[caption id="attachment_48090" align="alignleft" width="150"] Dr. Chew[/caption] MedicalResearch.com Interview Emily Y. Chew, M.D. Deputy Director, Division of Epidemiology and Clinical Applications National Eye Institute National...
MedicalResearch.com Interview with:
Naama Barnea-Goraly M.D.
Center for Interdisciplinary Brain Sciences Research
Stanford University
MedicalResearch.com: What are the main findings of the study?
Answer: Our main findings showed that compared with age and sex matched controls, children with type 1 diabetes have significant differences in white matter structure in widespread brain regions. Within the type 1 diabetes group, earlier onset of diabetes and longer duration were associated with greater alterations in white matter structure. In addition, measures of hyperglycemia and glucose variability, but not hypoglycemia were associated with white matter structure; however, hypoglycemia exposure and the number of severe hypoglycemia events in our sample were too small to identify statistically meaningful differences. Finally, we observed a significant association between white matter structure and cognitive ability in children with type 1 diabetes, but not in controls.
MedicalResearch.com Interview with:
Robert S. Rudin, Ph.D.
Associate Policy Researcher
RAND Corporation
Boston, MA 02116
MedicalResearch.com: What are the main findings of the study?
Dr. Rudin: We found that most published health IT implementation studies report positive effects on quality, safety, and efficiency. Most evaluations focus on clinical decision support and computerized provider order entry. However, not all studies report equally positive results, and differences in context and implementation are one likely reason for these varying results, yet details of context and implementation are rarely reported in these studies.
MedicalResearch.com Interview Invitation
Maurice Dysken, MD
Professor, School of Medicine
Department of Psychiatry
Minneapolis VA Health Care System,
Minneapolis, Minnesota
MedicalResearch.com: What are the main findings of the study?
Dr. Dysken: In patients with mild-to-moderate Alzheimer’s disease who were taking an acetylcholinesterase inhibitor, a dosage of 2000 IU/d of vitamin E significantly slowed functional decline compared to placebo by 6.2 months over the mean follow-up period of 2.27 years. Over this period of time caregiver time increased least in the vitamin E group compared to the other three groups (memantine alone, vitamin E plus memantine, and placebo) although the only statistically significant difference was between vitamin E alone and memantine alone. There were no significant safety concerns for vitamin E compared to placebo and mortality was lowest in the vitamin E alone group. It should be noted that patients who were on warfarin were excluded from the study because of a possible interaction with vitamin E that could have possibly increased bleeding events.
MedicalResearch.com Interview with:
Jordi Salas-Salvadó, MD, PhD
Human Nutrition Unit, Faculty of Medicine and Healthy Sciences
Universitat Rovira i Virgili, C/ Sant Llorenç, 21, 43201 Reus, Spain
MedicalResearch.com: What are the main findings of the study?
Answer: Randomized trials have shown that lifestyle interventions promoting weight loss can reduce the incidence of type-2diabetes, however, whether dietary changes without calorie restriction or increased physical activity also protect from diabetes development has not been evaluated in the past. In our study, we found that a long-term adherence to a high-quality dietary pattern akin to the traditional MedDiet and rich in extra-virgin olive oil was able to reduce the incidence of new cases of diabetes in older individuals at high cardiovascular risk. We have demonstrated for the first time that a beneficial effect on diabetes prevention could be obtained witha healthy dietary pattern (without calorie restriction, increased physical activity or weight loss). These benefits have been observed in participants between 55 to 80 years-old at high cardiovascular risk; therefore,the message is that it is never too late to switch to a healthy diet like the Mediterranean.
 MedicalResearch.com Interview with:
Sarah M. Hartz, MD, PhD
Assistant Professor of Psychiatry
Washington University in St. Louis, Missouri
MedicalResearch.com: What are the main findings of this study?
Dr. Hartz: This is the first large-scale study to comprehensively evaluate substance use in people with schizophrenia, bipolar disorder, and other severe mental illness.We found that people with severe mental illness have rates of smoking, alcohol use, and other substance use that are 3 to 5 times higher than people in the general population.
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MedicalResearch.com Interview with: Dr. Lawrence M. Lewis, MD Professor, Emergency Medicine and Medicine Washington University School of Medicine in St. Louis
MedicalResearch.com: What are the main findings of the study?
Dr. Lewis: The main finding of the study is that there is a dose-dependent increase in serum lactate concentration with increasing amounts of nebulized albuterol administered. This hyperlactatemia did not portend a worse prognosis, and was not associated with worse FEV1 or dyspnea scores. 
MedicalResearch.com Interview with
Dr. James Sheppard
MRC Research Fellow
Department of Primary Care Health Sciences
University of Oxford
MedicalResearch.com: What are the main findings of the study?
Dr. Sheppard: The aim of our study was to develop a decision-tree model which estimates the cost-effectiveness and potential implementation costs of a series of interventions which increase thrombolysis rates in acute stroke. The model examined all possible acute stroke patient pathways and was based on real life patient data. We found all proposed interventions to be cost saving whilst increasing patient quality of life after stroke. We estimate that, assuming a "willingness-to-pay" of USD $30,000 per quality adjusted life year gained, the potential budget available to deliver interventions which improve acute stroke care range from USD $50,000 to USD $144,000.
MedicalResearch.com Interview with:
Madhav Goyal MD, MPH
Assistant Professor
General Internal Medicine
Johns Hopkins School of Medicine
MedicalResearch.com: What are the main findings of the study?
Dr. Goyal:
MedicalResearch.com Interview with:
Prof Sirpa Jalkanen MD, PhD
MediCity Research Laboratory and Department of Medical Microbiology
University of Turku Turku, Finland
MedicalResearch.com: What are the main findings of the study?
Answer: Pulmonary vascular leakage occurs early in acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Mortality is high (35-45%), but no effective pharmacotherapy exists. Production of anti-inflammatory adenosine by ecto-5’-nucleotidase (CD73) maintains endothelial barrier function. Interferon-beta-1a (IFN-beta) increases CD73 synthesis and might thus reduce vascular leakage and mortality in ALI/ARDS. We tested this hypothesis and the findings were as follows:
1.IFN-beta increased the number of CD73-positive vessels in human lung culture (4- and 14.3-fold on days 1 and 4 respectively, p=0.04 and 0.004).
2. The optimal tolerated FP-1201 dose (a unique intravenous formulation of interferon-beta 10 μg /day for six days) caused a significant rise in serum MxA (a marker for interferon response) and CD73 levels and a fall in interleukin-6 (an inflammatory cytokine) concentration.
3. Most importantly, odds of 28-day mortality was 81% lower in the treated than untreated subjects (8% vs 32%, OR[95% CI]0.19[0.03 to 0.72], p=0.01).
MedicalResearch.com Interview with
Michael McClung, MD
Founding Director, Oregon Osteoporosis Center
5050 NE Hoyt Street, Suite 626
Portland, OR 97213
MedicalResearch.com: What are the main findings of the study?
Dr. McClung: In this Phase 2 trial, each of five romosozumab dose regimens significantly increased BMD compared with pooled placebo groups at the lumbar spine, total hip and femoral neck regions (all p<0.001). The largest increases were observed with the romosozumab 210 mg once-monthly dose, with mean increases, compared with baseline, of 11.3 percent at the lumbar spine, 4.1 percent at the total hip and 3.7 percent at the femoral neck.
MedicalResearch.com Interview Invitation with:
Dr. Peter Lindenauer MD MS
Director, Center for Quality of Care Research
Baystate Medical Center, Springfield, MA, US
MedicalResearch.com: What are the main findings of the study?
Answer: Among a cohort of 250,000 patients hospitalized for pneumonia at 347 US hospitals, those with a diagnosis of obstructive sleep apnea were twice as likely to be intubated at the time of hospital admission than patients without sleep apnea. In addition, patients with sleep apnea had approximately 50% higher risk of needing to be transferred to the ICU after initial admission to a regular bed, and a 70% increased risk of requiring intubation later in the hospital stay. Patients with sleep apnea stayed longer in the hospital and incurred higher costs than those without sleep apnea.
Dr. Bruce Reed PhD
Professor of Neurology,
Associate Director UC Davis Alzheimer's Disease Center
Davis, CA 95616
MedicalResearch.com: What are the main findings of the study?
Dr. Reed: We found that high LDL cholesterol and low HDL cholesterol in blood were both associated with higher amyloid deposition in the brain. This is potentially very important because the deposition of amyloid seems to be a critical step that kicks off a whole chain of events that eventually lead to Alzheimer's disease. It is widely believed (although not proven) that if this deposition of amyloid could be blocked that we could greatly decrease the incidence of Alzheimer's. The connection to cholesterol is exciting because we know a fair amount about how to change cholesterol levels. A great deal more research needs to be done, but this does suggest a potential new path toward trying to prevent AD.
MedicalResearch.com Interview with:
Stewart C. Alexander, PhD
Department of Medicine
Duke University Medical Center
Durham, North Carolina
MedicalResearch.com: What are the main findings of the study?
Dr. Alexander: Adolescents are reluctant to talk about sex with their doctors and won't raise the topic with their doctors. For physicians, there are common and valid barriers to talking about sexuality with adolescents, including time pressures and discomfort with the topic. Two-thirds of adolescents in our study had some sexuality talk during their annual visit, lasting 36 seconds long. Girls, African Americans, and older teens were more likely to receive sexuality talk. Additionally, longer visits and visits where the physician talked confidentially with their adolescent patient were more likely to have sexuality talk. Our study suggest that sexuality conversations in annual visits can be improved.
MedicalResearch.com Interview with:
Harry J de Koning, MD PhD
Professor of Public Health & Screening Evaluation
Rotterdam, The Netherlands.
MedicalResearch.com: What are the main findings of the study?
Dr. de Koning: Annual CT screening for lung cancer has a favorable benefit-to-harm ratio for individuals ages 55 through 80 years with 30 or more pack-years’ exposure to smoking. It would lead to 50% (model ranges, 45% to 54) of cases of cancer being detected at an early stage (stage I/II), 575 screenings examinations per lung cancer death averted, a 14% (range, 8.2% to 23.5%) reduction in lung cancer mortality, 497 lung cancer deaths averted, and 5250 life-years gained per the 100 000-member (1950-) cohort. Harms would include 67 550 false-positive test results, 910 biopsies or surgeries for benign lesions, and 190 overdiagnosed cases of cancer (3.7% of all cases of lung cancer [model ranges, 1.4% to 8.3%]), again for a 100 000-member (1950-) cohort.
MedicalResearch.com Interview with:
Ajay K Parsaik, MD, MS
Department of Psychiatry and Behavior Sciences
The University of Texas Medical School, Houston
Department of Neurology and Mayo Alzheimer’s Disease Research Center, Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What are the main findings of the study?
Dr. Parsaik: Main findings of our study are that clinical and subclinical hypothyroidism is not associated with mild cognitive impairment in an elderly population after accounting for possible confounding factors and interactions.
MedicalResearch.com Interview with:
Dr. Jacques Donzé MD PhD
Research Associate
Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital
Harvard Medical School, Boston, MA 02115,
MedicalResearch.com: What are the main findings of the study?
Dr. Donzé: In a large retrospective cohort study, we identified the primary diagnoses of 30-day potentially avoidable readmissions in medical patients according to the most common comorbidities. Interestingly, almost all of the top five diagnoses of potentially avoidable readmissions for each comorbidity were possible direct or indirect complications of that comorbidity. Patients with cancer, heart failure, and chronic kidney disease had a significantly higher risk of potentially avoidable readmission than those without those comorbidities. Also, when readmitted, patients with chronic kidney disease had a 20% higher risk of having the readmission be potentially avoidable.
MedicalResearch.com Interview with:
Dr. Yang Liu
Preceptor and
Dr. David A. Sullivan, MS, PhD, FARVO
Senior Scientist, Schepens Eye Research Institute, Associate Professor, Department of Ophthalmology Harvard Medical School
Boston, MA, USA 02114
MedicalResearch.com: What is the main finding of the study?
Answer: We discovered that azithromycin (AZM) can directly stimulate the function of human meibomian gland epithelial cells. Given this finding, it is possible that this antibiotic may prove beneficial as a treatment for meibomian gland dysfunction (MGD), which is the leading cause of dry eye disease in the world.
MedicalResearch.com Interview with:
Scott W. Powers, PhD APBB
Division of Behavioral Medicine and Clinical Psychology and
Division of Neurology, Cincinnati Children’s Hospital Medical Center Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
MedicalResearch.com: What are the main findings of the study?
Dr. Powers: Cognitive behavioral therapy plus amitriptyline resulted in greater reductions in days with headache and migraine-related disability compared with the use of headache education plus amitriptyline. Children and adolescents with chronic migraine began the study with an average of 21 days with headache per 28 days and disability measured in the severe range. After 20 weeks of treatment, 2 out of 3 participants in the CBT group had a 50% or greater reduction in headache days and 3 out of 4 had a reduction in disability to the mild to none range.
MedicalResearch.com Interview with:
Prof. Raj S Bhopal
Bruce and John Usher Professor of Public Health
Edinburgh Ethnicity and Health Research Group,
Centre for Population Health Sciences,
University of Edinburgh, Teviot Place, Edinburgh EH89AG
MedicalResearch.com: What are the main findings of the study?
Prof. Bhopal: In a randomised controlled trial, a tailored, family orientated intervention whereby dietitians worked in the family home to provide diet and exercise advice in people at high risk of developing diabetes, had a modest but potentially important effect in reducing weight at the end of the three-year intervention, by 1.6 kg more than in the control group.
Medical Research.com Interview with:
Dr. Beate Wieseler
Head of Department Dept. Drug Assessment
Institute for Quality and Efficiency
in Health Care (IQWiG)
Im Mediapark
Köln Germany
MedicalResearch.com: What are the main findings of the study?
Dr. Wieseler: Our study shows that unpublished clinical study reports, i.e. reports submitted to regulatory authorities during the approval procedure for a drug, provide substantially more information on patient-relevant outcomes than publicly available sources, i.e. articles published in medical journals and reports published in online clinical trial registries. (A “patient-relevant outcome” is an outcome describing morbidity, mortality or health-related quality of life.)
MedicalResearch.com Interview with:
Nita Ahuja, MD
Departments of Surgery and Oncology,
Johns Hopkins University School of Medicine
Baltimore, Maryland
MedicalResearch.com: What are the main findings of the study?
Dr. Ahuja: Across the nation, laparoscopic colectomy is performed about as frequently as open colectomy, despite being associated with a lower complication rate and a lower overall hospital cost. On the other hand, an exponentially growing prevalence was found with robotic colectomy, a procedure that has so far demonstrated only equivalent outcomes with laparoscopic colectomy but a higher overall cost.
MedicalResearch.com Interview with:
Maya J. Lambiase, PhD
Department of Psychiatry
University of Pittsburgh School of Medicine
Pittsburgh, PA 15213
MedicalResearch.com: What are the main findings of the study?
Dr. Lambiase: Higher levels of anxiety were associated with a greater risk for stroke.
MedicalResearch.com Interview Invitation M.E. Fenton MD MSc FRCPC FCCP Associate Professor Program Director, Respirology Training Program Division of Respirology, Critical Care and Sleep Medicine University...
MedicalResearch.com Interview with:
Prof. Dr. T.R.D.J. Radstake, MD, PhD
Staff Rheumatologist / head translational Immunology
Department of Rheumatology & Clinical Immunology EULAR Center of Excellence
Director, UMC Utrecht Infection and Immunity FOCIS Center of Excellence
University Medical Center Utrecht, The Netherlands
MedicalResearch.com: What are the main findings of the study?
Prof. Radstake: We observed that the chemokine CXCL4 is highly produced by so-called plasmacytoid dendritic cells in systemic sclerosis (Ssc). CXCL4 is associated with the progression and clinical phenotype of Ssc and thus provides a tool for clinicians to identify those patients in need for aggressive therapy and on the other hand, avoid unnecessary side-effects for those who have mild disease. Moreover, the identified roles for CXCL4 in SSc sparks our knowledge on the pathogenic pathways at hand in this terrible conditions. Now, we and other groups will have to further unravel the precise roles for CXCL4 in SSc and possibly other fibrotic and immune mediated conditions that cover the spectrum of medicine.