Author Interviews, Diabetes, JCEM / 16.06.2014

L. Keoki Williams, MD, MPH Center for Health Policy and Health Services Research Department of Internal Medicine Henry Ford Health System Detroit, Michigan 48104MedicalResearch.com Interview with L. Keoki Williams, MD, MPH Center for Health Policy and Health Services Research Department of Internal Medicine Henry Ford Health System Detroit, Michigan 48104 MedicalResearch: What are the main findings of the study? Dr. Williams: Metformin is recommended as first line treatment for type 2 diabetes, and these recommendations are based on the results of clinical trials performed almost exclusively in white individuals.  This is the first study to specifically assess whether metformin is effective at reducing blood glucose levels in African American individuals.  In our large study of over 19,000 individuals, we showed that metformin was consistently more effective at reducing glycated hemoglobin (HbA1c) levels (a measure of long-term blood glucose control) in African Americans when compared with white individuals. (more…)
Author Interviews, Cost of Health Care, Pharmacology, University of Pittsburgh / 09.06.2014

MedicalResearch.com Interview with: Yuting Zhang, Ph.D. Associate professor Graduate School of Public Health Department of Health Policy and Management. University of Pittsburgh MedicalResearch: What are the main findings of the study? Dr. Zhang: Since 2006, the government has randomly assigned low-income enrollees to stand-alone Part D plans, based upon the region in which they live. If low-income Medicare Part D enrollees were assigned to the least expensive plan instead of a random plan, the government and beneficiaries could save more than $5 billion in the first year. (more…)
Annals Internal Medicine, Author Interviews, Electronic Records, Outcomes & Safety / 05.06.2014

Lisa M. Kern, MD, MPH, FACP Associate Professor of Healthcare Policy and Research and of Medicine Associate Director for Research, Center for Healthcare Informatics and Policy Deputy Director, Health Information Technology Evaluation Collaborative Weill Cornell Medical College New York, NY 10065MedicalResearch.com Interview with: Lisa M. Kern, MD, MPH, FACP Associate Professor of Healthcare Policy and Research and of Medicine Associate Director for Research, Center for Healthcare Informatics and Policy Deputy Director, Health Information Technology Evaluation Collaborative Weill Cornell Medical College New York, NY 10065 MedicalResearch: What are the main findings of the study? Dr. Kern: We found that primary care physicians participating in Patient-Centered Medical Homes (PCMHs) improved their quality of care over time at a significantly higher rate than their non-PCMH peers. (more…)
Allergies, Author Interviews, BMJ, Environmental Risks / 05.06.2014

Elaine Fuertes Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg, Germany and School of Population and Public Health University of British Columbia, Vancouver, British Columbia, CanadaMedicalResearch.com Interview with: Elaine Fuertes Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre for Environmental Health Neuherberg, Germany and School of Population and Public Health University of British Columbia, Vancouver, British Columbia, Canada MedicalResearch: What are the main findings of the study? Answer: The main finding of our study was that despite the use of identical study designs and statistical methods, the level of greenness (measured using the Normalized Difference Vegetation Index) around a child's home address was differentially associated with the development of allergic health outcomes among children living in two areas in Germany. In our urban study centre, which includes the city of Munich, we found that higher greenness levels around a child's home increased their risk of developing allergic rhinitis and experiencing eyes and nose symptoms. In contrast, greenness around the home appeared to be protective for allergic rhinitis, nose and eye symptoms and sensitization to inhalant allergens in the second more rural study centre investigated. These observations emphasize that the effects of greenness around the home on respiratory health is complex and multifaceted, and are based on 5,803 German children followed from birth to 10 years as part of the GINIplus and LISAplus birth cohorts. (more…)
Author Interviews, Breast Cancer, NEJM / 05.06.2014

Dr. Olivia Pagani Institute of Oncology of Southern Switzerland Ospedale San Giovanni, SwitzerlandMedicalResearch.com Interview with: Dr. Olivia Pagani  Institute of Oncology of Southern Switzerland Ospedale San Giovanni, Switzerland   MedicalResearch: What are the main findings of the study? Dr. Pagani: The studies show that also in premenopausal women (as already proven in postmenopausal women), aromatase inhibitors (AIs) (in this case Exemestane) given as adjuvant treatment are more effective than Tamoxifen in women with hormone receptor positive early breast cancer who are given concomitantly ovarian suppression to lower estrogen production. The 28% improvement in disease free survival is comparable to that seen in postmenopausal women. In particular, outcomes in women who did not receive chemotherapy (43% of the entire population, 29% of whom with node positive disease) were strikingly good (<97% were breast cancer free at 5 years). (more…)
Author Interviews, MRSA / 05.06.2014

Dr. Brad Spellberg MD Associate Program Director, Internal Medicine Training Program Professor of Medicine, David Geffen School of Medicine at UCLA Division of General Internal MedicineMedicalResearch.com Interview with: Dr. Brad Spellberg MD Associate Program Director Internal Medicine Training Program Professor of Medicine, David Geffen School of Medicine at UCLA, Division of General Internal Medicine MedicalResearch: What are the main findings of the study? Dr. Spellberg:  The rates of community-onset methicillin-resistant Staphylococcus aureus (CO-MRSA) varied dramatically among academic medical centers in California, New York, Illinois and North Carolina, suggesting there is not a uniform change in the "national epidemic" of the "superbug" that has generated extensive public health concern over the past decade, according to a new study.The study surveyed hospital records of 4,171 cases of MRSA and MRSA-related infections between 2008 and 2011 in five medical centers located in Los Angeles, San Francisco, Chicago, New York City and Raleigh-Durham, NC.The rates of MRSA acquired in the community declined 57% from 2008-2011 in the Los Angeles medical center. In contrast, CO-MRSA rates tripled at the New York medical center, while the rates remained stable in San Francisco, Chicago and Raleigh-Durham. (more…)
Author Interviews, Outcomes & Safety / 04.06.2014

Dr. Hiroshi Hoshijima Evidence-based Anesthsia Research Group Tohoku Universit y Graduate School of Dentistry, Dept of Anaesthesiology, Sendai, Japan,MedicalResearch.com Interview with: Dr. Hiroshi Hoshijima Evidence-based Anesthsia Research Group Tohoku Universit y Graduate School of Dentistry, Dept of Anaesthesiology, Sendai, Japan, MedicalResearch: What are the main findings of the study? Dr.  Hoshijima: Our systematic review shows that weekend admission is associated with higher mortality compared with weekday admission.Subgroup analysis revealed that patients admitted during the weekend were at a higher risk of death than weekday admission in patients in 5 categories (patients who had stroke; cardiovascular disease; upper gastrointestinal haemorrhage; medical disease; mixed medical and surgical disease.) (more…)
Author Interviews, JAMA, Respiratory, UT Southwestern / 04.06.2014

Dr. Eric M. Mortensen, M.D., M.Sc. VA North Texas Health Care System and University of Texas Southwestern Medical Center, DallasMedicalResearch.com Interview with: Dr. Eric M. Mortensen, M.D., M.Sc. VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas   MedicalResearch: What are the main findings of the study? Dr. Mortensen: The main findings of our study was that for older patients hospitalized with pneumonia that with the use of azithromycin although there is a small increase in the number of non-fatal heart attacks there was a much lower decrease in mortality.   In addition there were no other significant increases in cardiac events.  So the overall risk:benefit ratio was that for each non-fatal heart attack there were 7 deaths that were prevented. (more…)
Annals Internal Medicine, General Medicine, Hospital Readmissions / 04.06.2014

Cindy Feltner, MD, MPH Assistant Professor, Division of General Medicine University of North Carolina--Chapel Hill RTI- UNC Evidence-based Practice CenterMedicalResearch.com Interview with: Cindy Feltner, MD, MPH Assistant Professor, Division of General Medicine University of North Carolina--Chapel Hill RTI- UNC Evidence-based Practice Center MedicalResearch: What are the main findings of the study? Dr. Feltner: We conducted a systematic review and meta-analysis to assess the efficacy, comparative effectiveness, and harms of transitional care interventions to reduce readmission and mortality rates for adults hospitalized with heart failure. We included a broad range of intervention types applicable to adults transitioning from hospital to home that aimed to prevent readmissions. Although 30-day readmissions are the focus of quality measures, we also included readmissions measured over 3 to 6 months because these are common, costly, and potentially preventable. Forty-seven trials were included, most enrolled adults with moderate to severe heart failure and a mean age of 70 years. We found that interventions providing multiple home visits soon after hospital discharge can reduce 30-day readmission rates. Both home-visiting programs and multidisciplinary heart failure clinics visits can improve mortality and reduce all-cause readmission in the six months after hospitalization. Telephone support interventions do not appear to reduce all-cause readmission, but can improve survival and reduce readmission related to heart failure. Programs focused on telemonitoring or providing education only did not appear to reduce readmission or improve survival. (more…)
Annals Internal Medicine, Author Interviews, Colon Cancer, Erasmus, Sloan Kettering / 03.06.2014

MedicalResearch.com Interview with: Frank van Hees MSc Erasmus University Medical Center Rotterdam, the Netherlands and Ann G. Zauber PhD Memorial Sloan Kettering Cancer Center, New York MedicalResearch: What are the main findings of the study? Answer: The main finding of our study is that colorectal cancer screening of individuals without previous screening is worthwhile well beyond age 75, which is the recommended age to stop screening in individuals with an adequate screening history. The exact age up to which screening should be considered in unscreened elderly depends on an individual's health status: in healthy individuals screening remains worthwhile up to age 86, whereas in individuals with a severe illness, such as heart failure, screening remains worthwhile up to age 80. (more…)
Author Interviews, Lancet, Weight Research / 01.06.2014

Rhonda Stewart Senior Communications Institute for Health Metrics and Evaluation Seattle, WA 98121, USAMedicalResearch.com Interview with: Rhonda Stewart Senior Communications Institute for Health Metrics and Evaluation Seattle, WA 98121, USA MedicalResearch: What are the main findings of the study? Answer: Globally, obesity has become a public health epidemic. Obesity is affecting not just developed countries, but developing countries as well. Almost one-third of the world’s population, over 2 billion people, are considered to be overweight or obese. Of this group, nearly two-thirds (62%) are in developing countries. If current trends continue, this number will continue to rise. Between 1980 and 2013, the prevalence of overweight or obesity for children and adolescents increased by nearly 50%. This study is the first analysis of global trends on obesity and covers more than 30 years and 188 countries. (more…)
Author Interviews, Diabetes, Diabetes Care, Pharmacology / 29.05.2014

MedicalResearch Interview with: Dr. Valeria Pechtner Medical Advisor, Lilly Diabetes MedicalResearch: What are the main findings of the study? Dr. Pechtner: Used as monotherapy, once-weekly dulaglutide resulted in significant, sustained glycemic lowering, as measured by HbA1c change from baseline. Both the 1.5 mg and the 0.75 mg dose were superior to metformin at the primary endpoint of 26 weeks. At 52 weeks, dulaglutide 1.5 mg continued to demonstrate superiority to metformin, with dulaglutide 0.75 mg showing non-inferiority. In addition, a majority of patients in all arms achieved the American Diabetes Association’s recommended HbA1c target of less than 7 percent, with more patients achieving this goal in the dulaglutide groups at the 26-week endpoint, and more patients achieving the target in the dulaglutide 1.5 mg group at the 52 week timepoint. Additionally, dulaglutide 1.5 mg and metformin resulted in similar weight loss. The tolerability and safety profile was comparable for both medications. (more…)
Testosterone, Weight Research / 28.05.2014

Dr. Farid Saad Global Medical Affairs Men’s Healthcare, Bayer Pharma, Berlin, Germany; Gulf Medical University School of Medicine Ajman, United Arab Emirates;MedicalResearch.com Interview with: Dr. Farid Saad Global Medical Affairs Men’s Healthcare, Bayer Pharma, Berlin, Germany; Gulf Medical University School of Medicine Ajman, United Arab Emirates MedicalResearch: What are the main findings of the study? Dr. Saad: There are two ongoing registry studies in men with testosterone deficiency (hypogonadism, defined by two separate measures of low serum testosterone and the presence of symptoms which are typical for testosterone deficiency). The studies are being conducted by office urologists. The total number of men who have been treated for a maximum duration of six years is 561, mean age just under 60 years. All men received three-monthly intra-muscular injections of a long-acting testosterone depot preparation. The main findings were that at baseline only five per cent of these men had normal weight, some 25 per cent were overweight and the majority obese. Both overweight and obese men showed reductions in weight and waist circumference. The more obese men were, the more they lost. Men in the highest obesity category grade III (BMI ≥ 40 kg/m2), had a mean weight loss of 26 kg and a reduction of waist size by 12 cm. In parallel, all components of the metabolic syndrome improved in a clinically meaningful magnitude, i.e., blood pressure, lipid profile, and glycemic control. When we analyzed a subgroup of 156 men with type 2 diabetes, we found marked improvements in their diabetes as a result of adding testosterone to the standard diabetes treatment men are receiving by their famaily physicians. (more…)
Author Interviews, BMJ, Stroke / 26.05.2014

Michael T. C. Poon, MBChB, BMedSci (Hons) Junior Doctor, Wycombe General Hospital Buckinghamshire Healthcare NHS Trust, UKMedicalResearch.com Interview with: Michael T. C. Poon, MBChB, BMedSci (Hons) Junior Doctor, Wycombe General Hospital Buckinghamshire Healthcare NHS Trust, UK   MedicalResearch: What are the main findings of the study? Dr. Poon: At present, we know that the incidence and one-month case fatality of intracerebral haemorrhage (ICH) have remained static for the past two decades. However, any trend in long-term survival after ICH is less clear. Survivors face the risks of recurrent ICH as well as ischaemic events in the future. The balance between these risks has particular clinical implication on the decision about restarting antiplatelet/anticoagulant therapy after ICH. To address these questions, we undertook a systematic review and meta-analysis to determine whether long-term survival after intracerebral haemorrhage has changed over time, and to re-assess the balance between the risks of recurrent ICH and ischaemic events in studies quantifying both of these risks in the same population. The survival rates after ICH at 1 year and 5 years do not appear to have changed over time – 1 year survival was 46% and 5 year survival was 29%. The risk of recurrent ICH may be influenced by the ICH location, with lobar ICH having a higher rate of recurrence. In contrast to the previous systematic review, we found the risk of ischaemic stroke to be at least as high as the risk of recurrent ICH over 3 years after ICH. This reinforces the difficulty that clinicians and patients have in deciding about antithrombotic treatment after ICH. (more…)
Author Interviews, Dermatology, Duke, Pain Research / 26.05.2014

MedicalResearch.com Interview with: Seok-Yong Lee, Ph.D. Assistant Professor of BiochemistrySeok-Yong Lee, Ph.D. Assistant Professor of Biochemistry and Ru-Rong Ji, Ph.D. Distinguished Professor of Duke University Professor of Anesthesiology and Neurobiology Chief of Pain ResearchRu-Rong Ji, Ph.D. Distinguished Professor  of Duke University Professor of Anesthesiology  and Neurobiology Chief of Pain Research Duke University Medical Center Durham, NC 27710 MedicalResearch: What are the main findings of the study?

 Answer: We have developed an antibody that can block the pain and itching sensations in mice simultaneously with high efficacy. We would like to point out that our discovery has the potential to be applied to human once the antibody is humanized. Given the high selectivity, general safety profile, and long half-lives of monoclonal antibodies, this method we developed to raise antibodies against therapeutic targets (e.g., ion channels) can have broad applications to other diseases. (more…)
Author Interviews, Breast Cancer, JAMA / 25.05.2014

Dr. Sarah Hawley PhD MPH Associate Professor in the Division of General Medicine University of Michigan Research Investigator, Ann Arbor VA Center of Excellence in Health Services Research & DevelopmentMedicalResearch.com Interview with: Dr. Sarah Hawley PhD MPH Associate Professor in the Division of General Medicine University of Michigan Research Investigator, Ann Arbor VA Center of Excellence in Health Services Research & Development   MedicalResearch: What are the main findings of the study? Dr. Hawley: There are a couple of main findings.
  • First, we found that nearly 20% of women in our population based sample of breast cancer patients reported strongly considering having contralateral prophylactic mastectomy (CPM, which means they had their unaffected breast removed at the same time as the breast with cancer), and about 8% received it. Of those who did receive contralateral prophylactic mastectomy, most (about 70%) did not have a clinical indication for it, which included a positive genetic mutation of BRCA1 or BRCA2 or a strong family history of breast or ovarian cancer.
  • However, most women (90%) who received it reported having a strong amount of worry about the cancer coming back (also called worry about recurrence).
  • We also found that when women had an MRI as part of their diagnostic work-up for breast cancer, they more often received contralateral prophylactic mastectomy than when they did not have an MRI.
(more…)
Author Interviews, Heart Disease / 25.05.2014

Bríain ó Hartaigh, Ph.D. Assistant Research Professor of Epidemiology Dalio Institute of Cardiovascular Imaging NewYork-Presbyterian Hospital and the Weill Cornell Medical College Belfer Research Building New York, NY 10021MedicalResearch.com Interview with: Bríain ó Hartaigh, Ph.D. Assistant Research Professor of Epidemiology Dalio Institute of Cardiovascular Imaging NewYork-Presbyterian Hospital and the Weill Cornell Medical College Belfer Research Building New York, NY 10021 MedicalResearch: What are the main findings of the study Dr. Hartaigh: Elevated resting heart rate (RHR) during childhood and midlife are associated with an increased risk of all-cause mortality. (more…)
Nutrition, Prostate Cancer / 23.05.2014

Assistant Professor Department of Obstetrics & Gynecology Division of Clinical & Epidemiologic Research and Cancer Prevention, Detection and Control Research Program and Department of Surgery Division of Urology Duke University School of Medicine Durham, NC 27710 MedicalResearch.com Interview with: Adriana C. Vidal, Ph. D. Assistant Professor Department of Obstetrics & Gynecology Division of Clinical & Epidemiologic Research and Cancer Prevention, Detection and Control Research Program and Department of Surgery Division of Urology Duke University School of Medicine Durham, NC 27710 MedicalResearch: What are the main findings of the study? Dr. Vidal: Among 430 veterans at the VA Hospital in Durham, N.C., including 156 men with confirmed prostate cancer, we found that men who self-reported a higher intake of carbohydrates were at a reduced risk of both low-grade and high-grade prostate cancer. Moreover, we found that intake of foods with high glycemic index increased total prostate cancer risk in black men. However, a higher fiber intake was associated with reduced risk of high grade prostate cancer. (more…)
Author Interviews, Circadian Rhythm, Gastrointestinal Disease, Sugar / 23.05.2014

Dr. Robin Voigt PhD Department of Internal Medicine Division of Gastroenterology Rush University Medical Center Chicago, IllinoisMedicalResearch.com Interview with: Dr. Robin Voigt PhD Department of Internal Medicine Division of Gastroenterology Rush University Medical Center Chicago, Illinois MedicalResearch: What are the main findings of the study?  Dr. Voigt: We found that chronic circadian rhythm disruption has no effect on the intestinal microbiota when mice are fed a standard chow diet but when combined with a high-fat, high-sugar diet circadian rhythm disruption results in intestinal dysbiosis and an increase in pro-inflammatory bacteria. (more…)
Author Interviews, Exercise - Fitness, General Medicine, JAMA, Rheumatology / 21.05.2014

Professor Kim Bennell ARC Future Fellow Department of Physiotherapy University of Melbourne Parkville, Vic 3010 AustraliaMedicalResearch.com Interview Professor Kim Bennell ARC Future Fellow Department of Physiotherapy University of Melbourne Parkville, Vic 3010 Australia MedicalResearch: What are the main findings of the study? Professor Bennell: In 102 people with painful hip osteoarthritis, we compared a 'real' physical therapy program involving exercise, manual therapy techniques,education and provision of a cane if appropriate to a sham physical therapy treatment that was made to look as though it was real but instead involved turned off ultrasound and gentle application of a hand crème to the hip region. Participants in both groups went to see a physical therapist on 10 occasions over 12 weeks and performed home exercises if in the 'real' physical therapy group or lightly applied the cream at home if in the sham group. Participants were followed for 9 months in total. We found that while both groups showed improvements in pain and physical function, the improvements were similar between the two groups. That is, the real physical therapy program did not show greater benefits over a sham treatment.  (more…)
Asthma, Author Interviews, Cost of Health Care / 21.05.2014

dr_vicki_fung MedicalResearch.com Interview with: Vicki Fung, Ph.D. Assistant Professor Department of Medicine, Harvard Medical School Mongan Institute for Health Policy, Massachusetts General Hospital   MedicalResearch: What are the main findings of the study? Dr. Fung: We found that lower income parents of children with asthma were more likely to delay or avoid taking their children to a doctor's office visit or to the emergency room if they had to pay higher out-of-pocket costs for care; they were also more likely to report borrowing money to pay for asthma care. (more…)
Author Interviews, JAMA, Kidney Stones, Urology / 21.05.2014

Charles D. Scales, Jr MD MSHS Assistant Professor of Surgery Division of Urologic Surgery Duke University Medical CenterMedicalResearch Interview with: Charles D. Scales, Jr MD MSHS Assistant Professor of Surgery Division of Urologic Surgery Duke University Medical Center   MedicalResearch: What are the main findings of the study? Dr. Scales: When it comes to treating kidney stones, less invasive is not always better. We used the best method short of a randomized trial to balance out patients in terms of factors that might influence the success of treatment.  In other words, we achieved a “statistical toss-up” for factors that could influence the outcome of the procedure. When we balanced out all of the factors that might influence the chance of a repeat procedure, we found that about 11% of patients treated with non-invasive SWL had a repeat procedure, as compared to <1% with minimally invasive URS. (more…)
Author Interviews, End of Life Care, Heart Disease / 21.05.2014

MedicalResearch.com Interview with: Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine University of Colorado, Division of Cardiology Section of Advanced Heart Failure and TransplantationMedicalResearch.com Interview with: Colleen K. McIlvennan, DNP, ANP Assistant Professor of Medicine University of Colorado, Division of Cardiology Section of Advanced Heart Failure and Transplantation   MedicalResearch: What are the main findings of the study? Answer: We interviewed 22 patients who were offered destination therapy left ventricular assist devices (DT LVAD), 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an overriding desire to live as long as possible: [LVAD] was the only option I had…that or push up daisies…so I automatically took this. In contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: There are worse things than death. Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Education / 21.05.2014

Dr. Price Kerfoot MD, EdM Rabkin Fellow in Medical Education Associate Professor of Surgery, Harvard Medical SchoolMedicalResearch.com Interview with: Dr. Price Kerfoot MD, EdM Rabkin Fellow in Medical Education Associate Professor of Surgery, Harvard Medical School   MedicalResearch: What are the main findings of the study? Dr. Kerfoot: (1) An online spaced education game improved clinicians' knowledge of hypertension intensification and generated a modest but significant improvement in time to blood pressure target among their patients with hypertension. (2) As a method to increase clinicians' long-term knowledge, the spaced education game was significantly more effective than providing the identical content via a traditional method (online posting with e-mail reminders). (more…)
Asthma, Author Interviews, Lancet, Pediatrics / 20.05.2014

Adnan Custovic DM MD PhD FRCP Professor of Allergy Institute of Inflammation and Repair University of Manchester University Hospital of South Manchester Manchester M23 9LT, UKMedicalResearch.com Interview with: Adnan Custovic DM MD PhD FRCP Professor of Allergy Institute of Inflammation and Repair University of Manchester University Hospital of South Manchester Manchester M23 9LT, UK MedicalResearch: What are the main findings of the study? Dr. Custovic: In a longitudinal analysis of the data from our birth cohort study collected from birth to age eleven years, we demonstrated an association between early-life antibiotic prescription and development of wheezing, but not atopy. Furthermore, amongst children with wheezing, antibiotic prescription in infancy increases the risk of subsequent severe wheeze/asthma exacerbations and hospital admissions. This is the first demonstration that children who receive antibiotics in infancy have impaired antiviral immunity later in life, and that early-life antibiotic prescription is associated with variants on chromosome 17q21 locus (which is an asthma susceptibility locus). Our findings suggest that the association between antibiotics and childhood asthma reported in previous studies arises through a complex confounding by indication, in which hidden factors which increase the likelihood of both antibiotic prescription in early life and subsequent asthma development are increased susceptibility to virus infections consequent to impaired antiviral immunity, and genetic variants on 17q21. Our results raises an important issue that effects which are often attributed to environmental exposures may be a reflection of genetic predisposition. (more…)
Mayo Clinic, Urology / 20.05.2014

Daniel S. Elliott, M.D MAYO Clinic, Associate Professor Department of Urology Section of Pelvic and Reconstructive Surgery Rochester, MinnesotaMedicalResearch.com Interview with: Daniel S. Elliott, M.D MAYO Clinic, Associate Professor Department of Urology Section of Pelvic and Reconstructive Surgery Rochester, Minnesota MedicalResearch: What are the main findings of the study?  Dr. Elliott: The biggest issue is that we were able to devise a new procedure that is a simple outpatient anti-incontinence surgery for women that does NOT use any synthetic meshes.  The importance of this is that all traditional (meaning NON-mesh) surgeries for female incontinence have been large surgeries with fairly significant risks such as pain, bleeding and prolonged recovery.  When the meshes came out in the late ‘90’s, their big benefit was that they were outpatient and quick procedures.  But now that we are discovering all the long term complications from meshes such as chronic pain, scarring, painful intercourse, vaginal extrusion of the meshes, and organ injury, patients have become VERY reluctant and fearful to undergo any mesh type surgery.    Therefore, we devised a new procedure that used a very small piece of the patient’s own tissue (from the rectus fascia) and placed this via the “transobturator route.”  In the process, we melded together the “best” of both worlds---a NON-mesh, outpatient anti-incontinence procedure that is safe (no long term problems as seen with meshes) . (more…)
Cancer Research, Diabetes / 20.05.2014

MedicalResearch.com Interview with: Sarah P. Psutka, MD Fellow in Urologic Oncology Department of Urology, Mayo Clinic MedicalResearch: What are the main findings of each study?  Dr. Psutka: In this study we identified all diabetic patients with localized clear cell renal cell carcinomas who were surgically treated between 1990 and 2008 in our institution and matched them with nondiabetic patients. Our main findings were that, after controlling for major confounders such as age, sex, type of surgery, renal function, smoking status, performance status, and tumor grade and stage, diabetic patients had inferior overall survival than nondiabetic patients. Furthermore, among patients with clear cell carcinoma, diabetic patients also had shorter cancer-specific survival, suggesting that diabetes is a poor prognostic factor for patients with surgically treated renal cell carcinoma. (more…)
Mayo Clinic, Urology / 20.05.2014

MedicalResearch.com Interview with: Sarah P. Psutka, MD Fellow in Urologic Oncology Department of Urology, Mayo Clinic MedicalResearch: What are the main findings of each study?  Dr. Psutka: In this study, we analyzed 1335 patients who underwent radical cystectomy at the Mayo clinic between 1996 and 2006. We categorized patients who stayed in the hospital longer than 10 days, putting them in the top 25th percentile of the length of stay, as having a prolonged hospital stay. We noted that prolonged hospital stay was associated with adverse postoperative outcomes, including serious complications and early postoperative death. Patients who had a prolonged length of stay had a higher burden of comorbidities, American Society of Anesthesiologist score, and their Eastern Cooperative Oncology Group Score. A multivariable analysis, holding these factors and other clinically relevant potential confounders constant, revealed that only the ECOG performance score independently predicted whether or not a patient had a prolonged hospital course following radical cystectomy. (more…)
Addiction / 19.05.2014

Jennifer Peltzer-Jones, R.N., Psy.D. Henry Ford's Department of Emergency Medicine MedicalResearch.com Interview with: Jennifer Peltzer-Jones, R.N., Psy.D. Henry Ford's Department of Emergency Medicine MedicalResearch: What are the main findings of the study? Answer: We found that within our group of 255 known Emergency Department “super-frequent users,” 77% had with some type of addiction disorder, and 47 percent visited the Emergency Department seeking narcotics for pain. Women were more likely to be narcotic seeking. Using our individualized Electronic Medical Record care plan intervention, created and overseen by our multidisciplinary team (comprised of Emergency Department staff physicians, a psychologist, residents, nurses and support staff), we found that our plan significantly decreased annual rates of visits by these super-frequent users and those who sought pain-relief narcotics and other super-frequent users. (more…)
Blood Clots, General Medicine, UCSD / 19.05.2014

MedicalResearch.com Interview withTimothy Fernandes, M.D., M.P.H. University of California, San Diego - La Jolla, CA Timothy Fernandes, M.D., M.P.H. University of California, San Diego La Jolla, CA MedicalResearch: What are the main findings of this study? Dr. Fernandes: The fibrinopeptides are cleaved off of fibrinogen by thrombin during the generation of a new clot. These small molecules are excreted into the urine and we have developed a urine assay to measure the level of FPB. We examined the performance of urine FPB as a screening test for acute pulmonary embolism, blood clots that travel to the lungs. The study group consisted of 344 patients: 61 (18%) with pulmonary embolism and 283 (83%) without. At a threshold of 2.5 ng/ml, urine FPB demonstrated sensitivity of 75.4% (95% CI: 62.4-85.2%), specificity of 28.9% (95% CI: 23.8-34.7%), and negative likelihood ratio of 0.18 (0.11-0.29), weighted by prevalence in the sample population. However, the thresholds of 5 ng/ml and 7.5 ng/ml had sensitivities of only 55.7% (95% CI: 42.5-68.2%), and 42.6% (30.3-55.9%), respectively. The urine fibrinopeptide B assay at a cut-off of 2.5 ng/ml had a sensitivity of 75.4% for detecting pulmonary embolism. For diagnosis of PE, this sensitivity is comparable to previously published values for the first generation plasma latex and whole blood D-dimer assays (not as well and the D dimer ELISA assay). (more…)