Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Medical Research Centers / 26.06.2013

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 HealthMedicalResearch.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. (more…)
Author Interviews, Heart Disease, JAMA, Yale / 25.06.2013

Dr. Kumar Dharmarajan MD MBA  Yale School of Medicine Center for Outcomes Research & Evaluation (CORE)Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart FailureMedicalResearch.com  Interview with Dr. Kumar Dharmarajan MD MBA

Yale School of Medicine Center for Outcomes Research & Evaluation (CORE)Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart Failure MedicalResearch.com: What are the main findings of the study? We found that among a large contemporary cohort of heart failure hospitalizations, beta blockers are frequently started in patients with markers of clinical instability such as residence in an intensive care unit (ICU), volume overload requiring intravenous diuresis, and poor cardiac output requiring intravenous inotropes. Approximately 40% of patients in whom a beta blocker is started has at least one of these three potential contraindications to treatment. This finding is concerning, as recent performance measures for heart failure recommend that a beta blocker be started during hospitalization for heart failure among patients with left ventricular systolic dysfunction. However, these performance measures also state that persons in whom a beta blocker is started "should not be hospitalized in an ICU, should have no or minimal evidence of fluid overload or volume depletion, and should not have required recent treatment with an intravenous positive inotropic agent." Moving forward, we are concerned that the unselective application of the new performance measure may lead to the further use of beta blocker therapy in patients at higher risk for adverse consequences of therapy. (more…)
HIV, Infections, JAMA, Race/Ethnic Diversity / 21.06.2013

MedicalResearch.com Interview with Dr. H. Irene Hall, PhD Division of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC 1600 Clifton Road, MS E-47, Atlanta, GA 30333 MedicalResearch.com: What are the main findings of the study? Dr. Hall: Our research finds that, across all populations, far too few Americans with HIV receive the care they need to stay healthy and reduce risk of transmission. According to our research, gaps in care are the largest among African Americans and young people. Moving forward, improving care for all HIV-infected people will be critical to achieving the goal of an AIDS-free generation in America. More specifically, some of the key findings of the study include:
  • Overall, only a quarter of all Americans with HIV have a suppressed viral load – meaning the level of HIV in their bodies is low enough to stay healthy and dramatically reduce the chance of transmitting to others.
  • By race/ethnicity, African-Americans and Hispanics or Latinos are less likely to be aware of their infection compared to whites.
  •  By age, younger Americans are less likely to be in ongoing care and have a suppressed viral load; HIV care and viral suppression generally improved with age. For example:
  • Fifteen percent of those aged 25-34 were virally suppressed, compared to 36 percent of those aged 55-64.
  • In terms of ongoing care, 28 percent of those 25-34 years old were retained in care, compared to 46 percent of those aged 55-64. (more…)
Diabetes, JAMA, Pediatrics / 20.06.2013

MedicalResearch.com Interview with:  Dr. Ezio Bonifacio, Ph.D. Professor, Preclinical Stem Cells/Diabetes Center for Regenerative Therapies Dresden Technische Universität Dresden MedicalResearch.com:  What are the main findings of the study? Dr. Bonifacio: Children who develop multiple islet autoantibodies are destined to develop diabetes. Only a minority will be diabetes-free 15 years after developing islet autoantibodies. This is regardless of whether they have a family history of type 1 diabetes. Progression to diabetes after seroconversion varied from weeks to decades, and 20% of children had diabetes within 2 years from seroconverting. Progression was fastest in children who developed their islet autoantibodies before age 3 years. MedicalResearch.com:  Were any of the findings unexpected? Dr. Bonifacio: Unexpected is probably not the right word. The Eisenbarth model of chronic disease proposes that diabetes will happen some time after autoimmunity and the findings show the reality of it. Perhaps the unexpected finding is that it is not always chronic and that for a number of children, intervention would need to be applied quickly. (more…)
Author Interviews, JAMA, Pediatrics, Rheumatology, Vaccine Studies / 19.06.2013

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 UtrechtMedicalResearch.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. (more…)
Author Interviews, JAMA, Nutrition, Outcomes & Safety, Vegetarians / 06.06.2013

MedicalResearch.com eInterview with: Michael J. Orlich, M.D. Program Director Preventive Medicine Residency Loma Linda University www.lluprevmedres.org Research Fellow, Adventist Health Studies www.adventisthealthstudy.org MedicalResearch.com: What are the main findings of the study? Dr. Orlich: The main findings were these. Vegetarians, as we defined them, had reduced risk of death during the study period compared to non-vegetarians. This was true also for particular vegetarian diets including for vegans, lacto-ovo-vegetarians, and pesco-vegetarians.  Reduced risk was seen in particular for deaths related to disease of the heart, kidneys, and diabetes. Findings were stronger in men than women. (more…)
ADHD, Author Interviews, JAMA, Mental Health Research, Pediatrics / 30.05.2013

Kathryn L. Humphreys, M.A., Ed.M.  Clinical Psychology Doctoral Student UCLA Department of Psychology 1285 Franz Hall, Box 951563 Los Angeles, CA 90095MedicalResearch.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. (more…)
Author Interviews, JAMA, Stroke / 22.05.2013

Dr. Rishi Gupta, MD Associate Professor of Neurology, Neurosurgery and Radiology Emory University School of Medicine Director, Vascular Neurology Fellowship Program Director, Multi-Hospital Acute Stroke Network Marcus Stroke and Neuroscience Center Grady Memorial Hospital MedicalResearch.com: What are the main findings of the study? Dr. Gupta: The main findings of this study are that patients with more proximal cerebral arterial occlusion involving the middle cerebral artery and internal carotid artery appear to be the targets for endovascular reperfusion therapy trials. Moreover, previous clinical trials have used a NIHSS > 8 or > 10 threshold to include patients into randomzed trials comparing endovascular therapy versus IV tPA. The threshold may need to be higher and in our analysis we found that threshold to be 14 or greater. (more…)
Author Interviews, JAMA, Nutrition / 14.05.2013

MedicalResearch.com eInterview with: Mary Scourboutakos PhD student at the University of Toronto Mary R. L'Abbe, PhD Earle W. McHenry Professor, and Chair, Department of Nutritional Sciences Faculty of Medicine, University of Toronto FitzGerald Building, 150 College Street, Rm 315 Toronto, ON, Canada M5S 3E2 MedicalResearch.com: What are the main findings of the study? Answer: We found that chain restaurant meals on average contained half a day's worth of calories, almost a full day's worth of fat and saturated fat, and more than a day's worth of sodium. (more…)
JAMA, Macular Degeneration, Ophthalmology / 10.05.2013

MedicalResearch.com eInterview with: Emily Y. Chew, MD Division of Epidemiology and Clinical Applications National Eye Institute (NEI)/National Institutes of Health (NIH), Bethesda, Maryland MedicalResearch.com: What are the main findings of the study?
 Dr. Chew: For patients who have intermediate age-related macular degeneration (AMD) or those with advanced AMD in one eye, we have recommended a mixture of vitamins and minerals (vitamin C, E and beta-carotene, and zinc oxide and cupric oxide), known as Age-Related Eye Disease Study (AREDS) formulation.  We tested the effects of adding carotenoids, lutein/zeaxanthin, or omega-3 fatty acids or both to the AREDS formulation.  Omega-3 fatty acids did not have any effect on AMD.  Addition of lutein/zeaxanthin provided an additional 10% increase in the reduction of progression to advanced AMD.  In persons with the lowest dietary intake of lutein/zeaxanthin, supplementation with lutein/zeaxanthin provided 25% reduction in rates of developing advanced AMD When we tested lutein/zeaxanthin directly against beta-carotene, the risk of progressing to advanced AMD was reduced by 20%. Furthermore, beta-carotene was found to increase the risk of lung cancer.  To improve the safety and efficacy of the AREDS formulation, we would suggest the elimination of beta-carotene and adding lutein/zeaxanthin.  Omega-3 fatty acids added no further benefit. (more…)
Author Interviews, JAMA, Medical Imaging, Mental Health Research, MRI / 26.04.2013

Medical Research.com eInterview with: Prof. Jean Decety PhD  Irving B. Harris Professor of Psychology and Psychiatry The University of Chicago 5848 S. University Ave. Chicago, IL 6063Prof. Jean Decety PhD Irving B. Harris Professor of Psychology and Psychiatry The University of Chicago 5848 S. University Ave. Chicago, IL 60637 - USA Faculty Web page: http://psychology.uchicago.edu/people/faculty/jdecety.shtml SCNL Web page: www.scnl.org Child NeuroSuite: www.childneurosuite.org MedicalResearch.com: What are the main findings of the study? Dr. Decety: In our study, psychopaths exhibited significantly less activation in the ventromedial prefrontal cortex, lateral orbitofrontal cortex, and brainstem relative to controls, but surprisingly showed greater activation in the insula.  The major difference in brain response between psychopaths compared to controls during the perception of others in pain was the lack of engagement of regions in the brainstem, orbitofrontal cortex (OFC) and ventromedial prefrontal cortex (vmPFC). (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Mental Health Research, UCSF / 26.04.2013

MedicalResearch.com eInterview with Dr. David Perry UCSF School of Medicine Clinical Fellow in Neurology 675 Nelson Rising Lane San Francisco CA 94158 MedicalResearch.com: What are the main findings of the study? Dr. Perry: We described two patients with clinical syndromes and brain imaging patterns that are consistent with Alzheimer’s disease. Both were found to have mutations in GRN, which are typically associated with inherited frontotemporal dementia. They both showed evidence of underlying Alzheimer’s pathology, in one case through autopsy confirmation (demonstrating Alzheimer’s disease in addition to TDP-43 pathology), and in the other case from a positive amyloid PET scan. (more…)
Author Interviews, Exercise - Fitness, Heart Disease, JAMA, Smoking, Tobacco Research / 16.04.2013

MedicalResearch.com Author Interview with Dr. Koon Teo, MB, PhD Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada MedicalResearch.com: What are the main findings of the study? Dr. Teo: In this study we examined the prevalence of smoking cessation or avoidance, eating a healthy diet and undertaking regular physical activities in nearly 8000 individuals who had previously experienced a coronary heart disease event or stroke, on average 5 years after their events. The individuals were recruited from over 600 communities in 17 countries with varying incomes and economic development.  We found that although these healthy lifestyle activities could reduce the risk of further heart or stroke events, about one fifth of individuals continued to smoke, only one third undertook regular leisure or work related physical activities and about two fifths ate a healthy diet. (more…)
Abuse and Neglect, Author Interviews, JAMA / 12.04.2013

MedicalResearch.com eInterview with XinQi Dong, MD MPH APSA Congressional Policy Fellow/Health and Aging Policy Fellow Chair, IOM Global Violence Prevention Forum on Elder Abuse Senior Policy and Research Advisor, Administration on Aging Senior Policy Advisor (OCSQ), Center for Medicare and Medicaid Services Director, Chinese Health, Aging and Policy Program Associate Director, Rush Institute for Healthy Aging Associate Professor of Medicine, Nursing and Behavioral Science Rush University Medical Center Chicago, IL 60612 www.chinesehealthyaging.org MedicalResearch.com: What are the main findings of the study? Answer: Dong and Simon investigated the prospective association between elder abuse and rate of hospitalization in a Chicago community population. From the Chicago Health and Aging Project, the study surveyed 6,674 older adults. After consideration of potential confounding factors, elder abuse victims compared to those without elder abuse had 2.7 times more frequent rate of hospitalizations in this Medicare population. Older adults who suffered psychological abuse, financial exploitation and caregiver neglect also had more frequent rate of hospitalization. Health care professionals should consider screening for elder abuse in hospital settings. Future research is needed to quantify impact of elder abuse and broader health service utilization in community-dwelling older persons. Elder abuse and neglect is something hundreds of thousands of senior citizens suffer from. It is advised to act if you suspect elder abuse is occurring by contacting the police. People may also see it fit to enlist the services of an elder neglect attorney to fight for the rights of the elderly (siegel-law-elder-abuse-neglect-attorney). (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, JAMA, Medical Research Centers, Melatonin, Sleep Disorders / 04.04.2013

 Dr. Ciaran McMullan MD from Channing Division of Network Medicine in Boston, a research division within the Department of Medicine at Brigham and Women’s Hospital, Boston MassMedicalResearch.com Interview with Dr. Ciaran McMullan MD from Channing Division of Network Medicine in Boston, a research division within the Department of Medicine at Brigham and Women’s Hospital, Boston Mass MedicalResearch.com: What are the main findings of the study? Dr. McMullan: In this observational study performed in non-diabetic women we found that lower nocturnal melatonin secretion predicted future risk of developing type 2 diabetes. When we categorized the individuals by category of nocturnal melatonin secretion we found that those in the lowest category had twice the risk as those in the highest category of nocturnal melatonin secretion. This association remained even after adjusting for other well established risk factors for development of diabetes including body mass index, physical activity, dietary factors, family history of diabetes, smoking and hypertension. This increased risk translates into the lower melatonin secretion group having an additional 5 cases of incident diabetes per 1000 person years than the high melatonin secretion group. (more…)
Author Interviews, Exercise - Fitness, JAMA, Stroke / 19.03.2013

MedicalResearch.com Interview with Carron D. Gordon, PhD Section of Physical Therapy, University of the West Indies, Mona, Box 126, Kingston 7, Jamaica, West Indies MedicalResearch.com:  What are the main findings of the study? Dr. Gordon: The walking group showed a 17.6% improvement in distance walked in six minutes (measure of endurance) compared to 4% in the control group and 16.7% improvement in SF36-Physical Component (health-related quality of life) compared to 2.6% in the control group. (more…)