Medical Research Journals

08 May

Posted at 21:10h in Author Interviews, JAMA, Schizophrenia
MedicalResearch.com Interview with: [caption id="attachment_41566" align="alignleft" width="186"]Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead, NY Investigator, Center for Psychiatric Neuroscience Feinstein Institute for Medical Research Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital, Department of Psychiatry Dr. Correll[/caption] Christoph U. Correll, MD Professor of Psychiatry and Molecular Medicine The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead, NY Investigator, Center for Psychiatric Neuroscience Feinstein Institute for Medical Research Medical Director, Recognition and Prevention (RAP) Program The Zucker Hillside Hospital, Department of Psychiatry   MedicalResearch.com: What is the background for this study? Response: Schizophrenia and other psychotic disorders are still all to often chronic and recurring mental health conditions that not uncommonly take a course during which individuals have varying degrees of significantly impaired personal, social and educational/vocational functioning. Prior individual studies examining early specialty intervention services, which integrate multiple different and complementary treatment components, had shown that this treatment approach can yield superior outcomes for people with early-phase schizophrenia and other psychotic disorders compared to usual care given to all people with psychotic disorders. However, we were lacking a broad overview of the type and results of treatment programs that had been conducted across different countries, continents and mental health service delivery systems. Moreover, we did not yet have a synthesis across all important outcomes that had been examined across these individual studies. This first comprehensive meta-analysis on this topic provides previously missing information on the different early intervention programs and their components as well as on all relevant outcomes for people who did or did not receiving early integrated care, also recently called ‘coordinated specialty care.’

08 May

Posted at 10:54h in Alzheimer's - Dementia, Author Interviews, Brain Injury, JAMA
MedicalResearch.com Interview with: Deborah E. Barnes, PhD, MPH Professor, UCSF Weill Institute for Neurosciences Departments of Psychiatry and Epidemiology & Biostatistics University of California, San Francisco: http://profiles.ucsf.edu/deborah.barnes Research Health Sciences Specialist, San Francisco VA Medical Center Senior Investigator, Tideswell at UCSF: http://www.tideswellucsf.org/ Deborah E. Barnes, PhD, MPH Professor, UCSF Weill Institute for Neurosciences Departments of Psychiatry and Epidemiology & Biostatistics University of California, San Francisco: http://profiles.ucsf.edu/deborah.barnes Research Health Sciences Specialist San Francisco VA Medical Center MedicalResearch.com: What is the background for this study? What are the main findings?
  • Previous studies have found a link between moderate to severe head injuries and increased dementia risk.
  • The association between mild head injuries and dementia – especially mild head injury that doesn’t result in loss of consciousness – is less well established
  • We examined the association between mild head injuries with and without loss of consciousness and dementia diagnoses in nearly 360,000 Veterans receiving care in the VA health care system.
  • We found that Veterans with a head injury diagnoses were two to four times more likely to be diagnosed with dementia than those without head injury diagnoses.
  • The risk of dementia diagnosis was doubled in Veterans who experienced head injury without loss of consciousness compared to those with no head injury. 

08 May

Posted at 10:49h in Accidents & Violence, Author Interviews, BMJ, Race/Ethnic Diversity
MedicalResearch.com Interview with: “police” by istolethetv is licensed under CC BY 2.0Anthony L. Bui, MPH M.D. Candidate, David Geffen School of Medicine at UCLA Matthew M. Coates, MPH Associate, Harvard Medical School, Department of Global Health and Social Medicine Ellicott C. Matthay, MPH Ph.D. Candidate, Division of Epidemiology, University of California, Berkeley School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Protests after recent deaths from encounters with law enforcement, the Black Lives Matter movement, and activism over social media platforms have raised the profile of the problem of police violence. Several studies have suggested that the public health community has a duty to address these deaths as a public health problem. These studies have also pointed out that although there is a lack of officially reported statistics on police violence, other journalistic and crowd-sourced efforts such as “The Counted” from The Guardian, FatalEncounters.org, U.S. Police Shootings Database, KilledbyPolice.net, and Mapping Police Violence have relatively complete documentation of deaths from police violence. To help frame the issue as a public health problem, we calculated years of life lost (YLLs) attributed to deaths from encounters with law enforcement. YLLs are, a metric that measures premature deaths, by age, gender, and race/ethnicity. To do this, we followed established methods, subtracting the age of each death from a corresponding standard life expectancy. For example, if an individual who died at age 25 had a life expectancy of 75, their YLL would be 50. 

07 May

Posted at 23:34h in Author Interviews, JAMA, Pain Research, Psychological Science
MedicalResearch.com Interview with: [caption id="attachment_41491" align="alignleft" width="131"]Dr. M. Carrington Reid, MD PhD Associate Professor of Medicine Irving Sherwood Wright Associate Professor in Geriatrics Joachim Silbermann Family Clinical Scholar in Geriatric Palliative Care Joan and Sanford I. Weill Department of Medicine Weill Cornell Medical College  Dr. Reid[/caption] Dr. M. Carrington Reid, MD PhD Associate Professor of Medicine Irving Sherwood Wright Associate Professor in Geriatrics Joachim Silbermann Family Clinical Scholar Geriatric Palliative Care Joan and Sanford I. Weill Department of Medicine Weill Cornell Medical College MedicalResearch.com: What is the background for this study?   Response: Major guidelines (American College of Physicians, Centers for Disease Control, Veterans Administration) on the management of chronic pain strongly encourage clinicians to use nonpharmacologic approaches to include psychological therapies when managing pain. While many studies have evaluated psychological therapies such as cognitive behavioral theraphy (CBT) in nonelderly populations with chronic pain, far fewer have evaluated these treatments in studies of older adults. We identified 22 randomized controlled trials that evaluated a psychological therapy for chronic pain in older adults and examined the impact of these treatments on salient outcomes to include ability to reduce pain and pain-related disability, improve patients' self efficacy to manage pain, and improve their physical health and function and their psychological health (by reducing rates of anxiety and depression).

07 May

Posted at 11:01h in Author Interviews, CMAJ, OBGYNE
MedicalResearch.com Interview with: “Childbirth” by DAVID Swift is licensed under CC BY 2.0 Dr. Carmen Young Department of Obstetrics and Gynecology University of Alberta MedicalResearch.com: What is the background for this study? Response: For women who have had a single previous cesarean section, the optimal mode of delivery in a subsequent pregnancy is controversial. This is because there are risks and benefits to attempting a vaginal birth after cesarean section (VBAC) or having an elective repeat cesarean section. Attempted VBAC is associated with a higher risk of uterine rupture and other maternal and infant complications. Repeat cesarean sections are associated with an increased risk of surgical complications and placental complications in subsequent pregnancies. Furthermore, it is difficult to predict which patients will have a successful VBAC. This study is unique in that it uses recent Canadian data, allowing assessment of the impact of contemporary obstetrical care on maternal and neonatal outcomes in Canada.

06 May

Posted at 18:07h in Author Interviews, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_41522" align="alignleft" width="200"]Robin Nijveldt  MD PhD FESC Radboudumc Department of Cardiology The Netherlands Dr. Nijveldt[/caption] Robin Nijveldt  MD PhD FESC Radboudumc, Department of Cardiology and VU University Medical Center Department of cardiology the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know from previous studies that patients with unrecognized myocardial infarcts have worse prognosis than people without infarcts. It was currently unknown in how many patients presenting with a first acute myocardial infarction had previous unrecognized MI, and if so, if this is still a prognostic marker on long term follow-up. In this paper we studied 405 patients from 2 academic hospitals in the Netherlands, with an average follow-up duration of 6.8 years. We found that silent MI was present in 8.2% of patients presenting with first acute MI, and that silent MI is a strong and independent predictor for adverse long-term clinical outcome such as death (HR 3.69) or the composite end point of death, reinfarction, ischemic stroke, or CABG (HR 3.05). Additionally, it appears that ECG is of limited value to detect silent MI, since our study did not reveal an association with long-term clinical outcome.

05 May

Posted at 12:49h in Author Interviews, BMJ, Diabetes, Technology
MedicalResearch.com Interview with: [caption id="attachment_41250" align="alignleft" width="200"]Dr-Apostolos Tsapas Dr. Tsapas[/caption] Apostolos Tsapas, MD PhD MSc(Oxon) Associate Professor of Medicine Director of the Second Medical Department | Aristotle University Thessalonik Cruddas Link Fellow Harris Manchester College University of Oxford   MedicalResearch.com: What is the background for this study? Response: Artificial pancreas treatment, also referred to as closed loop glucose control, is an emerging treatment option combining a pump and continuous glucose monitoring with a control algorithm to deliver insulin (and potentially glucagon) in a glucose responsive manner. Compared with insulin pumps or sensor augmented pumps, artificial pancreas use can reduce the burden for patients by automatically adjusting the amount of insulin entering the body on the basis of sensor glucose levels. The US Food and Drug Administration has recently approved the first artificial pancreas system for use by people with type 1 diabetes over 14 years of age, based on a safety outpatient study.

04 May

Posted at 10:07h in Author Interviews, BMJ, Global Health, Pediatrics, Vitamin D, Weight Research
MedicalResearch.com Interview with: Dr Javeria Saleem PhD Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry Queen Mary University of London London, United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: Severe acute malnutrition is the most extreme and visible form of undernutrition. Affected children have very low weight for their height and severe muscle wasting; they may also have swollen feet, face and limbs. Around 20 million children suffer from severe acute malnutrition worldwide of whom an estimated 1.4 million live in Pakistan. The condition is a major cause of death in children under 5 in Asia and Africa. The standard treatment is to give a high-energy, micronutrient enhanced paste called ready-to-use therapeutic food (RUTF). Vitamin D deficiency has been reported to be a risk factor for severe wasting in children with severe acute malnutrition Ready-to-use therapeutic food contains relatively modest amounts of vitamin D. However, the effects of adding high-dose vitamin D to this standard treatment have not previously been evaluated. We therefore did a clinical trial to assess whether high-dose vitamin D hastened recovery in 185 children aged 6-58 months who were receiving standard treatment for severe acute malnutrition in Southern Punjab, Pakistan. The 93 children in the active arm of the study received two doses of 5 mg vitamin D by mouth, while the 92 children in the control arm received placebo (a dummy medicine containing no vitamin D). Our findings were very striking: after 2 months of treatment, the children who received high-dose vitamin D in addition to standard therapy had significantly better weight gain, and significantly better motor and language development, than those who received standard treatment alone.

04 May

Posted at 10:04h in Author Interviews, Biomarkers, Heart Disease, JAMA, Race/Ethnic Diversity
MedicalResearch.com Interview with: [caption id="attachment_41395" align="alignleft" width="200"]Dr. Karl T. Kelsey, MD, MOH Professor of Epidemiology and Pathology and Laboratory Medicine Fellow, Collegium Ramazzini Providence, R.I. 02912 Dr. Kelsey[/caption] Dr. Karl T. Kelsey, MD, MOH Professor of Epidemiology and Pathology and Laboratory Medicine Fellow, Collegium Ramazzini Providence, R.I. 02912 MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​There is a large literature suggesting that the ratio of neutrophils to lymphocytes (the neutrophil to lymphocyte ratio or NLR) in the peripheral blood at the time of diagnosis is robustly predictive ​of outcome in acute cardiovascular disease. We were curious to know if the peripheral blood profile and this ratio was a feature of the disease process, since, to our knowledge, this had not been investigated in a prospective study.  Hence, we used the resources of 2 prospective studies to assess this question, the Jackson Heart Study and the Normative Aging Study.  In both cases, the NLR predicted all cause mortality and, in the Jackson Heart Study, where we had well adjudicated outcomes, the NLR predicted various specific cardiovascular outcomes as well. Interestingly, the outcome was also modified by a well known genetic polymorphism of African origin that results in a relative neutropenia.

03 May

Posted at 21:36h in Author Interviews, BMJ, Outcomes & Safety, Surgical Research, UCLA
MedicalResearch.com Interview with: “Untitled” by Marcin Wichary is licensed under CC BY 2.0Yusuke Tsugawa, MD, MPH, PhD Assistant professor Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at UCL Los Angeles, CA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We studied whether patients’ mortality rate differ based on age and sex of surgeons who performed surgical procedures. Using a nationally representative data of Medicare beneficiaries aged 65-99 years who underwent one of 20 major non-elective surgeries, we found that patients treated by older surgeons have lower mortality than those cared for by younger surgeons, whereas there was no difference in patient mortality between male and female surgeons. When we studied age and sex together, we found that female surgeons at their 50s had the lowest patient mortality across all groups.

03 May

Posted at 15:37h in Author Interviews, Biomarkers, Breast Cancer, JAMA, Radiation Therapy
MedicalResearch.com Interview with: [caption id="attachment_41471" align="alignleft" width="130"]Chelain Goodman, MD PhD PGY-3, Radiation Oncology Northwestern University Chicago, IL 60611 Dr. Goodman[/caption] Chelain Goodman, MD PhD PGY-3, Radiation Oncology Northwestern University Chicago, IL 60611 MedicalResearch.com: What is the background for this study? Response: Circulating tumor cells are cancer cells that are shed from the primary tumor into the peripheral blood stream and are hypothesized to be one of the first steps in the initiation of metastatic progression. Prospective studies have demonstrated that approximately 15-25% of patients with early-stage breast cancer can be found to have at least one circulating tumor cell in a small sample of their blood. Currently, all patients with early-stage invasive breast cancer who undergo breast conserving surgery receive adjuvant radiation therapy. In these analyses, we wanted to determine whether presence of circulating tumor cells may be predictive of benefit of radiation therapy following surgery.

03 May

Posted at 15:25h in Author Interviews, Breast Cancer, Brigham & Women's - Harvard, JAMA, Mammograms
MedicalResearch.com Interview with: [caption id="attachment_41460" align="alignleft" width="200"]Anne Marie McCarthy, PhD Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston Dr. McCarthy[/caption] Anne Marie McCarthy, PhD Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston MedicalResearch.com: What is the background for this study? What are the main findings? Response: Mammography is effective in reducing breast cancer mortality. However, it is not perfect, and approximately 15% of breast cancers are diagnosed despite a negative mammogram before the next recommended screening. MedicalResearch.com: What should clinicians and patients take away from your report? Response: Using data from the NCI funded PROSPR (Population-Based Research Optimizing Screening through Personalized Regimens) Consortium, we determined the rates of cancer diagnosis within one year following a negative or positive screening mammogram. The rate of cancer diagnosis within one year of a negative mammogram was small (5.9 per 10,000 screenings), but those cancers were more likely to have poor prognosis than cancers diagnosed after a positive mammogram (43.8% vs. 26.9%). As expected, women with dense breasts were more likely to have cancer diagnosed within 1 year of a negative mammogram. However, breast density was not a good predictor of poor prognosis among women diagnosed with cancer after a negative mammogram. Younger women were more likely to be diagnosed with poor prognosis breast cancer after a negative screening mammogram.

03 May

Posted at 10:52h in Author Interviews, JAMA, Outcomes & Safety, Race/Ethnic Diversity, Surgical Research
MedicalResearch.com Interview with: Dr-Hillary-J-Mull Hillary J. Mull, PhD, MPP Center for Healthcare Organization and Implementation Research Veterans Affairs (VA) Boston Healthcare System Department of Surgery, Boston University School of Medicine Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: Little is known about outpatient procedures that can be considered invasive but are not conducted in a surgical operating room. These procedures are largely neglected by quality or patient safety surveillance programs, yet they are increasingly performed as technology improves and the U.S. population gets older. We assessed the rate of invasive procedures across five specialties, urology, podiatry, cardiology, interventional radiology and gastroenterology in the Veterans Health Administration between fiscal years 2012 and 2015. Our analysis included examining the rates of post procedure emergency department visits and hospitalizations within 14 days and the key patient, procedure or facility characteristics associated with these outcomes. We found varying rates of post procedure ED visits and hospitalizations across the specialties with podiatry accounting for a high volume of invasive outpatient care but the lowest rate of postoperative utilization (1.8%); in contrast, few of the procedures were in interventional radiology, but the postoperative utilization rate was the highest at 4.7%. In a series of logistic regression models predicting post procedure healthcare utilization for each specialty, we observed significantly higher odds of post procedural outcomes for African American patients compared to white patients.

03 May

Posted at 10:50h in Alzheimer's - Dementia, Author Interviews, BMJ, Cognitive Issues

Medicalresearch.com Interview with: [caption id="attachment_41413" align="alignleft" width="132"] Prof. Myint[/caption] Professor Phyo Kyaw Myint Chair in Old Age Medicine University of Aberdeen Medicalresearch.com: What is the background for this study? Response: We have previously studied the potential harmful effects of a group of medications called anticholinergics. They can have side effects on central as well peripheral...

02 May

Posted at 21:27h in Alzheimer's - Dementia, Author Interviews, Merck, NEJM
MedicalResearch.com Interview with: Dr. Michael F. Egan MD Merck & Co. North Wales, PA 19454   MedicalResearch.com: What is the background for this study? What are the main findings? Response: A leading theory of Alzheimer's Disease is that it is caused by the buildup of amyloid plaques in the brain. Amyloid is composed of a sticky peptide called Abeta.  Abeta production can be blocked by Inhibiting an enzyme called BACE.  In animal models, BACE inhibtion prevent amyloid accumulation.  We aimed to see if a potent BACE inhibitor would slow clinical decline in Alzheimer's Disease. EPOCH was a Phase 2/3 randomized, placebo-controlled, parallel-group, double-blind study evaluating efficacy and safety of two oral doses of verubecestat an investigational BACE inhibitor, administered once-daily versus placebo in patients with mild-to-moderate AD currently using standard of care treatment. The primary efficacy outcomes of the study are the change from baseline in cognition (assessed using the Alzheimer's Disease Assessment Scale Cognitive Subscale, or ADAS-Cog),  as well as the change from baseline in function (assessed using the Alzheimer's Disease Cooperative Study – Activities of Daily Living, or ADCS-ADL)  after 78 weeks of treatment. Following the recommendation of the external Data Monitoring Committee (eDMC), which assessed overall benefit/risk during  the trial,  the study was stopped early, as there was “virtually no chance of finding a positive clinical effect.” Verubecestat did not reduce cognitive or functional decline in patients with mild-to moderate Alzheimer’s disease and was associated with treatment-related adverse events. 

01 May

Posted at 17:27h in Author Interviews, Cost of Health Care, End of Life Care, JAMA
MedicalResearch.com Interview with: [caption id="attachment_41387" align="alignleft" width="130"]R. Sean Morrison, MD Ellen and Howard C. Katz Professor and Chair Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York, NY 10029 Dr. Morrison[/caption] R. Sean Morrison, MD Ellen and Howard C. Katz Professor and Chair Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York, NY 10029 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Palliative care is team based care that is focused on improving quality of life and reducing suffering for persons with serious illness and their families.  It can be provided at any age and in concert with all other appropriate medical treatments.  Palliative care has been shown to improve patient quality of life, patient and family satisfaction, and in diseases like cancer and heart failure, improve survival.  A number of individual studies have shown that palliative care can reduce costs by providing the right care to the right people at the right time. This study pooled data from six existing studies to quantify the magnitude of savings that high quality palliative care provides.

01 May

Posted at 09:52h in AHA Journals, Author Interviews, Smoking
MedicalResearch.com Interview with: “Stop smoking!” by Emil_95 is licensed under CC BY 2.0Janina Markidan MS III, MD Student University of Maryland School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In a study of 1,145 young men, we found a strong dose-response relationship between the number of cigarettes smoked daily and the risk of ischemic stroke. We categorized the participants as never smokers, former smokers and current smokers. Current smokers were divided into groups based on the number of cigarettes smoked daily, 1 to 10, 11 to 20, 21 to 39, or 40 or more. We found that men who smoked were 88 percent more likely to have a stroke than men who never smoked. Among current smokers, men who smoked fewer than 11 cigarettes daily were 46 percent more likely to have a stroke than those who never smoked. But the heavier smokers, smoking at least two packs a day, were nearly 5 times (466%) more likely to have a stroke than those who never smoked. 

30 Apr

Posted at 22:13h in AHA Journals, Author Interviews, Brigham & Women's - Harvard, Heart Disease, Lifestyle & Health

MedicalResearch.com Interview with: Yanping Li PhD, Research Scientist Department of Nutrition Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that a  healthy lifestyle is associated with less chance of premature mortality; however, it is not clear how much it...

30 Apr

Posted at 21:00h in Author Interviews, JACC, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_41363" align="alignleft" width="135"]Morgana Mongraw-Chaffin, PhD MPH Wake Forest School of Medicine North Carolina Dr. Mongraw-Chaffin[/caption] Morgana Mongraw-Chaffin, PhD MPH Wake Forest School of Medicine North Carolina MedicalResearch.com: What is the background for this study? What are the main findings? Response: While some large studies and meta-analyses of this topic suggest that metabolically healthy obesity (MHO) is not a benign condition, discrepancies persist in the results of individual studies. Lack of a clear explanation for these differences drives the continuing controversy over whether MHO is a useful tool for risk stratification or an intermediate condition on the pathway to cardiometabolic risk. In the Multi-Ethnic Study of Atherosclerosis (MESA), we found that 48% of those with metabolically healthy obesity transitioned to unhealthy obesity by the end of follow-up. Those who transitioned had higher odds of developing cardiovascular disease compared to those who maintained normal weight. We further found that earlier transition from MHO to unhealthy obesity was associated with higher odds.

30 Apr

Posted at 10:47h in Author Interviews, NEJM, Stroke
MedicalResearch.com Interview with: [caption id="attachment_41321" align="alignleft" width="200"]A/Prof Bruce Campbell MBBS(Hons), BMedSc, PhD, FRACP Dr. Campbell[/caption] A/Prof Bruce Campbell MBBS(Hons), BMedSc, PhD, FRACP Consultant Neurologist, Head of Stroke Department of Neurology, Royal Melbourne Hospital Principal Research Fellow,Melbourne Brain Centre @ RMH Department of Medicine University of Melbourne Australia  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Patients with stroke due to a large blood vessel in the brain receive a clot-dissolving medication followed by clot retrieval surgery performed via an angiogram. The standard clot dissolving medication "alteplase" rarely opens the artery prior to clot retrieval surgery. Tenecteplase is genetically modified form of alteplase that may be more effective and is widely available (it is the standard clot dissolving medication used for heart attacks). It can be given over 10 seconds instead of the 1 hour required to infuse alteplase, meaning that patients can be transferred between hospitals to receive treatment more easily. Tenecteplase is also less expensive than alteplase. In EXTEND-IA TNK we found that tenecteplase doubles the number of patients who have blood flow restored to the brain earlier than is possible with clot retrieval surgery (22% vs 10%) and improves patient outcomes compared to the current standard medication called alteplase. 1 in 5 tenecteplase treated patients have blood flow rapidly restored and do not require clot retrieval surgery compared to 1 in 10 with alteplase.

26 Apr

Posted at 08:10h in Author Interviews, Emory, Infections, JACC, Orthopedics
MedicalResearch.com Interview with: [caption id="attachment_41288" align="alignleft" width="150"]Dr-W-Robert-Taylor Dr. Taylor[/caption] Robert Taylor, MD, PhD Marcus Chair in Vascular Medicine Executive Vice Chair, Medicine Director, Division of Cardiology Professor of Medicine and Biomedical Engineering Emory University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The early identification and localization of bacterial infections is a critical step for initiating effective treatment.   This is particularly challenging in the setting of infections associated with implanted medical devices.  We have developed a highly specific probe for bacteria that is based on the fact that bacteria have a specific system for taking up maltodextrins which are polysaccharides that mammalian cells cannot take up directly.  We can label this probe with either a fluorescent of radioactive tag that allows visualization of the bacteria. In the current article, we have used an animal model of implantable cardiac devices to demonstrate that our probe is very specific and sensitive for detecting bacterial infections.  It is worth noting that these are subclinical infections that could not be detected by any other means except for surgical removal.

24 Apr

Posted at 11:53h in Annals Internal Medicine, Author Interviews, Hepatitis - Liver Disease, Johns Hopkins, Opiods
MedicalResearch.com Interview with: Christine Marie Durand, M.D. Assistant Professor of Medicine Johns Hopkins Medicine  MedicalResearch.com: What is the background for this study Response: Most Americans know that the United States faces an epidemic of deaths due to drug overdose.  And many are also aware that there is a critical shortage of organs available for transplant.  Perhaps less widely known is that today, more than 1 in every 8 deceased organ donors died from a drug overdose.  The objective of our study was to look at the outcomes of patients who received transplants with organs donated after an overdose.

23 Apr

Posted at 21:17h in Author Interviews, Emory, Hematology, JAMA, Neurological Disorders, Stroke
MedicalResearch.com Interview with : [caption id="attachment_41371" align="alignleft" width="200"]Dr. Hyacinth I Hyacinth MD Aflac Cancer and Blood Disorder Center, Emory Children’s Center, Department of Pediatrics, Emory University School of Medicine Atlanta, GA 30322 Dr. Hyacinth[/caption] Dr. Hyacinth I Hyacinth MD Aflac Cancer and Blood Disorder Center, Emory Children’s Center, Department of Pediatrics, Emory University School of Medicine Atlanta, GA 30322 MedicalResearch.com: What is the background for this study? This study was conducted against the backdrop of a significantly higher risk for stroke among African Americans compared to non-Hispanic Whites, despite adjusting for traditional risk factors. Also, sickle cell disease is a well-known genetic risk factor for stroke and recent studies show that sickle cell trait is a risk factor for chronic kidney disease, venous thromboembolism and pulmonary embolism, all of which are potential risk factors for stroke.

20 Apr

Posted at 11:45h in Author Interviews, Education, JAMA, Pediatrics
MedicalResearch.com Interview with: “Children Playing at Swyalana Lagoon” by Doug Hay is licensed under CC BY 2.0Dr Anuja Pandey Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health London UK  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Evidence from longitudinal studies suggests that self-regulation skills can be a powerful predictor of positive health, educational, financial and social outcomes. Hence, self-regulation has received interest as an intervention target and a number of interventions have been evaluated in children and adolescents. Our study summarised the evidence from 50 rigorously evaluated self-regulation interventions in children and adolescents including 23098 participants. We found that while most interventions were successful in improving self-regulation (66%), some of them did not produce a noticeable change (34%).Curriculum based approach was most commonly used to deliver interventions, and this involved training teachers, who implemented these interventions. 

20 Apr

Posted at 02:12h in Author Interviews, Blood Pressure - Hypertension, NEJM
MedicalResearch.com Interview with: “Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0José R. Banegas, M.D. Department of Preventive Medicine and Public Health Universidad Autónoma de Madrid Madrid, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Population-based studies and a few relatively small clinical investigations have defined the prognostic role of ambulatory blood pressure monitoring (ABPM) in hypertensive patients. However, previous studies were mostly limited by relatively small number of outcomes. Our study is the largest worldwide and provides unequivocal evidence that ABPM is superior to clinic pressure at predicting total and cardiovascular mortality across a wide range of clinical scenarios – the differences are striking. Also, whether white-coat hypertension is a benign phenotype is still debated. Our study demonstrates that white-coat hypertension was not benign. Lastly, masked hypertension patients (clinic BP normal but ABPM elevated) experienced the greatest risk of death.  

19 Apr

Posted at 15:43h in Annals Internal Medicine, Author Interviews, ENT, Environmental Risks, Hearing Loss
Christine Marie Durand, M.D. Assistant Professor of Medicine Johns Hopkins Medicine MedicalResearch.com Interview with: Dr. Véronique J. C. Kraaijenga MD Department of Otorhinolaryngology–Head and Neck Surgery Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands MedicalResearch.com: What is the background for this study? Response: During the past two decades, the frequency of hearing loss among young people has increased and going to music concerts, clubs and festivals may part of the reason. Noise-induced hearing loss because of recreational noise exposure is reduced by using earplugs. Our study evaluated 51 adults who attended an outdoor music festival in Amsterdam, the Netherlands, in September 2015. The study measured music festival visit for 4.5 hours (intervention); temporary hearing loss (outcome).

19 Apr

Posted at 11:11h in Alzheimer's - Dementia, Author Interviews, NIH, PNAS, Sleep Disorders
MedicalResearch.com Interview with: [caption id="attachment_41271" align="alignleft" width="150"]Nora D. Volkow MD Senior Investigator Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism National Institutes of Health, Bethesda, MD 20892 Dr. Nora Volkow[/caption] Nora D. Volkow MD Senior Investigator Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism National Institutes of Health, Bethesda, MD 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Findings from animal studies had shown that sleep deprivation increased the content of beta-amyloid in brain, which is a risk factor for Alzheimer’s disease.  We wanted to test whether this also happened in the human brain after one night of sleep deprivation. We found that indeed one night of sleep deprivation led to an accumulation of beta amyloid in the human brain, which suggest that one of the reasons why we sleep is to help clean our brain of degradation products that if not removed are toxic to brain cells. 

18 Apr

Posted at 15:52h in Author Interviews, Cancer Research, Dermatology, JAMA, Melanoma, Primary Care, University of Pittsburgh
MedicalResearch.com Interview with: [caption id="attachment_34201" align="alignleft" width="200"]Laura Korb Ferris, MD, PhD Associate Professor, University of Pittsburgh Clinical and Translational Science Institute Director of Clinical Trials, Department of Dermatology University of Pittsburgh Medical Center Dr. Laura K. Ferris[/caption] Laura K. Ferris MD, PhD Associate Professor, University of Pittsburgh Clinical and Translational Science Institute Director of Clinical Trials, UPMC Department of Dermatology University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Dermatology is one of the greatest utilizers of physician extenders, including physician assistants (PAs) in medicine. The scope of practice of PAs has also expanded over time from a role in assisting the dermatologist to taking a more independent role and many PAs now do skin cancer screening examinations and make independent decisions about which lesions are suspicious for skin cancer and need to be biopsied. Our main findings were that, overall, in comparison to board-certified dermatologists, PAs were more likely to perform biopsies of benign lesions. For every melanoma that they found, PAs biopsied 39 benign lesions whereas dermatologists biopsied 25. In addition, PAs were less likely than dermatologists to diagnose melanoma in situ, the earliest and most curable, but also hardest to identify and diagnose, form of melanoma. However, PAs had a similar rate of diagnosing the more clinically-obvious forms of skin cancer, including invasive melanoma, basal cell carcinoma, and squamous cell carcinoma.

17 Apr

Posted at 18:38h in Author Interviews, Heart Disease, JAMA, Lipids
MedicalResearch.com Interview with: [caption id="attachment_41237" align="alignleft" width="142"]Dr. Jennifer Robinson, MD MPH professor of epidemiology, University of Iowa College of Public Health. CREDIT Tom Langdon Dr. Robinson[/caption] Dr. Jennifer Robinson, MD MPH Professor, Departments of Epidemiology & Medicine Director, Prevention Intervention Center Department of Epidemiology University of Iowa MedicalResearch.com: What is the background for this study? Response: Compared to previous placebo-controlled statin trials, the FOURIER trial where all patients were on high or moderate intensity statin, had no reduction in cardiovascular or total mortality and the reduction in cardiovascular events was less than expected.  However, other PCSK9 inhibitor trials performed in populations with higher baseline low density lipoprotein cholesterol (LDL-C) had cardiovascular risk reductions similar to that in the statin trails.

16 Apr

Posted at 22:13h in Author Interviews, Blood Pressure - Hypertension, JAMA, Primary Care
MedicalResearch.com Interview with: “Doctors” by Tele Jane is licensed under CC BY 2.0Doug Einstadter, MD, MPH Center for Health Care Research and Policy MetroHealth System and Case Western Reserve University  MedicalResearch.com: What is the background for this study?   Response: Despite the recognized importance of blood pressure (BP) control for those with hypertension, based on national surveys only 54% of patients with hypertension seen in primary care have their BP controlled to less than 140/90 mm Hg. Blood pressure measurement error is a major cause of poor BP control. Reducing measurement error has the potential to avoid overtreatment, including side effects from medications which would be intensified or started due to a falsely elevated blood pressure. One way to reduce measurement error is to repeat the BP measurement during an office visit. The American Heart Association recommends repeating a blood pressure at the same clinic visit with at least 1 minute separating BP readings, but due to time constraints or lack of evidence for the value of repeat measurement, busy primary care practices often measure BP only once. Repeating the BP at the same office visit when the initial blood pressure measurement is high has the potential to improve clinical decision-making regarding BP treatment. Several studies have described the effect of a repeat BP measurement in the inpatient setting, but there are little data available to characterize the effect of repeating blood pressure measurement in an outpatient primary care setting.