Medical Research Journals

19 May COPD: Benefits of high dose N-acetylcysteine

Posted at 09:49h in Author Interviews, CHEST, Pulmonary Disease

MedicalResearch.com Interview with: Dr. Hoi Nam Tse, FCCP, MRCP, MBChB Associate Consultant, Kwong Wah Hospital, Hong Kong Life member and Council member of Hong Kong Thoracic Society MedicalResearch: What are the main findings of the study? Dr. Hoi Nam Tse: N-acetylcysteine (NAC) is an oral mucolytic containing anti-oxidative and anti-inflammatory property. Our study demonstrated that long term use of high-dose : N-acetylcysteine (600 mg twice daily for 1 year) was a well-tolerated treatment, and it reduced exacerbations and prolonged time to first exacerbation in ‘high-risk’ COPD patients--which was defined as patients who had 2 or more exacerbations per year, FEV1<50% or both. Such beneficial effect was not obvious in the ‘low-risk’ COPD patients.

18 May Pulmonary Embolism: Evaluation of Age-Adjusted Threshold of D-Dimer Blood Test

Posted at 10:23h in Author Interviews, Blood Clots, CHEST

MedicalResearch.com Interview with Scott C. Woller, MD Co-Director Thrombosis Program Intermountain Medical Center Associate Professor of Internal Medicine University of Utah School of Medicine Murray, UT 84157-7000 Dr. Woller: By way of background, D-dimer, a simple blood test that is used to investigate the diagnosis of suspected pulmonary embolism (PE), and it increases with age. Recent research suggests that the use of an age-adjusted d-dimer threshold may improve diagnostic efficiency without compromising safety. We wished to assess the safety of using an age-adjusted d-dimer threshold in the work-up of patients with suspected pulmonary embolism. MedicalResearch: What are the main findings of the study? Dr. Woller: In this retrospective cohort study we identified 923 patients age > 50 years who presented to our emergency department with suspected pulmonary embolism, and had their pretest probability of PE calculated along with a d-dimer performed. All patients underwent computed tomography pulmonary angiography (CTPA). We observed that among patients unlikely to have PE, adoption of an age-adjusted D-dimer cut-off (compared with a conventional D-dimer cut-off) reduced the need for CTPA in an additional 18.3% of patients, and was associated with a low 90-day rate of failure to diagnose PE.

17 May Two Large Meals May Be Better Than Six Small Meals For Weight, Diabetes Control

Posted at 10:40h in Author Interviews, Diabetes, Diabetologia, Weight Research

MedicalResearch.com Interview with: Hana Kahleova, MD, PhD Diabetes Centre, Institute for Clinical and Experimental Medicine 140 21 Prague Czech Republic MedicalResearch: What was the aim of your study? Dr. Kahleova: The aim of the study was to compare the effect of six (A6 regimen) vs two meals a day, breakfast and lunch (B2 regimen), on body weight, hepatic fat content (HFC), insulin resistance and beta cell function. MedicalResearch: What are the main findings of the study? Dr. Kahleova: Comparison of the effect of six vs. two meals (breakfast and lunch) with the same daily caloric restriction (-500 kcal/day) and macronutrient content, each regimen lasting 12 weeks, demonstrated a superior effect of breakfast and lunch on body weight, hepatic fat content, fasting plasma glucose, C-peptide, glucagon and insulin sensitivity.

17 May Rheumatoid Arthritis: Obesity Impairs Disease Control

Posted at 00:12h in Author Interviews, BMJ, Karolinski Institute, Rheumatology, Weight Research

MedicalResearch.com Interview with: Maria E.C. Sandberg, MSc PhD Institutet för Miljömedicin / Institute of Environmental Medicine Karolinska Institutet Stockholm, Sweden MedicalResearch: What are the main findings of the study? Dr. Sandberg: Overweight at diagnosis significantly decreases the chance of achieving good disease control during the early phase of rheumatoid arthritis (RA).

16 May Tdap Vaccine During Pregnancy: Safety and Efficacy

Posted at 10:36h in Author Interviews, Baylor College of Medicine Houston, JAMA, OBGYNE, Vaccine Studies

MedicalResearch.com Interview with: Flor M. Munoz, MD Department of Pediatrics Department of Molecular Virology and Microbiology Baylor College of Medicine, Houston, Texas MedicalResearch.com: What are the main findings of the study? Dr. Munoz: 1. Tdap vaccine was safe and well tolerated during pregnancy 2. Women who are pregnant have adequate responses to the Tdap vaccine, similar to those of women who are not pregnant. 3. Antibodies to pertussis are efficiently transferred to the fetus through the placenta so that babies of mothers who were vaccinated during pregnancy had significantly higher concentrations of antibody at birth and up to 2 months of age, when compared to infants of mothers who were vaccinated post-partum. 4. Higher antibody concentrations in the first two months of life are likely to provide protection against pertussis during this period of high vulnerability 5. Infants of mothers who were vaccinated during pregnancy had adequate responses to their routine pertussis vaccines at 2, 4, and 6 months of age, and had expected and adequate responses to their 4th dose of vaccine at 1 year of age. The absolute concentration of antibodies to some of the pertussis antigens might be modestly lower after the primary series of vaccines in some infants of mothers who were vaccinated during pregnancy, but this difference does not persist after the 4th dose.

15 May Migraines Associated With Increased Risk of Silent Stroke

Posted at 21:32h in AHA Journals, Author Interviews, Pain Research, Stroke

MedicalResearch Interview with: Dr. Teshamae Monteith MD Assistant professor of Neurology Chief of the Headache Division University of Miami Miller School of Medicine. MedicalResearch: What are the main findings of the study? Dr. Monteith:

A doubling of silent brain infarctions in those with migraine even after adjusting for other stroke risk factors;
No increase in the volume of white-matter hyperintensities (small blood vessel abnormalities) that have been associated with migraine in other studies;
Migraines with aura — changes in vision or other senses preceding the headache — wasn’t common in participants and wasn’t necessary for the association with silent cerebral infarctions.
High blood pressure, another important stroke risk factor, was more common in those with migraine. But the association between migraine and silent brain infarction was also found in participants with normal blood pressure.

14 May Tackle Football Linked to Smaller Hippocampal Volume and Slower Reaction Times

Posted at 18:45h in Accidents & Violence, Author Interviews, Brain Injury, JAMA

MedicalResearch Interview with: Patrick S. F. Bellgowan, PhD Laureate Institute for Brain Research Faculty of Community Medicine, The University of Tulsa, Tulsa, Oklahoma MedicalResearch: What are the main findings of the study? Dr. Bellgowan: These results demonstrate 14% and 24% smaller hippocampal volumes in collegiate football players with and without a history of concussion relative to education-, sex- and age-matched controls participants. Further, the number of years of tackle football experience was correlated with smaller hippocampi and slower baseline reaction times. The hippocampus plays a key role in memory and emotional regulation. Volumetrics of other medial temporal lobe structures (I.e. The amygdala) did NOT show differences among groups suggesting that this effect is localized to the hippocampus.

14 May Evolocumab for LDL Cholesterol Reduction in Statin-Treated Patients

Posted at 15:48h in Author Interviews, JAMA, Statins

MedicalResearch.com Interview with: Jennifer G. Robinson, MD, MPH Professor ,Departments of Epidemiology & Medicine Director, Prevention Intervention Center Department of Epidemiology College of Public Health University of Iowa Iowa City, IA 52242-2007 MedicalResearch: What are the main findings of the study? Dr. Robinson: The PCSK9 antibody, evolocumab, reduced LDL (or bad) cholesterol by about 65-70% regardless of the dose or type of statin used. This is a greater percentage reduction than ezetimibe, another drug used to lower LDL cholesterol in statin-treated patients, which lowered LDL cholesterol 15-20%. Side effects of evolocumab were similar to those for ezetimibe or placebo.

14 May Brief Exercise Before Meals May Improve Blood Sugar Control

Posted at 11:11h in Author Interviews, Diabetes, Diabetologia, Exercise - Fitness, Sugar

MedicalResearch Interview with: Monique Francois Teaching Fellow & Research Assistant at the University of Otago School of Physical Education, Sport and Exercise Sciences University of Otago Dunedin, New Zealand MedicalResearch: What are the main findings of the study? Answer: We found that small 'snacks' of interval exercise before the three main meals lowered postprandial blood glucose and contributed to a lower blood glucose across the day. Whereas 30 minutes of continuous moderate exercise before dinner did not lower postprandial blood glucose nor mean glucose levels the exercise day or the following day, compared to exercise snacking. Six one minute intervals as walking or a combination of walking and resistance 3x per day (before the three main meals) improved glycaemic control in individuals with insulin resistance.

14 May Stroke Risk Reduced by Increased Fruit and Vegetable Consumption

Posted at 10:54h in AHA Journals, Author Interviews, Nutrition, Stroke

MedicalResearch Interview with: Dr. Yan Qu Qingdao Municipal hospital Fruits and Vegetables Consumption and Risk of Stroke A Meta-Analysis of Prospective Cohort Studies MedicalResearch: What are the main findings of the study? Reply: First, both fruits and vegetables were found inversely associated with risk of stroke, and the relationships might be linear. Second, the inverse association of fruits and vegetables consumption with risk of stroke is consistent across subgroup analysis by outcome (stroke incidence and stroke mortality), location where the study was conducted (USA, Europe and Asia), sex (male and female), and stroke subtypes (ischemic and hemorrhagic). Third, citrus fruits, leafy vegetables and apples/pears were found inversely associated with risk of stroke. Fourth, very similar results were found in the subgroup analysis by status [yes: 0.78 (0.71-0.86) or no: 0.79 (0.74-0.85)] of adjusting for 6 or more of the 7 covariates (smoking, alcohol, blood pressure/hypertension, serum cholesterol, physical activity, body mass index, ≥3 dietary variables). These findings generally indicated that the association of fruits and vegetables consumption with the reduced risk of stroke may not be the result of confounding by the known factors.

14 May Post Heart Attack: Insulin Based Diabetes Control and Improved Longevity

Posted at 00:55h in Author Interviews, Diabetes, Heart Disease, Karolinski Institute, Lancet

MedicalResearch.com Interview with: Viveca Ritsinger MD Karolinska Institute, Department of Medicine, Cardiology Unit, Karolinska University Hospital, Stockholm Unit for Research and Development Kronoberg County Council, Växjö, Sweden MedicalResearch: What are the main findings of the study? Dr. Ritsinger: This is a long-term follow-up of the Swedish DIGAMI 1 study where patients with acute myocardial infarction and diabetes were randomized to either intensified insulin-based glycaemic control or to standard glucose lowering treatment. Patients and controls were followed for mortality for over 20 years and 90% of the patients died during follow up. Survival improved during a period of about 8 years. Intensified insulin-based glycaemic control increased survival time by an average of 2.3 years.

13 May Neighborhood Socioeconomic Status Impact On Medicare Rating for Heart Failure

Posted at 21:48h in AHA Journals, Author Interviews, Health Care Systems, Hospital Readmissions, Medicare

MedicalResearch.com Interview with: Alex Blum, MD MPH FAAP Chief Medical Officer Evergreen Health, Baltimore MD 21211 MedicalResearch.com: What are the main findings of the study? Dr. Blum: Accounting for the social risk of patients using a measure of neighborhood socioeconomic status (SES), did not alter the hospital rankings for congestive heart failure (CHF) readmission rates.

13 May Multifaceted Approach Required to Improve Self-Care, Reduce Hospital Readmissions

Posted at 19:58h in Author Interviews, Hospital Readmissions, JAMA, Mayo Clinic

MedicalResearch.com Interview with: Aaron L. Leppin, MD Knowledge and Evaluation Research Unit Mayo Clinic, Rochester, Minnesota MedicalResearch.com: What are the main findings of the study? Dr. Leppin: We conducted a systematic review and meta-analysis of randomized trials assessing the effectiveness of hospital discharge interventions on reducing 30-day readmission rates. We identified 47 trials, 42 of which contributed to the primary meta-analysis. Overall, the interventions that have been tested to reduce early hospital readmissions reduce them by about 20%. The ones that are most effective, though, reduce them by almost 40% and use a consistent but complex approach. These interventions make a robust effort to fully understand the patient’s post-discharge context, often by visiting the patient’s home. They focus on identifying all the things the patient needs to do to be well—whether that’s organizing medications, getting a ride to the clinic, or paying the electric bill—and they determine whether the patient has the necessary resources and capacity to pull it all off. When limitations are found, these interventions have a strategy in place to support the patient through the post-discharge period.

13 May Male Circumcision: Rate of Adverse Events

Posted at 10:12h in Author Interviews, JAMA, Pediatrics

MedicalResearch Interview with: Charbel El Bcheraoui, PhD, MSc Acting Assistant Professor, Global Health Institute for Health Metrics and Evaluation University of Washington Seattle, WA 98121 MedicalResearch: What are the main findings of the study? Dr. El Bcheraoui: We found a low rate of adverse events associated with male circumcision from U.S. hospital settings, especially if the procedure is performed within the first year of life. The rate of adverse events increased about 10 - 20 times if the procedure was performed later in life.

13 May Pregnancy and Risk of Serious Car Crash

Posted at 01:16h in Accidents & Violence, Author Interviews, CMAJ, OBGYNE

Dr. Donald Redelmeier, MD Professor, Full SGS Member Director, Clinical Epidemiology Unit Sunnybrook Health Sciences Centre Toronto, ON MedicalResearch: What are the main findings of the study? Dr. Redelmeier: We identified every woman in Ontario, Canada, who gave birth to a newborn baby between 2006 and 2011 and then evaluated each driver for the months before, during, and after pregnancy. This amounted to about half a million women who accounted for almost 8000 serious crashes that sent the driver to hospital. We found that the second trimester of pregnancy led to a 42% increase in the risk of a serious motor vehicle crash. The increased risk included diverse populations, distinct obstetrical cases, different crash characteristics. The risk equated to about twice the population norm but was still below male drivers at this age.

13 May Suicide A Risk Factor for Mental Health Issues, Suicide in Bereaved

Posted at 01:11h in Author Interviews, Lancet, Mental Health Research

MedicalResearch.com interview with: Dr Alexandra Pitman MBBS MRC Psych MRC Clinical Research Fellow, UCL Division of Psychiatry, UCL (University College London MedicalResearch: What are the main findings of the study? Answer: We conducted a systematic review of all published research comparing the experience of suicide bereavement with bereavement due to other causes, in which we considered the evidence from 57 studies evaluating the effect of bereavement on death, mental health, and social functioning of family members, friends, and other close contacts of the deceased. These studies showed that parents and children bereaved by suicide were at higher risk of mental health problems after the loss than parents and children bereaved by other causes, and that spouses and mothers bereaved by suicide were at higher risk of suicide than spouses and mothers bereaved by other causes. We also found some evidence that people from a range of kinship groups bereaved by suicide report more rejection and shame than people bereaved by other violent deaths, and that feeling stigmatised by the death is commonly experienced after any violent bereavement. It seemed that people bereaved by violent deaths, for example due to accidental death, homicide, drug-related death, motor vehicle crash, undetermined death or suicide, shared a sense of feeling blamed for the death or tainted by their association with the deceased.

12 May Resveratrol Levels In Older Adults Found To Be Unrelated to Lifespan

Posted at 22:33h in Aging, Author Interviews, JAMA

MedicalResearch.com Interview with: Richard D. Semba, MD MPH W. Richard Green Professor of Ophthalmology The Johns Hopkins University School of Medicine Baltimore, MD 21287 MedicalResearch: What are the main findings of the study? Dr. Semba: Resveratrol levels in older adults are not related to the risk of heart disease or cancer and are not related with lifespan. These findings were made in the InCHIANTI Study, a rigorously conducted study of human aging that is sponsored by the National Institute on Aging.

10 May Melanoma: How Many Lymph Nodes Should Be Excised?

Posted at 05:55h in Author Interviews, Cancer Research, JAMA, Surgical Research

MedicalResearch.com Interview with: Dr. Carlo Riccardo Rossi, MD Melanoma and Sarcoma Unit, Veneto Institute of Oncology Surgery Branch, Department of Surgery Oncology, and Gastroenterology, University of Padova, Padova, Italy MedicalResearch: What are the main findings of the study? Dr. Rossi: A total of 90% patients undergone lymph node dissection for melanoma had 12, 7, 14, 6 and 13 excised lymph nodes (10^th percentile of the distribution) after 3 level axillary, 3 level or less neck, 4 level or more neck, inguinal, or ilio-inguinal dissections, respectively.

10 May Frailty Score Helps Predict Postoperative Mortality

Posted at 05:20h in Author Interviews, Frailty, Geriatrics, JAMA, Surgical Research

MedicalResearch.com Interview with: Kwang-il Kim, MD, PhD Associate Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea MedicalResearch: What are the main findings of the study? Answer: There are few tools of preoperative risk stratification for the older adults. We found that not only disease itself but also frailty can lead to post-operative complication and mortality. So we made a scoring model to predict post-operative mortality and morbidity based on comprehensive geriatric assessment and it worked exactly. MedicalResearch: Were any of the findings unexpected? Answer: Under our predictive model, there was inflection point of mortality slope at point 5. Post-operative mortality of someone who scores 4~5 is below 10%, but it of other who scores 6~7 is about 30%. It was unexpected drastic change, so we think that there is physiologic threshold point. MedicalResearch: What should clinicians and patients take away from your report? Answer: Because the elderly are different from adults, clinicians have to focus on functional capacity, co-morbidity, and frailty for their older surgical patients. Make operative decision base on comprehensive geriatric assessment or our scoring model. If you depend on your own feeling, some older patients will suffer from post-operative complication and someone will forfeit his chance of surgery.

08 May Maintaining Physical Activity Important For Healthy Aging

Posted at 09:54h in AHA Journals, Author Interviews, Exercise - Fitness, Geriatrics, Heart Disease

MedicalResearch.com Interview with: Luisa Soares-Miranda, PhD Research Center in Physical Activity, Health and Leisure Faculty of Sport, University of Porto Rua Dr. Plácido Costa, Porto PORTUGAL MedicalResearch: What are the main findings of the study? Dr. Soares-Miranda: Modest physical activity, such as the distance and pace of walking, is important for the heart’s electrical well being of older adults. In our study, older adults that increased their walking pace or distance had a better heart rate variability when compared with those that decreased their walking pace or distance. Our results suggest not only that regular physical activity later in life is beneficial, but also that certain beneficial changes that occur may be reduced when physical activity is reduced. This supports the need to maintain modest physical activity throughout the aging process. Even small increases can lead to a better health, while reducing physical activity has the opposite effect. So, any physical activity is better than none, and more is better.

07 May Prostate Cancer: Low Testosterone Levels Linked to Aggressive Disease

Posted at 10:37h in Author Interviews, BMJ, Prostate Cancer, Testosterone

MedicalResearch.com Interview with: Dr. Ignacio F. San Francisco Departamento de Urología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile MedicalResearch: What are the main findings of the study? Answer: Increasingly, men with low-risk prostate cancer are undergoing a close monitoring regimen called active surveillance, instead of moving forward immediately with treatment. However it is still unclear which men will develop evidence for worsening or more aggressive disease during active surveillance. In this study of 154 men with Gleason 6 prostate cancer followed for 38 months, we found that low levels of free testosterone were significantly associated with increased risk of developing more aggressive disease. We found no significant association with total testosterone concentrations, although there was a general trend towards increased risk with lower levels.

07 May Mortality Dropped After Massachusetts Health Care Reform

Posted at 10:28h in Annals Internal Medicine, Author Interviews, Cost of Health Care, Health Care Systems

MedicalResearch.com Interview with: Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard School of Public Health / Brigham & Women's Hospital Boston, MA 02115 MedicalResearch.com: What are the main findings of the study? Dr. Sommers: We find that over the first four years since Massachusetts' 2006 comprehensive health reform law, all-cause mortality in the state fell by 2.9%, compared to a similar population of adults living in counties outside Massachusetts that did not expand insurance during this period. We also found that the law reduced the number of adults in Massachusetts without insurance, reduced cost-related barriers to care, increased use of outpatient visits, and led to improvement in self-reported health. Overall, we estimate that the health reform law prevented over 320 deaths per year in the state - or one life saved per 830 adults gaining health insurance. Mortality rates declined primarily due to fewer deaths from causes amenable to health care, such as cancer, infections, and heart disease. We also found that the health benefits were largest for people living in poor counties in the state, areas with higher percentage of uninsured adults before the law was passed, and for minorities.

07 May Alzheimer’s : Amyloid Deposits In Healthy People Signals Increased Brain Atrophy

Posted at 10:16h in Alzheimer's - Dementia, Author Interviews, Biomarkers, JAMA

MedicalResearch.com Interview with: Niklas Mattsson MD, PhD University of California San Francisco Center for Imaging of Neurodegenerative Diseases VA Medical Center San Francisco, CA 94121, USA Clinical Neurochemistry Laboratory Institute of Neuroscience and Physiology Sahlgren’s University Hospital/Mölndal MedicalResearch.com: What are the main findings of the study? Dr. Mattsson: The main finding of this study was that cognitively healthy people with signs of...

06 May Pediatric Diabetes Incidence Rises Dramatically in Last Decade

Posted at 01:27h in Author Interviews, Diabetes, JAMA, Pediatrics

MedicalResearch.com Interview with: Dana Dabelea, MD, PhD Professor and Associate Dean, Faculty Affairs Colorado School of Public Health University of Colorado Denver Aurora, CO 80045 MedicalResearch.com: What are the main findings of the study? Dr. Dabelea: We found that the proportion of US youth living with Type 1 Diabetes has increased by at least 21% over a period of only 8 years. This increase was seen in both boys and girls, most age-groups and race/ethnic groups. While we do not completely understand the reasons for this increase, since the causes of Type 1 Diabetes are still unclear, it is likely that something has changed in our environment- both in the US and elsewhere in the world- causing more youth to develop the disease, maybe at increasingly younger ages.

05 May Hepatitis C: Successful Treatment Without Interferon for HCV 3

Posted at 10:33h in Author Interviews, Gastrointestinal Disease, Hepatitis - Liver Disease, NEJM

MedicalResearch.com Interview with: Stefan Zeuzem, M.D. Professor of Medicine, Chief Department of Medicine JW Goethe University Hospital Frankfurt Germany MedicalResearch.com: What are the main findings of the study? Dr. Zeuzem: Main finding is that also patients infected with HCV 3 can be cured with an IFN-free regimen. However, duration of therapy must be prolonged to 24 weeks.

04 May Coffee Consumption and Risk of Type 2 Diabetes

Posted at 12:40h in Author Interviews, Coffee, Diabetes, Diabetologia

MedicalResearch.com Interview with: Dr. Frank B. Hu MD MPH PhD Professor of Nutrition and Epidemiology From the Departments of Nutrition and Epidemiology Harvard School of Public Health, Boston, MA MedicalResearch.com: What are the main findings of the study? Dr. Hu: We found that people who increased the amount of coffee they drank each day by more than one cup over a four-year period had a 11% lower risk for type 2 diabetes than those who made no changes to their coffee consumption, but those who decreased their coffee consumption by more than a cup per day increased their type 2 diabetes risk by 17%.

04 May Dietary Fiber: Potential Mechanism of Appetite Suppression Discovered

Posted at 12:25h in Author Interviews, Nature, Nutrition

MedicalResearch.com Interview with: Professor Gary Frost PhD RD Head of the Nutrition and Dietetic Research Group NIHR Senior Investigator Division of Diabetes, Endocrinology and Metabolism Faculty of Medicine Imperial College Hammersmith Campus London W12 ONN MedicalResearch.com: What are the main findings of the study? Prof. Frost: That acetate that is derived from the fermentation of dietary fiber in the colon by the microbiota is taken up by the hypothalamus in the brain. In the hypothalamus the way the cells metabolize acetate creates a signal that suppresses appetite

03 May Chest Pain in the Emergency Room: Clinical Decision Strategy

Posted at 10:46h in Author Interviews, BMJ, Emergency Care, Heart Disease

MedicalResearch.com Interview with: Dr. Richard Body Emergency Department Manchester Royal Infirmary Manchester UK MedicalResearch.com: What are the main findings of the study? Dr. Body: This paper actually reports the findings of two consecutive, separate studies. We aimed to derive and then externally validate a clinical decision rule to risk stratify patients with suspected acute coronary syndromes in the Emergency Department (ED). This rule could then be used to reduce unnecessary hospital admissions while also making judicious use of specialist high dependency resources. In the first study we derived a clinical decision rule that incorporates 8 variables: high sensitivity troponin T, heart-type fatty acid binding protein; ECG ischaemia; worsening angina; hypotension (systolic blood pressure <100mmHg on arrival); sweating observed in the ED; pain associated with vomiting; and pain radiating to the right arm or shoulder. When we validated the rule at a different centre, we found that its use could have avoided hospital admission for over a quarter of patients while effectively risk stratifying others. Of the 10% of patients who were identified as 'high risk', approximately 95% had a major adverse cardiac event within 30 days. The findings suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule could be used to 'rule in' and 'rule out' acute coronary syndromes immediately, using information gathered at the time of initial presentation to the ED. Before clinical implementation, we recommend that effect of using the MACS rule in practice should first be evaluated in a trial setting. This will enable us to determine: (a) whether physicians and patients are likely to comply with (and be satisfied with) the MACS rule; (b) the safety of the MACS rule when used in practice; and (c) whether use of the MACS rule leads to cost savings for the health service.

02 May Psychological Distress Increases Risk of Diabetes in Pre-Diabetics

Posted at 23:37h in Author Interviews, Diabetes, Diabetes Care, Mental Health Research

MedicalResearch.com Interview with: Marianna Virtanen PhD Finnish Institute of Occupational Health Helsinki, Finland MedicalResearch: What are the main findings of the study? Dr. Virtanen: We examined whether psychological distress predicts incident type 2 diabetes and if the association differs between populations at higher or lower risk of type 2 diabetes. We used a clinical type 2 diabetes risk score to assess future diabetes risk and in addition, participants’ prediabetes status. We found that psychological distress did not predict future type 2 diabetes among participants who were normoglycemic and among those with prediabetes combined with a low diabetes risk score. However, psychological distress doubled the risk of type 2 diabetes among participants with prediabetes and a high diabetes risk score.

02 May Organ Transplantation: What is the Risk of Cancer Transmission?

Posted at 23:20h in Author Interviews, BMJ, Cancer Research, Surgical Research, Transplantation

MedicalResearch.com Interview with: Rajeev Desai SpR Gastroenterology, City Hospital Birmingham Honorary Clinical Research Fellow University Hospital Birmingham / NHS Blood and Transplant, Bristol MedicalResearch: What are the main findings of the study? Dr. Desai: This study of a large national cohort of organ donors shows that, following careful assessment and selection, organs from some donors with a previous history of cancer can be used safely for transplantation. The risks of accepting such organs for transplantation should be balanced with risks of non-acceptance and its consequences including delayed transplantation or non-transplantation.