Author Interviews, Cannabis, Lancet / 10.09.2014

MedicalResearch.com Interview with: Edmund Silins PhD, Research Fellow National Drug and Alcohol Research Centre UNSW Medicine University of New South Wales Sydney  Australia Medical Research: What are the main findings of the study? Dr. Silins: There were three particularly interesting aspects to the findings.
  • Firstly, we found clear and consistent associations between adolescent cannabis use and the young adult outcomes investigated.
  • Secondly, there was evidence of a dose-response effect such that the more frequently adolescents used cannabis the more likely they were to experience harms later in life.
  • Thirdly, for most outcomes, these associations remained even after taking into account a wide range of other factors which might potentially explain them.
The adverse effects were greatest for daily cannabis users. Specifically, adolescents who were daily cannabis users were, by the age of 25, more than 60% less likely to complete high school or obtain a university degree, seven times more likely to have attempted suicide, 18 times more likely to have been cannabis dependent, and eight times more likely to have used other illicit drugs, than adolescents who had never used the drug. (more…)
Alzheimer's - Dementia, Author Interviews, BMJ / 10.09.2014

Sophie Billioti de Gage PharmD University of Bordeaux Segalen FranceMedicalResearch.com Interview with: Sophie Billioti de Gage PharmD University of Bordeaux Segalen France   Medical Research: What are the main findings of the study? Answer: The risk of Alzheimer’s disease was found increased by 43-51% in persons (>65) having initiated a treatment with benzodiazepines in the past (>5 years before). Risk increased with the length of exposure and when long acting benzodiazepines were used. (more…)
Author Interviews, Heart Disease, JACC / 09.09.2014

MedicalResearch.com Interview with: Laura A. Graham, MPH Center for Surgical, Medical Acute Care Research, and Transitions Birmingham Veterans Affairs Medical Center Section of Gastrointestinal Surgery, Department of Surgery University of Alabama at Birmingham, Birmingham Medical Research: What are the main findings of the study? Answer: The main findings of the study are that the recommendations made in the guidelines published by the American College of Cardiology / American Heart Association in 2007 were effective at reducing postoperative major adverse cardiac events following noncardiac surgery in patients with a cardiac stent.1  These guidelines recommended the delay of noncardiac surgeries in patients with a drug-eluting stent for 365 days if the surgery was not emergent or the delay of surgery for 4 to 6 weeks among patients with a bare metal stent.1  In addition to a 26% reduction in postoperative major adverse cardiac events, we also found an increase in the time between drug-eluting stent placement and non-cardiac surgery consistent with the guideline recommendations. (more…)
Author Interviews, Cost of Health Care, JAMA / 09.09.2014

Michael Johansen, MD MS Assistant Professor Dept of Family Medicine Ohio State UniversityMedicalResearch.com Interview with: Michael Johansen, MD MS Assistant Professor Dept of Family Medicine Ohio State University Medical Research: What are the main findings of the study? Dr. Johansen: Between 2007-2011, the United States spent $63.4 billion on high-cost proton pump inhibitors of which $47.1 billion was in excess of using generic omeprazole. (more…)
Author Interviews, Cancer Research, Diabetes, Diabetologia / 09.09.2014

Professor Yuli Huang The First People's Hospital of Shunde, Daliang Town, China, and colleaguesMedicalResearch.com Interview with: Professor Yuli Huang The First People's Hospital of Shunde, Daliang Town, China, and colleagues Medical Research: What are the main findings of the study? Professor Huang: In this meta-analysis of 16 prospective cohort studies comprising more than 890,000 individuals, we found that the presence of prediabetes at baseline associated with a 15% increased risk of cancer overall. The results were consistent across cancer endpoint, age, duration of follow-up and ethnicity. There was no significant difference for the risk of cancer with different definitions of prediabetes (impaired fasting glucose [IFG] and/or impaired glucose tolerance [IGT]). (more…)
Annals Internal Medicine, Author Interviews, Orthopedics, UCLA / 09.09.2014

Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at University of California, Los Angeles UCLA Medicine/GIM Los Angeles, CA 90024MedicalResearch.com Interview with: Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at University of California, Los Angeles   Medical Research: What are the main findings of the study? Dr. Crandall: 1.        We found high-strength evidence that several medications decrease fracture risk when used by persons with bone density in the osteoporotic range and/or with pre-existing hip or vertebral fracture.  While many of the medications (alendronate, risedronate, zoledronic acid, ibandronate, denosumab, teriparatide, and raloxifene) reduce vertebral fractures, a reduction in the risk of hip fracture is not demonstrated for all of the medications.  In particular, hip fracture reduction is only demonstrated for alendronate, risedronate, zoledronic acid, and denosumab.  Unfortunately, due to a lack of head-to-head trials, the comparative effectiveness of the medications is unclear. 2.       The adverse effects of the medications vary.  For example, raloxifene is associated with an increased risk of thromboembolic events, whereas denosumab and the bisphosphonate medications have been associated with increased risk of osteonecrosis of the jaw and atypical subtrochanteric femoral fractures. (more…)
Author Interviews, Cancer, Cancer Research, End of Life Care / 09.09.2014

MedicalResearch.com Interview with: Karin Jors MA Department of Palliative Care, Comprehensive Cancer Center, University Medical Center Freiburg, Freiburg, Germany Medical Research: What are the main findings of the study? Answer: The findings of our study shed light on the current circumstances for dying in cancer centers. Physicians and nurses in our study reported that they rarely have enough time to care for dying patients. In addition, only a minority of staff members felt that they had been well-prepared during their training to care for dying patients and their families. Overall, only 56% of participants indicated that it is usually possible for patients to die in dignity on their ward. This is likely the result of various factors such as: inadequate rooms for dying patients and their families (i.e. shared rooms), poor communication with patients regarding burdensome treatments, an overuse of life-prolonging measures, etc. Striking differences were found between the responses of palliative care staff and staff from other wards (e.g. general care, oncology, intensive care). For example, palliative care staff reported that they usually have enough time to care for dying patients. In addition, 95% of palliative care staff indicated that it is usually possible for patients to die in dignity on their ward. Overall, nurses perceived the situation for dying patients more negatively than physicians. Whereas 72% of physicians reported that patients can usually die a dignified death on their ward, only 52% of nurses shared this opinion. Although only slightly more than half of participants believed that patients can usually die in dignity on their ward, this is a considerable improvement to the situation 25 years ago. In a similar study published in 1989, researchers found that 72% of physicians and nurses experienced the situation for patients dying on their hospital ward as undignified. (more…)
Author Interviews, Infections, NEJM / 08.09.2014

MedicalResearch.com Interview with: Stephen H. Gillespie, M.D., D.Sc University of St. Andrews Medical School, St. Andrews Stephen H. Gillespie, M.D., D.Sc University of St. Andrews Medical School, St. Andrews Medical Research: What are the main findings of the study? Dr. Gillespie: REMox TB was a pioneering trial that has shown that a large-scale trial can be run efficiently in resource-poor settings with a high TB burden, adhere to the highest standards of good clinical trial practices, and deliver a clear, unequivocal result. REMoxTB was among the most rigorous Tuberculosis drug trials ever conducted in the modern era of TB treatment and among the largest ever conducted for a new TB treatment. It enrolled 1,931 patients at 50 sites in nine countries, mostly in Africa and Asia. Previously, there were thought to be regional differences in way in which patients' response to treatment across the world but we showed that a rigorous approach to trial conduct there was no evidence for that difference. The study confirmed that daily moxifloxacin was safe over four months of therapy and the moxifloxacin containing arms were more bactericidal initially. Despite its substantial anti-TB activity it did not prove possible to shorten therapy to four months.  . These findings, with the safety of moxifloxacin, and its activity against TB, support the continued clinical testing of moxifloxacin as a component of other novel regimens. (more…)
Author Interviews, Breast Cancer, JCEM / 06.09.2014

MedicalResearch.com Interview with: Lu Chen, MPH Researcher in the Public Health Sciences Division Fred Hutchinson Cancer Research Center Doctoral student in the Department of Epidemiology University of Washington School of Public Health Medical Research: What are the main findings of the study? Dr. Chen: We found no evidence that wearing a bra is associated with breast cancer risk. Further, breast cancer risk was not impacted by bra wearing frequency, wearing a bra with an underwire, or starting to wear a bra at a young age. (more…)
Author Interviews, JAMA, Ophthalmology / 06.09.2014

Louis R. Pasquale, MD Channing Division of Network Medicine Department of Ophthalmology Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MassachusettsMedicalResearch.com Interview with: Louis R. Pasquale, MD Channing Division of Network Medicine Department of Ophthalmology Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Pasquale: We found that more time spent outdoors in summer was associated with increased risk of exfoliation syndrome. (more…)
Author Interviews, JAMA, Mental Health Research, Schizophrenia / 06.09.2014

MedicalResearch.com Interview with: Sandra M. Meier, PhD The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, National Centre for Register-Based Research Aarhus University, Aarhus, Denmark Medical Research: What are the main findings of the study? Dr. Meier: People with an obsessive-compulsive disorder are at a 6 to 7 times higher risk of developing schizophrenia than people without an obsessive-compulsive disorder. If the parents are diagnosed with an obsessive-compulsive disorder, their offspring experience a 3 to 4 times higher chance to develop schizophrenia. (more…)
AHA Journals, Author Interviews / 05.09.2014

Sylvia Wassertheil-Smoller, PhD Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx, NY 10461.MedicalResearch.com Interview with: Sylvia Wassertheil-Smoller, PhD Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx, NY 10461. First author on this paper was Arjun Seth, BS, Dr. Wassertheil-Smoller’s mentee and a medical student at the Albert Einstein College of Medicine. Medical Research: What are the main findings of the study? Dr. Wassertheil-Smoller: We found in study of nearly 100,000 postmenopausal women in the Women's Health Initiative that a high intake of dietary potassium was associated with a lower risk of ischemic stroke and death from all causes. (more…)
Author Interviews, JAMA, Multiple Sclerosis / 05.09.2014

Jeffrey Cohen MD Department of Neurology Cleveland ClinicMedicalResearch.com Interview with: Jeffrey Cohen MD Department of Neurology Cleveland Clinic Medical Research: What are the main findings of the study? Dr. Cohen: This study assessed the relationship between walking speed, as measured by the Timed 25-foot Walk test, and patient-reported quality of life, as measured by the Physical Component Summary score of the 36-Item Short Form Health Survey (SF-36), in a pooled dataset from the AFFIRM, SENTINEL, and IMPACT multiple sclerosis Phase 3 trials.  It showed that slowed walking speed is associated with decreased quality of life.  It also showed that 20-25% slowing of walking speed is a clinically meaningful change. (more…)
BMJ, General Medicine, Pediatrics / 05.09.2014

Dr. Steve Turner Child Health, Royal Aberdeen Children's Hospital Aberdeen,UKMedicalResearch.com: Interview with: Dr. Steve Turner Child Health, Royal Aberdeen Children's Hospital Aberdeen,UK   Medical Research: What are the main findings of the study? Dr. Turner: There is evidence that being small for a given gestational age is associated with a broad range of what could be loosely considered “disadvantageous” outcomes in early childhood, eg increased risk for wheeze, increased blood fat levels, increased blood pressure and low bone mineral density.  Many of these outcomes are subclinical – ie unless they were measured no-one would be any the wiser – and what remains to be determined is whether as these individuals grow up these subclinical measurements become important.  Follow up may take many years, decades for outcomes such as coronary artery disease and type II diabetes. (more…)
Antibiotic Resistance, Author Interviews, PNAS / 05.09.2014

MedicalResearch.com Interview with: David T. Fox, Ph.D. Scientist 3 Los Alamos National Laboratory andDavid T. Fox, Ph.D. Scientist 3 Los Alamos National Laboratory and Prof. Samir Mitragotri Center for Bioengineering and Department of Chemical Engineering University of California, Santa Barbara, CA 93106Prof. Samir Mitragotri Center for Bioengineering and Department of Chemical Engineering University of California, Santa Barbara, CA 93106 Medical Research: What are the main findings of this study? Answer: Our research team identified a molten salt, choline-geranate, that possessed multiple beneficial biological traits. Specifically, when mixed in a 1:2 ratio (choline:geranate) this solvent is able to effectively disrupt and neutralize 72-hour biofilms formed by both Pseudomonas aeruginosa and Salmonella enterica. Further, our studies demonstrated the same solvent exhibited minimal cytotoxicity effects to normal human bronchial epithelial (NHBE) cells and was able to deliver an antibiotic, cefadroxil, through the stratum corneum into the epidermis and dermis. Most importantly, the research culminated in demonstrating the molten salt was able to neutralize ~95% of the bacteria found within a 24-hour P. aeruginosa biofilm when grown on a skin wound model (MatTek)  and ~98% of the bacteria when formulated with the antibiotic, ceftazidime. When the biofilm was treated with only antibiotic in a saline solution, less than 20% of the bacteria were neutralized. (more…)
Author Interviews, BMJ, Heart Disease, Metabolic Syndrome / 04.09.2014

Dr Weiguo Zhang, MD PhD Cardiovascular and Neurological Institute 6771 San Fernando, Irving, TX 75039, USAMedicalResearch.com Interview with: Dr Weiguo Zhang, MD PhD Cardiovascular and Neurological Institute 6771 San Fernando, Irving, TX 75039, USA

Medical Research: What are the main findings of the study?

Prof. Zhang: Higher heart rate has emerged as a cardiovascular risk factor and is associated with higher mortality rate. However the mechanistic link between heart rate and mortality outcome in population has been missing. The main findings of the present study in a relatively large population are two-fold: Firstly, there is a strong and positive association between resting heart rate and metabolic syndrome, which is defined when an adult has 3 of the following: obesity (waist circumference ≥90 cm for men or ≥80 for women); hypertriglyceridemia (triglycerides ≥1.7 mmol/L); low plasma level of high-density lipoprotein <1.03 mmol/L for men or <1.30 mmol/L for women); hypertension (systolic blood pressure/ diastolic blood pressure≥130/85 mmHg or current use of antihypertensive medications); hyperglycemia (fast blood glucose ≥5.6 mmol/L or previously diagnosed type 2 diabetes or current use of hypoglycaemic agents or insulin). Secondly and more importantly, those without metabolic syndrome but with higher resting heart rate will have greater risk in developing metabolic syndrome in the near future. As such, the findings from both cross-sectional and longitudinal studies provide evidence that resting heart rate is an independent risk factor for existing metabolic syndrome and a powerful predictor for its future incidence. (more…)

Author Interviews, HIV, Infections, NEJM / 04.09.2014

Bongani M. Mayosi, M.B., Ch.B., D.Phil. Department of Medicine, Old Groote Schuur Hospital Cape Town, South AfricaMedicalResearch.com Interview with: Bongani M. Mayosi, M.B., Ch.B., D.Phil. Department of Medicine, Old Groote Schuur Hospital Cape Town, South Africa Medical Research: What are the main findings of this study? Dr. Mayosi: In those with definite or probable tuberculous pericardial effusion: (1)       Prednisolone for 6 weeks and Mycibacterium indicus pranii  for three months had no significant effect on the combined outcome of death from all causes, cardiac tamponade requiring pericardiocentesis or constrictive pericarditis. (2)      Both therapies were associated with an increased risk of HIV-associated malignancy. (3)       However, use of prednisolone reduced the incidence of constrictive pericarditis and hospitalization. (4)       The beneficial effects of prednisolone on constriction and hospitalization were similar in HIV-positive and HIV-negative patients (more…)
Author Interviews, Heart Disease, JACC / 04.09.2014

Martin Huth Ruwald, MD, PhD Post doctoral research fellow Heart Research Follow-up Program University of Rochester Medical Center Rochester, NY, USMedicalResearch.com Interview with: Martin Huth Ruwald, MD, PhD Post doctoral research fellow Heart Research Follow-up Program University of Rochester Medical Center Rochester, NY, US Medical Research: What are the main findings of the study? Dr. Ruwald: A high percentage of biventricular pacing is required for optimal outcome in patients treated with cardiac resynchronization therapy (CRT), but the influence of ectopic beats on the success of biventricular pacing has not been well established. We found that patients with increasing amount of ectopic beats (the ectopic burden) (≥0.1%) were more likely to achieve low biventricular pacing <97% and had higher risk of heart failure or death and ventricular arrhythmias. Similarly the study identified patients with a very low amount of ectopic beats, less than 1 in 1000, who are very likely to obtain high biventricular pacing and who have very low risk of adverse outcomes. (more…)
Annals Internal Medicine, Author Interviews, Diabetes / 04.09.2014

Andy Menke PhD Department of Epidemiology, Tulane University School of Medicine New Orleans, LouisianaMedicalResearch.com Interview with Andy Menke PhD Department of Epidemiology, Tulane University School of Medicine New Orleans, Louisiana Medical Research: What are the main findings of the study? Dr. Menke: The prevalence of diabetes increased more in men than women between 1976 and 2010 in the US, from 4.7% to 11.2% in men and from 5.7% to 8.7% in women. Changes over time in the distribution of age, race/ethnicity, and obesity in the population explained all of the increase in women and only half of the increase in men. (more…)
Author Interviews, PLoS, Technology / 04.09.2014

Giulio Ruffini PhD Starlab Barcelona Neuroelectrics Barcelona Barcelona, Spain.MedicalResearch.com Interview with: Giulio Ruffini PhD Starlab Barcelona Neuroelectrics Barcelona Barcelona, Spain. Medical Research: What are the main findings of the study? Dr. Ruffini: We demonstrated that it is possible to transmit information directly from a brain to another one, without intervention of the peripheral nervous system (PNS) - e.g., the senses. By hyperinteraction we mean this: the technologically mediated transmission of information directly from one brain to another, bypassing our senses or effectors (all which require the intervention of the PNS). (more…)
Author Interviews, JAMA, Nutrition / 03.09.2014

MedicalResearch.com Interview with: Dong D. Wang, MD, MSc Department of Nutrition Harvard School of Public Health Boston, Massachusetts Medical Research: What are the main findings of the study? Dr. Wang:
  • The quality of the US diet improved modestly from 1999 to 2010, but the dietary quality of US population remains far from optimal and huge room exists for further improvements.
  • More than half of the improvement in diet quality was due to a large reduction in consumption of trans fat.
  • he improvement in dietary quality was greater among persons with higher socioeconomic status and healthier body weight, thus disparities that existed in 1999 increased over the next decade.
(more…)
Author Interviews, Diabetes, Diabetes Care / 03.09.2014

Jordi Salas-Salvadó MD PhD Physiopathology of Obesity and Nutrition Institute of Health Carlos III, Madrid, SpainMedicalResearch.com Interview with: Jordi Salas-Salvadó MD PhD Physiopathology of Obesity and Nutrition Institute of Health Carlos III, Madrid, Spain Medical Research: What are the main findings of the study? Dr. Salas-Salvadó: The main finding of our study is that an increase in albumin-adjusted serum calcium increases the risk of type 2 diabetes in Mediterranean individuals at high cardiovascular risk. This association remained significant even after taking classic risk factors into account. To the best of our knowledge this is the first study assessing the association between changes in serum calcium levels and the risk of type 2 diabetes development. (more…)
Author Interviews, JAMA, Weight Research / 03.09.2014

Bradley Johnston, PhD Scientist | Child Health Evaluative Sciences Hospital for Sick Children Research Institute Assistant Professor | Department of Clinical Epidemiology & Biostatistics McMaster University Toronto, Ontario, Canada, M5G 0A4MedicalResearch.com Interview with: Bradley Johnston, PhD Scientist | Child Health Evaluative Sciences Hospital for Sick Children Research Institute Assistant Professor | Department of Clinical Epidemiology & Biostatistics McMaster University Toronto, Ontario, Canada Medical Research: What are the main findings of the study? Dr. Johnston:
  • Our findings represent the first meta-analysis using advanced epidemiological methods to summarize popular branded diets for weight loss, trials having been investigated using randomized trial methodology.
  • Among the 48 original RCTs included in our NMA, low to moderate quality evidence showed that both low-carbohydrate and low-fat diets were associated with an approximate 8 kg weight loss at 6 months when compared to no diet. Approximately 1-2 kg of this effect was lost by 12-months.
  • Although statistical differences existed among several of the diet macronutrient classes, the differences were small and unlikely to be important to those seeking to lose weight.
  • Similarly, our results showed that although there are statistically significant differences between some of the brand named diets, these differences are small and not likely patient important.
  • In terms of potential effect modifiers, behavioural support was significant at 6-months (enhancing weight-loss by 3.23 kg) and exercise was significant at 12-months (enhancing weight loss by 2.13 kg)
  • Regarding our sensitivity analyses, Differences in weight loss were not clinically important based on risk of bias, missing data, baseline weight, gender, and those with and without specific health conditions
  • Overall, our findings suggest that patients may choose, among those associated with the largest weight loss, the diet that gives them the least challenges with adherence.
(more…)
Annals Internal Medicine, Author Interviews, Weight Research / 02.09.2014

MedicalResearch.com Interview with: Tian Hu, MD, MS Research Fellow ​Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine New Orleans, LA 70112 Medical Research: What are the main findings of the study? Dr. Hu: Participants on the low-carbohydrate diet lost more weight than those on the low-fat diet at 3, 6, and 12 months. At 12 months, those in the low-carbohydrate group lost an average of almost 8 pounds more than those in the low-fat group. Participants on the low-carbohydrate diet lost more fat mass and did not lose lean mass (muscle) compared to those on the low-fat diet. Overall, bad cholesterol (low-density lipoprotein cholesterol) that is a predictor of risk for cardiovascular disease decreased on both diets, but good cholesterol (high-density lipoprotein cholesterol) increased more in the low-carbohydrate group. Physical activity was similar in the groups throughout the study, suggesting that the greater weight loss among participants in the low-carbohydrate group was not because they exercised more. When we evaluated the black and white participants separately, the results were similar. (more…)
Author Interviews, Heart Disease, NEJM / 01.09.2014

Gilles Montalescot M.D., Ph.D. Professor of Cardiology University of Paris VI; Director, Cardiac Care Unit Institute of Cardiology, Pitié-Salpêtrière University Hospital Paris, FranceMedicalResearch.com Interview with: Gilles Montalescot M.D., Ph.D. Professor of Cardiology University of Paris VI; Director, Cardiac Care Unit Institute of Cardiology, Pitié-Salpêtrière University Hospital Paris, France Medical Research: What are the main findings of the study? Dr. Montalescot : Among the 1862 patients with ongoing STEMI who were enrolled in the ATLANTIC study, we found no difference between those randomized to pre-hospital (in-ambulance) ticagrelor 180 mg and those randomized to in-hospital (in-catheterization laboratory) ticagrelor 180 mg in terms of either pre-PCI ST-segment elevation resolution (≥70%) or pre-PCI TIMI 3 flow in the culprit artery, which were the co-primary endpoints. There was also no difference between the groups in terms of major adverse cardiovascular events at 30 days, with the exception that rates of definite stent thrombosis were lower in the pre-hospital ticagrelor group than in the in-hospital group, both in the first 24 hours (0% versus 0.8%, p= 0.008) and at 30 days (0.2% versus 1.2%, p = 0.02). The safety of pre-hospital ticagrelor did not appear to be an issue, since the incidence of non-CABG-related major bleeding was low and similar in both treatment groups, whichever bleeding definition was used (PLATO, TIMI, STEEPLE, GUSTO, ISTH or BARC). (more…)
Author Interviews, Diabetes, Diabetologia, University of Pittsburgh / 31.08.2014

MedicalResearch.com Interview with: Dr. Sabita Soedamah-Muthu Division of Human Nutrition,Wageningen University Wageningen, the Netherlands and Prof Trevor Orchard Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA Medical Research: What are the main findings of the study? Answer: We present a new prognostic model combining information on age, glycated haemoglobin, waist-hip ratio, albumin/creatinine ratio and HDL (good) cholesterol to assess the 3, 5 and 7 year risk of developing major outcomes in patients with type 1 diabetes. (more…)
Author Interviews, Heart Disease, JAMA / 31.08.2014

Massimo Imazio. MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital and University of Torino Torino, ItaliaMedicalResearch.com Interview with: Massimo Imazio on behalf of the COPPS-2 Investigators Massimo Imazio. MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital and University of Torino Torino, Italia Medical Research: What is the background for this investigation? Dr. Imazio: Post-pericardiotomy syndrome, post-operative atrial fibrillation (AF), and post-operative effusions may be responsible for increased morbidity and healthcare costs after cardiac surgery. Postoperative use of colchicine prevented these complications in a single trial (the COPPS trial published on EHJ in 2010). Here all events occurred within 3 months and colchicine was given after cardiac surgery starting from postoperative day 3 for 1 month. However most postoperative AF events are reported in the first 3 days and thus pre-treatment with colchicine may give better outcomes. Thus we performed the COPPS-2 giving colchicine 48 to 72 hours before surgery for 1 month without a loading dose and weight adjusted doses (i.e. 0.5 mg twice daily for patients >70kg or 0.5 mg once for patients <70Kg) in order to improve patients compliance.The Colchicine for Prevention of the Post-pericardiotomy Syndrome and post-operative atrial fibrillation (COPPS-2 trial) is an investigator-initiated, double-blind, placebo-controlled, randomized clinical trial. A total of 360 consecutive candidates for cardiac surgery, 180 for each arm, were enrolled in 11 Italian centers between March 2012 and March 2014. Main exclusion criteria were absence of sinus rhythm at enrollment, cardiac transplantation, and contraindications to . (more…)
Author Interviews, Heart Disease, NEJM / 30.08.2014

MedicalResearch.com Interview with: John J.V. McMurray, M.D Professor of Medical Cardiology British Heart Foundation, Cardiovascular Research Centre University of Glasgow, Glasgow, United Kingdom MedicalResearch.com Interview with: John J.V. McMurray, M.D Professor of Medical Cardiology British Heart Foundation, Cardiovascular Research Centre University of Glasgow, Glasgow, United Kingdom Medical Research: What are the main findings of the study? Dr. McMurray: That compared to an evidence-based dose of an evidence-based ACE inhibitor (enalapril 10 mg bid), LCZ696 reduced the primary composite outcome of cardiovascular death or heart failure hospitalization by 20%, both the components of that composite and all-cause mortality (the latter by 16%) - all reductions are highly statistically significant and clinically important. LCZ696 treated patients also reported fewer symptoms and physical limitations due to heart failure. We think this is a remarkable finding - to beat what has been the gold-standard, cornerstone, therapy for around 25 years. The findings show conclusively that adding neprilysin inhibition to renin-angiotensin system blockade is superior to renin-angiotensin system blockade alone in patients with heart failure and reduced ejection fraction . (more…)
Author Interviews, Lancet, Obstructive Sleep Apnea / 30.08.2014

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