Author Interviews, Cost of Health Care, JAMA, University of Michigan / 17.11.2018

MedicalResearch.com Interview with: Renuka Tipirneni, MD, MSc Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine, Divisions of General Medicine and Hospital Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI 48109Renuka Tipirneni, MD, MSc Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine Divisions of General Medicine and Hospital Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Navigating health insurance and health care choices is challenging and requires significant health insurance literacy (knowledge and application of health insurance concepts). We looked at the association between U.S. adults' health insurance literacy and avoidance of health care services due to perceived cost. We found that 30% of people we surveyed reported delayed or foregone care because of perceived cost, and that those with lower health insurance literacy reported significantly greater avoidance of both preventive and nonpreventive health care services.
Author Interviews, Global Health, Heart Disease, JAMA, Pediatrics, Surgical Research / 17.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45975" align="alignleft" width="144"]Marcelo G. Cardarelli, MD A member of Inova Medical Group Dr. Cardarelli[/caption] Marcelo G. Cardarelli, MD Inova Children’s Hospita Fairfax, Falls Church, Virginia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Global Humanitarian Medical efforts consume a large amount of resources (nearly $38B in 2016) and donors (Countries, International organizations, WHO, Individuals) make the decisions as to where their funds should be allocated based on cost-effectiveness studies. Most resources go to prevent/treat infectious diseases, sanitation efforts and maternal/child care issues. An insignificant amount of resources is directed to satisfy the surgical needs of the populations in low and middle income countries (LMICs). The idea behind our project was to find out if it was cost-effective to perform a tertiary surgical specialty (pediatric cardiac surgery) in this context and the answer (at $171 per DALY averted) was an overwhelming yes! But most importantly, we believe, as many others do, that judging the cost/effectiveness of an intervention in order to decide resources allocation is valid for diseases that can be prevented, but not relevant when it comes to surgical problems that are not preventable. Instead, we propose the use of another measure of effectiveness, what we call "The Humanitarian Footprint". The Humanitarian Footprint represents the long term benefits, as measured by changes in the life expectancy, extra years of schooling and potential lifetime earnings of patients treated surgically during humanitarian interventions. To our surprise and based on the results, the effects on society of at least this particular surgical intervention were greater than we expected. We suspect this measure can be used in many other surgical humanitarian interventions as well. 
Allergies, Author Interviews, Dermatology, Immunotherapy, JAMA / 17.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46078" align="alignleft" width="162"]Hives - Wikipedia image James Heilman, MD - Own work Hives - Wikipedia image[/caption] Christopher S. Lee, PhD, RN, FAHA, FAAN, FHFSA Professor and Associate Dean for Research Boston College William F. Connell School of Nursing Chestnut Hill, MA 02467 MedicalResearch.com: What is the background for this study? Response: Although the efficacy of omalizumab (i.e. can it work?) in the treatment of chronic idiopathic (spontaneous) urticaria has been established in clinical trials, the effectiveness of omalziumab (i.e. does it work?) in the real-world management is less well established. The purpose of this study was to synthesize what is known about the benefits and harms of omalizumab as used in real-world treatment of Chronic Idiopathic (Spontaneous) Urticaria.
Author Interviews, Heart Disease, JACC, Outcomes & Safety / 17.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46093" align="alignleft" width="142"]Teryl K. Nuckols, MD Vice Chair, Clinical Research Director, Division of General Internal Medicine Cedars Sinai Los Angeles, California Dr. Nuckols[/caption] Teryl K. Nuckols, MD Vice Chair, Clinical Research Director, Division of General Internal Medicine Cedars Sinai Los Angeles, California MedicalResearch.com: What is the background for this study? Response: The Medicare Hospital Readmissions Reduction Program (HRRP) penalizes hospitals with increased 30-day readmission rates among seniors admitted with heart failure (HF).  Heart failure readmission rates declined markedly following the implementation of this policy. Two facts have raised concerns about whether the HRRP might have also inadvertently increased 30-day heart failure mortality rates. First, before the policy was implemented, hospitals with higher heart failure readmission rates had lower 30-day HF mortality rates, suggesting that readmissions are often necessary and beneficial in this population. Second, 30-day HF mortality rose nationally after the HRRP was implemented, and the timing of the increase has suggested a possible link to the policy. Are hospitals turning patients away, putting them at risk of death, or is the increase in heart failure mortality just a coincidence? To answer this question, we compared trends in 30-day HF mortality rates between penalized hospitals and non-penalized hospitals because 30-day HF readmissions declined much more at hospitals subject to penalties under this policy.
Allergies, Author Interviews, Pediatrics / 16.11.2018

MedicalResearch.com Interview with: Eliane Abou-Jaoude, MD  Allergy and Immunology Fellow Henry Ford Health System Detroit, MichiganEliane Abou-Jaoude, MD  Allergy and Immunology Fellow Henry Ford Health System Detroit, Michigan MedicalResearch.com: What is the background for this study? Response: Early life exposure to diverse types of microbes is necessary for healthy immune development and may impact the risk for developing allergic disorders. Theoretically the transfer of parental microbes to their offspring during infancy can influence a child’s developing gut microbiome and subsequent immune response patterns. We wished to investigate whether parental pacifier cleaning methods, reported at 6-months of age, were associated with altered serum IgE trajectory over the first 18 months of life. 
Author Interviews / 16.11.2018

MedicalResearch.com Interview with: "Mothers and Daughters" by Joe Shlabotnik is licensed under CC BY 2.0Robert F. Lynch, PhD Department of Biology University of Turku Turku, Finland  MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  The take home message is that we were trying to experimentally induce something called a Trivers-Willard effect in humans. The Trivers-Willard hypothesis is a theory that uses evolutionary logic to predicts that parents who are in good condition will bias investment towards sons, while parents who are in poor condition will bias investment towards daughters.  The logic is that this should be the case because high-quality sons are expected to out-reproduce high quality daughters, while low-quality daughters are expected to out-reproduce low quality sons. We found almost nothing supporting this.  Instead we found strong and consistent effects across 4 dependent variables (explicitly stated preferences, implicit associations via IAT tests, actual donations to charities after an experimental prime and a forced choice adoption preference) of women preferring daughters or girls and men having either a slight or no preference for sons or boys. Of course we get into the details of why this may not be so surprising after all from an evolutionary point of view.  And we also discuss how things like sexual genetic conflict might mask TW effects and how cultural changes regarding the expected value of males and females may also play a role in explaining these differences.   
Author Interviews, Gastrointestinal Disease, Microbiome, Pediatrics / 16.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46046" align="alignleft" width="180"]Thomas Thymann PhD DVM MSc Department of Veterinary and Animal Sciences Comparative Pediatrics and Nutrition Faculty of Health and Medical Sciences University of Copenhagen Frederiksberg, Denmark Prof. Thymann[/caption] Thomas Thymann PhD DVM MSc Department of Veterinary and Animal Sciences Comparative Pediatrics and Nutrition Faculty of Health and Medical Sciences University of Copenhagen Frederiksberg, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infants that are born preterm are at risk of developing a severe and life threatening intestinal disease referred to as necrotizing enterocolitis (NEC). This condition is known to be under influence of several factors including the microorganisms that start to colonize the intestine immediately after birth. We wanted to see whether fecal matter collected from healthy 10-day old piglets, would benefit the pattern of early colonization, and prevent NEC.
Allergies, Asthma, Author Interviews, Pediatrics, Science / 16.11.2018

MedicalResearch.com Interview with: "Dogs and Kids Mix Well" by Tony Alter is licensed under CC BY 2.0Catarina Almqvist Malmros MD, PhD Professor | Consultant Pediatrician Dept of Medical Epidemiology and Biostatistics | Karolinska Institutet Lung and Allergy Unit | Astrid Lindgren Children’s Hospital Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have previously shown an association between growing up with dogs and a lower risk of childhood asthma (doi: 10.1001/jamapediatrics.2015.3219) but it has been unknown whether this link is modified by characteristics of the dog. Sex of the dog may have an effect on expressed allergens, and uncastrated male dogs release more of a certain allergen than castrated male dogs and female dogs. Some breeds are also described as ‘hypoallergenic’, but there is no scientific evidence whether they are more suitable for people with allergies. We examined how variables such as sex, breed, number of dogs or size of dog are associated with the risk of asthma and allergy among children with a dog in their home during the first year of life. We included all Swedish children born between January 2001 and December 2004 whose parents had a registered dog in a dog-owner register and linked the data to the Swedish population- and health data registers. Main findings are that children raised with only female dogs at home had a 16 per cent lower risk of asthma than those with male dogs, and that children living with two or more dogs had a 21 per cent lower risk of asthma than those with only one dog. Importantly, families with parental asthma or allergies had ‘hypoallergenic’ breeds more often than children whose parents did not have asthma or allergies; 11.7% compared to 7.6 . Exposure to these breeds was associated with a 27 per cent higher risk of allergy and no decreased risk of asthma. 
Author Interviews, Lancet, Mental Health Research, PTSD / 16.11.2018

MedicalResearch.com Interview with: [caption id="attachment_46001" align="alignleft" width="160"]Sanford Nidich, Ed.D. Director, Center for Social-Emotional Health Maharishi University of Management Research Institute Fairfield, Iowa Dr. Nidich[/caption] Sanford Nidich, Ed.D. Director, Center for Social-Emotional Health Maharishi University of Management Research Institute Fairfield, Iowa MedicalResearch.com: What is the background for this study? What are the main findings? Response: Posttraumatic stress disorder (PTSD) is a complex and difficult-to-treat disorder, affecting 10-20% of veterans across eras. Previous research raised the question of whether a non-trauma focused treatment can be as effective as trauma exposure therapy in reducing PTSD symptoms. The overall objective of the study was to compare Transcendental Meditation (TM), a non-trauma focused practice, to prolonged exposure (PE) in a non-inferiority clinical trial, and to compare both to a PTSD health education control group. Transcendental Meditation was found to be as effective as PE in reducing PTSD symptoms severity from baseline to three-month posttest. In standard superiority comparisons, significant reductions in PTSD symptoms were found for TM vs. HE, and PE vs. HE. Percentages of participants with clinically significant improvement, as measured by the Clinician-Administered PTSD Scale (CAPS) interview (≥10 point reduction), were TM=61%, PE=42%, and HE=32% 
Author Interviews, Depression, JAMA, Testosterone / 16.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45941" align="alignleft" width="200"]Dr. Andreas Walther Dr. Walther[/caption] Dr. Andreas Walther PhD Department of Biological Psychology, Technische Universität Dresden, Dresden, Germany Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland Task Force on Men’s Mental Health of the World Federation of the Societies of Biological Psychiatry MedicalResearch.com: What is the background for this study? Response: The study situation with regard to endogenous testosterone level and depressive symptoms in men is currently very mixed. There are studies that show no association, but other studies show that low testosterone levels are associated with increased depressive symptoms. That is why several studies have tried to administer testosterone in men to treat depressive symptomatology among other conditions (e.g. erectile dysfunction, cognitive decline). However, no clear conclusions could be drawn from the studies to date, as some studies reported positive results, while others did not show any effects. Likewise, some studies showed better results in certain subgroups of men such as dysthymic men, treatment resistant, men with low testosterone, which raised the question of relevant moderators.
Author Interviews, Brigham & Women's - Harvard, JAMA, Prostate Cancer, Radiation Therapy, Surgical Research / 16.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45955" align="alignleft" width="200"]Anthony Victor D'Amico, MD, PhD Professor and Chief, Genitourinary Radiation Oncology Harvard Medical School Dr. D'Amico[/caption] Anthony Victor D'Amico, MD, PhD Professor and Chief, Genitourinary Radiation Oncology Harvard Medical School MedicalResearch.com: What is the background for this study? Response: This study investigated whether surgery followed by the use of adjuvant low dose radiation and short course hormonal therapy as compared to high dose radiation and hormonal therapy could provide an equivalent low risk of death from prostate cancer amongst men presenting with aggressive and not infrequently fatal Gleason score 9 or 10 prostate cancer. It has been shown previously (https://jamanetwork.com/journals/jama/fullarticle/2673969) and validated in the current study that surgery alone in such cases leads to a more then 2.5-fold increase in the risk of death from prostate cancer as compared to high dose radiation and hormonal therapy. 
Author Interviews, Weight Research / 16.11.2018

MedicalResearch.com Interview with: Gelesis, Inc.H.M. Heshmati, M.D. Executive Vice President, Endocrinology and Metabolism Gelesis, Inc.  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Gelesis Loss Of Weight (GLOW) clinical study is a pivotal, multicenter, double-blind, placebo-controlled study of our lead investigational product candidate, Gelesis100, which is an oral, non-systemic approach to weight loss. The GLOW study was designed to assess change in body weight in adults with overweight or obesity after six months of treatment with Gelesis100. Main findings from the GLOW study include the following:
  • 59% of Gelesis100-treated adults achieved weight loss of at least 5% over six months.
o   The new data show that Gelesis100-treated adults fell into two groups: responders, the 6 out of 10 who lost an average of 10% of their total body weight (about 22 pounds) and nearly 4 inches from their waist circumference. Non-responders, the 4 out of 10 who lost an average of 1% of their total body weight (about 2 pounds). o   The complete Gelesis100 treatment group (including both responders and non-responders) demonstrated superiority compared to placebo (–6.4% vs. –4.4%, P=0.0007)
  • Successful response to Gelesis100 may be predicted by elevated fasting plasma glucose at baseline or weight loss as early as week 8.
  • There was a clear and early separation between responders and non-responders. More specifically, weight loss of at least 3% as early as after eight 8 weeks of treatment predicted clinically meaningful weight loss at six months, with sensitivity and specificity levels exceeding 80%.
  • The study also showed that nearly half of the adults with prediabetes or drug-naive type 2 diabetes were super-responders. These individuals, who typically face greater challenges to lose weight, had six times greater odds of being super-responders, compared to placebo (adjusted OR: 6.1, P=0.0071).
  • Gelesis100 had a highly favorable safety and tolerability profile. 
Author Interviews, Autism, Environmental Risks, JAMA, Pediatrics / 16.11.2018

MedicalResearch.com Interview with: "Cairo Air Pollution with less smog - Pyramids1" by Nina Hale is licensed under CC BY 2.0Lief Pagalan, MSc Faculty of Health Sciences, Simon Fraser University Research Trainee, Centre for Hip Health and Mobility Vancouver Coastal Health Research Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pregnant women more heavily exposed to air pollution had higher chances of having children with autism spectrum disorder (ASD). The causes of ASD are not fully understood, but this study adds to the growing evidence that environmental risk factors have a role to play. Our study found an association between autism spectrum disorder in the children of women more heavily exposed to air pollution. We observed these results using well-defined cases of ASD and in Vancouver, Canada, which typically has lower air pollution. These findings are consistent with studies done in the U.S., Israel, and Taiwan, which have also found an increased risk of ASD from exposure to air pollution. 
Author Interviews, CDC, Gastrointestinal Disease, Infections, Vaccine Studies / 15.11.2018

MedicalResearch.com Interview with: "Day 19: Norovirus (stomach flu) visits our home." by Loren Kerns is licensed under CC BY 2.0Rachel M. Burke, PhD, MPH Epidemiologist, Viral Gastroenteritis Branch Centers for Disease Control and Prevention Atlanta, GA 30329 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Noroviruses are the leading cause of vomiting and diarrhea from acute gastroenteritis (inflammation of the stomach or intestines) among people of all ages in the United States. Each year in the United States, norovirus illness is responsible for an estimated 19 to 21 million cases of acute gastroenteritis, and contributes to 56,000 to 71,000 hospitalizations and 570 to 800 deaths, mostly among children and the elderly. CDC linked information from two different surveillance systems to analyze 3,747 norovirus outbreaks reported by health departments from 2009 to 2016. Our study provides a comprehensive description of norovirus outbreaks from the epidemiology and laboratory perspectives, using the National Outbreak Reporting System (NORS) and CaliciNet, respectively.  Norovirus outbreaks caused by GII.4 strains occurred more often in healthcare settings, affected older adults, and caused more severe illness, leading to hospitalization or death.
Addiction, Author Interviews, Opiods / 15.11.2018

MedicalResearch.com Interview with: Kirk Evoy, PharmD, BCACP, BC-ADM, CTTS "Wolf Administration Holds a Press Conference Expanding Access to Naloxone" by Governor Tom Wolf is licensed under CC BY 2.0Clinical Assistant Professor  College of Pharmacy, The University of Texas at Austin Adjoint Assistant Professor  School of Medicine, University of Texas Health Science Center at San Antonio Ambulatory Care Pharmacist  Southeast Clinic, University Health System  UT Health Science Center at San Antonio Pharmacotherapy Education and Research Center San Antonio, TX 78229  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Previous studies in Indiana and New York City, and the similar study in California published alongside ours identified that, despite the fact that laws designed to increase naloxone access had been in place for 2-3 years, patients were still not able to obtain naloxone without first seeing a doctor in many pharmacies. Our study showed contrasting results to the previous studies, with a much higher proportion of pharmacies stocking naloxone and stating their willingness to dispense without an outside prescription. Among the 2,317 Texas chain community pharmacies we contacted, 83.7% correctly informed our interviewers that they could obtain naloxone without having to get a prescription from their doctor before coming to the pharmacy.  We also found that 76.4% of the pharmacies had at least one type of naloxone currently in stock.
Author Interviews, Dermatology, Environmental Risks / 15.11.2018

MedicalResearch.com Interview with: Audra Stinchcomb, PhD Principal Investigator Professor of Pharmaceutical Sciences University of Maryland School of Pharmacy MedicalResearch.com: What is the background for this study?   Response: We have been studying the heat effects and repeated dose effects on the absorption of drugs across the skin for more than 5 years.  We were curious to see if the effects we saw on gel, cream, and ointment pharmaceuticals also occurred with sunscreen. Sunscreens are typically used in the hot sun and with reapplication every 80 minutes or so, depending on the product and user.
Author Interviews, Gender Differences, Lifestyle & Health / 15.11.2018

MedicalResearch.com Interview with: "Blood pressure check" by Army Medicine is licensed under CC BY 2.0Pallavi Bhandarkar MPH Nova Southeastern University Kirkland, Washington preetipshenoy@gmail.com  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gender based preventative health has been of interest to medical community since 1900’s with health disparities between males and females being of particular interest. United States founded National Research Institutes for female health in 1900. This led to comprehensive and systematic medical services being offered which have improved female health care significantly. Similar research programs and initiatives to improve men’s health were started only in 2000 (1). Cultural depiction of men being fearless and based on perception of masculinity leads them to underutilize the preventative health care screenings available to them or sometimes even delay care when they need it the most. Males have been found to have higher mortality rates compared to females. Life expectancy for females was 5.0 years higher than for males. The difference in life expectancy between the sexes has narrowed since 1979, when it was 7.8 years, but it increased 0.2 year in 2016 from 2015, the first increase since 1990. Death rates for males increased significantly for age groups 15–24, 25–34, 35–44, and 55–64. Rates decreased significantly for age groups 75–84 and 85 and over” (2) My research study adopted the basic survey design and conducted an anonymous survey throughout United States with men aged 18 to 40 being the participants. Our goal was to identify these gaps, analyze the reasons for underutilization and identify opportunities to improve preventative care guidelines among the male population. The main findings were almost similar to the BFRSS data obtained by CDC in the year 2016.
Author Interviews, Menopause, Sleep Disorders / 15.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45992" align="alignleft" width="142"]Sooyeon Suh, PhD Department of Psychology Sungshin University Seoul, Republic of Korea Dr. Suh[/caption] Sooyeon Suh, PhD Department of Psychology Sungshin University Seoul, Republic of Korea MedicalResearch.com: What is the background for this study? What are the main findings? Response: Women who are going through menopause frequently complain of sleep complaints and depressive symptoms in addition to other typical symptoms such as hot flashes and night sweats. Two of the most common ways of becoming menopausal are through natural menopause and surgical menopause. While natural menopause is usually experienced in the course of aging, surgical menopause is usually induced by OBGYN surgery such as bilateral oopherectomy, often as a result of illnesses such as ovarian cancer. Many studies have found that women who experience surgical menopause often experience more psychological and physical difficulties compared to women who transition through menopause naturally due to a more acute drop in estrogen following surgery, it sometimes leads to the need for practices like Advanced Gynecology to help manage the symptoms. Unfortunately, in clinical settings, women who undergo surgical menopause are not provided with additional psychoeducation or customized treatment to address these issues. The main findings of these studies support these issues. In 526 postmenopausal women, women who went through surgical menopause reported significantly worse sleep quality an shorter sleep duration. Additionally, they had a 2.13 times higher likelihood of having insomnia that warranted treatment. Finally, even though women who went through surgical menopause engaged in the same sleep-interfering behaviors (e.g., drinking caffeine, drinking alcohol before bed, watching TV in bed, etc) as women who went through menopause naturally, their sleep was impacted more negatively.
Author Interviews, Environmental Risks, NIH, Nutrition, OBGYNE, Pediatrics / 14.11.2018

MedicalResearch.com Interview with: "Baby Bottle" by brokinhrt2 is licensed under CC BY 2.0Kristen Upson, PhD, MPH and Donna D. Baird, PhD Epidemiology Branch National Institute of Environmental Health Sciences Research Triangle Park, NC 27709  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Menstrual pain is the most common menstrual complaint and can substantially affect the quality of women’s lives. A prior study in young adults who participated in feeding studies as infants reported an increased risk of greater menstrual pain severity in adulthood with soy formula feeding. Since that study, evidence from laboratory animal studies support the disruptive effects of a phytoestrogen present in soy formula, genistein, on reproductive system development, including aspects involved in menstrual pain. The laboratory animal studies also demonstrate that the developmental changes with genistein can persist into adulthood. Given these results, we were interested in further evaluating the association between infant soy formula feeding and menstrual pain in a cohort of young women. In our study of women ages 23-35 years old, we observed that soy formula feeding during infancy was associated with several indicators of severe menstrual pain in reproductive-age women. This included a 40% increased risk of ever using hormonal contraception for menstrual pain and 50% increased risk of moderate/severe menstrual discomfort with most periods during early adulthood. 
Author Interviews, JAMA, Opiods, Pharmacology / 14.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45915" align="alignleft" width="152"]Talia Puzantian,  PharmD, BCPP Associate Professor of Clinical Sciences,  School of Pharmacy and Health Sciences Keck Graduate Institute  Dr. Puzantian[/caption] Talia Puzantian,  PharmD, BCPP Associate Professor of Clinical Sciences, School of Pharmacy and Health Sciences Keck Graduate Institute   MedicalResearch.com: What is the background for this study? Response: Naloxone has been used in hospitals and emergency rooms since the early 1970s. Distribution to laypersons began in the mid-1990s with harm reduction programs such as clean needle exchange programs providing it, along with education, to mostly heroin users. In the years between 1996-2014, 152,000 naloxone kits were distributed in this way with more than 26,000 overdoses reversed (https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6423a2.htm). We have data showing that counties in which there was greater naloxone distribution among laypeople, there were lower opioid death rates (Walley AY et al BMJ 2013). However, not all opioid users at risk for overdose will interface with harm reduction programs, particularly prescription opioid users, hence more recent efforts to increase access to laypersons through pharmacists. Naloxone access laws have been enacted in all 50 states but very little has been published about how they’ve been adopted by pharmacists thus far. One small study (264 pharmacies) from Indiana (Meyerson BE et al Drug Alcohol Depend 2018) showed that 58.1% of pharmacies stocked naloxone, only 23.6% provided it without prescription, and that large chain pharmacies were more likely to do so.
Author Interviews, Weight Research / 14.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45964" align="alignleft" width="153"]Dr. Jamy Ard MD Professor of Epidemiology and Prevention Co-director,the Wake Forest Baptist Health Weight Management Center Wake Forest School of Medicine Dr. Ard[/caption] Dr. Jamy Ard MD Professor of Epidemiology and Prevention Co-director,the Wake Forest Baptist Health Weight Management Center Wake Forest School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obesity continues to be a growing health challenge, and doctors need as many resources as possible to help their patients achieve success. The OPTIWIN trial shows that a total meal replacement program like OPTIFAST can help with significant and sustained weight loss. The OPTIFAST Program is a medically monitored weight loss program that combines meal replacement with behavioral counseling and personalized support. In the OPTIWIN study, participants were randomized to either the OPTIFAST Program (OP) or a behavioral intervention using a food-based diet (FB). At both 26 and 52 weeks, the OP group lost, on average, twice as much of their initial body weight as the FB group:
  • At 26 weeks: 12.4% (SE 0.6) vs 6.0% (SE 0.6) of body weight lost (OP vs FB, respectively; p<0.001)
  • At 52 weeks: 10.5% (SE 0.6) vs 5.5% (SE 0.6) of body weight lost (OP vs FB, respectively; p<0.001)
Additionally, the proportion of participants who achieved clinically meaningful weight loss (≥5%, ≥10%, and ≥15%) was significantly higher in the OP group. For example:
  • At 26 weeks, 55% of the OP group lost at least 10% of their initial body weight vs 23% of the FB group (p<0.001)
  • At 52 weeks, 44% of the OP group lost at least 10% of their initial body weight vs 22% of the FB group (p<0.001)
Author Interviews, Geriatrics, JAMA, Pharmacology / 14.11.2018

MedicalResearch.com Interview with: Cara Tannenbaum, MD, MSc Director | Directrice Canadian Deprescribing NetworkCara Tannenbaum, MD, MSc Director | Directrice Canadian Deprescribing Network MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The D-Prescribe trial was driven by the need to show that seniors can cut down on their medication in a safe and effective manner. Pharmacists intervened in a proactive way to flag patients who were on potentially risky meds such as sleeping pills, NSAIDs and glyburide and to inform them of the risks, using an educational brochure. Pharmacists also communicated with their physician using an evidence-based pharmaceutical opinion to spark conversations about deprescribing. As a result, 43% of patients succeeded in discontinuing at least one medication over the next 6 months.  
Addiction, Author Interviews, Opiods / 14.11.2018

MedicalResearch.com Interview with: "Drug Addiction" by Joana Faria is licensed under CC BY-NC-ND 4.0Yingxi (Cimo) Chen, MD, MPH, PhD Postdoctoral Fellow Radiation Epidemiology Branch, DCEG, NCI, NIH Rockville MD 20850  MedicalResearch.com: What is the background for this study? Response: Death rates from drug overdose have more than doubled in the US in the 21st century. Similar increases in drug overdose deaths have been reported in other high-income countries but few studies have compared rates across countries. 
Author Interviews, Immunotherapy, Pancreatic / 14.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45950" align="alignleft" width="200"]Dr James Kuo, MBBS Medical oncologist and Deputy Medical Director Scientia Clinical Research Sydney, Australia  Dr. Kuo[/caption] Dr James Kuo, MBBS Medical oncologist and Deputy Medical Director Scientia Clinical Research Sydney, Australia MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Immune checkpoint inhibitors (ICI) that have seen success in the treatment of patients with various tumour types have not been as effective in patients with metastatic pancreatic cancer and therefore immune-therapeutic agents of novel mechanism of action, in particular in combination with existing ICI, need to be investigated. This study set out to test the safety and efficacy of pixatimod, a novel immunomodulatory agent, in combination with nivolumab, firstly in the dose escalation cohorts in patients with any solid tumour for the maximal tolerable dose, and then using this dose to further treat an expansion cohort of patients with pancreatic cancer. Altogether 16 patients had received the combination and in 10 patients in whom treatment response was evaluable, 4 patients experienced a clinical benefit and continued treatment in the trial, with 1 patient having a significant partial response now treated for 48 weeks. Interestingly, all these 4 patients had metastatic colorectal cancer. Side effect profile has been consistent with other immunotherapeutic agent combination and in the patients who had clinical benefit, no treatment related side effects were observed. 
Author Interviews, Biomarkers, Endocrinology, Prostate Cancer / 14.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45946" align="alignleft" width="200"]Diagram_showing_prostate_cancer_that_has_spread_to_the_bones_CRUK_183.svg.png Prostate cancer that has metastasized to the bone: Wikipedia Image[/caption] Vincenza Conteduca, MD, PhD Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Srl - IRCCS Meldola , Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: In our previous publications, we showed that the study of plasma cell-free DNA holds promise for improving treatment choice in metastatic castration-resistant prostate cancer (mCRPC). Specifically, we demonstrated that the detection in plasma of aberrations (copy number alterations and/or point somatic mutations) of androgen receptor (AR), using an easy and robust multiplex droplet digital PCR method, predicted an adverse outcome in mCRPC patients treated with second-generation AR-directed therapies (abiraterone or enzalutamide) in both settings: chemotherapy-naïve and post-docetaxel. This current multi-institution work builds on our previous discoveries. We investigated the association of androgen receptor status and survival in men treated with docetaxel. Moreover, we performed an exploratory analysis in patients treated with docetaxel or AR-directed therapies as first-line therapy. Interestingly, we observed that plasma AR-gained patients do not have a worse outcome compared to AR-normal patients when treated with docetaxel as first-line therapy. This introduces the opportunity to use plasma to select for docetaxel in preference to androgen receptor-directed therapies in AR gained mCRPC patients.
Alzheimer's - Dementia, Author Interviews, Coffee, Parkinson's / 14.11.2018

MedicalResearch.com Interview with: Donald Weaver, PhD, MD, FRCPC, FCAHS Senior Scientist and Director, Research Institute Krembil Research Institute University Health Network Toronto, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: First, we are seeking novel molecules that might have usefulness in the treatment of Alzheimer’s disease (AD). Since Mother Nature is a superb chemist, natural products are an ideal place to start looking for possible therapeutics. There is a long history (penicillin, digitalis …) of drugs identified from natural product sources. Moreover, in earlier work by us, we have shown that other natural products extracted from maple syrup have possible therapeutic efficacy against AD. Therefore, it was logical for us to look at extracts of coffee. We see similarities between maple syrup and coffee. In both of these natural products, the plant derived material (i.e. the coffee bean, or sap from maple syrup) is initially boiled or roasted prior to its use; thus, it is not a direct simple plant product, but one that has been heated (boiled or roasted). We suspect that the heating process “does more chemistry” enabling the generation of new molecules from the plant derived materials. In our study we show that a class of compounds (phenylindanes) from roasted coffee has the ability to inhibit the misfolding of two proteins (beta-amyloid, tau) whose misfolding and aggregation (“clumping”) is implicated in the disease process of AD. Second, as described below, there is already epidemiological evidence that coffee consumption may offer some protective effects against Alzheimer’s disease and Parkinson’s disease (PD), so by looking at the constituents of coffee for chemicals that might block the clumping of beta-amyloid and/or tau, was an attempt to seek a molecular link explaining the epidemiology.
Author Interviews, Surgical Research, Weight Research / 14.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45933" align="alignleft" width="133"]Alison E. Field, ScD Professor and Chair of Epidemiology Brown University School of Public Heath Providence, RI Dr. Field[/caption] Alison E. Field, ScD Professor and Chair of Epidemiology Brown University School of Public Heath Providence, RI MedicalResearch.com: What is the background for this study?   Response: In the United States, approximately 40% of adults are obese. There are a range of treatment options, but relatively few people are able to lose weight and maintain the loss. The most effective treatment is bariatric surgery, but even among patients who have undergone bariatric surgery, there is a range in weight change patterns after surgery. This suggests that not all people with obesity are similar. There may be different causes and optimal treatment plans that vary by obesity subgroup. Our goal was to identify subgroups and to examine if they differed in terms of weight loss after bariatric surgery.
Author Interviews, Exercise - Fitness, Frailty, Geriatrics, JAMA / 13.11.2018

MedicalResearch.com Interview with: "COUCHair for physical therapy" by ewa garniec is licensed under CC BY-NC-ND 3.0Mikel Izquierdo PhD Head and Full professor Department of Health Sciences Public University Navarra, Spain  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Acute hospital admissions are a major contributor to disability in the elderly. Despite resolution of the reason for hospitalization, patients (especially those who are frail) are often discharged with a new major disability. This is a problem that providers of health care and policy makers should prioritize given the expectations of further growth of the population segment composed by old people.  Traditional models of acute hospitalization for older adults seldom include a comprehensive approach to prevent hospitalization-associated impairment in functional and cognitive capacity. In contrast, exercise and early rehabilitation protocols applied during acute hospitalization can prevent functional and cognitive decline in older patients and are associated with a reduced length of stay and lower costs. Yet, patients with cognitive impairment or multimorbidity at baseline are commonly excluded from exercise intervention trials and only ‘conservative’ or ‘traditional’ programs (i.e., focusing on light walking while avoiding resistance training) have been typically applied to elders who are acutely hospitalized. Our intervention proved safe and effective to reverse the aforementioned impairment. We therefore propose that an individualized prescription of multicomponent exercise should become an inherent part of the routine management of hospitalized older adults. 
Author Interviews, Exercise - Fitness, Pain Research / 13.11.2018

MedicalResearch.com Interview with: Ms Lynne Gaskell MSc University of Salford Manchester UK MedicalResearch.com: What is the background for this study? Response: Musculoskeletal Pain as a result of common problems affecting the back, neck, shoulder, knee and multi-site pain is an increasing cause of reduced function and quality of life, and ever increasing demands on healthcare, Prognosis is often poor with many people reporting persistent symptoms after consulting their primary care practitioner. The likelihood of persistent and recurrent clinical symptoms may accentuate the physical, psychological, and social impacts of musculoskeletal pain particularly with the middle aged and elderly populations. Pilates is an exercise approach that has become increasingly popular in recent years and includes over fifty different exercises to improve flexibility, balance, core strength, core stability. It can therefore can be individualised for people with different needs, preferences, musculoskeletal conditions, ages and abilities. Aligning exercise to patient’s functional needs has been linked to long-term exercise adherence. Many physiotherapists such as sydney physio solutions have started to specialise in this as a form of treatment, click here for more info on pilates and the many benefits they can have on your physical health. This study investigated the personal experiences and perceptions of the impact of Pilates on the day-to-day lives of adults with a myriad of chronic MSK conditions following a 12 week Pilates Exercise Programme.The results were organised into five main themes: 1. Physical Improvements strength, core stability, flexibility and balance. 2. Pilates Promotes an Active Lifestyle and improved performance at work and / or hobbies. 3. Psychosocial benefits and improved confidence, 4. Increased Autonomy in Managing their own Musculoskeletal Condition and 5. Motivation to continue with exercise.