MedicalResearch.com Interview with:Dewleen G. Baker, MD
Department of Psychiatry
School of Medicine, University of California,
Veterans Affairs San Diego Healthcare System
Veterans Affairs Center of Excellence for Stress and Mental Health
San Diego, California
MedicalResearch.com: What are the main findings of the study?Dr. Baker: Pre-deployment psychiatric symptoms, combat intensity, and traumatic brain injury (TBI) were significant predictors of post-deployment PTSD symptom severity. However, the strongest predictor was deployment-related TBI; mild TBI increased symptom scores by 23%, and moderate to severe injuries increased scores by 71%.
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MedicalResearch.com Interview with: Garrett M. Chinn, MD, MS
Division of General Medicine, Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston
MedicalResearch.com: What are the main findings of this study:Dr. Chinn: Despite the desire of most Americans facing terminal illness to spend their remaining time at home, only 24% of those aged 65 and older do so. Many spend their final days in an institutional setting such as an acute care hospital, often receiving aggressive care.
In the case of patients facing stage 4 lung cancer, many who would prefer to emphasize pain relief over extending life report not having discussed hospice with a physician. More than 25% indicate that they had not addressed advanced care directives such as do-not-resuscitate orders with their doctors but wanted to do so. This tells us that patients wish to better understand their illness and prognosis and might be interested in learning about hospice. And although the general trend for hospice utilization has increased over the past decade, a high percentage of hospice enrollment occurs quite late in the course of illness, often during an acute hospitalization.
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MedicalResearch.com Interview with: Dr. Miguel-Ángel Martínez-García
Respiratory Department, Hospital Universitario y Politécnico La Fe
Valencia, Spain
MedicalResearch.com: What are the main findings of this study:Answer: The main findings of the study are:
1. The treatment with CPAP
(continuous positive airway pressure) achieves a clinically and
statistically significant reduction of blood pressure in patients with
resistant hypertension (blood pressure that remains above goal in spite of
the use of at least three antihypertensive drugs) and obstructive sleep apnea.
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MedicalResearch.com Interview with:Ghassan Dbaibo, M.D., FAAP
Professor and Vice-Chair for Research and Faculty Development
Department of Pediatrics and Adolescent Medicine
Head, Division of Pediatric Infectious Diseases
Director, Center for Infectious Diseases Research
Professor, Department of Biochemistry and Molecular Genetics
American University of Beirut Beirut, Lebanon
MedicalResearch.com: What are the main findings of the study?Dr. Dbaibo:
55% efficacy (95% CI 39–67%) for prevention of all influenza
These results are comparable with other estimates of efficacy and effectiveness for trivalent inactivated flu vaccines in this age group
73% efficacy (97.5% CI 47–86%) for prevention of moderate-to-severe influenza
By preventing moderate-to-severe influenza, vaccination prevented the most clinically consequential outcomes of infection, reducing hospitalisations by 75% and medical visits by 69%.
Seroprotection rates of more than 95% for each of the four influenza strains in the vaccine
An acceptable safety and reactogenicity profile
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MedicalResearch.com Interview with:Dr. Merja K. Laine
Department of General Practice and Primary Health Care
University of Helsinki
MedicalResearch.com: What is the background of your study?Answer: We were interesting to know does a top-level sport during young adulthood protect against disturbances in glucose regulation in later life. In Finland, a unique study program including former male elite athletes and their age- and area-matched controls already initiated in 1985. In 2008, we invited those subjects who participated in the study earlier and were still alive.
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MedicalResearch.com Interview with:Dr Kamal Ivory
Institute of Food Research
Norwich Research Park Norwich, UK
Gut Health & Food Safety ISP
The Institute of Food Research receives strategic funding from BBSRCMedicalResearch.com: What are the main findings of the study?Dr. Ivory: In the present study we show that administration of probiotics in the gut can induce changes at the nasal mucosa where the immune system meets pollen allergen. This implies a potential to alter the course of allergic rhinitis. However, in our single high dose pollen challenge in the clinic (out of pollen season), we did not measure any significant changes in the clinical parameters we had set. It is not clear if this was because a single challenge fails to replicate occurrence during natural seasonal exposure to pollen in terms of dosage and timing. That aside, the mode of action may vary from one probiotic organism to another and it is possible that a cocktail of probiotic organisms may be needed for clinical effectiveness. If funding becomes available, we would like to repeat the study during the pollen season.
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MedicalResearch.com Interview with:Catherine H. Mercer Ph.D.
Senior Lecturer
UCL Centre for Sexual Health & HIV Research
Research Department of Infection & Population Health
University College London London U.K.
MedicalResearch.com: What are the main findings of the study?Dr. Mercer: Firstly, the National Surveys of Sexual Attitudes and Lifestyles, Britain’s nationally-representative surveys of sexual behaviour (or Natsal for short), have captured substantial changes in sexual attitudes and lifestyles over the past 60 years, having collected data from over 45,000 people born between the 1930s and the 1990s – a period spanning much of the 20th Century.
Secondly, the recent changes in behaviour that we have observed - so over the past decade - have however been considerably more marked for women than men, with the gender gap in reported behaviour narrowing, and in some cases, disappearing altogether.
Thirdly, we’ve seen a greater acceptance of more diverse sexual lifestyles, such as same-sex sexual partnerships, but greater intolerance of what many people might consider as ‘disrespectful’ sexual partnerships, including non-exclusivity in marriage.
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MedicalResearch.com Interview with;Dr. Wanpen Vongpatanasin, MD
Professor of Medicine
Director, Hypertension Section, Cardiology Division
UT Southwestern Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Vongpatanasin: We found that more than 50% of patients with resistant hypertension were non-adherent to at least one drug prescribed by their primary care physicians for blood pressure control.
When we provided this information back to the patients, as part of care in our hypertension specialty clinic, we found that many patients report difficulty taking prescribed medications due to either associated side effects or cost of the medication. When we adjusted patient's medications to fit their needs, BP levels were substantially improved during subsequent visits without increasing the number of medications.
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MedicalResearch.com Interview with:Dr. Meghan Azad, PhD
Banting Postdoctoral Fellow
Department of Pediatrics
University of Alberta
MedicalResearch.com: What are the main findings of the study?Dr. Azad: In this study, our goal was to evaluate the clinical evidence for using probiotics (live "healthy bacteria") to prevent childhood asthma. We reviewed the results of 20 clinical trials involving over 4000 infants, where probiotics were administered during pregnancy or the first year of life, and found no evidence to support the use of probiotics for asthma prevention. Children receiving probiotics were just as likely to develop asthma as children receiving placebo. Similarly, there was no effect of probiotic supplementation on the development of wheezing.
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MedicalResearch.com Interview with:Mr Peter Tennant
Research Associate (Epidemiology)
Institute of Health & Society,
Newcastle University,
Baddiley-Clark Building, Richardson Road,
Newcastle upon Tyne, NE2 4AX.
MedicalResearch.com: What are the main findings of the study?Answer: For women with type 1 or type 2 diabetes, the prevalence of stillbirth or late miscarriage (3%) was around four times greater than in women without the condition, while the risk of their infant dying during the first year of life (0.7%) was nearly twice as high. There was no difference in risk between women with type 1 or type 2 diabetes.
A woman's blood glucose concentration around the start of pregnancy, estimated from her glycated haemoglobin concentration (HbA1c), was the most important predictor of risk. The risk increased by 2% for each 1mmol/mol (0.1% in traditional DCCT units) increase in HbA1c above the target of 53mmol/mol (7%) recommended by the American Diabetes Association (ADA). If all the women in our study had achieved that ADA target before pregnancy, we estimate that around 40% of the stillbirths, late miscarriages, and infant deaths could have been avoided.
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MedicalResearch.com Interview with:Aniket D. Kulkarni, M.B., B.S., M.P.H
Women's Health and Fertility Branch
Centers for Disease Control and Prevention
Atlanta, Georgia
MedicalResearch.com: What are the main findings of the study?Dr. Kulkarni: Our study estimates the contribution of fertility treatments and natural conception to multiple births. Fertility treatments include IVF and non-IVF treatments. Non-IVF treatments primarily include ovulation induction and ovarian stimulation coupled with timed intercourse or intrauterine insemination (IUI). All estimated proportions were adjusted for maternal age which makes this study unique.
The incidence of twin births nearly doubled and the incidence of triplet and higher-order births quadrupled over the last 4 decades.
Our study estimates that by 2011, a total of 36% of twin births and 77% of triplet and higher-order births resulted from conception assisted by fertility treatments, after adjusting for maternal age.
After initial increase, the incidence of triplet and higher order births decreased by 29% from 1998 to 2011. The decrease in triplet and higher order births has coincided with a 70% reduction in the transfer of 3 or more embryos during IVF and a 33% decrease in the proportion of triplet and higher order births attributable to IVF. The decline in the number of embryos transferred during IVF became possible due to monitoring of ART treatments and outcomes and the work of professional societies, which have repeatedly revised practice guidelines to include recommendations for lowering the number of embryos transferred.
In contrast, non-IVF fertility treatments of ovulation induction and ovarian stimulation are estimated to contribute the increasing number of multiple births. Hence there is a need for surveillance of births from non-IVF fertility treatments.
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MedicalResearch.com Interview with:Dr Kirstin R Mitchell PhD
Lecturer in Sexual and Reproductive Health
Dept of Social and Environmental Health Research
Faculty of Public Health & Policy
London School of Hygiene and Tropical Medicine
MedicalResearch.com: What are the main findings of the study?Dr. Mitchell: We explored the distribution of sexual function in the British population using a probability sample survey (the third National Survey of Sexual Attitudes and Lifestyles [Natsal-3]) of 15 162 individuals aged 16–74 years. We measured sexual function using the Natsal-SF, a novel validated measure, which assessed problems with individual sexual response, sexual function in a relationship context, and self-appraisal of sex life.
Men and women in the oldest age groups surveyed (55 – 74) were more likely to have low overall sexual function than those in the youngest age group (16 – 24). After taking account of age differences, low sexual function was associated in both men and women with being unemployed, with current depression, and with poor general health. It was also associated with higher numbers of lifetime partners (women only), paying for sex (men only), and reporting same-sex partners, as well as with other aspects of sexual health, such as being diagnosed with an STI and experiencing sex against their will.
Low sexual function was associated with relationship breakdown, and with people not being happy with their relationship. Within relationships, the most common problem was an imbalance in level of interest in sex between partners, which affected around a quarter of both men and women. Just under one in five men and women said their partner had experienced sexual difficulties in the last year, and this proportion increased with age, particularly among women.
Lack of interest in sex was one of the most commonly reported problems for both men and women, affecting three in every twenty (15%) men, and with women twice as likely as men to say that this had been an issue in the last year. Difficulty reaching climax (16%) and vaginal dryness (13%) were among common problems for women; and reaching a climax more quickly than desired (15%), and difficulty getting or keeping an erection (13%) among men.
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MedicalResearch.com Interview with:J. Randall Curtis, MD, MPH
Professor of Medicine
Director, UW Palliative Care Center of Excellence
Section Head, Pulmonary and Critical Care Medicine, Harborview Medical CenterA. Bruce Montgomery, M.D. – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA 98104
MedicalResearch.com: What are the main findings of the study?Dr. Curtis: We examined the effect of a communication-skills intervention for internal medicine and nurse practitioner trainees on patient- and family-reported outcomes. The study was funded by the National Institutes of Nursing Research of the National Institutes of Heatlh. We conducted a randomized trial with 391 internal medicine and 81 nurse practitioner trainees at two universities. Participants were randomized to either an 8-session simulation-based, communication-skills intervention or to usual education. We collected outcome data from a large number of patients with life-limiting illness and their families, including 1866 patient ratings and 936 family ratings. The primary outcome was patient-reported quality of communication and, overall, this outcome did not change with the intervention. However, when we restricted our analyses to only patients who reported their own health status as poor, the intervention was associated with increased communication ratings. Much to our surprise, the intervention was associated with a small but significant increase in depression scores among post-intervention patients. Overall, this study demonstrates that among internal medicine and nurse practitioner trainees, simulation-based communication training compared with usual education improved communication skills acquisition, but did not improve quality of communication about end-of-life care for all patients. However, the intervention was associated with improved patient ratings of communication for the sickest patients. Furthermore, the intervention was associated with a small increase in patients’ depressive symptoms, and this appeared most marked among patients of the first-year residents.
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MedicalResearch.com Interview with:James Guevara, MD, MPH
Associate Professor of Pediatrics & Epidemiology
Senior Diversity Search Advisor, Perelman School of Medicine
University of Pennsylvania,Director of Interdisciplinary Initiatives
PolicyLab: Center to Bridge Research, Practice, & Policy
The Children's Hospital of Philadelphia,Philadelphia, PA 19104
MedicalResearch.com: What did the study attempt to address?Dr. Guevara: Medical schools have sought to build more diverse faculty in their institutions through faculty development programs targeted to underrepresented minority faculty members. This study was conduct by THE CHILDREN'S HOSPITAL OF PHILADELPHIA'S POLICYLAB and The University of Pennsylvania and sought to determine if there was an association between minority faculty development programs and the representation, recruitment, and promotion of underrepresented minority faculty.
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MedicalResearch.com Interview with:Alessandra d’Azzo PhD
Department of Genetics, St Jude Children’s Research Hospital
262 Danny Thomas Place, Memphis, Tennessee 38105
MedicalResearch.com: What are the main findings of the study?Dr. d’Azzo: We have discovered a connection between a rare childhood disorder and Alzheimer’s disease that usually affects older people.
The culprit is a metabolic enzyme called NEU1 that normally controls the recycling or disposal of proteins in a specific cell compartment, the lysosome.
When NEU1 is defective, children develop the severe metabolic disease, sialidosis.
Our study suggests that NEU1 also plays an important role in the development of Alzheimer’s disease. Based on this discovery, we decided to increase NEU1 enzyme activity in the brain of an Alzheimer’s disease mouse model that shows features characteristic of the human disease, namely the accumulation of toxic protein aggregates or plaques. Remarkably, we could significantly diminish the number of plaques in the brain of these mice by increasing NEU1 enzyme activity.
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MedicalResearch.com Interview with:Ian Kronish, MD, MPH
Assistant Professor of Medicine
Center for Behavioral Cardiovascular Health
Division of General Medicine
Columbia University Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Kronish:Among primary care patients with persistently uncontrolled blood pressure despite medication treatment, we found that medication non-adherence was more than twice as common in patients with PTSD (68%) as compared to patients without PTSD (26%). The association between PTSD and medication non-adherence remained present after adjustment for key covariates including regimen complexity and depression. Recent research shows that PTSD not only contributes to psychological distress, but is also associated with increased risk for incident and recurrent cardiovascular disease. The data from our study suggest that medication non-adherence may be an important mechanism by which PTSD increases risk for cardiovascular disease.
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MedicalResearch.com Interview with:Hans-Willem Snoeck MD, PhD
Columbia University Medical Center
MedicalResearch.com: What are the main findings of the study?Dr. Snoeck: We were, for the first time, able to differentiate human embryonic stem cells and induced pluripotent stem cells into at least 6 different types of lung and airway epithelial cells. Furthermore, we could demonstrate function of surfactant-producing type II alveolar epithelial cells, and the lung progenitors we generated could generate airway after transplantation under the kidney capsule of immunodeficient mice.
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MedicalResearch.com Interview with:Dr Nigel Field MBPhD
Research Department of Infection and Population Health
University College London, London, UK
MedicalResearch.com: What are the main findings of the study? Dr. Field:This study, published in The Lancet on Tuesday 26 November, reports data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal), interviewing over 15,000 participants aged 16-74 years, to systematically assess the association between people’s health and their sexual lifestyles in Britain. The key findings from the study are that close to one in six (17%) of men and women feel that their health had affected their sex life in the past year. This rises to three fifths (60%) among men and women who say that they are in bad health. However, only a quarter of men (24%) and under a fifth of women (18%) who say that ill-health affects their sex life had sought help from a health profession, usually a family doctor.
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MedicalResearch.com Interview with:Dr. Victor W. Henderson MD
Professor of Health Research and Policy and of Neurology and Neurological Sciences
Stanford University, Stanford, CA 94305
MedicalResearch.com: What are the main findings of the study?Dr. Henderson: Estrogen or hormone therapy effects on some health outcomes differ by age, harmful at one age and beneficial at another.
This difference is sometimes referred to as the “critical window” or “timing” theory. It is controversial whether the so-called critical-window applies to memory or other cognitive skills.
In assessing the critical window hypothesis, we found that the relation between blood levels of estrogen and memory or reasoning skills is the same in younger postmenopausal women as in older postmenopausal women. Essentially, there is no association at either age.
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MedicalResearch.com Interview with Marzia Lazzerini, PhD
Institute for Maternal and Child Health IRCCS “Burlo Garofolo,”
Trieste, Italy
MedicalResearch.com: What are the main findings of the study?Answer: In children and adolescent with Crohn’s disease refractory to first and second line treatment, thalidomide was effective in inducing and maintaining clinical remission. About 60% of children achieved clinical remission, and clinical remission was maintained for a mean time of 180 weeks. The main reason to stop thalidomide was peripheral neuropathy.
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MedicalResearch.com Interview with:Julie A. Schmittdiel, PhD
Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612
MedicalResearch.com: What are the main findings of the study?Dr. Schmittdiel:We found that patients with diabetes who used mail order pharmacy were less likely to visit the emergency room than those who did not use mail order pharmacy during a 3 year follow-up period. We also did not see safety concerns associated with mail order pharmacy for most diabetes patients.
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MedicalResearch.com Interview with Deanna Kepka, PhD, MPH
Assistant Professor
College of Nursing & Huntsman Cancer Institute
University of Utah
MedicalResearch.com: What are the main findings of the study?
Dr. Kepka: Nearly two-thirds, 64.8% (95% CI: 62.2% - 67.3%) of women reporting a hysterectomy also reported a recent Pap test since their hysterectomy and more than half, 58.4% (95% CI: 55.3% - 61.4%) of women age 65 years and older without a hysterectomy reported a Pap test in the past three years. Together, this represents approximately 14 million in the United States.
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MedicalResearch.com Interview with:Professor Clive Page
Director, Sackler institute of Pulmonary Pharmacology
Joint Head, Institute of Pharmaceutical Science
King's College London
150 Stamford Street Waterloo Campus
London SE1 9NH
MedicalResearch.com: What are the main findings of the study?Prof. Page: RPL 554 was shown to cause bronchodilation and anti-inflammatory activity at the same dose. The drug showed benefit in both patients with COPD and asthma.
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MedicalResearch.com Interview with:Michael Ho, MD, PhD
Assistant Professor of Medicine, Division of Cardiology
Cardiology 111B 1055 Clermont Street
Denver CO 80220
MedicalResearch.com: What are the main findings of the study?Dr. Ho: We found that testosterone use was associated with a 29% increased risk of death, MI and stroke over a follow-up period of 27 months. The risk was similar among patients with or without coronary artery disease on coronary angiography.
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MedicalResearch.com Interview with:Alize J. Ferrari
University of Queensland
School of Population Health
Herston, Queensland, Australia
MedicalResearch.com: What are the main findings of the study?Answer: In our paper recently published in PloS Medicine, we report findings from the Global Burden of Disease Study 2010 for depression. We found that depression (defined as major depressive disorder and dysthymia) accounted fr 8% of the non fatal burden in 2010, making it the second leading cause of disability worldwide. Burden due to depression increased by 35% between 1990 and 2010, although this increase was entirely driven by population growth and ageing. Burden occurred across the entire lifespan, was higher in females compared to males, and there were differences between world regions.When depression was considered a risk factor for other health outcomes it explained 46% of the burden allocated to suicide and 3% of the burden allocated ischemic heart disease.
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MedicalResearch.com Interview with:Prof Eric Lawitz MD
Vice President of Scientific and Research Development at The Texas Liver Institute
Clinical professor of Medicine
San Antonio University of Texas Health Science Center.
MedicalResearch.com: What are the main findings of the study?Dr. Lawitz: Currently available treatments for HCV involve weekly injections of pegylated interferon and daily doses of oral antivirals that must be taken for up to a year. These regimens are not only burdensome for patients, but are not always effective and can cause serious and debilitating side effects, including anemia. So there is a significant need for new tablet-based treatment regimens for HCV that eliminate interferon and ribavirin, are more effective, better tolerated and easier for patients to take.
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MedicalResearch.com Interview with:Ilke Sipahi, MD
Department of Cardiology
Acibadem University Medical School, Istanbul, Turkey
Harrington Heart and Vascular Institute, University Hospitals Case Medical Cente, Case Western Reserve University School of Medicine, Cleveland, Ohio
MedicalResearch.com: Were you surprised at the extreme difference between these 2analyses?Answer: I was surprised. However, it is not unusual to find completely
contradictory results in medical studies. I was more surprised at the
fact that FDA paid more attention to it administrative observational
dataset rather than the huge large randomized clinical trials, all
showing excess GI bleeds with dabigatran (Pradaxa). Anyone who is even
slightly familiar with the medical literature knows that randomized trials are the gold standard in medical studies.
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MedicalResearch.com Interview with:Dr. Kelly K. Hunt, M.D., F.A.C.S.
Professor, Department of Surgical Oncology, Division of Surgery
Chief, Breast Surgical Oncology Section, Department of Surgical Oncology
The University of Texas MD Anderson Cancer Center, Houston, TX
MedicalResearch.com: What are the main findings of the study?Dr. Hunt: The primary endpoint of the Z1041 trial was the proportion of patients who had pathological complete response in the breast, defined as the percentage of women who started the neoadjuvant treatment with no histological evidence of disease in the breast at surgery. We found that high pathologic response rates were observed in both treatment groups with similar cardiac safety profiles in both arms of the trial. Specifically, 56.5% of patients in the sequential group (fluorouracil, epirubicin and cyclophosphamide on day one of a 21-day cycle for four cycles followed by paclitaxel plus trastuzumab weekly for 12 weeks) had a complete pathological response versus 54.2% of the patients who received the concurrent regimen (paclitaxel and trastuzumab weekly for 12 weeks followed by fluorouracil, epirubicin and cyclophosphamide on day one of a 21-day cycle with trastuzumab on days one, eight and 15 of the 21-day cycle for four cycles). The difference in pathologic complete response rates between the treatment arms was not statistically significant. Cardiac safety was a secondary endpoint of the trial and we found that both regimens had acceptable cardiac safety profiles.
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MedicalResearch.com Interview with:Alyshah Abdul Sultan, doctorate student
Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building Phase 2, City Hospital, Nottingham NG5 1PB, UK
MedicalResearch.com: What are the main findings of the study?Answer: Overall, we found that hospitalisation during pregnancy was associated with an excess risk of 16.6 cases per 1,000 person-years compared with time outside hospital (17.5-fold increase in risk). There was also an excess risk of 5.8 cases per 1,000 person years in the 28 days after discharge with VTE events more likely to occur in the third trimester of pregnancy and in women aged 35 years and over.
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MedicalResearch.com InterviewYuri E. Nikiforov, M.D., Ph.D.
Professor of Pathology, Vice Chair for Molecular Pathology
Director, Division of Molecular & Genomic Pathology
Department of Pathology, University of Pittsburgh Pittsburgh, PA
MedicalResearch.com: What are the main findings of the study?Dr. Nikiforov: This is examined temporal changes in mutational profiles and standardized histopathologic features of thyroid cancer in the U.S. over the last four decades. It showed a significant change in molecular profiles of thyroid cancer during the past 40 years as it determined two major trends in changing the mutational make-up of thyroid cancer: a rapid increase in the prevalence of RAS mutations, particularly for the last 10 years, and continuous decrease in frequency of RET/PTC rearrangement. The rising incidence of RAS mutations points to new and more recent etiologic factors, probably of a chemical or dietary nature. The decreasing incidence of RET/PTC rearrangements, a known marker of high-dose environmental and medical radiation, suggest that the impact of ionizing radiation, at least as related to high-dose environmental exposures and historical patterns of radiation treatment for benign conditions, is diminishing.
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MedicalResearch.com Interview with:
Dewleen G. Baker, MD
Department of Psychiatry
School of Medicine, University of California,
Veterans Affairs San Diego Healthcare System
Veterans Affairs Center of Excellence for Stress and Mental Health
San Diego, California
MedicalResearch.com: What are the main findings of the study?
Dr. Baker: Pre-deployment psychiatric symptoms, combat intensity, and traumatic brain injury (TBI) were significant predictors of post-deployment PTSD symptom severity. However, the strongest predictor was deployment-related TBI; mild TBI increased symptom scores by 23%, and moderate to severe injuries increased scores by 71%.
(more…)
