MedicalResearch.com Interview with: Evropi Theodoratou School of Molecular, Genetic and Population Health Sciences University of Edinburgh MedicalResearch.com: What are the main findings of the...
MedicalResearch.com Interview with:
Prof Guangwei Li MD
Department of Endocrinology
China-Japan Friendship Hospital
Center of Endocrinology and Cardiovascular Disease, National Center of Cardiology & Fuwai Hospital, Beijing, China
MedicalResearch.com: What are the main findings of the study?
Answer: Our study first shows that a six-year period of lifestyle intervention in Chinese people with IGT reduced the incidence of diabetes over a protracted time period and was ultimately associated with a significant reduction in total and cardio-vascular disease mortality. This reduction in mortality appears to be mediated in part by the delay in onset of diabetes resulting from the lifestyle interventions.
(more…)
MedicalResearch.com Interview with:
Professor Harvey White
MB ChB DSc FRACP FACC FESC FAHA FHKCC (Hon) FCSANZ FRSNZ La'auli (matai); Prince Mahidol Laureate; John Neutze Scholar, Director of Coronary Care & Green Lane Cardiovascular Research Unit, Green Lane Cardiovascular Service
Auckland City Hospital NEW ZEALAND
MedicalResearch.com: What are the main findings of the study?
Prof. White: During follow-up (median 3.7 years), the composite primary end point (cardiovascular death, myocardial infarction or stroke) occurred in 9.7% of the 7,924 patients randomly assigned to darapladib and 10.4% of the 7,904 patients in the placebo group (HR 0.94, 95% CI 0.85-1.03 p=0.199).
In the first prespecified secondary endpoint of major coronary events (CHD death, MI or urgent revascularization) compared with placebo, darapladib reduced the rate (9.3% vs. 10.3%; HR=0.9; 95% CI, 0.82-1 p=0.045). Total coronary events (14.6% vs. 16.1%; HR = 0.91; 95% CI, 0.84-0.98,p=0.019). (CHD death, MI, any coronary revascularization, hospitalization for unstable angina) were also reduced. No major safety concerns arose during the trial. (more…)
MedicalResearch.com Interview with:
Dr. Lydia Pace, MD, MPH
Division of Women’s Health, Brigham and Women’s Hospital
Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study?
Dr. Pace: We reviewed the existing literature about the benefits and harms of mammography, focusing on the reduction of breast cancer deaths associated with mammography, as well as the two most often-discussed harms: false positive results and overdiagnosis. We also reviewed the literature about interventions to help patients make informed decisions. We found that the literature suggests that routine screening mammography does reduce mortality associated with breast cancer, across all age groups. However, it is also associated with high rates of false positive results, and considerable rates of overdiagnosis. Overdiagnosis is the most concerning potential risk of mammography screening. Overdiagnosis is the detection of a tumor through screening that would never have caused problems for a patient. It occurs either because of a very slow-growing tumor, or because a woman has medical problems (or is old enough) such that she will likely die of another cause before the cancer became apparent. Overdiagnosis is concerning because we cannot know when a cancer is overdiagnosed, and thus a patient who is overdiagnosed will receive unnecessary treatment for cancer. The scientific literature on mammography is complex, and there are important limitations to the studies both of mammography’s benefits and harms. However, we feel that the best available data suggest that among 10,000 50 year old women undergoing annual mammography for 10 years, 5 deaths will be averted through screening mammography, while about 6130 women will experience at least one positive result. Furthermore, there is about a 19% chance that, if that woman is diagnosed with cancer detected by a mammogram, that cancer is one that would never have caused her problems. Lastly, our review showed that we need more studies to guide us in how an individual woman’s risk should dictate her mammography decisions, and how to support women in making those decisions. However, we know that most women with higher risk for breast cancer will experience higher benefit from mammography screening.
(more…)
MedicalResearch.com Interview with:
Daniel J. Elliott, M.D., MSCE, FACP
Associate Chair of Research
Department of Medicine and Research Scholar
Value Institute, Christiana Care Health System
MedicalResearch.com: What are the main findings of the study?
Dr. Elliott: The optimal workload for hospitalists has been a question since the earliest days of hospital medicine. However there has been very little empirical evidence to understand the relationship between workload and outcomes.
The objective of our study was to determine the association of daily workload for hospitalists on the efficiency, quality, and cost of care. We analyzed data from a single private practice hospitalist group at a community-based health system between February 2008 and January 2011. Our research showed that both length of stay and cost increased for patients as hospitalist workload increased.
At the same time, our research showed that workload did not affect patient satisfaction as measured by HCAHPS scores or quality and safety outcomes including admissions, rapid response team activation and mortality.
(more…)
MedicalResearch.com Interview with:
Professor Rodney Sinclair
University of Melbourne and Epworth Hospital
Melbourne, VIC, Australia
MedicalResearch.com: What are the main findings of the study?
Answer: Activation of Wnt signalling promoted hair growth and fat growth. Inhibition of Wnt signalling reduces fat growth and hair growth. We looked at the fat layer on the scalp. It was reduced by 50% over the bald areas of alopecia areata. The patch of alopecia areata we looked at was new- only appeared a few days earlier and so the changes in fat thickness are rapid.
What is interesting is that the fat layer is dynamic, and significant fluctuations can occur in a rapid period of time in sync with the hair cycle. It is also interesting that ligands for BMP6 and IGF2 are pro-adipogenic.
There are a couple of bigger questions that earlier media reports did not focus on- namely upstream factors regulating the hair cycle clock and the beauty of synchronization of fat and hair growth for seasonal thermal insulation.
(more…)
MedicalResearch.com Interview with:
Dr Oyinlola Oyebode
Specialist Registrar in Public Health
Dept of Epidemiology & Public Health
University College London
MedicalResearch.com: What are the main findings of the study?
Dr. Oyebode: We found that the more fruit and vegetables consumed, the lower the risk of death from any cause, from cancer or from heart disease or stroke. We found that vegetables were better than fruit at equivalent amounts.
(more…)
MedicalResearch.com Invitation with:
Dr Valerie Sung MBBS(Hons) FRACP MPH
NHMRC PhD Candidate, Department of Paediatrics, University of Melbourne, and Community Health Services Research, Murdoch Childrens Research Institute
Paediatrician, Centre for Community Child Health
The Royal Children’s Hospital
MedicalResearch.com: What are the main findings of the study?
Dr. Sung: Lactobacillus reuteri was NOT effective in reducing crying or fussing in infants with colic, whether they are breast or formula fed. This is the largest and most rigorous trial to date to show this.
(more…)
MedicalResearch.com Interview with:
Mary A.M. Rogers, PhD, MS
Research Associate Professor
Research Director, Patient Safety Enhancement Program
Department of Internal Medicine
University of Michigan Ann Arbor, MI 48109-2800
MedicalResearch.com: What are the main findings of the study?
Dr. Rogers: The risk of serious infection is considerably elevated after receiving allogeneic (donor) red blood cell transfusions. For every 38 patients under consideration for transfusion, 1 patient could be spared an infection if more restrictive hemoglobin thresholds were used. When patients were given transfusions only after their hemoglobin fell below 7.0 g/dL, 1 patient avoided an infection of every 20 patients treated. The results were most consistent in elderly patients receiving hip and knee replacement surgeries. Their risk of infection decreased by 30% when lower hemoglobin thresholds were used.
(more…)
MedicalResearch.com Interview with:
Dr. Thomas M. Pisansky MD
Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of the study?
Dr. Pisansky: This patient-reported outcomes research did not identify a beneficial effect of once-daily tadalafil to prevent radiotherapy-related erectile dysfunction in men with prostate cancer.
(more…)
Karen E Lasser, MD MPH
Associate Professor of Medicine
Boston University School of Medicine, Boston, MA
MedicalResearch.com: What are the main findings of the study?
Dr. Lasser: After controlling for variables that could affect the risk of readmission, we found that:
MedicalResearch.com Interview with:
Evan A. Stein, M.D., Ph.D. FRCP(C), FCAP
Metabolic and Atherosclerosis Research Center
Cincinnati, OH 45225,
MedicalResearch.com: What are the main findings of the study?
Dr. Stein: The study which is the first 52 week randomized double blind trial of a PCSK9 to report results (all others have been 12 weeks) demonstrated that the excellent LDL-C reductions of 55-60% seen at 12 weeks are maintained through 52 weeks, with no fall off in patient compliance, tolerability of efficacy. It also demonstrated that with longer treatment no new or unexpected side effects.
The study also had a unique design in that prior to randomization to the PCSK9 inhibitor (evolocumab) or placebo patients had a run in period during which time they were assigned, based on NCEP-ATP III criteria, to appropriated background therapy which ranged from diet only, to atorvastatin 10 mg a day, to atorvatatin 80 mg a day or atorvastatin 80 mg a day plus ezetimibe - reflecting how these patients are treated in practice. Only then if their LDL-C was still above 75 mg/dL were they randomized into the treatment part of the study with the new drug. The study showed that irrespective of background therapy the reduction with evolocumab was consistent.
(more…)
Timothy Hughes, PhD, MPH
Roena B. Kulynych Center for Memory & Cognition Research
Department of Internal Medicine
Division of Gerontology and Geriatric Medicine
Wake Forest School of Medicine
Medical Center Boulevard, Winston-Salem, NC 27157-1207
MedicalResearch.com: What are the main findings of the study?
Dr. Hughes: This study is a follow-up to our recent paper that showed a novel relationship between arterial stiffness (commonly measured by pulse wave velocity) and the presence and extent of amyloid deposition in the brain, a hallmark of Alzheimer’s disease. For this study, we repeated brain amyloid imaging (using the Pittsburgh Compound B during PET imaging) in order to look for predictors of change in amyloid over two years in n=81 elderly adults aged 80+ and free from dementia. We observed that measures of systemic arterial stiffness (e.g. brachial ankle pulse wave velocity) was strongly associated with the extent of amyloid deposition in the brain at both baseline and follow-up. The change in brain amyloid accumulation over two years resulted in an increase in in the number of participants with Alzheimer’s-like (amyloid-positive) from 45% at baseline to a surprising 75% after just two years. This change in brain amyloid accumulation over two years was strongly related to having greater central stiffness (as measured by carotid femoral pulse wave velocity). These relationships between arterial stiffness and brain amyloid deposition were independent of the effects of age, gender, body mass index, antihypertensive medication use and even current blood pressure.
(more…)
M.S. Reimers, MD PhD Student
and
Dr. Jan Liefers MD
Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
MedicalResearch.com: What are the main findings of the study?
Answer: Aspirin use was associated with an improved survival, as we have published before when investigating this cohort (Bastiaannet et al, Brit J Cancer 2012/ Reimers et al. J Am Geriatr Soc. 2012. In this study we have focused on investigating which patients will benefit from aspirin treatment by investigating some tumor markers, such as PTGS2 expression, HLA class I expression and PIK3CA mutation status. Interestingly, only patients with HLA class I expression on their tumor membrane will benefit from aspirin treatment and have a better outcome. We raise the hypothesize that aspirin inhibits platelet aggregation to circulating tumors cells. By interfering with this process, the metastatic potential of these circulating tumour cells is inhibited, thereby preventing metastasis and colon cancer death.HLA class I expression might be needed for signalling between platelets and circulating tumor cells. If this hypothesis is confirmed by others or in vitro studies, than this might explain the finding that aspirin seems not only beneficial as an adjuvant therapy for colorectal cancer patients, but also for patients with other malignancies (oesophagus, breast, etc). Interestingly, preliminary findings from our team investigating aspirin use in oesophageal cancer also showed that aspirin use in these tumors was associated with an improved survival.
(more…)
MedicalResearch.com Interview with:
Hanna Sanoff MD, MPH
Lineberger Comprehensive Cancer Center
Department of Medicine
University of North Carolina, Chapel Hill, NC
MedicalResearch.com: What are the main findings of the study?
Dr. Sanoff: We measured p16, a protein that increases with cellular aging, in blood cells of women receiving chemotherapy for breast cancer. We found that a standard course of chemotherapy led to an increase in p16 expression equivalent to what we have previous seen in people over the course of 10-15 years of chronological aging. This increase persisted in cancer survivors an average of three and half years after treatment.
(more…)
MedicalResearch.com Interview with:
Beatrice A. Golomb MD, PhD
Professor of Medicine
Family and Preventive Medicine
University of California, San Diego
MedicalResearch.com: What are the main findings of the study?
Dr. Golomb: The main finding is that veterans with Gulf War illness have bioenergetic defects -- dysfunction of mitochondria, the energy producing elements of cells -- that is evident in comparing affected veterans to matched healthy controls.
An estimated 1/4 to 1/3 of the ~700,000 US veterans from the 1990-1 Gulf War developed chronic multisymptom health problems that entail fatigue, cognitive and other CNS problems, muscle pain, weakness and exercise intolerance, with high rates of gastrointestinal (especially diarrhea) and neurological problems, and other symptoms - as well as autonomic dysfunction. Evidence suggests these problems have not abated with time. Veterans from other nations that have conducted epidemiological studies, including the UK, Canada, and Australia, also show elevated rates of problems.
(more…)
MedicalResearch.com Interview with:
Michael J. Pencina, PhD
Professor of Biostatistics and Bioinformatics
Director of Biostatistics
Duke Clinical Research Institute
Durham, NC 27710
MedicalResearch.com: What motivated your research?
Dr. Pencina: After the new guidelines were issued last November, we were intrigued by the change in treatment philosophy from that based on cholesterol levels (used by the “old guidelines” known as NCEP ATPIII) to one based on 10-year risk of cardiovascular disease (used by the new AHA-ACC guidelines). We were curious what the practical consequences of this shift would be.
Furthermore, the media quoted a lot of experts making educated guesses on the impact. We realized that this question can be answered much more precisely based on the NHANES data.
(more…)
MedicalResearch.com Interview with:
Michael Laxy
Helmholtz Zentrum München
German Research Center for Environmental Health
Institute of Health Economics and Health Care Management
Neuherberg, Germany
MedicalResearch.com: What are the main findings of the study?
Answer: In patients with type 2 diabetes a high level of self-management behavior was associated with a better glycemic control, i.e. a lower HbA1c level, in the cross-sectional perspective and a reduced mortality over a 12-year period. This effect remained robust after controlling for socio-demographic and disease related factors, including medication.
(more…)
MedicalResearch.com Interview with:
Dr. Hong-Mei Xiao M.D.,Ph.D.
Cognition Section
Professor of Gynecology，Reproductive Medicine
The Institute of Reproduction and Stem Cell Engineering
Xiangya School of Medicine, Central South University
Vice director, Reproduction and Genetics Hospital of CITIC-Xiangya
China, Changsha
MedicalResearch.com Interview with:
Yun Gong, M.D.
Associate Professor
Department of Pathology, Unit 53
M D Anderson Cancer Center
Houston, TX 77030
MedicalResearch.com: What are the main findings of the study?
Dr. Gong: Androgen receptor (AR) was positive in 39% of the inflammatory breast cancer (IBC) tumors, approximately one-third of estrogen receptor (ER)-negative and progesterone receptor (PR)-negative tumors and 42.6% triple-negative tumors. AR positivity was significantly associated with lymphovascular invasion but not with other clinicopathologic parameters. There was a trend toward association between AR expression and PR expression.
Univariate survival analysis indicated that patients with AR-negative/ER-negative tumors had significantly worse overall survival and disease-specific survival than the patients with tumors showing other combinations of AR/ER status (i.e., AR-negative/ER-positive, AR-positive/ER-negative, or AR-positive/ER-positive). Notably, the study was performed using post-neoadjuvant IBC surgical specimens.
(more…)MedicalResearch.com Interview with: Prof. Dr. Bernd Schultes Endocrinology and Diabetes Internal Medicine eSwiss Medical & Surgical Center Brauerstrasse 97 9016 St. Gallen Schweiz MedicalResearch.com: What...
MedicalResearch.com Interview with:
Jill Cameron, PhD
CIHR New Investigator, Associate Professor,
Department of Occupational Science and Occupational Therapy
Graduate Department of Rehabilitation Science
Faculty of Medicine, University of Toronto
Adjunct Scientist, UHN-Toronto Rehabilitation Institute
MedicalResearch.com: What are the main findings of the study?
Dr. Cameron: In our study with 399 stroke survivor, caregiver dyads, caregivers reported more psychological wellbeing when they provided more assistance to stroke survivors who had fewer symptoms of depression, better cognitive functioning, and who had more severe strokes. In addition, caregivers who maintained participation in valued activities, had more mastery, gained personally providing care, were in better physical health, and were older reported more psychological wellbeing.
(more…)