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Author Interviews, Hepatitis - Liver Disease, HIV, Lancet / 05.02.2015

MedicalResearch.com Interview with: Prof Jean-Michel Molina Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, Paris France MedicalResearch.com Interview with: Prof Jean-Michel Molina Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, Paris France Medical Research: What is the background for this study? What are the main findings? Prof. Molina: Treatment of co-infected patients is complicated by drug drug interactions with HIV drugs, and the news DAAs are not very potent on HCV G2 and 3 infections. (more…)
Author Interviews, Depression, Lancet, Multiple Sclerosis / 04.02.2015

Dr Stefan M Gold Institute of Neuroimmunology and Multiple Sclerosis (INIMS) Centre for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf Hamburg, GermanyMedicalResearch.com Interview with: Dr Stefan M Gold Institute of Neuroimmunology and Multiple Sclerosis (INIMS) Centre for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf Hamburg, Germany Medical Research: What is the background for this study? What are the main findings? Dr. Gold: Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system (brain and the spinal cord). In addition to motor symptoms such as walking impairment, patients with Multiple sclerosis frequently suffer from psychological problems including difficulties with learning and memory as well as depressed mood. Depression is particularly common in this patient group with a 3-4 fold elevated risk for developing major depressive disorder compared to the general population. Depression in Multiple sclerosis is associated with decreased quality of life, absence from work, and numerous other psychosocial problems. Despite this major impact on patients’ lives, depression in Multiple sclerosis is often not adequately diagnosed and treated: Antidepressant medication in this patient group often has side effects and the neurological problems associated with MS such as difficulties with concentration and fatigue make it particularly difficult for MS patients to complete “classical” depression treatments such as psychotherapy. The goal of our study was to make psychological treatments available for the many patients with Multiple sclerosis suffering from depression, who often have difficulties to find adequate treatment. For this study, published in The Lancet Psychiatry, we conducted a randomized controlled trial of a fully-automated, computer-based program that can be accessed directly from patients’ homes over the internet. The program called “deprexis” was developed by the Hamburg-based company GAIA and uses methods of “cognitive behavioral therapy” or “CBT”. Ninety Multiple sclerosis patients were enrolled in the trial and randomly assigned to a 3 months therapy using the deprexis program or a waitlist control group. At the end of the intervention, depression had significantly decreased in the treatment group but remained unchanged in patients who did not have access to the program. In addition, patients using the computer program also reported reduced fatigue and improved quality of life. (more…)
Author Interviews, CDC, Infections, Lancet, Vaccine Studies / 04.02.2015

MedicalResearch.com Interview with: Dr Matthew R Moore, MD National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USADr Matthew R Moore, MD National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA MedicalResearch: What is the background for this study? Dr. Moore: Since introduction, pneumococcal conjugate vaccines have resulted in dramatic decreases in the number of cases of invasive pneumococcal disease in both children and adults.  The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced into the routine infant immunization program in the United States in 2000. It was recommended for infants using a 4-dose schedule: 2, 4, 6, and 12 through 15 months of age. Studies showed that PCV7 was highly effective in preventing invasive pneumococcal disease. In 2010, the 13-valent pneumococcal conjugate vaccine (PCV13) replaced PCV7 using the same 4-dose schedule. PCV13 is similar to PCV7, but includes protection against six additional serotypes of Streptococcus pneumoniae. There are more than 90 serotypes of pneumococcal bacteria. Streptococcus pneumoniae, or pneumococcus, is a major cause of illness and death globally. Pneumococcus can cause many types of illness that ranging from mild to life-threatening, including pneumonia, ear and sinus infections, meningitis, and bacteremia. Some of these infections are considered invasive because they invade parts of the body that are normally free from bacteria. Invasive pneumococcal disease, including meningitis and bacteremia, is often severe and can be deadly. MedicalResearch: What are the main findings? Dr. Moore: Invasive pneumococcal disease decreased substantially in the first 3 years after PCV13 was introduced into the U.S. infant immunization schedule. By June 2013, more than 30,000 cases of invasive pneumococcal disease and 3,000 deaths are estimated to have been prevented in the United States due to PCV13. Children under the age of five, which is the age group that actually received the vaccine, experienced the greatest and quickest benefit from PCV13.  For example, the overall number of cases of invasive pneumococcal disease decreased by 64% in this age group between 2010 and 2013. Significant decreases were seen as early as six months after the immunization recommendation was made. Adults, who were not targeted for vaccination, also experienced health benefits from PCV13 introduction. For example, the overall number of cases of invasive pneumococcal disease decreased by 32% for adults aged 18 to 49 years, while adults 65 and older experienced a more modest 12% decrease.  These reductions are further evidence that both PCV7 and PCV13 reduce the spread of pneumococcus, which is why vaccinating children leads to disease reductions in adults. For both children and adults, the greatest reductions were seen in the number of cases of invasive pneumococcal disease that were caused by serotypes that are covered by PCV13 but not PCV7 (serotypes 19A and 7F specifically). (more…)
Author Interviews, Lancet, Neurological Disorders, Pediatrics, Respiratory / 31.01.2015

Samuel Dominguez MD Departments of Pediatric Infectious Diseases Children's Hospital Colorado and University of Colorado School of Medicine Aurora, COMedicalResearch.com Interview with: Samuel Dominguez MD Departments of Pediatric Infectious Diseases Children's Hospital Colorado and University of Colorado School of Medicine Aurora, CO Medical Research: What is the background for this study? What are the main findings? Dr. Dominguez: Due to global poliovirus eradication efforts, clusters of acute flaccid paralysis (AFP) and/or cranial nerve dysfunction in children are rare and associated with few pathogens, primarily enteroviruses and flaviviruses.  Our study reports the first geographically and temporally defined cluster of acute flaccid paralysis and cranial nerve dysfunction in children associated with an outbreak of EV-D68 respiratory illness, strengthening the potential link between EV-D68 and neurologic disease in children. (more…)
Asthma, Author Interviews, Compliance, Lancet, Technology / 30.01.2015

Amy Chan BPharm(Hons) RegPharmNZ MPS ANZCP Pharmacist / PhD candidate Department of Paediatrics Auckland Hospital Faculty of Medical & Health Sciences University of Auckland Auckland, New ZealandMedicalResearch.com Interview with: Amy Chan   BPharm(Hons) RegPharmNZ  MPS  ANZCP Pharmacist / PhD candidate Department of Paediatrics Auckland Hospital Faculty of Medical & Health Sciences University of Auckland  Auckland, New Zealand Medical Research: What is the background for this study? What are the main findings? Response: Asthma is one of the most common childhood conditions, affecting 1 in 4 children in New Zealand.  Although there are many effective medications available for asthma, of which the most important are inhaled corticosteroids, asthma control remains suboptimal due to poor adherence.  In children, adherence to regular preventive asthma therapy is about 50%, and can be as low as 30%.  Our randomised controlled trial looked at use of an electronic monitoring device with an in-built audiovisual reminder to see if it improved adherence and asthma control.  We recruited 220 children aged between 6-15yrs, who presented to the emergency department with asthma and randomised them to receive the device either with the audiovisual function enabled or disabled.  It found that those who received the audiovisual reminder (the intervention arm) took a median of 84% of their inhaled corticosteroids compared to just 30% in those who did not receive the reminder (control arm).  This equates to a 180% improvement in adherence.  We found significant improvements also in asthma control (including reduced asthma symptoms and increased participation in daily activities) and a reduction in reliever use from 17.4% to 9.5% in those who received the reminder. (more…)
Author Interviews, Lancet, Stroke / 20.01.2015

MedicalResearch.com Interview with: Prof. dr. Diederik van de Beek Department of Neurology, Academic Medical Center, University of Amsterdam The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Dr. van de Beek: In adults with acute stroke, infections occur commonly and are associated with an unfavourable functional outcome. In the Preventive Antibiotics in Stroke Study (PASS) we aimed to establish whether or not preventive antimicrobial therapy with a third-generation cephalosporin, ceftriaxone, improves functional outcome in patients with acute stroke. PASS is an investigator-initiated, randomised, open-label, masked-endpoint trial that was undertaken between 2010 and 2014 in 30 Dutch centres and enrolled 2550 patients with ischaemic or haemorrhagic stroke. Randomly assigned in a 1:1 ratio to either preventive antibiotic therapy or a control group, all patients received standard stroke unit care. Starting within 24 h after stroke onset, patients in the preventive antibiotic group were given additional treatment with ceftriaxone administered intravenously at a dose of 2 g every 24 h for 4 days. The main findings were that preventive ceftriaxone did not improve 3-month functional outcome on the modified Rankin Scale (adjusted common odds ratio 0·95 [95% CI 0·82–1·09]); however, clinically diagnosed post-stroke infections were significantly reduced (adjusted odds ratio 0·55 [0·44–0·70]). Preventive antibiotic therapy with ceftriaxone is a safe treatment. (more…)
Author Interviews, Hepatitis - Liver Disease, Lancet, NIH / 13.01.2015

MedicalResearch.com Interview with: Anita Kohli MD Critical Care Medicine Department NIH Clinical Center, National Institutes of Health, Bethesda, MD Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research,  National Laboratory for Cancer Research, Frederick, MD, Medical Research: What is the background for this study? What are the main findings? Dr. Kohli: While therapy using for 8-12 weeks of all oral directly acting antivirals (DAAs) has been shown to result in high SVR "cure" rates for hepatitis C, the optimal combination and minimum duration required for treatment of hepatitis C has not been defined. The development of the simplest, short duration regimen for hepatitis C possible with high cure rates is important given the ~180 million people infected globally. Medical Research: What should clinicians and patients take away from your report? Dr. Kohli: Combination therapy with  directly acting antivirals may allow for the further shortening of treatment duration for hepatitis C. Using the right combination of DAA's therapy for as short as six-weeks may results in high rates of SVR. (more…)
Author Interviews, Diabetes, Lancet / 07.01.2015

Ahmad Haidar PhD Institut de Recherches Cliniques de Montreal Montreal, QC, CanadaMedicalResearch.com Interview with: Ahmad Haidar PhD Institut de Recherches Cliniques de Montreal Montreal, QC, Canada Medical Research: What is the background for this study? What are the main findings? Response: We published a study in 2013 (Canadian Medical Association Journal 185.4 (2013): 297-305) where we did the first randomized trial comparing dual-hormone artificial pancreas against conventional pump therapy. We showed spectacular reduction in hypoglycemia (8-fold) with the artificial pancreas, but the first question people asked: Out of the improvement you showed, how much is due to simply closing the loop between the glucose sensor and the insulin pump, and how much is due to adding glucagon? In other words: if you just close the loop with insulin alone and use an advanced dosing algorithm, you may get a very high reduction of hypoglycemia that glucagon may not be needed (glucagon is associated with increased cost and device complexity). We were not able to answer this question with our study design. Since then, there have been other studies by other groups either comparing single-hormone artificial pancreas vs conventional pump therapy, or comparing dual-hormone artificial pancreas vs conventional pump therapy, and most of these studies showed improvement of both artificial pancreas systems compared to conventional pump therapy. However, there has been no study comparing the three interventions to allow us to quantify the relative benefits of simply closing the loop between glucose sensor and insulin pump versus adding glucagon to the system. Quantifying the relative benefits of glucagon is important given the increased cost and device complexity of the dual-hormone artificial pancreas. So our study compared the three interventions, and is the first study to do so. (more…)
Author Interviews, HPV, Lancet, Vaccine Studies / 28.12.2014

MedicalResearch.com Interview with: Huachun Zou PhD on behalf of all authors. Melbourne Sexual Health Centre, Alfred Health, Carlton, VIC, Melbourne School of Population and Global Health University of Melbourne, Melbourne, VIC, Australia Medical Research: What is the background for this study? What are the main findings? Response: Anogenital human papillomavirus (HPV) infection and anal cancer are common among men who have sex with men (MSM) and preventable with the HPV vaccine. However, the optimal strategy for vaccinating MSM against HPV requires an accurate understanding of the age specific incidence of early HPV infection. In addition to understanding the optimal age at which to vaccinate young MSM, policy makers also need to know the vaccine coverage required in MSM. In this paper we aimed to provide estimates for the site specific incidence of HPV and to use this to estimate the probability of transmission per partner in a cohort of very young MSM aged 16 to 20 years. These data will assist governments in deciding what HPV vaccination strategy is likely to be the most effective in MSM. (more…)
Author Interviews, Cancer Research, Lancet / 28.11.2014

Dr Claudia Allemani PhD FHEA MFPH Senior Lecturer in Cancer Epidemiology Cancer Research UK Cancer Survival Group Department of Non-Communicable Disease Epidemiology London School of Hygiene and Tropical Medicine, London UKMedicalResearch.com Interview with: Dr Claudia Allemani PhD FHEA MFPH Senior Lecturer in Cancer Epidemiology Cancer Research UK Cancer Survival Group Department of Non-Communicable Disease Epidemiology London School of Hygiene and Tropical Medicine, London UK Medical Research: What is the background for this study? Dr. Allemani:  Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. The first CONCORD study was published in 2008.1 It brought together data from 101 cancer registries in 31 countries, and included 1.9 million patients diagnosed during 1990-94 with a cancer of the colon, rectum, breast or prostate and followed up to the end of 1999. It revealed very wide international differences in five-year survival, and it confirmed the well-known racial discrepancy in cancer survival in the USA. CONCORD-2 is the most comprehensive international comparison of trends in population-based cancer patient survival to date. It extends the first study in three ways:
  • it covers 10 common cancers: collectively, these account for almost two-thirds (63%) of all cancer patients diagnosed each year in both developed and developing countries
  • it includes data on more than 25 million cancer patients, provided by 279 cancer registries in 67 countries, in 40 of which the data provide complete (100%) coverage of the national population
  • it examines trends in cancer survival for patients diagnosed over the 15-year period 1995-2009 (more…)
Author Interviews, Heart Disease, Infections, Lancet / 24.11.2014

MedicalResearch.com Interview with: Dr. Martin Thornhill PhD Department of Cardiology, Taunton and Somerset NHS Trust Taunton, Somerset, UK Medical Research: What is the background for this study? What are the main findings? Dr. Thornhill: In 2008 NICE introduced controversial new guidance recommending that antibiotic prophylaxis to prevent infective endocarditis should no longer be used. It was a rational decision, given the evidence for the effectiveness of antibiotic prophylaxis and potential concerns about costs, the development of antibiotic resistance and possible side effects from antibiotics, but it went against other guidelines from around the world that existed at the time. The main findings are that in England:
  1. There has been a large and significant decline in the use of antibiotic prophylaxis.
  2. There has been a significant increase in the number of cases of infective endocarditis, above the baseline trend, using hospital coding data, corrected for changes in the size of the English population.
(more…)
Author Interviews, Heart Disease, Lancet / 17.11.2014

Prof Gavin D. Perkins MD Clinical Professor in Critical Care Medicine Warwick Clinical Trials Unit Co-Director of Research; Warwick Medical School and Heart of England NHS Foundation TrustMedicalResearch.com Interview with: Prof Gavin D. Perkins MD Clinical Professor in Critical Care Medicine Warwick Clinical Trials Unit Co-Director of Research; Warwick Medical School and Heart of England NHS Foundation Trust Medical Research: What is the background for this study? Prof. Perkins: Each year around 30,000 people in the United Kingdom suffer out of hospital cardiac arrests and less than one in twelve of those returns home alive. Early high quality Cardio- Pulmonary Resuscitation (CPR – ventilation and chest compressions) is critical to survival. However maintaining high quality chest compressions during resuscitation is difficult for crews of emergency vehicles, especially if they are on their own, because of fatigue and the need to perform other actions. Chest compression is particularly difficult in moving vehicles. A number of mechanical devices, suitable for out of hospital use, have been developed over the years to improve the quality of chest compressions and therefore attempt to improve patient outcomes. Some NHS organisations decided to purchase devices to use although there is limited evidence of their effectiveness. To equip all emergency vehicles in the NHS would cost tens of millions of pounds plus costs for on-going training and maintenance. This prompted the UK Joint Royal College Ambulance Liaison Committee to advise against the purchase of further mechanical chest compression devices until further research had been carried out. The aim of this trial was to compare the effects of the mechanical chest compressions (LUCAS-2) device versus standard manual chest compressions (crew using their hands) on survival. (more…)
Author Interviews, Ebola, Lancet / 16.11.2014

Professor Tom Solomon, FRCP PhD Director, NIHR Health Protection Research Unit in Emerging and Zoonotic Infections Director, Institute of Infection and Global Health, University of Liverpool MedicalResearch.com Interview with: Professor Tom Solomon, FRCP PhD Director, NIHR Health Protection Research Unit in Emerging and Zoonotic Infections Director, Institute of Infection and Global Health, University of Liverpool Medical Research: What is the background for this study? What are the main findings? Dr. Solomon: Since the Ebola outbreak began there has been concern about transmission to new countries by airline passengers who were infected, but didn’t know it. This was underscored by such transmission to Nigeria, and to USA. Screening for symptoms of Ebola virus disease in airline passengers whose journeys originated from the three most affected countries—Guinea, Liberia, and Sierra Leone—has recently been introduced at some airports. We examined the current growth rate of the epidemic in West Africa, and airline travel patterns to predict how many people with Ebola are likely to attempt to fly. Our research showed that we can expect approximately 29 infected passengers to try and leave West Africa by the end of the year. Based on the incubation period of the virus, and looking at how long people have symptoms before they are hospitalised, we estimated ten of these people with Ebola would have symptoms of the disease as they leave the affected countries, and so would be detected by exit screening. Of the remaining 19, one to two would be expected to fly to the UK, and up to three to the USA, based on current airline passenger data. At most one of these passengers would have developed symptoms by the time they arrive in the UK or USA, and thus would be detected by entry screening (more…)
Author Interviews, Cancer Research, Lancet, Thromboembolism / 08.10.2014

MedicalResearch.com Interview with: Prof Martin H Prins MD Maastricht University Medical Centre, Maastricht, Netherlands Medical Research: What are the main findings of the study? Dr. Prins: Patients with active cancer, i.e. a cancer that was diagnosed or treated within 6 months before the episode, that was recurrent or metastatic, or that was diagnosed during treatment, who had a symptomatic episode of venous thromboembolism, were included in this pooled subgroup analysis of the Einstein DVT and PE studies. The incidence of recurrent venous thromboembolism was similar between groups. It occurred in 16 (5%) of 354 patients allocated to rivaroxaban and 20 (7%) of 301 patients allocated to enoxaparin and vitamin K antagonist (hazard ratio [HR] 0•67, 95% CI 0•35 to 1•30). Clinically relevant bleeding was also similar and occurred in 48 (14%) of 353 patients receiving rivaroxaban and in 49 (16%) of 298 patients receiving standard therapy (HR 0•80, 95% CI 0•54 to1•20). However, major bleeding was less frequent among rivaroxaban recipients and occurred in eight (2%) of 353 patients receiving rivaroxaban and in 15 (5%) of 298 patients receiving standard therapy (HR 0•42, 95% CI 0•18 to 0•99). Mortality was also similar. (more…)
Author Interviews, Diabetes, Lancet / 03.10.2014

Dr Nita Forouhi Lead Scientist and Programme Leader MRC Epidemiology Unit University of Cambridge School of Clinical MedicineMedicalResearch.com Interview with: Dr Nita Forouhi, MRCP, PhD, FFPHM Lead Scientist and Programme Leader MRC Programme Leader and Consultant Public Health Physician MRC Epidemiology Unit University of Cambridge School of Clinical Medicine Cambridge Biomedical Campus Cambridge, UK Medical Research: What are the main findings of the study? Dr. Forouhi: This large study found that low blood concentrations of 25-hydroxyvitamin D [25(OH)D], a clinical indicator of vitamin D status, were associated with an increased risk of type 2 diabetes, but this did not appear to be a cause-effect relationship. To investigate these associations, we did two things. We first did a systematic review and meta-analysis across 22 published studies and confirmed that there was a strong inverse relation between vitamin D levels and the risk of future new-onset type 2 diabetes among people who did not initially have diabetes. We then used a genetic approach, called Mendelian randomisation, which allows us to test a cause-effect relationship, and found that genetically lower vitamin D levels were not related to risk of type 2 diabetes. This means that we were able to distinguish between association and causation, and concluded that the vitamin D levels did not have a causal link with type 2 diabetes. (more…)
Author Interviews, Lancet, Lipids / 02.10.2014

MedicalResearch.com Interview with: Dr. Raul Santos Unidade Clínica de Lipides InCor-HCFMUSP Sao Paulo, Brazil. Medical Research: What are the main findings of the study? Dr. Santos: Evolocumab 420 mg injected subcutaneously every 4 weeks reduced LDL-C by 31% on average, in relation to placebo, in Homozygous familial hypercholesterolemia patients that were using maximally tolerated lipid lowering therapy but not on lipid apheresis regimen. Patients were separated according to the type of LDL receptor mutation, those with at least one allele codifyng a defective mutation on the LDL receptor (residual receptor activity 2-25%) had on average a 41% reduction on LDL-cholesterol. The 2 patients  homozygotes with alleles that codify a null mutation )receptor activity < 2%), did not respond to treatment. This was expected since PCSK9 inhibitors need a functional LDL receptor do work. Basically they increase the expression of the receptor that facilitates the clearance from plasma of circulating LDL particles. In those patients with defective LDL receptor  mutations there was 24% reduction of lipoprotein(a) concentrations, an extra risk factor for cardiovascular disease in familial hypercholesterolemia patients. (more…)
Author Interviews, General Medicine, Lancet, Lipids / 02.10.2014

Professor F. J. Raal FRCP, FRCPC, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism Faculty of Health Sciences, University of the Witwatersrand Johannesburg Hospital Johannesburg South AfricaMedicalResearch.com Interview with: Professor F. J. Raal FRCP, FRCPC, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism Faculty of Health Sciences, University of the Witwatersrand Johannesburg Hospital Johannesburg South Africa Medical Research: What are the main findings of the study? Dr. Raal: Heterozygous familial hypercholesterolaemia (HeFH)  is one of the most common inherited disorder in man affects between 1:250 to 1:300 persons worldwide. Thus, there are likely more than 3 million patients with heterozygous familial hypercholesterolaemia in the United States and Europe alone. The RUTHERFORD-2 study was a large world-wide multinational study  of the use of the PCSK9-inhibitor, evolocumab, in over 300 patients with heterozygous familial hypercholesterolaemia (HeFH). Evolocumab administered either 140 mg biweekly or 420 mg monthly as a subcutaneous injection, much like an insulin injection, was well tolerated with minimal side effects,  and markedly reduced levels of LDL cholesterol or “bad cholesterol”  by over 60% compared to placebo. (more…)
Accidents & Violence, Author Interviews, Frailty, Lancet / 25.09.2014

MedicalResearch.com Interview with: Dr. MichaelD. Keall PhD Otago University, Wellington, New Zealand Medical Research: What are the main findings of the study? Dr. Keall: We found that home injuries from falls could be reduced by 26% by making some simple modifications to people’s homes, consisting of handrails for steps and stairs, grab rails for bathrooms, outside lighting, edging for outside steps and slip-resistant surfacing for outside surfaces such as decks and porches. (more…)
Author Interviews, JAMA, Lancet / 25.09.2014

Prof Mika Kivimäki PhD Department of Epidemiology and Public Health, University College London, London, UK Hjelt Institute, Medical Faculty, University of Helsinki, Helsinki, FinlandMedicalResearch.com Interview with: Prof Mika Kivimäki PhD Department of Epidemiology and Public Health, University College London, London, UK Hjelt Institute, Medical Faculty, University of Helsinki, Helsinki, Finland Medical Research: What are the main findings of the study? Prof. Kivimäki: In our study, we pooled published and unpublished data from 222 120 men and women from the USA, Europe, Japan, and Australia. Of them, 4963 individuals developed type 2 diabetes during the mean follow-up of 7.6 years. This is the largest study to date on this topic. In an analysis stratified by socioeconomic status, the association between long working hours and diabetes was evident in the low socioeconomic status group, but was null in the high socioeconomic status group. The association in the low socioeconomic status group did not change after taking into account age, sex, obesity, physical activity, and shift working. So, the association was very robust. In brief, the main finding of our meta-analysis is that the link between longer working hours and type 2 diabetes was apparent only in individuals in the low socioeconomic status groups. (more…)
Author Interviews, Cancer Research, Lancet / 17.09.2014

Judith Trotman MBChB, FRACP, FRCPA Associate Professor Concord Hospital University of Sydney, AustraliaMedicalResearch.com Interview with: Judith Trotman MBChB, FRACP, FRCPA Associate Professor Concord Hospital University of Sydney, Australia Medical Research: What are the main findings of the study? Dr. Trotman: That PET-CT (applying the cut-off of ≥4 on the now internationally recommended 5 Point Scale) is a more powerful predictor of both Progression Free and Overall Survival than conventional CT in patients responding to first line immunochemotherapy for advanced follicular lymphoma.  It is also a much stronger predictor than the pre-treatment prognostic indices FLIPI and FLIP2. Patients who achieve PET-negative status have a median PFS over 6 years compared to only 17 months in those who remain PET-positive. (more…)
Author Interviews, Lancet, Lung Cancer, Radiation Therapy / 15.09.2014

Prof. dr. B.J. Slotman VU University Medical Center Cancer Center Amsterdam NetherlandsMedicalResearch.com Interview wth: Prof. dr. B.J. Slotman VU University Medical Center Cancer Center Amsterdam Netherlands Medical Research: What are the main findings of this study? Prof. Slotman: This randomized trial showed that the use of thoracic radiotherapy in patients with extensive stage small cell lung cancer reduces the risk of intrathoracic progression by about 50% and improves 2 years survival from 3 to 13%. (more…)
Author Interviews, Heart Disease, Lancet, Statins / 11.09.2014

Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Herlev Hospital, Copenhagen University Hospital Dept. Clinical Biochemistry Herlev Ringvej 75, DK-2730 Herlev, DenmarkMedicalResearch.com Interview with: Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Herlev Hospital, Copenhagen University Hospital Dept. Clinical Biochemistry Herlev Ringvej Herlev, Denmark Medical Research: What are the main findings of the study? Dr. Nordestgaard: Among all patients with diabetes in Denmark during 1996-2009 and compared with non-statin users, statin users had a 40% lower risk of diabetic retinopathy, a 34% lower risk of diabetic neuropathy, and a 12% lower risk of gangrene of the foot, while the risk of diabetic nephropathy was similar. (more…)
Author Interviews, Cannabis, Lancet / 10.09.2014

MedicalResearch.com Interview with: Edmund Silins PhD, Research Fellow National Drug and Alcohol Research Centre UNSW Medicine University of New South Wales Sydney  Australia Medical Research: What are the main findings of the study? Dr. Silins: There were three particularly interesting aspects to the findings.
  • Firstly, we found clear and consistent associations between adolescent cannabis use and the young adult outcomes investigated.
  • Secondly, there was evidence of a dose-response effect such that the more frequently adolescents used cannabis the more likely they were to experience harms later in life.
  • Thirdly, for most outcomes, these associations remained even after taking into account a wide range of other factors which might potentially explain them.
The adverse effects were greatest for daily cannabis users. Specifically, adolescents who were daily cannabis users were, by the age of 25, more than 60% less likely to complete high school or obtain a university degree, seven times more likely to have attempted suicide, 18 times more likely to have been cannabis dependent, and eight times more likely to have used other illicit drugs, than adolescents who had never used the drug. (more…)
Author Interviews, Lancet, Obstructive Sleep Apnea / 30.08.2014

MedicalResearch.com Interview with: Prof. Mary J Morrell Faculty of Medicine, National Heart & Lung Institute Professor of Sleep & Respiratory Physiology Imperial College, London Medical Research: What are the main findings of the study? Prof. Morrell: Our results showed that when older patients with obstructive sleep apnea were treated with continuous positive airway pressure (CPAP) they had significantly less daytime sleepiness than those not treated with CPAP. A comparison of the costs and benefits of treatment suggested that CPAP would meet the usual criteria for being funded by the NHS. (more…)
Author Interviews, Cancer Research, Lancet, Weight Research / 16.08.2014

Dr Krishnan Bhaskaran MSc PhD. Senior Lecturer in Statistical Epidemiology & National Institute for Health Research Postdoctoral Fellow London School of Hygiene and Tropical Medicine London WC1E 7HTMedicalResearch.com Interview with: Dr Krishnan Bhaskaran MSc PhD. Senior Lecturer in Statistical Epidemiology & National Institute for Health Research Postdoctoral Fellow London School of Hygiene and Tropical Medicine London WC1E 7HT Medical Research: What are the main findings of the study? Dr. Bhaskaran: Body mass index was associated with the majority of cancer types studied, and for 10 cancers, including some of the most common like colon cancer and postmenopausal breast cancer, higher body mass index was clearly associated with higher risk. The cancer type that was most strongly related to BMI was uterine cancer, the 4th most common cancer in women. For a woman of average height, each 2 stone (13kg) increase in weight increased risk by over 60%. Body mass index also had particularly large effects on risk of kidney and gallbladder cancers. In total, we estimated that over 12,000 cases of the 10 affected cancers may be caused each year by excess weight, and that if average body mass index in the population continues to increase, there may be several thousand more cases of these cancers each year as a result. (more…)
Author Interviews, Erasmus, Lancet, Prostate Cancer / 10.08.2014

Professor Fritz H Schröder Department of Urology, Erasmus University Medical Center Rotterdam, NetherlandsMedicalResearch.com Interview with: Professor Fritz H Schröder Department of Urology, Erasmus University Medical Center Rotterdam, Netherlands Medical Research: What are the main findings of the study? Professor Schröder: I consider as the main finding that we could report a continuing effect of PSA driven screening on prostate cancer mortality for men aged 55 – 69 years in the screen arm of our study after 13 years of follow-up. The absolute reduction in the risk of death from prostate cancer amounts to 1.28 per 1000 men randomized to the screening arm. This translated into numbers to be invited to screening and numbers needed to be diagnosed to save one prostate cancer death of 781 and 27. These figures show an increasing effect with increasing time of follow-up. The relative risk reduction related to the control arm has remained unchanged with respect to the 11 year follow-up period. For men who actually participated and were screened the relative risk reduction amounted to 27%, the figure most applicable to men who consider to be tested. (more…)
Author Interviews, Kidney Disease, Lancet, Transplantation / 28.07.2014

MedicalResearch.com Interview with Dr. Richard Haynes Clinical Trial Service Unit and Epidemiological Studies Unit Roosevelt Drive, Headington Oxford OX3 Medical Research: What are the main findings of the study? Dr. Haynes: The main result from this analysis is that alemtuzumab-based induction therapy (ie, alemtuzumab followed by low-dose mycophenolate and tacrolimus with steroid avoidance) reduced biopsy-proven acute rejection by about half during the first 6 months after transplantation among a wide variety of different types of participant, compared to standard basiliximab-based induction therapy (basiliximab followed by standard dose mycophenolate, tacrolimus and steroids). This reduction was achieved despite the lower doses of tacrolimus used and there was no excess of infection observed. (more…)
Author Interviews, Lancet, Pain Research / 24.07.2014

MedicalResearch.com Interview with: R Chris Williams PhD Honorary Fellow, Musculoskeletal Division The George Institute for Global Health Sydney NSW 2000 Australia Medical Research: What are the main findings of the study? Dr. Williams: We found that in addition to advice and reassurance, ‘regular’ or ‘as needed’ paracetamol did not improve recovery time for people with low back pain, compared to placebo. We also found the pain intensity and a range of other relevant measures, such as patient’s physical function was not different between the treatment groups. (more…)
Author Interviews, Flu - Influenza, Lancet / 22.07.2014

MedicalResearch.com Interview with: Prof. Jean-Francois Rossignol, FRSC, FRCPath Romark Laboratories, LC MedicalResearch: What are the main findings of the study? Prof. Rossignol: Nitazoxanide, a new orally administered drug in development for treating influenza, reduced the duration of symptoms of uncomplicated influenza compared to a placebo. The drug also reduced viral shedding. Side effects were similar for the drug and placebo treatment arms. The study was designed and conducted in compliance with FDA guidelines for studying new drugs for influenza. (more…)
Author Interviews, HIV, Lancet / 20.07.2014

Dr. Colette SmithMedicalResearch.com Interview with: Dr. Colette Smith: PhD Research Department of Infection and Population Health University College London, London, UK   Medical Research: What are the main findings of the study? Dr. Smith: We followed a group of approximately 45,000 HIV-positive people from Europe, USA and Australia between 1999 to 2011. We found that the death rate approximately halved over the 12-year study period. For every 1,000 people, around 18 died per year in 1999-2001, reducing to 9 deaths per year in 2009-2011. We also studied what people died of. We found that the death rate from AIDS and from liver disease decreased by around two-thirds. Deaths from heart disease approximately halved. However, the rate of cancer deaths (excluding cancers that are classified as AIDS events) remained constant over time. One in three deaths were caused by AIDS in 1999 to 2011, and this decreased to one in five deaths in the last two years of the study. However, even in recent years it was the joint most common cause of death. The proportion of deaths from cancer increased over time. One in ten deaths were from cancer in 1999 to 2001, and this increased to one in five deaths in 2009 to 2011. By the end of the study it was the joint-most common cause of death. (more…)