Medical Research Journals

MedicalResearch.com Interview with: [caption id="attachment_28124" align="alignleft" width="120"]Elvira Gosmanova MD Department of Nephrology University of Tennessee Health Science Center Memphis TN, 38163 Dr. Elvira Gosmanova[/caption] Elvira Gosmanova MD Department of Nephrology University of Tennessee Health Science Center Memphis TN, 38163 MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been long known that elevated blood pressure is a risk factor for numerous adverse health-related outcomes. However, the majority of individuals do not have blood pressure in a constant range. In contrary, blood pressure measured in the same individual tends to fluctuate over time. Moreover, some individuals have more blood pressure fluctuation, as compared with others. The impact of fluctuation in blood pressure is still poorly understood. Smaller studies suggested that increased fluctuation in blood pressure may be associated with hazardous health outcomes. However, large scale studies were still lacking. Therefore, we conducted a study involving close to 3 million US veterans to investigate the association of increased visit-to-visit variability of systolic blood pressure (which was our measure of fluctuation of blood pressure over time) and all-cause mortality, and incident coronary heart disease, stroke, and end-stage renal disease. We found that there was strong and graded increase in the risk of all the above outcomes with increasing visit-to-visit variability of systolic blood pressure.

MedicalResearch.com Interview with: [caption id="attachment_28116" align="alignleft" width="135"]Prof. John C. Mathers Director, Human Nutrition Research Centre Institute of Cellular Medicine and Newcastle University Institute for Ageing Newcastle University Biomedical Research Building Campus for Ageing and Vitality Newcastle on Tyne Prof. John C. Mathers[/caption] Prof. John C. Mathers Director, Human Nutrition Research Centre Institute of Cellular Medicine and Newcastle University Institute for Ageing Newcastle University Biomedical Research Building Campus for Ageing and Vitality Newcastle on Tyne MedicalResearch.com: What is the background for this study? Response: More than 90 different genetics variants are associated with body fatness and, of these, the FTO gene has the biggest effect. People who are homozygous for the unusual variant of FTO i.e. carry two copies of the risk allele, are on average 3kg heavier than those not carrying the risk allele. In addition, they have 70% greater risk of being obese. Since the FTO gene is associated with being heavier, we wondered whether it made it more difficult for people to lose weight.

MedicalResearch.com Interview with: [caption id="attachment_28141" align="alignleft" width="200"]Anat Mirelman, PhD Director- Laboratory of Early Markers of Neurodegeneration (LEMON) Center for the study of Movement , Cognition and Mobility (CMCM) Department of Neurology Tel Aviv Sourasky Medical Center Sackler School of Medicine, Tel Aviv University Tel Aviv 64239, Israel Dr. Anat Mirelman[/caption] Anat Mirelman, PhD Director- Laboratory of Early Markers of Neurodegeneration (LEMON) Center for the study of Movement , Cognition and Mobility (CMCM) Department of Neurology Tel Aviv Sourasky Medical Center Sackler School of Medicine, Tel Aviv University Tel Aviv 64239, Israel MedicalResearch.com: What is the background for this study? What are the main findings? Response: The main aim of this research was to evaluate the efficacy of using a motor cognitive training using virtual reality in reducing fall frequency and fall risk in older adults. Falls are a leading cause of morbidity and mortality in older adults. The prevalence of falls is huge, with one out of every 3 adults aged 65 years or older will fall at least once per year, with approximately half of these fallers suffering multiple falls in this period . These statistics are even higher in neurodegenerative conditions such as in Parkinson’s disease and in people with cognitive impairments. For example, studies have shown that as much as 80% of people with Parkinson’s disease fall each year. So many older adults are falling. The consequences of falls are huge. The most dramatic result is hip fracture. But this is relatively rare. However, even in the absence of a fracture or other injury, falls often lead to fear of falling, social isolation, and depression, which in turn often leads to inactivity, muscle weakness, impaired balance and gait, more falls, more social isolation. In other words, falls often start a vicious cycle, which has many important negative health consequences. Falls are associated with morbidity and mortality and they also have a huge economic impact. In many western countries, 1-2% of healthcare dollars are spent on falls. For many years, age-associated changes in muscle strength, balance and gait were viewed as the key factors that contribute to the risk of falls. However, more recently, we and others showed that certain aspects of cognition are also critical to safe ambulation. For example people with AD often fall, almost to the same amount as people with PD, highlighting the cognitive component of falls. This makes sense intuitively if we Imagine the cognitive skills we need just to cross a busy intersection. These tasks require executive function, specially, planning, the ability to avoid obstacles, and the ability to perform two or more tasks at the same time.

MedicalResearch.com Interview with: Nish Patel, MD and Nileshkumar J. Patel, MD University of Miami Miller School of Medicine MedicalResearch.com: What is the background for this study? Response: Out of hospital cardiac arrest (OHCA) is estimated to affect approximately 300,000 people in the United States annually. Pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) contributes 23-54% of OHCA patients, with the median values at the lower end of this range. Coronary artery disease is thought to be responsible for up to 70% of these OHCA cases. It has been suggested that urgent coronary intervention in unconscious patients after cardiac arrest may improve survival. In the 2015 American Heart Association (AHA) guidelines, coronary angiography is recommended in patients with OHCA patients with a suspected cardiac etiology and ST elevations (STE) on ECG (Class of recommendation I, Level of evidence B), and it should be considered in patients after cardiac arrest presenting without STE but with suspected cardiac etiology of cardiac arrest (Class of recommendation II a, Level of evidence B). However, there is paucity of information about the use of coronary angiography and percutaneous coronary intervention (PCI) and its potential benefit for the VT/VF OHCA patient population. Therefore, we reviewed the Nationwide Inpatient Sample (NIS), to examine temporal trends of coronary angiography and PCI in VT/VF OHCA in the United States, for patients with and without STE. We also studied the temporal trends of survival to discharge in these patient populations.

MedicalResearch.com Interview with: Islam Elgendy, MD Cardiology Fellow University of Florida MedicalResearch.com: What is the background for this study? What are the main findings? Response: The optimal systolic blood pressure target in adults with coronary artery disease is not well known. The Eighth Joint National Committee Panel recommended a target therapeutic goal <150 mm Hg for adults aged ≥60 years and <140 mm Hg in those aged <60 years. These recommendations are inconsistent with the different society guidelines (such as American Heart Association/American College of Cardiology, European Society of Cardiology, and American Society of Hypertension) which recommended a therapeutic target < 140 mm Hg. Given that the dyad of hypertension and coronary artery disease is the most prevalent chronic disease dyad among adults, we aimed to assess the long term risk of all-cause mortality with the different systolic blood pressure targets. Using the extended follow-up data from the US cohort of the INVEST trial, we demonstrated that achieving a systolic blood pressure of 130 to <140 mm Hg in the initial 2-3 years of treatment is associated with reduced all-cause mortality after ≈11.6 years of follow-up in hypertensive patients with coronary artery disease.

MedicalResearch.com Interview with: [caption id="attachment_28053" align="alignleft" width="200"]Layal Chaker, MD, MSc Research and Curriculum Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Boston, MA Dr. Layal Chaker[/caption] Layal Chaker, MD, MSc PhD candidate Department of Endocrinology and Epidemiology Erasmus Medical Center Rotterdam, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association of thyroid function with coronary heart disease is well–established but not much was known about the association of thyroid function with sudden cardiac death. We conducted the study with the hypothesis that thyroid hormone levels affect cardiovascular risk factors and therefore could also affect the risk of sudden cardiac death (SCD). We were surprised to see that when we control our analyses for these cardiovascular risk factors, the association of high and high-normal thyroid function with SCD remained similar, suggesting that other pathways could play a role. Thyroid hormone has different effects on the cardiovascular systems and future studies should identify which pathway could be responsible for the increased risk of sudden cardiac death with higher thyroid hormone levels. This could lead to better assessment of individual risk and identify possible prevention targets.

MedicalResearch.com Interview with: [caption id="attachment_28049" align="alignleft" width="133"]Dr. Daria Van Tyne, PhD The Gilmore Lab Department of Ophthalmology Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, Massachusetts Dr. Daria Van Tyne[/caption] Dr. Daria Van Tyne, PhD The Gilmore Lab Department of Ophthalmology Harvard Medical School Massachusetts Eye and Ear Infirmary Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: A specific clone of E. coli, type ST131, which produces an extended-spectrum beta-lactamase (ESBL – an enzyme that inactivates many penicillin-type antibiotics), has rapidly spread around the globe to become the leading cause of multidrug-resistant, non-intestinal E. coli infection. Despite this, E. coli is a rare cause of infection of the cornea. A patient was recently seen at the Massachusetts Eye and Ear Infirmary with a severe E. coli infection of the cornea, and the large number of antibiotic resistances of this strain tipped us off to the possibility that it might be the highly virulent ST131 ESBL type. By sequencing the DNA of its genome, we found that it was indeed ST131 ESBL E. coli. Moreover, we discovered a new mutation in this strain that allows it to produce a slimy outer coating on its surface. This slime layer, or capsule, makes the bacteria more resistant to removal by phagocytic cells of the immune system. The slime layer also makes these particular colonies appear different on a special type of agar that contains the dye Congo Red.

MedicalResearch.com Interview with: [caption id="attachment_28022" align="alignleft" width="165"]Holly Mattix-Kramer, MD, MPH</strong> Public Health Sciences Medicine, Nephrology Associate Professor Loyola Medicine, Illinois Dr. Holly Mattix-Kramer[/caption] Holly Mattix-Kramer, MD, MPH Public Health Sciences Medicine, Nephrology Associate Professor Loyola Medicine, Illinois MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that the Systolic Blood Pressure Lowering Intervention Trial (SPRINT) showed that intensive systolic blood pressure lowering reduces all-cause mortality by 27% compared to standard blood pressure lowering among adults age 50 years and older without diabetes or stroke but with high cardiovascular disease risk. We applied these findings to the U.S. population and asked "What if intensive systolic blood pressure lowering were applied to the U.S. population who meet SPRINT eligibility criteria? We found that approximately 18.1 million U.S. adults meet SPRINT criteria and that their annual mortality rate is 2.2%. If intensive systolic blood pressure lowering reduces all-cause mortality by 27%, then the annual mortality rate would be reduced to 1.6% and approximately 107,500 deaths would be prevented each year.

MedicalResearch.com Interview with: [caption id="attachment_27999" align="alignleft" width="146"]Ilana B. Richman, MD Palo Alto VA Health Care System, Palo Alto, California Center for Primary Care and Outcomes Research/Center for Health Policy Department of Medicine Stanford University School of Medicine Stanford, California Dr. Ilana B. Richman[/caption] Ilana B. Richman, MD Palo Alto VA Health Care System, Palo Alto, California Center for Primary Care and Outcomes Research/Center for Health Policy Department of Medicine Stanford University School of Medicine Stanford, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: In November of 2015, researchers published results from the Systolic Blood Pressure Intervention Trial (SPRINT). This large, NIH-funded study compared a systolic blood pressure target of 120 mm Hg vs 140 mm Hg among hypertensive, nondiabetic patients at elevated risk for cardiovascular disease. SPRINT reported a 25% reduction in the rate of cardiovascular disease and death among those treated to a lower target. Those treated to a lower target blood pressure, though, experienced certain adverse events more frequently. Our cost effectiveness analysis asked two questions: given the potential risks and benefits described in SPRINT, does achieving a lower systolic blood pressure result in net benefit over the course of a lifetime? And if it does, how much would it cost, compared to standard treatment? We found that achieving a lower blood pressure target does result in a net benefit, with a gain of about 0.9 years of life (quality adjusted) among those treated to a lower target compared to those treated to a standard target. This gain, though, required some investment. We found that treating to a lower blood pressure target cost $23,777 per quality-adjusted life year gained. Compared to other commonly used interventions here in the US, this would be considered an excellent value.

MedicalResearch.com Interview with: [caption id="attachment_27981" align="alignleft" width="104"]Dr. Joseph Leigh Simpson Dr. Joseph Leigh Simpson[/caption] Joseph Leigh Simpson, MD FACOG, FACMG President at International Federation of Fertility Societies March of Dimes Foundation White Plains, NY MedicalResearch.com: What is the background for this study? Response: Preterm birth (PTB) is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. A total of 1.1 million infants die each year. Preterm births and their complications are the leading cause of deaths in children under age 5. The biological basis of preterm birth remains poorly understood, and for that reason, preventive interventions are often empiric and have only limited benefit. Large differences exist in preterm birth rates across high income countries: 5.5 percent in Sweden and at present 9.6 percent in the U.S. The International Federation of Gynecologists and Obstetricians (FIGO)/March of Dimes Working Group on Preterm Birth Prevention hypothesized that identifying the risk factors underlying these wide variations could lead to interventions that reduce preterm birth in countries having high rates.

MedicalResearch.com Interview with: Taulant Muka, MD, MPH, PhD Postdoctoral Researcher Erasmus University, Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: Menopause marks a major life transition for women, resulting in the loss of ovarian follicle development. Although menopause is a universal phenomenon among women, the timing of the final menstrual period differ greatly between women, and is considered a marker of aging. By quantifying data of nearly 310,329 non-overlapping women, we found that women who experienced an early menopause (i.e. younger than 45 years) have an excess risk of CHD, CVD-mortality and all-cause mortality. Furthermore, being 45-49 years at menopause compared to ≥50 years was associated with increased risk of carotid atherosclerosis.

MedicalResearch.com Interview with: Tehillah S. Menes, MD Department of Surgery Tel Aviv-Sourasky Medical Center Tel Aviv, Israel MedicalResearch.com: What is the background for this study? Response: Atypical ductal hyperplasia (ADH) is a known risk factor for breast cancer. The diagnosis is made by a biopsy showing a uniform proliferation of cells lining the ducts of the breast. These cells have monomorphic round nuclei and characteristically fill only part of the involved duct. Women diagnosed with ADH are recommended to undergo increased surveillance and offered chemoprevention (i.e. Tamoxifen) for risk reduction. Most studies reporting on the risk of subsequent breast cancer in women with ADH were done prior to the wide use of screening mammography and percutaneous needle biopsy. Our study examined 10-year risk of invasive breast cancer in women diagnosed with ADH (by needle biopsy or excisional biopsy), using data collected by the Breast Cancer Surveillance Consortium (BCSC).

MedicalResearch.com Interview with: [caption id="attachment_27929" align="alignleft" width="133"]Kevin S. LaBar, Ph.D. Professor and Head, Cognition & Cognitive Neuroscience Program Co-Director of Undergraduate Studies in Neuroscience Center for Cognitive Neuroscience Duke University Durham, NC Dr. Kevin LaBar[/caption] Kevin S. LaBar, Ph.D. Professor and Head, Cognition & Cognitive Neuroscience Program Co-Director of Undergraduate Studies in Neuroscience Center for Cognitive Neuroscience Duke University Durham, NC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Emotion research is limited by a lack of objective markers of emotional states. Most human research relies on self-report, but individuals may not have good insight into their own emotions. We have developed a new way to identify emotional states using brain imaging and machine learning tools. First, we induced emotional states using film and music clips while individuals were in an MRI scanner. We trained a computer algorithm to identify the brain areas that distinguished 7 emotions from each other (fear, anger, surprise, sadness, amusement, contentment, and a neutral state). This procedure created a brain map for each of the 7 emotions. Then, a new group of participants self-reported their emotional state every 30 seconds in an MRI scanner while no stimuli were presented. We could predict which emotion was spontaneously reported by the subjects by comparing their brain scans to each of the 7 emotion maps. Finally, in a large group of 499 subjects, we found that the presence of the fear map during rest predicted state and trait anxiety while the presence of the sadness map predicted state and trait depression.

MedicalResearch.com Interview with: [caption id="attachment_27922" align="alignleft" width="150"]Professor Jenny Donovan  PhD   OBE FMedSci NIHR-SI AcSS FFPHM Director, NIHR CLAHRC West (National Institute for Health Research Collaboration for  Leadership in Applied Health Research and Care West) at University Hospitals Bristol NHS Trust Bristol, UK Prof. Jenny Donovan[/caption] Professor Jenny Donovan  PhD OBE FMedSci NIHR-SI AcSS FFPHM Director, NIHR CLAHRC West (National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West) at University Hospitals Bristol NHS Trust Bristol, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: PSA testing identifies many men with prostate cancer, but they do not all benefit from treatment. Surgery, radiation therapy and various programs of active monitoring/surveillance can be given as treatments for fit men with clinically localized prostate cancer. Previous studies have not compared the most commonly used treatments in terms of mortality, disease progression and patient-reported outcomes. In the ProtecT study, we used a comprehensive set of validated measures, completed by the men at baseline (before diagnosis), at six and 12 months and then annually for six years. The main finding is that each treatment has a particular pattern of side-effects and recovery which needs to be balanced against the findings from the paper reporting the clinical outcomes (Hamdy et al).

MedicalResearch.com Interview with: [caption id="attachment_27808" align="alignleft" width="149"]Gillian D. Sanders-Schmidler Ph.D. Professor of Medicine Duke Evidence Synthesis Group, Director Duke Evidence-based Practice Center, Director Duke Clinical Research Institute Duke University Dr. Gillian D. Sanders-Schmidler[/caption] Gillian D. Sanders-Schmidler Ph.D. Professor of Medicine Duke Evidence Synthesis Group, Director Duke Evidence-based Practice Center, Director Duke Clinical Research Institute Duke University MedicalResearch.com: What is the background for this study? Response: In 1996, the original panel on cost effectiveness in health and medicine published recommendations for the use of cost effectiveness analysis. During the 20 years since the original panel’s report, the field of cost-effectiveness analysis has advanced in important ways and the need to deliver health care efficiently has only grown. In 2012 the Second Panel on Cost Effectiveness in health and Medicine was formed with a goal of reviewing and updating the recommendations. This paper summarizes those recommendations. This process provided an opportunity for the Panel to reflect on the evolution of cost-effectiveness analysis and to provide guidance for the next generation of practitioners and consumers.

MedicalResearch.com Interview with: [caption id="attachment_27715" align="alignleft" width="114"]Larissa A. Meyer, MD MPH F.A.C.O.G. Assistant Professor Dept of Gynecologic Oncology and Reproductive Medicine Houston, TX 77030-1362 Dr. Larissa Meyer[/caption] Larissa A. Meyer, MD MPH F.A.C.O.G. Assistant Professor Dept of Gynecologic Oncology and Reproductive Medicine Houston, TX 77030-1362 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the completion of two randomized controlled trials, controversy regarding the optimal approach for the treatment of advanced ovarian cancer remains. Our observational study highlights the importance of thoughtful selection of individuals for primary cytoreductive surgery for advanced ovarian cancer. Our results suggest that primary cytoreductive surgery may improve survival for patients with stage IIIC ovarian cancer who are likely to achieve an optimal cytoreduction, while neoadjuvant chemotherapy may be the preferred option for many women with stage IV ovarian cancer.

MedicalResearch.com Interview with: Johanna M. Uitti, MD Department of Paediatrics and Adolescent Medicine Turku University Hospital Turku, Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: According to several national guidelines, close follow-up is required if initial observation without antimicrobial agents is chosen for the management of acute otitis media (AOM) in children. The aim of this study was to examine whether close follow-up with reexamination is needed for children with AOM initially managed without antimicrobial agents who have symptomatic improvement during the first week after diagnosis, as assessed by their parents. Of the 104 children with symptomatic improvement, 3 (2.9%) developed worse signs or perforation of the tympanic membrane as seen on otoscopy. In contrast, of the 54 children with symptomatic failure, 16 (29.6%) developed worse signs or perforation of the tympanic membrane as seen on otoscopy.

MedicalResearch.com Interview with: [caption id="attachment_27794" align="alignleft" width="144"]Pooja Rao, MD, MSCE Assistant Professor Division of Pediatric Hematology/Oncology Milton S. Hershey Medical Center Penn State College of Medicine Dr. Pooja Rao[/caption] Pooja Rao, MD, MSCE Assistant Professor Division of Pediatric Hematology/Oncology Milton S. Hershey Medical Center Penn State College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although many chemotherapy drugs can cause birth defects, no standardized guidelines exist for pregnancy screening in adolescent female patients with cancer. Additionally, little is known about how often they are screened prior to receiving treatment. Our study found that adolescent girls are not adequately screened for pregnancy prior to receiving chemotherapy or CT scans that could potentially harm a developing fetus. Adolescents with acute lymphoblastic leukemia, the most common childhood cancer, had the lowest pregnancy screening rates of the patients studied.

MedicalResearch.com Interview with: [caption id="attachment_27901" align="alignleft" width="150"]Prof. Xavier Jouven Service de Cardiologie Hôpital Européen Georges Pompidou Paris Prof. Xavier Jouven[/caption] Prof. Xavier Jouven Service de Cardiologie Hôpital Européen Georges Pompidou Paris MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many cardiac arrests (around 300 000 per year in United States). The possibility to collect organs from a certain proportion of those cardiac arrests represents an important opportunity to fill the gap of the organ shortage. It is absolutely mandatory to identify patients with no chance of survival. This study showed 3 criteria which allow this early identification. Several thousands of patients die every year waiting for organ transplantation.

MedicalResearch.com Interview with: [caption id="attachment_27845" align="alignleft" width="200"]R. Grant Steen, PhD Medical Affairs, Bioventus LLC Durham, North Carolina Dr. R. Grant Steen[/caption] R. Grant Steen, PhD Medical Affairs, Bioventus LLC Durham, North Carolina MedicalResearch.com: What is the background for this study? What are the main findings? Response: When we started this research, it was really only guesswork as to how big a problem fracture nonunion really is. What we've done is to work with an enormous database of patient health claims, with two goals. First, we wanted to characterize how common fracture nonunion is among patients across a wide age range. Second, we wanted to identify risk factors that make a patient more likely to have problems healing. We've now succeeded in both aims. We know that roughly 5% of fracture patients will go to nonunion, and we know a whole host of risk factors that predispose them to do so. Most of the risk factors that we've identified—with a few exceptions—would not be a surprise to physicians who treat fracture patients. However, what we've done is to put all of these risk factors in a broader context, so that we know which risk factors are most important and which are less so. For example, it has been known for a long time that smoking is a risk factor for nonunion. What we've shown is that, in the scheme of things, it's not all that important. Let me be more precise here, because this is an important point. If all you know about a patient is that they smoke, we've shown that smoking is associated with a 62% increase in risk of nonunion. That's a lot. But, as you learn more about that patient and can factor that new knowledge into a risk prediction, it turns out that smoking, all by itself, increases the risk of nonunion by only about 20%. However, smoking is a surrogate marker for a range of other risk factors that also increase risk, including male gender, cardiovascular disease, obesity, vitamin D deficiency, alcoholism, and so on. Once you factor these separate risk factors into your new nonunion prediction, you have a much more nuanced—and probably much more accurate—prediction of nonunion risk.

MedicalResearch.com Interview with: Laura M. Gottlieb, MD, MPH Department of Family and Community Medicine, 2Center for Health and Community University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous studies have demonstrated that childhood exposures to social adversities, like family financial insecurity, food insecurity, and housing instability, lead to poorer health outcomes across the life course. These social adversities disproportionately affect low-income and racial minority populations. In response to this evidence there have been calls to address social needs in pediatric clinical care settings. For example, recently the American Academy of Pediatrics’ Task Force on Childhood Poverty endorsed the promotion of evidenced-based strategies to reduce the negative health effects of poverty on low-income children, including by increasing the availability of clinic-based interventions addressing social risks. In response to these calls to action, a growing number of pediatric health care organizations are screening for and address families’ social needs. There is a critical need for more evidence on the effectiveness of these types of interventions. Many of the studies conducted so far have focused primarily on assessing program process outcomes or impacts on families’ social needs, but have not evaluated actual health outcomes resulting from program participation. To our knowledge, this study was the first randomized clinical trial evaluating the impacts of a pediatric social needs navigation program on child health. The reported number of social needs identified at baseline ranged from 0 to 11 out of 14 possible items, with a mean [SD] of 2.7[2.2] needs identified by participating families. Family participation in the navigation program intervention significantly decreased families’ reports of social needs by a mean (SE) of .39(0.13) vs. an increase of a mean (SE) of .22(0.13) in the active control arm. Participation in the navigation program also significantly improved parent-reported overall child health, with a mean (SE) change of -.036(0.05), compared to the active control arm with a mean (SE) change of -0.12(0.05). At 4 months post enrollment, the number of social needs reported by those that participated in the navigation program decreased by a mean (SE) of .39(0.13).

MedicalResearch.com Interview with: Ayodele Odutayo, DPhil student Centre for Statistics in Medicine Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Oxford, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atrial fibrillation is associated with an increased risk of all cause mortality and stroke, as well as higher medical costs and a reduced quality of life. The association between atrial fibrillation and cardiovascular outcomes other than stroke is less clear. We found that atrial fibrillation is associated with a wide range of cardiovascular events, including cardiovascular mortality, major cardiovascular events, heart failure, ischaemic heart disease, chronic kidney disease, and sudden cardiac death, as well as stroke and all cause mortality. The relative and absolute risk increase associated with many of these events is greater than that of stroke. Interventions are needed to reduce the risk of non-stroke cardiovascular outcomes in adults with atrial fibrillation.

MedicalResearch.com Interview with: [caption id="attachment_27789" align="alignleft" width="200"]Armando E. del Río Hernández, PhD European Research Council Fellow Head, Cellular and Molecular Biomechanics Laboratory http://biomechanicalregulation-lab.org/ Senior Lecturer, Department of Bioengineering Imperial College London Dr. del Río Hernández[/caption] Armando E. del Río Hernández, PhD European Research Council Fellow Head, Cellular and Molecular Biomechanics Laboratory http://biomechanicalregulation-lab.org/ Senior Lecturer, Department of Bioengineering Imperial College London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pancreatic cancer is an extremely aggressive disease with an unacceptably low survival rate that has not changed during the last 40 years despite significant efforts aimed at developing therapies against cancer cells. Pancreatic cancer is characterised by an extensive desmoplasia, which forms the majority of the tissue around the tumour. This desmoplastic tissue is known to help the tumour to grow and metastasize, and hinders drug delivery. We have focused our efforts on understanding how pancreatic stellate cells (PSCs), which are the key effectors that orchestrate the desmoplastic reaction in pancreatic cancer, can promote tumour progression. PSCs in healthy pancreas have abundant vitamin A storage in their cytoplasm and exist in a quiescent state that guarantees a balanced tissue homeostasis. In pancreatic cancer, loss of this balance activates PSCs, which lose the vitamin A content and remodel the surrounding tissue to make it favourable for cancer cell invasion. We found that treating PSCs which ATRA (All trans-retinoic acid), the active metabolite of vitamin A mechanically reprograms PSCs to promote quiescence in vitro. Quiescent PSCs are unable to remodel the microenvironment to allow pancreatic cancer cell invasion. To get more information about our findings please find the article in the open access journal Nature Communications:http://www.nature.com/articles/ncomms12630

MedicalResearch.com Interview with: [caption id="attachment_27772" align="alignleft" width="157"]Patricia Ducy, PhD Associate Professor Department of Pathology & Cell Biology Columbia University New York, NY 10032 Dr. Patricia Ducy[/caption] Patricia Ducy, PhD Associate Professor Department of Pathology & Cell Biology Columbia University New York, NY 10032 MedicalResearch.com: What is the background for this study? Response: In the past few years, several large clinical studies have reported an association between the use of selective serotonin reuptake inhibitors (SSRIs) and an increased risk of bone fractures. Yet, a few studies conducted on small cohorts using these drugs for a short time showed a decrease in bone resorption parameters and thus minor bone gain. To understand this paradox and to define how the deleterious effect of SSRIs could be prevented we conducted a series of studies in mice treated with fluoxetine, the active molecule of the widely prescribed SSRI Prozac.

MedicalResearch.com Interview with: Sheila Eckenrode, RN, CPHQ Project Manager Medicare Patient Safety Monitoring System (MPSMS) Qualidigm MedicalResearch.com: What is the background for this study? What are the main findings? Response: We sought to investigate the association at the hospital-level between 21 in-hospital adverse event rates and both mortality and readmission rates for Medicare Fee-For-Service patients with AMI. We used data from the Medicare Patient Safety Monitoring System (MPSMS), the nation's largest randomly selected hospital medical record-abstracted patient safety database, and data from the Centers for Medicare & Medicaid Services, which includes hospital performance on mortality and readmissions for over 4,000 Medicare-certified hospitals, to assess the association between hospital performance on patient safety and hospital performance on 30-day all-cause mortality and readmissions for Medicare fee-for-service patients discharged with AMI. We found that hospital performance on patient safety is associated with hospital performance on mortality and readmission rates for AMI. Hospitals with poorer patient safety performance are likely to have higher 30-day all-cause mortality and readmission rates for these patients.

MedicalResearch.com Interview with: [caption id="attachment_27754" align="alignleft" width="146"]Andrew C. Eppstein, MD, FACS Assistant Professor of Clinical Surgery Indiana University School of Medicine Department of Surgery, Division of General Surgery Richard L. Roudebush VA Medical Center Indianapolis, Indiana Dr. Andrew Eppstein[/caption] Andrew C. Eppstein, MD, FACS Assistant Professor of Clinical Surgery Indiana University School of Medicine Department of Surgery, Division of General Surgery Richard L. Roudebush VA Medical Center Indianapolis, Indiana MedicalResearch.com: What is the background for this study? What are the main findings? Response: A few years ago we encountered long wait times for patients undergoing elective general surgery in our tertiary care VA medical center. Demand had grown and our existing systems were not able to accommodate surgical patients in a timely fashion. By fiscal year (FY) 2012, our wait times averaged 33 days, though patients with malignancies would be moved to the head of the line, pushing more elective cases further back. To address rising demand and worsening wait times, our Surgery Service convened an analysis of our processes using Lean methodology in collaboration with the Systems Redesign Service. Multidisciplinary meetings were held in 2013 to analyze inefficiencies in the current system and ways to address them to create a streamlined, ideal system. The collaborations included surgeons, nurses, ancillary staff, operating room and sterile processing staff, and hospital administration. Projects were rolled out stepwise in mid-2013 under General Surgery, the busiest surgical service at our institution. We noted a sharp decline in patient wait times after initiation of reforms such as improved OR flexibility, scheduling process changes, standardization of work within the department, and improved communication practices. These wait times dropped to 26 days in FY 2013 and further to 12 days in FY 2014, while operating volume and overall outpatient evaluations increased, with decreased no-shows to clinic. Our decreased wait times were sustained through the remainder of the observed period.

MedicalResearch.com Interview with: [caption id="attachment_27762" align="alignleft" width="200"]Conny Vrieling, M.D., Ph.D. Radiation Oncologist Clinique des Grangettes Geneva Dr. Conny Vrieling[/caption] Conny Vrieling, M.D., Ph.D. Radiation Oncologist Clinique des Grangettes Geneva MedicalResearch.com: What is the background for this study? Response: In the early ’90s, the EORTC (European Organisation for Research and Treatment of Cancer) ran the “boost no-boost” trial, randomizing 5569 early-stage breast cancer patients, treated with breast-conserving surgery and whole-breast irradiation, between no boost and a 16-Gy boost. A third of the patients were included in a central pathology review. The 10-year follow-up results of this subpopulation showed that young age and high-grade invasive carcinoma were the most important risk factors for ipsilateral breast tumor recurrence (IBTR). In this study, we re-analyzed with long-term follow-up the pathological prognostic factors related to IBTR, with a special focus on the evolution of these effects over time.

MedicalResearch.com Interview with: [caption id="attachment_27742" align="alignleft" width="133"]Dr. Francisco Garcí Task Force member and director Chief medical officer Pima County Department of Health Tucson, AZ Dr. Francisco Garcia[/caption] Dr. Francisco García M.D. M.P.H. Task Force member and Director and Chief medical officer at Pima County Department of Health Tucson, AZ MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tuberculosis infection is one of the most common infectious diseases in the world. Although less common in the United States, many people still become infected every year and are at risk of getting sick and spreading the infection to others. We know there are effective screening tests that can detect latent tuberculosis infection before people become sick with active tuberculosis disease. Additionally, there are effective treatments to prevent people from progressing from latent tuberculosis infection to active tuberculosis disease. Thus, for people with increased risk of contracting tuberculosis, the Task Force recommends screening for latent tuberculosis infection. People who are considered at increased risk include those who were born in or have lived in countries where tuberculosis is highly prevalent, or who have lived in congregate settings where exposure to tuberculosis is more likely, such as homeless shelters or correctional facilities.

MedicalResearch.com Interview with: Dr. Joel G. Ray MD, MS, FRCPC Professor, Department of Medicine, University of Toronto Professor Department of Obstetrics and Gynecology St. Michael’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have little information about the fetal safety to of MRI in the first trimester of pregnancy, or that of MRI with gadolinium contrast performed at any point in pregnancy.

MedicalResearch.com Interview with: [caption id="attachment_27630" align="alignleft" width="142"]Dr. Kevin J. Whitehead MD Adjunct Associate Professor, Pediatrics Associate Professor, Internal Medicine University of Utah Dr. Kevin Whitehead[/caption] Dr. Kevin J. Whitehead MD Adjunct Associate Professor, Pediatrics Associate Professor, Internal Medicine University of Utah MedicalResearch.com: What is the background for this study? Response: Hereditary hemorrhagic telangiectasia (or Osler-Weber-Rendu Syndrome) is a genetic vascular malformation syndrome that results in arteriovenous malformations. This syndrome is found in 1:5000 individuals, and is inherited in autosomal dominant fashion. It is often under diagnosed by the medical community (some estimate that 90% of patients do not know that they are affected). In the skin and mucous membranes small AVMs - termed telangiectasias - form, and they have the potential to rupture and bleed. This happens most commonly in the nose, and 95% of patients with HHT have recurrent nose bleeding (epistaxis). While other dangerous internal organ AVMs also form, epistaxis is the most important determinant of quality of life for these patients. This epistaxis can lead to anemia, heart failure and rarely death. Patients often seek therapy for epistaxis, but cautery or laser treatment of the telangiectasias tends to provide only temporary benefit. Definitive therapy to eliminate epistaxis requires surgical closure of the nasal passages, and is too drastic for most patients. We sought to test medical therapy for HHT-related epistaxis with our best candidate drugs in nose spray form. The drugs with the most anecdotal support include bevacizumab (an anti-angiogenic drug), estriol (an estrogen), and tranexamic acid (an inhibitor of fibrinolysis). Our patients received a nose spray with one of these drugs or a saline placebo and used two sprays in each nostril daily for 12 weeks and recorded their nose bleed frequency and duration in a daily diary.