AHA Journals, Author Interviews, Heart Disease / 03.07.2014

Sripal Bangalore, MD, MHA Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, Associate Professor of Medicine, New York University School of Medicine, New York, NY 10016MedicalResearch.com Interview with: Sripal Bangalore, MD, MHA Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, Associate Professor of Medicine, New York University School of Medicine, New York, NY 10016 Medical Research: What are the main findings of the study? Dr. Bangalore: We found that while CABG was associated with mortality benefit when compared with bare metal stents or first generation drug eluting stent, the gap between CABG and PCI was smaller and non significant when PCI was with newer generation DES. The same was true for repeat revascularization with the magnitude of benefit with CABG descending considerable from comparison with balloon angioplasty to newer generation DES. (more…)
Author Interviews, Cancer Research, Lancet, Mayo Clinic, Radiation Therapy / 03.07.2014

Dr. Robert Foote MD Chair, Department of Radiation Oncology Mayo Clinic, Rochester, MNMedicalResearch.com Interview with: Dr. Robert Foote MD Chair, Department of Radiation Oncology Mayo Clinic, Rochester, MN MedicalResearch: What are the main findings of the study? Dr. Foote: Charged particle therapy (mainly protons and carbon ions) provide superior overall survival, disease-free survival and tumor control when compared to conventional photon therapy.  In particular, it appears that proton beam therapy provides superior disease-free survival and tumor control when compared to the state of the art intensity modulated radiation therapy using photons. (more…)
Author Interviews, Gastrointestinal Disease, Genetic Research, NEJM, Pediatrics / 03.07.2014

Dr. Daniel AgardhMedicalResearch.com Interview with: Dr. Daniel Agardh M.D., Ph.D Department of Pediatrics Diabetes and Celiac Disease Unit Skåne University Hospital Malmo, Sweden, MedicalResearch: What are the main findings of the study? Dr. Agardh: In this study, we stratify the risk of celiac disease among children according to their HLA genotype and country of residence. We confirm that HLA-DQ2/2 genotype is the major risk factor for early celiac disease, but also show how the risk differs between the participating countries despite of sharing similar HLA risk. This points to the direction of an interaction between HLA and the environment that eventually lead to an autoimmune response in genetic susceptible children. (more…)
AHA Journals, Author Interviews, Chocolate, PAD / 03.07.2014

MedicalResearch.com Interview with: Lorenzo Loffredo, MD and Francesco Violi, MD Department of Internal Medicine and Medical Specialties Sapienza University of Rome, Rome, Italy; MedicalResearch: What are the main findings of the study? Answer: Dark chocolate is rich of polyphenols; these natural substances exert antioxidant properties and, through an increase of nitric oxide, dilate arteries. Our research group applied this effect to enhance blood flow in a very common disease, the peripheral arterial disease. This disease is characterized by reduced blood flow to the limbs. There are not any drugs that improve this blood flow, but dark chocolate could. Our study suggest that dark chocolate, and only dark chocolate, could reduce oxidative stress and improve blood flow and walking autonomy in patients with peripheral arterial disease. We observed no effect on blood flow, oxidative stress and on walking autonomy in PAD patients after milk chocolate assumption. This lack of effect was probably due to the low concentration of polyphenols in milk chocolate. (more…)
Accidents & Violence, Author Interviews, Global Health, Lancet, Pharmacology / 03.07.2014

MedicalResearch.com Interview with: Tamara Haegerich, PhD Deputy Associate Director for Science Division of Unintentional Injury Prevention CDC - National Center for Injury Prevention and ControlMedicalResearch.com Interview with: Tamara Haegerich, PhD Deputy Associate Director for Science Division of Unintentional Injury Prevention CDC - National Center for Injury Prevention and Control MedicalResearch: What are the main findings of the study? Dr. Haegerich: In the first three decades of life, more people in the US die from injuries and violence than from any other cause. Approximately 60% of fatal injuries are unintentional (for example, from motor vehicle crashes, drug overdose, and falls), 20% are due to suicide, and 20% are due to homicide. Injuries and violence have been linked to a wide range of physical, mental health, and reproductive health problems, and chronic diseases. They take an enormous economic toll, including the cost of medical care and lost productivity. Importantly, injuries and violence are preventable through education, behavior change, policy, engineering, and environmental supports. For example, laws that promote the use of seat belts and child safety seats, and prevent drunk driving, can reduce motor-vehicle-related injuries. Early childhood home visitation, school-based programs, and therapeutic foster care are examples of evidence-based approaches to preventing violence. Improving proper prescribing of painkillers and access to treatment for substance misuse could prevent prescription drug overdoses. Improvements are possible by framing injuries and violence as preventable, identifying interventions that are cost-effective and based on research, providing information to decision makers, and strengthening the capacity of the health care system. (more…)
Author Interviews, Hematology, JAMA, Stem Cells, Transplantation / 03.07.2014

John F. Tisdale, MDMedicalResearch.com Interview with: Dr. John Tisdale MD Molecular and Clinical Hematology Branch National Institute of Diabetes and Digestive and Kidney Diseases, National Heart, Lung, and Blood Institute, Bethesda, Maryland MedicalResearch: What are the main findings of the study? Dr. Tisdale: Using a nonmyeloablative allogeneic HLA-match peripheral blood stem cell transplantation strategy aimed at tolerance induction, we were able to revert the phenotype in 26 of 30 adult patients with severe sickle cell disease ranging in age from 16 to 65 years. In contrast to standard transplantation strategies which rely on high doses of chemo and/or radiotherapy after which the entire bone marrow and blood system is replaced by that of the donor, our patients had a mixture of their own and that of their donor. This procedure was well tolerated, with no non-relapse mortality, and led to complete replacement of red blood cells by that of the donor in successfully engrafted patients. This replacement resulted in decreases in pain, pain medication usage, hospitalizations, and improvements in organ function. (more…)
Author Interviews, Diabetes, Lancet / 03.07.2014

MedicalResearch.com Interview with: Professor Yves Reznik Department of Endocrinology, University of Caen Côte de Nacre Regional Hospital Center Caen, France MedicalResearch: What are the main findings of the study? Prof. Reznik: OPT2MISE definitively demonstrate that pump therapy is a valuable option for treating those type 2 diabetes patients with uncontrolled hyperglycemia despite a high dose insulin regimen including at least 3 injections per day of rapid-acting and slow-acting insulin analogues, the gold standard for intensified insulin therapy. Such benefit on glucose control is obtained with lower daily insulin doses and without weight gain in comparison with multiple injection therapy. Pump therapy is effective in a population of patients un-preselected for their ability to deal with a medical device. (more…)
Author Interviews, Breast Cancer, JNCI, MD Anderson, Weight Research / 02.07.2014

Sai-Ching Jim Yeung, MD, PhD, FACP Professor of Medicine The University of Texas MD Anderson Cancer Center Department of Emergency Medicine Department of Endocrine Neoplasia & Hormonal Disorders Houston, Texas 77230-1402MedicalResearch.com Interview with Sai-Ching Jim Yeung, MD, PhD, FACP Professor of Medicine The University of Texas MD Anderson Cancer Center Department of Emergency Medicine Department of Endocrine Neoplasia & Hormonal Disorders Houston, Texas  77230-1402 MedicalResearch: What are the main findings of the study? Dr. Yeung: We believe that this study has bridged a significant gap in knowledge between epidemiological data (the association of obesity and poor breast cancer prognosis) and biological mechanisms mediating the impact of obesity on cancer. This study provides an important mechanistic insight into the causal relationship between obesity and breast cancer growth.
  1. Direct evidence for the links between obesity-associated changes in the biological processes and hallmarks of cancer in human estrogen receptor-positive (ER+) breast cancer. 
It is well known that obesity is associated epidemiologicaly with decreased survival in ER+ breast cancer patients. Although a body of experimental literature exists to suggest important roles for estrogen, insulin/IGF-1 and adipokine signaling and inflammation in the mechanisms mediating the impact of obesity on cancer, direct evidence for these mechanisms and their importance relative to one another is lacking in cancers from obese humans. Functional transcriptomic analysis of a prospective observation cohort with treatment-naïve ER+ breast cancer samples identified the insulin/PI3K signaling and secretion of cytokines among the top biological processes involved. Many of the obesity-associated changes in biological processes can be linked to cancer hallmarks.  Upstream regulator analysis identified estrogen (?-estradiol), insulin (INS1), insulin-like growth factor-1 (IGF1), and adipokines [vascular endothelial growth factor A (VEGFA), tissue necrosis factor (TNF), interleukin-6 (IL6), oncostatin-M (OSM), chemokine ligand 5 (CCL5), leptin (LEP), leukemia inhibitory factor (LIF), C-reactive protein (CRP), adiponectin (ADIPOQ), and interleukin-10 (IL10)] in mediating the impact of obesity on human ER+ breast cancer.
  1. Experimental evidence that obesity causes accelerated oncogene-driven ER+ breast cancer carcinogenesis.
While it is not possible to conduct a human experiment to prospectively examine the causal relationship between obesity and breast cancer, we created a transgenic mouse model with genetically induced obesity and oncogene-driven breast cancer.  With this model we found strong in vivo evidence using both longitudinal experiments and cross-sectional experiments that obesity accelerated oncogene-driven breast carcinogenesis. (more…)
Author Interviews, Heart Disease, NEJM, Stroke / 01.07.2014

MedicalResearch.com Interview with: Dr. Tommaso Sanna MD Institute of Cardiology Catholic University of the Sacred Heart Rome, Italy MedicalResearch: What are the main findings of the study? Dr. Sanna: In patients with cryptogenic stroke, continuous ECG monitoring with an implantable device, called the Reveal XT Insertable Cardiac Monitor (ICM), discovered Atrial Fibrillation in 6.4 times more patients than conventional diagnostic strategies at six months, 7.3 times more patients at 12 months, and 8.8 times more patients at 36 months. In more detail, after 36 months of follow-up, 30% of patients with cryptogenic stroke had at least one episode of atrial fibrillation. (more…)
Author Interviews, Colon Cancer, JNCI / 01.07.2014

Kaspar Truninger, MD, FMH Gastroenterology and Internal Medicine Langenthal, SwitzerlandMedicalResearch.com Interview with: Kaspar Truninger, MD, FMH Gastroenterology and Internal Medicine Langenthal, Switzerland MedicalResearch: What are the main findings of the study? Dr. Truninger: In our study, we investigated the effect of lifestyle exposure on DNA methylation. We measured genome-wide promoter CpG methylation in 1092 normal colon biopsies from 546 healthy females. We observed that fewer CpGs acquired age-dependent methylation in users of aspirin and hormonal replacement therapy compared with nonusers, whereas more CpGs were affected in smokers and individuals with a body mass index > 25 compared with nonsmokers and less obese females. Half of the CpGs showing age-dependent methylation gain were hypermethylated in tissue of colorectal cancer. These loci gained methylation with a higher rate and were particularly susceptible to lifestyle exposure compared to age-only methylated CpGs. In addition, these CpGs were enriched for polycomb regions.  Finally, all effects were different according to the anatomic location along the colon. (more…)
Author Interviews, BMJ, Gender Differences, Mental Health Research / 01.07.2014

Dr. Flora I Matheson PhD Centre for Research on Inner City Health St. Michael's Hospital Toronto, ON, CanadaMedicalResearch.com Interview with: Dr. Flora I Matheson PhD Centre for Research on Inner City Health St. Michael's Hospital Toronto, ON, Canada MedicalResearch: What are the main findings of the study? Dr. Matheson:
  • We found that women were 10 per cent more likely to use mental health services than men.
  • And that within any 3-year period, women with physical illness used medical services for mental health treatment 6 months earlier than men.
(more…)
Author Interviews, Cost of Health Care, Global Health, Lancet / 01.07.2014

MedicalResearch.com Interview with:  M Luca Lorenzoni OECD Organisation for Economic Co-operation and Development Health Accounts, Asian Health and Social Policy Outreach ELS/Health Division MedicalResearch: What are the main findings of the study? Answer: 
  • The United States is an outlier in the scenery of OECD as it ranks first for health care expenditure, but last for coverage.
  • The slowdown in US health care spending during the past decade brought the growth rate closer to that of other high-spending countries -Canada, France, Germany, the Netherlands and Switzerland- at around 1%. Previously in 2002, the US's health expenditure growth was around 7%, much higher than the approximate 3% which was the average for the other countries examined in the study
  • Higher health-sector prices (e.g., hospital care and prescription drugs) are thought to be the main driver of expenditure differences between the US and other high-spending countries, and recent price dynamics largely explain declines in health expenditure growth. (more…)
Author Interviews, Diabetes, JAMA / 01.07.2014

MedicalResearch.com Interview with:Sandeep Vijan, MD, MS Center for Clinical Management Research Ann Arbor Veterans Affairs Hospital, Department of Internal Medicine, University of Michigan, Ann Arbor Michigan Sandeep Vijan, MD, MS Center for Clinical Management Research Ann Arbor Veterans Affairs Hospital, Department of Internal Medicine, University of Michigan, Ann Arbor Michigan MedicalResearch: What are the main findings of the study? Dr. Vijan: The main finding was that the burdens and side effects of intensive glycemic treatment significantly detract from the overall benefit of lower risks of diabetes complications, often to the point where the treatments cause more loss than gain in quality of life. It takes many (often 15-20) years to gain benefit from treatment, but the burdens begin right away and continue throughout treatment. By the time you might experience treatment benefit in terms of reduced complication risk, you've had a lot of years to have the downsides of treatment - which commonly include significant weight gain, low blood sugars, gastrointestinal symptoms, not to mention having to take multiple pills or injections on a daily basis. (more…)
Annals Internal Medicine, Author Interviews, Herpes Viruses, HIV / 01.07.2014

Connie Celum, MD, MPH Professor of Global Health and Medicine Director, International Clinical Research Center University of Washington Harborview Medical Center Seattle WA 98104MedicalResearch.com: Interview with Connie Celum, MD, MPH Professor of Global Health and Medicine Director, International Clinical Research Center University of Washington Harborview Medical Center Seattle WA  98104 MedicalResearch: What are the main findings of the study? Dr. Celum: We conducted a randomized, double blind study of daily oral tenofovir and tenofovir combined with emtricitabine (FTC) as oral pre-exposure prophylaxis (PrEP) for HIV among HIV serodiscordant couples (in which onepartner had HIV and the other partner did not) in Kenya and Uganda. Because of recent studies showing that tenofovir gel could reduce the chances of becoming HSV-2 infected, we studied the subset of HIV-uninfected partners who did not have HSV-2 and compared the rates who became HSV-2 infected during follow-up among those  who received oral pre-exposure prophylaxis versus those who received placebo.  We found that oral pre-exposure prophylaxis reduced HSV-2 acquisition by 30%. (more…)
Author Interviews, Diabetes, Genetic Research, Nature / 30.06.2014

Dr. Domenico Accili MD Professor of Medicine Department of Medicine Columbia University College of Physicians and Surgeons New York, New York 10032MedicalResearch.com: Interview with Dr. Domenico Accili MD Professor of Medicine Department of Medicine Columbia University College of Physicians and Surgeons New York, New York 10032 MedicalResearch: What are the main findings of the study? Dr. Accili: By switching off a single gene (foxo1), scientists at Columbia University’s Naomi Berrie Diabetes Center have converted human gastrointestinal cells into insulin-producing cells, demonstrating in principle that a drug could retrain cells inside a person’s GI tract to produce insulin. (more…)
AHA Journals, Author Interviews, Heart Disease / 30.06.2014

MedicalResearch.com Interview with: Eddie Hulten, MD MPH FACC FSCCT Eddie Hulten, MD MPH FACC FSCCT and Ron Blankstein, MD FACCRon Blankstein, MD FACC Cardiovascular Imaging Noninvasive Cardiovascular Imaging Walter Reed National Military Medical Center Brigham and Women’s Hospital Bethesda, MD Boston, MA MedicalResearch: What are the main findings of the study? Answer:  Although any medical test should be used to change management, the extent to which CCTA (Cardiac computed tomography angiography) findings are associated with medication changes (aspirin and lipid lowering) is not previously extensively studied. Thus, we conducted the largest and one of the longest follow up studies of preventive cardiovascular medications before and after coronary computed tomography angiography (CCTA).  We demonstrated that CCTA findings are associated with significant changes in preventive medications after CCTA. (more…)
Allergies, Author Interviews, BMJ, Smoking / 29.06.2014

Dr. Wojciech Feleszko Department of Pediatric Respiratory Diseases and Allergy The Medical University of Warsaw Działdowska Warsaw, PolandMedicalResearch.com Interview with Dr. Wojciech Feleszko Department of Pediatric Respiratory Diseases and Allergy The Medical University of Warsaw Działdowska Warsaw, Poland MedicalResearch: What are the main findings of the study? Dr. Feleszko: We combined data from nineteen population-based cohort studies of 24 000 children and we found that household exposure to tobacco smoke after birth has immunomodulating effects.  We demonstrated an increased sensitivity to allergens, measured by serum IgE and skin testing which may contribute to the increased development of allergy in children exposed postnatally to household tobacco smoke. (more…)
Author Interviews, CHEST, Critical Care - Intensive Care - ICUs / 27.06.2014

MedicalResearch.com Interview with: James R. Klinger, MD, FCCP Professor of Medicine, Brown University Darren Taichman, MD, PhD, FCCP Adjunct Associate Professor of Medicine, University of Pennsylvania Greg Elliott, MD, MACP, FCCP Professor of Medicine, University of Utah School of Medicine Background: The authors discuss the June 17, 2014 CHEST publication: Pharmacological Therapy for Pulmonary Arterial Hypertension in Adults: CHEST Guideline MedicalResearch: How widespread is the problem of Pulmonary Arterial Hypertension (PAH)? Greg Elliott: PAH is an uncommon, but important disorder because untreated it is usually progressive and fatal, AND there are effective treatments. This makes the guidelines important for physicians, patients and insurers. MedicalResearch: What are the most common causes of PAH? Greg Elliott: Common causes are connective tissues diseases like scleroderma, toxins like methamphetamine and cases for which the cause is not known, i.e. idiopathic. Some (about 20 %) idiopathic cases are caused by gene mutations. (more…)
Author Interviews, BMJ, Endocrinology, Weight Research / 27.06.2014

MedicalResearch.com Interview with: Mojca Jensterle Department of Endocrinology. Diabetes and Metabolic Diseases. University Medical Centre. Zaloska 7. Slovenia. MedicalResearch: What are the main findings of the study? Answer: This is the first report demonstrating that selective phosphodiesterase enzyme (PDE) 4 inhibitor roflumilast added to metformin (MET) was superior to metformin alone in reducing mean body weight after 12 weeks of treatment in obese women with polycystic ovary syndrome (PCOS), primarily due to a loss of fat mass. 31 women with PCOS diagnosed by the National Institute of Child Health and Human Development criteria aged 33.8 ± 7.4 years with BMI 36.4 ± 5.1 kg/m2concluded the study. They were randomized to MET 1000 mg BID or combined treatment (COM) with MET 1000 mg BID and roflumilast 500 mcg QD. The primary outcome were changes in anthropometric measures of obesity. At study endpoint subjects treated with COM lost on average 4.2 ± 2.8 kg compared to a 0.9± 2.5 kg weight gain in METgroup (p<0.001). BMI decreased for 1.6 ± 1.1 kg/m2 in COM arm compared to increase for 0.9 ± 2.4 kg/m2 in MET arm (p= 0.001). Total body fat decreased for 0.7±0.4 % in COM as opposed to 0.2 ± 0.1 % increase in MET and visceral adipose tissue (VAT) area as assessed by DXA decreased for 15.5 ± 1.6 cm2 in COM as opposed to 11.4 ± 5.3 cm2 increase in MET. The greater waist circumference reduction was noted in COM (4.2 ± 1 cm) compared with MET (0.8 ± 0.7 cm). The improvements of obesity measures were associated with beneficial effects on fasting glucose levels, insulin resistance and resolution of metabolic syndrome in affected women. The hypothesis behind the weight decrease and beneficial metabolic impact observed with roflumilast is based on the PDE4 regulation of signaling pathways linked to GLP-1 release. In experimental rodent model a single treatment with roflumilast enhanced plasma GLP-1 levels up to 2.5 -fold. (more…)
Author Interviews, BMJ, Disability Research / 27.06.2014

MedicalResearch:com Interview with: Stephen Honeybul FDS RCS (Eng), FRCS (SN), FRACS Consultant Neurosurgeon Sir Charles Gairdner Hospital HOD Royal Perth Hospital Perth WA Australia MedicalResearch: What are the main findings of this study?  Dr. Honeybul: Amongst those patients who had been adjudged severely disabled or in a vegetative state at 18 months, remained as such at the three years follow up. Most patients who were able to provide a response said that they would have provided consent to the "life saving" intervention even if they had known their final outcome (more…)
Author Interviews, Autism, Lancet, Mental Health Research / 26.06.2014

Dr Sarah Cassidy PhD Autism Research Centre,Department of Psychiatry University of Cambridge, Cambridge, UKMedicalResearch.com Interview with: Dr Sarah Cassidy PhD Autism Research Centre,Department of Psychiatry University of Cambridge, Cambridge, UK MedicalResearch.com: What are the main findings of the study? Dr. Cassidy: We found that adults with late diagnosis of Asperger Syndrome (31 years on average), were at significantly higher risk of contemplating suicide during their lifetime (66%) than those from the general UK population (17%), and a sample of patients with Psychosis (59%). We also found that adults diagnosed with Asperger Syndrome with a history of depression, were significantly more likely to experience suicidal thoughts, and suicide plans or attempts, than those with Asperger Syndrome without a history of depression.  A higher level of autistic traits was also a significant risk factor for having planned or attempted suicide. (more…)
Author Interviews, JAMA, Pediatrics, Surgical Research / 26.06.2014

Frank H. Morriss, Jr., MD, MPH Professor of Pediatrics - Neonatology University of Iowa Carver College of MedicineMedicalResearch.com Interview with: Frank H. Morriss, Jr., MD, MPH Professor of Pediatrics  - Neonatology University of Iowa Carver College of Medicine   MedicalResearch: What are the main findings of the study? Dr. Morriss: Our aim was to assess the association between surgery performed during the initial hospitalization of very low- birth-weight infants and subsequent death or neurodevelopmental impairment at 18-22 months’ corrected age. We conducted a retrospective cohort analysis of patients who were prospectively enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998 to 2009. Surgery was classified by the expected anesthesia type as either major surgery that likely would have been performed under general anesthesia; or minor surgery, that is, procedures that could have been performed under non-general anesthesia and in general were shorter in duration. There were 2,186 major surgery patients and 784 minor surgery patients and more than 9,000 patients who did not undergo surgery. We found that any surgical procedure  increased the adjusted risk of death or neurodevelopmental impairment in low birth weight infants by about 30%. Not all surgical procedures were associated with increased risk, however. Compared with those who did not undergo surgery, patients  who were classified as having major surgery had a risk-adjusted odds ratio of death or neurodevelopmental impairment of 1.52 (95% confidence interval 1.24-1.87). However, those who were classified as having minor surgery had no increased adjusted risk. Among survivors who had major surgery compared with those who did not undergo surgery the risk-adjusted odds ratio for neurodevelopmental impairment was 1.56 (95% confidence interval 1.26-1.93), and the risk-adjusted mean Bayley II Mental Developmental Index and mean Psychomotor Developmental Index values were significantly lower. (more…)
Author Interviews, BMJ, Infections, Pediatrics, Vaccine Studies / 25.06.2014

Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UKMedicalResearch.com: Interview with Kay Wang Academic Clinical Lecturer Nuffield Department of Primary Care Health Sciences University of Oxford, Oxford, UK MedicalResearch: What are the main findings of the study? Dr. Wang: We have found evidence of recent whooping cough infection in 1 in 5 school age children who see their doctor with a persistent cough and in 1 in 6 children who have been fully vaccinated against whooping cough.  We have also shown that whooping cough can still cause clinically significant cough in fully vaccinated children. (more…)
Author Interviews, CMAJ, Compliance, Pharmacology, Statins / 25.06.2014

Dr. Heli Halava: Departments of Public Health and Pharmacology, Turku, FinlandMedicalResearch.com Interview with: Dr. Heli Halava: Departments of Public Health and Pharmacology, Turku, Finland MedicalResearch: What are the main findings of the study? Dr. Halava: The associations between lifestyle factors and nonadherence to statin therapy varied by cardiovascular comorbidity status. Of the participants without cardiovascular comorbidities (n = 6458), 3171 (49.1%) were nonadherent with their statin therapy. Of the participants with cardiovascular comorbidities (n = 2827), 1155 (40.9%) were nonadherent. People with cardiovascular comorbidities who had risky drinking behaviours or a cluster of lifestyle risks were at increased risk of nonadherence. (more…)
AHA Journals, Author Interviews, Race/Ethnic Diversity, Stroke / 25.06.2014

Wuwei (Wayne) Feng MD MS FANA Assistant Professor, Department of Neuroscience Department of Health Science & Research Medical University of South Carolina Stroke Center The Center of Rehabilitation Research in Neurological ConditionsMedicalResearch.com Interview with: Wuwei (Wayne) Feng MD MS FANA Assistant Professor, Department of Neuroscience Department of Health Science & Research Medical University of South Carolina Stroke Center The Center of Rehabilitation Research in Neurological Conditions MedicalResearch: What are the main findings of the study? Dr. Feng: Stroke hospitalization rate is decreasing in the elderly, but increasing in the young/middle aged population, but this increase is mainly driven by the increase in blacks (not in whites) which incurred persistent racial disparity in stroke. It has tremendous economic impact as outlined in the paper. Of hospital charges totaling $2.8 billion over 10-year period, $453.2 million (16.4%) are associated with racial disparity (79.6% from patients <65 years). By way of background: 84,179 stroke hospitalizations occurred in South Carolina from 2001 to 2010. Blacks accounted for 29,846 (35.5%) and whites accounted for 54,333 (64.5%) of the strokes. Among blacks, 50.4% were <65 years of age compared to 29.6% among whites. The overall stroke hospitalization rate decreased over the 10-year period. There was a significant reduction in stroke hospitalization rate in the older (≥65 years old) populations, for both blacks and whites. Whereas, in the younger populations (<65 years old), the overall rate of stroke hospitalizations actually increased significantly; however this increase was only associated with black patients. For example, the hospitalization rate per 100,000 for young blacks was 121 in 2001, 139 in 2005 and 142 in 2010 (a 17.3% increase from 2001). This racial disparity was more severe in the younger group with the highest disparity seen in the 45-54 year age groups for both ischemic strokes (having a clot) and intra-cerebral hemorrhagic strokes. (more…)
Author Interviews, Gender Differences, Heart Disease, JAMA / 25.06.2014

MedicalResearch.com Interview with: David Strauss, M.D., Ph.D., Senior Author Medical Officer Center for Devices and Radiological Health U.S. Food and Drug Administration, Silver Spring, Md MedicalResearch: What are the main findings of the study? Dr. Strauss: The underrepresentation of women in clinical trials for cardiac resynchronization therapy (CRT) devices, as with other devices, has made it difficult to assess differences in the safety and effectiveness of these devices for women vs. men. The FDA is exploring the potential of pooling and analyzing data from multiple trials to bridge the knowledge gap for certain subpopulations (such as women) often underrepresented in medical device clinical trials. By conducting one such meta-analysis, the FDA found that women benefit from cardiac resynchronization therapy (CRT) significantly more than men do. (more…)
Author Interviews, Heart Disease, Lancet / 24.06.2014

Professor Lixin Jiang MD, PhD, F.A.C.C. National Clinical Research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular Disease Fuwai Hospital, National Center for Cardiovascular Diseases Beijing , ChinaMedicalResearch.com Interview with: Professor Lixin Jiang MD, PhD, F.A.C.C. National Clinical Research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular Disease Fuwai Hospital, National Center for Cardiovascular Diseases Beijing , China MedicalResearch: What are the main findings of the study? Professor Jiang: In this first representative nationwide assessment of quality of care in China, we studied 13,815 hospital admissions for STEMI in 162 hospitals across China over the past decade. We found that the incidence of hospital admission for STEMI quadrupled from 3.7 per 100,000 in 2001 to 15.8 per 100,000 in 2011. There were substantial changes in testing and treatment patterns. Over the study period, the rate of testing for troponin increased from 21.4% in 2001 to 66.5% in 2011. Additionally, based at the ideal patients’ analysis, the use of several highly effective treatments for STEMI, including aspirin, clopidogrel and statins, improved over the study period. However, other therapies known to reduce mortality in STEMI patients – such as β-blockers and ACE inhibitors – were underused with only 57.7% of patients receiving beta-blockers and 66.1% ACE inhibitors respectively in 2011. While the proportion of patients receiving reperfusion therapy remained constant, there was a notable shift away from fibrinolysis, which was the primary means of reperfusion in 2001, towards primary PCI. However, in 2011, only 27.6% of patients admitted to Chinese hospitals for STEMI received primary PCI, the gold standard of treatment, while 27.4% received fibrinolytic therapy in the ideal patients. Despite increasing overall intensity of treatment, procedure use, and testing, no significant change in the rate of in-hospital death from STEMI was seen over the study period. (more…)
Author Interviews, Hospital Readmissions, JAMA, Surgical Research / 24.06.2014

Benjamin S. Brooke, M.D., Ph.D. Assistant Professor of Surgery Division of Vascular Surgery University of Utah School of MedicineMedicalResearch.com Interview with: Benjamin S. Brooke, M.D., Ph.D. Assistant Professor of Surgery Division of Vascular Surgery University of Utah School of Medicine MedicalResearch: What are the main findings of the study? Dr. Brooke: This study was designed to evaluate whether high-risk surgical patients who visit a primary care provider (PCP) during the early period following hospital discharge are less likely to be readmitted within 30-days.  We examined this question by performing a retrospective cohort analysis of Medicare beneficiaries (2003-2010) who underwent a high risk surgery (open thoracic aortic aneurysm repair) as well as a control group of patients who underwent a lower risk surgical procedure (open ventral hernia repair), and then determining whether there was evidence of early PCP follow-up. In risk-adjusted analyses, we found that early primary care provider-follow-up was associated with a significant lower likelihood of 30-day readmission for high-risk patients undergoing open thoracic aortic aneurysm repair, particularly if a post-operative complication had occurred.  In comparison, early primary care provider follow-up did not have a significant effect on lowering readmissions in uncomplicated patients and those undergoing lower-risk operations such as ventral hernia repair. (more…)
Author Interviews, Cognitive Issues, JAMA, Mayo Clinic / 24.06.2014

Prashanthi Vemur, Ph.D. Mayo Clinic Rochester, MinnesotaMedicalResearch.com Interview with: Prashanthi Vemur, Ph.D. Mayo Clinic Rochester, Minnesota   MedicalResearch: What are the main findings of the study? Dr. Vemuri: Lifetime intellectual enrichment might delay the onset of cognitive impairment and be used as a successful preventive intervention to reduce the impending dementia epidemic. We studied two non-overlapping components of lifetime intellectual enrichment: education/occupation-score and mid/late-life cognitive activity measure based on self-report questionnaires. Both were helpful in delaying the onset of cognitive impairment but the contribution of higher education/occupation was larger. (more…)
Author Interviews, JAMA, Pediatrics, Stanford, Surgical Research / 24.06.2014

Kay W. Chang, MD Associate Professor of Otolaryngology and Pediatrics Stanford University Department of Otolaryngology Lucile Packard Children's Hospital at Stanford Division of Pediatric OtolaryngologyMedicalResearch.com Interview with: Kay W. Chang, MD Associate Professor of Otolaryngology and Pediatrics Stanford University Department of Otolaryngology Lucile Packard Children's Hospital at Stanford Division of Pediatric Otolaryngology MedicalResearch: What are the main findings of the study? Dr. Chang: At 18 months after surgery, weight percentiles in the study group increased by a mean of 6.3 percentile points, and body mass index percentiles increased by a mean of 8.0 percentile points. The greatest increases in weight percentiles were observed in children who were between the 1st and 60th percentiles for weight and younger than 4 years at the time of surgery. An increase in weight percentile was not observed in children who preoperatively were already above the 80th percentile in weight. (more…)