Author Interviews, Brigham & Women's - Harvard, Electronic Records, JAMA, Outcomes & Safety / 04.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26595" align="alignleft" width="80"]Stephanie Mueller, MD MPH FHM Division of General Medicine Brigham and Women's Hospital Boston, MA 02120 Dr. Stephanie Mueller[/caption] Stephanie Mueller, MD MPH FHM Division of General Medicine Brigham and Women's Hospital Boston, MA 02120 MedicalResearch.com: What is the background for this study?  Response: Failures in communication among healthcare personnel are known threats to patient safety, and occur all too commonly during times of care transition, such as when patient care responsibility is transferred from one provider to another (i.e., handoff). Such failures in communication put patients at risk for adverse outcomes.
Asthma, Author Interviews, NEJM, Pediatrics / 04.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26649" align="alignleft" width="100"]Donata Vercelli, MD Professor of Cellular and Molecular Medicine, University of Arizona Director, Arizona Center for the Biology of Complex Diseases Associate Director, Asthma and Airway Disease Research Center The BIO5 Institute, Rm. 339 Tucson, AZ 85721 Dr. Donata Vercelli[/caption] Donata Vercelli, MD Professor of Cellular and Molecular Medicine, University of Arizona Director, Arizona Center for the Biology of Complex Diseases Associate Director, Asthma and Airway Disease Research Center The BIO5 Institute Tucson, AZ 85721 MedicalResearch.com: What is the background for this study? Response: By probing the differences between two farming communities—the Amish of Indiana and the Hutterites of South Dakota—our interdisciplinary team (which included, among others, Erika von Mutius from Ludwig-Maximilians University in Munich, Carole Ober and Anne Sperling from the University of Chicago, and myself) found that substances in the house dust from Amish, but not Hutterite, homes shape the innate immune system in ways that may prevent the development of allergic asthma. Growing up in a microbe-rich farm environment has been known to protect against asthma. Our current study extends these findings by showing that in both humans and mice protection requires engagement of the innate immune system. The Amish and Hutterite farming communities in the United States, founded by immigrants from Central Europe in the 18th and 19th centuries, provide textbook opportunities for comparative studies. The Amish and the Hutterites have similar genetic ancestry and share lifestyles (e.g., family size, diet, lack of exposure to indoor pets) known to affect asthma risk. However, their farming practices differ. The Amish have retained traditional methods, live on single-family dairy farms and rely on horses for fieldwork and transportation. In contrast, the Hutterites live on large communal farms and use modern, industrialized farm machinery. This distances young Hutterite children from the constant daily exposure to farm animals.
Author Interviews, Breast Cancer, MRI, PLoS / 02.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26671" align="alignleft" width="75"]Barbara Bennani-Baiti, MD, MS Dr. Bennani-Baiti[/caption] Barbara Bennani-Baiti, MD, MS and [caption id="attachment_26672" align="alignleft" width="69"]Pascal Andreas Baltzer MD Dr. P. Baltzer[/caption] Pascal Andreas Baltzer MD Departement of Biomedical Imaging and Nuclear Medicine Medical University of Vienna Vienna, Austria MedicalResearch.com: What is the background for this study? What are the main findings? Response: Breast MRI ist the most sensitive method for detecting breast cancer. It is currently routinely used in the screening of high-risk patients and as an additional imaging technique in case of inconclusive conventional imaging (mammography and ultrasound). Besides its high sensitivity for detection of breast cancer, breast MRI further provides functional information about normal breast tissue perfusion. Background parenchymal enhancement (BPE) reflects the perfusion or vascularization of the breast and is generally higher in active breast tissue. High-risk patients harbor breast tissue that is at an elevated risk for breast cancer due to several factors (i.e. mutations such as BRCA1, high familial risk, previous radiation of the chest wall, etc.). After a connection between increased breast cancer odds and elevated BPE has been shown in high-risk patients, the community has since assumed that an elevated background enhancement at breast MRI equates an elevated risk for breast cancer for all women. We have shown that this not true for women that are not considered high-risk. In fact, the only risk factor for women undergoing breast MRI without additional risk factors is age.
Author Interviews, Brigham & Women's - Harvard, JAMA, Nutrition, Protein, Vegetarians / 02.08.2016

MedicalResearch.com Interview with: Mingyang Song Sc.D, research fellow Clinical and Translational Epidemiology Unit and Division of Gastroenterology MGH and Department of Nutrition Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have been focused on the amount of protein intake, while little is known regarding the health effect of different food sources for protein intake. In this study, we found that high animal protein intake was associated with higher mortality, whereas high plant-based protein was associated with lower mortality. Replacement of animal protein with plant protein was associated with lower mortality. Overall, the findings support the importance of food sources for protein intake for long-term health outcomes.
Author Interviews, Brain Injury, JAMA, Pediatrics / 02.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26633" align="alignleft" width="142"]Danny G. Thomas, MD, MPH Department of Pediatrics, Emergency Medicine Children’s Hospital of Wisconsin Corporate Center Milwaukee, WI Dr. Danny Thomas[/caption] Danny G. Thomas, MD, MPH Department of Pediatrics, Emergency Medicine Children’s Hospital of Wisconsin Corporate Center Milwaukee, WI MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a secondary analysis of a randomized controlled trial of strict rest after concussion published last year. We wanted to find out how mental and physical activity levels related to symptom spikes or sudden increases in concussion symptoms. We found that one in three patients had symptoms spikes in recovery. Patients who had symptom spikes tended to have higher symptoms in the emergency department and throughout recovery. Most symptom spikes were not associated with an increase in physical and mental activity level the day prior. We did find that a sudden increase in activity like returning to school did increase the risk of having a symptom spike, but the good news is these symptom spikes seemed to resolve the following day and did not impact recovery by 10 days.
AHA Journals, Author Interviews, Brigham & Women's - Harvard, Heart Disease, Omega-3 Fatty Acids / 02.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26637" align="alignleft" width="120"]Raymond Y. Kwong, MD MPH Director of Cardiac Magnetic Resonance Imaging Associate Professor of Medicine Harvard Medical School Dr. Raymond Kwong[/caption] Raymond Y. Kwong, MD MPH Director of Cardiac Magnetic Resonance Imaging Associate Professor of Medicine Harvard Medical School MedicalResearch.com: What is the background for this study? Response: In the past several decades, Omega-3 fatty acids (O3FA) primarily from fish oil have been reported to have many beneficial effects, either directly on the heart or through other effects that indirectly help the heart. However, when it was tested on patients who suffered an acute heart attack by looking at whether patients can live longer by taking omega-3 fatty acids early after the heart attack, there has been some conflicting data in some of the large clinical trials. There are several major factors that inspired the designs of the current OMEGA-REMODEL study: a) Over recent years, many highly effective treatments to improve the survival of heart attack victims have become routine. b) The studies in the past used a relatively lower dose of  Omega-3 fatty acids (1g per day). c) Some have also raised the question whether just patient mortality should be the only/best way we should considered in assessing new treatments for heart attack patients. d) Cardiac remodeling: after a heart attack, heart muscle not damaged by the initial heart attack insult has to overwork to compensate for the damage from the heart attack. Over time scarring may form in the overworked heart muscle, in addition to weakened heart function, may lead to the heart to fail. e)New imaging method: a MRI of the heart, can precisely determine the heart function and the amount of scarring of the overworked heart muscle not damaged from the heart attack.
Aging, Author Interviews, Diabetes, Diabetologia / 29.07.2016

MedicalResearch.com Interview with: Dr. Stephanie Read, PhD University of Edinburgh, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: The number of people living with type 2 diabetes in Scotland is increasing. We wanted to identify to what extent this trend was due to people living longer with type 2 diabetes or due to increasing numbers of new cases each year.
Author Interviews, Exercise - Fitness, Lancet, Lifestyle & Health / 29.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26511" align="alignleft" width="133"]Ulf Ekelund, PhD FACSM Professor Department of Sports Medicine Norwegian School of Sport Sciences Prof. Ulf Ekelund[/caption] Ulf Ekelund, PhD FACSM Professor Department of Sports Medicine Norwegian School of Sport Sciences  MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is known that long sitting hours may be detrimental to health and previous studies have suggested associations between sitting time and all-cause mortality.However, it is not known whether physical activity can eliminate the increased risk of death associated with long sitting time. We found that at least one hour of physical activity every day appear to offset the increased risk associated with more than eight hours of sitting. We also found that those who were physically inactive and sat for less than 4 hours every day were at greater risk compared with those who were physically active and sat for more than 8 hours providing further evidence on the benefits of physical activity.
Author Interviews, Exercise - Fitness, Global Health, Lancet, Lifestyle & Health / 29.07.2016

MedicalResearch.com Interview with: [caption id="attachment_22664" align="alignleft" width="180"]Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow/Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney Dr. Melody Ding[/caption] Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney MedicalResearch.com: What is the background for this study? Response: Understanding the true burden of a pandemic is indispensable for informed decision making. After decades of research, we now have established knowledge about how physical inactivity contributes to pre-mature deaths and chronic diseases, but the economic burden of physical inactivity remains unquantified at the global level. Through estimating the economic burden of physical inactivity for the first time, we hope to create a business case for investing in cost-effective actions to promote physical activity at the global levels.
Author Interviews, Gastrointestinal Disease, Genetic Research, JAMA / 29.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26492" align="alignleft" width="133"]Amitabh Chak, MD University Hospitals Case Medical Ctr Cleveland, OH, 44106 Dr-Amitabh-Chak[/caption] Amitabh Chak, MD University Hospitals Case Medical Ctr Cleveland, OH, 44106 MedicalResearch.com: What is the background for this study? What are the main findings? Response: About 20 years ago we discovered that Barrett's esophagus and esophageal cancer aggregate in a small proportion of families suggesting there might be a genetic basis to these complex diseases. As we started looking at these families, we identified a rare family with multiple members who had Barrett's esophagus and multiple members who had passed away from esophageal cancer at a young age. Advances in exome sequencing have now allowed us to identify a mutation in a gene whose function is not known that predisposes this family to develop Barrett's esophagus. Functional studies suggest that this gene, VSIG10L, is involved in maturation of normal squamous esophagus.
Author Interviews, Cancer Research, Genetic Research, Lancet, Lymphoma / 29.07.2016

MedicalResearch.com Interview with: Jin-Xin BEI, Ph.D. Principal Investigator State Key Laboratory of Oncology in South China Sun Yat-sen University Cancer Center Guangzhou China MedicalResearch.com: What is the background for this study? Response: Natural killer T-cell lymphoma (NKTCL) is a rare and aggressive malignancy with remarkable prevalence in Asian and Latin populations, suggesting that the heritable components contribute to the disease risk. Epstein-Barr virus (EBV) infection has been thought to be major factor associated with NKTCL, and EBV DNA load in plasma has been applied in clinical managements, including diagnosis, treatment response and prognosis. However, the genetic component leading to NKTCL predisposition has not been identified.
Author Interviews, JAMA, Melanoma / 29.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26588" align="alignleft" width="184"]Dr. Michael Pignone MD MPH Task Force member Professor of medicine and Inaugural Chair Department of Internal Medicine at the Dell Medical School The University of Texas at Austin. Editor’s note: Dr. Pignone discusses the recent US Preventive Services Task Force Recommendation Statement on the effectiveness of screening for skin cancer with a clinical visual skin examination Dr. Michael Pignone[/caption] Dr. Michael Pignone MD MPH Task Force member Professor of medicine and Inaugural Chair Department of Internal Medicine Dell Medical School The University of Texas at Austin. Editor’s note: Dr. Pignone discusses the recent US Preventive Services Task Force Recommendation Statement on the effectiveness of screening for skin cancer with a clinical visual skin examination MedicalResearch.com: What is the background for this recommendation? How Does the USPSTF Grade Preventive Services? Response: The Task Force’s primary concern is the health of Americans, and all of our recommendations are based on an assessment of the evidence of both the benefits and harms of a particular preventive service. For this recommendation statement, we looked at all available evidence on a visual skin exam, including studies of exams conducted by both primary care clinicians and dermatologists, to see how effective this exam was at preventing death from skin cancer. Unfortunately, there is not enough evidence to know with certainty whether or not a visual skin exam leads to a reduction in death from skin cancer, which resulted in the Task Force issuing an I statement. The Task Force encourages more research that could provide future evidence on the effectiveness of visual screening to prevent death from skin cancer.
Author Interviews, Breast Cancer, JAMA, Technology / 29.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26499" align="alignleft" width="150"]Lauren P. Wallner, PhD, MPH Assistant Professor, Departments of Medicine and Epidemiology University of Michigan Ann Arbor, MI Dr. Lauren Wallner[/caption] Lauren P. Wallner, PhD, MPH Assistant Professor, Departments of Medicine and Epidemiology University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? What are the main findings? Response: Online communication tools like email and social media could be used to support patients through their cancer treatment decision making and ongoing care. Yet, we know very little about whether and how newly diagnosed cancer patients use these tools and whether using online communication influences patients appraisals of their treatment decision making process. We surveyed 2,460 women with newly diagnosed breast cancer as part of the iCanCare Study about their use of email, texting, social media and web-based support groups following their diagnosis. Our findings suggest that women who more often used these online communication tools deliberated more about their surgical treatment and were more satisfied with their treatment decision. However, the use of social media in this diverse population was lower than we expected (12%), and was less common in older women, those with less education, and Black and Latina women.
Author Interviews, Global Health, Lancet, Methamphetamine, OBGYNE, STD / 29.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26580" align="alignleft" width="200"]N. Saman Wijesooriya Public Health Advisor/Technical Advisor Centers for Disease Control and Prevention N. Saman Wijesooriya[/caption] N. Saman Wijesooriya Public Health Advisor/Technical Advisor Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: The article Global burden of maternal and congenital syphilis in 2008 and 2012: a health systems modeling study by Wijesooriya, et al published in the August 2016 issue of The Lancet Global Health (Open source - http://dx.doi.org/10.1016/S2214-109X(16)30135-8) estimates the incidence and prevalence of maternal and congenital syphilis for both time periods and identifies gaps antenatal care access and syphilis testing and treatment services to assess progress in the global elimination of congenital syphilis, or mother-to-child transmission of syphilis, as a public health problem. Untreated maternal syphilis is understood to be transmitted from mother-to-child in utero in 50% of cases resulting in tragic adverse pregnancy outcomes, or congenital syphilis infections, including early fetal death, stillbirth, preterm birth, low birthweight, neonatal death, and congenital infections in infants. Since most maternal syphilis infections are asymptomatic, it is recommended that screening for syphilis use a combination of serological tests for pregnant women and treatment of syphilis seropositive women with at least 2.4 million units of benzathine penicillin intramuscularly early in pregnancy to prevent most congenital syphilis infections. In 2007, the World Health Organization responded to estimates indicating 2 million maternal and 1.5 congenital syphilis infections would occur annually without treatment and launched the global initiative for the Elimination of Congenital Syphilis (ECS). The strategy includes reducing the prevalence of syphilis in pregnant women and mother-to-child transmission of syphilis. The objective is for countries to achieve high performing antenatal care systems providing access to antenatal care to more than 95% of pregnant women, syphilis testing for more than 95% of pregnant women, and treatment for more than 95% of seropositive women to attain a congenital syphilis rate of 50 or fewer cases per 100,000 live births.
Author Interviews, Brigham & Women's - Harvard, Dermatology, Science, Technology / 28.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26574" align="alignleft" width="138"]Mei X. Wu, Ph.D. Associate Professor Wellman Center for Photomedicine Massachusetts General Hospital Dermatology Department Harvard Medical School Dr. Mei Wu[/caption] Mei X. Wu, Ph.D. Associate Professor Wellman Center for Photomedicine Massachusetts General Hospital Dermatology Department Harvard Medical School MedicalResearch.com: What is the background for this study? Response: An abnormally low count of platelets, a disorder called thrombocytopenia, is life-threatening owing to a high risk of uncontrollable bleeding. The disorder can be caused by a variety of conditions like trauma, an autoimmune disorder that attacks platelets, side-effects of some drugs especially chemotherapeutic drugs, and in premature newborns and patients with HIV-infection or a genetic defect leading to insufficient platelet generation. Platelet transfusion is the most effective modality to treat the disorder, but it is associated with complications including allergic reaction, fever, infection, and immunosuppression and limited only to the most severe patients. Several FDA-approved drugs are currently used in the clinics or clinical trials to increase platelet levels, which however must be carefully dosed to avoid excessive platelet production that is also dangerous and are not suitable to many forms of thrombocytopenia.
Author Interviews, Cost of Health Care, Health Care Systems, JAMA, Surgical Research / 28.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26484" align="alignleft" width="160"]Richard Hoehn, MD Resident in General Surgery College of Medicine University of Cincinnati Dr. Richard Hoehn[/caption] Richard Hoehn, MD Resident in General Surgery College of Medicine University of Cincinnati MedicalResearch.com: What is the background for this study? What are the main findings? Response: A recent study from our research group (Hoehn et al, JAMA Surgery, 2015) found that safety-net hospitals perform complex surgery with higher costs compared to other hospitals, and that these higher costs are potentially due to intrinsic differences in hospital performance. In this analysis, we decided to simulate different policy initiatives that attempt to reduce costs at safety-net hospitals. Using a decision analytic model, we analyzed pancreaticoduodenectomy performed at academic hospitals in the US and tried to reduce costs at safety-net hospitals by either 1) reducing their mortality, 2) reducing their patients’ comorbidities and complications, or 3) sending their patients to non-safety-net hospitals for their surgery. While reducing mortality had a negligible impact on cost and reducing comorbidities/complications had a noticeable impact on cost, far and away the most successful way to reduce costs at safety-net hospitals, based on our model, was to send patients away from safety-net hospitals for their pancreaticoduodenectomy.
AHA Journals, Author Interviews, Cannabis, Pulmonary Disease, UCSF / 27.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26428" align="alignleft" width="200"]Matthew L. Springer, Ph.D. Professor of Medicine Division of Cardiology University of California, San Francisco San Francisco, CA Dr. Matthew Springer[/caption] Matthew L. Springer, Ph.D. Professor of Medicine Division of Cardiology University of California, San Francisco San Francisco, CA MedicalResearch.com: What is the background for this study? Response: We've known for many years that secondhand smoke from tobacco cigarettes is harmful, and the vast majority of deaths thought to result from secondhand smoke are from cardiovascular disease. However, very little has been known about cardiovascular consequences of exposure to secondhand smoke from marijuana, and people tend to mistake the lack of evidence that it is harmful, for evidence that is it not harmful. As a result, many people seem relatively unconcerned about smoking marijuana and being exposed (or exposing others) to marijuana secondhand smoke. Politicians and policy makers also seem less willing to limit where people can smoke marijuana (under legal circumstances) than tobacco. What has been lacking is research into how exposure to marijuana smoke affects cardiovascular health. It has been difficult to do such experiments because marijuana is illegal in the eyes of the federal government. However, we have been studying the harmful effects of secondhand tobacco smoke on the function of rat blood vessels, which is similar to its harmful effects on human blood vessels, and we now have studied how the function of rat blood vessels is affected by exposure to secondhand marijuana smoke.
Author Interviews, Environmental Risks, Genetic Research, Nature / 27.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26542" align="alignleft" width="120"]Dalton Conley PhD Department of Sociology Princeton University Princeton, NJ 08644 Dr. Dalton Conley[/caption] Dalton Conley PhD Department of Sociology Princeton University Princeton, NJ 08644 MedicalResearch.com: What is the background for this study? What are the main findings? Response: An increasing number of nationally representative social science surveys are now genotyping respondents. The Health and Retirement Study, which follows a representative group of Americans 50 and older since 1992, genotyped its subjects in 2006 and 2010. The range of birth cohorts allowed us to see if genetic effects increased or decreased across the middle half of the twentieth century for a number of outcomes. We found that for height and weight, genetics increased in importance, but for heart disease and education, genes became less important.
Author Interviews, Columbia, Heart Disease, JACC / 27.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26379" align="alignleft" width="132"]Ajay J. Kirtane, MD, SM, FACC, FSCAI Associate Professor of Medicine at Columbia University Medical Center Chief Academic Officer, Center for Interventional Vascular Therapy Director, NYP/Columbia Cardiac Catheterization Laboratories New York, NY 10032 Dr. Ajay Kirtane[/caption] Ajay J. Kirtane, MD, SM, FACC, FSCAI Associate Professor of Medicine at Columbia University Medical Center Chief Academic Officer, Center for Interventional Vascular Therapy Director, NYP/Columbia Cardiac Catheterization Laboratories New York, NY  10032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with inpatient heart failure are a higher-risk patient population who can benefit from the identification and treatment of coronary artery disease. We sought to identify how frequently these patients in fact underwent testing for coronary artery disease.
AHA Journals, Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease / 27.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26317" align="alignleft" width="133"]Andrea K. Chomistek, MPH, ScD Assistant Professor Department of Epidemiology and Biostatistics School of Public Health Indiana University-Bloomington Dr. Andrea K. Chomistek[/caption] Andrea K. Chomistek, MPH, ScD Assistant Professor Department of Epidemiology and Biostatistics School of Public Health Indiana University-Bloomington MedicalResearch.com: What is the background for this study?  Response: Previous studies of exercise and  coronary heart disease have been primarily conducted in middle-aged and older adults, so we thought it was important to examine this association in younger women as mortality rates in young women have not declined in recent years like they have in other age groups.
Author Interviews, Infections, PNAS / 27.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26526" align="alignleft" width="119"]Adam Hayward PhD Impact Research Fellow University of Stirling Dr. Adam Hayward[/caption] Adam Hayward PhD Impact Research Fellow University of Stirling MedicalResearch.com: What is the background for this study? Response: Adult life expectancies in industrialized countries have increased dramatically in the last 150 years, even once we’ve accounted for the fact that previously common deaths in childhood and now very rare. One hypothesis seeking to explain this increase is that childhood infections cause chronic inflammation, which are then linked with heart disease and stroke in later life, reducing lifespan. Since such childhood infections were previously common but are now, thanks to vaccine and sanitation, much rarer, chronic inflammation should be lower and people should live longer and be less likely to die from early-onset heart disease. If this hypothesis is correct, we should see that higher exposure to infections in early life leads to increased adult mortality and deaths from heart disease and stroke.
Author Interviews, Gastrointestinal Disease, Lancet, Surgical Research / 27.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26515" align="alignleft" width="200"]Mr Steven Brown MBChB, BMedSci, FRCS, MD Reader in Surgery Honorary Secretary to the ACPGBI Consultant colorectal surgeon University of Sheffield, UK Mr. Steven Brown[/caption] Mr Steven Brown MBChB, BMedSci, FRCS, MD Reader in Surgery Honorary Secretary to the ACPGBI Consultant colorectal surgeon University of Sheffield, UK MedicalResearch.com: What is the background for this study? Response: Haemorrhoids are common. One in 4 of us will at some time have symptoms that can be directly attributed to piles. Whilst most symptoms will settle spontaneously or with improvement to our lifestyle, there remains a large group of patients who require intervention to reduce symptomatology. Numerous interventions exist ranging from relatively minor office therapy to procedures that may take several weeks to recover from. Haemorrhoidal artery ligation (HAL) is one of the more recent surgical operations for haemorrhoidal therapy. It has been introduced certainly into the UK associated with a significant element of media hype purporting ‘painless surgery for piles’. Substantial subsequent medical literature has also suggested an efficacy rivaling other more invasive procedures. Too good to be true? Perhaps. Several systematic reviews have highlighted the lack of good quality data as evidence for the advantages of the technique. A well designed randomized controlled trial was required. The existing literature on  haemorrhoidal artery ligation at the time of the trial suggested the procedure was most effective for less symptomatic haemorrhoids (those that are associated with bleeding and/or minor prolapse; grade II or mild III piles). These type of haemorrhoids also tend to be the most common requiring intervention. The most frequently used alternative procedure for these grade of haemorrhoids in the UK is rubber band ligation (RBL), a simple office therapy not requiring anaesthetic. Hence participants with this grade of haemorrhoids were chosen as the participants with RBL as the comparator. Multiple outcomes were investigated but a patient reported outcome measure of recurrence was chosen as the primary outcome.
Author Interviews, Cancer Research, Chemotherapy, Nature, Technology / 27.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26504" align="alignleft" width="157"]Natalie Artzi PhD Assistant Professor at Brigham and Women’s Hospital, Harvard Medical School Associate member of the Broad Institute of Harvard and MIT. Dr. Natalie Artzi[/caption] Natalie Artzi PhD Assistant Professor at Brigham and Women’s Hospital, Harvard Medical School Associate member of the Broad Institute of Harvard and MIT. MedicalResearch.com: What is the background for this study? Response: We have shown in the last years that dendrimer:dextran adhesive hydrogels represent a platform with ahuge potential for delivery. In 2015, we were able to report that these gels doped with smart nanoparticles could sense and differentially react with the disease microenvironment (e.g. can sense the tissue microenvironment by detecting the expression of specific genes related with multidrug resistance, Conde et al. PNAS 2015), potentiating targeted drug release and uptake in certain disease settings. Later, these hydrogels prove to be incredibly useful for miRNA delivery by using the self-assembly of a triple-helix forming miRNA structure that lead to nearly 90% levels of tumor shrinkage two weeks post-gel implantation (Conde et al. Nature Materials 2016a). Here, we took a step-forward, and used these hydrogels to develop a prophylactic patch for gene, chemo and phototherapy in a triple-combination approach to achieve complete tumor resection when applied to non-resected tumors and to the absence of tumor recurrence when applied following tumor resection (Conde et al. Nature Materials 2016b). This study also identifies the molecular and genetic pathways triggered in response to the three therapeutic modalities − photo-, gene- and chemo-therapy − by tumor gene expression profiling in treated mice.
Author Interviews, Diabetes, PLoS, Primary Care, Telemedicine / 26.07.2016

MedicalResearch.com Interview with: Brian McKinstry MD Professor of primary care e-health and General practitioner MacKenzie Medical Centre EdinburghBrian McKinstry MD Professor of primary care e-health and General practitioner MacKenzie Medical Centre Edinburgh MedicalResearch.com: What is the background for this study?  Response: The prevalence of diabetes is rising as the population ages and becomes more obese. Clinical services are increasingly stretched, so much so that it will be difficult for doctors and nurses to continue to look after patients using the same service delivery they have used in the past. Increasingly patients are being asked to self-manage long-term illnesses, but particularly with type 2 diabetes they find this stressful. One solution is to encourage self-management but with monitoring at a distance through telehealth. We performed a randomised controlled trial in family practices in four regions of the United Kingdom among 321 people with type 2 diabetes and glycated haemoglobin (HbA1c) ( a measure of control over the previous three months) >58 mmol/mol. The supported telemonitoring intervention involved self-measurement and transmission to a secure website of twice weekly morning and evening glucose for review by family practice clinicians. The control group received usual care, with at least annual review and more frequent reviews for people with poor glycaemic or blood pressure control in the context of incentives in family practice based on a sliding scale of financial rewards for achieving glycaemic and blood pressure control targets. HbA1c assessed at nine months was the primary outcome. Intention-to-treat analyses were performed.
Author Interviews, JAMA, Schizophrenia / 26.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26441" align="alignleft" width="133"]Prof. Jayashri Kulkarni Prof. Jayashri Kulkarni[/caption] Professor Jayashri Kulkarni MBBS, MPM, FRANZCP, PhD Director, Monash Alfred Psychiatry research centre Vic Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Schizophrenia is a complex psychiatric disorder and many patients are not able to achieve remission on the available treatments. There are clear sex differences in many aspects of the illness, which not only implicates a role for the sex hormone estrogen in schizophrenia, but also highlights the need for sex-specific treatments. Our group has conducted many clinical trials using adjunctive estradiol treatment, with excellent improvement in psychotic symptoms- however, there can be physical side effects with longer term estradiol use. Raloxifene and other selective estrogen receptor modulators ( SERMs) - the so-called "brain estrogens", with their more specific brain impacts and less body side effects - provide an option to use longer term estrogen in people with refractory schizophrenia. We conducted the first ever pilot study of raloxifene in 2010, and now present findings from a bigger study of adjunctive raloxifene treatment in schizophrenia.
Author Interviews, Genetic Research, JAMA, Pediatrics, Surgical Research / 26.07.2016

MedicalResearch.com Interview with: Dr. Katherine Nelson MD Staff Paediatrician with the Paediatric Advanced Care Team at SickKids and PhD student University of Toronto MedicalResearch.com: What is the background for this study? Response: Trisomy 13 and 18 are rare genetic conditions that cause problems in multiple organ systems, including heart defects and severe neurologic impairment.  A majority of children with trisomy 13 and 18 die in the first days to weeks after birth, though a small number survive beyond one year.  For years, health care providers have debated the effectiveness and ethics of surgical interventions in these populations.
Author Interviews, Cannabis, JAMA, Pediatrics / 25.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26469" align="alignleft" width="144"]George Sam Wang MD FAAP Assistant Professor of Pediatrics Section of Emergency Medicine, Medical Toxicology Department of Pediatrics University of Colorado Anschutz Medical Campus Children's Hospital Colorado Dr. Wang[/caption] George Sam Wang MD FAAP Assistant Professor of Pediatrics Section of Emergency Medicine, Medical Toxicology Department of Pediatrics University of Colorado Anschutz Medical Campus Children's Hospital Colorado MedicalResearch.com: What is the background for this study? Response: Many states have allowed medical and now recreational marijuana. The impact on pediatric population has not been fully described. MedicalResearch.com: What are the main findings? Response: Unintentional exposures presenting to our children's hospital and calls to our regional poison center significantly increased after our state allowed recreational marijuana. MedicalResearch.com: What should readers take away from your report? Response: Exposures in children are increasing in our state that allows medical and recreational Marijuana, many were edible products. Marijuana products should be treated like medications and household products in home and properly and safely stored. States looking to legalize marijuana need to consider safety rules and regulations during rule making processes.
Author Interviews, Health Care Systems, JAMA, Stroke / 25.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26501" align="alignleft" width="133"]Kimon Bekelis, MD Chief Resident Department of Neurosurgery Dartmouth-Hitchcock School of Medicine Dr. Kimon Bekelis[/caption] Kimon Bekelis, MD Chief Resident Department of Neurosurgery Dartmouth-Hitchcock School of Medicine MedicalResearch.com: What is the background for this study? Response: Physicians often must decide whether to treat acute stroke patients locally, or refer them to a more distant Primary Stroke Center (PSC). There is little evidence on how much the increased risk of prolonged travel time offsets benefits of specialized  Primary Stroke Center care.
Author Interviews, Cost of Health Care, JAMA / 25.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26408" align="alignleft" width="152"]James C. Robinson PhD Leonard D. Schaeffer Professor of Health Economics Director, Berkeley Center for Health Technology Division Head, Health Policy and Management University of California School of Public Health Berkeley, CA Dr. James C. Robinson[/caption] James C. Robinson PhD Leonard D. Schaeffer Professor of Health Economics Director, Berkeley Center for Health Technology Division Head, Health Policy and Management University of California School of Public Health Berkeley, CA MedicalResearch.com: What is the background for this study? Response: To moderate the increase in insurance premiums, employers are increasing consumer cost sharing requirements. Under reference pricing, the employer establishes a limit to what it will contribute towards each service or product, typically set at the 60th percentile or other midpoint in the distribution of prices in the market. If the patient selects a facility charging less than or equal to this contribution, he/she receives full coverage, but if a more expensive facility is chosen, the patient must pay the full difference.
Author Interviews, JAMA, Johns Hopkins, Race/Ethnic Diversity, Stroke / 25.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26417" align="alignleft" width="80"]Romanus Roland Faigle, M.D., Ph.D. Assistant Professor of Neurology The Johns Hopkins Hospital Dr. Roland Faigle[/caption] Romanus Roland Faigle, M.D., Ph.D. Assistant Professor of Neurology The Johns Hopkins Hospital MedicalResearch.com: What is the background for this study? Response: Stroke care entails a variety of procedures and interventions, which generally fall into one of the two following categories: 1) curative/preventative procedures (such as IV thrombolysis and carotid revascularization), which intent to prevent injury and restore function; and 2) life-sustaining procedures (such as gastrostomy, mechanical ventilation, tracheostomy, and hemicraniectomy), which intent to address complications from a stroke and to prevent death. The use of curative/preventative procedures is supported by excellent evidence and is guided by well-defined criteria, while those are largely lacking for life-sustaining procedures. Therefore, curative/preventative are desirable for eligible patients, while life-sustaining procedures indicate the need to address undesired complications and in itself have questionable utility. We wanted to determine whether race differences in the use of the individual stroke-related procedures exist, and whether presence and directionality of differences by race follow a pattern unique to each of the 2 procedure groups.