AHA Journals, Author Interviews, Heart Disease / 21.07.2014

Kanako K. Kumamaru, MD PhD Assistant Professor, Departments of Radiology Brigham and Women’s Hospital & Harvard Medical School Boston, MA 02446MedicalResearch.com Interview with: Kanako K. Kumamaru, MD PhD Assistant Professor, Departments of Radiology Brigham and Women’s Hospital & Harvard Medical School Boston, MA 02115 Medical Research: What are the main findings of the study? Dr. Kumamaru: When a patient does not have diabetes and had no or ≤25% coronary stenosis in his/her previous coronary CT angiography (CCTA) performed within 3 years, the probability of newly developed coronary artery disease (CAD) is very low, suggesting no repeat CCTA necessary, even if the clinical scenario suggested CCTA to be appropriate. Especially, when coronary arteries were completely normal at the prior scan, no patient underwent subsequent revascularization during the study period. (more…)
Author Interviews, Brigham & Women's - Harvard, HIV, JAMA, Weight Research / 21.07.2014

Steven Grinspoon, MD Professor of Medicine, Harvard Medical School Director, MGH Program in Nutritional Metabolism Co-Director, Nutrition Obesity Research Center at Harvard Massachusetts General Hospital Boston, MA 02114MedicalResearch.com Interview with Steven Grinspoon, MD Professor of Medicine, Harvard Medical School Director, MGH Program in Nutritional Metabolism Co-Director, Nutrition Obesity Research Center at Harvard Massachusetts General Hospital Boston, MA 02114 Medical Research: What are the main findings of the study? Dr. Grinspoon: The primary finding is that tesamorelin, a hypothalamic peptide that increases the endogenous pulsatile secretion of growth hormone, reduced liver fat in HIV-infected patients with increased visceral (abdominal) fat.  Increased visceral fat is very closely linked with increased liver fat in HIV patients, but the effects on liver fat were not known.  Our data show that tesamorelin reduces liver fat in conjunction with decreasing visceral fat, which may be clinically important for patients with HIV-infection who have both increased abdominal fat and fatty liver disease. In addition the study demonstrated that this treatment strategy was neutral to glucose by the end of the 6 month study. (more…)
Author Interviews, CDC / 21.07.2014

MedicalResearch.com: Interview withDr. Sonia Singh Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA Dr. Sonia Singh Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA Medical Research: What are the main findings of the study? Dr. Singh: While there is a great deal of information about the epidemiology of HIV among MSM (men who have sex with men), there is much less information about a subset of MSM who also have sex with women – MSMW.  In this article, CDC researchers examined HIV diagnoses among MSMW and MSM only (MSMO) from 2008 to 2011 to obtain a better understanding of the characteristics of men diagnosed with HIV who have ever had sex with both men and women.  Of all MSM diagnosed with HIV during 2011, 26% also had sex with women with women in the past.  From 2008 to 2011, HIV diagnoses among MSMW were relatively stable while there was an increase among young MSMO aged 13 to 29 years. (more…)
Author Interviews, Gender Differences, Heart Disease, Pharmacology / 21.07.2014

Lisa A. McDonnell Program Manager, Prevention & Wellness Centre, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.MedicalResearch.com Interview with: Lisa A. McDonnell Program Manager, Prevention & Wellness Centre, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Medical Research: What are the main findings of the study? Answer: The analysis focuses on a comparison of women’s perceptions of their heart disease knowledge and heart health risk with their self‐reported knowledge and heart health risk status. In summary, it gives insight into the Perceptions vs Reality when it comes to women and their heart health. Heart disease knowledge: For the purposes of measuring knowledge related to heart health, a scoring index was created on which women responding to the survey could score as low as 0 or as high as 40. The overall mean score among women in the survey was 15.0, which is fairly modest given the maximum of 40. In a comparison of actual and perceived heart disease knowledge, 80% of respondents with a low knowledge score perceived that they were moderately or well informed. The risk factors that Canadian women most commonly associate with heart disease are being overweight/having abdominal obesity (ov/ob), physical inactivity, smoking, and lacking fruits/vegetables. Smoking, diabetes and high blood pressure account for up to 53% of MI’s, followed by Ov/Ob, psychosocial factors, a lack of physical activity, and a lack of fruits/vegetables. The limited awareness of high blood pressure, high cholesterol and diabetes as key risk factors is particularly surprising, given that these are key determinants of heart disease. Low awareness of symptomology among women in our survey were noted when comparing the occurrence of symptoms versus their recognition of these symptoms as possibly being related to their heart. Only 4 in 10 women could name chest pain as a symptom of heart disease, and a smaller proportion could identify symptoms including dyspnea, radiating pain, or typical prodromal symptoms. Such shortcomings might contribute to the greater number of unrecognized myocardial infarctions in women than in men, not to mention inappropriate treatment of acute events and premature discharge from emergency care. (more…)
Author Interviews, CDC, HIV / 21.07.2014

Anna Satcher Johnson MPH Division of HIV/AIDS Prevention Centers for Disease Control and Prevention (CDC) Atlanta, GeorgiaMedicalResearch.com: Interview with: Anna Satcher Johnson MPH Division of HIV/AIDS Prevention Centers for Disease Control and Prevention (CDC) Atlanta, Georgia Medical Research: What are the main findings of the study? Answer: The new analysis confirms historical trends suggesting that we’ve made significant progress in reducing HIV in the U.S. over time – overall and among several key populations, including injection drug users and heterosexuals.  Overall, new HIV diagnoses from 2002 to 2011 declined 33 percent.  However, these findings underscore continued concerns of a surging HIV epidemic among young gay and bisexual men.  We found a significant increase in HIV diagnoses among young men who have sex with men between the ages of 13 and 24. (more…)
AHA Journals, Author Interviews, Heart Disease / 21.07.2014

MedicalResearch.com Interview with: Cheol Whan Lee and Seung-Jung Park Division of Cardiology, Asan Medical Center, University of Ulsan Seoul, Korea Medical Research: What are the main findings of the study? Answer: The time window of DES (drug-eluting stent) failure is widely variable from soon after DES implantation to several years after DES implantation. We observed patients with late DES failure are commonly presented with acute coronary syndrome. We hypothesized that temporal patterns of DES failure may be different, and analyzed all patients with first DES failure at our institution. We found that late drug-eluting stent failure is more likely to progress to acute myocardial infarction, aggressive angiographic patterns, and worse outcomes following retreatment. (more…)
Author Interviews, Neurology, Stroke / 20.07.2014

Sang-Beom Jeon, MD, PhD From the Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul, Republic of Korea.MedicalResearch.com Interview with: Sang-Beom Jeon, MD, PhD From the Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul, Republic of Korea. Medical Research: What are the main findings of the study? Dr. Sang-Beom Jeon: In this MRI study of 825 stroke patients, we demonstrated that high plasma concentrations of homocysteine, also known as hyperhomocysteinemia, were associated with small-vessel disease (lacunar infarcts and leukoaraiosis) and large-vessel atherosclerosis of cerebral arteries. (more…)
Author Interviews, HIV, Lancet / 20.07.2014

Dr. Colette SmithMedicalResearch.com Interview with: Dr. Colette Smith: PhD Research Department of Infection and Population Health University College London, London, UK   Medical Research: What are the main findings of the study? Dr. Smith: We followed a group of approximately 45,000 HIV-positive people from Europe, USA and Australia between 1999 to 2011. We found that the death rate approximately halved over the 12-year study period. For every 1,000 people, around 18 died per year in 1999-2001, reducing to 9 deaths per year in 2009-2011. We also studied what people died of. We found that the death rate from AIDS and from liver disease decreased by around two-thirds. Deaths from heart disease approximately halved. However, the rate of cancer deaths (excluding cancers that are classified as AIDS events) remained constant over time. One in three deaths were caused by AIDS in 1999 to 2011, and this decreased to one in five deaths in the last two years of the study. However, even in recent years it was the joint most common cause of death. The proportion of deaths from cancer increased over time. One in ten deaths were from cancer in 1999 to 2001, and this increased to one in five deaths in 2009 to 2011. By the end of the study it was the joint-most common cause of death. (more…)
Author Interviews, HIV, JAMA, OBGYNE / 19.07.2014

Jared Baeten, MD PhD Professor, Departments of Global Health and Medicine Adjunct Professor, Department of Epidemiology University of Washington Seattle, WA 98104MedicalResearch.com Interview with: Jared Baeten, MD PhD Professor, Departments of Global Health and Medicine Adjunct Professor, Department of Epidemiology University of Washington Seattle, WA 98104 Medical Research: What are the main findings of the study? Dr. Baeten: Among heterosexual African couples in which the male was HIV positive and the female was not, receipt of antiretroviral pre-exposure preventive (PrEP) therapy did not result in significant differences in pregnancy incidence, birth outcomes, and infant growth compared to females who received placebo. (more…)
Author Interviews, Rheumatology / 19.07.2014

Ling Zhao Ph. D. Associate Professor College of Acupuncture-Tuina, Shanghai University of Traditional Chinese Medicine, ChinaMedicalResearch.com Interview with: Ling Zhao Ph. D. Associate Professor College of Acupuncture-Tuina, Shanghai University of Traditional Chinese Medicine, China Medical Research: What are the main findings of the study? Dr. Zhao: In our study, we found that a 6-week course of moxibustion treatment (i.e., a modality of traditional acupuncture using burning moxa to warm and stimulate the acupoint) significantly reduced pain and improved function in patients with knee osteoarthritis compared to a credible placebo control. Our findings suggest that this ancient modality might be a useful adjunctive treatment for knee osteoarthritis. We also found that our sham device is credible for a double-blind randomized clinical trial assessing this traditional treatment modality. (more…)
Author Interviews, Infections / 18.07.2014

MedicalResearch.com Interview with: Dr Joshua Thaden MD, PhD Duke University Division of Infectious Diseases Durham, North Carolina Medical Research: What are the main findings of the study? Dr. Thaden: The primary findings of the study are that
  • The rate of detection of particularly antibiotic resistant bacteria -- the carbapenem-resistant Enterobacteriaceae (CRE) -- has increased 5-fold in a set of community hospitals in the southeastern United States, and that
  • This increase is due to both changes in how we detect CRE and in increased endemicity (i.e., there are just more CRE around).
(more…)
Author Interviews, Exercise - Fitness, Frailty, Geriatrics / 18.07.2014

Dr. Wenjun Li , PhD Health Statistics and Geography Lab Division of Preventive and Behavioral Medicine University of Massachusetts Medical School, Worcester.MedicalResearch.com: Interview with: Dr. Wenjun Li , PhD Health Statistics and Geography Lab Division of Preventive and Behavioral Medicine University of Massachusetts Medical School, Worcester. Medical Research: What are the main findings of the study? Dr. Wenjun Li: Compared to those walking for recreational purposes only, older adults walking for utilitarian purposes had higher risk for outdoor falls and fall-related injuries that require medical attention. (more…)
Author Interviews, Karolinski Institute, Red Meat / 18.07.2014

Andrea Bellavia From the Unit of Nutritional Epidemiology and the Unit of Biostatistics Institute of Environmental Medicine Karolinska Institutet, Stockholm, SwedenMedicalResearch.com Interview with: Andrea Bellavia From the Unit of Nutritional Epidemiology and the Unit of Biostatistics Institute of Environmental Medicine Karolinska Institutet, Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Bellavia: By evaluating together the consumption of processed and fresh red meat, we observed that processed red meat consumption was associated with shorter life, implying a potential negative effect on health. On the other hand, consumption of only fresh red meat was not associated with either shorter or longer survival. Therefore, the main finding of this work is that the negative effects of red meat consumption might only be due to meat processing, which counteract the positive effects of the beneficial nutrients of meat. (more…)
Author Interviews, Breast Cancer, Cognitive Issues / 17.07.2014

Florien Boel MSc VU University Medical Center Department of Medical Psychology Amsterdam, The Netherlands MedicalResearch.com Interview with: Florien Boel MSc VU University Medical Center Department of Medical Psychology Amsterdam, The Netherlands Medical Research: What are the main findings of the study? Answer: In postmenopausal breast cancer patients, endocrine therapy is widely used, and often for many years on end. Endocrine therapy is thought to have an effect on cognitive functioning, but previous studies have not yet accounted for the possible influence of the diagnosis of cancer and subsequent anxiety, depression or fatigue on cognitive performance. In addition, the cognitive effects of endocrine therapy after long-term use are still mostly unknown. Therefore, we compared cognitive functioning of postmenopausal breast cancer patients who underwent surgery and/or radiotherapy (N=43) with the cognitive performance of women who also received adjuvant endocrine therapy (tamoxifen) (N=20) and a group of healthy matched individuals (N=44). In accordance with the literature, we found that especially cognitive domains that rely heavily on verbal abilities (verbal memory and fluency) seem to be at risk for deterioration during long-term treatment (~2.5 years) with tamoxifen. (more…)
Accidents & Violence, Author Interviews / 17.07.2014

Charles A. Jennissen, MD Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City, IA 52242MedicalResearch.com Interview with: Charles A. Jennissen, MD Department of Emergency Medicine University of Iowa Carver College of Medicine Iowa City, IA 52242   MedicalResearch: Why did you perform this study?  Dr. Jennissen: More youth 15 years and younger in the United States are killed in all-terrain vehicle (ATV) crashes than on bicycles. Since 2001, children represent nearly 30% of all ATV-related injuries and 20% of all ATV-related deaths.  Although previous studies have shown children to have high exposure to ATVs, these studies have been mostly limited to select rural and agricultural groups.  With this study, we wanted to investigate the epidemiology of ATV use and safety-related behaviors among a large cross-sectional sample of adolescents. (more…)
Author Interviews, Brain Injury, JAMA / 17.07.2014

MedicalResearch.com Interview with: Emmanuel Lagarde Director of Research at INSERM, France Medical Research: What are the main findings of the study? Dr. Lagarde: Concussion accounts for more than 90 percent of all traumatic brain injuries, although little is known about prognosis for the injury. The symptoms cited as potentially being part of post concussion syndrome fall into three areas: cognitive, somatic and emotional. But the interpretation of symptoms after concussion should also take into account that injuries are often sustained during psychologically distressing events which can lead to Posttraumatic Stress Disorder. Medical Research: Were any of the findings unexpected? Dr. Lagarde: Yes, as we were expecting to observe long term (3-month) symptoms following brain injury, but few were found to be specific : most of them were as frequent among patients with other injuries. Medical Research: What should clinicians and patients take away from your report? Dr. Lagarde: It seems as if there is little evidence of the existence of a specific syndrome following mild traumatic brain injury. However, patients who experienced a concussion are at risk of another well-known syndrome called Posttraumatic Stress Disorder, which is associated with the distressing event that led to the injury. Medical Research: What recommendations do you have for future research as a result of this study? Dr. Lagarde: The classification system of symptoms following mild brain injury should be revisited as our results are challenging the very relevance of the DSM-V post concussion syndrome. Citation: Association of Symptoms Following Mild Traumatic Brain Injury With Posttraumatic Stress Disorder vs Postconcussion SyndromeMedicalResearch.com Interview with: Emmanuel Lagarde Director of Research at INSERM, France Medical Research: What are the main findings of the study? Dr. Lagarde: Concussion accounts for more than 90 percent of all traumatic brain injuries, although little is known about prognosis for the injury. The symptoms cited as potentially being part of post concussion syndrome fall into three areas: cognitive, somatic and emotional. But the interpretation of symptoms after concussion should also take into account that injuries are often sustained during psychologically distressing events which can lead to Posttraumatic Stress Disorder. (more…)
AHA Journals, Author Interviews, Heart Disease, Red Meat / 17.07.2014

MedicalResearch.com Interview with: Dr inz. Joanna Kaluza Department of Human Nutrition Warsaw University of Life Sciences - SGGW Warsaw POLAND Medical Research: What are the main findings of the study? Response: The most important finding of my study is the fact that processed red meat consumption, but not unprocessed red meat, increases a risk of Heart Failure incidence and Heart Failure mortality. (more…)
Author Interviews, Heart Disease, Lipids, NEJM / 17.07.2014

Professor Jane Armitage Professor of Clinical Trials and Epidemiology Clinical Trial Service Unit, Oxford Cardiovascular Science Oxford, United KingdomMedicalResearch.com Interview with: Professor Jane Armitage Professor of Clinical Trials and Epidemiology Clinical Trial Service Unit, Oxford Cardiovascular Science Oxford, United Kingdom Medical Research: What are the main findings of the study? Prof. Armitage: The study showed that adding extended release niacin with laropiprant (to reduce the flushing) to standard treatment including statins in people with heart disease or strokes did not improve their outcome or reduce the risk of recurrent heart attacks or strokes. (more…)
Author Interviews, JAMA, Stroke, Surgical Research / 17.07.2014

Mads E. Jørgensen, M.B. University of Copenhagen, DenmarkMedicalResearch.com Interview with: Mads E. Jørgensen, M.B. University of Copenhagen, Denmark Medical Research: What are the main findings of the study? Answer: We included all patients undergoing non-cardiac surgery in 2005-2011, which were then categorized by time elapsed between stroke and surgery. Patients with a very recent stroke, i.e. less than 3 months prior to surgery, had a significant 14 times higher relative risk of 30-day MACE following surgery, compared with patients without prior stroke. Patients with a more distant stroke had a 2-5 fold higher risk of MACE following surgery, and still significantly higher than risks in patients without prior stroke. An additional model including time between stroke and surgery as a continuous measure showed a steep decrease in risks of perioperative MACE during the first 9 months. After 9 months, an increase in time between stroke and surgery did not further reduce the risks. The results for 30-day all-cause mortality showed similar patterns, although estimates were not as dramatic as for 30-day MACE. When analyzing the MACE components individually, we found that recurrent strokes were the main contributor to the high risk of MACE. A history of stroke any time prior to surgery was associated with a 16 fold increased relative risk of recurrent stroke, compared with patients without prior stroke. We also performed analyses stratified by surgery risk as low- (OR for stroke anytime, 3.97; 95% CI, 2.79-5.66), intermediate- (OR for stroke anytime, 4.46; 95% CI, 2.87-5.13) and high-risk (OR for stroke anytime, 1.98; 95% CI, 1.20-3.27), which were somewhat challenged in power. However, results indicated that stroke associated relative risk was at least as high in low and intermediate-risk surgery as in high risk surgery. (more…)
Author Interviews, Ophthalmology, Stem Cells, Transplantation / 17.07.2014

Ben Mead Molecular Neuroscience Group Neurotrauma and Neurodegeneration Section School of Clinical and Experimental Medicine University of Birmingham, BirminghamMedicalResearch.com Interview with: Ben Mead Molecular Neuroscience Group Neurotrauma and Neurodegeneration Section School of Clinical and Experimental Medicine University of Birmingham, Birmingham Medical Research: What are the main findings of the study? Answer: Traumatic and neurodegenerative disease of the retina lead to an irreversible loss of retinal ganglion cells (RGC) which are the neuronal cells located in the inner retina that transmit visual signals to the brain. Thus RGC injury results in visual defects which can ultimately progress into permanent blindness. One promising therapeutic approach is the use of stem cells as a source of replacement for lost retinal cells. However a theory has emerged suggesting that stem cells can act through the secretion of signalling molecules (growth factors). One stem cell that has recently shown great promise for neuronal repair are dental pulp stem cells (DPSC), which are multipotent stem cells easily isolated from adult teeth, including third molars (Mead et al 2013, 2014). In our research, we transplanted either dental pulp stem cells or the more widely studied bone marrow-derived mesenchymal stem cell (BMSC) into the vitreous chamber of the eye after optic nerve crush (Mead et al 2013). The main finding of this study was that DPSC, to a significantly greater degree than BMSC, promoted the survival of injured RGC and the regeneration of their axons. We also showed that the mechanism of action was not through differentiation and replacement of cells but was actually paracrine mediated, i.e. through DPSC-derived growth factors (Mead et al, 2013, 2014). (more…)
Author Interviews, JAMA, Prostate Cancer, Testosterone / 16.07.2014

Grace Lu-Yao PhD, MPH Professor of Medicine Robert Wood Johnson Medical School Rutgers, The State University of New Jersey Rutgers Cancer Institute of New Jersey New Brunswick, NJ 08903-2681MedicalResearch.com Interview with: Grace Lu-Yao PhD, MPH Professor of Medicine Robert Wood Johnson Medical School Rutgers, The State University of New Jersey Rutgers Cancer Institute of New Jersey New Brunswick, NJ 08903-2681 Medical Research: What are the main findings of the study? Dr. Lu-Yao: Primary ADT (ie., use of androgen deprivation as an alternative to surgery, radiation or conservative management for the initial management of prostate cancer) is not associated with improved overall or disease specific survival. (more…)
Author Interviews, Cancer Research / 16.07.2014

John D'Orazio, M.D., Ph.D. Drury Pediatric Research Endowed Chair Associate Professor, Univ. KY College of Medicine Pediatric Hematology-Oncology The Markey Cancer Center Lexington, KY 40536-0096MedicalResearch.com Interview with: John D'Orazio, M.D., Ph.D. Drury Pediatric Research Endowed Chair Associate Professor, Univ. KY College of Medicine Pediatric Hematology-Oncology The Markey Cancer Center Lexington, KY 40536-0096 Medical Research: What is the background for this study? Dr. D'Orazio: Malignant melanoma is the deadliest of skin cancers, and it’s incidence has increased enormously over the last several decades.  In the 1930’s only one in every fifteen hundred Americans would get melanoma in his/her lifetime.  Now it’s one in fifty or sixty.  Plus, it often affects young adults in the prime of their lives.  Altogether, nearly 10,000 Americans die of melanoma every year.  However, risk is not equally shared.  Fair-skinned people who tend to burn rather than tan from sun exposure have a much higher risk than dark skinned people.  On the surface, it would appear that the amount of melanin in the skin would be the only determinant of melanoma risk but the truth is more complex.  Our lab has been interested in a particular hormonal pathway in the skin that directly influences melanoma risk.  When UV radiation (sunlight) hits the skin, it causes damage to the cells of the skin.  Cells respond to this damage to protect themselves against further injury.  One way in which they do this is by turning on a hormone called melanocyte stimulating hormone, abbreviated “MSH”.  Made by keratinocytes, the most abundant cells in the epidermis, MSH is directly responsible for ramping up melanin production by melanocytes, the cells that make the pigment in the skin that gives us a tan.  This pigment called melanin acts as natural sunscreen and blocks UV radiation from penetrating into the skin.  This is very important because people who can tan are in a much safer state the next time they get sun exposure.  Because they have more melanin in the skin, the UV won’t cause as much damage.  The key is to realize that UV causes mutations in melanocytes, and with enough damage to the DNA, melanocytes can turn cancerous and become melanomas.   People who have the melanoma-prone, “can’t tan” skin type often have problems in this MSH hormonal pathway.  Specifically, they have inherited problems with the receptor on melanocytes that binds to MSH and makes the cells make more pigment.  This protein, called the melanocortin 1 receptor (or “MC1R”), is the way that melanocytes sense that the skin has been injured and needs more melanin.  If the MC1R won’t signal, then melanocytes just sit there and can’t be induced to make more melanin pigment.  Surely this is a major reason why people with MC1R signaling defects are at high risk of melanomas. (more…)
Author Interviews, Cancer, Cancer Research / 16.07.2014

Rebecca H. Johnson, MD Assistant Professor, Clinical Genetics University of Washington Seattle, WashingtonMedicalResearch.com Interview with  Rebecca H. Johnson, MD Assistant Professor, Clinical Genetics University of Washington Seattle, Washington Medical Research: What are the main findings of the study? Dr. Johnson: We observed that, over the past two decades, there has been an increase in the incidence of testicular cancer in Hispanic American adolescents and young adults (AYAs) between 15 and 39 years of age. This increase is seen in both major subtypes of testicular cancer and affects Hispanic AYA patients with all stages of disease at the time of diagnosis. No comparable increase was observed in non-Hispanic white AYA,s or in older American men regardless of Hispanic ethnicity.  Between 1992 and 2010, the incidence of testicular cancer in AYA Hispanics has increased 58% in contrast to just 7% in non-Hispanic white AYAs. (more…)
Author Interviews, JAMA, Pain Research / 15.07.2014

Kurt Kroenke, M.D. Professor of Medicine, Indiana University School of Medicine Research Scientist, Indiana University Center for Health Services and Outcomes Research Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc. Director of Education and Training Programs, Regenstrief Institute, Inc. Core Investigator, VA HSR&D Center for Health Information and CommunicationMedicalResearch.com Interview with: Kurt Kroenke, M.D. Professor of Medicine, Indiana University School of Medicine Research Scientist, Indiana University Center for Health Services and Outcomes Research Research Scientist, Center for Health Services Research, Regenstrief Institute, Inc. Director of Education and Training Programs, Regenstrief Institute, Inc. Core Investigator, VA HSR&D Center for Health Information and Communication
Medical Research: What are the main findings of the study? Dr. Kroenke: The telecare intervention including monitoring of pain using automated phone calls or the Internet with contacts by a nurse care manager who met weekly with a physician pain specialist to discuss treatment of new patients or patients already being followed who were not improving.
  • Almost twice as many patients in the telecare group had improvement in their pain compared to the usual care control group (52% vs. 27%).
  • Moreover, nearly twice as many patients in the usual care group got worse over 12 months (36% vs. 19%).  Thus, patients with chronic pain may not only fail to improve with current treatment, they in fact can get worse over time.
  • Although one-third of these chronic pain patients were on opioids at start of study, there were very few patients in which opioids needed to be started or dose increased.
  • The intervention group was about equally divided between those who chose to do automated symptom monitoring (ASM) by IVR (51%) or internet (49%).  The majority of patients rated the monitoring as easy to do, and the telecare intervention helpful.
(more…)
Author Interviews, Kidney Disease, Transplantation / 15.07.2014

Dr Hallvard Holdaas Consultant in Nephrology National Hospital of Oslo, NorwayMedicalResearch.com Interview with: Dr Hallvard Holdaas Consultant in Nephrology Department of Transplant Medicine Oslo University Hospital Rikshospitalet, Oslo Norway. Medical Research: What are the main findings of the study? Dr. Holdaas: Most studies examining long-term risk for living kidney donors have included  comparators from the background population with hypertension, diabetes mellitus, reduced renal function, cancer and other concomitant diseases; or for the few studies with more “healthy” comparators the follow-up time have been restricted. In our study we compared living donors to a healthy non-donor population which would have qualified as donors themselves, with median follow-up of 15.1 years for the donors. The relative risk for the living donors compared to a healthy control was 11.38 for endstage renal disease (ESRD), 1.4 for cardiovascular death and 1.3 for all-cause mortality (Mjoen et al., 2014). (more…)
Author Interviews, Kidney Disease, NEJM, Transplantation / 15.07.2014

Paul Kimmel, M.D. Division of Kidney, Urologic and Hematologic Diseases National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health Professor Division of Renal Diseases and Hypertension The George Washington UniversityMedicalResearch.com Interview with: Paul Kimmel, M.D. Division of Kidney, Urologic and Hematologic Diseases National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health Professor Division of Renal Diseases and Hypertension The George Washington University Medical Research:   What are the main findings of the review? Dr. Kimmel: AKI (Acute Kidney Injury) and CKD (Chronic Kidney Disease), two syndromes approached separately in medical school  curricula  as well as in the clinical arena are inextricably intertwined.  They should be taught as a combined entity, culminating in progressive loss of renal function necessitating renal replacement therapy (dialysis or transplantation). The two syndromes increase risk for cardiovascular disease and diminished quality of life as well.  Preventive and therapeutic strategies should be directed at the combined entity. (more…)
AHA Journals, Author Interviews, Stroke / 15.07.2014

Iftikhar J. Kullo, MD Division of Cardiovascular Diseases Mayo Clinic Rochester, MNMedicalResearch.com Interview with: Iftikhar J. Kullo, MD Division of Cardiovascular Diseases Mayo Clinic Rochester, MN   Medical Research: What are the main findings of the study? Dr. Kullo: The main findings of the study are: 1) Family history of stroke or heart attack is associated with presence of significant narrowing (greater than 70%) of the carotid arteries. These are the arteries that supply blood to the brain and narrowing or blockage of these arteries is associated with increased risk of stroke; 2) Having a sibling history of stroke or heart attack was more strongly associated with narrowing of the carotid artery than having a parent with such history; 3) The greater number of relatives with history of stroke or heart attack, the greater the odds of having narrowing in one of the carotid arteries. (more…)
Author Interviews, BMJ, End of Life Care / 15.07.2014

Dr. Kirsty Boyd Programme theme head (Clinical Communication) Honorary Clinical Senior Lecturer Primary Palliative Care Research Group Division of Community Health Sciences: General Practice University of EdinburghMedicalResearch.com Interview with: Dr. Kirsty Boyd Programme theme head (Clinical Communication) Honorary Clinical Senior Lecturer Primary Palliative Care Research Group Division of Community Health Sciences: General Practice University of Edinburgh Medical Research: What do we know already about people with ‘multimorbidity’? Dr. Boyd: We know that an increasing number of patients have multiple life-limiting illnesses or progressively deteriorating health due to several long term conditions or general frailty. Caring for them well poses major challenges and they are often hospitalised in the last year of life. They do not fit well into illness and healthcare models that focus on single conditions. Understanding the experiences of patients and their family caregivers is vital to inform improvements in best supportive care and palliative care. We wanted to build on care models for integrated care of people with long term conditions and consider the needs of those at risk of dying with multiple conditions in more detail. (more…)
Author Interviews, BMJ, Emergency Care / 15.07.2014

MedicalResearch.com Interview with: Jeffrey Allen Kline Vice Chair of Research Department of Emergency Medicine MedicalResearch.com Interview with: Jeffrey Allen Kline Vice Chair of Research Department of Emergency Medicine Indiana University Health Medical Research: What are the main findings of this study? Dr. Kline: We believe that clinicians use information from their patients’ faces to make decisions about diagnostic testing. This is particularly relevant in emergency medicine, where the clinicians make decisions rapidly with limited information. We videotaped patients’ faces who had chest pain and dyspnea and used the most well-known facial scoring system to assess their facial expression variability in response to seeing visual stimuli. We found that patients who ultimately had emergent problems tended to hold their faces in a neutral position and be less likely to show the expression of surprise. The investigators were not surprised at this, but we did find that patients with emergent problems also tended to have less negative affect as well as less positive affect. In other words, patients who were sickest even tended to frown less than patients with no medical problem. (more…)