Author Interviews, Nature, Nutrition / 04.05.2014

Professor Gary Frost PhD RD Head of the Nutrition and Dietetic Research Group NIHR Senior Investigator Division of Diabetes, Endocrinology and Metabolism Faculty of Medicine Imperial College Hammersmith Campus London W12 ONNMedicalResearch.com Interview with: Professor Gary Frost PhD RD Head of the Nutrition and Dietetic Research Group NIHR Senior Investigator Division of Diabetes, Endocrinology and Metabolism Faculty of Medicine Imperial College Hammersmith Campus London W12 ONN MedicalResearch.com: What are the main findings of the study?  Prof. Frost: That acetate that is derived from the fermentation of dietary fiber in the colon by the microbiota is taken up by the hypothalamus in the brain.  In the hypothalamus the way the cells metabolize acetate creates a signal that suppresses appetite (more…)
Author Interviews, BMJ, Emergency Care, Heart Disease / 03.05.2014

Dr. Richard Body Emergency Department Manchester Royal Infirmary Manchester UKMedicalResearch.com Interview with:  Dr. Richard Body Emergency Department Manchester Royal Infirmary Manchester UK   MedicalResearch.com: What are the main findings of the study? Dr. Body: This paper actually reports the findings of two consecutive, separate studies.  We aimed to derive and then externally validate a clinical decision rule to risk stratify patients with suspected acute coronary syndromes in the Emergency Department (ED).  This rule could then be used to reduce unnecessary hospital admissions while also making judicious use of specialist high dependency resources. In the first study we derived a clinical decision rule that incorporates 8 variables: high sensitivity troponin T, heart-type fatty acid binding protein; ECG ischaemia; worsening angina; hypotension (systolic blood pressure <100mmHg on arrival); sweating observed in the ED; pain associated with vomiting; and pain radiating to the right arm or shoulder.  When we validated the rule at a different centre, we found that its use could have avoided hospital admission for over a quarter of patients while effectively risk stratifying others.  Of the 10% of patients who were identified as 'high risk', approximately 95% had a major adverse cardiac event within 30 days.  The findings suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule could be used to 'rule in' and 'rule out' acute coronary syndromes immediately, using information gathered at the time of initial presentation to the ED.  Before clinical implementation, we recommend that effect of using the MACS rule in practice should first be evaluated in a trial setting.  This will enable us to determine: (a) whether physicians and patients are likely to comply with (and be satisfied with) the MACS rule; (b) the safety of the MACS rule when used in practice; and (c) whether use of the MACS rule leads to cost savings for the health service. (more…)
Heart Disease, Vitamin D / 01.05.2014

Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner HospitalMedicalResearch.com Interview with: Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital MedicalResearch.com: What are the main findings of the study? Dr. Lewis: We tested the hypothesis raised by others that calcium supplementation with or without vitamin D increases coronary heart disease and mortality risk in elderly women. To do this we undertook a meta-analysis of published and unpublished data from patient level and cluster randomized controlled trials of calcium supplements with or without vitamin D in elderly women. Importantly all events included in this large meta-analysis were verified by clinical review, hospital record or death certificate. We did not observe any significant increase in all-cause mortality or coronary heart disease events that included myocardial infarction, angina pectoris and acute coronary syndromes and chronic coronary heart disease. (more…)
Accidents & Violence, Author Interviews, Exercise - Fitness / 01.05.2014

Lara McKenzie, Ph.D. MA Associate Professor of Pediatrics Center for Injury Research and Policy The Research Institute at Nationwide Children's Hospital Columbus, OhioMedicalResearch.com Interview with: Lara McKenzie, Ph.D. MA Associate Professor of Pediatrics Center for Injury Research and Policy The Research Institute at Nationwide Children's Hospital Columbus, Ohio MedicalResearch.com: What are the main findings of the study? Dr. McKenzie: Our study was the first to compare and describe epidemiological patterns of basketball-related injuries presenting for treatment to emergency departments and to the high school athletic training setting using surveillance data captured from large, nationally representative samples. Specifically, we compared estimated national incidence, rates of injury and body sites injured, and diagnoses. Nationally, an estimated 1,514,957 athletes with basketball-related injuries reported to the emergency department and 1,064,551 presented to the athletic training setting. Patterns of basketball-related injuries presenting to the emergency department differ from those presenting to the high school athletic training setting for treatment, with those presenting to the emergency department being more severe. In general, injuries that could be relatively quickly assessed and more easily diagnosed and treated, such as strains and/or sprains, presented more commonly to the athletic training setting, while injuries that required more extensive diagnostic or treatment procedures, such as fractures, were treated more commonly in the emergency department. (more…)
Author Interviews, Lancet, Mental Health Research / 20.04.2014

Dr. George Patton Department of Paediatrics, University of Melbourne Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, AustraliaMedicalResearch.com Interview with: Dr. George Patton Department of Paediatrics, University of Melbourne Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia MedicalResearch.com: What are the main findings of the study? Dr. Patton: Although there has been wide acceptance that the teens are a time when emotional problems are common, views have been polarized about their significance. Some have viewed these problems are usual for this phase of life with little significance for later life mental health; others have argued that early psychiatric intervention was essential given the risks of ongoing disorders. In this sample almost two thirds of girls and a third of boys had an episode of emotional troubles (anxiety and depression) at a level that would concern a family physician. For those where the episode were brief lasting weeks to months, recovery without further later life episodes was common. In contrast those with persistent (longer than 6 months) or recurrent emotional problems during the teens had a high likelihood of similar problems with depression and anxiety in their twenties. In general these emotional problems persisted more in females than in males. (more…)
Author Interviews, BMJ, McGill, Pediatrics / 16.04.2014

MedicalResearch.com Interview with: Ethan K Gough, PhD candidate Department of Epidemiology Biostatistics and Occupational Health McGill University, Montreal, QC, Canada MedicalResearch.com: What are the main findings of the study? Answer: Antibiotic use produces significant gains toward expected growth in children, for their age and sex, from low- and middle-income countries. Children included in our study were generally smaller in height and weight than adequately nourished children of the same age, reflecting the spectrum of stunting and wasting malnutrition seen in low- and middle-income countries. Antibiotic use had a larger impact on weight than height, and the effect on weight was larger in populations who may be at greater risk of infections and early mortality, such as populations with a high prevalence of HIV infection or exposure, and a high prevalence of severe acute malnutrition. (more…)
Author Interviews, JAMA, Lung Cancer, Pulmonary Disease / 15.04.2014

Renda Soylemez Wiener, MD, MPH Assistant Professor of Medicine The Pulmonary Center Boston University School of Medicine Center for Healthcare Organization & Implementation Research Edith Nourse Rogers Memorial VA HospitalMedicalResearch.com Interview with: Renda Soylemez Wiener, MD, MPH Assistant Professor of Medicine The Pulmonary Center Boston University School of Medicine Center for Healthcare Organization & Implementation Research Edith Nourse Rogers Memorial VA Hospital MedicalResearch.com: What are the main findings of the study? Dr. Soylemez Wiener: The main finding is that evaluation of pulmonary nodules to determine whether or not they are cancerous is inconsistent with clinical practice guideline recommendations in almost half of cases, suggesting there is room for improvement in clinical care of these patients. Patients with pulmonary nodules are sometimes evaluated more aggressively than they should be (18%), which can cause harms to patients from unnecessary invasive tests (biopsies or surgery) or unneeded radiation exposure from imaging studies. Still more patients (27%) are followed less aggressively than they should be, which in the worst case scenario could lead to delays in the diagnosis and treatment of cancer. It is particularly important to improve care of these patients now, because new guidelines from the US Preventive Services Task Force recommend CT screening for lung cancer screening, which often finds pulmonary nodules that require evaluation. (more…)
Addiction, Frailty, Geriatrics, JAMA, Pharmacology / 15.04.2014

Cara Tannenbaum, MD, MSc The Michel Saucier Endowed Chair in Geriatric Pharmacology, Health and Aging La Chaire pharmaceutique Michel-Saucier en santé et vieillissement Professor of Medicine and Pharmacy University of Montreal Centre de Recherche Institut Universitaire de Gériatrie de Montréal Montreal, QC MedicalResearch.com Interview with: Cara Tannenbaum, MD, MSc The Michel Saucier Endowed Chair in Geriatric Pharmacology, Health and Aging,Professor of Medicine and Pharmacy University of Montreal Centre de Recherche Institut Universitaire de Gériatrie de Montréal Montreal, QC MedicalResearch.com: What are the main findings of the study? Dr. Tannenbaum: The EMPOWER study showed that providing older patients with information about the harms of sleeping pill use led to discontinuation or dose reduction in 1-in-every 4 patients with longstanding use of benzodiazepines. Receipt of evidence-based information about drug harms resulted in a 8-fold higher likelihood of benzodiazepine cessation. Many physicians think that patients become too dependent on sedative-hypnotics to successfully discontinue. Regardless of age, sex, and duration of use, 27% of patients aged 65-95 in this study successfully completed the recommended 20-week tapering protocol during a 6-month time period and another 11% were in the process of tapering. EMPOWERing patients with evidence-based information therefore results in appropriate risk reduction. (more…)
Author Interviews, Lipids, NEJM, Statins / 31.03.2014

Evan A. Stein, M.D., Ph.D. FRCP(C), FCAP Metabolic and Atherosclerosis Research Center Cincinnati, OH 45225,MedicalResearch.com Interview with: Evan A. Stein, M.D., Ph.D. FRCP(C), FCAP Metabolic and Atherosclerosis Research Center Cincinnati, OH 45225,   MedicalResearch.com: What are the main findings of the study? Dr. Stein: The study which is the first 52 week randomized double blind trial of a PCSK9 to report results (all others have been 12 weeks) demonstrated that the excellent LDL-C reductions of 55-60% seen at 12 weeks are maintained through 52 weeks, with no fall off in patient compliance, tolerability of efficacy. It also demonstrated that with longer treatment no new or unexpected side effects. The study also had a unique design in that prior to randomization to the PCSK9 inhibitor (evolocumab) or placebo patients had a run in period during which time they were assigned, based on NCEP-ATP III criteria, to appropriated background therapy which ranged from diet only, to atorvastatin 10 mg a day, to atorvatatin 80 mg a day or atorvastatin 80 mg a day plus ezetimibe - reflecting how these patients are treated in practice. Only then if their LDL-C was still above 75 mg/dL were they randomized into the treatment part of the study with the new drug. The study showed that irrespective of background therapy the reduction with evolocumab was consistent. (more…)
Author Interviews, Colon Cancer, JAMA / 31.03.2014

MedicalResearch.com Interview with: M.S. ReimersM.S. Reimers, MD PhD Student and Dr. Jan Liefers MD Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands MedicalResearch.com: What are the main findings of the study? Answer: Aspirin use was associated with an improved survival, as we have published before when investigating this cohort (Bastiaannet et al, Brit J Cancer 2012/ Reimers et al. J Am Geriatr Soc. 2012. In this study we have focused on investigating which patients will benefit from aspirin treatment by investigating some tumor markers, such as PTGS2 expression, HLA class I expression and PIK3CA mutation status. Interestingly, only patients with HLA class I expression on their tumor membrane will benefit from aspirin treatment and have a better outcome. We raise the hypothesize that aspirin inhibits platelet aggregation to circulating tumors cells. By interfering with this process, the metastatic potential of these circulating tumour cells is inhibited, thereby preventing metastasis and colon cancer death.HLA class I expression might be needed for signalling between platelets and circulating tumor cells. If this hypothesis is confirmed by others or in vitro studies, than this might explain the finding that aspirin seems not only beneficial as an adjuvant therapy for colorectal cancer patients, but also for patients with other malignancies (oesophagus, breast, etc). Interestingly, preliminary findings from our team investigating aspirin use in oesophageal cancer also showed that aspirin use in these tumors was associated with an improved survival. (more…)
Diabetes, Diabetes Care, Mental Health Research / 31.03.2014

MedicalResearch.com Interview with: Gao-Jun Teng, MD Chair and Professor, Dept of Radiology Zhongda Hospital, Southeast University Nanjing 210009, China MedicalResearch.com: What are the main findings of the study? Answer: This current study demonstrates that the aberrant resting-state functional connectivity among default mode network (DMN) regions, especially the posterior cingulated cortex (PCC) to right middle temporal gyrus (MTG), is associated with insulin resistance and cognitive performance, which might be the key to understanding the cognitive impairment in type 2 diabetes (T2DM). (more…)
Author Interviews, Depression, Pediatrics, PLoS, Psychological Science / 29.03.2014

MedicalResearch.com Interview with: Dr. Prof. Natalia N. Kudryavtseva Head of Neurogenetics of Social Behavior Sector, Institute of Cytology and Genetics SD RAS, Novosibirsk, Russia MedicalResearch.com: What are the main findings of the study? Answer: Hostile environment and social instability stress can have a significant impact on adolescents, causing the development of anxiety and depression. (more…)
Author Interviews, Diabetes, Diabetes Care, NIH / 28.03.2014

Michael Laxy Helmholtz Zentrum München German Research Center for Environmental Health Institute of Health Economics and Health Care Management Neuherberg, GermanyMedicalResearch.com Interview with: Michael Laxy Helmholtz Zentrum München German Research Center for Environmental Health Institute of Health Economics and Health Care Management Neuherberg, Germany MedicalResearch.com: What are the main findings of the study? Answer: In patients with type 2 diabetes a high level of self-management behavior was associated with a better glycemic control, i.e. a lower HbA1c level, in the cross-sectional perspective and a reduced mortality over a 12-year period. This effect remained robust after controlling for socio-demographic and disease related factors, including medication. (more…)
Author Interviews, Outcomes & Safety, Surgical Research / 28.03.2014

dr_najma_ahmedMedicalResearch.com Interview with: Dr. Najma Ahmed Trauma and Acute Care Surgeon, St. Michael's Hospital Residency Training Director, General Surgery, University of Toronto   MedicalResearch.com: What are the main findings of this study: Dr. Ahmed: The main findings if the study were that the recent reduction of resident duty hours to much less than 80 hours decreases health outcomes in patients, has adverse educational outcomes for residents and does not improve wellness in surgery. (more…)