Author Interviews, JAMA, Macular Degeneration, Ophthalmology, Primary Care / 01.05.2017

MedicalResearch.com Interview with: [caption id="attachment_34283" align="alignleft" width="114"]David C Neely, MD The University of Alabama at Birmingham Dr. Neely[/caption] David C Neely, MD The University of Alabama at Birmingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study examined the prevalence of eyes with age-related macular degeneration (AMD) in patients seen in primary eye care clinics who purportedly have normal macular health. Approximately 25.0% of eyes deemed to be normal based on dilated eye examination by primary eye care providers had macular characteristics that indicated age-related macular degeneration.
Accidents & Violence, Author Interviews, JAMA, Mental Health Research, Surgical Research / 30.04.2017

MedicalResearch.com Interview with: Elinore J. Kaufman, MD, MSHP Department of Surgery, New York Presbyterian Hospital Weill Cornell Medicine New York, New York MedicalResearch.com: What is the background for this study? What are the main findings? Response: Deaths of civilians in contact with police have recently gained national public and policy attention. However, we know very little about nonfatal injuries, which far outnumber deaths. MedicalResearch.com: What should readers take away from your report? Response: Nonfatal injuries are much more pervasive than law enforcement-associated deaths, and rates have remained stable over several years, at approximately 51,000 emergency department visits and hospitalizations each year. These injuries primarily affect young men, and mental illness is a common theme. As a physician, my goal is always to get to zero preventable injuries.
Author Interviews, Dermatology, JAMA, Melanoma, Technology / 27.04.2017

MedicalResearch.com Interview with: [caption id="attachment_34201" align="alignleft" width="200"]Laura Korb Ferris, MD, PhD</strong> 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 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 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We found that a non-invasive adhesive patch applied to the skin over a pigmented skin lesion allowed us to capture enough genetic material from the lesion to analyze and predict if that lesion is likely to be melanoma, meaning a biopsy is warranted, or if it is likely benign, meaning the patient would not need a skin biopsy. In this study, we asked dermatologists to use their clinical judgement to decide if they would recommend biopsying a skin lesion based on photos and information about the lesion and the patients, such as the patient's age, personal and family history of skin cancer, and if the lesion was new or changing. We then provided them the read out of the gene test and asked them how this influence their decision. We found that with this test result, dermatologists were more accurate in their decision making, meaning they were more likely to recommend biopsy of melanomas and less likely to biopsy harmless moles than they were without the test. This is important as it means this test has the potential to reduce the number of unnecessary skin biopsies performed, saving patients from undergoing a procedure and having a scar as a result, without increasing the risk of missing a melanoma.
Addiction, Author Interviews, Cannabis, JAMA / 27.04.2017

MedicalResearch.com Interview with: [caption id="attachment_34181" align="alignleft" width="165"]Deborah S. Hasin, Ph.D. Professor of Epidemiology Columbia University New York, New York 10032 Dr. Hasin[/caption] Deborah S. Hasin, Ph.D. Professor of Epidemiology Columbia University New York, New York 10032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Among adults, the prevalence of cannabis use and cannabis use disorders has increased in recent years. Concerns have been raised that for various reasons, medical marijuana laws would promote use of cannabis and consequently, cannabis-related consequences. Many studies show that this didn't happen among adolescents, but very little was known about the relationship between medical marijuana laws and adults. Using data from three surveys spanning the years 1991-2013, the study findings suggested that medical marijuana laws did play a role in increasing rates of cannabis use and cannabis use disorders.
Aging, Author Interviews, BMJ, Cognitive Issues, Exercise - Fitness / 26.04.2017

MedicalResearch.com Interview with: Dr. Joseph Michael Northey UC Research Institute for Sport and Exercise (UCRISE), Discipline of Sport and Exercise Science, Faculty of Health University of Canberra, Canberra, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Physical exercise has an important role to play in maintaining cognitive function across the lifecycle. However, the benefits of implementing a physical exercise intervention were not clear. To address these issues which prevented evidence-based prescription of exercise for cognitive function, a systematic review of all the available literature up to November of 2016 in adults older than 50 was conducted.
Author Interviews, HIV, JAMA, Pediatrics, Sexual Health / 25.04.2017

MedicalResearch.com Interview with: [caption id="attachment_34177" align="alignleft" width="200"]Robin Lin Miller, Ph.D. Professor, Ecological-Community Psychology Co-Director, MA in Program Evaluation Chair, Graduate Program in Ecological-Community Psychology Michigan State University East Lansing, MI 48824 Dr. Miller[/caption] Robin Lin Miller, Ph.D. Professor, Ecological-Community Psychology Co-Director, MA in Program Evaluation Chair, Graduate Program in Ecological-Community Psychology Michigan State University East Lansing, MI 48824 MedicalResearch.com: What is the background for this study? Response: We wanted to identify promising strategies for providing access to HIV-testing for gay and bisexual male youth. We were especially interested in testing strategies to reach gay and bisexual male youth of color, as they bear a disproportionate burden of the HIV epidemic and are the least likely to be aware of their HIV status. We also wanted to explore approaches to successfully link these youth with HIV-negative test results to diverse HIV prevention services, including pre-exposure prophylaxis, when warranted. Although some argue that the ideal place to test adolescents and young adults is via emergency rooms and in routine medical care visits, we found that we were able test many more youth with previously undiagnosed HIV-infection through intensive, targeted community outreach efforts. We also tested a much higher proportion of young men of color through targeted outreach.
Annals Internal Medicine, Author Interviews, Emergency Care, Heart Disease / 25.04.2017

MedicalResearch.com Interview with: [caption id="attachment_34167" align="alignleft" width="180"]Judith Poldervaart MD, PhD Assistant professor Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Dr.Poldervaart[/caption] Judith Poldervaart MD, PhD Assistant professor Julius Center for Health Sciences and Primary Care University Medical Center Utrecht MedicalResearch.com: What is the background for this study? What are the main findings? Response: Since its development in 2008, interest in the HEART score is increasing and several research groups around the world have been publishing on the HEART score. After validation of any risk score for cardiac events, there is a concern about the safety when used in daily practice. We were able to show the HEART score is just as safe as the usual care currently used at EDs, which has not been shown yet in previous research. That we did not find a decrease in costs, is probably due to the hesitance of physicians to discharge low-risk patients from the ED without further testing. But extrapolation of the findings of a cost-effectiveness analysis (including nonadherence) suggests that HEART care could lead to annual savings of €40 million in the Netherlands. Hopefully, in time (and more publications of the HEART score now appearing almost weekly from all over the world) this effect on use of health care resources will become more apparent.
Author Interviews, BMJ / 25.04.2017

MedicalResearch.com Interview with: Gary Evoniuk, PhD Director of Publication Practices, Medical Communications Quality & Practices GlaxoSmithKline Research and Development, Research Triangle Park, NC 27709 MedicalResearch.com: What is the background for this study? Response: In recent years, industry, and to a lesser extent academia, have been criticised for failing to submit clinical trial data for publication, especially when the data are perceived to be “negative”, (i.e. unfavourable to the drug under study) leading to publication bias. We felt it was important to determine whether this criticism is based on perception or reality and so we conducted what is, to our knowledge the only study to systematically address the issue of submission and publication bias based on study outcome.
Author Interviews, Heart Disease, JACC / 25.04.2017

MedicalResearch.com Interview with Phyllis K. Stein, PhD Division of Hospital Medicine Washington University School of Medicine St. Louis, Missouri MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was based on results from the Cardiovascular Health Study (CHS) which was designed to be a prospective study of risk factors for cardiovascular disease and stroke in community-dwelling older adults. Of this cohort, about ¼ volunteered to have Holter recordings. They form the basis of our study. All participants were carefully followed and all outcomes fully adjudicated. Thus, we were able to add the Holter findings to the existing Health ABC study and determine whether they added to a validated risk score.
Author Interviews, Biomarkers, Hepatitis - Liver Disease, Lancet, Merck / 25.04.2017

MedicalResearch.com Interview with: [caption id="attachment_34147" align="alignleft" width="200"]Jason Grebely PhD Associate Professor Senior Research Fellow (UNSW) Viral Hepatitis Clinical Research Program Dr. Grebely[/caption] Jason Grebely PhD Associate Professor Senior Research Fellow (UNSW) Viral Hepatitis Clinical Research Program MedicalResearch.com: What is the background for this study? What are the main findings? Response: Globally, testing and diagnosis of hepatitis C virus infection remain low. Although point of care tests for HCV infection exist, but many of these tests only measure HCV antibodies (previous exposure), not HCV RNA (active infection). Given that 25% of individuals spontaneously clear HCV infection, efforts to enhance diagnosis of chronic HCV infection and improve the HCV care cascade requires enhanced uptake of HCV RNA testing. We conducted the first evaluation of the Xpert HCV Viral Load test (manufactured by Cepheid) - a point-of-care hepatitis C virus test that can detect active infection - from a finger-stick sample of blood. We established that there is good sensitivity and specificity of the Xpert HCV Viral Load point-of-care test using blood samples collected by finger-stick in participants attending drug health and homelessness services in Australia.
Author Interviews, JAMA, Mental Health Research, Pediatrics / 25.04.2017

MedicalResearch.com Interview with: [caption id="attachment_34053" align="alignleft" width="200"]Yongfu Yu, PhD Department of Clinical Epidemiology Aarhus University Hospital Aarhus N, Denmark Dr. Yong Yu[/caption] Dr. Yongfu Yu, PhD Department of Clinical Epidemiology Aarhus University Hospital Aarhus, Denmark MedicalResearch.com: What is the background for this study? Response: Bereavement by the death of a close relative is ranked as one of the most severe life events and it is likely to cause psychological stress regardless of coping mechanisms. An increased risk of mortality and adverse health outcomes has been observed among the bereaved spouses, parents, and children. It is estimated that nearly 8% of individuals in the US experienced a sibling death in childhood but much less is known about its health consequences. Sibling relationship tends to be the longest and the most intimate in family thus the death of a sibling can be a devastating life event, especially when this event happens at early ages. However, to our knowledge, no study has investigated the effects of sibling death in childhood on subsequent mortality in bereaved siblings with a long follow-up time.
Author Interviews, JAMA, Prostate Cancer, UCSF / 24.04.2017

MedicalResearch.com Interview with: [caption id="attachment_34129" align="alignleft" width="154"]Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S. Lee Goldman, MD, endowed chair in medicine and professor of medicine and of epidemiology and biostatistics University of California, San Francisco Chair of the U.S. Preventive Services Task Force Dr. Bibbins-Domingo[/caption] Kirsten Bibbins-Domingo, Ph.D., M.D., M.A.S. Lee Goldman, MD, endowed chair in medicine and professor of medicine and of epidemiology and biostatistics University of California, San Francisco Chair of the U.S. Preventive Services Task Force MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer is one of the most common cancers to affect men, and the Task Force believes all men should be aware of the benefits and harms of screening for prostate cancer. Prostate cancer screening with PSA testing can help men reduce their chance of dying of prostate cancer or of having metastatic cancer. These are important benefits but occur in a small number of men. There are risks associated with screening, specifically overdiagnosis and overtreatment with surgery and radiation that can have important side effects like impotence and incontinence. Since the release of our 2012 recommendation, new evidence has emerged that increased the Task Force’s confidence in the benefits of screening, which include reducing the risk of metastatic cancer (a cancer that spreads) and reducing the chance of dying from prostate cancer. This draft recommendation also reflects new evidence on the use of active surveillance in men with low-risk prostate cancers that may help mitigate some of the harms in these men by allowing some men with low risk cancer to delay or avoid surgery or radiation. Therefore, in our new 2017 draft recommendation, the Task Force encourages men ages 55 to 69 to make an individual decision about whether to be screened after a conversation with their clinician about the potential benefits and harms. For men age 70 years and older, the potential benefits do not outweigh the harms, and these men should not be screened for prostate cancer.
Author Interviews, Education, JAMA, Outcomes & Safety, Surgical Research / 24.04.2017

MedicalResearch.com Interview with: Haggi Mazeh, MD, FACS Endocrine and General Surgery Department of Surgery Hadassah-Hebrew University Medical Center, Mount Scopus Jerusalem, Israel 91240 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The level of operating room autonomy given to surgical residents varies greatly between different institutions and different countries. On one hand, providing residents the opportunity to operate alone augments their confidence and their sense of responsibility, possibly accelerating their learning process. On the other hand, it may be argued that the presence of a senior general surgeon in every operation is a safer approach. Before 2012, a large proportion of appendectomies at our institution were performed by surgical residents alone. After 2012, our institutional policy changed to require the presence of a senior general surgeon in every appendectomy case. This unique situation provided us the opportunity to compare the outcomes of appendectomies performed by residents alone to those performed in the presence of a senior general surgeon. Our study demonstrated no difference in the complication rates between the two groups of patients. However, surgeries performed in the presence of senior general surgeons were significantly shorter than those performed by residents.
Addiction, Author Interviews, Infections, JAMA, Ophthalmology / 22.04.2017

MedicalResearch.com Interview with: Aubrey Tirpack, PGY3 New England Eye Center Tufts Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Intravenous drug abuse is a known risk factor for the development of endogenous fungal endophthalmitis (EFE), a severe intraocular infection cause by the seeding of mycotic organisms to the eye. Our institution noted a marked increase in cases of EFE beginning in May 2014, which correlates to increasing rates of opioid abuse throughout the New England region. Ten patients were found to have intravenous drug abuse related EFE over the two year time period studied. The most common presenting symptoms were floaters, decreased vision, and pain. All patients were treated with systemic antifungals and nine patients underwent intravitreal antifungal injection. All patients were ambulatory at presentation and the majority were without systemic signs of infection.
Author Interviews, BMJ, Karolinski Institute, Mental Health Research, Pediatrics / 22.04.2017

MedicalResearch.com Interview with: Charlotte Björkenstam PhD Dept of Clinical Neuroscience Karolinska Institutet Division of Insurance Medicine Stockholm MedicalResearch.com: What is the background for this study? What are the main findings? Response: In a prior study we revealed that exposure to childhood adversities were associated with a substantial risk increase for self-harm. The risk was even higher for those exposed to accumulated childhood adversities. This finding together with the fact that the suicide rate among young adults is increasing (as opposed to decreasing in the general population) lead us to want to examine the relationship between childhood adversities and death by suicide. We investigated 7 different childhood adversities, including familial death (suicide analyzed separately), parental substance abuse, parental psychiatric disorder, substantial parental criminality, parental separation/single-parent household, public assistance recipiency, and residential instability occurring between birth and age 14. We then followed the individuals up until age 24 at most. All adversities were entailed with an increased suicide risk from IRR: 1.6 (95% CI: 1.1 to 2.4) for residential instability to IRR: 2.9 (95% CI; 1.4 to 5.9) for familial suicide. We also found a dose-response relationship between accumulating CA and suicide risk where IRR ranged between 1.1 (95% CI: 0.9 to 1.4) for those exposed to 1 CA, to 2.6 (95% CI: 1.9 to 3.4) for those exposed to 3 or more adversities.
Aging, Author Interviews, Breast Cancer, JAMA, Mammograms, NYU/NYMC / 21.04.2017

MedicalResearch.com Interview with: Cindy S. Lee, MD Department of Radiology and Biomedical Imaging University of California, San Francisco, San Francisco Now with Department of Radiology NYU Langone Medical Center, Garden City, New York MedicalResearch.com: What led you and colleagues to conduct this study? Response: I am a breast imager. I see patients who come in for their screening mammograms and I get asked, a lot, if patients aged 75 years and older should continue screening, because of their age. There is not enough evidence out there to determine how breast cancer screening benefits women older than 75. In fact, all previously randomized trials of screening mammography excluded people older than 75 years. Unfortunately, age is the biggest risk factor for breast cancer, so as patients get older, they have higher risks of developing breast cancer. It is therefore important to know how well screening mammography works in these patients.
Author Interviews, Inflammation, JAMA / 20.04.2017

MedicalResearch.com Interview with: Andrew Dick FRSB FMedSci Professor of Ophthalmology Bristol Eye Hospital, University of Bristol, Bristol, England National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital, Institute of Ophthalmology, University College London, London, England and John Sheppard, MD President, Virginia Eye Consultants Professor of Ophthalmology, Eastern Virginia Medical School MedicalResearch.com: What should readers take away from your report? Dr. Andrew Dick: These findings demonstrate that adalimumab is associated with clinically meaningful improvements in visual functioning for patients with non-infectious intermediate uveitis, posterior uveitis, and panuveitis. The emphasis of this work is that for the first time in uveitis we have seen patient reported outcome benefit of a biologic treatment. This analysis supports the use of adalimumab as a promising new treatment option, having demonstrated improvements in both clinical and visual functioning outcomes in patients with active and inactive uveitis. Dr. John Sheppard: Uveitis has a substantial effect on individuals’ physical, professional, psychological, avocational and social functioning in day-to-day life. Adalimumab, an anti-inflammatory drug that binds to tumor necrosis factor, was recently approved for the treatment of non-infectious intermediate uveitis, posterior uveitis, and panuveitis. It is the first systemic therapy specifically approved for uveitis.  The analyses in this study provide evidence that patients with noninfectious uveitis treated with adalimumab experience significant and clinically meaningful improvements in vision-related quality of life, compared with those who received placebo.
Author Interviews, Blood Pressure - Hypertension, Gender Differences, JAMA, Race/Ethnic Diversity / 20.04.2017

MedicalResearch.com Interview with: [caption id="attachment_33996" align="alignleft" width="150"]Shakia Hardy, MPH, CPH. PhD Dr. Hardy[/caption] Shakia Hardy, MPH, CPH. PhD Department of Epidemiology The University of North Carolina at Chapel Hill MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies characterizing blood pressure levels across the life course have relied on prevalence estimates at a given age. Our study was interested in identifying critical ages at which net transitions between levels of blood pressure occurred. We used data from the National Health and Nutrition Examination Survey (2007-2012) to estimate age-, race-, and sex-specific annual net transition probabilities between ideal blood pressure, prehypertension and hypertension. We found that African Americans and men were more likely to transition from ideal levels of blood pressure in childhood or early adulthood compared to white Americans and women, which puts them at increased risk of developing prehypertension and hypertension earlier in life.
Author Interviews, Diabetes, NEJM, Ophthalmology, Personalized Medicine / 20.04.2017

MedicalResearch.com Interview with: John M. Lachin, Sc.D. Research Professor of Biostatistics and of Epidemiology, and of Statistics The George Washington University Biostatistics Center and David Matthew Nathan, M.D. Professor of Medicine, Diabetes Unit Massachusetts General Hospital  MedicalResearch.com: What is the background for this study? Response: Traditional guidelines for screening for retinopathy, based on indirect evidence, call for annual examinations. The automatic annual screening for retinopathy, without considering potential risk factors for progression,  appears excessive based on the slow rate of progression through sub-clinical states of retinopathy.
Author Interviews, Compliance, Heart Disease, JAMA / 20.04.2017

MedicalResearch.com Interview with: [caption id="attachment_33991" align="alignleft" width="130"]Robert Rosenson, MD Professor of Medicine and Cardiology Icahn School of Medicine at Mount Sinai New York Dr. Rosenson[/caption] Robert Rosenson, MD Professor of Medicine and Cardiology Icahn School of Medicine at Mount Sinai New York MedicalResearch.com: What is the background for this study? What are the main findings? Response: High intensity statin therapy is underutilized in patients with acute coronary syndromes. In 2011, 27% of patients were discharged on a high intensity statin (Rosenson RS, et al. J Am Coll Cardiol). In this report, we investigate the factors associated with high adherence to high intensity statin. High adherence to high intensity statins was more common among patients who took high intensity statin prior to their hospitalization, had fewer comorbidities, received a low-income subsidy, attended cardiac rehabilitation and more visits with a cardiologist.
Author Interviews, Breast Cancer, Chemotherapy, JAMA, MD Anderson, Surgical Research / 20.04.2017

MedicalResearch.com Interview with: [caption id="attachment_33987" align="alignleft" width="136"]Audree Tadros, MD, MPH Chief Administrative Fellow, Breast Surgical Oncology Training Program Department of Breast Surgical Oncology MD Anderson Cancer Center and Dr. Tadros[/caption] Audree Tadros, MD, MPH Chief Administrative Fellow, Breast Surgical Oncology Training Program Department of Breast Surgical Oncology MD Anderson Cancer Center and [caption id="attachment_33988" align="alignleft" width="120"]Henry M. Kuerer, MD, PhD, FACS Executive Director, Breast Programs MD Anderson Cancer Network PH and Fay Etta Robinson Distinguished Professor in Cancer Research Department of Breast Surgical Oncology Director, Breast Surgical Oncology Training Program Dr. Kuerer[/caption] Henry M. Kuerer, MD, PhD, FACS Executive Director, Breast Programs MD Anderson Cancer Network PH and Fay Etta Robinson Distinguished Professor in Cancer Research Dept of Breast Surgical Oncology Director, Breast Surgical Oncology Training Program MedicalResearch.com: What is the background for this study? Response: Neoadjuvant chemotherapy (NCT) has the ability to confer a pCR (pathologic complete response-when no residual cancer is found) in both the breast and axillary lymph nodes. We know that this is most likely to occur in women with HER2 positive and triple negative disease. The high rate of pCR among these patients raises the question of whether surgery is still required, particularly among those who will receive adjuvant radiation therapy. Until recently, we lacked the ability to pre-operatively predict patients who achieved a breast pCR. Recently, we completed a clinical feasibility trial examining the ability of image-guided biopsy to predict a pCR after neoadjuvant chemotherapy. Our biopsy technique was able to accurately predict a pCR in 98% of patients with only a 5% false negative rate. Based upon these findings, we believe we can accurately determine which patients achieve a breast pCR. This led us to develop a clinical trial to see if breast surgery is redundant in patients who achieve a pCR. An important question that remained was if we are going to omit breast surgery in these exceptional responders, can we also omit axillary surgery?
Annals Internal Medicine, Author Interviews, Biomarkers, Heart Disease / 19.04.2017

MedicalResearch.com Interview with: Martin P. Than, MBBS Emergency Department, Christchurch Hospital and Dr John W Pickering, PhD Associate Professor Senior Research Fellow in Acute Care Emergency Care Foundation, Canterbury Medical Research Foundation, Canterbury District Health Board | Christchurch Hospital Research Associate Professor | Department of Medicine | University of Otago Christchurch New Zealand MedicalResearch.com: What is the background for this study? Response: Patients being investigated for possible acute coronary syndrome comprise one of the largest groups of patients presenting to emergency rooms. Troponin assays have developed such that they can now measure with greater accuracy much lower concentrations of troponin. A large retrospective registry based study and a couple of smaller prospective studies suggested that patients with a very low concentrations of troponin T (below the current limit of detection of 5 ng/L) measured with Roche Diagnostic’s high-sensitivity troponin T (hsTnT) assay on presentation to the emergency department (ie single blood draw) are very unlikely to be having a myocardial infarction (MI). Our study gathers the current best evidence for using concentrations below the limit of detection in conjunction with no evidence of new ischaemia on ECG to safely risk stratify patients to a very low-risk group for MI and, therefore, potentially identify patients safe for early discharge.
Author Interviews, Heart Disease, JACC, Medical Imaging, MRI / 19.04.2017

MedicalResearch.com Interview with: [caption id="attachment_34037" align="alignleft" width="132"]Pr. Juerg Schwitter MD Médecin Chef Cardiologie Directeur du Centre de la RM Cardiaque du CHUV Centre Hospitalier Universitaire Vaudois - CHUV Suisse Pr. Schwitter[/caption] Pr. Juerg Schwitter MD Médecin Chef Cardiologie Directeur du Centre de la RM Cardiaque du CHUV Centre Hospitalier Universitaire Vaudois - CHUV Suisse  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Coronary artery disease (CAD) is still one of the leading causes of death in the industrialized world and as such, it is also an important cost driver in the health care systems of most countries. For the European Union, the estimated costs for CAD management were 60 billion Euros in 2009, of which approximately 20 billion Euros were attributed to direct health care costs (1). In 2015, the total costs of CAD management in the United States were estimated to be 47 billion dollars (2). Substantial progress has been achieved regarding the treatment of CAD including drug treatment but also revascularizations procedures. There exists a large body of evidence demonstrating myocardial ischemia as one of the most important factors determining the patient’s prognosis and reduction of ischemia has been shown to improve outcome. On the other hand, techniques to detect CAD, i.e. relevant myocardial ischemia, were insufficient in the past. Evaluation of myocardial perfusion by first-pass perfusion cardiac magnetic resonance (CMR) is now closing this gap (3) and CMR is recommended by most international guidelines for the work-up of known or suspected CAD (4,5). Still, a major issue was not clarified until now, i.e. “how much ischemia is required to trigger revascularization procedures”. Thus, this large study was undertaken to assess at which level of ischemia burden, patients can be safely deferred from revascularization and can be managed by risk factor treatment only. Of note, this crucial question was addressed in both, patients with suspected CAD but also in patients with known (and sometimes already advanced) CAD, thereby answering this question in the setting of daily clinical practice.
Author Interviews, Diabetes, Nutrition, PLoS / 19.04.2017

MedicalResearch.com Interview with: Huaidong Du Senior Research Fellow China Kadoorie Biobank Medical Research Council Population Health Research Unit Clinical Trial Service Unit & Epidemiological Studies Unit Nuffield Department of Population Health Oxford UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: This research article describes findings from the China Kadoorie Biobank study which is a large population based prospective cohort study including about 0.5 million adults recruited from 10 areas in China. The main reason for us to perform this study is because previous evidence on potential benefit of fruit consumption in diabetes prevention and management is very limited. The sugar content of fruit has led to concerns in many parts of the world (e.g. China and several other Asian countries) about its potential harm for people with (high risk of) diabetes. This has consequently Chinese people diagnosed with diabetes tend to restrict their fruit intake. With the rapid increase of diabetes incidence in China and many other Asian countries, it is critically important to investigate the associations of fruit consumption with the incidence diabetes and, among those with diabetes already, diabetic macro- and microvascular complications. Through analysing data collected during 7 years of follow-up, the study found that people who eat fresh fruit more frequently are at lower risk of developing diabetes and diabetes related vascular complications. Compared with non-consumers, those who ate fresh fruit daily had a 12% lower risk of developing diabetes. Among participants with diabetes at the start of the study, higher fresh fruit consumption also showed health benefits, with a 100g portion of fruit per day associated with 17% lower overall mortality, 13% lower risk of developing diabetes-related complications affecting large blood vessels (e.g. ischaemic heart disease and stroke) and 28% lower risk of developing complications affecting small blood vessels (e.g. kidney and eye diseases).
Author Interviews, Autism, Depression, JAMA, OBGYNE, Pediatrics / 19.04.2017

MedicalResearch.com Interview with: [caption id="attachment_33979" align="alignleft" width="133"]Simone Vigod, MD, MSc, FRCPC Psychiatrist and Lead, Reproductive Life Stages Program Women’s Mental Health Program Women’s College Hospital Toronto, ON Dr. Vigod[/caption] Simone Vigod, MD, MSc, FRCPC Psychiatrist and Lead, Reproductive Life Stages Program Women’s Mental Health Program Women’s College Hospital Toronto, ON MedicalResearch.com: What is the background for this study? What are the main findings? Response: Depression is one of the most common problems that can complicate a pregnancy. Untreated, or incompletely treated, it can be associated with significant harm to mother and child. While psychotherapies alone may be effective for women with mild (or even moderate) severity symptoms, sometimes antidepressant medication is required. In these cases, the benefits of treatment must be weighed against potential risks. Previous research suggested that there may be an increased risk for autism in children exposed to antidepressant medication during pregnancy. However, previous studies were limited in their ability to account for other potential causes of autism in their analyses. In our study, we used several different strategies to try to compare children whose pregnancy exposures were very similar, except for exposure to an antidepressant. The main finding was that after using these strategies, there was no longer a statistically significant association between in-utero antidepressant exposure and autism.
Author Interviews, JAMA / 19.04.2017

MedicalResearch.com Interview with: [caption id="attachment_33953" align="alignleft" width="156"]Neha Pagidipati, MD MPH Duke Clinical Research Institute Duke University Durham, North Carolina Dr. Pagidipati[/caption] Neha Pagidipati, MD MPH Duke Clinical Research Institute Duke University Durham, North Carolina MedicalResearch.com: What is the background for this study? What are the main findings? Response: The 2013 ACC/AHA guidelines for treatment of blood cholesterol to prevent cardiovascular disease created a new paradigm for lipid management and raised numerous ongoing controversies. In 2016, the US Preventive Services Task Force released recommendations for primary prevention statin therapy which were different in some important ways from the 2013 ACC/AHA guidelines. We aimed to understand the practical difference between these two sets of guidelines in terms of the number of Americans who would be potentially eligible for statin therapy. Using U.S. cross-sectional survey data between 2009 and 2014, we found that, if fully implemented, the USPSTF recommendations would reduce the percentage of US adults age 40-75 who should initiate statin therapy from 24% to 16% as compared to the 2013 ACC/AHA guidelines. Those newly recommended for statin therapy would be in addition to the 21% of US adults already taking lipid-lowering therapy. Of the approximately 9 million adults who would no longer be recommended to receive statin therapy under the new USPSTF recommendations, over half of them would be younger adults with a high long-term risk of cardiovascular disease (about 1 in 3), and over one quarter would be individuals with diabetes.
Author Interviews, Baylor College of Medicine Houston, Genetic Research, PLoS / 18.04.2017

MedicalResearch.com Interview with: Daryl Armstrong Scott, M.D., Ph.D Associate Professor Molecular and Human Genetics Baylor College of Medicine Houston, TX, US MedicalResearch.com: What is the background for this study? What are the main findings? Response: This case started with a male child with intellectual disability, developmental delay, hypotonia, hypermobile joints and relative macrocephaly (large head size). Clinical testing showed that he carried a small deletion on chromosome Xp11.22. Since the deleted region had not been previously associated with human disease, the patient was referred to our clinic for additional testing. However, a more detailed analysis revealed that mice that were missing one of the genes located in the deletion interval, Maged1, had neurocognitive and neurobehavioral problems. This sparked additional inquiries which resulted in the identification of three other males from two other families who carried small, overlapping Xp11.22 deletions and had similar features. In all cases, their deletions were inherited from their asymptomatic mothers. We concluded that deletion of an ~430 kb region on chromosome Xp11.22 that encompasses two pseudogenes (CENPVL1 and CENPVL2) and two protein-coding genes (MAGED1 and GSPT2) causes a novel, syndromic form of X-linked intellectual disability characterized by developmental delay, hypotonia, hypermobile joints and relative macrocephaly.
Author Interviews, Heart Disease, Inflammation, Nature / 18.04.2017

MedicalResearch.com Interview with: [caption id="attachment_33993" align="alignleft" width="163"]Borja Ibáñez MD Spanish National Centre for Cardiovascular Research Madrid Dr. Ibáñez[/caption] Borja Ibáñez MD Spanish National Centre for Cardiovascular Research Madrid MedicalResearch.com: What is the background for this study? What are the main findings? Response: Acute myocardial infarction (heart attack) is a severe condition responsible for thousands of deaths every year and with important long-term consequences for survivors. Best treatment for acute myocardial infarction is a rapid coronary reperfusion. Upon reperfusion, all inflammatory cells and mediators accumulated in the circulation during the infarction process, enter into the myocardium and causes an extra damage to the heart. Activated neutrophils play a critical role in this damage occurring upon reperfusion. The final size of infarction is the main determinant for mortality and long-term morbidity. The possibility of limiting the extent of infarcted tissue is of paramount importance. Betablockers have been used in patients for more than 4 decades, mainly to treat arrhythmias and high blood pressure. Recently the same group of investigators demonstrated that the very early administration (i.e. during ambulance transfer to the hospital) of the betablocker “metoprolol” was able to reduce the size of infarction in patients. The mechanism by which metoprolol was protective in patients suffering a myocardial infarction was unknown.
Author Interviews, Cancer Research, Genetic Research, JAMA / 18.04.2017

MedicalResearch.com Interview with: [caption id="attachment_33859" align="alignleft" width="166"]Fergus J. Couch, Ph.D. Zbigniew and Anna M. Scheller Professor of Medical Research Chair, Division of Experimental Pathology Department of Laboratory Medicine and Pathology Mayo Clinic Rochester, MN 55905 Dr. Couch[/caption] Fergus J. Couch, Ph.D. Zbigniew and Anna M. Scheller Professor  of Medical Research Chair, Division of Experimental Pathology Department of Laboratory Medicine  and Pathology Mayo Clinic Rochester, MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: The main finding is that RAD51D, BARD1, and MSH6 can now be included in the list of moderate risk breast cancer genes. In contrast, other genes such as MRE11A and RAD50 do not increase risk of breast cancer. In addition, we provide initial estimates of the level of breast cancer risk associated with mutations in the genes that cause breast cancer. The "new" breast cancer genes may now be useful for identifying women who can benefit from enhanced screening. These new data will need to be considered by the National Comprehensive Cancer Network (NCCN) which provides guidelines for clinical management of individuals with mutations in cancer predisposition genes. These results will also be useful for identifying members of families who are at increased risk of breast cancer.
Author Interviews, JAMA, Opiods, Surgical Research, University of Michigan / 18.04.2017

MedicalResearch.com Interview with: [caption id="attachment_33814" align="alignleft" width="124"]Chad M. Brummett, MD Division of Pain Medicine, Department of Anesthesiology University of Michigan Medical School Ann Arbor, MI 48109 Dr. Brummett[/caption] Chad M. Brummett, MD Division of Pain Medicine, Department of Anesthesiology University of Michigan Medical School Ann Arbor, MI 48109  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The opioid epidemic has received considerable attention, but most of the focus has been on chronic pain and primary care. However, surgeons prescribe ~40% of the opioids in the US, and little attention has been given to the importance of prescribing after surgery. In this study, we found that among patients not using opioids in the year prior to surgery, ~6% of patients continued to use opioids long after what would be considered normal surgical recovery. Furthermore, there was no difference between patients undergoing minor and major surgeries, thereby suggesting that some patients continue to use opioids for reasons other than pain related to surgery.