Author Interviews, JAMA, Thromboembolism / 17.09.2014

Dr. Marc Carrier, MD MSc Scientist, Clinical Epidemiology, Ottawa Hospital Research Institute Physician, Hematology (Thrombosis), The Ottawa Hospital Associate Professor, Department of Medicine, Faculty of Medicine, and Research Chair in Venous Thromboembolism and Cancer (Tier 2) at the University of OttawaMedicalResearch.com Interview with: Dr. Marc Carrier, MD MSc Scientist, Clinical Epidemiology, Ottawa Hospital Research Institute Physician, Hematology, The Ottawa Hospital Associate Professor, Department of Medicine, Faculty of Medicine, and Research Chair in Venous Thromboembolism and Cancer (Tier 2) at the University of Ottawa MedicalResearch.com: What are the main findings of this study? Dr. Carrier: Venous thromboembolism (VTE), comprised of deep vein thrombosis and pulmonary embolism, is the third leading cause of cardiovascular death. There are many anticoagulant treatments available but there is little guidance about which treatment is most effective and safe. This systematic review and network meta-analysis evaluated eight different treatment options for acute Venous thromboembolism.  Forty-five trials were included in the analysis and there were no significant differences in clinical or safety outcomes associated with most treatment options when compared to the combination of LMWH-VKA.. (more…)
Author Interviews, General Medicine, JAMA, Pediatrics / 17.09.2014

Lex W Doyle MD BS MSc FRACP Professor of Neonatal Paediatrics Department of Obstetrics and Gynaecology The Royal Women’s Hospital Parkville, Victoria, AustraliaMedicalResearch.com Interview with: Lex W Doyle MD BS MSc FRACP Professor of Neonatal Paediatrics Department of Obstetrics and Gynaecology The Royal Women’s Hospital Parkville, Victoria, Australia Medical Research: What are the main findings of the study? Dr. Doyle: From collectively pooling data from five large trials carried out around the world over the past 20 years, we know that magnesium sulfate given under strict medical protocols in hospital to women threatening to deliver preterm reduces the risk of cerebral  palsy in their children in early childhood.  Following  from this knowledge, magnesium sulfate is now given routinely to women, under strict medical conditions, who are threatening to deliver very early in Australia, and in other parts of the world, to try to prevent cerebral palsy in their child.  What we do not know is if magnesium sulfate used this way has any longer-term effects on the brain or on other important outcomes. One of the initial studies that contributed to the overall evidence about cerebral palsy was carried out in Australia and New Zealand and completed more than 10 years ago.  Over 1000 women and their babies were enrolled in that study and although the rate of cerebral palsy was not substantially reduced by magnesium sulfate in our study, we showed that there were fewer children at 2 years of age who were not walking in the group whose mothers were given magnesium compared with those whose mothers were given placebo.  With this knowledge, and given the unknown longer-term benefits or risks, we re-evaluated the children from our study at school-age, between 6-11 years of age.  We thoroughly evaluated their brain function, including movement and co-ordination, thinking ability, behaviour, and school progress, as well as general health and well-being.  The basic message from our longer-term study is that magnesium sulfate, as used in our trial, does not have any substantial benefits or harms on brain or cognitive function, or any other outcome at school age. (more…)
Author Interviews, JAMA, Stroke / 16.09.2014

Silvia Koton, PhD, MOccH, RN Chair, Department of Nursing The Stanley Steyer School of Health Professions Tel Aviv University Tel Aviv, IsraelMedicalResearch.com Interview with: Silvia Koton, PhD, MOccH, RN Chair, Department of Nursing The Stanley Steyer School of Health Professions Tel Aviv University Tel Aviv, Israel Medical Research: What are the main findings of the study? Dr. Koton: Based on data on 14,357 participants in the Atherosclerosis Risk in Communities (ARIC) study who were free of stroke when the study began in 1987 and followed until the end of 2011, we found a 24 percent overall decline in first-time strokes in each of the last two decades and a 20 percent overall drop per decade in deaths after stroke. The results were similar across race and gender, but varied by age: the decline in stroke risk was concentrated mainly in the over-65 set, while the decrease in stroke-related deaths was primarily found among those under age 65. (more…)
Author Interviews, CDC, Gender Differences, JAMA, Weight Research / 16.09.2014

MedicalResearch.com Interview with:  Earl S. Ford, MD, MPH Medical officer, U.S Public Health Service Centers for Disease Control and Prevention Atlanta, GA 30341 Medical Research: What are the main findings of the study? Dr. Ford:  The main finding of the study is that mean waist circumference and the prevalence of abdominal obesity in US adults have increased since 1999-2000 and that these increases are being driven primarily by trends in women. Mean waist circumference and the percentage of abdominal obesity in men has been relatively stable since 2003-2004. (more…)
Cleveland Clinic, Multiple Sclerosis / 16.09.2014

Jeffrey Cohen MD Department of Neurology Cleveland ClinicMedicalResearch.com: Interview with: Jeffrey A. Cohen, MD Hazel Prior Hostetler Endowed Chair Professor, Cleveland Clinic Lerner College of Medicine Director, Mellen Center for MS Treatment and Research Neurological Institute Cleveland Clinic Cleveland, OH  44195 Medical Research: What are the main findings of the study? Dr. Cohen: The primary objective of the GATE trial was to compare the efficacy and safety of generic glatiramer acetate to the approved form (Copaxone) in relapsing-remitting multiple sclerosis.  The study demonstrated equivalent efficacy of generic glatiramer acetate and Copaxone measured by gadolinium enhancing brain MRI lesions at months 7, 8, and 9 and a number of additional measures of MRI lesion activity.  The study also showed comparable safety (measured by adverse events) and injection site tolerability. (more…)
Author Interviews, Heart Disease / 16.09.2014

Muthiah Vaduganathan, MD MPH Department of Medicine Massachusetts General Hospital Boston, MassMedicalResearch.com Interview with: Muthiah Vaduganathan, MD MPH Department of Medicine Massachusetts General Hospital Boston, Mass Medical Research: What are the main findings of the study? Dr. Vaduganathan: Based on data from a large, multinational randomized controlled trial of patients hospitalized for heart failure and reduced ejection fraction (HFrEF), we conducted a retrospective analyses of the clinical profiles associated with baseline serum uric acid levels. Serum uric acid was commonly elevated in patients hospitalized for heart failure and reduced ejection fraction (mean ~9 mg/dL), especially in men and black patients. Higher uric acid levels were associated with lower systolic blood pressure and EF, higher natriuretic peptides, and more impaired renal function. After accounting for 24 known baseline covariates, serum uric acid was independently predictive of post-discharge mortality and rehospitalization in patients with relatively preserved renal function, but not in those with poor renal function. (more…)
Author Interviews, Cancer Research, CDC, Pediatrics / 16.09.2014

Dr. Jun Li, MD, PhD, MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health PromotionMedicalResearch.com Interview with: Dr. Jun Li, MD, PhD, MPH Epidemiology and Applied Research Branch Division of Cancer Prevention and Control National Center for Chronic Disease Prevention and Health Promotion Medical Research: What are the main findings of the study? Dr. Li: Using the 2001 to 2009 National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) data, which represent 94.2% of the US population, we identified 120,137 pediatric cancer cases with an incidence rate of 171 cases per million children and adolescents. Overall cancer incidence rates were stable from 2001-2009. However, we found rates were increasing significantly at 1.3% per year in African American children and adolescents.  This increase might be partially attributed to the rise among renal tumors and thyroid cancer. We also found rising incidence in thyroid cancer and renal carcinoma among children and adolescents. As has been previously established, pediatric cancer is more common in males, in white, in adolescents, and in the Northeast. Leukemia is the most common pediatric cancer, followed by central nervous system (CNS) neoplasms, and then lymphomas. (more…)
Annals Internal Medicine, Author Interviews, Pain Research / 16.09.2014

Gert Bronfort, DC, PhD Professor, Integrative Health and Wellbeing Research Program Center for Spirituality & Healing University of MinnesotaMedicalResearch.com Interview with: Gert Bronfort, DC, PhD Professor, Integrative Health and Wellbeing Research Program Center for Spirituality & Healing University of Minnesota Medical Research: What are the main findings of the study? Were any of the findings unexpected? Dr. Bronfort: Our study found that spinal manipulative therapy  SMT coupled with home exercise and advice (HEA) appears to be helpful compared to home exercise and advice alone (especially in the short term) for patients with sub-acute and chronic back-related leg pain (BRLP). BRLP was defined as radiating pain originating from the lumbar spine, which travels into the proximal or distal lower extremity, with or without neurological signs. Patients with progressive neurological deficits, cauda equina syndrome, spinal fracture, and other potentially serious causes of BRLP (and often candidates for surgery) were EXCLUDED. There were a few things we did find to be quite interesting. First, it is notable that the spinal manipulative therapy & home exercise and advice group experienced less self-reported medication use after one year than the  home exercise and advice alone group (SMT&HEA was 2.6 times more likely to experience fewer medication days than HEA alone at 1 year). Given the growing concerns of overuse of pain medications (and the potential for adverse events and addiction), this is a finding that has important public health consequence. Another interesting and important finding is that the adverse events observed in this study were only mild to moderate and self-limiting. No serious adverse events occurred that were related to the study interventions. Mild to moderate adverse events (e.g. temporary aggravation of pain, muscle soreness, etc.) were reported by 30% of the patients in the SMT&HEA group, and 42% in the HEA group. This is important as few studies have systematically recorded the side effects and adverse events related to SMT&HEA and HEA alone; this is one of the first, larger clinical trials to do so. These findings are especially notable because SMT is often not recommended for patients with leg symptoms because of safety concerns (which might be related to the previous absence of robust scientific data to support its use). Finally, while an advantage of SMT& HEA versus HEA was found (especially in the short term), we do find the findings of the HEA alone group to also be of interest. Almost half of the HEA patients experienced a 50% reduction in leg pain symptoms in both the short (at 12 weeks) and long term (at 52 weeks). That’s an important improvement and warrants future investigation. Self-management strategies (like home exercise) that emphasize the importance of movement and fitness, restoration of normal activities, and allow patients to care for themselves embrace important principles for promoting overall health and wellbeing that could have a big impact if routinely put into practice. (more…)
Breast Cancer / 15.09.2014

Nienke de Glas, MD PhD-student Leiden University Medical Center Department of Surgery Leiden The NetherlandsMedicalResearch.com Interview with: Nienke de Glas, MD PhD-student Leiden University Medical Center Department of Surgery Leiden The Netherlands Medical Research: What are the main findings of the study? Dr. de Glas: It remains unclear whether mass breast cancer screening has a beneficial effect in older women. In the Netherlands, the upper age limit of the breast cancer screening program was extended from 69 to 75 years in 1998. If a screening program is effective, it can be expected that the incidence of early stage tumours increases, while the incidence of advanced stage tumours decreases. The aim of this study was to assess the incidence of early stage and advanced stage breast cancer before and after the implementation of mass screening in women aged 70-75 years in the Netherlands. We showed that the extension of the upper age limit to 75 years has only led to a small decrease of advanced stage breast cancer, while the incidence of early stage tumours has strongly increased. For every advanced stage tumour that was prevented, 20 “extra” and early stage tumours were diagnosed. (more…)
Author Interviews, Telemedicine, University of Michigan / 15.09.2014

Rashid Bashshur, PhD Senior Advisor for eHealth Professor Emeritus, Department of Health Management and Policy Executive Director, UMHS eHealth Center University of Michigan Health SystemMedicalResearch.com Interview with:  Rashid Bashshur, PhD Senior Advisor for eHealth Professor Emeritus, Department of Health Management and Policy Executive Director, UMHS eHealth Center University of Michigan Health System Medical Research: What are the Main findings of the study? Dr. Bashshur: The main findings can be summarized as follows:
  •  The prevalence of chronic disease is increasing due to the changing demographic composition of the population and unhealthy life styles. Chronic diseases are expensive, accounting for about 70% of health care expenditures;  but  they are amenable to telemedicine interventions.  These interventions consist of ongoing monitoring of patients living in their own home environments, engaging them in managing their health,  providing them with educational materials and the necessary tools to manage their life style mostly by avoiding risky behaviors and adopting healthy ones.
  • Telemedicine interventions consist of various configurations of technology (telephone, video, wired or wireless, automated or manual) , human resources (physicians, nurses, combinations, and patient populations at various levels risk levels or severity of illness, The interventions investigated to date also vary in terms of study design, duration of application (during the study period), and frequency of administration of the intervention.  Hence, the findings must be viewed from the perspective of the specific methodological attributes  of the studies that were performed.
  • Using only robust studies from 2000 to the near present, and limited to congestive heart failure, stroke and COPD.  With notable exceptions,  overall there is substantial and fairly consistent evidence of:
  • A decrease in use of service, including hospitalization, rehospitalization, and emergency depart visits as a result of the telemedicine intervention.
  • Improved health outcomes.
  • Improved event timing for stroke patients.
  • Reduced exacerbations of symptoms for COPD patients
  • Some interesting  trends  to be considered:
  • Frail and elderly patients, those with co-morbid conditions, and those in advanced stages of illness are not likely to benefit from telemedicine interventions, as compared to their counterparts.
  • Visual information as in videoconferencing proved superior to telephone only connection for the diagnosis and treatment of stroke patients.
  • There could be a tradeoff between extra nursing time versus reduced physician time in some settings, but the net effect is cost savings.
  • There seems to be a paradoxical telemedicine effect in terms of increasing longevity but no reduction in hospitalization, reported in few studies.
(more…)
Author Interviews, Brigham & Women's - Harvard, Nature / 15.09.2014

MedicalResearch.com Interview with: MichDr. Michael Super, Ph.D.ael Super M.Sc., PhD Senior Staff Scientist Advanced Technology Team Wyss Institute at Harvard Center for Life Science, 2nd Floor Boston MA 02115 Medical Research: What is the background for this study? How big a problem is sepsis? Dr. Super:
  • Sepsis is a major problem and is the primary cause of death from infection. The incidence of sepsis is rising.
  • Sepsis affects more than 18 M people each year and at least 1/3 ( 6 million) die every year of sepsis.
  • Sepsis is a disease that affects the very young and old and it is estimated that 60-80% of childhood deaths in the developing world are due to sepsis.
(more…)
Author Interviews, Brain Injury, University of Pittsburgh / 15.09.2014

Anthony P. Kontos, Ph.D. Assistant Research Director UPMC Sports Medicine Concussion Program Associate Professor Department of Orthopaedic Surgery University of PittsburghMedicalResearch.com Interview with: Anthony P. Kontos, Ph.D. Assistant Research Director UPMC Sports Medicine Concussion Program Associate Professor Department of Orthopaedic Surgery University of Pittsburgh Medical Research: What are the main findings of the study? Dr. Kontos: Our new Vestibular/Ocular Motor Screening (VOMS) examination was able to accurately identify nearly 90% of patients with a concussion. In our study of 64 concussed patients approximately five days post-injury and 78 healthy control-group patients who were administered VOMS by trained clinicians, we also found that more than 60% of patients with a concussion reported symptoms or had impairment on the VOMS following their injury. The VOMS, which was developed in conjunction with an interdisciplinary team of experts, assesses five areas of the vestibular ocular system: smooth pursuits, saccades (rapid eye movement), horizontal vestibular ocular reflex (VOR), visual motion sensitivity (VMS), and near-point-of-convergence (NPC) distance. (more…)
Author Interviews, Lancet, Lung Cancer, Radiation Therapy / 15.09.2014

Prof. dr. B.J. Slotman VU University Medical Center Cancer Center Amsterdam NetherlandsMedicalResearch.com Interview wth: Prof. dr. B.J. Slotman VU University Medical Center Cancer Center Amsterdam Netherlands Medical Research: What are the main findings of this study? Prof. Slotman: This randomized trial showed that the use of thoracic radiotherapy in patients with extensive stage small cell lung cancer reduces the risk of intrathoracic progression by about 50% and improves 2 years survival from 3 to 13%. (more…)
Author Interviews, Pain Research, Sexual Health / 15.09.2014

MedicalResearch.com Interview with: Natalie Sidorkewicz, MSc (Kin) PhD (HSG) Student Spine Biomechanics Laboratory School of Public Health and Health Systems, Faculty of Applied Health Sciences University of Waterloo Waterloo, ON Medical Research: What are the main findings of the study? Answer: First, we successfully documented male spine motion and muscle activity during sex -- this biomechanics study was the first of its kind. Second, we used this data to develop general recommendations for low back pain patients whose pain is worsened by motions and postures. The general recommendations focus on changing how people move, and position themselves during sex, as seen on websites similar to Nu-Bay. To make any sex position more spine-sparing, we recommend that the individual controlling the movement use their hips and knees more than their spine and that the individual not controlling the movement maintain a more neutral-spine position. An excellent working example is one of the sex positions that we studied: the missionary position. The man, who is controlling the movement with pelvic thrusting, is recommended to do so with more hip and knee movement than spine movement. The women, who is lying on her back, is recommended to use a back support placed underneath the natural curve of her spine to maintain a more neutral spine position. The general recommendations can be applied to any sex position for both men and women. Finally, we developed specific guidelines for men whose back pain is worsened by two specific types of motion: flexion and extension. If a man's low back pain is worsened by spine flexion movements, such as touching their toes or sitting for long periods of time, we would consider them to be flexion-motion-intolerant. The ideal sex position for a flexion-motion-intolerant patient would then be one that uses minimal spine flexion, so as not to worsen that patient's pain. When we compared the five sex positions, which you can do yourself by checking out some videos on a website such as sex free hd xxx, we found that men used the least amount of spine flexion in doggy-style as well as the missionary position as long as the male was propped up on his hands (as opposed to his elbows). If a man's low back pain is worsened by spine extension movements, such as arching their back or lying on their stomach, we would consider them to be extension-motion-intolerant. The ideal sex position for an extension-motion-intolerant patient would then be one that uses minimal spine extension, so as not to worsen the patient's pain. When we compared the five sex positions, we found that men used the least amount of spine extension in spooning and the missionary position as long as the male was propped up on his elbows (as opposed to his hands). (more…)
Author Interviews, Mental Health Research, NIH / 15.09.2014

MedicalResearch.com Interview with: Dr Oliver J Robinson Ph.D. Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health, NIH, Bethesda, MD, Institute of Cognitive Neuroscience University College London, London, UK Medical Research: What are the main findings of the study? Dr. Robinson: This study is looking at a symptom of anxiety disorders known as “negative affective bias”. This describes the tendency of people with anxiety disorders to focus on negative or threatening information at the expense of positive information. We completed a number of previous studies looking at so called “adaptive” anxiety in healthy individuals – this is the normal, everyday anxiety that everyone experiences; walking home in the dark, for instance (in these prior studies we used unpredictable electrical shocks to make people anxious and stressed). When we made healthy people transiently anxious in this way we showed that this was also associated with negative affective bias and driven by a specific brain circuit: the dorsal medial prefrontal (anterior cingulate) cortex—amygdala aversive amplification circuit. In this study we showed that the same circuit that was engaged by transient anxiety in our healthy sample was actually engaged ‘at baseline’ (i.e. without stress) in our patient group. This suggests that this mechanism which can be temporarily activated in healthy controls becomes permanently ‘switched on’ in our patient group. This might explain why people with anxiety disorders show persistent ‘negative affective biases’. Furthermore, the extent to which this circuit was turned on correlated with self-reported anxiety. That is to say the more anxious an individual said they were, the greater the activity in this circuit. Therefore, there seems to be more of a dimension or scale of anxiety, rather than a simple well/unwell diagnosis. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension / 14.09.2014

MedicalResearch.com Interview with: Sourabh Aggarwal, MD University College of Medical Sciences Western Michigan University School of Medicine in Kalamazoo. Medical Research: What are the main findings of the study? Dr. Aggarwal: The main findings were that from 2006 to 2011:
  • ER visits for essential hypertension increased by 25 percent, while the admission percentage for these patients fell by 15 percent.
  • ER visits for hypertension with complication and secondary hypertension increased by 19 percent, while the admission percentage for these patients fell by 12 percent
(more…)
Author Interviews, Multiple Sclerosis, Sleep Disorders, UC Davis / 14.09.2014

Steven D. Brass, M.D., M.P.H., M.B.A. PI and Lead Author on the study Director of Neurology Sleep Clinical Program Co-Medical Director of Sleep Medicine Laboratory Associate Clinical Professor in the Department of Neurology UC Davis Health System 4860 Y Street — Suite 3700 Sacramento, CA 95817 MedicalResearch.com Interview with: Steven D. Brass, M.D., M.P.H., M.B.A. PI and Lead Author on the study Director of Neurology Sleep Clinical Program Co-Medical Director of Sleep Medicine Laboratory Associate Clinical Professor in the Department of Neurology UC Davis Health System 4860 Y Street — Suite 3700 Sacramento, CA 95817 Medical Research: What was the primary finding of your study? Dr. Brass : Among the 11,400 surveys mailed out to all members of the Northern California Chapter of the National Multiple Sclerosis Society, 2,810 (24.6%) were returned. Of these, 2,375 (84.5%) met the inclusion criteria. Among the completed surveys, 898 (37.8%) screened positive for obstructive sleep apnea, 746 (31.6%) for moderate to severe insomnia, and 866 (36.8%) for restless legs syndrome.  In contrast, only 4%, 11%, and 12% of the cohort reported being diagnosed by a health care provider with obstructive sleep apnea, insomnia, and restless legs syndrome, respectively. Excessive daytime sleepiness was noted in 30% of respondents based on the Epworth Sleepiness Scale. More than 60% of the respondents reported an abnormal level of fatigue based on the Fatigue Severity Scale.  There was also an increased risk between complaints of Fatigue based on screening positive for the Fatigue Severity Scale  and screening positive for Obstructive Sleep Apnea  (1.850, with a 95% p-value < 0.001). (more…)
Heart Disease, JACC / 13.09.2014

Thomas M. Maddox, MD MSc FACC FAHA Cardiology, VA Eastern Colorado Health Care System Associate Director, VA CART Program Associate Professor, Department of Medicine, University of Colorado School of MedicineMedicalResearch.com Interview with: Thomas M. Maddox, MD MSc FACC FAHA Cardiology, VA Eastern Colorado Health Care System Associate Director, VA CART Program Associate Professor, Department of Medicine, University of Colorado School of Medicine Medical Research: What are the main findings of the study? Dr. Maddox: We were curious to know if the VA, as a provider of PCI at centers without on-site CT surgery, was providing better access to its veterans without compromising their safety.  We were pleased to find that there was evidence of better access, with patients reducing their drive time to PCI facilities by, on average, 90 minutes.  In addition, there was no compromised safety.  Rates of both peri-procedural and 1-year adverse outcomes were low and no different between centers with and without on-site CT surgery. (more…)
Diabetes, Heart Disease / 13.09.2014

Carlos F. Sánchez-Ferrer, M.D., Ph.D. Professor of Pharmacology Universidad Autónoma de Madrid, Spain.MedicalResearch.com Interview with: Carlos F. Sánchez-Ferrer, M.D., Ph.D. Professor of Pharmacology Universidad Autónoma de Madrid, Spain. Medical Research: What are the main findings of the study? Dr. Sánchez-Ferrer: We were studying the possible ways of interaction between high glucose levels, which are found in diabetes mellitus, with vascular damage, which is the most common and devastating consequence of this disease. An intriguing fact is that a very strict control of blood sugar in diabetic patients is not sufficient to avoid the development of such diabetes-induced cardiovascular diseases. We think our results can explain why this is happening. Using cultured smooth muscle cells from the main human artery (aorta) in the presence of high concentrations of extracellular glucose, we observed: 1. In the absence of inflammation, excess glucose in the culture fluid didn’t enter the cells. 2. When extra glucose was forced into the cells, no harm was done in the absence of inflammation. 3. When the inflammation-stimulating protein interleukin-1 (IL-1) was introduced, more glucose entered the cells. 4. With IL-1, the glucose entering the cells was metabolized via chemical pathways that spur escalating inflammation, overwhelming the cells’ ability to counteract it. 5. In the presence of the anti-inflammatory drug anakinra, which blocks the activity of IL-1, the deleterious changes didn’t occur. (more…)
Author Interviews, Gastrointestinal Disease, General Medicine, Surgical Research / 13.09.2014

Dr. Dee Fenner, M.D. Professor of Obstetrics and Gynecology Director of Gynecology University of MichiganMedicalResearch.com Interview with: Dr. Dee Fenner, M.D. Professor of Obstetrics and Gynecology Director of Gynecology University of Michigan MedicalResearch.com Editor’s note: American Medical Systems Inc. (AMS), a subsidiary of Endo International plc (Nasdaq: ENDP) (TSX: ENL), released top-line results from its TRANSFORM study that show the investigational TOPAS™ System improves fecal incontinence in women. The results show that over a 12 month period, 69% of women suffering from fecal incontinence who were implanted with the TOPAS™ System experienced at least a 50% reduction in weekly incontinence episodes and experienced a durable, consistent effect across the study period. The results were presented in Cape Town, South Africa at the International Society of University Colon & Rectal Surgeon (ISUCRS) Congress. Dr. Fenner, a primary investigator of the study, kindly answered the questions below: Medical Research: How common/prevalent is the problem of fecal incontinence in women? Dr. Fenner: Fecal incontinence, also known as accidental bowel leakage (ABL), is estimated to affect nearly 11 million women and 10% of women over the age of 20 in the United States.1,2 Additionally, nearly one in five women over the age of 45 experience ABL at least once a year.3 (more…)
Author Interviews, Diabetes, Diabetes Care, Heart Disease / 12.09.2014

Kristian Filion, PhD FAHA Assistant Professor of Medicine Division of Clinical Epidemiology Jewish General Hospital/McGill University Montreal, Quebec H3T 1E2 CanadaMedicalResearch.com Interview with: Kristian Filion, PhD FAHA Assistant Professor of Medicine Division of Clinical Epidemiology Jewish General Hospital/McGill University Montreal, Quebec H3T 1E2 Canada Medical Research: What are the main findings of the study? Dr. Filion: Previous studies have raised concerns that the use of incretin-based drugs, a type of medication used to treat diabetes, may increase the risk of congestive heart failure.  We therefore examined this potential drug safety issue using a large, population-based database, which allowed us to study the safety of these medications in a real world setting.  In doing so, we found that the use of incretin-based drugs was not associated with an increased risk of congestive heart failure among patients with type 2 diabetes.  Similar results were obtained among both classes of incretin-based drugs (glucagon like peptide-1 [GLP-1] analogs and dipeptidyl peptidase-4 [DPP-4] inhibitors), and no duration-response relationship was observed. (more…)
Author Interviews, Diabetes, Diabetologia / 12.09.2014

MedicalResearch.com Interview with: Association Between Arterial Catheter Use and Hospital Mortality in Intensive Care UnitsDr. Sophia Zoungas: Faculty of Medicine, Nursing & Health Sciences Monash University, Clayton   Medical Research: What are the main findings of the study Dr. Zoungas: Our study shows that age (or age at diagnosis) and duration of diabetes disease are linked to the risk of death and marcovascular complications (those in larger blood vessels) whereas only diabetes duration is linked to the risk of microvascular complications (in smaller blood vessels such as those in the kidney and eyes) (more…)
Author Interviews, Diabetes, Obstructive Sleep Apnea / 12.09.2014

Paul M. Macey, Ph.D. Assistant Professor in Residence Associate Dean for Information Technology and Innovations, Chief Innovation Officer UCLA School of Nursing and Brain Research InstituteMedicalResearch.com Interview with: Paul M. Macey, Ph.D. Assistant Professor in Residence Associate Dean for Information Technology and Innovations, Chief Innovation Officer UCLA School of Nursing and Brain Research Institute Medical Research: What are the main findings of the study? Dr. Macey: People with sleep apnea are less able to control the blood flowing to their brain, in particular when they grip tightly, or have their foot put in cold water. We measured changes in blood flowing through the brain using an MRI scanner while people gripped hard, had their foot placed in cold water, and breathed out hard into a tube with a very small hole in it. These activities all lead to more blood flowing to the brain in healthy people, which probably helps protect the cells from being starved of blood and oxygen. However, people with sleep apnea send less blood that the healthy participants during the gripped and cold foot activities. A further important finding is that women with sleep apnea are worse off than men. The female patients showed much weaker blood flow than the males, even accounting for normal differences between men and women. (more…)
Author Interviews, Ebola, Infections / 12.09.2014

Dr. Gerardo Chowell-Puente Ph.D. Associate Professor School of Human Evolution and Social Change College of Liberal Arts and Sciences Arizona State UniversityMedicalResearch.com: Interview with: Dr. Gerardo Chowell-Puente Ph.D. Associate Professor School of Human Evolution and Social Change College of Liberal Arts and Sciences Arizona State University Medical Research: What are the main findings of the study? Dr. Chowell-Puente: 1.We estimated the effective reproduction number of Ebola virus disease, i.e. average number of secondary cases produced by a single primary case at calendar time t (Rt), for the ongoing epidemic in West Africa from March to August 2014. Estimates of Rt for the Guinea, Sierra Leone and Liberia, countries that are experiencing sustained community transmission were consistently above 1.0 since June 2014. 2.Country-specific estimates of the reproduction number for Liberia and Sierra Leone lied between 1.0 and 2.0, reflecting continuous growth of cases in these countries 3. Effective reproduction number below 2 indicate that control could be attained by preventing over half of the secondary transmissions per primary case (e.g. by means of effective case isolation and contact tracing). (more…)
Author Interviews, Autism / 12.09.2014

Anilkumar Pillai, Ph.D. Associate Professor Department of Psychiatry Medical College of Georgia Georgia Regents University (Formerly Georgia Health Sciences University)MedicalResearch.com: Interview with: Anilkumar Pillai, Ph.D. Associate Professor, Department of Psychiatry Medical College of Georgia, Georgia Regents University (Formerly Georgia Health Sciences University) Medical Research: What are the main findings of the study? Dr. Pillai: GABA receptors are responsible for binding GABA, the main inhibitory neurotransmitter in the human brain. Recent studies have indicated a potential role for alterations in GABAA receptors in the pathophysiology of Autism Spectrum Disorder (ASD). However, the mechanism of regulation of GABAA receptor in Autism Spectrum Disorder is not known. Our study shows that GABAA levels are altered at the protein level, but not at the mRNA level in the middle frontal gyrus of Autism Spectrum Disorder subjects. Our study also finds that Synoviolin 1 (SYVN1) plays a critical role as an E3 ligase in GABAAα1 degradation. SYVN1 has been previously determined to function as a removal system of inappropriately folded or unfolded proteins from the ER to the cytosol of the cell for degradation. Our study ultimately provides a mechanism for GABAAα1 deficits in Autism Spectrum Disorder subjects and possible new treatment strategies to reverse deficits seen in ASD and other related disorders. (more…)
Author Interviews, Cancer Research, NEJM / 12.09.2014

MedicalResearch.com Interview with: Dr. Charles Mullighan, M.D., MBBS(Hons), MSc Department of Pathology St. Jude Children's Research Hospital Memphis, TN 38105 MedicalResearch: What are the most important take home points from this study for practicing clinicians and their patients? Dr. Mullighan: Acute lymphoblastic leukemia (ALL) remains a leading cause of cancer death in children, and the prognosis worsens with increasing age. Current therapies are inadequate for many patients. This study has defined the genetic basis of a recently described subtype of Acute lymphoblastic leukemia called Ph-like ALL. We show that the prevalence increases with rising age, and that in both children and young adults the disease is driven by a diverse range of genetic changes that activate kinase signaling, which fuels the growth of leukemia cells. Ph-like Acute lymphoblastic leukemia currently has a poor outcome. The activated kinases may be inhibited by currently approved tyrosine kinase inhibitors (TKIs). We have shown efficacy of these inhibitors in cell lines and experimental models, and in a series of patients with Ph-like Acute lymphoblastic leukemia treated with TKIs. (more…)
Author Interviews, Cancer Research, Dartmouth, Melanoma, Nature / 12.09.2014

Dr. Constance Brinckerhoff Professor of Medicine Professor of Biochemistry Geisel School of Medicine at DartmouthMedicalResearch.com Interview with: Dr. Constance Brinckerhoff Professor of Medicine Professor of Biochemistry Geisel School of Medicine at Dartmouth Medical Research: What are the main findings of the study? Dr. Brinckerhoff: The genetic mutation BRAFV600E , frequently found in metastatic melanoma, not only secretes a protein that promotes the growth of melanoma tumor cells, but can also modify the network of normal cells around the tumor to support the disease’s progression. Targeting this mutation with Vemurafenib reduces this interaction, and suggests possible new treatment options for melanoma therapy. (more…)
Author Interviews, Cancer Research, Genetic Research, University of Pennsylvania / 12.09.2014

Renata Afi Rawlings-Goss, Ph.D. Postdoctoral Fellow Tishkoff Lab, University of PennsylvaniaMedicalResearch.com Interview with: Renata Afi Rawlings-Goss, Ph.D. Postdoctoral Fellow Tishkoff Lab, University of Pennsylvania   Medical Research: What are the main findings of the study? Dr. Rawlings-Goss: We found genetic mutations in key gene regulators that have been linked to ethnic disparities in cancer. Our investigation identified more than 30 previously undescribed mutations in important regulatory molecules called microRNAs. Individual microRNA molecules can regulate large numbers of genes in some cases over 6000 genes at once. Therefore, mutations in these genes have been linked to numerous diseases. By and large, however, microRNA mutations have not been studied in people of diverse ethnic backgrounds. (more…)
Author Interviews, CMAJ / 12.09.2014

Annemarieke de Jonghe Academic Medical Center University of Amsterdam Departement of Internal Medicine Section of Geriatric Medicine F4-218 Amsterdam, The NetherlandsMedicalResearch.com Interview with: Annemarieke de Jonghe Academic Medical Center University of Amsterdam Departement of Internal Medicine Section of Geriatric Medicine F4-218 Amsterdam, The Netherlands Medical Research: What are the main findings of the study? Dr. de Jonghe: We investigated the preventive properties of melatonin versus placebo in a prospective cohort of elderly hip fracture patients (n=378). We found that 3mg melatonin vs placebo, given for 5 days from the day of admission, did not influence the incidence of delirium. However, in a posthoc analysis we found that more patients in the placebo group more often had a longer lasting delirium. (more…)