Author Interviews, Depression / 05.03.2023

Editor's note: This piece discusses suicide. If you have experienced suicidal thoughts or have lost someone to suicide and want to seek help, you can contact the Crisis Text Line by texting "START" to 741-741 or call the Suicide Prevention Lifeline at 800-273-8255. MedicalResearch.com Interview with: Alexia Aguilar Geisinger Commonwealth School of Medicine Scranton, PA     MedicalResearch.com: What is the background for this study? Response: Traditional antidepressants like Zoloft and Lexapro have three major drawbacks.
  • First, they have a therapeutic lag and take at least a couple weeks to begin to improve mood.
  • Second, they do not work very well for many patients with only about one-third experiencing a remission.1
  • Third, they carry a Food and Drug Administration black box warning for increasing the risk of suicide in young-adults. There is tremendous enthusiasm for the anesthetic ketamine and esketamine because they overcome all three of these limitations. The brand name of esketamine is Spravato. Spravato received conditional approval from the FDA in March of 2019 as a nasal spray for treatment resistant depression or acute suicidality.  The goal of this study was to examine prescriptions for ketamine and esketamine in 2019 and 2020.

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Author Interviews, Gender Differences, JAMA, Surgical Research / 03.03.2023

MedicalResearch.com Interview with: Mario FL Gaudino, MD, PhD, MSCE, FEBCTS, FACC, FAHA Stephen and Suzanne Weiss Professor in Cardiothoracic Surgery (II) Assistant Dean for Clinical Trials Professor of Clinical Epidemiology and Health Services Research at Weill Cornell Graduate School Director of the Joint Clinical Trials Office (JCTO) Director of Translational and Clinical Research, Department of Cardiothoracic Surgery Chair Coronary Artery Task Force, European Association for Cardio-Thoracic Surgery Weill Cornell Medicine | NewYork – Presbyterian Hospital Department of Cardiothoracic Surgery MedicalResearch.com: What is the background for this study? Response: It is well-documented that women undergoing CABG have higher mortality and morbidity when compared with men. They are referred to surgery later than men, with more cardiovascular risk factors than men, and present more frequently with heart failure or in non-elective settings. However, overall CABG outcomes have improved over time, and so we sought to evaluate national trends in outcomes specifically in women. (more…)
Alzheimer's - Dementia / 03.03.2023

Dementia is a condition that affects many older adults aged 65 years and older but is increasingly being diagnosed in much younger people. It is a tragic disease as the personality of the sufferer changes, they struggle to identify close family members, and there is a profoundly sad loss of dignity as the disease progresses. Medical researchers are very active in undertaking experiments to find better ways of early diagnosis and treating patients more effectively. We look at the more recent research in this regard.

Improved Digital Markers

Scientists have found a new method to predict dementia before its onset or while it is still mild. This allows those who are positively identified to make lifestyle changes to stay healthy for longer and to begin preparing for special care when they can no longer look after themselves. The research tests comprised a study of driving behaviors. This was a longitudinal study. It had a 96% accuracy and considered 200 driving elements. Just under 3000 test subjects participated in the study, which took place in five US states. All the participants were still driving their own vehicles as a way of retaining their independence as they entered the older age stages of life, with everyone being between 65 and 79 years of age. Eighty-five percent of this age group were found to still be driving at this stage of life. None had signs of cognitive decline. Follow-up of the participants took place three years after the testing phase. Sixty-one participants had gone on to develop Alzheimer’s disease, some cognitive decline, or other types of dementia. The researchers compared their results against two other popular methods (logistic regression and random forests) of predicting dementia and found that their test had a 6-10% greater accuracy than the rest. Two aspects of driving that were especially useful for predicting future dementia were how many times drivers braked hard with 0.4 g or greater deceleration and the ratio of right and left turns. Regarding the latter, older people found it less risky to turn right rather than left. Early warning of possible dementia later in life is essential to preparing for increasing levels of care, from overnight, to 24/7. Check out this guide if you want to know more about what is overnight care. Many dementia patients with mild impairment may start with this form of assistance. A bit of help when needed can allow the person to store their energy for greater independence in intimate activities like bathing. (more…)
Author Interviews, Cost of Health Care, Heart Disease, JACC / 26.02.2023

MedicalResearch.com Interview with: Rishi K. Wadhera, MD, MPP, MPhil Section Head, Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research Associate Program Director Cardiovascular Medicine Fellowship at Beth Israel Deaconess Medical Center Assistant Professor of Medicine, Harvard Medical School @rkwadhera MedicalResearch.com: What is the background for this study? Response: High and rising prescription drug costs in the United States contribute to medication non-adherence and financial strain among adults with cardiovascular risk factors or disease. As a result, addressing prescription drug costs in patients with chronic conditions has become a national priority. In response to these growing concerns, federal policymakers passed the Inflation Reduction Act on August 16, 2022, which aims to address high out-of-pocket drug costs for adults enrolled in Medicare Part D, by placing a $2000 annual cap on out-of-pocket prescription drug costs and expanding eligibility for full low-income subsidies to individuals that reduce deductible costs and prescription copayments (among several other provisions). It is unclear how these provisions will affect Medicare beneficiaries with cardiovascular risk factors and/or conditions. (more…)
Author Interviews, Herpes Viruses, JAMA, STD, USPSTF / 23.02.2023

MedicalResearch.com Interview with: James Stevermer, M.D., M.S.P.H. Vice chair for clinical affairs Professor of family and community medicine University of Missouri Medical director of MU Health Care Family Medicine–Callaway Physicians, Dr. Stevermer joined the U.S. Preventive Service Task Force in January 2021.     MedicalResearch.com: What is the background for this study? Response: Genital herpes is a common sexually transmitted infection (STI) that unfortunately has no cure and cannot accurately be detected in people who do not have signs of the condition. The current screening tests have limitations and there is a high chance that test results will say a person has the condition when they do not. In addition, the available treatments are focused on managing symptoms and preventing the condition from reoccurring. As a result, the Task Force concluded that the harms of screening outweigh the benefits. (more…)
Author Interviews, Endocrinology, Environmental Risks / 23.02.2023

MedicalResearch.com Interview with: Jesse Goodrich PhD Assistant Professor Department of Population and Public Health Sciences Keck School of Medicine University of Southern California MedicalResearch.com: What is the background for this study? Response: Per- and poly-fluoroalkyl substances (PFAS) are a group of persistent chemicals that are known to interfere with hormones and metabolism. In our previous research, we have found that PFAS exposure is associated several specific diseases, especially in children and adolescents. These include obesity, type 2 diabetes, liver disease, and even liver cancer. However, we are still only just starting to fully understand all of the health effects of the many different PFAS in existence. Previous studies have focused primarily on one or two main PFAS. However, there are over 9,000 known PFAS, and people are exposed not just to a single PFAS but to mixtures of many PFAS. Importantly, the combination of these chemical exposures may affect us differently than single exposures alone. To address this challenge, we used an innovative approach to study design to examine how exposure to PFAS impacts biological processes which may underly the development of many different diseases in adolescents and young adults. To do this, we first measured thousands of naturally occurring chemicals, known as metabolites, in people's blood. Then, using a new biostatistical method developed by our team, we identified how exposure to a mixture of several PFAS impacted each individual chemical. Finally, we used this information to determine which biological processes are changed by PFAS exposure. (more…)
Alzheimer's - Dementia, Author Interviews, Genetic Research, Race/Ethnic Diversity, Stanford / 21.02.2023

MedicalResearch.com Interview with: Yann Le Guen, Ph.D. Assistant Director, Computational Biology Quantitative Sciences Unit Stanford Medicine MedicalResearch.com: What is the background for this study? Response: Apart from aging, the strongest contributing factor for late-onset Alzheimer’s disease is a specific allele of the APOE gene, which has three common alleles E2, E3, and E4. While E3 is the most common and considered as the reference, E2 is associated with decreased Alzheimer’s disease risk and E4 is associated with increased Alzheimer’s disease risk. Notably the prevalence of E4 among Alzheimer’s patient is high with about 60% of these carrying at least one E4 allele, while solely about 30% Americans carry one E4 allele. It’s worth emphasizing that individuals with an E4/E4 genotype have an exponential increased in their risk to develop AD (10 times as likely than the reference E3/E3 genotype), and individuals with an E3/E4 genotype have an intermediate risk. Though, most studies of Alzheimer’s disease genetic have been focused on European ancestry, this is beginning to change thanks to NIH’s efforts to fund more studies in non-European ancestry individuals. Our study built on these recent efforts to assess the Alzheimer disease risk associated with an APOE variant (R145C) present in about ~4% African Americans, but extremely rare in Europeans. (more…)
Author Interviews, Gender Differences, JAMA / 21.02.2023

MedicalResearch.com Interview with: Michael Liu, MPhil Rhodes Scholar,MPhil in Evidence-Based Social Intervention and Policy Evaluation. Harvard Medical School Boston, Massachusetts   MedicalResearch.com: What is the background for this study? Response: Over the past few decades, research has shown that lesbian, gay, and bisexual (LGB) individuals have worse health outcomes and face unique challenges related to their experiences and costs of care. These disparities are driven by “minority stress” associated with belonging to a marginalized group. Such stressors erode health through a range of structural and interpersonal forces, including employment discrimination, family rejection, and internalized stigma One early analysis established national baseline estimates for LGB health outcomes using 2013-2014 National Health Interview Survey (NHIS) data. Since then, there have been substantial shifts in social policy and public opinion that may have differentially affected sexual minority subgroups. The US Supreme Court decision in Obergefell v. Hodges guaranteed the constitutional right to same-sex marriage across all states. Over the last decade, states have expanded rights and protections for LGB populations related to employment and housing discrimination, sexual orientation conversion efforts, HIV criminalization, and religious exemptions. Public support for LGB-related issues has also been increasing with more representation in media, uptake of LGB-affirming policies, and advocacy efforts. No studies have assessed national trends in health status or healthcare access among specific sexual minority subgroups amid the rapidly shifting sociocultural and policy landscape. Thus, we sought out to evaluate if and how health status and healthcare access have changed between 2013 and 2018 in the US among LGB adults, and whether differences relative to their heterosexual counterparts have changed over time. (more…)
Author Interviews, Heart Disease, JACC, Kidney Disease, Transplantation / 21.02.2023

MedicalResearch.com Interview with: Shinobu Itagaki, MD, MSc Assistant Professor Cardiovascular Surgery Icahn School of Medicine at Mount Sinai, New York, NY MedicalResearch.com: What is the background for this study? Were the transplants from a single donor? Response: The heart transplantation is the gold standard therapy for end-stage heart failure patients. As the kidney is affected by the heart function, it is common that the heart transplant candidates have some degree of kidney dysfunction as well. In these cases, the candidates are considered for simultaneous heart and kidney transplantation from a same donor. Unlike isolated heart transplantation, where the indication and benefits have been well established, simultaneous heart and kidney transplantation has less clear indication and benefits. This uncertainty is also complicated by the competing interest with isolated kidney transplantation candidates who in general wait longer on the waiting list. (more…)
Author Interviews, Genetic Research, NIH, Pediatrics / 20.02.2023

MedicalResearch.com Interview with: Natalie Shaw, M.D., MMSc. Principal Investigator Head of the Pediatric Neuroendocrinology Group Dr. Shaw holds a secondary appointment in NIEHS Reproductive and Developmental Biology Laboratory.   MedicalResearch.com: What is the background for this study? Would you briefly describe the two affected conditions? Dr. Shaw: Congenital arhinia is a rare congenital malformation characterized by the complete absence of an external nose and internal olfactory (smell) structures.  It is frequently associated with eye and reproductive defects.  Facioscapulohumeral muscular dystrophy (FSHD) type 2 is a form of muscular dystrophy that presents in young adulthood.  Both conditions are caused by mutations in the gene SMCHD1.  In FSHD type 2, we know that loss of SMCHD1 activity leads to expression of a toxic protein called DUX4 in muscle.  The cause of arhinia was unknown. (more…)
Author Interviews, Genetic Research, Heart Disease, Technology / 17.03.2022

MedicalResearch.com Interview with: Ali Torkamani, Ph.D. Director of Genomics and Genome Informatics Scripps Research Translational Institute Professor, Integrative Structural and Computational Biology Scripps Research La Jolla, CA 92037 MedicalResearch.com:  What is the background for this study?  Response: Prior research has shown that people with higher polygenic risk for coronary artery disease achieve greater risk reduction with statin or other lipid lowering therapy. In general, adherence to standard guidelines for lipid lowering therapy is low - about 30% of people who should be on lipid lowering therapy are, with no correlation to their genetic risk. We set out to see whether communicating personalized risk, including polygenic risk, for coronary artery disease would drive the adoption of lipid lowering therapy. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Chocolate, Heart Disease, Supplements / 16.03.2022

MedicalResearch.com Interview with: Howard D. Sesso, ScD, MPH Associate Professor of Medicine Division of Preventive Medicine Brigham and Women's Hospital MedicalResearch.com:  What is the background for this study? How does the amount of flavanols in the study arm compare to what might be obtained in a typical diet? Response: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a randomized, double-blind, placebo-controlled clinical trial that tested the effects of two promising dietary supplements on cardiovascular disease (CVD) and cancer in 21,442 older adults. Cocoa flavanols have been shown to have favorable vascular effects in small and short-term clinical trials. The 500 mg/day flavanols tested in COSMOS exceeds that readily obtained in the diet typically from cocoa, tea, grapes, and berries. Of note, flavanol content in not typically listed on food labels. COSMOS also tested a multivitamin, the most common dietary supplement taken by US adults and previously linked with a potential modest reduction in cancer in a previous long-term trial of men conducted by our research group at the Division of Preventive Medicine at Brigham and Women’s Hospital. (more…)
Author Interviews, Education, JAMA, Race/Ethnic Diversity, Social Issues / 15.03.2022

MedicalResearch.com Interview with: Arman A. Shahriar Medical Student, University of Minnesota Medical School Research Consultant, HealthPartners Institute Minneapolis, MinnesotaArman A. Shahriar Medical Student, University of Minnesota Medical School Research Consultant, HealthPartners Institute Minneapolis, Minnesota

  MedicalResearch.com:  What is the background for this study?  Response: In recent years there has been a significant focus on the diversity of medical students, but to date, most work has focused on ‘visible’ forms of diversity; such as race, ethnicity and gender. (more…)
Aging, Author Interviews, Sleep Disorders / 15.03.2022

MedicalResearch.com Interview with: Rene Cortese, PhD Assistant Professor Department of Child Health – Child Health Research Institute Department of Obstetrics, Gynecology and Women’s Health School of Medicine Core Faculty - MU Institute for Data Science and Informatics University of Missouri Columbia, MO 65212 MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Obstructive sleep apnea (OSA) affects 22 million people in the U.S. and is linked to a higher risk of hypertension, heart attacks, stroke, diabetes, and many other chronic conditions. We have found that untreated OSA also accelerates the biological aging process, and that appropriate treatment can slow or possibly reverse the trend. Age acceleration testing involves a blood test that analyzes DNA and uses an algorithm to measure a person’s biological age. The phenomenon of a person’s biological age surpassing their chronological age is called “epigenetic age acceleration” and is linked to overall mortality and to chronic diseases. (more…)
Author Interviews, Fertility, OBGYNE / 15.03.2022

MedicalResearch.com Interview with: Dr. Lora Shahine MD FACOG Host of the fertility podcast Baby or Bust https://www.lorashahine.com/ Dr. Shahine is double board-certified in reproductive endocrinology and infertility as well as obstetrics and gynecology Clinical assistant professor at the University of Washington Pacific NorthWest Fertility MedicalResearch.com: How did you become interested in reproductive medicine? Response: I love the combination of technology, women’s health, and helping people during a vulnerable time with all the emotions that come with it. I knew becoming a reproductive endocrinologist would mean a career of learning and helping people build families. MedicalResearch.com: When should women consider freezing their eggs?   Response: There is no one perfect age. The younger someone freezes eggs (in their 20s), the higher quality the eggs will be and the higher success in the future but the more likely someone may not need the. The older someone freezes eggs (in their late 30s and 40s), the lower quality and the lower chance of success over time. For many people and in general - the research supports its most cost effect to freeze eggs in your mid 30s. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Kidney Disease / 15.03.2022

MedicalResearch.com Interview with: Susan P. Y. Wong, MD MS Assistant Professor Division of Nephrology University of Washington VA Puget Sound Health Care System  MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Very little is known about the care and outcomes of patients who reach the end stages of kidney disease and do not pursue dialysis. We conducted a systematic review of longitudinal studies on patients with advanced kidney disease who forgo dialysis to determine their long-term outcomes. We found that many patients survived several years and experienced sustained quality of life until late in the illness course. However, use of acute care services was common and there was a high degree of variability in access to supportive care services near the end of life. (more…)
Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, NIH / 12.03.2022

MedicalResearch.com Interview with: Lenore J. Launer, Ph.D. Chief, Laboratory of Epidemiology and Population Sciences Intramural Research Program, National Institute on Aging. MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Identifying early risk factors and early changes in the brain will have a major impact on future clinical and public health priorities related to the looming epidemic of dementia. Several studies based on older populations suggest mid-life is an important period to start prevention measures. To date control of blood pressure levels has been the most robust and promising candidate to target for prevention of future cognitive impairment. Although several studies have looked at levels of blood pressure and risk for cognitive impairment, it was not known whether trajectories from young adulthood to middle age studies provided additional information about risk. To investigate possible biomarkers of future risk, we chose to examine the association of the mean arterial blood pressure trajectories to indicators of pathology seen on MRI and that are associated with cognition. We highlight the results of the mean arterial blood pressure (MAP) measure, which is an integrated measure of systolic and diastolic blood pressure. (more…)
Author Interviews, Endocrinology, Nutrition, Testosterone, Weight Research / 11.03.2022

MedicalResearch.com Interview with: Joe Whittaker, MSc Nutritionist MedicalResearch.com:  What is the background for this study?  Response: There are several studies showing a generational decline in men's testosterone levels, beginning in the 1970s. This is due to a variety of factors such as poorer diets, lack of physical activity, and increasing toxin exposure. Therefore, there is intense research interest in ways we can optimise testosterone levels, to combat this generational decline. Some well-known studies have found low-carbohydrate diets boost testosterone levels, but others have show the reverse effect. So, to settle the controversy we gathered and reanalysed all known studies on the topic. There was also the question of high protein diets and their effects on testosterone, which are currently disputed. (more…)
Author Interviews, Dental Research, NYU, Tobacco, Tobacco Research / 10.03.2022

MedicalResearch.com Interview with: Scott Thomas, PhD Assistant Research Scientist, Department of Molecular Pathobiology and Fangxi Xu, Junior Research Scientist & Clinical Research Coordinator Department of Molecular Pathobiology NYU College of Dentistry  MedicalResearch.com:  What is the background for this study?  What are the main findings?  vaping-e-cig-smoking-tobaccoResponse: Cigarette smoking is one of the well-established causes of periodontitis, but the effect of using electronic cigarettes (e-cig), especially its long-term impact on periodontal health, is not yet clearly understood. Considering the increased popularity of e-cig use, especially among teenagers and young adults, and the known effect of high nicotine concentration in e-cigarette products, we conducted this clinical research to see if there were differences in periodontal health between e-cig users, traditional smokers, and nonsmokers. The study consisted of two visits, 6 months apart, where measures of oral and periodontal health were obtained. Our data showed significantly greater clinical attachment loss in the e-cigarette users and cigarette smokers than in the non-smokers at both study visits. In only e-cigarette users, we observed an over 0.2 mm average increase in the clinical attachment loss after 6 months.  (more…)
Author Interviews, Biomarkers, BMJ, Gastrointestinal Disease, Pancreatic / 09.03.2022

MedicalResearch.com Interview with: Ece Kartal, PhD Postdoctoral Fellow Saez-Rodriguez Group Universitätsklinikum Heidelberg Institute for Computational Biomedicine Heidelberg MedicalResearch.com:  What is the background for this study?    Response: Pancreatic cancer is one of the deadliest types of cancer: although incidence rates are relatively low (only few people develop pancreatic cancer in their lifetimes), it has a high lethality, with a five year survival rate of less than ~5%. Pancreatic cancer symptoms are generally unspecific so that the disease is usually detected very late which further  limits therapeutic options. In light of this, earlier detection of pancreatic cancer could dramatically improve prognosis, but there are currently no affordable and non-invasive tests available in the clinic. For pancreatic ductal adenocarcinoma (PDAC),the most common form of pancreatic cancer, it was previously found that the oral, gut and pancreatic microbiome are risk factors and may affect prognosis . (more…)
Nursing / 08.03.2022

There is a massive nursing shortage being faced by countries all around the world. The ever-increasing population means more resources and professionals in the healthcare sector are needed. Though healthcare as a whole suffers from massive shortages, the shortage is felt most keenly within nursing. Nurses make up for half the global healthcare workforce. Globally it is estimated that there will be a shortage of between 7 million and 13 million. A global shortage indicates a global issue. Many professionals believe that to offset this shortage, and finally make headway with improving healthcare as a whole, a global solution is necessary.

The Nursing Shortage and Its Complications

Globally it is estimated that by 2030 there will be a shortage of 7 million to 13 million nurses. This includes the current shortage of 6 million nurses we are currently facing around the world. Many experts believe a global solution is essential when the issue spans across borders. Though the issue is a global one, the current method that many developed countries are using is no longer working. In the past, the solution was simply to hire nurses from abroad to work here. On average, it is estimated that 16% of nurses are foreign-born. The nursing shortage is nothing new. There has been a shortage of nurses in the United States since the 1930s. Immigration requirements have eased and encouraged international nurses to move to the United States to work there since the 1950s. While immigration itself is not a problem, looking only for solutions outside of home soil does cause international issues. Hiring talented healthcare workers from other countries often leaves the healthcare situation in their home country in a worse situation. Jamaica, for example, has lost 29% of its critical care nurses to migration. Hiring from other countries is not a long-term solution. Nor is it a solution that works on a global scale. Improving working conditions, education conditions, and the work/life balance of nurses is a must. There is a pervasive view that nurses are overworked and underpaid. Addressing the cause of this view, and the view itself, can help transition nursing from a vocation to a vied-for career. One of the most critical issues that exacerbate the nursing shortage is the fast turnaround of nurses. Thomas Jordan, an American Hospital Association spokesperson, claims that up to 33% of new nurses will leave the workforce within two years. (more…)
AHA Journals, Blood Pressure - Hypertension, Dental Research, Menopause / 07.03.2022

MedicalResearch.com Interview with: Michael J. LaMonte, PhD, MPH Research Professor (epidemiology) Department of Epidemiology and Environmental Health School of Public Health and Health Professions Women’s Health Initiative Northeast Regional Center University at Buffalo – SUNY Buffalo, NY 14214 MedicalResearch.com:  What is the background for this study?  What are the main findings? Dr. LaMonte:  The rationale for this study was based on existing study results showing
  • (1) oral bacteria are involved with conversion of dietary nitrate (e.g., from leafy greens and beets) to nitric oxide which is a chemical involved keeping arteries healthy and maintaining blood pressure;
  • (2) rinsing the mouth with antiseptic solution (mouthwash) kills oral bacteria and results in rapid increases in systolic and diastolic blood pressure; and
  • (3) a very limited amount of epidemiological data suggest that the oral bacteria found beneath the gums (responsible for gingivitis and periodontal disease) are associated with blood pressure and history of hypertension in middle-aged adults.
Thus, we conducted our study to determine whether oral bacteria (beneath the gums) would be predictive of developing hypertension among women who were without this condition at the time the bacteria were measured. Because the bacteria (exposure) would be known to precede development of hypertension (disease), an association seen in our study would be strongly suggestive of a role for oral bacteria in the development of high blood pressure. Our primary result was for statistically significant higher risks of developing hypertension associated with 10 bacterial species, and significantly lower risks of developing hypertension associated with 5 bacterial species. Our findings were evident even after we accounted for differences in demographic factors, lifestyle factors, and clinical factors, and generally were of consistent magnitudes we examined across subgroups of older and younger women, white and black women, normal weight and overweight/obese women, those with normal or slightly elevated blood pressure at study enrollment, and those who were using or not using menopausal hormone therapy at baseline. Therefore, while our observational study evidence for an association is not equivalent to causation, the robustness of the associations between oral bacteria and hypertension risk supports a need to further understand this relationship, ideally with a clinical trial design that would provide definitive evidence to support or refute causation.  (more…)
Author Interviews, Environmental Risks, Pediatrics, Toxin Research / 07.03.2022

MedicalResearch.com Interview with: Jeanette Stingone PhD Assistant Professor, Epidemiology Mailman School of Public Health Columbia University MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Lead is a well-established neurotoxin, particularly when exposure occurs early in life and in childhood. Associations between elevated blood lead levels and lower scores on tests of neurodevelopment and cognition are seen consistently across studies, even when examining lower levels of exposure. While reducing exposure to lead is the primary intervention to prevent these adverse outcomes, there aren’t many interventions designed to support the neurodevelopment of children who have been exposed to lead. Some municipalities consider elevated blood lead levels as a criteria for inclusion in Early Intervention programs. Early Intervention programs are mandated under the Individuals with Disabilities Education Act and provide services for children younger than 3 years old with disabilities or developmental delays. The objective of this study was to compare 3rd grade standardized test scores among children who had elevated blood lead levels early in life to see if children who had received Early Intervention services performed better on these tests than those who did not receive services. Using matching methods and an existing administrative data linkage of children who were born and attended public school in New York City, we observed that children exposed to lead who received Early Intervention services scored higher on standardized tests in both math and English Language arts than children exposed to lead who did not receive services.  (more…)
Author Interviews, Exercise - Fitness, Heart Disease, JNCI / 03.03.2022

MedicalResearch.com Interview with: Fiona Bartoli PhD Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds  MedicalResearch.com:  What is the background for this study?  Response: Physical activity improves our health and reduces the risk of developing cardiovascular disease, diabetes, depression or even cancer. However, sedentary lifestyles are increasing, and people fail to exercise enough, for reasons such as illnesses, injuries, or computer usage. This puts people at more risk of disease. During physical exercise, the heart beats faster so more blood is pumped through the body. The very large protein called Piezo1 is found in the lining of blood vessels and acts as an “exercise sensor” by detecting the change in blood flow during exercise and acting accordingly. (more…)
Author Interviews, Biomarkers, Heart Disease, NEJM / 03.03.2022

MedicalResearch.com Interview with: PJ Devereaux MD PhD Professor of Medicine, and of Health Research Methods, Evidence and Impact McMaster University President of the Society of Perioperative Research and Care  MedicalResearch.com:  What is the background for this study?  Response: More than 1 million patients undergo cardiac surgery in the United States and Europe annually. Although cardiac surgery has the potential to improve and prolong a patient’s quality and duration of life, it is associated with complications. Prognostically important heart injury – detected by an elevated blood concentration of either cardiac troponin or creatine kinase myocardial MB isoform (CK-MB) – is one of the most common complications after cardiac surgery and is associated with increased mortality. Although elevated CK-MB was historically used to define heart injury after cardiac surgery, this assay is no longer available in many hospitals worldwide, and consensus statements have recommended high-sensitivity cardiac troponin assays as the preferred biomarker. Based on expert opinion, the Fourth Universal Definition of Myocardial Infarction suggested that a cardiac troponin concentration >10 times the upper reference limit, in patients with a normal baseline measurement, should be the threshold used in the diagnosis of heart attack along with evidence of ischemia (e.g., ischemic ST changes on an ECG) in the first 48 hours after coronary artery bypass grafting (CABG). Although the Academic Research Consortium-2 Consensus stated there was no evidence-based threshold for cardiac troponin after CABG, they endorsed a threshold for the diagnosis of heart attack of ≥35 times the upper reference limit together with new evidence of ischemia, based on expert opinion. They also defined a threshold of ≥70 times the upper reference limit as a stand-alone criterion for clinically important periprocedural myocardial injury. Globally, many hospitals now use high-sensitivity cardiac troponin assays; however, limited data are available to define a prognostically important degree of myocardial injury after cardiac surgery based on these assays. We undertook the Vascular Events in Surgery Patients Cohort Evaluation (VISION) Cardiac Surgery Study to examine clinical outcomes after cardiac surgery. A primary objective was to determine the relationship between postoperative levels of high-sensitivity cardiac troponin I and the risk of death 30 days after cardiac surgery.  (more…)
Anesthesiology, Author Interviews, Columbia, JAMA, OBGYNE / 28.02.2022

MedicalResearch.com Interview with: Jean Guglielminotti MD,PhD Assistant Professor of Anesthesiology Columbia University Irving Medical Center New York 10032  MedicalResearch.com:  What is the background for this study?  Response: An old study (2004-2006) conducted in France suggested that epidural analgesia during childbirth resulted in a decreased risk of postpartum hemorrhage, the first cause of preventable maternal morbidity and mortality. We believed it was important to replicate this study in the United States, because of the advances in obstetric and anesthesia care practices during the last 15 years, and because of the marked differences in the health care systems between the United States and France. (more…)
Allergies, Author Interviews / 26.02.2022

MedicalResearch.com Interview with: Edmond S. Chan MD, FRCPC, FCSACI, FAAAAI Head | Division of Allergy & Immunology | Department of Pediatrics, Faculty of Medicine Clinical Professor, The University of British Columbia Clinical Investigator, BC Children's Hospital Research Institute BC Children's Hospital, Allergy Clinic Vancouver, BC  Canada Treasurer, CSACI (Canadian Society of Allergy & Clinical Immunology) MedicalResearch.com:  What prompted you to look at the safety of peanut oral immunotherapy specifically in this patient population? Response: Our previous research has investigated the overall safety of peanut oral immunotherapy (OIT) in preschool populations. However, we have not investigated the relationship between specific patient characteristics and the safety of OIT. Previous literature has shown that patient factors, such as age, gender, baseline sIgE levels, and atopic comorbidities have been shown to impact the safety of OIT for other food allergies and in older patients. However, no data exist on which factors predict safety of peanut OIT in preschool populations. (more…)
Author Interviews, Dermatology, Diabetes / 22.02.2022

MedicalResearch.com Interview with: Chih-Shan Jason Chen, MD, PhD Director, Dermatologic and Mohs Micrographic Surgery Unit Memorial Sloan Kettering Skin Cancer Center at Hauppauge Attending Mohs Surgeon, Dermatology Service Memorial Sloan Kettering Cancer Center Chief, Dermatologic Surgery Northport VA Medical Center Associate Professor of Clinical Dermatology Renaissance School of Medicine at Stony Brook University MedicalResearch.com:  What is the background for this study?    Response: Managing a surgical wound on the lower leg can be a challenge. Often, higher wound tension, atrophic skin, edema, and compromised circulation result in higher risks of wound dehiscence and infection, and significantly limit the capacity of wound closure post-surgically. Therefore, healing by secondary intention is a practical option for many lower leg Mohs defects. However, a secondary intention wound on the lower leg is expected to take a longer time to heal. Certain factors such as older age and health conditions of the host may adversely affect healing time. Timolol is a nonselective beta-adrenergic receptor antagonist that has FDA approval for the treatment of glaucoma. In addition to this FDA-approved indication, topical timolol has several off-label uses in dermatology, such as for the treatment of infantile hemangiomas, venous stasis ulcers, and refractory wounds. Although timolol solution has been used in chronic wounds, knowledges of the efficacy and utility of timolol in an acute post-surgical wound setting is lacking. (more…)