Author Interviews, Blood Pressure - Hypertension, Diabetes, Genetic Research, University of Pennsylvania / 05.03.2014

MedicalResearch.com Interview with: Brendan Keating D.Phil Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania Lead Clinical Data Analyst, Center for Applied Genomics Children's Hospital of Philadelphia,Brendan Keating D.Phil Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania Lead Clinical Data Analyst, Center for Applied Genomics Children's Hospital of Philadelphia Michael V. Holmes, MD, PhD, MSc, BSc, MRCP Transplant Surgery Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USAMichael V. Holmes, MD, PhD, MSc, BSc, MRCP Transplant Surgery Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA MedicalResearch.com: What are the main findings of the study? Answer: We found that individuals with a genetically-elevated BMI had higher blood pressure, inflammatory markers, metabolic markers and a higher risk of type 2 diabetes, although there was little correlation with coronary heart disease in this study population of over 34,500 European-descent individuals of whom over 6,000 had coronary heart disease. (more…)
Author Interviews, Health Care Systems, Lancet, Nursing, University of Pennsylvania / 04.03.2014

Professor Linda H Aiken PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology Director of the Center for Health Outcomes and Policy Research Center for Health Outcomes and Policy Research University of Pennsylvania School of NursingMedicalResearch.com Interview with: Professor Linda H Aiken PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology Director of the Center for Health Outcomes and Policy Research Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing MedicalResearch.com: Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. Against that backdrop, can you start by letting us know the background of the study?  Prof. Aiken: European Surgical Outcomes Study in 28 countries showed higher than necessary deaths after surgery. A comparable study in the US showed that despite the nation spending hundreds of millions of dollars on improving patient safety, there were no improvements in adverse outcomes after surgery in US hospitals between 2000 and 2009.  Clearly it is time to consider new solutions to improving hospital care for surgical patients, who make up a large proportion of all hospital admissions.  Our study was designed to determine whether there are risks for patients of reducing hospital nurse staffing, and what, if any, are the benefits to patients of moving to a more educated nurse workforce. (more…)
Alcohol, Author Interviews, Genetic Research, University of Pennsylvania / 14.02.2014

Henry R. Kranzler, MD Professor, Department of Psychiatry Director of the Center for Studies of Addiction. University of Pennsylvania Perelman School of Medicine, PhiladelphiaMedicalResearch.com Interview with: Henry R. Kranzler, MD Professor, Department of Psychiatry Director of the Center for Studies of Addiction. University of Pennsylvania Perelman School of Medicine, Philadelphia MedicalResearch.com: What are the main findings of the study? Dr. Kranzler: The study had two main findings:
  • First, topiramate, at a maximal dosage of 200 mg/day, which is lower than the 300 mg/day used in prior treatment trials, substantially reduced the frequency of heavy drinking and increased the frequency of abstinent days more than placebo. The lower dosage was well tolerated.
  • Second, a variant in a gene that encodes a receptor subunit that binds topiramate moderated the response to topiramate. That is, C-allele homozygotes in the single nucleotide polymorphism rs2832407 in GRIK1, the gene encoding the GluK1 subunit of the kainate receptor, were the subgroup that accounted for the effects of topiramate on heavy drinking. This has important implications for the personalized treatment of alcohol use disorder, in that 40% of people of European ancestry have this genotype and, if confirmed, these findings would make it possible to screen people genetically to select an effective treatment.
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Author Interviews, Dermatology, JAMA, University of Pennsylvania / 13.02.2014

Dr. Misha A. Rosenbach Assistant Professor of Dermatology Hospital of the University of Pennsylvania Section Editor, JAMA Dermatology Patient PageMedicalResearch.com Interview with: Dr. Misha A. Rosenbach Assistant Professor of Dermatology Hospital of the University of Pennsylvania Section Editor, JAMA Dermatology Patient Page MedicalResearch.com: What are the main findings of the study? Dr. Rosenbach: There is strong agreement between teledermatologists and in-person dermatologists when evaluating inpatients at a tertiary care academic hospital.  The primary aim of this study was to assess telederm as a triage tool.  Many dermatologists are not full-time hospitalists, but work in private practice or clinics which may be remote from affiliated hospitals.  The goal was to evaluate whether teledermatology could help those providers assess the acuity of inpatient consults.  There was strong concordance. (more…)
Author Interviews, Cost of Health Care, Education, JAMA, University of Pennsylvania / 19.12.2013

Mitesh Patel, MD, MBA RWJF Clinical Scholar, University of Pennsylvania Mitesh Patel, MD, MBA is a Robert Wood Johnson Clinical Scholar the University of Pennsylvania and primary care physician at the Philadelphia VA Medical CenterMedicalResearch.com Interview with: Mitesh Patel, MD, MBA RWJF Clinical Scholar, University of Pennsylvania Mitesh Patel, MD, MBA is a Robert Wood Johnson Clinical Scholar the University of Pennsylvania and primary care physician at the Philadelphia VA Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Patel: We evaluated survey responses from nearly 300 internal medicine residency programs directors to assess whether residency programs were teaching residents the fundamental concepts of practicing high-value, cost-conscious care.  We found that 85% of program directors feel that graduate medical education has a responsibility to help curtail the rising costs of health care.  Despite this, about 6 out of every 7 internal medicine residency programs have not yet adopted a formal curriculum teaching new physicians these important concepts. (more…)
Author Interviews, Education, JAMA, University of Pennsylvania / 06.12.2013

James Guevara, MD, MPH Associate Professor of Pediatrics & Epidemiology Senior Diversity Search Advisor, Perelman School of Medicine University of Pennsylvania,Director of Interdisciplinary Initiatives PolicyLab: Center to Bridge Research, Practice, & Policy The Children's Hospital of Philadelphia,Philadelphia, PA 19104MedicalResearch.com Interview with: James Guevara, MD, MPH Associate Professor of Pediatrics & Epidemiology Senior Diversity Search Advisor, Perelman School of Medicine University of Pennsylvania,Director of Interdisciplinary Initiatives PolicyLab: Center to Bridge Research, Practice, & Policy The Children's Hospital of Philadelphia,Philadelphia, PA  19104 MedicalResearch.com: What did the study attempt to address? Dr. Guevara: Medical schools have sought to build more diverse faculty in their institutions through faculty development programs targeted to underrepresented minority faculty members. This study was conduct by THE CHILDREN'S HOSPITAL OF PHILADELPHIA'S POLICYLAB  and The University of Pennsylvania and sought to determine if there was an association between minority faculty development programs and the representation, recruitment, and promotion of underrepresented minority faculty. (more…)
AHRQ, Author Interviews, Electronic Records, Hospital Readmissions, University of Pennsylvania / 28.11.2013

Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center University of Pennsylvania Philadelphia, PA 19104MedicalResearch.com Interview with: Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center University of Pennsylvania Philadelphia, PA 19104 MedicalResearch.com: What are the main findings of the study? Dr. Umscheid: We developed and successfully deployed into the electronic health record of the University of Pennsylvania Health System an automated prediction tool which identifies newly admitted patients who are at risk for readmission within 30 days of discharge.  Using local data, we found that having been admitted to the hospital two or more times in the 12 months prior to admission was the best way to predict which patients are at risk for being readmitted in the 30 days after discharge. Using this finding, our automated tool identifies patients who are “high risk” for readmission and creates a “flag” in their electronic health record (EHR). The flag appears next to the patient’s name in a column titled “readmission risk.” The flag can be double-clicked to display detailed information relevant to discharge planning.  In a one year prospective validation of the tool, we found that patients who triggered the readmission alert were subsequently readmitted 31 percent of the time. When an alert was not triggered, patients were readmitted only 11 percent of the time.  There was no evidence for an effect of the intervention on 30-day all-cause readmission rates in the 12-month period after implementation. (more…)
Author Interviews, Menopause, University of Pennsylvania / 03.10.2013

MedicalResearch.com Interview with: Katherine Newton, PhD Senior Investigator at Group Health Research Institute in Seattle MedicalResearch.com: What are the main findings of the study? Answer: We found that when women took a 12-week yoga class and practiced yoga at home, they had significantly less insomnia than did women who did not. This was the only statistically significant finding in this MsFLASH (Menopause Strategies: Finding Lasting Answers for Symptoms and Health) Network randomized controlled trial. We also found that being in the yoga class did not decrease the number of hot flashes or night sweats. Yoga  was linked to better sleep quality and less depression—but  these effects were not statistically significant. In separate papers, published slightly earlier, our MsFLASH group reported that a non-yoga exercise program seemed linked to slightly improved sleep and less insomnia and depression—but these effects were not statistically significant. And an omega-3 (fish oil) supplement was not linked to any improvement in hot flashes, night sweats, sleep, or mood.   (more…)
Author Interviews, Lung Cancer, University of Pennsylvania / 20.08.2013

Sandra Ryeom, PhD, Assistant professor of Cancer Biology, Perelman School of Medicine, University of Pennsylvania MedicalResearch.com Interview with: Sandra Ryeom, PhD, Assistant professor of Cancer Biology, Perelman School of Medicine, University of Pennsylvania MedicalResearch.com: What are the main findings of the study? Answer: We identified an important pathway (calcineurin-NFAT-Angiopoeitin2) in the vasculature of early metastatic lung lesions that is critical for promoting lung metastases. MedicalResearch.com: Were any of the findings unexpected? Answer: Since there is limited understanding of regulation of tumor angiogenesis at metastatic sites, identification of the calcineurin pathway and a newly identified target of calcineurin-NFAT signaling  was all unexpected. (more…)
Author Interviews, Biomarkers, Parkinson's, University of Pennsylvania / 13.08.2013

Alice Chen-Plotkin, MD Assistant Professor Department of Neurology University of Pennsylvania School of Medicine MedicalResearch.com: Interview with Alice Chen-Plotkin, MD Assistant Professor Department of Neurology University of Pennsylvania School of Medicine   MedicalResearch.com: What are the main findings of the study? Answer: Parkinson's disease (PD) is an incurable neurodegenerative disease.  Many neurons die, but the neurons that make dopamine (dopaminergic neurons) are particularly vulnerable.  We think that the disease actually starts well before the time when people show clinical symptoms.  We were therefore interested in finding proteins from the blood that correlated with better or worse dopaminergic neuron integrity.  Since it's hard to access the dopaminergic neurons directly, we looked at a tracer that labels the ends of the dopaminergic neurons in people who do not have Parkinson's disease but are at high risk for developing it, and we also looked at the age at onset of PD in people who are already symptomatic.  Screening just under 100 different proteins from the blood, we found that higher plasma levels of apolipoprotein A1 (ApoA1) were correlated with better tracer uptake in the people who did not yet have PD, and with older ages at onset in the people who already had PD.  These data suggest that plasma ApoA1 may be a marker for PD risk, with higher levels being relatively protective. (more…)
Author Interviews, Genetic Research, Kidney Disease, Nature, University of Pennsylvania / 12.08.2013

MedicalResearch.com Interview with: Dr. Wen-Ya Ko, Ph.D. Postdoctoral Fellow, First author of the paper Department of Genetics School of Medicine University of Pennsylvania 426 Clinical Research Building 415 Curie Boulevard Philadelphia, PA 19104-6145Dr. Wen-Ya Ko, Ph.D. Postdoctoral Fellow, First author of the paper Department of Genetics School of Medicine University of Pennsylvania 426 Clinical Research Building 415 Curie Boulevard Philadelphia, PA 19104-6145 Dr. Sarah Tishkoff, Ph.D., Senior author of the paper David and Lyn Silfen University Professor Departments of Genetics and Biology School of Medicine School of Arts and Sciences University of PennsylvaniaDr. Sarah Tishkoff, Ph.D., Senior author of the paper David and Lyn Silfen University Professor Departments of Genetics and Biology School of Medicine School of Arts and Sciences University of Pennsylvania MedicalResearch.com: What are the main findings of the study?

 Answer: In humans the APOL1 gene codes for Apolipoprotein L1, a major component of the trypanolytic factor in serum.  The APOL1 gene harbors two risk alleles (G1 and G2) associated with chronic kidney disease (CKD) among individuals of recent African ancestry. We studied APOL1 across genetically and geographically diverse ethnic groups in Africa. We have discovered a number of novel variants at the APOL1 functional domains that are required to lyse trypanosome parasites inside human blood vessels. We further identified signatures of natural selection influencing the pattern of variation on chromosomes carrying some of these variants. In particular, we have identified a haplotype (a cluster of genetic variants linked along a short region of a chromosome), termed G3, that has evolved adaptively in the Fulani population who have been practicing cattle herding which has been historically documented as early as in the medieval ages (but which could have begun thousands of years earlier).  Many of the novel variants discovered in this study are candidates to play a role conferring protection against trypanosomiasis and/or to play a role in susceptibility of CKD in humans. (more…)
Author Interviews, Gastrointestinal Disease, PNAS, University of Pennsylvania / 08.08.2013

MedicalResearch.com Interview with Frederic D. Bushman, Ph.D. Professor, Department of Microbiology Department of Microbiology Perelman School of Medicine University of Pennsylvania 426A Johnson Pavilion 3610 Hamilton Walk Philadelphia, PA 19104MedicalResearch.com Interview with Frederic D. Bushman, Ph.D. Professor, Department of Microbiology Department of Microbiology Perelman School of Medicine University of Pennsylvania 426A Johnson Pavilion 3610 Hamilton Walk Philadelphia, PA 19104   MedicalResearch.com: What are the main findings of the study? Dr. Bushman: Viral populations in the human gut are huge, and some of the viruses change rapidly over time. (more…)
General Medicine, JAMA, University of Pennsylvania / 08.08.2013

MedicalResearch.com Interview with Edna B. Foa, PhD Department of Psychiatry, University of Pennsylvania, Philadelphia MedicalResearch.com: What are the main findings of the study? Dr. Foa: Naltrexone was effective in decreasing the percentage of days drinking in people with alcohol dependence and posttraumatic stress disorder during active treatment.  Six months after treatment discontinuation, participants who received prolonged exposure therapy for PTSD drank less than those who did not receive prolonged exposure.  Participants who received a combined treatment of prolonged exposure and naltrexone had the lowest drinking level after six-month treatment discontinuation. The main message of the study is that simultaneous treatment of alcohol dependence and PTSD yield superior outcome than each treatment alone. Importantly, the findings indicated that prolonged exposure therapy was not associated with increased drinking or alcohol craving, a concern that has been voiced by some investigators. In fact, reduction in PTSD severity and drinking was evident for all four treatment groups. This finding contradicts that common view that trauma-focuses therapy is contraindicated for individuals with alcohol dependence and PTSD, because it may exacerbate PTSD symptoms and thereby lead to increased alcohol use. (more…)
Author Interviews, Cancer Research, Nature, University of Pennsylvania / 25.07.2013

MedicalResearch.com Interview with: Xiaolu Yang, Ph.D.MedicalResearch.com Interview with: Xiaolu Yang, Ph.D. Professor of Cancer Biology at the Perelman School of Medicine University of Pennsylvania and the Abramson Family Cancer Research Institute, MedicalResearch.com: What are the main findings of the study? Dr. Yang: TAp73 is a structural homologue of the preeminent tumor suppressor p53, but its role in tumorigenesis has been unclear. In this study, we show that TAp73 supports the proliferation of tumor cells. Mechanistically, TAp73 activates the expression of glucose-6-phosphate dehydrogenase (G6PD), a rate-limiting enzyme in the pentose phosphate pathway. This function of TAp73 is required for maintaining a robust biosynthesis and anti-oxidant defense in tumor cells. These finding connects TAp73 to oncogenic growth and suggest that G6PD may be a valuable target for tumor therapy. (more…)
Author Interviews, Mental Health Research, Sleep Disorders, University of Pennsylvania / 18.05.2013

MedicalResearch.com eInterview with: Linden Oliver, MA, Clinical Research Coordinator University of Pennsylvania Behavioral Sleep Medicine Research Program Philadelphia, Pa MedicalResearch.com: What are the main findings of the study? Answer: We found that less sleep is associated with greater suicide risk in those with insomnia. Specifically, we looked at suicide risk in people with insomnia, and also asked how much sleep they got in the past month. In those with some suicide risk, the likelihood of being high risk (versus low risk) decreased by 72% for every hour of sleep that person reported getting at night. (more…)
Author Interviews, Prostate Cancer, University of Pennsylvania / 28.03.2013

MEDICALRESEARCH.COM INTERVIEW WITH Charnita Zeigler-Johnson, Ph.D., M.P.H. Research Assistant Professor CCEB University of Pennsylvania MEDICALRESEARCH.COM: What are the main findings of the study? Dr. Zeigler-Johnson: The main findings of the study are:
  • Younger African-American men diagnosed with advanced prostate cancer at an early age (under the age of 60) are more likely to have had a personal history of early-onset baldness (baldness by age 30.)
  • For older patients, this is not necessarily the case, and future studies will need to focus on which factors place men in this age group at risk for prostate cancer. (more…)