About Marie Benz MD FAAD

Physician in practice over 30 years. Editor of MedicalResearch.com. All interviews conducted exclusively for MedicalResearch.com by Marie Benz, MD.

Illicit Drug Use Spikes During Special Events

MedicalResearch.com Interview with:
Bikram Subedi, PhD Assistant Professor of Analytical Chemistry Murray State University, Murray KYBikram Subedi, PhD

Assistant Professor of Analytical Chemistry
Murray State University, Murray KY

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The USA is one of the major consumers of diverse neuropsychiatric and illegal drugs, and recently declared a national public health emergency on opioid abuse. Law enforcement typically utilized conventional methods of determining drug consumption rate which are based on survey questionnaire, hospital admissions, drug-related crime statistics, and self-reported information. Conventional methods typically underestimate the actual consumption rate of drugs.

Our new approach of determining consumption rates of drugs in community is time and cost effecting and comprehensive. Based on levels of drugs quantified from raw sewage, the per capita consumption rates of several illicit drugs including methamphetamine, amphetamine, cocaine, and THC in two communities of Western Kentucky (similar population and only ~50 miles apart) were significantly different. During special events such as July 4th and 2017 solar eclipse, the consumption rates were found even higher. The consumption rate of methamphetamine was among one of the highest ever reported in the country.  Continue reading

Cardiovascular Risk Factors Also Linked to Dementia

MedicalResearch.com Interview with:

Cécilia Samieri, PhD Université de Bordeaux, INSERM Bordeaux Population Health Research Center Bordeaux, France

Dr. Samieri

Cécilia Samieri, PhD
Université de Bordeaux, INSERM
Bordeaux Population Health Research Center
Bordeaux, France

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous research has demonstrated that heart diseases and brain diseases share common risk factors. Favorable health factors (optimal levels of BMI, blood pressure, blood glucose and cholesterol) and behaviors (non smoking, physical activity and diet at optimal levels), which are known to protect the heart, have also been associated with a lower risk of age-related brain diseases (eg, dementia) and lower rate of cognitive decline in some epidemiological studies. However, studies have been controversial and importantly, very limited research has considered risk factors simultaneously. This may be an explanation for the lack of established consensus for recommendations aimed at dementia prevention.

This study adds to previous knowledge by evaluating cardiovascular health factors and behaviors simultaneously in relation to cognitive decline and the risk of dementia in older age. We used the American Heart Association 7-item tool to promote primordial prevention, which aims to prevent the developement of risk factors in a first place as a prevention strategy against cardiovascular diseases.

We found that each additional favorable health factor/behavior was associated with a 10% lower risk to develop dementia in the following decade.

These findings support the promotion if cardiovascular health to prevent the development of risk factors associated with dementia.  

MedicalResearch.com: What should readers take away from your report?

Response: When considering cardiovascular health, each additional improvement of the level of one or several health factors/behaviors is associated with a lower risk opf dementia and less cognitive decline.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Evaluate the change in risk factors over time as well was possible differential weighting of the factors in relation to dementia risk. 

Citation:

Samieri C, Perier M, Gaye B, et al. Association of Cardiovascular Health Level in Older Age With Cognitive Decline and Incident Dementia. JAMA. 2018;320(7):657–664. doi:10.1001/jama.2018.11499

Aug 21, 2018 @ 5:49 pm 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Breast and Ovarian Cancers: More Genes Than BRCA1 and BRCA2

MedicalResearch.com Interview with:
Ambry GeneticsShuwei Li, PhD
Principal Statistical Geneticist
Ambry Genetics

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Breast cancer is the most commonly diagnosed cancer, while ovarian cancer is the fifth leading cause of death due to cancer, in US women. Since the discovery of BRCA1 and BRCA2, multiple genes have been reported as risk factors; however, it is still unclear whether the known findings represent the complete genetic landscape of breast and ovarian cancers.

Our team performed exome sequencing on more than 10,000 breast and/or ovarian cancer patients and nearly 4,000 controls. We observed increased risk of breast cancer associated with PALB2, ATM, CHEK2 and MSH6 genes, and increased risk of ovarian cancer associated with MSH6, RAD51C, TP53 and ATM genes.   Continue reading

Maybe Spinal Repair Cells Can Be Turned On and Off

MedicalResearch.com Interview with:

Pier Lorenzo Puri, M.D PhD Professor in the Development, Aging and Regeneration Program Sanford Burnham Prebys Medical Discovery Institute 

Dr. Puri

Pier Lorenzo Puri, M.D PhD
Professor in the Development, Aging and Regeneration Program
Sanford Burnham Prebys Medical Discovery Institute 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: My lab has been studying special repair cells called fibro-adipogenic progenitors (FAPs) and how these cells change in models of motor neuron diseases. These cells usually repair muscles after acute injury. But we are finding the FAPs change dramatically in disease settings.

In this study we looked at these cells in models of spinal cord injury, ALS and spinal muscular atrophy, including muscle tissue from ALS patients. We found that FAPs change radically in several ways.

Most importantly, the cells used a different signaling pathway, IL-6-STAT3, and when we blocked this signaling muscle atrophy and fibrosis halted. While further studies in humans are needed, this is a promising finding as FDA-approved medicines that block IL-6 and STAT3 are available.  Continue reading

Despite Sunshine Act, Conflicts of Interest in Medical Research Still Not Transparent

MedicalResearch.com Interview with:

Mehraneh Dorna Jafari, MD Assistant Professor Associate Program Director Colon and Rectal Surgery UC Irvine Health

Dr. Jafari

Mehraneh Dorna Jafari, MD
Assistant Professor
Associate Program Director
Colon and Rectal Surgery
UC Irvine Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Financial ties between medical and surgical device companies and clinicians are very common. It has been shown that up to 94% of physicians in the United States receive a form of benefit from an external company. When we evaluate published works, it is important to assess the integrity and academic credentials of the authors.

In 2013, the Centers for Medicare and Medicaid Services established the Open Payments Database to house industrial payments’ information and increase transparency into the reporting of payments.

In our study, we found that in only 37% of their relevant 2016 publications were the Conflict of Interests declared by the authors.

Continue reading

40% of High School Drivers Text While Driving

MedicalResearch.com Interview with:,
Motao Zhu, MD, MS, PhD Principal Investigator Center for Injury Research and Policy The Research Institute at Nationwide Children’s Hospital​ Columbus, OHMotao Zhu, MD, MS, PhD
Principal Investigator
Center for Injury Research and Policy
The Research Institute at Nationwide Children’s Hospital​
Columbus, OH

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We know that texting while driving occurs frequently among teen drivers. This study looks at the differences of texting while driving among teens between states. 

Motor vehicle crashes continue to be the leading cause of death among teenagers in the United States. In 2016, over 2,000 teens in the US aged 14-18 years died in motor vehicle crashes and nearly 260,000 were seriously injured in traffic-related incidents. Teen motor vehicle crashes are preventable, and proven strategies can improve the safety of young drivers on the road. Among distracted driving, texting while driving may be especially risky because it involves at least three types of driver distraction: visual, physical, and cognitive. Texting while driving is banned for all drivers in 47 states and the District of Columbia, yet this study shows it still occurs regularly among teen drivers.

Overall (nationally), about 40% of high school student drivers text while driving at least once/month. The rate varies among states. The lowest is 26% (Maryland) and highest is 64% (South Dakota). Texting while driving among high school student drivers is highest in Montana, Wyoming, North Dakota, South Dakota, and Nebraska.

These results were not surprising. There are state level factors to explain them. The top 5 highest texting while driving among high school student drivers (Montana, Wyoming, North Dakota, South Dakota, and Nebraska) are rural states with a high percent of high school student drivers and students can get their learners permit by age 15. Continue reading

Understanding How Energy Drinks Plus Alcohol May Increase Risky Behavior

MedicalResearch.com Interview with:
“Energy drink” by joelklal is licensed under CC BY 2.0Barbara D. Fontana

Laboratory of Experimental Neuropsychobiology,
Department of Biochemistry and Molecular Biology
Natural and Exact Sciences Center
Graduate Program in Biological Sciences
Toxicological Biochemistry, Federal University of Santa Maria,
Santa Maria, Brazil 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Our research group has been working with taurine and alcohol association for a long time. The background for this study is around increased consumption of molecules present in energy drinks frequently used as mixers for alcoholic beverages. Taurine is one of the most abundant molecules found in energetic drinks and has a neuromodulatory role in brain. In this context, we explore the effects of taurine associated to alcohol. Thus, as result we observed that this association exacerbate risky choices and reduces social cohesion in zebrafish, having a negative impact in social and fear-related behavior.

Continue reading

Pregabalin Linked To Increased Risk for Opioid-Related Deaths

MedicalResearch.com Interview with:

Tara Gomes, MHSc Li Ka Shing Knowledge Institute, St Michael’s Hospital, The Institute for Clinical Evaluative Sciences Leslie Dan Faculty of Pharmacy Department of Health Policy, Management, and Evaluation University of Toronto, Toronto, Ontario, Canada

Tara Gomes

Tara Gomes, MHSc
Li Ka Shing Knowledge Institute, St Michael’s Hospital,
The Institute for Clinical Evaluative Sciences
Leslie Dan Faculty of Pharmacy
Department of Health Policy, Management, and Evaluation
University of Toronto, Toronto, Ontario, Canada 

MedicalResearch.com: What is the background for this study?

Response: Pregabalin is a medication increasingly being prescribed to manage pain, however there is emerging evidence that this drug may increase one’s risk of opioid overdose when prescribed with opioids.

Continue reading

Digitization of Pathology Specimens Allows for Improved Workflow and Incorporation of Advanced Techniques

MedicalResearch.com Interview with:|
Dr. Wendy L. Frankel, MD. Kurtz Chair and Distinguished Professor and
Dr. Anil Parwani, MD, PhD, MBA, Associate Professor
Wexner Medical Center
The Ohio State University

MedicalResearch.com: What is the background for this work? How does digital pathology differ from traditional H/E specimens?  Is there is different processing method?  Difference in prep time or costs?

Response: Traditional pathology involves patient tissue coming to the lab and being processed. The end result is a glass slide with a stained tissue that pathologists use under a microscope. The process in digital pathology is the same, up until the point right after when the glass slide is made. In digital pathology, we put the glass slide under a scanner instead of under a microscope. The scanner creates a large file image that can be reviewed remotely by pathologists around the world.

The advantage of digital pathology, and the reason we are doing this at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James), is because when the slide is digitized, the image can be rapidly shared with an expert for review, or another institute that the patient may be going to. In addition, I can look at the image and ask the computer to quantitate different types of features that are present in the sample. While this has historically been done manually with a microscope, it’s been a more subjective process that is open to human error.

On top of that, we now have computer programs that allow us to ask very specific questions about the sample. For example, we can ask how many nuclei are in the field, how many of the nuclei show signs of cancer, and the size and color of the nucleus. These programs make the whole diagnostic process more objective and standardized. This is something we just can’t do by looking at a glass slide under a microscope.

Finally, you can also use these images for presentations at clinical conferences or for teaching residents, fellows or other pathologists. You now have the means to create an archive of patient slides and have it instantaneously available.

Continue reading

Complex Racial and Ethnic Disparities in Childhood Cancer Survival

MedicalResearch.com Interview with:
Rebecca D. Kehm, PhD
Division of Epidemiology and Community Health
University of Minnesota School of Public Health
Minneapolis, MN  

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Racial and ethnic differences in childhood cancer survival have long been known, and there has been some research indicating that SES could explain disparities. However, our study is the first to use statistical methods that put numbers to the relative contribution of SES to survival disparities for different types of childhood cancer. We set out to investigate whether racial and ethnic disparities in childhood cancer survival are attributed to underlying differences in socioeconomic status, defined as one’s social and economic position in relation to others based on income, education, and occupation, which scientists abbreviate as SES. Our findings provide evidence that SES does in fact contribute to racial and ethnic disparities in survival for some types of childhood cancer. Specifically, we found that SES accounted for 28-73% of the racial and ethnic survival disparity for acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and non-Hodgkin lymphoma. However, SES did not significantly contribute to racial and ethnic disparities in survival for other types of childhood cancer including central nervous system tumors, soft tissue sarcomas, Hodgkin lymphoma, Wilms tumor, and germ cell tumors. These tumor-specific results help inform where to place resources to best reduce racial and ethnic survival disparities for each of the major types of childhood cancer.

Continue reading

Clinical Chemistry Score Helps Rule Out Diagnosis of Heart Attack

MedicalResearch.com Interview with:

Peter Kavsak, PhD, FCACB, FAACC, FCCS Professor, Pathology and Molecular Medicine McMaster University 

Prof.. Kavsak

Peter Kavsak, PhD, FCACB, FAACC, FCCS
Professor, Pathology and Molecular Medicine
McMaster University 

MedicalResearch.com: What is the background for this study?

Response: For patients who present to the hospital with symptoms suggestive of acute coronary syndrome (ACS) the preferred blood test to help physicians in making a diagnosis is cardiac troponin.

Recent studies have demonstrated that a very low or undetectable cardiac troponin level when measured with the newest generation of blood tests (i.e., the high-sensitivity cardiac troponin tests) in this population may rule-out myocardial infarction (MI or a heart attack) on the initial blood sample collected in the emergency department, thus enabling a faster decision and foregoing the need for subsequent serial measurements of cardiac troponin over several hours as recommended by the guidelines. The problem with this approach, however, is that using high-sensitivity cardiac troponin alone to do this has not reliably been demonstrated to achieve a sensitivity >99% for detecting MI, which is the estimate that most physicians in this setting consider as safe for discharge.

Our study goal was to compare the diagnostic performance of a simple laboratory algorithm using common blood tests (i.e., a clinical chemistry score (CCS) consisting of glucose, estimated glomerular filtration rate (eGFR), and either high-sensitivity cardiac troponin I or T) to high-sensitivity cardiac troponin alone for predicting MI or death within the first month following the initial blood work. Continue reading

FDA Approves Poteligeo® (mogamulizumab-kpkc) for T-Cell Lymphoma of the Skin

MedicalResearch.com Interview with:

Jeffrey S. Humphrey, MD President of Kyowa Kirin Pharmaceutical Development, Inc

Dr. Humphrey

Jeffrey S. Humphrey, MD
President of Kyowa Kirin Pharmaceutical Development, Inc

MedicalResearch.com: What is the background for this announcement? Would you briefly explain what is meant by Mycosis Fungoides and Sézary Syndrome?

Response: Kyowya Kirin has received FDA approval for Poteligeo (mogamulizumab), based on findings from the MAVORIC trial. Mogamulizumab is a humanized immunoglobulin G1 (IgG1) monoclonal antibody (mAb) that targets CC chemokine receptor 4 (CCR4), for the treatment of the most common subtypes of cutaneous T-cell lymphoma (CTCL), mycosis fungoides (MF) and Sézary syndrome (SS).

MF and SS may have a profound and severe impact on quality of life, including a patient’s functional, emotional and social well-being, as symptoms may include a scaly red rash or light or dark patches in areas of the body that are not usually exposed to the sun; thin, reddened, eczema-like rash; thickened scaly, red skin (or plaques) or psoriasis-like rash; more advanced disease can include tumors (with significant thickness) on the skin, which may develop ulcers and become infected. Because CTCL manifests in skin lesions, it is often mistaken for other skin conditions (early stage MF and SS can be diagnosed as other skin conditions), which can delay conclusive diagnosis and treatment options.

MF is the most common subtype of CTCL, affecting 50-70% of individuals. In most patients diagnosed with early stage MF, the skin involvement does not progress, but in some patients, it will slowly progress. SS accounts for approximately 3% of CTCL cases and is a more aggressive, leukemic form of CTCL, affecting the blood, skin, lymph nodes and visceral organs

Continue reading

Kidney Cancer: Biomarker Linked to Detection and Progression

MedicalResearch.com Interview with:

Dr. David Muller, PhD  Faculty of Medicine, School of Public Health Research Fellow in Epidemiology and Biostatistics Imperial College London

Dr. Muller

Dr. David C. Muller PhD
Faculty of Medicine, School of Public Health
Research Fellow in Epidemiology and Biostatistics
Imperial College, London

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our colleagues in the U.S. have been working on KIM-1 for years, particularly in the context of chronic kidney disease. Recently they found that KIM-1 is also elevated at the time of diagnosis of kidney cancer.

We wanted to see if KIM-1 concentrations could predict the chances of a future diagnosis of kidney cancer. We found that KIM-1 was a strong predictor of being diagnosis with kidney cancer in the next 5 years. We also found that higher pre-diagnostic KIM-1 was associated with worse survival after diagnosis.  Continue reading

Ethnic and Racial Disparities in Medicare Annual Wellness Visit Utilization

MedicalResearch.com Interview with:

Kim Lind, PhD, MPH Research Fellow Centre for Health Systems and Safety Research Australian Institute of Health Innovation Macquarie University, NSW 

Dr. Lind

Kim Lind, PhD, MPH
Research Fellow
Centre for Health Systems and Safety Research
Australian Institute of Health Innovation
Macquarie University, NSW

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Medicare Annual Wellness Visit (AWV) is a preventive care visit that was introduced in 2011 as part of the Patient Protection and Affordable Care Act. Prior to this, the only preventive care exam covered by Medicare was the Welcome to Medicare Visit, which is only available for people in their first year of Medicare enrolment. The AWV is available each year to beneficiaries without co-payment to people who are past their first year of Medicare enrolment. The AWV focuses on prevention and early detection of disease.

Racial disparities in healthcare utilization and health outcomes have been well documented in the US. Prior expansions of Medicare coverage have had varied effects on reducing disparities. For example, in 2001 Medicare began to cover colorectal cancer screening which reduced racial disparities for some minority groups with respect to screening rates and improved early detection.

Expanding coverage of preventive care for people on Medicare may help reduce disparities in health outcomes, but we first needed to know if people were using the Medicare Annual Wellness Visit. Our goal was to assess AWV utilization rates and determine if utilization differed by race or ethnicity. We analyzed a nationally representative database of Medicare beneficiaries (the Medicare Current Beneficiary Survey) that included self-reported race, ethnicity, income and education, linked to Medicare claims.

We found that Medicare Annual Wellness Visit use was low but increased from 2011 to 2013. We also found that people on Medicare who self-identified as belonging to a racial or ethnic minority group had lower AWV utilization rates than non-Hispanic white people. People with lower income or education, and people living in rural areas had lower Medicare Annual Wellness Visit utilization.  Continue reading

Why Are So Many Modern Men Single?

MedicalResearch.com Interview with:
“3-men-laughing” by desthal is licensed under CC BY-NC-ND 3.0Menelaos Apostolou  PhD
University of Nicosia
Cyprus

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: In this study I analyzed 6794 responses from a recent Reddit thread on why men were single, and I classified them in 43 reason categories.

Among the most frequent reasons that men indicated for being single included poor flirting skills, low self-confidence, poor looks, shyness, low effort, and bad experience from previous relationships.

Continue reading

Diabetes: Microvascular Complications Markedly Decreased After Bariatric Surgery

MedicalResearch.com Interview with:

David Arterburn, MD, MPH Kaiser Permanente Washington Health Research Institute Seattle, WA 

Dr. Arterburn

David Arterburn, MD, MPH
Kaiser Permanente Washington Health Research Institute
Seattle, WA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: More than 9 percent of adult Americans—about 30 million people—are estimated to have type 2 diabetes, according to the American Diabetes Association. The disease tends to worsen over time, with blood sugar levels rising along with the risks of developing large blood vessel (macrovascular) complications like heart attack and stroke, as well as small blood vessel (microvascular) complications affecting the nerves of the feet and hands (neuropathy), kidneys (nephropathy), and eyes (retinopathy).

Among more than 4000 patients who underwent bariatric surgery, the 5-year incidence of microvascular disease — including neuropathy, nephropathy, and retinopathy — was nearly 60% lower than that of 11,000 matched nonsurgical control patients receiving usual diabetes care.  Continue reading

Brain Imaging Reveals How Prolonged Intermittent Cannabis Can Induce Memory Deficits

MedicalResearch.com Interview with:

Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC

Ana Maria Sebastião, PhD
Professor of Pharmacology and Neurosciences
Director Institute of Pharmacology and Neurosciences, Faculty of Medicine and
Francisco Mouro, PhD
Unit of Neurosciences, Institute of Molecular Medicine
University of Lisbon, Portugal

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: There is pressing need to comprehend how cannabinoid exposure impacts brain functioning. While cannabinoid-related research has increased exponentially in the last decade, the mechanisms through which cannabinoids affect brain functioning are still elusive. Specifically, we need to know how prolonged cannabinoid exposure affects important cognitive processes, such as memory, and also find the roots of those effects. This is particularly relevant considering that several countries have already approved cannabis-based medicines.

In this sense, our work sheds new light into the mechanisms underlaying the memory-deficits provoked by a continuous exposure to a cannabinoid drug. More precisely, using brain imaging techniques, we found that long-term exposure to a synthetic cannabinoid drug impairs the ability of key brain regions involved in learning and memory to communicate with each other. Our data points to the necessity of considering cannabinoid actions in a broader perspective, including brain circuitry and communication.  Continue reading

Effects of Childhood Exposure to Secondhand Smoke Can Drift Into Adulthood

MedicalResearch.com Interview with:
“#smoke” by Seniju is licensed under CC BY 2.0Ryan Diver MSPH
Director, Data Analysis
American Cancer Society, Inc.
250 Williams St.
Atlanta, GA 30303

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Secondhand smoke is known to have adverse effects on the lung and vascular systems in both children and adults. But it is unknown whether childhood exposure to secondhand smoke is associated with mortality in adulthood.

To explore the issue, we examined associations of childhood and adult secondhand smoke exposure with death from all causes, ischemic heart disease, stroke, and chronic obstructive pulmonary disease among 70,900 never-smoking men and women from the Cancer Prevention Study II Nutrition Cohort. Study participants, primarily ages 50 to 74 at the beginning of the study, answered questions about their secondhand smoke exposure during childhood and as adults and were followed for 22 years.

Those who reported having lived with a daily smoker throughout their childhood had 31% higher mortality from chronic obstructive pulmonary disease compared to those who did not live with a smoker. Although the study counted only deaths, the increase in fatal COPD implies that living with a smoker during childhood could also increase risk of non-fatal COPD. In addition, secondhand smoke exposure (10 or more hours/week) as an adult was associated with a 9% higher risk of all-cause mortality, a 27% higher risk of death from ischemic heart disease, a 23% higher risk of death from stroke, and a 42% higher risk of death from COPD.

Continue reading

Some Pulmonary Embolism Patients Can Be Treated at Home

MedicalResearch.com Interview with:

Joseph Bledsoe MD, FACEP Clinical Assistant Professor of Emergency Medicine Stanford Medicine Director of Research Department of Emergency Medicine Intermountain Medical Center Murray, UT 84157

Dr. Bledsoe

Joseph Bledsoe MD, FACEP
Clinical Assistant Professor of Emergency Medicine
Stanford Medicine
Director of Research
Department of Emergency Medicine
Intermountain Medical Center
Murray, UT 84157

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Patients with blood clots in the lungs (pulmonary embolism) (PE) are routinely admitted to the hospital for blood thinning medications in the United States. However, evidence from other countries has shown that with appropriate risk stratification patients may be safe for outpatient treatment for their PE.

Our study is the largest prospective management study in the US to evaluate home treatment of patients with acute pulmonary embolism. We enrolled 200 patients and after risk stratification with the PE severity index score, leg ultrasounds and echocardiograms performed in the emergency department, patients were treated with blood thinning medications at home with routine outpatient follow up.

During the 90 day follow up period we found only one patient suffered a bleeding event after a traumatic injury, without any cases of recurrent symptomatic blood clots or death.  Continue reading

Single Dose of Ibalizumab Boosts Immunity in Resistant HIV

MedicalResearch.com Interview with:

Brinda Emu, MD Assistant Professor of Medicine (Infectious Diseases) Yale School of Medicine

Dr. Emu

Brinda Emu, MD
Assistant Professor of Medicine (Infectious Diseases)
Yale School of Medicine

MedicalResearch.com: What is the background for this study?

Response: This was a Phase 3 study of a new antiretroviral agent, ibalizumab, for the treatment of HIV-1 infection.  Ibalizumab is a monoclonal antibody that targets the CD4 receptor on host cells.  CD4 is the receptor that HIV uses to infect CD4+ T cells.  By binding to the CD4 receptor, ibalizumab prevents viral entry.  This study recruited patients that harbor multi-drug resistant HIV and were failing their current regimen of antiretroviral agents, and thus had limited options for treatment of their HIV-1 infection using approved medications.

Continue reading

Who Is More Likely To Be Shot by Police?

MedicalResearch.com Interview with:
“Me holding USP gun” by Nghị Trần is licensed under CC BY 2.0Brianna Mills, PhD
Research Scientist
Harborview Injury Prevention & Research Center
University of Washington

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We know that substance use, mental disorders, and arrest are markers of increased risk of firearm injury. However, many studies of firearm injury are limited in scope – looking only at one type of injury (assault-related, for example) and one type of data (often hospital records). Police shootings, although occurring with increasing frequency, have also received relatively less attention in research than other types of firearm injuries.

We combined data from a variety of sources, including both hospital and arrest records, so we could present a more complete picture of firearm injuries in Seattle, including contacts with law enforcement and healthcare in the two years prior to injury. We subdivided substance use, mental disorder, and arrests into more specific categories to present a more nuanced look at how each category may indicate increased risk of a specific type of firearm injury (assault-related, self-inflicted, unintentional, and police intervention).

We found that when you consider both arrest records and hospital records together a distinct pattern of prior contact emerges for people who were shot by police – they have arrest histories similar to people shot during an assault and hospital histories similar to people with self-inflicted firearm injuries. A majority of people shot during an assault or by police were either arrested or hospitalized in the two years prior to their injury. Compared to our control group, people shot by police were 22 times more likely to have a conduct disorder, 11 times more likely to have been diagnosed with a marijuana use disorder, and 7 times more likely to have a felony arrest, psychosis diagnosis, or depression/anxiety diagnosis.  Continue reading

Why Do Patients Seek Cosmetic Procedures?

MedicalResearch.com Interview with:
Murad Alam, MD Vice-Chair and Professor of Dermatology Chief of Cutaneous and Aesthetic Surgery Northwestern University Feinberg School of MedicineMurad Alam, MD
Vice-Chair and Professor of Dermatology
Chief of Cutaneous and Aesthetic Surgery
Northwestern University
Feinberg School of Medicine

MedicalResearch.com: What is the background for this study?

Response: For the purposes of our study, non-invasive procedures included laser and light treatments (for brown spots, blood vessels, wrinkle reduction, scar treatment, hair removal), chemical peels, and non-surgical skin tightening and fat reduction (with radiofrequency energy, cold treatment, or ultrasound).  These noninvasive treatments do not even break the skin, and are applied on top of the skin

Then we have minimally invasive procedures, which include those that just barely break the skin, but are like getting a shot, and don’t require cutting and sewing the skin as in traditional surgery.   These minimally invasive procedures include filler and neuromodulator injections to fill out the sagging aging face while reducing lines and wrinkles, as well as liposuction through tiny openings to suck out excess fat.

In the old days, cosmetic treatments meant getting traditional plastic surgery, like a face lift or tummy tuck.  These required general anesthesia, cutting and sewing the skin, significant risk of scarring, and days to weeks of recovery time.  More recently, dermatologists have pioneered noninvasive and minimally invasive procedures, such as those I just described, which provide many of the same benefits as traditional plastic surgery without the risk, scars, and downtime.   Now these minimally invasive and noninvasive treatments have become more popular than traditional cosmetic surgery.  Continue reading

Who Suffers From Phantom Smells?

MedicalResearch.com Interview with:
“Bad smell” by Brian Fitzgerald is licensed under CC BY 2.0Kathleen Bainbridge, PhD

Epidemiology and Biostatistics Program
NIDCD

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The causes of phantom odor perception are not understood. This study looked for the prevalence and risk factors for this disorder. We found that that 1 in 15 Americans (or 6.5 percent) over the age of 40 experiences phantom odors.

This study, is the first in the U.S. to use nationally representative data to examine the prevalence of and risk factors for phantom odor perception. The study included about 7,400 adults who participated in the National Health and Nutrition Examination Survey, a continuous survey conducted by the National Center for Health Statistics which is part of the Centers for Disease Control and Prevention. The study could inform future research aiming to unlock the mysteries of phantom odors.

We identified risk factors that may be related to the perception of phantom odors. People are more likely to experience this condition if they are female, and are relatively young—we found a higher prevalence in 40-60 year-olds compared to 60+ year-olds. Other risk factors include head injury, dry mouth, poor overall health, and low socio-economic status. People with lower socio-economic status may have health conditions that contribute to phantom odors, either directly or because of medications needed to treat their health conditions.

Continue reading

Triple Low Dose Combination Pill May Lower Blood Pressure With Fewer Side Effects

MedicalResearch.com Interview with:

Dr Ruth Webster PhD, BMedSc(hons), MBBS(hons), MIPH(hons) Head, Research Programs, Office of the Chief Scientist Senior Lecturer, Faculty of Medicine UNSW Sydney

Dr. Webster

Dr Ruth Webster PhD, BMedSc(hons), MBBS(hons), MIPH(hons)
Head, Research Programs, Office of the Chief Scientist
Senior Lecturer, Faculty of Medicine
UNSW Sydney
The George Institute for Global Health
Australia

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: We know from previous research that 80% of the blood pressure lowering efficacy of any medication occurs in the first half of the dose whilst most side effects occur at higher doses. We also know that most people will require at least 2 blood pressure lowering medications to reach their target blood pressure and that combining multiple pills into one combination medication helps patients take their medication more reliably. There was therefore good evidence to believe that using three half strength doses in one pill would be better than usual care in helping patients to achieve their blood pressure targets.

We showed that, compared with patients receiving usual care, a significantly higher proportion of patients receiving the Triple Pill achieved their target blood pressure of 140/90 or less (with lower targets of 130/80 for patients with diabetes or chronic kidney disease).

It’s estimated more than a billion people globally suffer from high blood pressure with the vast majority having poorly controlled blood pressure. Our results could help millions of people globally reduce their blood pressure and reduce their risk of heart attack or stroke.

Continue reading

How Common is Overdiagnosis of Lung Cancer with Low Dose CT Screening?

MedicalResearch.com Interview with:
“CT Scan” by frankieleon is licensed under CC BY 2.0Dr. Bruno Heleno MD PhD

Assistant Professor | Professor Auxiliar
NOVA Medical School | Faculdade de Ciências Médicas
Universidade Nova da Lisboa 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Danish Lung Cancer Screening Trial (DLCST) is a randomized controlled trial which enrolled 4104 participants (aged 50-70 years; current or former smokers; ≥20 pack years; former smokers must have quit <10 years before enrollment) to either 5 rounds of screening for lung cancer with low-dose CT-scans or to no screening.

After 10 years of follow-up, there was a 2.10 percentage points lung cancer absolute risk increase with low-dose CT-screening. Overdiagnosis, i.e. the detection of cancer that would not progress to symptoms or death, was estimated at 67.2% of the screen-detected cancers.

Continue reading