Author Interviews, Health Care Systems, Lancet, Nursing, University of Pennsylvania / 04.03.2014

Professor Linda H Aiken PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology Director of the Center for Health Outcomes and Policy Research Center for Health Outcomes and Policy Research University of Pennsylvania School of NursingMedicalResearch.com Interview with: Professor Linda H Aiken PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology Director of the Center for Health Outcomes and Policy Research Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing MedicalResearch.com: Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. Against that backdrop, can you start by letting us know the background of the study?  Prof. Aiken: European Surgical Outcomes Study in 28 countries showed higher than necessary deaths after surgery. A comparable study in the US showed that despite the nation spending hundreds of millions of dollars on improving patient safety, there were no improvements in adverse outcomes after surgery in US hospitals between 2000 and 2009.  Clearly it is time to consider new solutions to improving hospital care for surgical patients, who make up a large proportion of all hospital admissions.  Our study was designed to determine whether there are risks for patients of reducing hospital nurse staffing, and what, if any, are the benefits to patients of moving to a more educated nurse workforce.
Author Interviews, Gastrointestinal Disease, Lancet / 21.02.2014

Norbert Stefan, MD Heisenberg Professorship for Clinical and Experimental Diabetology Department of Internal Medicine IV University Hospital Tübingen Tübingen, GermanyMedicalResearch.com Interview with: Norbert Stefan, MD Heisenberg Professorship for Clinical and Experimental Diabetology Department of Internal Medicine IV University Hospital Tübingen Tübingen, Germany MedicalResearch.com: What are the main findings of the study? Dr. Stefan: Currently there is little evidence for an effective and safe pharmacological treatment of nonalcoholic fatty liver disease (NAFLD). Based on the fact that inhibition of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), the enzyme, that converts inactive cortisone into active cortisol in metabolic tissues such as liver and adipose, was found to be effective to improve lipid metabolism in animals, we hypothesized that inhibition of 11β-HSD1 may also prove to be effective to decrease liver fat content in patients with NAFLD. In our 12 week trial in 82 patients with NAFLD, inhibition of 11β-HSD1 with RO5093151 resulted in a 14 % decrease of liver fat content and in a resolution of NAFLD in 20 % of the patients. This was accompanied by a decrease of liver enzymes. Furthermore, inhibition of 11β-HSD1 brought about a reduction of body weight and total body- and visceral adipose tissue mass, while insulin sensitivity did not change. In agreement with findings from other trials, also in our study 11β-HSD1 inhibition was well tolerated and safe.
Author Interviews, CT Scanning, Lancet, Medical Imaging, MRI, Pediatrics, Stanford / 20.02.2014

Dr Heike Daldrup-Link Associate Professor of Radiology Stanford University School of Medicine, Palo AltoMedicalResearch.com: Interview with: Dr Heike Daldrup-Link Associate Professor of Radiology Stanford University School of Medicine, Palo Alto   MedicalResearch.com: What are the main findings of the study? Answer: We use magnetic resonance imaging, a technology based on magnetic fields rather than radiotracers or x-rays. The underlying technology is not new – it has been used for tumor staging for many years. This is an advantage as MR scanners are available in nearly every major Children’s Hospital where children with cancer are treated. What is new about our approach is that we combined anatomical and functional images, similar to current approaches that use radiotracers and CT (PET/CT):  We first acquired scans that showed the anatomy of the patient very well and we then acquired scans that depict tumors as bright spots with little or no background information. We did that by using an iron supplement as a contrast agent: The iron supplement can be detected by the MRI magnet and improved tumor detection and vessel delineation MR scans. We then fused the anatomical scans with the tumor scans.
Author Interviews, Lancet, Pulmonary Disease / 19.02.2014

Ganesh Raghu, M.D.,FCCP, FACP Professor of Medicine & Lab Medicine (Adjunct) Division of Pulmonary & Critical Care Medicine University of Washington(UW) Director,CENTER for Interstitial Lung Disease(ILD),UW Medicine, ILD, Sarcoid and Pulmonary Fibrosis Program Co-Director, Scleroderma Clinic, UW Medical center(UWMC) Seattle, WA 98195MedicalResearch.com Interview with: Ganesh Raghu, M.D.,FCCP, FACP Professor of Medicine & Lab Medicine (Adjunct) Division of Pulmonary & Critical Care Medicine University of Washington(UW) Director,CENTER for Interstitial Lung Disease (ILD),UW Medicine, ILD, Sarcoid and Pulmonary Fibrosis Program Co-Director, Scleroderma Clinic, UW Medical center(UWMC) Seattle, WA 98195 MedicalResearch.com: What are the main findings of the study? Dr. Raghu: In a subgroup of patients with typical clinical features of Idiopathic pulmonary fibrosis ( IPF) , further evaluation by a thorough evlauation by regional experts experienced in management of idiopathic pulmonary fibrosis and related diseases may lead to a diagnosis of idiopathic pulmonary fibrosis without the need for surgical lung biopsy if the HRCT features have a Possible-UIP pattern AND if there are no suspicion for environmental factors or collagen vascular diseases to explain the pulmonary fibrosis .
Author Interviews, Lancet, Pulmonary Disease / 14.02.2014

MedicalResearch.com Interview with: Jinping Zheng MD FACCP on behalf of Prof. Nanshan Zhong [caption id="attachment_3779" align="alignleft" width="113"]Prof. Nanshan Zhong Prof. Nanshan Zhong[/caption] --Jinping Zheng, MD, FCCP Guangzhou Institute of Respiratory Disease First Affiliated Hospital of Guangzhou Medical University 151 Yanjiang Rd. Guangzhou 510120, China MedicalResearch.com: What are the main findings of the study? Answer: PANTHEON is the largest, evidence-based study of long-term treatment with N-acetylcysteine (NAC) in COPD patients conducted to date. The main finding of this study is that 1-year of treatment with high dose NAC (600mg twice daily) was effective at reducing exacerbations in patients with COPD, especially in the earlier stage [GOLD II (moderate) of disease. NAC was well tolerated.
Accidents & Violence, Lancet, Sexual Health / 14.02.2014

MedicalResearch.com Interview with: Professor Naeemah Abrahams Senior Specialist Scientist:  Gender & Health Research Unit, South African Medical Research Council Extraordinary Professor:  Faculty of Community Health Sciences -School of Public Health: University of the Western Cape Associate Professor: Faculty of Health Sciences - School of Health and Rehabilitation Sciences: University of Cape Town MedicalResearch.com: What are the main findings of the study? Prof. Abrahams: We found a global estimate of non-partner sexual violence of 7.2%  for women 15 years and older - but this estimate varied across the globe. The regions with the highest prevalence was Sub Sahara Africa Central and Southern with a prevalence was 21% in the central region and  17.4 % in the Southern region. This is nearly 3 times the global estimate . The region with the lowest prevalence was  Asia South at 3.3%. The low level could be due to a number of reasons. Firstly data from this region was very limited – from 2 countries only  and we have found that if sexual violence questions are added to other larger studies the level of disclosure is not very high. It is also  more likely that people from Asia region do not disclose the violence in research studies because of stigma and shame.
Author Interviews, Diabetes, Lancet, Nutrition / 12.02.2014

MedicalResearch.com Interview with: Kirstie Bell Diabetes Dietitian, CDE & PhD Candidate Human Nutrition Unit The University of Sydney MedicalResearch.com: What are the main findings of the study? Answer: Overall, the evidence to support carbohydrate counting is limited, with current data showing a non-significant improvement in HbA1c.  Pooled results from 7 quality randomised control trials studies showed carbohydrate counting had no significant effect on glycemic control (-0.35%, p = 0.096).  There was a significant improvement in HbA1c of 0.64% points in studies in adults that were conducted in a parallel design. This is the first meta-analysis of carbohydrate counting in type 1 diabetes. Up until now, it has not been known what improvement in glycemic control can be expected. Current international guidelines for diabetes management have been based merely on gradings of the available evidence. However, assessing the overall effectiveness of carbohydrate counting is critical in clinical practice to guide medical and dietary management decisions.
Alcohol, Author Interviews, Lancet / 10.02.2014

Dr John Holmes PhD, MA, BA (Hons) (York) Section of Public Health, ScHARR, University of Sheffield, Sheffield S1 4DA, UKMedicalResearch.com with: Dr John Holmes PhD, MA, BA (Hons) (York) Section of Public Health, ScHARR, University of Sheffield, Sheffield S1 4DA, UK MedicalResearch.com: What are the main findings of the study? Dr. Holmes: The study aimed to examine which groups in society would be affected by a 45p minimum unit price for alcohol.  This was in response to concerns expressed by, among others, the UK Government that the policy may not tackle harmful drinking and may penalise responsible drinkers. We found no support for these concerns.  As the policy targets the cheap alcohol which is disproportionately purchased by those drinking at harmful levels, the effects are mainly felt by those at greatest risk of suffering harm from their drinking.  On the other hand, moderate drinkers, including those on low incomes, buy very little of this cheap alcohol so are relatively unaffected.
Author Interviews, Lancet, Weight Research / 28.01.2014

Professor Sally Wyke Deputy Director, Institute of Health and Wellbeing Professor (Institute of Health and Wellbeing Social Sciences) The University of GlasgowMedicalResearch.com Interview with: Professor Sally Wyke Deputy Director, Institute of Health and Wellbeing Professor (Institute of Health and Wellbeing Social Sciences) The University of Glasgow MedicalResearch.com: What are the main findings of the study? Prof. Wyke: The FFIT programme was very effective.  The men who did the programme lost nine times as much weight as the men who did not.  On average, they lost over 5.5kg  (11lbs)and kept it off for the full 12 months. In addition, we found highly significant differences in favour of the intervention objectively-measured waist, percentage body-fat, systolic and diastolic blood pressure, and self-reported physical activity, diet and indicators of well-being and physical aspects of quality of life.
Allergies, Asthma, Author Interviews, Lancet / 15.01.2014

Mariona Pinart, PhD CREAL-Centre for Research in Environmental Epidemiology ISGlobal alliance Parc de Recerca Biomèdica de Barcelona Doctor Aiguader, 88 | 08003 BarcelonaMedicalResearch.com Interveiw with: Mariona Pinart, PhD CREAL-Centre for Research in Environmental Epidemiology ISGlobal alliance Doctor Aiguader, 88 | 08003 Barcelona MedicalResearch.com: What are the main findings of the study? Answer: The study examined 23.434 children at 4 and 8 years from 12 ongoing European population-based birth cohort studies that recorded information on current eczema, rhinitis, and asthma from questionnaires and serum-specific IgE to six allergens. We wanted to assess how often eczema, rhinitis and asthma coexist in the same children (comorbidity) and whether the occurrence of comorbidities was due to causality or casualty and finally we wanted to examine whether the occurrence of comorbidity was modified by IgE sensitization. We found that comorbidity affects about 4% of children aged 4–8 years and that about 50% of this comorbidity is due to causality, suggesting that these diseases share common pathophysiological mechanisms. In addition, we found that children comorbidity at age 4 are 30 to 60 times more likely to have comorbidity at age 8 years, suggesting that the presence of comorbidity at age 4 years is a strong determinant of comorbidity at age 8 years. Even children with one single disease are also at high risk of developing comorbidity by age 8 years. Interestingly, we found that not only comorbidity is present in children both sensitized and not sensitized to IgE but also that only 38% of incident comorbidity at age 8 years is explained by the presence of IgE sensitization at age 4 years.
Author Interviews, Cancer Research, Lancet / 14.01.2014

MedicalResearch.com Interview with: Dr Jonathan Banks  Programme Manager: The Discovery Research Programme  Centre for Academic Primary Care  NIHR School for Primary Care Research  School of Social and Community Medicine  University of Bristol  Bristol BS8 2PSDr Jonathan Banks Programme Manager: The Discovery Research Programme Centre for Academic Primary Care NIHR School for Primary Care Research School of Social and Community Medicine University of Bristol  Bristol BS8 2PS MedicalResearch.com: What are the main findings of the study? Dr. Banks: We asked members of the public attending their local general practice or primary care centre to consider a series of hypothetical scenarios or vignettes which depicted cancer symptoms, their risk of cancer and the investigative processes involved in testing for cancer. We wanted to measure the point at which the risk of cancer outweighed the burden and inconvenience of testing in relation to lung, colorectal and pancreas cancers. Most people, around 88%, opted for testing even at the lowest risk of cancer which in our vignettes was 1%. Further analyses showed variation between cancers with fewer people opting for testing for colorectal cancer at a low (1%) risk and more people choosing to be tested for all cancers in the 60-69 age group.
Author Interviews, Lancet, Pulmonary Disease / 05.01.2014

Prof Sirpa Jalkanen MD, PhD MediCity Research Laboratory and Department of Medical Microbiology University of Turku Turku, FinlandMedicalResearch.com Interview with: Prof Sirpa Jalkanen MD, PhD MediCity Research Laboratory and Department of Medical Microbiology University of Turku Turku, Finland MedicalResearch.com: What are the main findings of the study? Answer: Pulmonary vascular leakage occurs early in acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Mortality is high (35-45%), but no effective pharmacotherapy exists. Production of anti-inflammatory adenosine by ecto-5’-nucleotidase (CD73) maintains endothelial barrier function. Interferon-beta-1a (IFN-beta) increases CD73 synthesis and might thus reduce vascular leakage and mortality in ALI/ARDS. We tested this hypothesis and the findings were as follows: 1.IFN-beta increased the number of CD73-positive vessels in human lung culture (4- and 14.3-fold on days 1 and 4 respectively, p=0.04 and 0.004). 2. The optimal tolerated FP-1201 dose (a unique intravenous formulation of interferon-beta 10 μg /day for six days) caused a significant rise in serum MxA (a marker for interferon response) and CD73 levels and a fall in interleukin-6 (an inflammatory cytokine) concentration. 3. Most importantly, odds of 28-day mortality was 81% lower in the treated than untreated subjects (8% vs 32%, OR[95% CI]0.19[0.03 to 0.72], p=0.01).
Author Interviews, Diabetes, Education, Lancet, Nutrition / 23.12.2013

Prof. Raj S Bhopal Bruce and John Usher Professor of Public Health Edinburgh Ethnicity and Health Research Group, Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH89AGMedicalResearch.com Interview with: Prof. Raj S Bhopal Bruce and John Usher Professor of Public Health Edinburgh Ethnicity and Health Research Group, Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH89AG MedicalResearch.com: What are the main findings of the study? Prof. Bhopal: In a randomised controlled trial, a tailored, family orientated intervention whereby dietitians worked in the family home to provide diet and exercise advice in people at high risk of developing diabetes, had a modest but potentially important effect in reducing weight at the end of the three-year intervention, by 1.6 kg more than in the control group.
Author Interviews, Lancet, Psychological Science, Sexual Health / 10.12.2013

Catherine H. Mercer Ph.D. Senior Lecturer UCL Centre for Sexual Health & HIV Research Research Department of Infection & Population Health University College London London U.K.MedicalResearch.com Interview with: Catherine H. Mercer Ph.D. Senior Lecturer UCL Centre for Sexual Health & HIV Research Research Department of Infection & Population Health University College London London U.K. MedicalResearch.com: What are the main findings of the study? Dr. Mercer: Firstly, the National Surveys of Sexual Attitudes and Lifestyles, Britain’s nationally-representative surveys of sexual behaviour (or Natsal for short), have captured substantial changes in sexual attitudes and lifestyles over the past 60 years, having collected data from over 45,000 people born between the 1930s and the 1990s – a period spanning much of the 20th Century. Secondly, the recent changes in behaviour that we have observed - so over the past decade - have however been considerably more marked for women than men, with the gender gap in reported behaviour narrowing, and in some cases, disappearing altogether. Thirdly, we’ve seen a greater acceptance of more diverse sexual lifestyles, such as same-sex sexual partnerships, but greater intolerance of what many people might consider as ‘disrespectful’ sexual partnerships, including non-exclusivity in marriage.
Author Interviews, Lancet, Sexual Health / 06.12.2013

Dr Kirstin R Mitchell PhD Lecturer in Sexual and Reproductive Health Dept of Social and Environmental Health Research Faculty of Public Health & Policy London School of Hygiene and Tropical Medicine 15-17 Tavistock Place  London WC1H 9SHMedicalResearch.com Interview with: Dr Kirstin R Mitchell PhD Lecturer in Sexual and Reproductive Health Dept of Social and Environmental Health Research Faculty of Public Health & Policy London School of Hygiene and Tropical Medicine MedicalResearch.com: What are the main findings of the study? Dr. Mitchell: We explored the distribution of sexual function in the British population using a probability sample survey (the third National Survey of Sexual Attitudes and Lifestyles [Natsal-3]) of 15 162 individuals aged 16–74 years. We measured sexual function using the Natsal-SF, a novel validated measure, which assessed problems with individual sexual response, sexual function in a relationship context, and self-appraisal of sex life. Men and women in the oldest age groups surveyed (55 – 74) were more likely to have low overall sexual function than those in the youngest age group (16 – 24). After taking account of age differences, low sexual function was associated in both men and women with being unemployed, with current depression, and with poor general health. It was also associated with higher numbers of lifetime partners (women only), paying for sex (men only), and reporting same-sex partners, as well as with other aspects of sexual health, such as being diagnosed with an STI and experiencing sex against their will. Low sexual function was associated with relationship breakdown, and with people not being happy with their relationship. Within relationships, the most common problem was an imbalance in level of interest in sex between partners, which affected around a quarter of both men and women. Just under one in five men and women said their partner had experienced sexual difficulties in the last year, and this proportion increased with age, particularly among women. Lack of interest in sex was one of the most commonly reported problems for both men and women, affecting three in every twenty (15%) men, and with women twice as likely as men to say that this had been an issue in the last year. Difficulty reaching climax (16%) and vaginal dryness (13%) were among common problems for women; and reaching a climax more quickly than desired (15%), and difficulty getting or keeping an erection (13%) among men.
Author Interviews, Lancet, Sexual Health / 02.12.2013

MedicalResearch.com Interview with: Dr Nigel Field MBPhD Research Department of Infection and Population Health University College London, London, UDr Nigel Field MBPhD Research Department of Infection and Population Health University College London, London, UK MedicalResearch.com: What are the main findings of the study?
 Dr. Field: This study, published in The Lancet on Tuesday 26 November, reports data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal), interviewing over 15,000 participants aged 16-74 years, to systematically assess the association between people’s health and their sexual lifestyles in Britain. The key findings from the study are that close to one in six (17%) of men and women feel that their health had affected their sex life in the past year. This rises to three fifths (60%) among men and women who say that they are in bad health. However, only a quarter of men (24%) and under a fifth of women (18%) who say that ill-health affects their sex life had sought help from a health profession, usually a family doctor.
Author Interviews, Lancet, Pulmonary Disease / 25.11.2013

Professor Clive Page Director, Sackler institute of Pulmonary Pharmacology Joint Head, Institute of Pharmaceutical Science King's College London 150 Stamford Street Waterloo Campus London SE1 9NHMedicalResearch.com Interview with: Professor Clive Page Director, Sackler institute of Pulmonary Pharmacology Joint Head, Institute of Pharmaceutical Science King's College London 150 Stamford Street Waterloo Campus London SE1 9NH MedicalResearch.com: What are the main findings of the study? Prof. Page: RPL 554 was shown to cause bronchodilation and anti-inflammatory activity at the same dose. The drug showed benefit in both patients with COPD and asthma.
Author Interviews, Hepatitis - Liver Disease, Lancet / 24.11.2013

Prof Eric Lawitz MD Vice President of Scientific and Research Development at The Texas Liver Institute Clinical professor of Medicine San Antonio University of Texas Health Science Center.MedicalResearch.com Interview with: Prof Eric Lawitz MD Vice President of Scientific and Research Development at The Texas Liver Institute Clinical professor of Medicine San Antonio University of Texas Health Science Center. MedicalResearch.com: What are the main findings of the study? Dr. Lawitz: Currently available treatments for HCV involve weekly injections of pegylated interferon and daily doses of oral antivirals that must be taken for up to a year.  These regimens are not only burdensome for patients, but are not always effective and can cause serious and debilitating side effects, including anemia. So there is a significant need for new tablet-based treatment regimens for HCV that eliminate interferon and ribavirin, are more effective, better tolerated and easier for patients to take.
Author Interviews, Breast Cancer, Chemotherapy, Lancet, MD Anderson / 24.11.2013

Dr. Kelly K. Hunt, M.D., 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: Dr. Kelly K. Hunt, M.D., 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: The primary endpoint of the Z1041 trial was the proportion of patients who had pathological complete response in the breast, defined as the percentage of women who started the neoadjuvant treatment with no histological evidence of disease in the breast at surgery.  We found that high pathologic response rates were observed in both treatment groups with similar cardiac safety profiles in both arms of the trial.  Specifically, 56.5% of patients in the sequential group (fluorouracil, epirubicin and cyclophosphamide on day one of a 21-day cycle for four cycles followed by paclitaxel plus trastuzumab weekly for 12 weeks) had a complete pathological response versus 54.2% of the patients who received the concurrent regimen (paclitaxel and trastuzumab weekly for 12 weeks followed by fluorouracil, epirubicin and cyclophosphamide on day one of a 21-day cycle with trastuzumab on days one, eight and 15 of the 21-day cycle for four cycles).  The difference in pathologic complete response rates between the treatment arms was not statistically significant.  Cardiac safety was a secondary endpoint of the trial and we found that both regimens had acceptable cardiac safety profiles.
Author Interviews, Brain Injury, Cognitive Issues, Lancet / 12.11.2013

prof_david_menonMedicalResearch.com Interview with: Prof David K Menon MD PhD FRCP FRCA FFICM FMedSci Head, Division of Anaesthesia, University of Cambridge 
Consultant, Neurosciences Critical Care Unit 
BOC Professor, Royal College of Anaesthetists Professorial Fellow, Queens' College, Cambridge Senior Investigator, National Institute for Health Research Box 93, Addenbrooke's Hospital, 
Cambridge CB2 2QQ, UK MedicalResearch.com: What is the background for your study? Dr. Menon: We have known for some time that a history of traumatic brain injury (TBI) results in a significant (between 2 and 10 fold) increase in the likelihood of getting dementia in later life.  On possible mechanistic explanation for this comes from the finding that about a third of individuals who died of TBI, regardless of age, are found at autopsy to have deposits of β-amyloid in the brain, often Aβ42, which is the same variant of amyloid seen in the brain of patients who have Alzheimer’s Disease. However, such detection after death has made it impossible to examine the linkage of such early amyloid deposition to late dementia.  More recently, imaging with positron emission tomography (PET) and Pittsburgh compound B (PIB) has been used to image amyloid deposits in Alzheimer’s  Disease.  However, the technique had not been validated in traumatic brain injury.
Author Interviews, Breast Cancer, Lancet, Radiation Therapy / 11.11.2013

Prof Jayant S Vaidya PhD Clinical Trials Group, Division of Surgery and Interventional Science University College London, London, UKMedicalResearch.com Interview with: Prof Jayant S Vaidya PhD Clinical Trials Group, Division of Surgery and Interventional Science University College London, London, UK MedicalResearch.com: What are the main findings of the study? Dr. Vaidya: The main findings are
  • a) these are longer term results that have confirmed our original publication in 201
  • (b) We found that when TARGIT intraoperative radiotherapy is given at the time of lumpectomy for breast cancer, the local control and survival from breast cancer is similar to several weeks of whole breast radiotherapy
  • c) we also found that with TARGIT there are significantly fewer deaths from other causes - i.e., fewer deaths from cardiovascular causes and other cancers
AHA Journals, Author Interviews, Lancet, Stroke / 07.11.2013

Dr. Colin Derdeyn Mallinckrodt Institute of Radiology and the Departments of Neurology and Neurosurgery Washington University School of Medicine, St Louis, MO, USAMedicalResearch.com Interview with: Dr. Colin Derdeyn Mallinckrodt Institute of Radiology and the Departments of Neurology and Neurosurgery Washington University School of Medicine, St Louis, MO, USA MedicalResearch.com: What are the main findings of the study?  Dr. Derdeyn: The primary results indicate that medical management, consisting of dual antiplatelets for 3 months after a transient ischemic attack (TIA) or stroke, and rapid, effective control of blood pressure (systolic BP less than 140 mm Hg and 130 mm Hg if diabetic) and LDL-cholesterol (less than 70 mg/dl), in addition to management of other risk factors, is superior to angioplasty and stenting in addition to the same medical regimen for reducing the risk of future stroke in patients with severe atherosclerotic stenosis (>70%) of a major intracranial artery.    In addition, while there were subgroups at higher risk for stroke on medical treatment (older age, female gender, prior stroke in the territory),  none of these subgroups appeared to have a benefit from stenting (i.e. stroke rates in the stenting groups in these subgroups was higher too).
Author Interviews, Lancet, Vaccine Studies / 01.11.2013

Dr Belén Pedrique Epidemiologist Drugs for Neglected Diseases initiative DNDi, 15 Chemin Louis Dunant 1202 Geneva, Switzerland MedicalResearch.com Interview with : Dr Belén Pedrique Epidemiologist Drugs for Neglected Diseases initiative DNDi, 15 Chemin Louis Dunant 1202 Geneva, Switzerland MedicalResearch.com : What are the main findings of the study? Dr. Pedrique: Of the 850 new drugs and vaccines approved for all diseases in 2000-2011, 4% (37) were for neglected diseases, defined broadly as those prevalent primarily in poor countries: malaria, tuberculosis, 17 neglected tropical diseases (NTDs) as defined by the World Health Organization (WHO), 11 diarrheal diseases, and 19 other diseases of poverty, excluding HIV/AIDS. Globally these neglected diseases represent an 11% health burden, based on a recent assessment of 2010 disability-adjusted life-years (DALYs). Most newly developed therapeutic products were repurposed versions of existing drugs. Of the 336 brand-new drugs (new chemical entities, or NCEs) approved for all diseases in 2000-2011, only four, or 1%, were for neglected diseases; three were for malaria, and one for diarrheal disease. None were for any of the 17 WHO-listed NTDs Of 148,445 phase I-III clinical trials registered as of Dec 31, 2011, only 1% (2,016) were for neglected diseases.
Author Interviews, Global Health, Infections, Lancet / 01.10.2013

Prof Didier Pittet, MD, MS Director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, SwitzerlandMedicalResearch.com Interview with : Prof Didier Pittet, MD, MS Director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland   MedicalResearch.com : What are the main findings of the study? Prof. Pittet: The main finding is that the WHO hand hygiene promotion strategy is feasible and sustainable across healthcare settings worldwide. For the first time, we have evidence of its feasibility and successful effects to improve hand hygiene in a variety of different geographical and income settings, with an even greater impact in low-/middle-income countries than in high-income countries.
Author Interviews, Cancer Research, Lancet, Prostate Cancer, Sloan Kettering / 26.09.2013

Dr. Ethan Basch MD Memorial Sloan-Kettering Cancer CenterMedicalResearch.com Interview with Dr. Ethan Basch MD Memorial Sloan-Kettering Cancer Center MedicalResearch.com: What are the main findings of the study? Dr. Basch: The primary clinical finding of this study is that treatment with abiraterone acetate delays the time until pain develops or worsens in men with advanced prostate cancer.  Furthermore, abiraterone delays the time until quality of life and functioning deteriorate, compared to placebo.  There is also a broader research finding of this study, which is that it is feasible to rigorously study the time until symptom progression in cancer clinical trials, which paves the way for future studies to use a similar approach.
Author Interviews, Lancet, Smoking / 20.09.2013

Dr. Chris Bullen MBChB MPH PhD FAFPM FNZCPHM Director School of Population Health, The University of Auckland Private Bag 92019 Auckland 1142, New Zealand Co-Director of the NZ Tobacco Control Research Turanga: A national programme of research to inform rapid smoking prevalence reduction.MedicalResearch.com Interview with:

Dr. Chris Bullen MBChB MPH PhD FAFPM FNZCPHM Director School of Population Health, The University of Auckland Private Bag 92019 Auckland 1142, New Zealand Co-Director of the NZ Tobacco Control Research Turanga: A national programme of research to inform rapid smoking prevalence reduction. Web: http://www.turanga.org.nz/ MedicalResearch.com: What are the main findings of the study? Dr. Bullen:
  • E-cigarettes, with or without nicotine, were modestly effective at helping smokers to quit, with similar levels of abstinence as with nicotine patches, and few adverse events.
  • ?At 6 months, verified abstinence was 7·3% with nicotine e-cigarettes, 5·8% with patches, and 4·1% with placebo e-cigarettes. However, there was insufficient statistical power to conclude superiority of nicotine e-cigarettes to patches or to placebo e-cigarettes.
  • No significant differences in rates of adverse events occurrence were found between the groups.
  • E-cigarettes, like the vapes found at MagicVaporizers, were very popular throughout the trial, with almost 90% of users stating they would recommend them to a friend trying to quit smoking.
Author Interviews, Breast Cancer, Cancer Research, Lancet / 20.09.2013

Prof Aron Goldhirsch Department of Medicine European Institute of Oncology Via Ripamonti 435, 20141 Milan, ItalyMedicalResearch.com Interview with: Prof Aron Goldhirsch Department of Medicine European Institute of Oncology Via Ripamonti 435, 20141 Milan, Italy MedicalResearch.com: What are the main findings of the study? Prof. Goldhirsch:  Two years of adjuvant trastuzumab after standard chemotherapy is not more effective than is 1 year of treatment with the drug for patients with HER2-positive early breast cancer.
Author Interviews, Breast Cancer, Lancet / 20.09.2013

Prof John R Yarnold Division of Radiotherapy and Imaging The Royal Marsden NHS Foundation Trust Sutton, Surrey SM2 5PT, UKMedicalResearch.com Interview with: Prof John R Yarnold Division of Radiotherapy and Imaging The Royal Marsden NHS Foundation Trust Sutton, Surrey SM2 5PT, UK   MedicalResearch.com: What are the main findings of the study? Prof. Yarnold: A 3-week schedule of curative post-operative radiotherapy for women with breast cancer involving 15 treatments (fractions) delivered Monday to Friday each week, is at least as safe and effective as historical schedules given over 5 or 6 weeks. In fact the 3-week schedule is gentler on the healthy tissues than earlier standard regimens.
Author Interviews, Lancet, OBGYNE / 20.09.2013

Prof Sally K Tracy DMid Midwifery and Women's Health Research Unit University of Sydney, Royal Hospital for Women Randwick, NSW, AustraliaMedicalResearch.com Interview with: Prof Sally K Tracy DMid Midwifery and Women's Health Research Unit University of Sydney, Royal Hospital for Women Randwick, NSW, Australia MedicalResearch.com: What are the main findings of the study? Prof. Tracy: We recruited 1748 pregnant women, of all risk types, from two tertiary teaching hospitals in different states in Australia and allocated them to receive either caseload midwifery care (871) or standard maternity care (877). The study found more women in caseload midwifery experienced an unassisted vaginal birth without pharmacological analgesia, and fewer women experienced an elective caesarean. While the trial findings did not show a statistically significant difference in the rate of caesarean sections between either group, the overall rate fell by more than 20 percent from pre-trial levels. Newborn infants in both groups achieved similar physical assessment scores (Apgar scores). A slightly lower number of pre-term births and neonatal intensive care admissions among the midwifery caseload group was not statistically significant. Important secondary findings of the study include:
  • 30 percent more spontaneous onset of labour
  • less induction of labour
  • less severe blood loss, and
  • stronger likelihood of breastfeeding at discharge from hospital.
These small differences accounted for an overall difference of AU$566.74 less with caseload midwifery than with standard care. Caseload midwifery appeared to alter some of the pathways that recurrently contribute to increased obstetric intervention.  Having this level of continuity of care works on the assumption that women will labour more effectively, need to stay in hospital less time and feel a stronger sense of satisfaction and personal control if they have the opportunity to get to know their midwife at the beginning of pregnancy.
Author Interviews, Gastrointestinal Disease, Infections, Lancet, Probiotics / 15.08.2013

Prof. Steve Allen Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow Room 314, The College of Medicine, Swansea University, Swansea, SA2 8PP, UK.Prof. Steve Allen Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow Room 314, The College of Medicine, Swansea University, Swansea, SA2 8PP, UK. MedicalResearch.com: What are the main findings of the study? Answer: Overall, diarrhoea occurred in just over 10% participants and diarrhoea caused by C. difficile in about 1%. These outcomes were equally common in those taking the microbial preparation and those taking placebo. Other outcomes (e.g. common GI symptoms, length of hospital stay, quality of life) were also much the same in the two groups. So, there was no evidence that the microbial preparation had prevented diarrhoea or had led to any other health benefit. In agreement with previous research, serious adverse events were also similar in the two groups – so we found no evidence that the microbial preparation caused any harm.