MedicalResearch.com Interview with:
Tobias Saam, MD
Institute of Clinical Radiology
Ludwig-Maximilians-Univ Hosp
Munich, Germany
MedicalResearch.com: What are the main findings of the study?
Dr. Saam: The results of our meta-analysis suggest that despite a large degree of detected heterogeneity of the published studies, the presence of intraplaque hemorrhage by MRI in patients with carotid artery disease is associated with an approximately 5.6-fold higher risk for cerebrovascular events, such as TIA or stroke, as compared to subjects without intraplaque hemorrhage.
MedicalResearch.com Interview with:
Shoshana M. Rosenberg, ScD, MPH
Researcher, Susan F. Smith Center for Women's Cancers
Dana-Farber Cancer Institute
MedicalResearch.com: What are the main findings of the study?
Answer: Rates of contralateral prophylactic mastectomy (CPM) have been increasing among all breast cancer patients, however this trend has been most pronounced among the youngest women with breast cancer. Because of this trend, we sought to better understand why the youngest women - those diagnosed at age 40 or younger - were deciding to have this surgery.
Many women not considered "high-risk", e.g., those without a cancer pre-disposing mutation, cited a desire to prevent the breast cancer from spreading as well as a desire to improve survival as reasons for undergoing the procedure, indicating they overestimate the benefit of having this surgery, as CPM does not affect these outcomes. While CPM does reduce the risk of developing breast cancer in the unaffected breast, in women who are not considered "high-risk", this risk is relatively low, however many women overestimated this risk as well.
MedicalResearch.com Interview with:
Ze'ev Ronai, Ph.D.
Professor and scientific director of Sanford-Burnham Medical Research Institute La Jolla San Diego, Calif.
MedicalResearch.com: What are the main findings of the study?
Answer: This study provides the first direct evidence of the importance of the PDK1 enzyme in the development of melanoma and in the metastasis of this aggressive tumor type. We demonstrate, with a genetic mouse melanoma model (harboring the Braf/Pten mutations commonly seen in human melanomas) and/or pharmacological inhibitors against PDK1, that melanoma requires this enzyme for its development, and more so – for its ability to metastasize. Since PDK1 is key kinase that regulates a number of protein kinases, which are currently being assessed in clinical trials (including AKT), our finding points to a new set of targets that could be more amenable for effective combination therapy in melanoma.
MedicalResearch.com Interview with:
Faisal G. Bakaeen, MD FACS
Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, Texas
MedicalResearch.com: What are the main findings of the study?
Dr. Bakaeen: The relative use of off-pump CABG peaked at 24% in 2003, followed by a slow decline after that to about 19%. In addition, the conversion rate from off- to on-pump decreased with time and has stayed below 3.5% in recent years. Perioperative mortality rates decreased over time for both on- and off-pump CABG and have stayed below 2% since 2006. The mortality associated with converted cases was high regardless of the surgery year.
MedicalResearch.com Interview with:
Mine Tezal, DDS, PhD
Oral Biology
University at Buffalo
NYS Center of Excellence in Bioinformatics and Life Sciences
MedicalResearch.com: What are the main findings of the study?
Dr. Tezal: We observed an inverse association between dental caries and head and neck cancer (HNSCC), which persisted among never smokers and never drinkers. Besides untreated caries, two other objective measures of long-standing caries history (endodontic treatments and crowns) were also inversely associated with HNSCC with similar effect sizes, supporting the validity of the association. Missing teeth was associated with increased risk of HNSCC in univariate analyses, but after adjustment for potential confounders, its effect was attenuated and was no longer statistically significant.
MedicalResearch.com Interview with:
Laura A. Petersen, MD, MPH
MEDVAMC Associate Chief of Staff, Research
Director, VA HSR&D Center of Excellence (152)
Houston TX 77030
Professor of Medicine
Chief, Section of Health Services Research
Baylor College of Medicine
HSR&D Center of Excellence
Michael E. DeBakey Veterans Affairs Medical Center
Houston, Texas 77030
MedicalResearch.com: What are the main findings of the study?
Dr. Petersen: VA physicians randomized to the individual incentive group were more likely than controls to improve their treatment of hypertension. The adjusted changes over the study period in Veterans meeting the combined BP/appropriate response measure were 8.8 percentage points for the individual-level, 3.7 for the practice-level, 5.5 for the combined, and 0.47 for the control groups. Therefore, a physician in the individual group caring for 1000 patients with hypertension would have about 84 additional patients achieving blood pressure control or appropriate response after 1 year. The effect of the incentive was not sustained after the washout period. Although performance did not decline to pre-intervention levels, the decline was significant. None of the incentives resulted in increased incidence of hypotension compared with controls. While the use of guideline-recommended medications increased significantly over the course of the study in the intervention groups, there was no significant change compared to the control group. The mean individual incentive earnings over the study represented approximately 1.6% of a physician’s salary, assuming a mean salary of $168,000.
MedicalResearch.com Interview with:
Fabian Bamberg, MD, MPH
Department of Clinical Radiology
Ludwig Maximilians University, Klinikum Grosshadern
Marchioninistrasse 15, 81377 Munich, Germany
MedicalResearch.com: What are the main findings of the study?
Dr. Bamberg: Our study shows that there is a substantial and heterogenous degree of subclinical cardiovascular disease burden in patients with diabetes undergoing whole-body MRI. These whole-body MRI findings have significant prognostic relevance. For instance, our results show that patients without any pathologic findings experience no adverse cardiovascular event over a period of six years while the risk for a heart attack or stroke increases with the degree of disease burden.
MedicalResearch.com Interview with:
Dr. Robert A. Wise MD
Professor of Medicine Johns Hopkins University School of Medicine
5501 Hopkins Bayview Circle
Baltimore, MD 21224
MedicalResearch.com: What are the main findings of the study?
Dr. Wise: The TIOSPIR trial was a landmark study, one of the largest ever conducted for chronic obstructive pulmonary disease (COPD). It was designed to test the comparative safety and effectiveness of two delivery devices of tiotropium, a long-acting bronchodilator. One formulation is the Respimat multi-dose soft mist inhaler and the other formulation is the single dose HandiHaler dry powder inhaler.
After following more than 17000 patients for an average of 2.3 years, TIOSPIR showed that there was no difference in either the safety in terms of mortality or adverse cardiovascular events between the two devices. Moreover, both devices showed similar effectiveness in terms of time to first COPD exacerbation.
A lung function substudy in 1370 patients showed that the 5 microgram dose of Respimat was equivalent to the HandiHaler as a bronchodilator, but the 2.5 microgram dose was not quite as effective.
Dr. Elsie Taveras
Massachusetts General Hospital for Children
Division of General Pediatrics, Department of Pediatrics
100 Cambridge St, 15th Floor
Boston, MA 02114
MedicalResearch.com: What are the main findings of the study?
Dr. Taveras: The main findings of the study were that, overall, the body mass index of children in the intervention group dropped an average of 0.18, while it rose 0.21 in the control group. Children in the intervention group were sleeping about 45 minutes longer than children in the control group. Time spent watching television on weekends dropped about an hour per day in the intervention group, leading to a significant difference from the control group, which increased weekend TV viewing. Both groups had a small reduction in weekday TV viewing, with a greater decrease in the intervention group, as well.
MedicalResearch.com Interview with:
R. Gilberto González, MD, PhD
Massachusetts General Hospital
Department of Radiology, PO Box 9657
Boston, MA
MedicalResearch.com: What are the main findings of the study?
Dr. González: Administration of IV tPA to patients with a severe stroke syndrome caused by occlusion of the distal internal carotid artery and/or the proximal middle cerebral arteries results in good outcomes in 35% compared to 17% of similar patients who did not receive tPA.
MedicalResearch.com Interview with:
Thanh N. Huynh, MD, MSHS
Clinical Instructor
UCLA Division of Pulmonary Critical Care
MedicalResearch.com: What are the main findings of the study?
Dr. Huynh: Our study shows that it is common for ICU doctors to recognize that futile treatment is provided to patients who cannot benefit from it. In our study, 11% of ICU patients were perceived as receiving futile treatment. The outcomes of these 123 patients were uniformly poor, with 85% dying within 6 months. Advances in critical care medicine has allowed us to save lives, but it has also allowed us provide aggressive life-sustaining treatments that may not benefit all patients. When aggressive treatment is poorly matched with a patient’s prognosis, doctors will consider such treatment as futile and our study shows that this is not an uncommon occurrence in our health system.
MedicalResearch.com Interview with:
Dr. Amy Sanderson MD
Department of Anesthesiology
Perioperative & Pain Medicine
Boston Children’s Hospital
Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study?
Dr. Sanderson: There is substantial variability in the interpretation of a DNR order. 66.9% of clinicians believed that a DNR order indicates limitation of resuscitative measures only on cardiopulmonary arrest, whereas 33.1% considered a DNR order to be the threshold for the limitation of treatments not specifically related to resuscitation. 68.7% of clinicians reported that the care of a patient changes once a DNR order is written. Of those reporting changes in care, 11.2% reported that this happens only if a cardiopulmonary arrest occurs, while 36.7% believed that there is an increased attention to comfort. Finally, 52.1% reported that care changes beyond both resuscitative measures and focusing on comfort, including limitation or withdrawal of diagnostic and therapeutic interventions. Most clinicians reported that resuscitation status discussions happen later in the illness course than is ideal.
MedicalResearch.com Interview with: Bert Uchino PhD
Department of Psychology and Health Psychology Program
University of Utah, Salt Lake City, Utah,
MedicalResearch.com: What are the main findings of the study?
Dr. Uchino: The main findings from our paper is that independent of one’s own social network quality, the quality of a spouse’s social network was related to daily life ambulatory blood pressure (ABP) levels. More specifically, the more supportive (positive) ties, and the less aversive (negative) or ambivalent (both positive and negative) ties in a spouse’s social network, the lower was one’s own ABP. In addition, looking at the social networks of couples as a whole showed that couples who combined had more supportive ties and less aversive or ambivalent ties showed lower ABP.
Marc F. Norcross, PhD, ATC
Assistant Professor
School of Biological & Population Health Sciences, Exercise & Sport Science Program
College of Public Health and Human Sciences
Oregon State University
Corvallis, OR 97331
MedicalResearch.com: What are the main findings of the study?
Dr. Norcross: In the scientific community, there remains considerable disagreement over which direction of knee loading is most responsible for causing an anterior cruciate ligament (ACL) injury event. Many researchers tend to fall into one of three “camps” in which they believe quadriceps loading (sagittal plane), “knock-kneed” landing (frontal plane), or twisting (transverse plane) is the essential factor in the injury mechanism. However, we know from cadaver studies that combined loading from all of these different planes puts the most strain on the ACL. We found that men and women are equally likely to use a sagittal plane landing strategy that we believe increases the risk for ACL injury. However, females were about 3.6 times more likely than males to use a higher risk frontal plane landing strategy. This suggests that the increased likelihood of greater frontal plane loading in women coupled with the equal likelihood of using a high-risk sagittal plane strategy is likely at least partly responsible for women’s 2-6 times greater risk for ACL injury.
MedicalResearch.com Interview with:
Seth A. Seabury, PhD
Department of Emergency Medicine, University of Southern California, Los Angeles Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles
MedicalResearch.com: What are the main findings of the study?
Dr. Seabury: We studied the trends in the earnings of male and female physicians in the US from 1987-2010 using nationally representative data from the Current Population Survey (CPS). We found that, while the number of female physicians grew significantly, male physicians continue to have significantly higher earnings than female physicians. The difference in the median earnings of male physicians compared to female physicians actually increased from $33,840 in 1987-1990 to $56,019 in 2006-2010, though the difference across years was not statistically significant. Our approach controlled for differences in hours worked, so earnings gap was not driven by differences in work hours, though it could be explained by other factors we did not observe in our data (e.g., specialty choice).
Looking at other occupations in the US health care industry, the male-female earnings gap was smaller for pharmacists and registered nurses and decreased over time, but was large and increased for physicians assistants. On the other hand, our numbers indicate that outside of the health care industry, the male-female earnings gap fell by more than 45%. Even though significant gender inequality persists across the US, female physicians do not appear to have benefited from the relative gains that female workers outside the health care industry have.
MedicalResearch.com Interview with:
Behnood Bikdeli, MD
Yale/YNHH Center for Outcomes Research and Evaluation
One Church St, Suite 200
New Haven CT 0651
MedicalResearch.com: What are the main findings of the study?
Dr. Bikdeli: We determined the trends in hospitalizations and mortality from endocarditis among US older adults from 1999 to 2010. Endocarditis is the most serious cardiovascular infection and our study that had a very large sample, signified the high burden of endocarditis in this time period.
MEDICALRESEARCH.COM: INTERVIEW WITH:
Qi Sun, MD ScD
Assistant Professor of Medicine
Channing Division of Network Medicine
Brigham and Women's Hospital and Harvard Medical School, Assistant Professor
Department of Nutrition, Harvard School of Public Health
665 Huntington Avenue, Boston, MA 02115
MEDICALRESEARCH.COM: What are the main findings of the study?
Response: We have three major findings.
MedicalResearch.com Interview with:
Ekaterina Rogaeva, PhD
Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, CanadaDepartment of Medicine, University of Toronto, Toronto, Ontario, CanadaCambridge Institute for Medical Research and Department of Clinical Neurosciences, University of Cambridge, Cambridge, England
MedicalResearch.com: What are the main findings of the study?
Answer: We tested the hypothesis that late-onset Alzheimer disease (AD) might be in part explained by the homozygosity of unknown loci. In a genome-wide study of a Caribbean Hispanic population with noticeable inbreeding and high risk of AD we assessed the presence of long runs of homozygosity (ROHs) – regions where the alleles inherited from both parents are identical. Our results suggest the existence of recessive AD loci, since the mean length of the ROH per person was significantly longer in AD cases versus controls, and this association was stronger in familial AD.