Medical Research Journals

31 May Today’s Heroin Users Mostly White, Suburban and Initiated Through Prescription Pain Pills

Posted at 11:11h in Addiction, Author Interviews, JAMA, Pharmacology

MedicalResearch.com Interview with: Theodore J. Cicero, PhD Professor, Vice Chairman for Research Department of Psychiatry Washington University in St Louis St Louis, Missouri MedicalResearch: What are the main findings of the study? Dr. Cicero: Heroin users nowadays are predominantly white men and women in their late 20s living outside large urban areas who were first introduced to opioids through prescription drugs compared to the 1960s when heroin users tended to be young urban men whose opioid abuse started with heroin.

31 May PCOS: Inflammatory Markers May Signal Increase Risk of Pregnancy Complications

Posted at 10:55h in Author Interviews, Endocrinology, JCEM

MedicalResearch.com Interview with: Prof. Stefano Palomba Department of Obstetrics and Gynecology University “Magna Graecia” of Catanzaro Catanzaro, Italy MedicalResearch: What are the main findings of the study? Prof. Palomba: Our study demonstrates that simple markers of inflammation, commonly detectable in clinical practice with commercial kits, are significantly modified in women with PCOS during pregnancy and associated at an increased risk of complications during pregnancy in the same population with PCOS.

30 May Cancer Center Advertisements Focus on Emotional Appeals

Posted at 09:08h in Annals Internal Medicine, Author Interviews, Cancer Research, University of Pittsburgh

MedicalResearch.com Interview with: Yael Schenker, MD, MAS Assistant Professor Division of General Internal Medicine Section of Palliative Care and Medical Ethics University of Pittsburgh Pittsburgh, PA 15213 MedicalResearch: What are the main findings of the study? Dr. Schenker: We analyzed the content of cancer center advertisements placed in top TV and magazine media markets in 2012. Out of 1427 advertisements that met our initial search criteria, we found 409 unique advertisements that promoted clinical services at 102 cancer centers across the country. These advertisements promoted cancer treatments (88%) more often than cancer screening (18%) or supportive services (13%). Provision of information about clinical services was scant. For example, 27% of advertisements mentioned a benefit of advertised services and 2% quantified these benefits. 2% mentioned a risk of advertised services and no advertisements quantified these risks. 5% mentioned costs or insurance coverage and no advertisements mentioned availability under specific insurance plans. In contrast, use of emotional appeals was frequent (85%). Emotional appeals commonly evoked hope for survival, focused on treatment advances, used fighting language, and/or evoked fear. Nearly half of all advertisements included patient testimonials, overwhelmingly focused on stories about survival or cure. Only 15% of testimonials included a disclaimer (for example, “most patients do not experience these results”) and none described the outcome that a typical patient may expect.

29 May Does Nebulized Hypertonic Saline Improve Pediatric Bronchiolitis ?

Posted at 11:05h in Author Interviews, JAMA, Pediatrics, Pulmonary Disease

MedicalResearch.com Interview with: Susan Wu MD Division of Hospital Medicine, Children's Hospital Los Angeles Assistant Professor of Clinical Pediatrics, Keck School of Medicine of the University of Southern California MedicalResearch: What are the main findings of the study? Dr. Wu: We performed a randomized trial at 2 urban free-standing children's hospitals, comparing inhaled 3% hypertonic saline to 0.9% normal saline in patients under 24 months with bronchiolitis. Patients with prematurity less than 34 weeks, cyanotic heart disease, chronic pulmonary disease, and previous episodes of wheezing or bronchodilator use were excluded. Patients were 4 mL of study medication nebulized up to 3 times in the emergency department; if admitted, patients continued to receive the assigned study medication three times a day until discharge. A total of 408 patients were analyzed. We found that 28.9% of patients treated with hypertonic saline required hospital admission, compared with 42.6% of patients in the normal saline group.

29 May Should Women on Seizure Medications Breastfeed Their Babies?

Posted at 10:49h in Author Interviews, JAMA, Neurological Disorders, Pediatrics

MedicalResearch.com Interview with: Kimford J. Meador, MD Professor Department of Neurology & Neurological Sciences Stanford Comprehensive Epilepsy Center Stanford University School of Medicine Stanford, CA 94305-5235. MedicalResearch: What are the main findings of the study? Dr. Meador: Breastfeeding while taking antiepileptic drugs does not appear to pose a risk to the child's development, and in fact the cognitive outcomes were better for those children who were breastfed vs. those were not.

29 May Diabetes: Study Finds Once Weekly Dulaglutide Lowers HbA1c

Posted at 10:35h in Author Interviews, Diabetes, Diabetes Care, Pharmacology

MedicalResearch Interview with: Dr. Valeria Pechtner Medical Advisor, Lilly Diabetes MedicalResearch: What are the main findings of the study? Dr. Pechtner: Used as monotherapy, once-weekly dulaglutide resulted in significant, sustained glycemic lowering, as measured by HbA1c change from baseline. Both the 1.5 mg and the 0.75 mg dose were superior to metformin at the primary endpoint of 26 weeks. At 52 weeks, dulaglutide 1.5 mg continued to demonstrate superiority to metformin, with dulaglutide 0.75 mg showing non-inferiority. In addition, a majority of patients in all arms achieved the American Diabetes Association’s recommended HbA1c target of less than 7 percent, with more patients achieving this goal in the dulaglutide groups at the 26-week endpoint, and more patients achieving the target in the dulaglutide 1.5 mg group at the 52 week timepoint. Additionally, dulaglutide 1.5 mg and metformin resulted in similar weight loss. The tolerability and safety profile was comparable for both medications.

29 May Medical Injuries Relatively Common Among Older Adults

Posted at 00:50h in Accidents & Violence, Author Interviews, BMJ, Geriatrics

MedicalResearch.com Interview Invitation Mary W. Carter, Ph.D. Gerontology Program Director Towson University Towson, MD 21252-0001 MedicalResearch: What are the main findings of the study? Dr. Carter: Nearly 1 in 5 older adults experienced at least one severe medical injury during the five-year study period, and more than half of these occurred in an ambulatory care setting (i.e., not in the hospital). Older adults that were in poorer health and who had greater levels of disability had the greatest risk. Mortality rates were nearly twice as high among older adults experiencing a medical injury in comparison with otherwise similar older adults not experiencing a medical injury. Among survivors, the impact of medical injury was observed for extended periods of time, reflecting increased medical use and costs associated with medical injury.

29 May Hepatitis B: Preventing Transmission from Mother to Baby

Posted at 00:27h in Annals Internal Medicine, Author Interviews, Hepatitis - Liver Disease, OBGYNE, Vaccine Studies

MedicalResearch.com Interview with: Ai Kubo, MPH PhD Kaiser Permanente Division of Research 2000 Broadway Oakland, CA 94612 MedicalResearch: What are the main findings of the study? Dr. Kubo: The main findings of the study are three folds: 1) The CDC guideline works for the majority of infants in preventing vertical transmission, if the immunizations are done according to the recommended schedule. 2) It takes an organized effort to case-manage each mother-infant pairs in order to achieve almost complete immunization rates and very low transmission rates. 3) Highest risk group was mothers with extremely high viral load and e-antigen positivity. This group of women may benefit from additional therapy to prevent the vertical transmission. However, for others, the risk of transmission is extremely low as long as the infants are immunized according to the guideline.

28 May Methamphetamine Users: Do Brain Function Differences Predispose to Risky Behavior?

Posted at 12:53h in Addiction, Author Interviews, JAMA, Neurological Disorders

MedicalResearch.com Interview with

Dr. Edythe D.London PhD Professor, Departments of Psychiatry and Biobehavioral Sciences, and Molecular and Medical Pharmacology David Geffen School of Medicine, UCLA MedicalResearch: What are the main findings of the study? Dr. London: Brain function related to risky decision-making was different in stimulant users (methamphetamine users) than in healthy control subjects. In healthy controls, activation in the prefrontal cortex (right dorsolateral prefrontal cortex) during risk-taking in the laboratory was sensitive to the level of risk. This sensitivity of cortical activation was weaker in stimulant users, who instead had a stronger sensitivity of striatum activation. The groups also differed in circuit-level activity (network activity) when they were not performing a task but were “at rest.” Stimulant users showed greater connectivity within the mesocorticolimbic system, a target of abused drugs. This connectivity was negatively related to sensitivity in the prefrontal cortex to risk during risky decision-making. In healthy control subjects, connectivity between the right dorsolateral prefrontal cortex and striatum was positively related to sensitivity of prefrontal cortical activation to risk during risky decision-making.

28 May Early Deafness, Cochlear Implants Associated With Cognitive Delays in Children

Posted at 12:45h in Author Interviews, Cognitive Issues, Hearing Loss, JAMA, Pediatrics

MedicalResearch.com Interview with: William Kronenberger, Ph.D., HSPP Professor and Director, Section of Psychology Acting Vice Chair of Administration Department of Psychiatry Indiana University School of Medicine Riley Child and Adolescent Psychiatry Clinic MedicalResearch: What are the main findings of the study? Dr. Kronenberger: The main findings of the study are that children with cochlear implants had two to five times the risk of delays in executive functioning compared to children with normal hearing. Executive functioning is the ability to regulate and control thinking and behavior in order to focus and achieve goals; it is important for everything from learning to social skills. The areas of executive functioning that were most affected in children with cochlear implants were working memory, controlled attention, planning, and concept formation. Approximately one-third to one-half of the sample of children with cochlear implants had at least mild delays in these areas, compared to one-sixth or fewer of the normal-hearing sample. We think that reduced hearing experience and language delays cause delays in executive functioning to occur at higher rates in children with cochlear implants.

27 May How Best to Manage Co-Infection with Both TB and HIV?

Posted at 10:47h in Author Interviews, HIV, Infections, Lancet

MedicalResearch.com Interview with: Dr. Duncan M. Chanda MD Institute for Medical Research & Training and UNZA-UCLMS Research and Training Project University Teaching Hospital Lusaka, Zambia MedicalResearch: What are the main findings of the study? Dr. Chanda: The main findings are that in this cohort of relatively healthy patients, with a median CD4 of 367, ART can be delayed till the end of TB short course chemotherapy without deleterious effects. This differs from studies that looked at cohorts with very low median CD4 ( around 25-150 in most cases) in which early cART was found to reduce mortality and other AIDS defining events.

27 May Cancer Vaccine Development: Using Synthetic Peptides to Penetrate Cell Membrane

Posted at 10:00h in Author Interviews, Cancer Research, JAMA, Vaccine Studies

MedicalResearch.com Interview with: Scott A. Gruber, M.D., Ph.D., MBA, FACS, FCP, FACHE, CPE Chief of Staff, John D. Dingell VA Medical Center Associate Dean for Veterans Affairs & Professor of Surgery Wayne State University School of Medicine John D. Dingell VA Medical Center Chief of Staff Detroit, MI 48201 MedicalResearch: What are the main findings of the study? Dr. Gruber: We successfully addressed the problem of inadequate intracellular delivery of tumor- specific antigens (TSAs) to dendritic cells (DCs) by using synthetic cell-penetrating domains or peptides (CPPs) to create fusion tumor antigens (Ags) that readily penetrate through the plasma membrane. We demonstrated cloning and purification of the TSA melanoma-associated antigen 3 (MAGE-A3) in frame with CPP, producing enhanced cytosolic bioavailability in dendritic cells without altering cell functionality. Further, we showed that recombinant bacterial proteins can be easily engineered to purify large amounts of CPP-MAGE-A3. Use of full-length proteins circumvents the need to define HLA class I allele binding before vaccination and increases the number of epitopes recognized by CD8⁺ cytotoxic T lymphocytes (CTLs) when compared with peptide-pulsed dendritic cells. Finally, the use of proteins rather than plasmids or viral vectors for in vitro dendritic cell vaccine preparation avoids the practical and theoretical safety concerns regarding genomic modification.

26 May After Intracerebral Bleeds: Risks Remain From Both Recurrent Bleed and Future Ischemic Events

Posted at 11:39h in Author Interviews, BMJ, Stroke

MedicalResearch.com Interview with: Michael T. C. Poon, MBChB, BMedSci (Hons) Junior Doctor, Wycombe General Hospital Buckinghamshire Healthcare NHS Trust, UK MedicalResearch: What are the main findings of the study? Dr. Poon: At present, we know that the incidence and one-month case fatality of intracerebral haemorrhage (ICH) have remained static for the past two decades. However, any trend in long-term survival after ICH is less clear. Survivors face the risks of recurrent ICH as well as ischaemic events in the future. The balance between these risks has particular clinical implication on the decision about restarting antiplatelet/anticoagulant therapy after ICH. To address these questions, we undertook a systematic review and meta-analysis to determine whether long-term survival after intracerebral haemorrhage has changed over time, and to re-assess the balance between the risks of recurrent ICH and ischaemic events in studies quantifying both of these risks in the same population. The survival rates after ICH at 1 year and 5 years do not appear to have changed over time – 1 year survival was 46% and 5 year survival was 29%. The risk of recurrent ICH may be influenced by the ICH location, with lobar ICH having a higher rate of recurrence. In contrast to the previous systematic review, we found the risk of ischaemic stroke to be at least as high as the risk of recurrent ICH over 3 years after ICH. This reinforces the difficulty that clinicians and patients have in deciding about antithrombotic treatment after ICH.

25 May Why Are More Breast Cancer Patients Choosing Contralateral Prophylactic Mastectomy?

Posted at 10:59h in Author Interviews, Breast Cancer, JAMA

MedicalResearch.com Interview with: Dr. Sarah Hawley PhD MPH Associate Professor in the Division of General Medicine University of Michigan Research Investigator, Ann Arbor VA Center of Excellence in Health Services Research & Development MedicalResearch: What are the main findings of the study? Dr. Hawley: There are a couple of main findings.

First, we found that nearly 20% of women in our population based sample of breast cancer patients reported strongly considering having contralateral prophylactic mastectomy (CPM, which means they had their unaffected breast removed at the same time as the breast with cancer), and about 8% received it. Of those who did receive contralateral prophylactic mastectomy, most (about 70%) did not have a clinical indication for it, which included a positive genetic mutation of BRCA1 or BRCA2 or a strong family history of breast or ovarian cancer.
However, most women (90%) who received it reported having a strong amount of worry about the cancer coming back (also called worry about recurrence).
We also found that when women had an MRI as part of their diagnostic work-up for breast cancer, they more often received contralateral prophylactic mastectomy than when they did not have an MRI.

24 May Primary Care and Suicide Screening: US Task Force Statement

Posted at 06:37h in Annals Internal Medicine, Author Interviews, Mental Health Research

MedicalResearch.com Interview with: MedicalResearch.com Interview with: Albert L. Siu, MD, MSPH Co-Vice Chair Mount Sinai School of Medicine, New York MedicalResearch: What are the main findings of the study? Dr. Siu: The Task Force looked to see if primary care clinicians could identify people who are at risk of suicide among those without a diagnosed mental...

24 May Prostate Cancer: Tomato Products May Reduce Risk

Posted at 06:23h in Author Interviews, JNCI, Nutrition, Prostate Cancer

MedicalResearch.com Interview with: Edward Giovannucci, MD, ScD Department of Nutrition Harvard School of Public Health Boston, MA MedicalResearch: What are the main findings of the study? Dr. Giovannucci: In 50,000 men followed over 24 years, we found that those regularly consuming tomato products, which are high in lycopene, had a 30% lower risk of developing lethal prostate cancer. Among men being screened regularly with PSA, the risk reduction from high tomato consumption was 50%. We also examined the prostate cancer tissue and found that higher dietary lycopene intake was associated with less new blood vessel formation, which may help explain why the cancers were less likely to progress.

24 May Diabetes: In-Hospital Mortality Risk Has Decreased Over Time

Posted at 00:23h in Author Interviews, Diabetes, JAMA, Yale

MedicalResearch.com Interview with: Neel M. Butala, AB Medical student at Yale School of Medicine New Haven, Connecticut MedicalResearch.com: What are the main findings of the study? Answer: We found that patients with diabetes had a disproportionate reduction in in-hospital mortality relative to patients without diabetes over the decade from 2000 to 2010.

24 May Moderate Physical Activity May Decrease Heart Disease Risk in Perimenopausal Women

Posted at 00:11h in Author Interviews, Exercise - Fitness, JCEM, Menopause

MedicalResearch.com Interview with: Unab I. Khan, M.B.,B.S., M.S. Assistant Professor of Pediatrics and Family & Social Medicine Division of Adolescent Medicine The Children’s Hospital at Montefiore The Pediatric Hospital for Albert Einstein College of Medicine Bronx, NY 10467 MedicalResearch: What are the main findings of the study? Dr. Khan: We wanted to find factors that lead to either an increase or decrease in risk of developing cardiovascular disease. We found that in middle aged overweight and obese women, who may not have any medical problems like diabetes, high blood pressure, high cholesterol, an increase in weight over time and the development of any of the conditions stated above, increased the risk of cardiovascular disease significantly. On the other hand, even moderate physical activity decreased the risk of heart disease, even in the presence of the above stated conditions.

23 May Schizophrenia Treatment Maintenance: Comparison of Long Acting Injectable Medications

Posted at 10:58h in Author Interviews, Compliance, JAMA, Pharmacology, Schizophrenia

MedicalResearch.com Interview with: Scott Stroup, MD, MPH Professor of Psychiatry Director, Program for Intervention Effectiveness Research, Associate Director for Adult Services, Division of Mental Health Services and Policy Research, New York State Psychiatric InstituteDepartment of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York MedicalResearch: What are the main findings of the study? Dr. Stroup: We conducted a study sponsored by the National Institute of Mental Health that compared long-acting injectable antipsychotics for people with schizophrenia. Long-acting injectable antipsychotics, also known as depot antipsychotics, are used to promote treatment adherence. We compared a newer injectable antipsychotic, paliperidone palmitate, to an older one, haloperidol decanoate. We did not find an advantage for the newer drug in overall effectiveness. The drugs performed very similarly, and were tolerated about the same.

22 May Statins for Sepsis-Associated Acute Respiratory Distress Syndrome?

Posted at 09:28h in Author Interviews, Critical Care - Intensive Care - ICUs, NEJM, Statins

Jonathon D. Truwit, MD, MBA Enterprise Chief Medical Officer Sr. Administrative Dean Froedtert-Medical College of Wisconsin Milwaukee, WI 53226

MedicalResearch.com Interview with: Jonathon D. Truwit, MD, MBA Enterprise Chief Medical Officer Sr. Administrative Dean Froedtert-Medical College of Wisconsin Milwaukee, WI 53226 MedicalResearch.com: What are the main findings of the study? Dr. Truwit: Rosuvastatin did not reduce mortality, nor days free of the breathing machine, in patients with sepsis-associated acute respiratory distress syndrome (ARDS). One in four patients with ARDS die.

22 May Both Genetics and Traditional Risk Factors Help Predict Premature Cardiac Events

Posted at 02:34h in Author Interviews, BMJ, Genetic Research, Heart Disease

MedicalResearch.com Interview with: Christopher Labos MD CM, FRCPC, MSc candidate Division of Epidemiology, Biostatistics and Occupational Health McGill University Montreal, Quebec Canada MedicalResearch: What are the main findings of the study? Dr. Labos: A higher genetic risk score (GRS) composed of a set of recently discovered genetic markers strongly linked to cardiovascular disease is associated with an earlier age of first acute coronary syndromes (ACS). We also found that other traditional risk factors such as smoking, obesity and male sex were also associated with an earlier ACS. Two medication classes were also associated with age of first ACS: hormone replacement therapy was associated with earlier ACS while aspirin was associated with ACS occuring at a later age.

22 May Physical Activity May Slow Progression From Gestational To Type 2 Diabetes

Posted at 02:18h in Author Interviews, Diabetes, JAMA, OBGYNE

MedicalResearch.com Interview with: Wei Bao MD, PhD Postdoc fellow, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Rockville, MD 20852 MedicalResearch: What are the main findings of the study? Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are: (1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI). (2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI. (3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI.

22 May Heart Failure Linked to Increased Risk of Diabetes

Posted at 01:57h in Author Interviews, Diabetes, Diabetologia, Heart Disease

MedicalResearch.com Interview with: Malene Nøhr Demant Department of Cardiology Copenhagen University Hospital Gentofte Hellerup, Denmark MedicalResearch: What are the main findings of the study? Dr. Demant: Our study shows that increasing severity of heart failure is associated with an increased risk of developing diabetes. Increasing loop-diuretic dosage was used as a proxy for heart failure severity. Patients with the most severe heart failure were three times more likely to develop diabetes than those with the least severe. Patients who were also being treated with ACE inhibitors (angiotensin-converting-enzyme inhibitors) had a less pronounced increase in diabetes risk. Patients who developed diabetes were 16% more likely to die than those who did not develop diabetes.

22 May Dramatic Increase In Hospitalizations For Atrial Fibrillation As Population Ages

Posted at 01:40h in AHA Journals, Author Interviews, Cost of Health Care, Heart Disease, JACC

MedicalResearch.com Interview with: Nileshkumar J. Patel MD Staten Island University Hospital Staten Island, NY, 10304 and Abhishek J. Deshmukh MD University of Arkansas Little Rock, AR MedicalResearch: What are the main findings of the study? Answer: We analyzed data from almost 4 million hospitalizations for atrial fibrillation (AF) from more than 1,200 hospitals across 45 states in last decade, and found that - Hospitalization rates for atrial fibrillation have increased exponentially among US adults during the past 10 years, particularly in those 65 years or older. - The most frequent coexisting conditions were hypertension (59.99%), diabetes (21.47%) and chronic pulmonary disease (20.01%). - In terms of geographic distribution of admissions, the hospitals in the South constitute (38.5%) the highest percentage of atrial fibrillation hospitalizations, followed by Midwest (24.9%), Northeast (22.2%) and West (14.4%). - Overall in-hospital mortality was 1%. The mortality rate was highest in >80 years age group (1.93%) and patients with concomitant heart failure (8.2%). - The percentage of patients discharged to nursing facility increased from 8.1% in 2000 to 11.5% in 2010 and need for home health care increased from 6.7% to 13.1%. Approximately one fourth of the patients (25.83%) were discharged to long-term care institution if atrial fibrillation hospitalization was complicated by acute ischemic stroke. - Mean cost of AF hospitalization increased significantly from $6,410 in 2001 to $8,439 in 2010 (24.04% increase, p <0.001) even after adjusting for inflation. This represents an absolute increment in annual national cost from approximate 2.15 billion dollars in 2001 to 3.46 billion dollars in 2010. The mean cost of care was highest if AF hospitalization was associated with heart failure ($33,161) and valvular disorders ($28,030).

21 May Pediatric Status Epilepticus: Lorazepam vs Diazepam?

Posted at 11:35h in Author Interviews, JAMA, Neurological Disorders, Pediatrics

MedicalResearch.com Interview with: James Chamberlain, MD Division Chief, Emergency Medicine Children’s National Health System Washington, DC MedicalResearch: What are the main findings of the study? Dr. Chamberlain: Contrary to our hypothesis, lorazepam was not superior to diazepam for treating pediatric seizures. Both medications had similar effectiveness (72-73%) and safety (15-16% incidence of assisted ventilation). Lorazepam caused a longer period of sedation prior to waking up. The difference was approximately 15 minutes.

21 May Hip Osteoarthritis: How Beneficial is Physical Therapy?

Posted at 11:27h in Author Interviews, Exercise - Fitness, General Medicine, JAMA, Rheumatology

MedicalResearch.com Interview Professor Kim Bennell ARC Future Fellow Department of Physiotherapy University of Melbourne Parkville, Vic 3010 Australia MedicalResearch: What are the main findings of the study? Professor Bennell: In 102 people with painful hip osteoarthritis, we compared a 'real' physical therapy program involving exercise, manual therapy techniques,education and provision of a cane if appropriate to a sham physical therapy treatment that was made to look as though it was real but instead involved turned off ultrasound and gentle application of a hand crème to the hip region. Participants in both groups went to see a physical therapist on 10 occasions over 12 weeks and performed home exercises if in the 'real' physical therapy group or lightly applied the cream at home if in the sham group. Participants were followed for 9 months in total. We found that while both groups showed improvements in pain and physical function, the improvements were similar between the two groups. That is, the real physical therapy program did not show greater benefits over a sham treatment.

21 May Kidney Stones: Non-Invasive Treatment Not Always Better

Posted at 10:23h in Author Interviews, JAMA, Kidney Stones, Urology

MedicalResearch Interview with: Charles D. Scales, Jr MD MSHS Assistant Professor of Surgery Division of Urologic Surgery Duke University Medical Center MedicalResearch: What are the main findings of the study? Dr. Scales: When it comes to treating kidney stones, less invasive is not always better. We used the best method short of a randomized trial to balance out patients in terms of factors that might influence the success of treatment. In other words, we achieved a “statistical toss-up” for factors that could influence the outcome of the procedure. When we balanced out all of the factors that might influence the chance of a repeat procedure, we found that about 11% of patients treated with non-invasive SWL had a repeat procedure, as compared to <1% with minimally invasive URS.

21 May Online Educational Game Improved Clinicians’ Hypertension Knowledge and Patient Outcomes

Posted at 09:58h in AHA Journals, Author Interviews, Blood Pressure - Hypertension, Education

MedicalResearch.com Interview with: Dr. Price Kerfoot MD, EdM Rabkin Fellow in Medical Education Associate Professor of Surgery, Harvard Medical School MedicalResearch: What are the main findings of the study? Dr. Kerfoot: (1) An online spaced education game improved clinicians' knowledge of hypertension intensification and generated a modest but significant improvement in time to blood pressure target among their patients with hypertension. (2) As a method to increase clinicians' long-term knowledge, the spaced education game was significantly more effective than providing the identical content via a traditional method (online posting with e-mail reminders).

20 May Antibiotics In Infancy and Childhood Asthma, Viral Infections

Posted at 09:36h in Asthma, Author Interviews, Lancet, Pediatrics

MedicalResearch.com Interview with: Adnan Custovic DM MD PhD FRCP Professor of Allergy Institute of Inflammation and Repair University of Manchester University Hospital of South Manchester Manchester M23 9LT, UK MedicalResearch: What are the main findings of the study? Dr. Custovic: In a longitudinal analysis of the data from our birth cohort study collected from birth to age eleven years, we demonstrated an association between early-life antibiotic prescription and development of wheezing, but not atopy. Furthermore, amongst children with wheezing, antibiotic prescription in infancy increases the risk of subsequent severe wheeze/asthma exacerbations and hospital admissions. This is the first demonstration that children who receive antibiotics in infancy have impaired antiviral immunity later in life, and that early-life antibiotic prescription is associated with variants on chromosome 17q21 locus (which is an asthma susceptibility locus). Our findings suggest that the association between antibiotics and childhood asthma reported in previous studies arises through a complex confounding by indication, in which hidden factors which increase the likelihood of both antibiotic prescription in early life and subsequent asthma development are increased susceptibility to virus infections consequent to impaired antiviral immunity, and genetic variants on 17q21. Our results raises an important issue that effects which are often attributed to environmental exposures may be a reflection of genetic predisposition.

20 May Are Statins Effective In Reducing COPD Flares?

Posted at 01:57h in Author Interviews, NEJM, Pulmonary Disease, Statins

MedicalResearch Interview with: Dr. Gerard J. Criner MD, FACP, FACCP Professor, Medicine Director, Medical Intensive Care Unit and Ventilator Rehabilitation Unit Co-Director, Center for Inflammation, Translational and Clinical Lung Research, Temple University Hospital in Philadelphia, PA MedicalResearch: What are the main findings of the study? Dr. Criner: The STATCOPE Trial (Simvastatin in the Prevention of COPD Exacerbations) found that a statin drug commonly used to lower cholesterol is not effective in reducing the number and severity of flare ups from chronic obstructive pulmonary disease (COPD). The study rigorously tested the hypothesis that statin drugs may be beneficial to persons with COPD because of the drugs’ purported anti-inflammatory effect. However, researchers found that:

40 mg. of daily simvastatin (statin drug) added to usual care did not reduce exacerbation rate or prolong the time to exacerbation in patients with moderate to severe COPD.
Simvastatin had no effect on lung function, quality of life, severe adverse events or mortality.
The data do not demonstrate a therapeutic benefit from statins in patients with moderate to severe COPD.