NEJM

26 Mar

Posted at 22:10h in Autism, Genetic Research, NEJM, UCSD
MedicalResearch.com Interview with: Dr. Erik Courchesne PhD Professor, Department of Neurosciences UC San Diego School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Courchesne: “Building a baby’s brain during pregnancy involves creating a cortex that contains six layers,” Courchesne said. “We discovered focal patches of disrupted development of these cortical layers in the majority of children with autism.” The authors created the first three-dimensional model visualizing brain locations where patches of cortex had failed to develop the normal cell-layering pattern. The study found that in the brains of children with autism key genetic markers were absent in brain cells in multiple layers. “This defect,” Courchesne said, “indicates that the crucial early developmental step of creating six distinct layers with specific types of brain cells – something that begins in prenatal life – had been disrupted.”  The study gives clear and direct new evidence that autism begins during pregnancy.

19 Mar

Posted at 19:24h in Author Interviews, Biomarkers, Colon Cancer, NEJM
Dr. Thomas Imperiale MD Professor of Medicine, Indiana University School of Medicine Research Scientist, Indiana University Center for Health Services and Outcomes Research Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc. Core Investigator, VA HSR&D Center for Health Information and CommunicationMedicalResearch.com Interview Invitation with: Dr. Thomas Imperiale MD Professor of Medicine, Indiana University School of Medicine Research Scientist, Indiana University Center for Health Services and Outcomes Research Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc. Core Investigator, VA HSR&D Center for Health Information and Communication MedicalResearch.com: What are the main findings of the study? Dr. Imperiale: The main findings are the performance characteristics of the multi-target test (sensitivity of 92.3%, specificity of 86.6%) and its performance as compared with the commercial FIT: more sensitive for colorectal cancer and advanced precancerous polyps, but less specific.

13 Mar

Posted at 11:57h in Author Interviews, NEJM, Outcomes & Safety, Surgical Research
David R. Urbach, M.D From the Institute for Clinical Evaluative Sciences Department of Surgery Institute of Health Policy, Management and Evaluation University of Toronto, the University Health Network Toronto, ON M5G 2C4, CanadaMedicalResearch.com Interview with: David R. Urbach, M.D From the Institute for Clinical Evaluative Sciences Department of Surgery Institute of Health Policy, Management and Evaluation University of Toronto, the University Health Network Toronto, ON M5G 2C4, Canada MedicalResearch.com: What are the main findings of the study? Dr. Urbach: After surgical safety checklists were adopted by hospitals in Ontario, surgical outcomes—death after surgery, complications, length of stay, readmissions—did not improve substantially.

06 Mar

Posted at 17:56h in Author Interviews, NEJM, Prostate Cancer, Surgical Research

MedicalResearch.com Interview with: Anna Bill-Axelson MD, PhD Department of Urology Uppsala University Hospital Uppsala, Sweden MedicalResearch.com: What are the main findings of this study? Dr. Bill-Axelson: The main finding is that surgery reduces prostate cancer mortality but not all men need curative treatment. After up to 23 years of follow up we found that men with low-risk tumors did not...

27 Feb

Posted at 17:16h in Author Interviews, Dengue, Infections, NEJM, Respiratory
Valérie D'Acremont, MD, PhD Group leader Swiss Tropical and Public Health Institute | Basel | Switzerland Médecin-adjointe, PD-MER Travel clinic | Department of Ambulatory Care and Community Medicine | University hospital of Lausanne | SwitzerlandMedicalResearch.com Interview with: Valérie D'Acremont, MD, PhD Group leader Swiss Tropical and Public Health Institute | Basel | Switzerland Médecin-adjointe, PD-MER Travel clinic | Department of Ambulatory Care and Community Medicine | University hospital of Lausanne | Switzerland MedicalResearch.com: What are the main findings of the study? Dr. D'Acremont: We discovered that, in a rural and an urban area of Tanzania, half of the children with fever (temperature >38°C) had an acute respiratory infection, mainly of the upper tract (5% only had radiological pneumonia). These infections were mostly of viral origin, in particular influenza. The other children had systemic viral infections such as HHV6, parvovirus B19, EBV or CMV. Overall viral diseases represented 71% of the cases. Only a minority (22%) had a bacterial infection such as typhoid fever, urinary tract infection or sepsis due to bacteremia. Malaria was found in only 10% of the children, even in the rural setting.

23 Feb

Posted at 00:45h in Infections, NEJM
Dr. T. M. A van Dongen, MD Univ Med Ctr Utrecht Julius Ctr Hlth Sci & Primary Care, Dept Epidemiol Utrecht, Netherlands.MedicalResearch.com Interview with: Dr. T. M. A van Dongen, MD Univ Med Ctr Utrecht Julius Ctr Hlth Sci & Primary Care, Dept Epidemiol Utrecht, Netherlands. MedicalResearch.com: What are the main findings of the study? Answer: We performed a pragmatic trial, in which we randomly assigned 230 children who had acute tympanostomy-tube otorrhea to receive antibiotic-glucocorticoid eardrops, oral antibiotics or to undergo initial observation. The primary outcome of our study was the presence of ear discharge, 2 weeks after study-group assignment. We also looked at, among others, the duration of the initial otorrhea episode and the total number of days of otorrhea and the number of otorrhea recurrences during 6 months of follow-up. We found that antibiotic–glucocorticoid eardrops were superior to oral antibiotics and initial observation for all outcomes.

22 Feb

Posted at 21:30h in Author Interviews, Brain Cancer - Brain Tumors, Cancer Research, NEJM
Minesh P. Mehta, M.B., Ch.B. F.A.S.T.R.O. Professor of Radiation Oncology, University of Maryland School of Medicine Radiation oncologist, University of Maryland Marlene and Stewart Greenebaum Cancer Center, Chair, RTOG brain tumor committeeMedicalResearch.com Interview with: Minesh P. Mehta, M.B., Ch.B. F.A.S.T.R.O. Professor of Radiation Oncology, University of Maryland School of Medicine Radiation oncologist, University of Maryland Marlene and Stewart Greenebaum Cancer Center MedicalResearch.com: What are the main findings of the study? Dr. Mehta: RTOG 0825 was a clinical trial evaluating whether the addition of a novel drug that inhibits tumor vascular growth, bevacizumab, to the standard of care for glioblastoma, an aggressive brain tumor, would prolong survival. Patients were allocated randomly to one of two different treatment regimens – the standard of care, which includes radiotherapy and a drug known as temozolomide, or another regimen of radiation, temozolomide and bevacizumab. The trial design was double-blinded, and therefore, on one arm patients received the bevacizumab, whereas on the other arm they received a placebo. The survival on both arms was equivalent, and therefore it was fairly concluded that bevacizumab failed to prolong survival when given initially as part of treatment for glioblastoma. Freedom from progression, referred to as progression-free survival was also measured on this trial, and although bevacizumab appeared to lengthen progression-free survival, this level of benefit did not meet the pre-defined goals, and is therefore regarded as statistically not demonstrating an improvement. Additional endpoints included outcomes reported by the patient, including the burden of symptoms, and the impact of these on the quality of life, as well as effects on the brain, known as neurocognitive changes. Bevacizumab did not improve these endpoints either.

20 Feb

Posted at 13:59h in Author Interviews, Cancer Research, Chemotherapy, NEJM
Krishnansu S. Tewari, MD, FACOG, FACS| Professor & Director of Research Principal Investigator - The Gynecologic Oncology Group at UC Irvine The Division of Gynecologic Oncology University of California, Irvine Medical Center Orange, CA 92868MedicalResearch.com Interview with: Krishnansu S. Tewari, MD, FACOG, FACS| Professor & Director of Research Principal Investigator - The Gynecologic Oncology Group at UC Irvine, Division of Gynecologic Oncology University of California, Irvine Medical Center Orange, CA 92868 MedicalResearch.com: What are the main findings of the study? Dr. Tewari: The main findings of this study were that the addition of bevacizumab to chemotherapy resulted in a significantly improved survival of 3.7 months in a population of patients that have very limited options. This improvement in overall survival was not accompanied by any significant deterioration in quality of life and serious side effects were limited to 3% to 8% of the study population.

14 Feb

Posted at 13:51h in Author Interviews, Genetic Research, Hematology, NEJM

MedicalResearch.com Interview with: Jun-ichi Nishimura, M.D., Ph.D. Assistant Professor Department of Hematology and Oncology Osaka University Graduate School of Medicine C9, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan MedicalResearch.com: What are the main findings of the study? Dr. Nishimura: Our major findings are a C5 mutation (c.2654G→A) in Japanese patients with PNH prevents binding and blockade by...

13 Feb

Posted at 18:18h in Author Interviews, Johns Hopkins, NEJM
MedicalResearch.com Interview with: Dr. Richard P. Allen Department of Neurology Johns Hopkins University Baltimore, MD 21224, MedicalResearch.com: What are the main findings of the study? Dr. Allen:  This study should serve to change medical practice by reducing use of pramipexole and ropinirole to avoid the insidious worsening of restless legs syndrome that occurs for many on these drugs. Pramipexole (Mirapex) a medication that mimics dopamine in the brain  in usual therapeutic doses for treatment of restless legs syndrome (RLS) works at first but over time one year makes the disease worse for up to 9% of the patients on 0.5 mg a day. Pregabalin (Lyrica) an anti-convulsant and pain drug  that works on a calcium channel in the brain in therapeutic dose for RLS (300 mg a day) does not make the disease worse  (There is some natural progression of the disease shown to occur fro 1 - 2% or patients over a year.. seen in this study). Pregabalin is in the short run as effective as pramipexole (over 12 weeks) and in the long run over 52 weeks more effective. These results confirm what had been expected that the dopamine drug pramipexole makes worse Restless Legs Syndrome while a drug not directly acting on the dopamine system does NOT make restless legs syndrome worse.

02 Feb

Posted at 14:38h in Alzheimer's - Dementia, Author Interviews, Baylor College of Medicine Houston, NEJM
Rachelle S. Doody, M.D.,Ph.D. Effie Marie Cain Chair in Alzheimer's Disease Research Director, Alzheimer's Disease and Memory Disorders Center Baylor College of Medicine-Department of Neurology Houston, Texas 77030: MedicalResearch.com MedicalResearch.com Interview with: Rachelle S. Doody, M.D.,Ph.D. Effie Marie Cain Chair in Alzheimer's Disease Research Director, Alzheimer's Disease and Memory Disorders Center Baylor College of Medicine-Department of Neurology Houston, Texas 77030: MedicalResearch.com MedicalResearch.com: What are the main findings of the study?  Dr. Doody: The study set out to see whether the antibody infusion treatment, Solanezumab, would improve the course of mild to moderate Alzheimer's disease in the ways necessary to gain drug approval.  Unfortunately, the results did not support an approvable treatment for this purpose.

24 Jan

Posted at 15:21h in Alzheimer's - Dementia, Author Interviews, NEJM

MedicalResearch.com Interview with: Stephen Salloway, MD, MS Director of Neurology and the Memory and Aging Program, Butler Hospital Professor of Neurology and Psychiatry Warren Alpert Medical School Brown University MedicalResearch.com: What are the main findings of this study? Dr. Salloway:  With the aging of the population, the G-8 and the US Congress have made finding...

15 Jan

Posted at 19:54h in Author Interviews, Gastrointestinal Disease, NEJM, Pediatrics, Vaccine Studies
W. Katherine Yih Ph.D., M.P.H Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care InstituteMedicalResearch.com Interview with: W. Katherine Yih Ph.D., M.P.H Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute MedicalResearch.com:  What are the main findings of the study? Dr. Yih: The main findings are that vaccination with the first dose of RotaTeq is associated with a small increase in the risk of intussusception, which is concentrated in the first week after vaccination.  The estimated risk is about 1.5 excess cases per 100,000 first doses administered.  This risk is fairly small, amounting to roughly 1/10 of the risk seen after the original rotavirus vaccine (called Rotashield) that was used in 1998-1999, before it was withdrawn from the market. We also found evidence that Rotarix increases the risk of intussusception.  However, the number of infants receiving Rotarix and the number getting intussusception after Rotarix were too small to allow us to estimate the risk after Rotarix with any precision.

15 Jan

Posted at 00:08h in Author Interviews, Gastrointestinal Disease, Infections, NEJM, Vaccine Studies
MedicalResearch.com Interview with Eric S. Weintraub, M.P.H. Epidemiologist at Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? Mr. Weintraub: While current rotavirus vaccines were not associated with intussusception in large pre-licensure trials, recent post-licensure data (from international settings) suggest the possibility of a low risk of intussusception occurrence after receipt of monovalent rotavirus vaccination (RV1).  We examined the risk of intussusception following RV1 vaccination in a U.S. population.  In this study of more than 200,000 doses of RV1, a slight increased risk of intussusception was observed after vaccination, which should be considered in light of the benefits of preventing rotavirus associated illness.

04 Jan

Posted at 00:57h in Author Interviews, Menopause, NEJM, Osteoporosis
Michael McClung, MD Founding Director, Oregon Osteoporosis Center 5050 NE Hoyt Street, Suite 626 Portland, OR 97213MedicalResearch.com Interview with Michael McClung, MD Founding Director, Oregon Osteoporosis Center 5050 NE Hoyt Street, Suite 626 Portland, OR 97213 MedicalResearch.com: What are the main findings of the study? Dr. McClung: In this Phase 2 trial, each of five romosozumab dose regimens significantly increased BMD compared with pooled placebo groups at the lumbar spine, total hip and femoral neck regions (all p<0.001). The largest increases were observed with the romosozumab 210 mg once-monthly dose, with mean increases, compared with baseline, of 11.3 percent at the lumbar spine, 4.1 percent at the total hip and 3.7 percent at the femoral neck.

02 Jan

Posted at 19:37h in Accidents & Violence, Author Interviews, NEJM
MedicalResearch.com Interview with: Sheila G. Klauer, Ph.D Virginia Tech Transportation Institute MedicalResearch.com: What are the main findings of the study? Dr.Klauer: We found that novice drivers are especially at risk of crash/near-crash involvement when engaging in secondary tasks that take their eyes off of the forward roadway.  This includes tasks with wireless devices such as texting, dialing, and reaching for the device as well as reaching for any object, eating, and looking at objects along the roadway.  We also found that the prevalence of engaging in these high risk tasks increases over time which concerns traffic safety researchers.  This is particularly concerning with the proliferation of highly capable smart phones where teens can do not only texting but also sending pictures, watching video, skype, etc.

26 Dec

Posted at 13:15h in Author Interviews, NEJM, Orthopedics, Surgical Research
MedicalResearch.com Interview with: Raine Sihvonen, M.D. From the Department of Orthopedics and Traumatology Hatanpää City Hospital, Tampere Finland MedicalResearch.com: What are the main findings of the study? Dr. Järvinen: The main finding of the study is that arthroscopic partial meniscectomy is not superior over sham-surgery (placebo) when treated patients with knee pain attributable to degenerative  meniscus tear, even in the `best-case-scenario, that is patients with no knee OA.

19 Dec

Posted at 12:49h in Author Interviews, Biomarkers, Connective Tissue Disease, NEJM
Prof. Dr. T.R.D.J. Radstake, MD, PhD Staff Rheumatologist / head translational Immunology Department of Rheumatology & Clinical Immunology EULAR Center of Excellence Director, UMC Utrecht Infection and Immunity FOCIS Center of Excellence University Medical Center Utrecht, The NetherlandsMedicalResearch.com Interview with: Prof. Dr. T.R.D.J. Radstake, MD, PhD Staff Rheumatologist / head translational Immunology Department of Rheumatology & Clinical Immunology EULAR Center of Excellence Director, UMC Utrecht Infection and Immunity FOCIS Center of Excellence University Medical Center Utrecht, The Netherlands MedicalResearch.com: What are the main findings of the study? Prof. Radstake: We observed that the chemokine CXCL4 is highly produced by so-called plasmacytoid dendritic cells in systemic sclerosis (Ssc). CXCL4 is associated with the progression and clinical phenotype of Ssc and thus provides a tool for clinicians to identify those patients in need for aggressive therapy and on the other hand, avoid unnecessary side-effects for those who have mild disease. Moreover, the identified roles for CXCL4 in SSc sparks our knowledge on the pathogenic pathways at hand in this terrible conditions. Now, we and other groups will have to further unravel the precise roles for CXCL4 in SSc and possibly other fibrotic and immune mediated conditions that cover the spectrum of medicine.

15 Dec

Posted at 23:42h in Author Interviews, Flu - Influenza, NEJM, Pediatrics, Vaccine Studies
Ghassan Dbaibo, M.D., FAAP Professor and Vice-Chair for Research and Faculty Development Department of Pediatrics and Adolescent Medicine Head, Division of Pediatric Infectious Diseases Director, Center for Infectious Diseases Research Professor, Department of Biochemistry and Molecular Genetics American University of Beirut Beirut, LebanonMedicalResearch.com Interview with: Ghassan Dbaibo, M.D., FAAP Professor and Vice-Chair for Research and Faculty Development Department of Pediatrics and Adolescent Medicine Head, Division of Pediatric Infectious Diseases Director, Center for Infectious Diseases Research Professor, Department of Biochemistry and Molecular Genetics American University of Beirut Beirut, Lebanon MedicalResearch.com: What are the main findings of the study? Dr. Dbaibo:
  • 55% efficacy (95% CI 39–67%) for prevention of all influenza
  • These results are comparable with other estimates of efficacy and effectiveness for trivalent inactivated flu vaccines in this age group
  •  73% efficacy (97.5% CI 47–86%) for prevention of moderate-to-severe influenza
  • By preventing moderate-to-severe influenza, vaccination prevented the most clinically consequential outcomes of infection, reducing hospitalisations by 75% and medical visits by 69%.
  • Seroprotection rates of more than 95% for each of the four influenza strains in the vaccine
  • An acceptable safety and reactogenicity profile

06 Dec

Posted at 18:47h in Author Interviews, NEJM, OBGYNE
MedicalResearch.com Interview with: Aniket D. Kulkarni, M.B., B.S., M.P.H Women's Health and Fertility Branch Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: What are the main findings of the study? Dr. Kulkarni: Our study estimates the contribution of fertility treatments and natural conception to multiple births. Fertility treatments include IVF and non-IVF treatments. Non-IVF treatments primarily include ovulation induction and ovarian stimulation coupled with timed intercourse or intrauterine insemination (IUI). All estimated proportions were adjusted for maternal age which makes this study unique. The incidence of twin births nearly doubled and the incidence of triplet and higher-order births quadrupled over the last 4 decades. Our study estimates that by 2011, a total of 36% of twin births and 77% of triplet and higher-order births resulted from conception assisted by fertility treatments, after adjusting for maternal age. After initial increase, the incidence of triplet and higher order births decreased by 29% from 1998 to 2011. The decrease in triplet and higher order births has coincided with a 70% reduction in the transfer of 3 or more embryos during IVF and a 33% decrease in the proportion of triplet and higher order births attributable to IVF. The decline in the number of embryos transferred during IVF became possible due to monitoring of ART treatments and outcomes and the work of professional societies, which have repeatedly revised practice guidelines to include recommendations for lowering the number of embryos transferred. In contrast, non-IVF fertility treatments of ovulation induction and ovarian stimulation are estimated to contribute the increasing number of multiple births. Hence there is a need for surveillance of births from non-IVF fertility treatments.

22 Nov

Posted at 16:36h in Author Interviews, Cancer Research, Lymphoma, NEJM
Kieron M. Dunleavy, M.D. Metabolism Branch Lymphoma Therapeutics Section Staff Clinician Center for Cancer Research National Cancer Institute Bethesda, MD 20892MedicalResearch.com Interview with Kieron M. Dunleavy, M.D. Metabolism Branch Lymphoma Therapeutics Section Center for Cancer Research National Cancer Institute, Bethesda, MD 20892 MedicalResearch.com: What are the main findings of the study? Dr. Dunleavy: We found that low-intensity therapy was highly effective in Burkitt's lymphoma and cured over 95% of patients with the disease.

14 Nov

Posted at 18:25h in Author Interviews, NEJM, Urinary Tract Infections
Thomas M. Hooton M.D. Associate Chief of Staff, Medical Service, Miami VA Healthcare System Professor of Clinical Medicine and Vice Chair for VA Affairs, Department of Medicine, UMSOM Clinical Director, Division of Infectious Diseases, UMSOMMedicalResearch.com Interview with: Thomas M. Hooton M.D. Professor of Medicine and Vice Chair for VA Affairs, University of Miami Miller School of Medicine Associate Chief of Staff, Medical Service, Miami VA Healthcare System Clinical Director, Division of Infectious Diseases MedicalResearch.com: What are the main findings of the study? Dr. Hooten: The main findings from this study are: ·        Voided urine colony counts of E. coli as low as 101 to 102 cfu/mL are highly sensitive and specific for their presence in bladder urine in symptomatic women (growth of bacteria in bladder urine is the gold standard for the etiology of UTI). Moreover, even when E. coli is found along with other mixed flora in voided urine, it should not be considered a contaminant since it likely represents true bladder infection. ·        On the other hand, enterococci and Group B streptococci, which are frequently isolated from voided urine, are rarely isolated from paired catheter specimens, suggesting that these organisms only rarely cause acute uncomplicated cystitis. In our study, E. coli frequently grew from the urines of these women and is the likely cause for UTI symptoms in such episodes. ·        Organisms usually considered contaminants, such as lactobacilli, occasionally grow from catheter urines, but they are rarely found alone with pyuria, suggesting that these bacteria rarely cause acute uncomplicated cystitis. ·        The etiology of a quarter of acute uncomplicated cystitis episodes is unknown.  It is possible that some of these women have E. coli urethritis, which has been documented in some women with UTI symptoms, but we did not do further studies to evaluate this. It is possible also that enterococci and Group B streptococci may also cause urethritis, but there is no published evidence of this in young women with UTI symptoms. ·        Although voided urine cultures growing mixed flora are common in women with acute cystitis, true polymicrobic cystitis, as determined by sampling bladder urine, appears to be rare in this population.

24 Oct

Posted at 14:15h in Allergies, Author Interviews, NEJM
MedicalResearch.com Interview with: Dr. Jian-Jun Liu Shangdong Provincial Institute of Dermatology and Venereology MedicalResearch.com: What are the main findings of the study? Answer: ·      HLA-B*13:01 is associated with the development of dapsone hypersensitivity syndrome. ·      Carrying one copy of HLA-B*13:01 increases one’s risk by 34 times of getting DHS, while carrying two copies increases risk by 100 times as compared to not carrying this allele. ·      HLA-B*13:01 has a sensitivity and specificity of above 85% in predicting the risk of DHS, theoretically reducing the risk of DHS by 7 fold when implemented in clinical screening.

09 Oct

Posted at 18:11h in Author Interviews, NEJM, OBGYNE
Associate scientist Sunnybrook Health Sciences Centre 2075 Bayview Ave., Room M4 172a Toronto, ON M4N 3M5MedicalResearch.com Interview with: Jon Barrett, M.B.Bch., FRCOG, MD, FRCSC Associate scientist Sunnybrook Health Sciences Centre 2075 Bayview Ave., Room M4 172a Toronto, ON M4N 3M5 MedicalResearch.com: What are the main findings of the study? Dr. Barrett: For twins at 32-38 weeks gestation where Twin A is presenting cephalic a policy of planned CS does not benefit the baby or the mother, compared to a policy of planned VB, and planned CS will result in delivery at a earlier gestational age.

26 Sep

Posted at 12:30h in Author Interviews, C. difficile, Infections, NEJM
MedicalResearch.com Interview with: David W. Eyre, B.M., B.Ch. Nuffield Department of Clinical Medicine University of Oxford National Institute for Health Research (NIHR) Oxford Biomedical Research Centre John Radcliffe Hospital MedicalResearch.com: What are the main findings of this study? Dr. Eyre: All cases of Clostridium difficile in Oxfordshire were studied over 3 years. Isolates were characterized by whole genome sequencing and the data was linked to hospital databases allowing epidemiological relationships between patients at the level of the hospital ward, hospital specialty, and post code to be identified. For comparison, similar information was also available for all other patients with and without diarrhea.  Preliminary work on the genetic diversity of Clostridium difficile within individuals and between individuals within discrete outbreaks allowed reliable interpretation of transmission events using genomic data. This allowed a complete reconstruction of the pattern of transmission between affected cases in Oxfordshire to be made. The findings were: 1. Unexpectedly few cases (13%) appear to be acquired from direct ward based contact with other symptomatic cases (these have previously been thought to be the main source of infections, and the focus of prevention efforts). Another 6% were associated with other hospital contact and 3% had plausible community contacts. 2. In 13% of cases potential donors were identified gnomically but no contact, within hospitals or the community, were identified. This suggests that the existence of other modes of transmission of Clostridium difficile. 3. The sources of Clostridium difficile infections were highly genetically diverse, with 45% of cases having a genetically distinct origin - suggesting a diverse reservoir of disease, not previously appreciated 4. During the 3 years of the study the rate of Clostridium difficile in Oxfordshire fell.  Any improvement in infection control techniques would be expected to reduce the incidence of cases caused by within hospital transmission. Surprisingly, similar rates of fall occurred in both in secondary cases (considered to be acquired from hospital associated symptomatic cases) and for primary cases (cases not associated with transmission from symptomatic cases).

19 Sep

Posted at 12:16h in Author Interviews, CMAJ, Colon Cancer, NEJM
Aasma Shaukat, M.D., M.P.H. Dept. of Medicine GI Division, MMC 36 University of Minnesota Minneapolis, MN 55455MedicalResearch.com Interview with: Aasma Shaukat, M.D., M.P.H. Dept. of Medicine GI Division, MMC 36 University of Minnesota Minneapolis, MN 55455 MedicalResearch.com: What are the main findings of the study? Dr. Shaukat: The study showed that screening for colon cancer using stool cards consistently reduces risk of death from colon cancer by one-third through thirty years. The benefit of screening in larger in men compared to women, and for women the benefit seems to start at age 60. However, screening did not make people live longer.

11 Sep

Posted at 19:40h in Author Interviews, Johns Hopkins, NEJM, Pulmonary Disease
MedicalResearch.com Interview with: Dr. Robert A. Wise MDMedicalResearch.com Interview with: Dr. Robert A. Wise MD Professor of Medicine Johns Hopkins University School of Medicine 5501 Hopkins Bayview Circle Baltimore, MD 21224   MedicalResearch.com: What are the main findings of the study?
 Dr. Wise: The TIOSPIR trial was a landmark study, one of the largest ever conducted for chronic obstructive pulmonary disease (COPD).  It was designed to test the comparative safety and effectiveness of two delivery devices of tiotropium, a long-acting bronchodilator.  One formulation is the Respimat multi-dose soft mist inhaler and the other formulation is the single dose HandiHaler dry powder inhaler. After following more than 17000 patients for an average of 2.3 years, TIOSPIR showed that there was no difference in either the safety in terms of mortality or adverse cardiovascular events between the two devices.  Moreover, both devices showed similar effectiveness in terms of time to first COPD exacerbation. A lung function substudy in 1370 patients showed that the 5 microgram dose of Respimat was equivalent to the HandiHaler as a bronchodilator, but the 2.5 microgram dose was not quite as effective.

02 Sep

Posted at 19:37h in Author Interviews, Heart Disease, NEJM
MedicalResearch.com Interview with: Massimo Imazio, MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital-ASLTO2 via Cibrario 72 10141 Torino, Italy MedicalResearch.com: What are the main findings of the study? Dr. Imazio: In a multicenter, double-blind trial, eligible adults with acute pericarditis (idiopathic/viral, post-pericardiotomy syndromes and pericarditis related to a systemic inflammatory disease) were randomly assigned to receive either colchicine (at a dose of 0.5 mg twice daily for 3 months for patients weighing >70 kg or 0.5 mg once daily for patients weighing ≤70 kg) or placebo in addition to conventional anti-inflammatory therapy with aspirin or ibuprofen. The primary study outcome was incessant or recurrent pericarditis. After a mean follow-up of 22 months (minimum 18 months) the primary outcome occurred in 20 patients (16.7%) in the colchicine group and 45 patients (37.5%) in the placebo group (relative risk reduction in the colchicine group, 0.56; 95% confidence interval, 0.30 to 0.72; number needed to treat, 4; P<0.001).

29 Aug

Posted at 12:56h in Author Interviews, NEJM, OBGYNE
MedicalResearch.com Interview with: Ms. Mølgaard-Nielsen Statens Serum Institut Artillerivej 5, 2300 Copenhagen S, Denmark MedicalResearch.com: What are the main findings of the study? Answer: Use of oral fluconazole during early pregnancy did not increase the risk of birth defects overall in common therapeutic doses. We also looked at 15 individual birth defects of previous concern and oral fluconazole was not associated with an increased risk for 14 of these birth defects.  However, we did see an increase in the risk of tetralogy of Fallot, an uncommon congenital heart defect, but the number of exposed cases was few.

27 Jul

Posted at 02:17h in Author Interviews, NEJM
Wendy Chung, MD PhD Herbert Irving Associate Professor of Pediatrics and Medicine Director of Clinical Genetics Columbia University 1150 St. Nicholas Avenue, Room 620 New York, NY 10032MedicalResearch.com Interview with: Wendy Chung, MD PhD Herbert Irving Associate Professor of Pediatrics and Medicine Director of Clinical Genetics Columbia University 1150 St. Nicholas Avenue, Room 620 New York, NY 10032 MedicalResearch.com: What are the main findings of the study? Dr. Chung: We have identified a potassium channel as a new genetic cause of pulmonary hypertension and demonstrated it as a cause of pulmonary hypertension in patients with familial disease and sporadic disease without a family history of pulmonary hypertension.  In vitro we were able to rescue several of the mutations pharmacologically.  This potassium channel now provides a new target for treatment for pulmonary hypertension.