Author Interviews, Boehringer Ingelheim, Surgical Research / 27.11.2017

MedicalResearch.com Interview with: Thomas Seck, M.D., vice president Clinical Development and Medical Affairs Primary Care Boehringer Ingelheim Pharmaceuticals, Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is a new subanalysis of the phase III RE-VERSE AD™ study, which evaluated the safety and efficacy of idarucizumab, marketed in the U.S. as Praxbind®, in reversing the anticoagulant effect of Pradaxa® (dabigatran etexilate mesylate). This data assessed idarucizumab in a subset of patients requiring an urgent procedure or emergency surgery. The analysis found that idarucizumab rapidly and completely reversed the anticoagulant effect of dabigatran in approximately 98 percent of patients based on dTT. The median time between administration of idarucizumab and start of surgery was 1.7 hours for patients requiring abdominal procedures, 1.9 hours for orthopedic procedures, 1.4 hours for vascular procedures, 1.3 hours for drainage procedures and 1.2 hours for catheter procedures. Among these patients, periprocedural homeostasis was assessed as normal in more than 92 percent of patients, across all surgery types. (more…)
Addiction, Author Interviews / 27.11.2017

MedicalResearch.com Interview with: Dr. Zoe Weinstein MD Instructor, Boston University School of Medicine Director of the Inpatient Addiction Consult Service Boston Medical CenterDr. Zoe Weinstein MD Instructor, Boston University School of Medicine Director of the Inpatient Addiction Consult Service Boston Medical Center MedicalResearch.com: What is the background for this study? Response: Substance use disorders are highly prevalent, especially among hospitalized patients, however substance use often goes unaddressed in the hospital setting, even if substance use is the underlying cause of the hospitalization (such as a blood stream infection from intravenous drug use). This study reviews the experience of one hospital in starting an Addiction Consult Service to address substance use among hospitalized patients, and help connect them with long-term outpatient addiction treatment directly from the hospital. (more…)
Author Interviews, CDC, Infections / 27.11.2017

MedicalResearch.com Interview with: Samuel J. Crowe, Ph.D., M.P.H. Food and Drug Administration College Park, MD CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Flour has been a suspected outbreak vehicle for Shiga toxin-producing E. coli (STEC) infections since 2009, when a multistate outbreak of foodborne disease was linked to prepackaged cookie dough. The 2016 STEC outbreak investigation described in this study was the first investigation to confirm flour as the source of an E. coli outbreak. Linking the outbreak to flour was challenging for several reasons, but epidemiologic, traceback, and microbiologic data ultimately confirmed that flour produced at a single facility was the source of the illnesses. (more…)
Author Interviews, CDC, Lyme / 27.11.2017

MedicalResearch.com Interview with: Kiersten Kugeler, PhD Division of Vector-Borne Diseases CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Lyme disease has been a nationally notifiable disease in the United States since 1991. Each year, possible cases of Lyme disease are investigated and tallied by state and local public health officials according to criteria set by the surveillance case definition. States voluntarily share human case data with CDC, which summarizes the data to provide a national perspective on disease trends. This report summarizes national Lyme disease data reported during 2008-2015. Lyme disease continues to be the most commonly reported vector-borne disease in the United States with more than 275,000 cases of Lyme disease reported to CDC during the study period. Although most cases continue to be reported from states with high incidence in the Northeast, mid-Atlantic, and upper Midwest regions, case counts in most of these states have remained stable or decreased during this time. In contrast, case counts have increased in states that neighbor those with high incidence. The trend of stable to decreasing case counts in many states with high incidence may be due to multiple factors, including the possibility that occurrence of the disease has stabilized in these areas or that some state health agencies have changed their reporting practices to lower the resource burden associated with Lyme disease surveillance. Lyme disease surveillance is not meant to document every case, but rather to indicate disease trends over time, define high-risk groups, and describe the geographic distribution of the condition. (more…)
Aging, Author Interviews, Heart Disease, Lancet, Social Issues / 26.11.2017

MedicalResearch.com Interview with: Prof Kazem Rahimi FRCP The George Institute for Global Health Oxford Martin School University of Oxford, Oxford MedicalResearch.com: What is the background for this study? Response: We decided to investigate this topic because disease incidence data is very important for public health bodies; for example, for the allocation of healthcare resources or for the design and assessment of disease prevention measures. When we reviewed the literature, we found that estimates of heart failure incidence, temporal trends, and association by patient features were scarce. Studies often referred to restricted populations (such as relatively small cohorts that may or may not be representative of the general population), or limited data sources (for example, only including patients hospitalized for their heart failure and not considering those diagnosed by clinicians outside of hospitals). Few studies reported comparable, age-standardized rates, with the result that the rates reported varied considerably across the literature. (more…)
Author Interviews, Biomarkers, Gastrointestinal Disease / 26.11.2017

MedicalResearch.com Interview with: Iquity IncChase Spurlock, PhD, CEO of IQuity Inc. and Thomas M. Aune, PhD, Co-Founder of IQuity Inc. MedicalResearch.com: Why did you develop IsolateIBS-IBD? Response: Isolate IBS-IBD arose from work started at Vanderbilt University, which found that autoimmune diseases exhibit distinct RNA patterns in blood and that these patterns often are specific for a particular disease. In our longitudinal and cross-sectional studies of many human conditions that span both autoimmune and non-autoimmune disease categories, we found that differences detected at the level of RNA can provide an accurate snapshot of a person’s disease. Using RNA, we can tell at a very early stage if a pattern exists that indicates a specific disease. With this information, providers can initiate treatment plans sooner and have an additional tool in their toolbox when making diagnostic determinations. We developed this test because the symptoms of IBS and IBD are very similar, which can make it difficult and time-consuming for doctors to achieve an accurate diagnosis. IsolateIBS-IBD helps providers distinguish between the two conditions. It shouldn’t be viewed as a replacement or stand-alone test — doctors still need to use it in conjunction with clinical observation combined with traditional tests and procedures like a CT scan or endoscopic examination of the colon — but it can dramatically speed the diagnostic process. IQuity delivers results to providers within seven days of receiving the patient’s sample in the laboratory, allowing doctors to begin discussing a course of treatment as soon as possible.  (more…)
Author Interviews, JAMA, Surgical Research / 26.11.2017

MedicalResearch.com Interview with: Brian C. Stagg, MD Department of Ophthalmology and Visual Sciences University of Michigan Medical School National Clinician Scholars Program University of Michigan Institute for Healthcare Policy and Innovation Joshua D. Stein, MD, MS Associate Professor University of Michigan Department of Ophthalmology and Visual Sciences Director, Center for Eye Policy and Innovation Ann Arbor  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cataract surgery is one of the most common surgeries in the US. It is typically performed at either hospital outpatient departments (HOPDs) or ambulatory surgery centers (ASCs). ASCs are cheaper and more efficient, but some people believe that HOPDs may be safer for people with co-morbid medical conditions. We conducted this study to evaluate how the use of ambulatory surgery centers for cataract and other ocular surgeries has changed since 2001. We also wanted to see what factors influenced whether or not a patient had cataract surgery at an ASC (versus a HOPD), and to compare ASC use for cataract surgery with ASC use for other common eye surgeries (glaucoma, cornea, retina, strabismus). (more…)
Author Interviews, Brigham & Women's - Harvard, Pediatrics, Psychological Science, Science / 26.11.2017

MedicalResearch.com Interview with: Shari Liu Dept Psychology Harvard University Cambridge, MA 02138  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Every day, we look out into the social world and see more than pixels changing across our retinas, or bodies moving in space. We see people brimming with desires, governed by their beliefs about the world and concerned about the costs of their actions and the potential rewards those actions may bring. Reasoning about these mental variables, while observing only people’s overt behaviors, is at the heart of commonsense psychology. (more…)
Author Interviews, BMJ, Nutrition / 26.11.2017

MedicalResearch.com Interview with: “Coffee” by Treacle Tart is licensed under CC BY 2.0Robin Poole Specialty registrar in public health Academic Unit of Primary Care and Population Sciences Faculty of Medicine University of Southampton MedicalResearch.com: What is the background for this study? Response: Worldwide, over two billion cups of coffee are consumed every day. Since such a lot of coffee is consumed it is important to understand whether this is beneficial or harmful to our health. Evidence to date has been mixed and this tends to vary between different outcomes. Coffee is a complex mixture of many bioactive compounds including caffeine, chlorogenic acids, and diterpenes. Laboratory experiments have previously highlighted the potential for coffee to have anti-oxidant, anti-inflammatory, anti-fibrotic and anti-cancer effects. Our research group is interested in liver conditions and we were aware of studies suggesting beneficial associations between drinking coffee and liver disease. We went on to conduct two meta-analyses and concluded that coffee drinking was beneficially associated with both liver cirrhosis and liver cancer. (more…)
Author Interviews, Technology / 26.11.2017

MedicalResearch.com Interview with: <a href="https://www.flickr.com/photos/fotologic/3862190141">“Virtual Reality”</a> by <i> <a href="https://www.flickr.com/people/fotologic/">fotologic</a> </i> is licensed under <a href="https://creativecommons.org/licenses/by/2.0"> CC BY 2.0</a>Professor Robert G. Parton FAA Institute for Molecular Bioscience, University of Queensland Brisbane, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have combined whole cell microscopy with image analysis and virtual reality visualization to allow a user to explore the surface of a cancer cell and then to move inside the cell and interact with the organelles vital for cellular function. The study utilized serial blockface electron microscopy data of a migratory breast cancer cell (combining thousands of electron microscopic images into one 3D dataset) together with to-scale animations of endocytic processes at the cell surface. Through the use of low-cost commercial VR headsets, the user could then ‘walk’ over the alien landscape of the cell surface, observe endocytic processes occurring around them in real-time, and then enter a portal into the cell interior. We provide guidelines for the use of VR in biology and describe pilot studies illustrating the potential of this new immersive experience as an educational too (more…)
Allergies, Author Interviews, Pediatrics / 26.11.2017

MedicalResearch.com Interview with: “Peanuts” by Daniella Segura is licensed under CC BY 2.0Vicki McWilliam Murdoch Children’s Research Institute (MCRI) MedicalResearch.com: What is the background for this study? What are the main findings? Response: Food allergy affects up to 10% of children and 2-3% of adults, and appears to increasing in prevalence. The rise in food allergy prevalence has coincided with increased reports of anaphylaxis. Previous research has shown that adolescents are most at risk of experiencing adverse food reactions and appear to be at higher risk of anaphylaxis fatalities but are an understudied age group in food allergy research. In a large population representative sample of 10,000 10-14 year olds in Melbourne, Australia we found that alarmingly over 40% had experienced an allergic reaction in the past year and almost 10% reported potentially life threatening reactions. Consistent with other research peanut and tree nuts were the most common trigger foods for reactions and those with nut allergy were most at risk of anaphylaxis. Having more than two food allergies doubled the risk of a food allergic reaction compared to those with a single food allergy. Surprisingly, reactions were found to occur most commonly at home rather than restaurants or school. (more…)
Author Interviews, Psychological Science, Technology / 23.11.2017

MedicalResearch.com Interview with: “FACEBOOK(LET) Front” by FACEBOOK(LET) is licensed under CC BY 2.0Phillip Ozimek M.Sc. Department of Social Psychology Faculty of Psychology Ruhr-University Bochum UniversitätsstrBochum, Germany MedicalResearch.com: What is the background for this study? Response: We started reading the classic book by Erich Fromm „To have or to be“ out of personal interest. I was very much interested in studying social media, so we wondered how materialists would use facebook. After all Facebook seemed to be a perfect tool for people who love social comparisons. Furthermore, Facebook is for free – materialists love tools that do not cost money! (more…)
Author Interviews, Microbiome, Multiple Sclerosis / 23.11.2017

MedicalResearch.com Interview with: Kouichi Ito, PhD Associate Professor Department of Neurology Robert Wood Johnson Medical School Rutgers MedicalResearch.com: What is the background for this study? What are the main findings? Response: Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system (CNS), and breakdown of immune tolerance to CNS proteins has been suggested to initiate CNS autoimmunity. Although the mechanism underlying the breakdown of immune tolerance to CNS proteins is still unknown, gut microbiota has been suggested to be involved in disease initiation and progression. To investigate the etiology of Multiple Sclerosis, we have created humanized transgenic mice expressing MHC class II and T cell receptor genes isolated from an Multiple Sclerosis patient and showed that gut dysbiosis, alteration in intestinal microbial composition, can induce gut leakiness and subsequently trigger the development of neurological deficits through activation of complement C3 and reduction of CBLB and Foxp3 genes. This study suggests that gut dysbiosis is one of the possible etiological factors for Multiple Sclerosis. (more…)
Author Interviews, Cognitive Issues, Dermatology, Infections, Mental Health Research, Neurological Disorders, NIH / 23.11.2017

MedicalResearch.com Interview with:   Byron Caughey, Ph.D. Senior Investigator Chief, TSE/prion Biochemistry Section Laboratory of Persistent Viral Diseases NIH/NIAID Rocky Mountain Laboratories Hamilton, MT      MedicalResearch.com: Would you briefly explain what is meant by Creutzfeldt-Jakob disease? Response: Creutzfeldt-Jakob disease (CJD) is an incurable—and ultimately fatal—transmissible, neurodegenerative disorder in the family of prion diseases. Prion diseases can be found in many mammalian species and are due to the conversion of normally harmless prion protein molecules into abnormally folded, aggregated and self-propagating clusters and filaments in the brain. The accumulation of these clusters has been associated with tissue damage that often leaves dying neurons and microscopic sponge-like holes in the brain. In the sporadic and genetic forms of CJD this pathogenic process appears to arise spontaneously in the patient. However, the transfer of the prion protein aggregates from a Creutzfeldt-Jakob disease patient into another human or experimental animal can initiate the pathogenic process in the recipient. These infectious forms of prion protein are called prions. Human prion diseases include fatal insomnia; kuru; Gerstmann-Straussler-Scheinker syndrome; and variant, familial and sporadic CJD. Sporadic CJD is the most common human prion disease, affecting about one in one million people annually worldwide. Other prion diseases include scrapie in sheep; chronic wasting disease in deer, elk and moose; and bovine spongiform encephalopathy (BSE), or mad cow disease, in cattle. (more…)
Author Interviews, Biomarkers, JAMA, Stroke / 23.11.2017

MedicalResearch.com Interview with: Pankaj Arora MD, FAHA Assistant Professor, Cardiology Division University of Alabama at Birmingham Section Editor, Circulation: Cardiovascular Genetics American Heart Association  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Natriuretic peptides are hormones produced by the heart in response to increased wall stress in the atria and ventricles. It is well known that blacks have increased prevalence of cardiovascular disease which contributes to racial disparities in outcomes. In the current work, we tested the hypothesis that black race is a natriuretic peptide deficiency state using a stratified random cohort of 4,415 participants selected from the REGARDS study (a national population-based cohort study evaluating racial and geographic disparities in stroke in US adults aged ≥45 years of age or older). Next, we looked for published results on the percentage difference in N-terminal proB-type NP (NTproBNP) levels by race in participants free of cardiovascular disease from other population cohorts. Lastly, we explored whether association of natriuretic peptides with all-cause mortality and CV mortality in apparently healthy individuals from REGARDS differs by race. We found that in multivariable adjustment, NTproBNP levels were up to 27% lower in black individuals as compared with white individuals in the REGARDS study. We pooled our results and found that in meta-analysis of the 3 cohorts, NTproBNP levels were 35% lower in black individuals than white individuals (more than 13,000 individuals in total). Lastly, we found that the higher NTproBNP levels were associated with higher incidence of all-cause mortality, and cardiovascular mortality in healthy blacks and white individuals, and this association did not differ by race. (more…)
Author Interviews, Cost of Health Care, Dermatology, JAMA, Medicare / 22.11.2017

MedicalResearch.com Interview with: Adewole Adamson, MD, MPP Department of Dermatology UNC – Chapel Hill North Carolina  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nurses practitioners and physician assistants, collectively known as non-physician clinicians (NPCs), provide many dermatology services, some which are billed for independently. Little is known about the types of these services provided. Even less is known about where these independently billed services are provided. Given that there is a purported shortage of dermatologists in the United States (US),  NPCs have been suggested as way to fill in the gap. In this study, we found that NPCs independently billed for many different types of dermatology associated procedures, including surgical treatment of skin cancer, flaps, grafts, and billing for pathology. Most of these NPCs worked with dermatologists. Much like dermatologists, NPCs were unevenly distributed across the US, concentrating mostly in non-rural areas. (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, Radiology / 22.11.2017

MedicalResearch.com Interview with: “IMGP6403_qtu-no-violence” by Rae Allen is licensed under CC BY 2.0Elizabeth George, MD PGY-4 Radiology Resident Brigham and Women’s Hospital Dr. Bharti Khurana MD Clinical Fellow, Harvard Medical School and Assistant Director, Emergency Radiology Director, Emergency Musculoskeletal Radiology Program Director, Emergency Radiology Fellowship Assistant Professor, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: According to the CDC, 1 in 3 women in the United States are victims of abuse by their intimate partner. Despite the US Preventive Services Task Force recommendations, intimate partner violence (IPV) screening is still not widely implemented and IPV remains very prevalent and often under-recognized. The goals of this study are to increase the awareness among physicians about this public health problem and to elucidate the potential role of imaging in the identification of these patients. In fact, there is a striking disparity in the literature on the role of imaging in identifying non-accidental trauma in children compared to intimate partner violence. The common patterns of injury we identified in this population were soft tissue injuries (swelling, hematoma or contusion) followed by extremity fractures, which often involve the distal upper extremities, suggesting injury from defensive attempts. Other common injuries were facial fractures, which represent an easily accessible site for inflicting trauma, and pregnancy failure. Since radiologists have access to both current and prior radiological studies of these patients, they could play a critical role by putting the pieces together in identifying victims of IPV. (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Medical Imaging, Weight Research / 22.11.2017

MedicalResearch.com Interview with: Miriam Bredella, MD Associate Professor of Radiology Harvard Medical School Department of Radiology Massachusetts General Hospital Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that body composition differs between men and women, with women having proportionally more fat and men more muscle mass. But not the amount of fat but its distribution is an important determinant of cardiometabolic risk, with certain ectopic fat depots, such as visceral adipose tissue, fat within muscle cells - intramyocellular (IMCL), and liver fat, being more detrimental than others, such as femorogluteal subcutaneous adipose tissue. We therefore wanted to study sex differences in body composition and cardiometabolic risk in men and women with obesity. We found that at the same BMI, men had relatively higher visceral adipose tissue, IMCL, liver fat, muscle and lean mass, while women higher percent fat mass and higher subcutaneous adipose tissue. This female anthropometric phenotype was associated with a better cardiometabolic risk profile at similar BMI compared to men. However, ectopic fat depots were more strongly associated with adverse cardiometabolic risk factors in women compared to men (more…)
Accidents & Violence, Author Interviews, CDC, Emergency Care, JAMA, Mental Health Research / 21.11.2017

MedicalResearch.com Interview with:

Dr. Melissa C. Mercado PhD, MSc, MA Behavioral scientist Division of Violence Prevention National Center for Injury Prevention and Control CDC

MedicalResearch.com: What is the background for this study? What are the main findings? Response: Suicide ranks as the 10th leading cause of death for all age groups combined and has been among the top 12 leading causes of death since 1975 in the U.S. In 2015, across all age groups, suicide was responsible for 44,193 deaths in the U.S., which is approximately one suicide every 12 minutes. Suicide was the second leading cause of death among U.S. youth aged 10-24 years in 2015. Self-inflicted injury is one of the strongest risk factors for suicide. This study examined trends in non-fatal self-inflicted injuries treated in hospital emergency departments (EDs) among youth aged 10 to 24 years in the United States from 2001-2015.  The overall weighted age-adjusted rate for this group increased by 5.7% annually during the 2008 to 2015 period.  Age-adjusted trends for males overall and across age groups remained stable throughout 2001-2015.  However, rates among females increased significantly, by 8.4% annually. The largest increase among females was observed among those aged 10-14 years, with an increase of 18.8% annually from 2009 to 2015. (more…)
Author Interviews, Blood Pressure - Hypertension, Cancer Research / 21.11.2017

MedicalResearch.com Interview with: Anton Wellstein, MD PhD Professor Oncology & Pharmacology Georgetown University Medical School Associate Director for Basic and Translational Science Lombardi Comprehensive Cancer Center Washington DC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tumor angiogenesis and signaling by growth factors such as Fibroblast growth factors (FGFs) are targets for the treatment of cancer. Targeting some of these factors will alter blood pressure. We show that FGF activation in an animal model can cause hypertension. We show that the hypertension is driven by sensitization of resistance vessels to the vasoconstrictor angiotensin II. We propose that drugs used to target FGF pathway signaling in cancer could be useful to treat hypertension. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA, Personalized Medicine / 21.11.2017

MedicalResearch.com Interview with: Dr. MalikDr. Shaista Malik MD PhD MPH Director of Samueli Center For Integrative Medicine Assistant Professor, School of Medicine University of California, Irvine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Having diabetes has been considered to be a risk equivalent to already had a myocardial infarction for predicting future cardiovascular events.  We were interested in testing whether further risk stratification in those with diabetes and metabolic syndrome, using coronary artery calcium (CAC), would result in improved prediction of cardiovascular events. We found that CAC score was associated with incident coronary heart disease and cardiovascular disease more than a decade after the scoring was performed.  We also found that even after we controlled for the duration of diabetes (of 10 years or more), insulin use, or hemoglobin A1c level, coronary artery calcium remained a predictor of cardiovascular events. (more…)
Author Interviews, Biomarkers, Brain Injury, JAMA / 21.11.2017

MedicalResearch.com Interview with: Dr. Steven D. Hicks,  M.D., Ph.D Penn State Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has shown that small epigenetic molecules called microRNAs are altered in the blood after a traumatic brain injury. Our own pilot research showed that microRNAs were also changed in the saliva after brain injury and that some of these changes mirrored changes in cerebrospinal fluid. In this study we investigated whether salivary microRNA patterns after a concussion could be used to predict the duration and character of symptoms one month after injury. We found that levels of five microRNAs predicted presence of symptoms one month later with greater accuracy (~85%) than standard surveys of symptom burden (~65%). Interestingly, one of the predictive salivary microRNAs (miR-320c) targets pathways involved in synaptic plasticity and was significantly correlated with attention difficulties one month after concussive injury.   (more…)
Author Interviews, Heart Disease, JACC, Kidney Disease, Mayo Clinic / 21.11.2017

Interview with: Dr Xiaoxi Yao PhD Assistant Professor Researcher Mayo Clinic What is the background for this study? What are the main findings? Response: Lifelong oral anticoagulation, either with warfarin or a non-vitamin K antagonist oral anticoagulant (NOAC), is indicated for stroke prevention in most patients with atrial fibrillation (AF). Emerging evidence suggests that NOACs may be associated with better renal outcomes than warfarin. The study found renal function decline is common among patients with atrial fibrillation treated with oral anticoagulants. NOACs, particularly dabigatran and rivaroxaban, may be associated with lower risks of adverse renal outcomes than warfarin. (more…)
Author Interviews, JAMA, Mental Health Research, Pediatrics / 21.11.2017

MedicalResearch.com Interview with: Julie M. Zito, PhD Professor of Pharmacy and Psychiatry University of Maryland, Baltimore Pharmaceutical Health Services Department Baltimore, MD 21201  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The growth of antipsychotic use in children, mainly for the treatment of behavior, has been of increasing concern in recent years. Clinical safety issues (Burcu et al. 2017) and government reports on overuse in the treatment of poor and foster care children (GAO, 2017; 2012) motivated our assessment of peer review programs. These programs are a relatively new approach to Medicaid oversight intended to monitor and assure clinical appropriateness of second generation antipsychotics in children. Critically important is the fact that most antipsychotic use is for child behavioral problems which are off-label conditions, i.e. without sufficient evidence of effectiveness or safety. (more…)
Author Interviews, Environmental Risks, OBGYNE / 21.11.2017

MedicalResearch.com Interview with: “Cairo Air Pollution with smog - Pyramids1” by Nina Hale is licensed under CC BY 2.0Pauline Mendola, PhD Investigator Epidemiology Branch Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH Bethesda, MD  20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We compared ambient air pollution levels at the residences of couples who were trying to get pregnant and estimated the risk of pregnancy loss associated with common pollutants. No prior studies have been done in the United States and most studies are retrospective, looking back in time, and asking couples to report on their reproductive outcomes. Without detailed prospective follow-up, early pregnancy losses that occur before entry into care (i.e., before women are aware that they are pregnant) are often missed. In contrast, we studied 501 couples in the Longitudinal Investigation of Fertility and the Environment (LIFE) study who were enrolled before pregnancy and followed until they became pregnant or tried for 12 months without a pregnancy. Using this prospective data, we found that both ozone and fine particles (PM2.5) were associated with a 12-13% increased risk of early pregnancy loss. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Nutrition / 20.11.2017

MedicalResearch.com Interview with: “Nuts” by fdecomite is licensed under CC BY 2.0Marta Guasch-Ferre, PhD Research Fellow Department of Nutrition. Harvard TH Chan School of Public Health 655 Huntington Ave, Building 2 Boston, Ma, 02115  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although previous evidence has shown that frequent nut consumption is associated with reduced cardiovascular risk factors including dyslipidaemia, type 2 diabetes and metabolic syndrome; as well as with lower risk of coronary heart disease (CHD); most of the previous prospective studies have focused on total nut consumption in relation to the risk of CVD. However, the associations between peanut butter and specific types of nuts, such as peanuts and walnuts, with major cardiovascular events, and specifically the relation with stroke were unclear. Of note, because the nutritional composition of peanuts and walnuts differs from other nuts, it was of particular interest to evaluate the health effects of specific types of nuts. Therefore, our main aim was to look at several types of nuts including total nut consumption, peanuts, walnuts, and tree nuts. Briefly, in three large prospective cohorts with up to 32 years of follow-up, people who regularly eat nuts, including peanuts, walnuts and tree nuts, have a lower risk of developing cardiovascular disease or coronary heart disease compared to people who never or almost never eat nuts. We found a consistent inverse association between total nut consumption and total cardiovascular disease (14% lower risk for those consuming nuts five or more times per week) and coronary heart disease (20% lower risk). Also, after looking at individual nut consumption, eating walnuts one or more times per week was associated with a 19 percent lower risk of cardiovascular disease and 21 percent lower risk of coronary heart disease. Participants who ate peanuts or tree nuts two or more times per week had a 15 percent and 23 percent, respectively, lower risk of coronary heart disease compared to those who never consumed nuts. (more…)
Alcohol, Author Interviews, Surgical Research, Weight Research / 20.11.2017

MedicalResearch.com Interview with: “Alcohol” by Takahiro Yamagiwa is licensed under CC BY 2.0 Marta Yanina Pepino PhD Department of Food Science and Human Nutrition College of Agricultural, Consumer and Environmental Sciences University of Illinois Urbana, IL  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study is not the first to look at whether sleeve gastrectomy affects alcohol absorption and metabolism. Before our study, there were three published studies in the literature on this issue. However, findings from these studies were discrepant. Two of the studies found that sleeve gastrectomy did not affect blood alcohol levels and one of the studies did found that peak blood alcohol levels were higher when people drink after having a sleeve gastrectomy. All these three studies used a breathalyzer to estimate blood alcohol levels. Our study tested the following two related hypothesis. First, that similar to Roux-en-Y- gastric bypass (RYGB), sleeve gastrectomy accelerates alcohol absorption, which cause peak blood alcohol levels to be higher and much faster than before surgery. Because the breathalyzer requires a 15 min of waiting time between drinking the last sip of alcohol and the time that you can read a good estimate of blood alcohol levels from the breath, we hypothesized that the breathalyzer was not a good technique to estimate peak blood alcohol levels in people who may reach a peak blood alcohol level before those 15 min have passed, such as people who underwent sleeve gastrectomy or RYGB. We found these two hypothesis to be truth: 1) Sleeve gastrectomy, similar to RYGB, can double blood alcohol levels; and 2) The breathalyzer technique is invalid to assess effects of gastric surgeries on pharmacokinetics of ingested alcohol (it underestimate blood alcohol levels by ~27% and it may miss peak blood alcohol levels). (more…)
Author Interviews, End of Life Care, JAMA, UCSF / 20.11.2017

MedicalResearch.com Interview with: Kara Bischoff, MD Assistant Clinical Professor, Hospital Medicine & Palliative Care Director of Quality Improvement for the Palliative Care Service UCSF Department of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Care planning, which we define as including both advance care planning and goals of care discussions, are a common need in seriously ill patients and a key function of palliative care teams. However, few studies have looked at how often and how care planning is being done by inpatient palliative care teams throughout the United States, and similarly few studies have examined the precise impact of these care planning activities. Therefore, using data from a large quality improvement registry in palliative care called the Palliative Care Quality Network, we examined: 1) the characteristics of hospitalized patients who are referred to inpatient palliative care consult services, 2) the activities that occurred during those inpatient palliative care consults, and 3) the outcomes that resulted. In looking at data from 73,145 patients who referred for an inpatient palliative care consult, we found that care planning was the most common reason for inpatient palliative care consultation, requested for 71.9% of patients who were referred to palliative care. Further, care planning needs were found in more than half (58%) of palliative care patients even when the consult was requested for reasons other than care planning. Patients referred to palliative care for care planning were somewhat older than patients referred for other reasons, they were less likely to have cancer, and were more often full code at the time of referral. Through care planning conversations, palliative care clinicians frequently identified surrogates and clarified patients’ preferences for life-sustaining treatments (including code status). For instance, 31% more patients chose a code status of DNR/DNI after a conversation with the palliative care team. However, we also found that legal forms such as advance directives and Physician Orders for Life-Sustaining Treatments (POLST) forms were completed for just 3.2% and 12.3% of the patients see by palliative care teams, respectively. This highlights an important quality gap in need of improvement. (more…)