is not clear whether this result indicates that soy does not prevent the development of prostate cancer, but men that have the disease probably do not benefit from soy supplementation.
MedicalResearch.com Interview with: Mary McGrae McDermott, MD Professor of Medicine Northwestern University Feinberg School of Medicine Contributing Editor, JAMA Home-Based Walking Exercise Intervention in Peripheral Artery Disease A Randomized Clinical Trial MedicalResearch.com: What are the main findings of the study? Answer: The goals trial found that a group-mediated cognitive behavioral intervention significantly improved six-minute walk performance, physical...
MedicalResearch.com Interview with: Susan Swetter, MD
Professor of Dermatology
Director, Pigmented Lesion & Melanoma Program
Stanford University Medical Center & Cancer Institute
MedicalResearch.com Interview with Genevieve Kenney Ph.D
Senior Fellow and Co-Director, Health Policy Center
The Urban Institute
2100 M Street NW Washington DC 20037
MedicalResearch.com: What are the main findings of the study?
Dr. Kenney: Our study is the first published analysis that draws on physical examinations, laboratory tests, and patient reports to assess the health needs and health risks of uninsured adults who could be eligible for Medicaid coverage under the Affordable Care Act relative to the adults who are already enrolled in Medicaid.
Our main findings are that the uninsured adults who could enroll under the ACA are less likely than the adults with Medicaid coverage to be obese and to have functional limitations and chronic health problems, such as hypertension, hypercholesterolemia, or diabetes, but that the uninsured adults with these chronic conditions are less likely to be aware that they have them and less likely to have the condition under control. In comparison to the Medicaid population, the uninsured adults in our study were also less likely to have seen a health professional in the prior year and to have a routine place for care. The rates of undiagnosed and uncontrolled chronic health care problems found in our study indicate that millions of low-income uninsured adults are currently at risk of premature mortality and other significant health issues. These findings provide new evidence of the potential health benefits associated with the Medicaid expansion under the Affordable Care Act.
MedicalResearch.com Interview with
Dr. Karen E. Joynt, MD MPH
Cardiovascular Division
Brigham and Women's Hospital and VA Boston Healthcare System
Department of Health Policy and Management, Harvard School of Public Health
MedicalResearch.com: What are the main findings of the study?
Dr. Joynt: The main findings of the study were two-fold.
First, high-cost patients in Medicare (the top decile of spenders) are responsible for about 80% of inpatient spending in the Medicare program, so understanding more about these patients' patterns of care is really important.
Second, we found that only about 10% of acute-care spending for these high-cost Medicare patients were for causes that we generally think of as preventable in the short term, like uncontrolled diabetes, COPD, or heart failure.
The rest of the spending was for acute conditions that we generally don't think of as preventable (at least in the short term), such as orthopedic procedures, sepsis, and cancer.
MedicalResearch.com Interview with Dr. Kumar Dharmarajan MD MBA
MedicalResearch.com Interview with:
Marloes Heijstek MD
University Medical Center, Wilhelmina Children's Hospital
Department of Pediatric Immunology and Rheumatology
Room number KC 03.063.0
P.O. Box 85090 Lundlaan 6
3508 AB Utrecht
MedicalResearch.com: What are the main findings of the study?
Dr. Heijstek: The main findings of our study are that MMR booster vaccination does not affect JIA disease, does not cause flares of arthritis and induces high rates of protective immunity.
MedicalResearch.com Interview with: Lilian Abbo, M.D. Associate Professor of Clinical Medicine Division of Infectious Diseases University of Miami Miller School of Medicine Medical Director of Antimicrobial Stewardship Program Jackson Memorial Hospital and University of Miami Hospita MedicalResearch.com: What are the main findings of the study? Dr. Abbo: We surveyed 744/1411 (53%) members of the Infectious Diseases Society...
MedicalResearch.com eInterview with Kathryn L. Humphreys, M.A., Ed.M.
Clinical Psychology Doctoral Student
UCLA Department of Psychology
1285 Franz Hall, Box 951563
Los Angeles, CA 90095
MedicalResearch.com: What are the main findings of the study?
Response: Our primary question was to answer whether the use of stimulant medication in the treatment of ADHD was associated with increased or decreased risk for a variety of substance use (ever tried) and substance use disorder (abuse or dependence) outcomes (alcohol, cocaine, marijuana, nicotine, and non-specific drug use).
Prior research from individual studies of children have provided mixed evidence (i.e., some found medication increased later risk, some found medication decreased risk, and still others found no difference in risk). We examined available longitudinal studies (i.e., medication treatment preceded measurement of substance outcome) together using meta-analysis, a technique that aggregates findings from a number of studies, in order to examine this question in a much larger sample of individuals.
Our main finding was that children with ADHD who received medication treatment did not differ in risk for lifetime substance use or abuse or dependence compared to those children with ADHD who did not receive medication treatment.
MedicalResearch.com eInterview with Luis Beck-da-Silva, MD, ScD Cardiology Division, Heart Failure Clinic Hospital de Clínicas de Porto Alegre Rua Ramiro Barcelos, 2350 Sala 2060 Porto Alegre, RS 90035-903, Brazil MedicalResearch.com: What are the main findings of the study? Answer: The actual take home message is that fluid and sodium restriction may not be of any benefit...