Medical Research Journals

17 Dec

Posted at 13:37h in Author Interviews, Brigham & Women's - Harvard, Dental Research, Infections, Rheumatology, Science
MedicalResearch.com Interview with: [caption id="attachment_30609" align="alignleft" width="200"]Maximilian F. Konig, MD Department of Medicine Massachusetts General Hospital Harvard Medical School Dr. Maximilian F. Konig[/caption] Maximilian F. Konig, MD Division of Rheumatology, Johns Hopkins University School of Medicine Current affiliation: Department of Medicine Massachusetts General Hospital Harvard Medical School MedicalResearch.com: What is the background for this study? Response:The idea that rheumatoid arthritis (RA), an autoimmune disease that leads to chronic joint inflammation and destruction, may be initiated by a bacterial infection is not novel, but has been posited for more than a century. Based on the clinical observation that patients with RA frequently have severe periodontal disease (gum disease), gum inflammation has long been thought to contribute to disease development in RA. However, limited understanding of the mechanisms that fuel and sustain the autoimmune attack in RA made it difficult to pinpoint a specific bacterial trigger. In recent years, our understanding of the abnormal immune response that attacks the joints in patients with RA has grown exponentially, and we now know that disease-specific autoantibodies (ACPAs) target modified self-proteins (this modification is known as citrullination). It is this abnormal immune response against citrullinated proteins that appears to drive the joint (and sometimes lung) inflammation seen in rheumatoid arthritis. Recent studies from our laboratory at The Johns Hopkins University (led by principle investigator Felipe Andrade, MD, PhD) suggested that an immune cell called the neutrophil, which normally protects us from infection at sites like the oral cavity or anywhere else in the body, also appears to be the source of the proteins attacked in RA. We were therefore interested to understand what drives the association of gum disease, an inflammation commonly triggered by bacteria, with RA.

17 Dec

Posted at 02:32h in Author Interviews, Heart Disease, JACC, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_30605" align="alignleft" width="132"]Frederick L. Grover, M. D. Professor, Division of Cardiothoracic Surgery Past Chair, Department of Surgery University of Colorado School of Medicine-Anschutz Medical Campus Aurora, CO Past President, Society of Thoracic Surgeons Vice Chair, Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry Dr. Frederick Grover[/caption] Frederick L. Grover, M. D. Professor, Division of Cardiothoracic Surgery Past Chair, Department of Surgery University of Colorado School of Medicine-Anschutz Medical Campus Aurora, CO Past President, Society of Thoracic Surgeons Vice Chair, Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry MedicalResearch.com: What is the background for this study? What are the main findings? Response: Following approval of the first transcatheter aortic heart valve late in 2011 the TVT-R was established and data entry was mandated by CMS for all patients who were undergoing transcatheter valve therapy.  Data is currently collected on transcatheter aortic valves (TAVR) from two companies, transcatheter mitral clip procedures (TMC), transcatheter mitral valve in valve or valve in ring procedures and aortic valve in valve procedures.  A report is published annually jointly in the Journal of the American College of Cardiology (JACC) and the Annals of Thoracic Surgery (ATS).  This report contains data from the beginning of 2012 through December 31, 2015.  Peoperative risk factors, operative details and outcomes data are collected prior to procedures, during the hospitalization, 30 days post procedure and at one year and later data can be collected by linking to CMS administrative data. For this annual report we concentrated on touching on some of the highlights since the length of the manuscript is limited. We discussed the trends in TAVR, since this is the most common procedure performed, the last two years’ experience in mitral clips since a very detailed paper was published on this last year, and the mitral valve in valve and ring since the results for this procedure were impressively good. In regard to TAVR, 418 sites perform this procedure and the number of cases in 2015 increased from 16,295 in 2014 to 24,808.  Very importantly, mortality and complications have been decreasing each year, probably related to improvements in the technology with smaller catheter and sheath sizes leading to less vascular complications, greater experience of those doing the procedures, a less sick group of patients going initially from those too ill to do an open operation on, to very high risk to high risk according to approval criteria.    The age of the patients however is most often in the 80s.

16 Dec

Posted at 22:24h in Author Interviews, BMJ, Heart Disease, Smoking
MedicalResearch.com Interview with: [caption id="attachment_30578" align="alignleft" width="133"]Dr. Kevin Campbell MD FACC Wake Heart and Vascular Assistant Professor of Medicine, UNC School of Medicine Cardiology and Cardiac Electrophysiology in Raleigh, Smithfield and Wilson North Carolina. Dr. Kevin Campbell[/caption] Dr. Kevin Campbell MD FACC Wake Heart and Vascular Assistant Professor of Medicine,  UNC School of Medicine Cardiology and Cardiac Electrophysiology in Raleigh, Smithfield and Wilson North Carolina  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this study, data was analyzed from nearly 1800 patients who had ST elevation MI.  Findings were published in Heart.  They found that younger  smokers (age under the age of 50)  had an 8-fold increased risk of acute STEMI , when compared to ex- and never smokers. In addition, researchers found that current smokers of all ages were 3.26 times more likely to have STEMI than ex- and never-smokers—suggesting that if you stop smoking, you can reduce your risk for heart attack.

16 Dec

Posted at 21:03h in AHA Journals, Author Interviews, Lipids, Pharmacology
MedicalResearch.com Interview with: [caption id="attachment_30566" align="alignleft" width="100"]Dr. Eli M. Roth MD, FACC President, Medical Director Sterling Research Group Cincinnati, OH Dr. Eli Roth[/caption] Dr. Eli M. Roth MD, FACC President, Medical Director Sterling Research Group Cincinnati, OH MedicalResearch.com: What is the background for this study? What are the main findings? Response: At this year’s AHA 2016, we presented a pharmacodynamics analysis of ODYSSEY CHOICE I, which evaluated the effects of Praluent 300 mg administered every four weeks (Q4W) for 24 weeks in hypercholesterolemia patients at moderate to very high cardiovascular risk who were on maximally tolerated statin or no statin and/or other lipid-lowering therapies. The pharmacodynamic analysis of CHOICE I in patients on statins supports the use of Praluent 300 mg Q4W as an alternative starting dose for patients who prefer a Q4W dosing regimen and demonstrates the value of LDL-C based dosing interval adjustment. The findings from this analysis were consistent with prior ODYSSEY Phase 3 studies, showing that Praluent substantially reduced circulating free PCSK9 concentration, resulting in significant LDL-C reductions. Additionally, Praluent was generally well tolerated.

16 Dec

Posted at 20:00h in Author Interviews, Genetic Research, JAMA
MedicalResearch.com Interview with: [caption id="attachment_30502" align="alignleft" width="142"]C. Anthony Blau, M.D. Professor of Medicine, Division of Hematology University of Washington School of Medicine Co-Director, University of Washington Institute for Stem Cell and Regenerative Medicine Director, Center for Cancer Innovation Dr. C. Anthony Blau[/caption] C. Anthony Blau, M.D. Professor of Medicine, Division of Hematology University of Washington School of Medicine Co-Director, University of Washington Institute for Stem Cell and Regenerative Medicine Director, Center for Cancer Innovation MedicalResearch.com: What is the background for this study? What are the main findings? Response: Matching cancer treatment to the molecular composition of a patient’s tumor holds promise for making cancer therapies more effective, and molecular testing for cancer patients has become widespread in recent years. Recently molecular testing of tumor samples has been complemented by blood tests that characterize tumor DNA that has been shed into the bloodstream.  Blood tests are attractive because they are much less invasive than obtaining tumor tissue via biopsies.

16 Dec

Posted at 14:54h in Author Interviews, Infections, Nature
MedicalResearch.com Interview with: [caption id="attachment_30421" align="alignleft" width="144"]Professor Alistair J P Brown DSc FSB FAAM FRSE Aberdeen Fungal Group, MRC Centre for Medical Mycology, University of Aberdeen, Institute of Medical Sciences, Foresterhill, Aberdeen UK Prof. Al Brown[/caption] Professor Alistair J P Brown  DSc FSB FAAM FRSE Aberdeen Fungal Group, MRC Centre for Medical Mycology, University of Aberdeen, Institute of Medical Sciences, Foresterhill, Aberdeen UK  MedicalResearch.com: What is the background for this study? Response: Most of us harbor the yeast Candida albicans, and most of the time it does us no harm.  However, under certain circumstances it can break out to cause nasty infections of the mouth or genitalia (thrush), or potentially fatal infections in vulnerable intensive care patients.  Indeed, over half of women will suffer at least one episode of vulvovaginal candidiasis in their lifetime, and over 5% of women suffer recurrent episodes (four or more episodes per annum).  Also, it has been estimated that there are over 400,000 life-threatening systemic Candida infections worldwide per annum, of which over 40% are fatal (see Science Translational Medicine (2012) vol. 4, 165rv13).  A key to this is the potency of our immunological defenses: the weaker our defenses the more vulnerable we are to fungal infection.  Therefore, we in the Medical Research Council (MRC) Centre for Medical Mycology – and other groups worldwide – are studying the mechanisms by which our immune cells recognize and kill invading Candida cells, thereby protecting us from infection.

16 Dec

Posted at 14:36h in Author Interviews, Gender Differences, JAMA, Surgical Research

MedicalResearch.com Interview with: Raúl J. Bellinga, MD, FEBOMS FACIALTEAM Surgical Group, Marbella High Care International Hospital, Marbella, Málaga, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Feminization rhinoplasty is one of the most common and important procedures in Facial Feminization Surgery. In this study our surgical group has evaluated...

16 Dec

Posted at 14:17h in Author Interviews, Nature, Neurological Disorders, Technology
MedicalResearch.com Interview with: [caption id="attachment_30535" align="alignleft" width="118"]Bin He, Ph.D. Director, Institute for Engineering in Medicine Director, Center for Neuroengineering Distinguished McKnight University Professor of Biomedical Engineering Medtronic-Bakken Endowed Chair for Engineering in Medicine University of Minnesota, Minneapolis, MN 55455 Dr. Bin He[/caption] Bin He, Ph.D. Director, Institute for Engineering in Medicine Director, Center for Neuroengineering Distinguished McKnight University Professor of Biomedical Engineering Medtronic-Bakken Endowed Chair for Engineering in Medicine University of Minnesota, Minneapolis, MN 55455 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This work is aimed at developing a noninvasive brains-computer interface to allow disabled patients to control their environment by just thinking about it. We found 8 human subjects were able to accomplish 3D reach and grasp tasks without using any muscle activities but just thinking about it.

15 Dec

Posted at 13:08h in Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Pediatrics, Pulmonary Disease
MedicalResearch.com Interview with: Kristin N. Ferguson, BSc The Royal Women’s Hospital and Deakin University Melbourne, Victoria, Australia MedicalResearch.com: What is the background for this study? Response: Weaning preterm infants from mechanical ventilation, thereby minimising the risks of having an endotracheal tube in situ which may further damage their fragile lungs, is something all neonatal clinicians are keen to do. We provide clinicians with a straightforward list of safe and effective strategies to help them in this task, as well as pointing out some treatments to either avoid or use with caution.

15 Dec

Posted at 12:54h in Author Interviews, Education, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_30490" align="alignleft" width="150"]Mohammed Al-Omran, MD, MSc, FRCSC Head, Division of Vascular Surgery St. Michael’s Hospital Professor, Department of Surgery University of Toronto Dr. Mohammed Al-Omran[/caption] Mohammed Al-Omran, MD, MSc, FRCSC Head, Division of Vascular Surgery St. Michael’s Hospital Professor, Department of Surgery University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: General surgery residency is among the most demanding clinical training programs in medicine. Several studies have suggested surgical residents have a relatively high attrition rate; however, no study has systematically reviewed the overall prevalence and causes of attrition among general surgery residents. We included over 20 studies representing 19,821 general surgery residents in our review. Most studies were from the US. We found the pooled estimate of attrition prevalence among general surgery residents was 18%. Female residents were more likely to leave than male (25% versus 15%), and residents were most likely to leave after their first training year (48%). Departing residents most commonly switched to another medical specialty (such as anaesthesia, plastic surgery, radiology or family medicine) or relocated to another general surgery program. The most common causes of attrition were uncontrollable lifestyle (range of 18% to 88%) and transferring to another specialty (range of 18% to 39%).

15 Dec

Posted at 12:18h in Author Interviews, Dermatology, Education, JAMA, Melanoma
MedicalResearch.com Interview with: [caption id="attachment_30478" align="alignleft" width="128"]June K. Robinson, MD Research Professor of Dermatology Northwestern University Feinberg School of Medicine Department of Dermatology Chicago, IL 60611 Dr. June Robinson[/caption] June K. Robinson, MD Research Professor of Dermatology Northwestern University Feinberg School of Medicine Department of Dermatology Chicago, IL 60611 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is a secondary finding from a randomized controlled trial of a structured skills training program for melanoma patients and their skin check partners. The pairs learned and performed skin self-examination for the early detection of melanoma. They continued to perform skin checks for 2 years and trained pairs identified more early melanoma (melanoma in situ and Stage 1A melanoma) than controls.

15 Dec

Posted at 12:09h in Author Interviews, Biomarkers, Breast Cancer, Genetic Research, PLoS, Yale

MedicalResearch.com Interview with: [caption id="attachment_30354" align="alignleft" width="133"] Dr. Christos Hatzis,[/caption] Christos Hatzis, PhD Assistant Professor of Medicine Director of Bioinformatics, Breast Medical Oncology Yale Comprehensive Cancer Center Yale School of Medicine New Haven, CT MedicalResearch.com: What is the background for this study? What are the main findings? Response: Triple negative breast cancer (TNBC) is a highly heterogeneous and aggressive...

13 Dec

Posted at 02:11h in Author Interviews, Leukemia, Nature, Pediatrics, UT Southwestern, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_30486" align="alignleft" width="148"]Chengcheng (Alec) Zhang, Ph.D. Associate Professor Hortense L. and Morton H. Sanger Professorship in Oncology Michael L. Rosenberg Scholar for Medical Research Department of Physiology UT Southwestern Medical Center Dr. Alec Zhang[/caption] Chengcheng (Alec) Zhang, Ph.D. Associate Professor Hortense L. and Morton H. Sanger Professorship in Oncology Michael L. Rosenberg Scholar for Medical Research Department of Physiology UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? Response: New therapeutic targets and approaches are needed to effectively treat leukemia. Acute myeloid leukemia (AML) is the most common form of adult acute leukemia whereas acute lymphoblastic leukemia (ALL) is the most common form of cancer in children; ALL also occurs in adults. Although treatment of pediatric ALL is highly effective, a sizeable number of patients are non-responders who succumb to this disease. The outcome of ALL in adults is significantly worse than for pediatric ALL. Additionally, some types of ALL have a much poorer prognosis than others. Dietary restriction, including fasting, delays aging and has prolonged effects in a wide range of organisms and has been considered for cancer prevention. In certain types of solid tumor,_ENREF_1 dietary restriction regimens are able to promote T cell-mediated tumor cytotoxicity and enhance anticancer immunosurveillance, and coordinate with chemotherapy to promote the anti-cancer effects. However, the responsiveness of hematopoietic malignancies to dietary restriction, including fasting, remains unknown. Furthermore, whether dietary restriction alone can inhibit cancer development is not clear.

12 Dec

Posted at 22:06h in Alzheimer's - Dementia, Annals Internal Medicine, Author Interviews, Critical Care - Intensive Care - ICUs, Health Care Systems, University of Pittsburgh
MedicalResearch.com Interview with: [caption id="attachment_30462" align="alignleft" width="144"]Dr-Joshua-M-Thorpe.jpg Dr. Joshua Thorpe[/caption] Joshua M. Thorpe, PhD, MPH From the Center for Health Equity Research and Promotion Veterans Affairs Pittsburgh Healthcare System Pittsburgh Pennsylvania, and Center for Health Services Research in Primary Care Department of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy MedicalResearch.com: What is the background for this study? Response: Care coordination for persons with dementia is challenging for health care systems under the best of circumstances. These coordination challenges are exacerbated in Medicare-eligible veterans who receive care through both Medicare and the Department of Veterans Affairs (VA). Recent Medicare and VA policy changes (e.g., Medicare Part D, Veteran’s Choice Act) expand veterans’ access to providers outside the VA. While access to care may be improved, seeking care across multiple health systems may disrupt care coordination and increase the risk of unsafe prescribing - particularly in veterans with dementia. To see how expanded access to care outside the VA might influence medication safety for veterans with dementia, we studied prescribing safety in Veterans who qualified for prescriptions through the VA as well as through the Medicare Part D drug benefit.

12 Dec

Posted at 21:16h in Author Interviews, Education, JAMA, Outcomes & Safety, UCSF
MedicalResearch.com Interview with: [caption id="attachment_30135" align="alignleft" width="225"]Charlie M. Wray, DO, MS Assistant Clinical Professor of Medicine University of California, San Francisco | Department of Medicine San Francisco VA Medical Center Dr. Charlie Wray[/caption] Charlie M. Wray, DO, MS Assistant Clinical Professor of Medicine University of California, San Francisco Department of Medicine San Francisco VA Medical Center MedicalResearch.com: What is the background for this study? Response: Since the establishment of residency duty hour regulations in 2010, which subsequently lead to increased discontinuity of inpatient care and more resident shift work, educators and researchers have attempted to establish which shift handoff technique(s) or strategies work best. National organizations, such as the ACGME, AHRQ, and the Joint Commission have made specific recommendations that are considered "best practice". In our study, using an annual national survey given to Internal Medicine Program Directors, we examined the degree of implementation of these recommended handoff strategies and the proportion of Program Director satisfaction with each of the respective strategies.

12 Dec

Posted at 20:30h in Author Interviews, Diabetes, Diabetes Care, Exercise - Fitness, Lifestyle & Health
MedicalResearch.com Interview with: [caption id="attachment_30507" align="alignleft" width="161"]Bernard M Duvivier Department of Human Biology and Movement Science NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre Maastricht, the Netherlands Dr. Bernard M Duvivier[/caption] Bernard M Duvivier  Department of Human Biology and Movement Science NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre Maastricht, the Netherlands MedicalResearch.com: What is the background for this study?  What are the main findings? Response: The health benefits of exercise have been well established but sitting is a risk factor for health, independent of exercise. As many people with type 2 diabetes don’t like to exercise we investigated whether replacing sitting time with light-intensity activities (standing and light walking) is equally effective to exercise when energy expenditure is comparable. Our results suggest that for people with type 2 diabetes, light-intensity activities (light walking and standing) can be an alternative to exercise to improve glucose regulation. In addition we showed that too much sitting has negative effects on insulin sensitivity which could not be fully compensated by 1 hour of exercise per day.

12 Dec

Posted at 17:33h in Author Interviews, BMJ, Dermatology, Herpes Viruses, HIV, Infections, STD
MedicalResearch.com Interview with: [caption id="attachment_30448" align="alignleft" width="165"]E. Charles Osterberg, M.D. Assistant Professor of Surgery Genitourinary Reconstruction and Trauma University of Texas- Dell Medical School Dell-Seton Medical Center / University Hospital Dr. Osterberg[/caption] E. Charles Osterberg, M.D. Assistant Professor of Surgery Genitourinary Reconstruction and Trauma University of Texas- Dell Medical School Dell-Seton Medical Center / University Hospital MedicalResearch.com: What is the background for this study? Response: Pubic hair grooming has become an increasingly common practice among men and women. Perceptions of genital normalcy have changed as modern society’s definition of attractiveness and feelings of femininity and masculinity have changed. Pubic hair grooming has been shown to increase morbidity such as genital injuries, however little is known about the relationship between grooming practices and sexually transmitted infections.

12 Dec

Posted at 17:21h in Author Interviews, Breast Cancer, Genetic Research, JAMA
MedicalResearch.com Interview with: [caption id="attachment_30290" align="alignleft" width="160"]Dr. Adrian Lee PhD Professor, Department of Pharmacology and Chemical Biology Director, Women's Cancer Research Center University of Pittsburgh Cancer Institute Dr. Adrian Lee[/caption] Dr. Adrian Lee PhD Professor, Department of Pharmacology and Chemical Biology Director, Women's Cancer Research Center University of Pittsburgh Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The goal of this study was to understand molecular changes which occur when breast cancers metastasize to the brain, with the eventual of identifying new therapeutic strategies. Brain metastases occur in 10-15% of patients with metastatic breast cancer and are a major clinical challenge. Limited therapeutic options exist for patients with brain metastases. We analyzed molecular changes in pairs of patient-matched primary breast cancers and brain metastases. We found that brain metastases tended to have the same intrinsic subtype as the primary breast cancer, however, there were many genes which changes in gene expression and may represent therapeutic targets. The most common change was an increase in ErbB2/HER2 which can be targeted clinically.

12 Dec

Posted at 17:14h in Author Interviews, Biomarkers, Infections, JAMA, Neurological Disorders
MedicalResearch.com Interview with: Zanusso Gianluigi M.D.Ph.D. Department of Neurosciences, Biomedicine and Movement Sciences University of Verona Verona, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: To determine RT-QuIC assay sensitivity and specificity in cerebrospinal fluid and olfactory mucosa in a large group of patients with a clinical diagnosis of probable, possible or suspect Creutzfeldt–Jakob disease (CJD) and controls. In these patients, RT-QuIC testing of CSF and olfactory mucosa provided a specificity and sensitivity of 100%. A softer swab for olfactory mucosa sampling provided the same sensitivity as using a brush .

10 Dec

Posted at 23:34h in Author Interviews, BMJ, Imperial College, Nutrition
MedicalResearch.com Interview with: [caption id="attachment_30430" align="alignleft" width="180"]Dr. Dagfinn Aune Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus London UK Dr. Dagfinn Aune[/caption] Dr. Dagfinn Aune Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus London  UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a growing body of evidence suggesting that intake of nuts may reduce the risk of coronary heart disease, but the relation between nut intake and other diseases like cancer and stroke, and the relation with mortality and less common causes of death is not clear. Also it is not clear how much nuts are needed to reduce the risk. So our current meta-analysis reviewed the data from 20 studies (29 publications) on nut intake and different health outcomes. We found that a nut intake of approximately one serving per day (28 g/d or a handful) was associated with a reduced risk of coronary heart disease (by 30%), total cancer (15%), all-cause mortality (22%) and mortality from respiratory disease (50%), diabetes (40%), and infections (75%), although there were few studies in the latter three analyses. We found that most of the benefit was observed up to an intake of around 20 grams per day. Similar results were found for total nuts, tree nuts and peanuts (which are botanically defined as legumes), but peanuts were also associated with reduced risk of stroke, while only tree nuts were associated with reduced cancer risk. We also calculated the number of deaths that potentially could be avoided, under the assumption that the observed associations are causal, and arrived at 4.4 million deaths in North and South America, Europe, Southeast Asia and the Western Pacific (unfortunately we did not have data on nut intake from West Asia and Africa so we were not able to include those areas).

09 Dec

Posted at 14:56h in Author Interviews, Education, JAMA, Outcomes & Safety
MedicalResearch.com Interview with: [caption id="attachment_30402" align="alignleft" width="133"]Joshua L Denson MD Pulmonary and Critical Care Medicine University of Colorado School of Medicine Dr. Joshua Denson[/caption] Joshua L Denson MD Pulmonary and Critical Care Medicine University of Colorado School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Miscommunication during physician transition in care has been associated with adverse patient events and medical errors; however, an understudied topic is the transition in care that occurs each month when resident physicians switch clinical rotations, also called an end-of-rotation transition. During this handoff, hospitalized patients (up to 10-20) are handed over to an oncoming physician who has never met the patients. We sought to investigate if this type of transition was associated with worse patient outcomes, specifically mortality. On July 1, 2011, the Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulations limited first-year resident physicians (interns) to 16 continuous hours of work. Although these rules do not appear to have affected overall patient safety outcomes, they have been associated with an increase in shift-to-shift handoffs among training physicians. Given this, we wanted to study how they might impact patient outcomes surrounding end-of-rotation transitions in care.

09 Dec

Posted at 14:36h in Author Interviews, Genetic Research, Nature, NIH, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_30390" align="alignleft" width="200"]Audrey Chu, Ph.D. Division of Intramural Research of the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health Dr. Audrey Chu[/caption] Audrey Chu, Ph.D. Division of Intramural Research National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Body shape reflects the underlying adipose tissue distributed throughout different compartments of the body (ectopic fat). Variation in ectopic fat is associated with diabetes, hypertension and heart disease. This is mostly independent of overall adiposity. Ectopic fat can be measured using special x-rays procedures such as CT (“CAT scans”) or MRI and can give more information about fat distribution. Fat distribution characteristics can run in families, suggesting that a person’s genes can help determine the amount of fat that can accumulate in different parts of the body. Identifying genes that are associated with ectopic fat can provide insight into the biological mechanisms leading to differences in cardiometabolic disease risk. In order to understand which genes might be involved, we examined genetic variants across the genome and their association with ectopic fat in the largest study of its kind including over 18,000 individuals of four different ancestral backgrounds. Several new genetic regions were identified in association with ectopic fat in addition to confirming previously known regions. The association of the new regions was specific to ectopic fat, since the majority of the regions were not associated with overall or central adiposity. Furthermore, most of these regions were not associated with type 2 diabetes, lipids, heart disease or blood pressure. The major exception was the region surrounding the UBE2E2 gene, which was associated with diabetes.

09 Dec

Posted at 14:23h in Author Interviews, FASEB, Microbiome, OBGYNE, Stanford
MedicalResearch.com Interview with: [caption id="attachment_30400" align="alignleft" width="155"]Carlos Simón, M.D., Ph. D. Professor of Obstetrics & Gynecology. Valencia University, Spain Scientific Director, Igenomix SL. Adjunct Clinical Professor, Department of Ob/Gyn, Stanford University, CA Adjunct Professor, Department of Ob/Gyn, Baylor College of Medicine, TX Dr. Carlos Simón[/caption] Carlos Simón, M.D., Ph. D. Professor of Obstetrics & Gynecology. Valencia University, Spain Scientific Director, Igenomix SL. Adjunct Clinical Professor, Department of Ob/Gyn, Stanford University, CA Adjunct Professor, Department of Ob/Gyn, Baylor College of Medicine, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: The main findings of this study reside in the concept that the uterine cavity, which has been classically considered as a sterile organ, possess its own microbiome and that the composition of this uterine microbiome have a functional impact on the reproductive outcome of IVF patients.

09 Dec

Posted at 12:48h in Author Interviews, Nature, Stem Cells
MedicalResearch.com Interview with: [caption id="attachment_30362" align="alignleft" width="200"]Professor Jan Karlseder Molecular and Cell Biology Laboratory Donald and Darlene Shiley Chair Salk Institute for Biological Studies Prof. Jan Karlseder[/caption] Professor Jan Karlseder Molecular and Cell Biology Laboratory Donald and Darlene Shiley Chair Salk Institute for Biological Studies MedicalResearch.com: What is the background for this study?  Response: Telomeres are repetitive stretches of DNA at the ends of each chromosome whose length can be increased by an enzyme called telomerase. Our cellular machinery results in a little bit of the telomere becoming lopped off each time cells replicate their DNA and divide. As telomeres shorten over time, the chromosomes themselves become vulnerable to damage. Eventually the cells die. The exception is stem cells, which use telomerase to rebuild their telomeres, allowing them to retain their ability to divide, and to develop (“differentiate”) into virtually any cell type for the specific tissue or organ, be it skin, heart, liver or muscle—a quality known as pluripotency. These qualities make stem cells promising tools for regenerative therapies to combat age-related cellular damage and disease.

09 Dec

Posted at 11:56h in Author Interviews, Depression, JAMA, McGill, Pharmacology, Stroke
MedicalResearch.com Interview with: Christel Renoux, MD, PhD Assistant Professor, Dept. of Neurology & Neurosurgery McGill University Centre For Clinical Epidemiology Jewish General Hospital - Lady Davis Research Institute Montreal  Canada MedicalResearch.com: What is the background for this study? Response: Selective serotonin reuptake inhibitors (SSRIs) increase the risk for abnormal bleeding, in particular, gastrointestinal tract bleeding. Previous studies also suggested an increased risk for intracranial hemorrhage (ICH) in patients treated with SSRIs compared to non users. However, even if this risk exists, the comparison with a non-treated group may exaggerate the strength of a potential association and the comparison with a group of patients treated with other antidepressants may help better delineate the risk. The potential bleeding effect of antidepressants is linked to the strength of serotonin inhibition reuptake, and antidepressants that are strong inhibitors of serotonin reuptake have been associated with the risk for gastrointestinal or abnormal bleeding compared with weak inhibitors but the risk of ICH is unclear.

09 Dec

Posted at 02:08h in Author Interviews, Cannabis, JAMA, Ophthalmology

MedicalResearch.com Interview with: Dr Vincent Laprévote Praticien Hospitalier (MD, PhD, HDR) Pôle Hospitalo-Universitaire de Psychiatrie du Grand Nancy Centre Psychothérapique de Nancy MedicalResearch.com: What is the background for this study? What are the main findings? Response: There was evidence in animal studies showing that cannabis use could impact visual processing, but lesser was known in...

09 Dec

Posted at 01:19h in Author Interviews, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_30321" align="alignleft" width="161"]Wayne C. Levy, MD Division of Cardiology University of Washington Seattle, Washington Dr. Wayne Levy[/caption] Wayne C. Levy, MD Division of Cardiology University of Washington Seattle, Washington MedicalResearch.com: What is the background for this study? Response: There is uncertainty how effective ICDs are outside of clinical trials in real world patients who are often older with more comorbidities. The recent DANISH ICD only reiterates provider and patient concerns regarding the effectiveness of an ICD, that may be life saving, but does not improve heart failure symptoms or reduce hospitalizations. Many patients die without ever having an ICD shock, so the ICD was not necessary for the patient. We postulated that the effectiveness of an ICD is not driven by the absolute risk of sudden death (event rate/year) but rather the proportion of all deaths that are due to sudden death vs non sudden death. If a patient has a 3% annual risk of sudden death and this is decreased to 1% with an ICD (a 67% reduction in sudden death), the patient benefit will be much greater if the non sudden death rate is 1%/year than if it is 12%/year. In the first scenario the absolute mortality is decreased from 4% to 2% (a 50% reduction) whereas in the second patient, the mortality would be decreased from 15% to 13% (a 13% benefit). We developed the Seattle Proportional Risk Model (SPRM) using 10 clinical variables that had a differential impact on the mode of death, sudden vs. non sudden, in ~10,000 patients with ~2,500 deaths. Sudden death was more common in younger patients, male, without diabetes mellitus, NYHA 1 or 2 vs. 3 or 4, lower EF, SBP closer to 140, normal sodium and creatinine, higher BMI, and digoxin use.

09 Dec

Posted at 00:58h in Author Interviews, Diabetes, Parkinson's, Science
MedicalResearch.com Interview with: [caption id="attachment_30315" align="alignleft" width="200"]Patrik Brundin, M.D., Ph.D. Director, Center for Neurodegenerative Science Van Andel Research Institute Dr. Patrik Brundin[/caption] Patrik Brundin, M.D., Ph.D. Director, Center for Neurodegenerative Science Van Andel Research Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The investigational drug at the heart of our study, MSDC-0160, has been in development to treat type 2 diabetes by improving cellular metabolism. In Parkinson’s, reductions in cellular metabolism slow down vital housekeeping processes that clear out toxic proteins that otherwise accumulate with age. If these proteins aren’t removed, they clump together, leading to the damage and cell death that causes Parkinson’s hallmark symptoms, such as rigidity and tremor. MSDC-0160 helps keep these housekeeping processes working, ultimately protecting the brain. We demonstrated that MSDC-0160 has strong, reproducible, positive effects across multiple models of Parkinson’s disease—it rescued dopamine-producing cells, improved behavioral deficits in mouse models and reversed inflammation. Overall, we believe it is a strong candidate for repurposing as a potential treatment that actually may slow the disease’s progression, rather than only mitigating symptoms.

08 Dec

Posted at 16:59h in Aging, Author Interviews, Genetic Research, JAMA, Macular Degeneration, Ophthalmology
MedicalResearch.com Interview with: dr-anneke-i-den-hollanderAnneke I. den Hollander, PhD Department of Ophthalmology and Department of Human Genetics Donders Institute for Brain, Cognition, and Behaviour Radboud University Medical Center Nijmegen, the Netherland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Age-related macular degeneration is caused by a combination of genetic and environmental factors. Rare genetic variants in the complement system have been described in AMD, but their effect remains largely unexplored. In this study we aimed to determine the effect of rare genetic variants in the complement system on complement levels and activity in serum. MedicalResearch.com: What are the main findings? Response: Carriers of CFI variants showed decreased FI levels, carriers of C9 Pro167Ser had increased C9 levels, while C3 and FH levels were not altered. Carriers of CFH and CFI variants had a reduced ability to degrade C3b, which for CFI was linked to reduced serum FI levels.

08 Dec

Posted at 16:33h in Author Interviews, Dermatology, Electronic Records, JAMA, Outcomes & Safety, Surgical Research
MedicalResearch.com Interview with: Sophia Akhiyat M.D. Candidate, Class of 2017 The George Washington University School of Medicine and Health Sciences METEOR Fellowship MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study was inspired by one of Choudhry et al,1 in which patients' preferences for skin biopsy result disclosure was surveyed at melanoma clinics affiliated with several academic institutions. We sought to broaden participant inclusion criteria by evaluating patients' preferences at a general dermatology clinic at an academic center. Our findings support that the highest ranked patient-preferred method for receiving skin biopsy results was through an online portal. Patients also reported that the most important factors when selecting a modality for communication were the amount of information given and time available to discuss results. We also observed a relationship between a younger patient age range and online portal experience as well as a preference for biopsy notification via online portal. 1Choudhry A, Hong J, Chong K, et al. Patients' Preferences for Biopsy Result Notification in an Era of Electronic Messaging Methods. JAMA Dermatol. 2015;151(5):513-521.