Patricia Louie[/caption]
Patricia Louie, MA
PhD Student, Department of Sociology
University of Toronto
Toronto, ON, Canada
MedicalResearch.com: What is the background for this study?
Response: While most physicians believe that they treat patients equally, research shows that racial inequality pervades the U.S. health care system (Feagin and Bennefield 2014; Williams 2012). Because these inequities persist even after demographic and other socio-economic differences are taken into consideration scholars have started to look at the representation of race in the medical curriculum. The idea is that medical curriculum creates both implicit and explicit connections between race and disease. We build on this body of work by investigating the representation of race (White, Black and Person of Color) and skin tone (light, medium and dark) in the images of four preclinical anatomy textbooks - Atlas of Human Anatomy, Bates’ Guide to Physical Examination & History Taking, Clinically Oriented Anatomy, and Gray’s Anatomy for Students. Skin tone is important.
The majority of medical imagery consists of decontextualized images of body parts where skin tone, which may be related to disease presentation, is the only phenotypical marker. If doctors associate light skin tones with White patients, this may also influence how doctors think about who is a “typical” patient, particularly for the type of disease that is shown in that image.
Dr. Cather[/caption]
Dr. Jennifer Cather MD
Medical Director at Modern Dermatology and Modern Research Associate
Dallas, Texas
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Genital psoriasis can be an uncomfortable and burdensome condition that many people living with moderate-to-severe plaque psoriasis experience. Due to the significant impact, Lilly conducted a 12-week Phase 3b clinical trial with patients with moderate-to-severe genital psoriasis treated with ixekizumab, which found that patients had a greater decrease in the impact of their condition on sexual activity compared to placebo as early as one week.
Specifically, trial patients were randomized to receive ixekizumab (80 mg every two weeks, following a 160-mg starting dose) or placebo and researchers measured pre-specified patient-reported outcomes, including the Genital Psoriasis Sexual Impact Scale (GPSIS), which is composed of the Sexual Activity Avoidance (Avoidance) and Impact of Sexual Activity on Genital Psoriasis Symptoms (Impact) subscales. Patient-reported outcomes were also measured by the Sexual Frequency Questionnaire (SFQ) item 2, evaluating the impact of genital psoriasis on the frequency of sexual activity, and the Dermatology Life Quality Index (DLQI) item 9, evaluating the impact of skin symptoms on sexual difficulties.
At 12 weeks, patients reported the following outcomes:
Dr. Renato Lopes[/caption]
Renato D. Lopes MD, MHS, PhD
Professor of Medicine, Division of Cardiology
Duke University Medical Center
Duke Clinical Research Institute
Terrace Level, Durham, NC 27705
MedicalResearch.com: What is the background for this study?
1- Digoxin is used in ≈ 30% of patients with atrial fibrillation (AF) worldwide, despite the lack of randomized clinical trials to assess its efficacy and safety in this setting.
2- Current AF guidelines recommend digoxin for rate control in patients with AF with and without heart failure (HF).
3- There are no specific recommendations about serum digoxin concentration monitoring in the atrial fibrillation guidelines.
Prof. Martin[/caption]
Richard Martin
Professor of Clinical Epidemiology
Head of Section, Clinical Epidemiology & Public Health
Population Health Sciences
Bristol Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Screening for prostate cancer using the PSA test aims to detect prostate cancer at an early stage, before symptoms develop, when treatment can be offered that may avoid the risks of advanced cancer or may extend life.
Evidence from a large European trial suggests that PSA screening at 2 to 4 yearly intervals could reduce prostate-cancer deaths by 20%. after 13 years of follow-up. However, there are problems with the accuracy of the PSA test and potential harmful consequences. In particular, using the PSA test to screen for prostate cancer results in some tested men being diagnosed with low-risk, harmless cancers that are unlikely to progress or require treatment. This problem may be particularly exacerbated when using repeated PSA testing as a screening strategy.
The CAP trial offered a one-off PSA test to men aged 50-69 years in the UK. The goal of this low-intensity, one-off PSA testing was to avoid unnecessary screening while still identifying men with high risk, aggressive cancers for whom screening and early detection can reduce morbidity and mortality. However, we found that after an average 10-years of follow-up, the PSA test still detected too many low-risk prostate cancers, while also missing cancers that did need treatment. After an average 10-years of follow-up, the group who had been screened had the same percentage of men dying from prostate cancer as those who had not been screened (0.29%).
Dr. Paessler[/caption]
Slobodan Paessler, D.V.M., Ph.D.
Professor, Department of Pathology;
Director, Galveston National Laboratory Preclinical Studies Core;
Director, Animal Biosafety Level 3, Institute for Human Infections and Immunity;
Member, Center for Biodefense & Emerging Infectious Diseases
University of Texas Medical Branch
Galveston, TX
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Zika virus infection is associated with various developmental issues for human embryos such as reduced head growth, reduced brain tissue growth, and damage to brain or eyes. We wanted to better understand if some of these birth defects are caused directly by the Zika virus or maybe by the host response to infection.
In our study we demonstrate that the Zika virus infection induces autoimmune response against the C1q protein. This protein is a very important immune protein as well as one of the essential proteins for healthy brain development. Attacking the C1q protein upon exposure with the Zika virus could contribute to the development of autoimmune disorders and birth defects.
Trine Moholdt, PhD
Research Fellow
Department of Circulation and Medical Imaging | Exercise, Cardiometabolic Health and Reproduction
Norwegian University of Science and Technology
MedicalResearch.com: What is the background for this study?
Response: Although obese individuals have an increased risk of cardiovascular disease, evidence from many observational studies shows that in those who already have cardiovascular disease, being overweight or obese is associated with lower risk of mortality compared to their normal weight counterparts.
This phenomenon is often called the “obesity paradox”. Recently we observed that in individuals who have a high physical activity level, there is no such obesity paradox and body mass index did not associate with survival time in those who with high physical activity (Moholdt et al, American Journal of Medicine, 2017).
Dr. Zoz[/caption]
Donald Zoz, MD
Senior Associate Director
Clinical Development & Medical Affairs IPF/ILD
Boehringer Ingelheim Pharmaceuticals, Inc.
MedicalResearch.com: What is the background for this platform? Would you briefly explain what is meant by scleroderma? How does it affect a person's skin and ability to function? Whom does this disease primarily affect?
Response: “More Than Scleroderma™: The Inside Story” is Boehringer Ingelheim’s new global initiative highlighting real-life, inspirational stories of people living with the rare disease scleroderma. The new effort, created with support from the Scleroderma Foundation in the U.S., aims to raise awareness of the disease, dispel misperceptions and provide important resources to support and guide those on their journey with scleroderma. The initiative’s website http://www.morethanscleroderma.com/us/ features a powerful and inspiring collection of diverse photographs and video profiles of 10 people across the U.S. living with scleroderma and sharing their ‘inside story.’ Each tells their unique and moving experience with scleroderma through diagnosis to learning to live with the disease and manage it. Many less fortunate people in developing countries have to deal with this on a daily basis and only have the support of Orphan Drug Distributors and charities and I'm so thankful that people like this are available to support these people!
Scleroderma, also known as systemic sclerosis, is a rare disease characterized by thickening and scarring of the skin, lungs and other organs. Scleroderma affects fewer than 200,000 people in the U.S. and typically affects women in the prime of their lives, between the ages of 25 and 55 taking a marked toll just as they are building their careers and bearing the responsibility of caring for their family. Nearly all people with scleroderma (more than 90%) will develop some skin symptoms including skin thickening, tightened skin around the joints, small red spots on the face and hands and hard lumps on pressure points and joints. Most people with the disease will also develop some degree of lung scarring, or interstitial lung disease (ILD). When the disease's signature thickening and scarring develops in vital organs, such as the lungs, there are potentially debilitating and life-threatening consequences.
Dr. Skrobik[/caption]
Yoanna Skrobik MD FRCP(c) MSc
McGill University Health Centre
Canada
MedicalResearch.com: What is the background for this study?
Response: My clinical research interests revolve around critical care analgesia, sedation, and delirium. I validated the first delirium screening tool in mechanically ventilated ICU patients (published in 2001), described ICU delirium risk factors, associated outcomes, compared treatment modalities and described pharmacological exposure for the disorder. I was invited to participate in the 2013 Society of Critical Care Medicine Pain, Anxiety, and Delirium management guidelines, and served as the vice-chair for the recently completed Pain, Agitation, Delirium, Early Mobility and Sleep upcoming guidelines.
Until this study, no pharmacological prevention or intervention could convincingly be considered effective in ICU delirium. Although Haloperidol and other antipsychotics are frequently used in practice, their lack of efficacy and possible disadvantages are increasingly being understood.
Dr. Paskhover[/caption]
Boris Paskhover, MD
Associate Professor,Department of Otolaryngology-Head and Neck Surgery
Rutgers New Jersey Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Facial fillers include a wide range of cosmetic products used by physicians for augmenting the face. Some fillers are permanent, while others are temporary. Lip filler material is included in this category. Any physician is allowed to perform these procedures but patient’s need to be aware that these are not benign procedures and have some serious complications. It’s important to always go to an experienced facial plastic surgeon, general plastic surgeon or possibly dermatologist for your aesthetic fillers. Our study detailed a decade-long review of FDA reported complications with aesthetic fillers.
Dr. Brestoff-Parker[/caption]
Jonathan R. Brestoff-Parker, MD, PhD
PSTP Resident, Clinical Pathology
Department of Pathology & Immunology
Washington University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Red meat allergy is a recently recognized food allergy in which people experience a delayed allergic response about 3-6 hours after eating red meats that contain the allergen alpha-gal.
Red meat allergy is thought to be caused by tick bites which expose humans to alpha-gal, however other factors that contribute to disease risk are not well described. Alpha-gal looks a lot like the B antigen, which is one of the factors that determines blood type. So we wondered whether people with blood types B or AB are protected from getting red meat allergy. We were amazed when we found that patients who make the B antigen (blood types B or AB) are 5 times less likely to have red meat allergy than patients who do not make the B antigen (blood types O or A).
Dr. Sarin[/caption]
Kavita Sarin, M.D., Ph.D.
Assistant Professor of Dermatology
Stanford University Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Drug reactions occur in the majority of patients undergoing cancer therapies. Half of serious drug reactions are detected after market approval which can result in painful complications and interruption in therapy. Post-market drug surveillance platforms such as FDA monitoring rely on medical publications and physician reporting and take time to identify trends. We sought to determine if we could identify trends in patient discussions in internet health forums to more rapidly identify chemotherapeutic drug reactions. We chose skin reactions as a proof-of-principle because patients can more easily describe what they see on their skin.
Julia Ransohoff, a medical student, and Azadeh Nikfarham, an informatics postdoctoral fellow trained a computer to recognize when a patient undergoing anti-cancer treatment with PD-1 antagonists or EGFR-inhibitors described a drug reaction in their internet forum posts.
Dr. Hall[/caption]
Jeffrey A. Hall, Ph.D.
Associate Professor
The University of Kansas
Relationships and Technology Lab
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The idea that new forms of media displace our face-to-face relationships with close friends and family is an old idea. Two decades ago, when the internet experienced a period of rapid growth, the most recent form of the social displacement hypothesis emerged. Studies from that time ended up finding little to no evidence of displacement by the internet.
The main findings of this study focus on displacement by social media. The first study was conducted with a longitudinal, nationally representative sample of Americans from 2009-2011. This study found that during a period of rapid social media adoption, there was little to no association between adopting and using social media and direct social contact over the three years of the study. Furthermore, using more social media did not result in lowered well-being.
The second study in this paper looked at data from 2015, and found that using social media in a day had little bearing on who people communicated with and how they communicated. That is, passive social media use did not seem to displaced face-to-face communication with close friends and family.
Dr. Chattopadhyay[/caption]
Ishanu Chattopadhyay, PhD
Assistant Professor, Department of Medicine
Section of Hospital Medicine
Institute for Genomics and Systems Biology
University of Chicago
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It is estimated that flu kills thousands every year in US, some estimates put the yearly death toll to around 30,000 -- that is just in US, and that is irrespective of whether a new virus emerges. But why do waves of the disease sweep the globe every year, as if on a schedule? It had been suggested before that the trigger is a specific change in weather conditions, specifically, when normally humid air turns dry.
In this new study, we explore this question in much greater detail than was possible before, bringing to bear massive amounts data, such as 150 million individual medical histories recorded over the last decade, along with massive climate datasets. What we found was both fascinating, and consequential -- no single factor is responsible wholly, and it requires a complex, yet precise, mix of weather conditions, demographic makeup, socio-economic variables, vaccination coverage, antigenic drift states of the virus, and human traveling habits, among others, to trigger the seasonal epidemic waves.
Quite surprisingly, long range air-travel is far less important compared to short range ground travel. This work attempts to finally settle the lack of consensus in the scientific community on which factors are responsible, as well as each factor’s relative importance.
Dr. Davis[/caption]
Dr. Lori Davis, MD
Research and Development Service, Tuscaloosa Veterans Affairs (VA) Medical Center,
Department of Psychiatry, School of Medicine, University of Alabama, Tuscaloosa
Tuscaloosa, Alabama
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Symptoms of posttraumatic stress disorder (PTSD) interfere with a person’s ability to function at work, making it harder to stay employed and establish oneself in a career. Veterans with PTSD are uniquely challenged given their motivation to serve others, be leaders and not be generally receptive to reaching out for help.
Conventional wisdom about PTSD and employment has traditionally been to first commit to treatment, learn coping skills, manage one’s symptoms and then reintegrate into mainstream employment. However, this view is being transformed by our research that suggests a more assertive recovery-oriented approach to the treatment of PTSD that involves returning to meaningful competitive employment as soon as possible.
This study compared Evidence-based Supported Employment (also known as Individual Placement and Support or IPS) integrated within PTSD treatment teams to the treatment as usual Transitional Work model offered within the VA. This multisite trial demonstrated significantly greater effectiveness of the IPS-supported employment over stepwise, transitional work vocational rehabilitation for Veterans living with chronic PTSD.
Dr. Paskhover[/caption]
Boris Paskhover, MD
Rutgers New Jersey Medical School
Adjunct Instructor,Department of Otolaryngology-Head and Neck Surgery
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study?
Response: Patient's and the general public routinely mention that their nose appears large, especially when they look at photos taken with their phone. I realized that patients in general are taking selfies more often nowadays. In my training, we routinely would tell patient’s not to use selfies as a marker of how they look, and we instead would take a 5ft distance photograph since we knew that is more realistic. I looked through the medical literature, and it appeared to me that no one had thoroughly discussed why selfies are a bad when evaluating the nose. I contacted a colleague at Stanford who has a PhD with interest in computer graphics and we developed a model for the face/nose.
Julia F. van den Berg, PhD
Leiden University, Department of Clinical Psychology
Leiden, The Netherlands
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Caffeine is the most used psychoactive substance worldwide, mostly consumed via coffee, energy drinks, tea and chocolate. Experimental studies have shown that caffeine can negatively affect sleep quality. The timing of caffeine consumption may play a role; the closer to bedtime, the more caffeine consumption is likely to have a negative effect on sleep. We also wondered if chronotype, being a morning or evening person, would make a difference in the effect of caffeine on sleep.
We sent out questionnaires on sleep quality, chronotype, and a detailed questionnaire on type and timing of caffeine use to 880 secondary education students (mean age 21.3 years). We found that for the entire group, the amount of caffeine per week was not associated with sleep quality, regardless of chronotype. However, when we divided the group into subgroups of students who did, and students who did not usually consume caffeine in the evening (after 6PM), we found something interesting. Only for students who did not consume caffeine in the evening (20% of the total sample), a higher total caffeine consumption per week was associated with poorer sleep, in spite of the fact that these students consumed a lot less caffeine per week than the group who did consume caffeine in the evening.
This suggests a self-regulatory mechanism: students who know they are sensitive to caffeine do not drink it in the evening, nevertheless, the caffeinated beverages they drink during the day do affect their sleep.
Dr. Rice[/caption]
Todd W. Rice, MD, MSc
Associate Professor of Medicine
Director, Vanderbilt University Hospital Medical Intensive Care Unit
Division of Allergy, Pulmonary, and Critical Care Medicine
Nashville, TN
MedicalResearch.com: What is the background for this study?
Response: Our study (called the SMART study) evaluates the effects of different types of intravenous fluids used in practice in critically ill patients. It is very similar to the companion study (called the SALT-ED study and published in the same issue) which compares the effects of different types of intravenous fluids on non-critically ill patients admitted to the hospital. Saline is the most commonly used intravenous fluid in critically ill patients. It contains higher levels of sodium and chloride than are present in the human blood. Balanced fluids contain levels of sodium and chloride closer to those seen in human blood.
Large observational studies and studies in animals have suggested that the higher sodium and chloride content in saline may cause or worsen damage to the kidney or cause death. Only a few large studies have been done in humans and the results are a bit inconclusive.
Dr. Self[/caption]
Wesley H. Self, MD, MPH
Associate Professor
Department of Emergency Medicine
Vanderbilt University Medical Center
Nashville, TN
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Doctors have been giving IV fluids to patients for more than 100 years. The most common IV fluid during this time has been saline; it has high levels of sodium and chloride in it (similar to table salt). Balanced fluids are an alternative type of IV fluid that has lower levels of sodium and chloride that are more similar to human blood.
Our studies were designed to see if treating patients with these balanced fluids resulted in better outcomes than saline. We found that patients treated with balanced fluids had lower rates of death and kidney damage than patients treated with saline.
Dr. Rigg[/caption]
Khary Rigg, Ph.D.
Assistant Professor
Department of Mental Health Law & Policy
University of South Florida
MedicalResearch.com: What is the background for this study?
Response: Over the past two decades, the demographic profile of MDMA (ecstasy/molly) users has changed. In particular, African American MDMA use has risen in some cities. One possible explanation of this new trend is the drug’s recent popularity (as molly) in hip-hop/rap (HHR) music. Several top rappers endorse the drug as a way to have fun or get women “loose.” There are currently no studies, however, that investigate the extent to which African American MDMA users listen to. hip-hop/rap music or the influence that these pro-MDMA messages have on their use of the drug.
This study used survey and interview data to identify the extent to which hip-hop/rap music is listened to by African American MDMA users and assess the perceived influence of HHR music on their decision to begin using.
Dr. Childers[/caption]
Dr. Chris Childers, M.D.
Division of General Surgery
David Geffen School of Medicine at UCLA
Los Angeles, CA 90095
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Over 20 million Americans undergo a surgical procedure each year with a price tag over $1 trillion. The operating room (OR) is a particularly resource dense environment, yet little is known about the actual costs of running an OR. Most previous efforts focusing on OR costs have come from single-site studies with little detail about the drivers of OR costs.
Using financial statements from all California hospitals we estimated that the average cost to the hospital for one minute of OR time was between $36 and $37. Perhaps more notable was the composition of these costs. Almost two-thirds ($20-21) was attributable to “direct costs” - those generated by the OR itself - including $14 for the wages and benefits of staff, $2.50-3.50 for surgical supplies, and $3 for “other” costs such as equipment repair and depreciation. Interestingly, the remainder ($14-16) was dedicated to “indirect costs” such as the costs associated with hospital security and parking. While these indirect costs are necessary for a hospital to run, they are not under the purview of the operating room.
Finally, we also learned that OR costs have increased quickly over the past 10 years – faster than other sectors of healthcare as well as the rest of the economy.
Dr. Bekelman[/caption]
David Bekelman, MD, MPH
Associate Professor of Medicine and Nursing
Eastern Colorado Health Care System, Department of Veterans Affairs, Denver, CO
University of Colorado School of Medicine at the Anschutz Medical Campus, Aurora, CO
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Many of the 5.8 million Americans with heart failure live with bothersome symptoms, reduced function and poor quality of life. Improving their care is important because many people with heart failure live with these challenges for years.
This study evaluated the effect of a team intervention, Collaborative Care to Alleviate Symptoms and Adjust to Illness, also called CASA, on several aspects of quality of life in 314 patients with heart failure. The patients, who received care at diverse health systems in Colorado, were randomized to receive usual care or usual care supplemented with the CASA intervention, which included a nurse and a social worker who collaborated with a primary care provider, cardiologist, and palliative care physician to address the patients’ needs.
The study found that the CASA intervention did not influence the primary outcome of heart failure health status, yet did improve patients’ depression and fatigue. CASA did not influence number of patient hospitalizations or mortality.
Shyueluen Chang[/caption]
Shyueluen Chang MD
Phlebologist with Dermatologist background
Vein Clinic, Department of Dermatology,
Chang Gung Memorial Hospital
Taoyuan, Taiwan
MedicalResearch.com: What is the background for this study?
Response: Varicose veins are common, with about 23 percent of U.S. adults having the condition, but they are rarely thought to be associated with serious health risks.
In contrast, venous thrombosis (DVT), pulmonary embolism (PE), and peripheral artery disease (PAD) are also vascular diseases that are associated with serious systemic effects. Not much is known about varicose veins and the risk of other vascular diseases. Elucidating potential associations between varicose veins and health-threatening diseases is important.
Partner's note: Understanding the broader impact of vascular diseases can provide valuable insights into the risks associated with varicose veins.
William Chopik PhD
Department of Psychology
Michigan State University
East Lansing, MI
MedicalResearch.com: What is the background for this study?
Response: The motivation for the study was that we saw a lot of differences in the way people defined "old age". We also noticed that there is a stigma that goes along with being old. So we had a natural curiosity to see how these perceptions my change as people age.
As people aged, the tended to report feeling younger and consider an older adult as "always in the future"--never quite where they are now.
We found that our results confirmed a lot of existing theories about how our attitudes toward aging change as we age ourselves.
A left ventricular assist device (LVAD) pumping blood from the left ventricle to the aorta, connected to an externally worn control unit and battery pack.
Dr. Alban[/caption]
Rodrigo F. Alban, MD FACS
Associate Director Performance Improvement
Associate Residency Program Director
NSQIP Surgeon Champion
Department of Surgery
Cedars-Sinai Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Continuous Renal Replacement Therapy (CRRT) is a modality of hemodialysis commonly used to manage renal failure in critically ill patients who have significant hemodynamic compromise. However, it is also resource-intensive and costly and its usage is highly variable and lacks standardization.
Our institution organized a multidisciplinary task force to target high value care in critically ill patients requiring CRRT by standardizing its process flow, promoting cross-disciplinary discussions with patients and family members, and increasing visibility/awareness of CRRT use. After our interventions, the mean duration of CRRT decreased by 11.3% from 7.43 to 6.59 days per patient. We also saw a 9.8% decrease in the mean direct cost of CRRT from $11642 to $10506 per patient. Finally, we also saw a decrease in the proportion of patients expiring on CRRT, and an increase in the proportion of patients transitioning to comfort care.