Author: Marie Benz MD FAAD
09 Oct Eczema Patients More Sensitive To Irritating Effects Of Hard Water
MedicalResearch.com Interview with: [caption id="attachment_37439" align="alignleft" width="125"] Dr. Danby[/caption] Dr. Simon G. Danby, PhD Independent Research Fellow Sheffield Dermatology Research, Department of Infection & Immunity & Cardiovascular Disease, Faculty of Medicine, Dentistry & Healthy, University of Sheffield UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Living in a hard water area has been...
09 Oct Antibiotics Prescribed By Dentists May Contribute To C.diff Infections
MedicalResearch.com Interview with: [caption id="attachment_37324" align="alignleft" width="200"]
Dr. Holzbauer[/caption]
Stacy Holzbauer, DVM, MPH, DACVPM
CDC Career Epidemiology Field Officer (CEFO)
Commander, USPHS
Minnesota Department of Health
St. Paul, MN
MedicalResearch.com: What is the background for this study?
- Antibiotics are not harmless drugs—Clostridium difficile infection, which can sometimes cause a deadly diarrhea, is a complication of antibiotic use and can occur after even one dose of an antibiotic.
- The Minnesota Department of Health (MDH) is part of the larger Centers for Disease Control and Prevention (CDC) Emerging Infections Program (EIP). The healthcare-associated infection component of CDC’s EIP engages a network of state health departments and their academic medical center partners to help answer critical questions about emerging HAI threats including Clostridium difficile also known as “C. diff.”
- In Minnesota, the majority of C. diff infections occur outside the hospital and are driven by antibiotic use in community or outpatient settings. In addition to routine surveillance data, we interview patients with C. diff who were not hospitalized prior to their infection to identify potential risks for developing C. diff infection, including identifying antibiotics received outside of routine healthcare settings.
- Dentists prescribe approximately 10% of the antibiotics in outpatient settings, which was over 24 million prescriptions in 2013. When asked about their prescribing practices in a 2015 survey with the Minnesota Dental Association, 36% of dentists surveyed prescribed antibiotics for dental conditions that are generally not recommended to receive antibiotics according to American Dental Association (ADA) guidelines.
09 Oct Low-Cost, High-Volume Services Add Billions To US Health Care Tab
MedicalResearch.com Interview with: [caption id="attachment_37423" align="alignleft" width="125"]
Dr. Mafi[/caption]
John N. Mafi MD MPH
Assistant Professor of Medicine
David Geffen School of Medicine
University of California, Los Angeles
Natural scientist in Health Policy
RAND Corporation
Santa Monica, California
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Of the 3 trillion dollars the U.S. spends annually on health care, an estimated 10-30% consists of “low-value care”, or patient care that provides no net benefit in specific clinical scenarios (think antibiotics given for the common cold virus). Determining where and why this waste occurs is critical to efforts to safely reducing healthcare spending. Little is known, however, about the distribution of costs among such “low-value” services. In this context, we used the Virginia All Payer Claims Database in order to assess the quantity and total costs of 44 low-value services in 2014 among 5.5 million beneficiaries.
09 Oct Poor and Racial Minorities Have Worse Home Health Care Outcomes
MedicalResearch.com Interview with: [caption id="attachment_37419" align="alignleft" width="145"]
Dr. Joynt-Maddox[/caption]
Karen Joynt Maddox, MD, MPH
Washington University School of Medicine
Saint Louis MO
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Home health is one of the fastest-growing sectors in Medicare, and the setting of a new federal value-based payment program, yet little is known about disparities in clinical outcomes among Medicare beneficiaries receiving home health care.
We found that beneficiaries who were poor or Black had worse clinical outcomes in home health care than their peers. These individuals were generally more likely to have unplanned hospitalizations, readmissions, and emergency department visits. Under Home Health Value-Based Purchasing, these patterns should be tracked carefully to ensure the program helps close the gaps rather than widening them.
09 Oct 40% of Cancers Associated With Overweight and Obesity
MedicalResearch.com Interview with: Dr. C. Brooke Steele D.O. Division of Cancer Prevention and Control Centers fo Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: This report contains new information about cancer risk and people being overweight and obese. Research shows that being overweight or having obesity is associated with at least 13 types of cancer (adenocarcinoma of the esophagus; cancers of the breast [in postmenopausal women], colon and rectum, endometrium, gallbladder, gastric cardia, kidney, liver, ovaries, pancreas, and thyroid; meningioma; and multiple myeloma). We also know that the number of people who weigh more than recommended has increased over the past few decades. Therefore, we looked at the numbers of new cases of cancers associated with overweight and having obesity in the United States, as well as how the rates have changed over a 10-year period. Because screening for colorectal cancer can reduce colorectal cancer incidence through detection and removal of precancerous polyps before they become cancerous, we analyzed trends with and without colorectal cancer.09 Oct Night Shift Work Linked To Increased Risk of Obesity
MedicalResearch.com Interview with: Sun Miaomiao Prof. Shelly Tse JC School of Public Health and Primary Care The Chinese University of Hong Kong Sha Tin, Hong Kong MedicalResearch.com: What is the background for this study? What are the main findings? Response: Approximately 20% of the overall workforce is involving in a shift work schedule, which is equivalent to nearly 0.7 billion workers. It has been several studies and systematic reviews reported that shift work could contribute a risk to abdominal obesity, that was identified to be associated with increased mortality. However, the previous related studies derived from different industries and companies that held with various occupational settings of night shift work, and the results have been inconsistent or lack of statistical power. We believed that a better understanding of the knowledge gaps on the associations between specific obesity types and different shift work settings has important implications for occupational health practice. Our meta-analysis provided a clearer picture for the association between night shift work and overweight/ obesity with a potential gradient association, especially for the abdominal obesity.07 Oct Gossip As An Evolutionary Strategy In Competition For Mates
MedicalResearch.com Interview with: Adam C. Davis, MSc PhD Education student University of Ottawa Ottawa, Ontario Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Charles Darwin argued that animals compete with members of the same sex for desired mates (i.e., intrasexual competition). Using this framework, evolutionary researchers have explored the variety of ways in which this kind of competition may play out across human cultures. Several researchers have argued that gossip may be an effective way for humans to compete for mates, but most of the research has been indirect up until this point. In our study, we provide evidence that the reported tendency to compete with same-sex others for mates is associated with gossiping and positive attitudes toward learning about and spreading gossip. Gossip has also been argued to be women’s weapon of choice to compete for mates; however, few studies have tested this hypothesis. We provide evidence that women gossip to a greater extent than men, particularly about social information (e.g., friendships, romantic relationships) and the physical appearance of others (e.g., clothing), whereas men gossip more about achievement (e.g., salaries, promotions). Women also expressed more favourable attitudes toward gossiping than men.07 Oct Human Kidney Organoids Underscore Importance of Microenvironment in Polycystic Kidney Disease
MedicalResearch.com Interview with: Benjamin Freedman, Ph.D. Assistant Professor | University of Washington Department of Medicine | Division of Nephrology Member, Kidney Research Institute Member, Institute for Stem Cell and Regenerative Medicine Seattle WA 98109 MedicalResearch.com: What is the background for this new technology and study? What are the main findings? Response: Polycystic kidney disease (PKD) is the leading genetic cause of end stage renal disease, affecting approximately twelve million people. The hallmark of the disease is the massive expansion of kidney tubules into large, fluid-filled cysts. Although we know the genes that are mutated in this disease, we do not have a firm grasp on what they do to protect the body from disease. We used a new system, human kidney organoids with gene-edited PKD mutations, to discover how factors outside the cell affect cyst formation. We found that liberating the organoids from plastic dishes into floating cultures greatly increased the number and size of cysts that formed. We also found that PKD organoids had problems in their ability to change the shape of collagen scaffolds surrounding them, compared to control organoids of the same genetic background.07 Oct Complexity of Animals Depends On Diverse Patterns of Gene Regulation
MedicalResearch.com Interview with: Colin Sharpe School of Biology Institute of Biomolecular and Biomedical Science School of Biological Sciences University of Portsmouth Portsmouth, United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have long been fascinated by the question of what underpins the increasing complexity of multicellular animals. In a recent publication we looked at changes to the diversity of the NCoR family corepressors (NCoRs) across the Deuterostomes and found an increase in diversity from sea urchins to humans (1). This is due to gene duplication, an increase in alternative splicing and the encorporation of more protein motifs and domains. In this study we devised a measure of functional diversity based on these three factors and calculated this value for over 12000 genes involved in transcription in nine species from the nematode worm to humans. Orthologues whose increase in diversity correlated with the increase in complexity of these animals were then selected and we looked for common features and interactions between the selected genes. We found that proteins that regulate the dynamic organisation of chromatin were significantly enriched within the selection.07 Oct NHS: Delayed Hospital Discharges May Be Linked To Increase in Mortality
MedicalResearch.com Interview with: Dr Mark A Green BA (Hons), MSc, PhD, AFHEA Lecturer in Health Geography University of Liverpool MedicalResearch.com: What is the background for this study? What are the main findings? Response: Between Dec 2013 and Dec 2015 there was an increase of 41% in the number of acute patients delayed being discharged from hospital. If we compare the previous year of data –Dec 2012- Dec 2014 – there was only a 10% increase. 2015 saw one of the largest annual spikes in mortality rates for almost 50 years – we wanted to explore if there was any correlation between these two trends.06 Oct Novel Brain Imaging May Detect Preclinical Alzheimer’s Disease
MedicalResearch.com Interview with: Dr. Sanja Josef Golubic, dr. sc Department of Physics, Faculty of Science University of Zagreb, Croatia MedicalResearch.com: What is the background for this study? Response: Our study was aimed to search the topological biomarker of Alzheimer’s disease. A recent evidences suggest that the decades long progression of brain degeneration that is irreversible by the stage of symptomatic Alzheimer’s disease, may account for failures to develop successful disease-modifying therapies. Currently, there is a pressing worldwide search for a marker of very early, possibly reversible, pathological changes related to Alzheimer’s disease in still cognitively intact individuals, that could provide a critical opportunity for evolving of efficient therapeutic interventions. Three years ago we reported the discovery of the novel, fast brain pathway specialized for rapid processing of the simple tones. We named it gating loop. Gating loop directly links auditory brain areas to prefrontal brain area. We have also noticed the high sensitivity of the gating loop processing on AD pathology. It was inspiration to focus our Alzheimer’s disease biomarker search in the direction of prefrontal brain activation during listening of simple tones.06 Oct Does Gender Bias Play A Role in Cardiovascular Surgery in Women?
Posted at 18:44h
in Annals Thoracic Surgery, Author Interviews, Gender Differences, Heart Disease, Surgical Research, Women's Heart Health
MedicalResearch.com Interview with:
[caption id="attachment_37407" align="alignleft" width="125"]
Dr. Jabagi[/caption]
Habib Jabagi B.Sc., M.Sc., M.D.
Department of Surgery
University of Ottawa , Ottawa
MedicalResearch.com: What is the background for this study? What are the main findings
Response: Women with coronary artery disease (CAD) are at a significant disadvantage compared to men, as they do not consistently receive the same intensive treatment. For example, when surgery is done in men, it is more common to use arteries, as opposed to saphenous veins from the leg to complete the bypass graft. Arteries, such as the left internal thoracic artery, appear to have much better long-term patency than veins, which translates into improved outcomes.
The motivation for this study was to see if our centre, which has embraced the use of arteries quite aggressively, has suffered the same gender disparities with respect to the use of multiple arterial revascularization strategies in coronary artery bypass grafting (CABG).
06 Oct Data From NY City Suggest PReP Use Is Increasing
MedicalResearch.com Interview with: Paul M. Salcuni, MPH Department of Health and Mental Hygiene New York City MedicalResearch.com: What is the background for this study? What are the main findings? Response: NYC Health Department is committed to ensuring equitable access to HIV pre-exposure prophylaxis (PrEP) for all New Yorkers who are HIV-negative and may be exposed to HIV. We examined trends in PrEP prescribing by 602 ambulatory care practices in New York City from 2014 to 2016, as well as associated patient and practice factors, to inform our comprehensive scale-up efforts. For every 100,000 medical visits in the first three months of 2014, roughly 39 involved a patient being prescribed PrEP. In the second quarter of 2016, 419 of every 100,000 medical visits at those same practices involved a PrEP prescription. Despite this nine-fold increase overall, some groups of patients among these practices were less likely to be prescribed PrEP. Those groups include men of color, women, and people getting health care at smaller private practices or practices outside of the city center.06 Oct Many US Women Face Distance Barriers To Abortion Access
MedicalResearch.com Interview with: Jonathan Marc Bearak, PhD Senior Research Scientist Guttmacher Institute New York MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although U.S. women who live farther from abortion clinics are less likely to obtain one, no national study has examined inequality in women’s access to abortion and whether inequality in abortion access has increased as the number of abortion clinics have declined. We found that half of women live within 11 miles of an abortion provider. However, 1 in 5 women would need to travel at least 43 miles. We found substantially greater variation within than across states, because even in relatively rural states, women and clinics were concentrated in urban areas. These disparities have persisted since at least 2000.06 Oct Stepped Care Case-Finding Intervention Can Provide Cost Effective Care For PTSD After a Disaster
MedicalResearch.com Interview with: [caption id="attachment_37442" align="alignleft" width="144"]
Dr. Cohen[/caption]
Gregory H. Cohen, MPhil, MSW
Statistical Analyst
Department of Epidemiology
School of Public Health
Boston University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We simulated a stepped care case-finding approach to the treatment of posttraumatic stress in New York City, in the aftermath of Hurricane Sandy.
Stepped care includes an initial triage screening step which identifies whether a presenting individual is in need of Cognitive Behavioral Therapy, or can be adequately treated at a lower level of care.
Our simulation suggests that a stepped care approach to treating symptoms of posttraumatic stress in the aftermath of a hurricane is superior to care as usual in terms of reach and treatment-effectiveness, while being cost-effective.
06 Oct Employer Health Plans Spend At Least $6 Billion Per Year On Preterm Infant Care
MedicalResearch.com Interview with: [caption id="attachment_37390" align="alignleft" width="180"]
Dr. Scott Grosse[/caption]
Scott D. Grosse, PhD
National Center on Birth Defects and Developmental Disabilities
CDC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The U.S. Institute of Medicine (IOM) in 2007 published estimates of the economic costs associated with preterm birth. That report is publicly available: https://www.ncbi.nlm.nih.gov/pubmed/20669423. The total societal cost over a lifetime of a single year’s cohort of infants born preterm was estimated as $26 billion in 2005 US dollars. The study in Pediatrics sought to provide more current estimates of one component of those costs: medical care between birth and 12 months and to answer two additional questions:
- What costs are specifically incurred by employer-sponsored private health plans?
- How much of the overall cost burden of prematurity is attributable to infants born preterm with major birth defects (congenital malformations and chromosome abnormalities)?
06 Oct How Do Viruses Trigger Cough In Asthmatic Children, Even Without Allergies
MedicalResearch.com Interview with: [caption id="attachment_37385" align="alignleft" width="160"]
Dr. Piedimonte[/caption]
Giovanni Piedimonte, MD
Steven and Nancy Calabrese Endowed Chair for Excellence in Pediatric Care, Research, and Education
Professor & Chair of Pediatrics
Cleveland Clinic Lerner College of Medicine
Case Western Reserve University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study proves that asthmatic children already have a hyperactive calcium channel that’s extremely sensitive to environmental triggers.
If these children contract a virus, such as RSV, the hyperactive channel causes more severe symptoms that may require care in a hospital setting.
When a child developed asthma or bronchitis in the past, doctors thought these conditions could only be triggered by environmental allergens. There was no explanation why two out of three children ages five and under who wheeze and cough – and still test negative for allergies.
We needed to explore the mechanisms of the calcium molecule and the epithelial cells, which seem to trigger these symptoms without an allergic reaction. If the molecule’s behavior is producing the cough, we just need to figure out how to control the molecule to properly deactivate the cough mechanism in the asthmatic child
05 Oct Surgical Delays For Melanoma Patients Are Common
MedicalResearch.com Interview with: Adewole Adamson, MD, MPP Department of Dermatology UNC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Surgery is the primary intervention for the treatment of melanoma. Little is known about how delays for surgery, defined as the time between diagnosis and surgical treatment, among melanoma patient differ by insurance type. After adjustment of patient-level, provider-level, and tumor-level factors we found that Medicaid patients experience a 36% increased risk of delays in surgery for melanoma. These delays were 19% less likely in patients diagnosed and 18% less likely in patients surgically treated by dermatologists. Non-white patients also had a 38% increased risk of delays.05 Oct Standard or Low Dose Alteplase in Acute Ischemic Stroke–Does It Matter?
MedicalResearch.com Interview with: [caption id="attachment_37265" align="alignleft" width="120"]
Prof. Anderson[/caption]
Craig Anderson | MD PhD FRACP
Executive Director
Professor of Neurology and Epidemiology, Faculty of Medicine, UNSW Sydney
Neurologist, Neurology Department, Royal Prince Alfred Hospital
The George Institute for Global Health at Peking University Health Science Center
Haidian District | Beijing, 100088 P.R. China
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is much controversy over the benefits of a lower dose of intravenous alteplase, particularly in Asia, after the Japanese regulatory authorities approved a dose of 0.6 mg/kg 10 years ago compared to the US FDA and other regulatory authorities approving 0.9 mg/kg 20 years ago. The investigator inititiated and conducted ENCHANTED trial aimed to determine the effectiveness and safety of these two doses in an international multicentre pragmatic open design.
The main results did not confirm the low-dose to be statistically ‘non-inferior’ partly due to the primary outcome measure chosen and partly due to the statistical approach, but it did confirm that the lower dose was safer with less risk of the major complication of this treatment, that of major bleeding in the brain. However, it would appear that this safety effect was offset by some reduce efficacy in terms of functional recovery.
The aim of this secondary analysis of the trial data was to examine in more detail the differences between low and standard dose alteplase according to the participants’ age, ethnicity (Asian vs non-Asian) and severity of neurological deficit at the time of treatment. We did this because the popular belief is that a lower dose might be preferred in older people, and Asians, because of the potential for more likelihood of bleeding, and preferentially to use the standard dose in those with more severe strokes potentially due to greater ‘clot burden’ from a blocked artery to the brain.
The results showed that the main findings on the outcome of surviving free of disability were the same according to age, ethnicity and stroke severity – that is, there was no preferential dose in any of these groups. Similarly, the safety benefit of low dose alteplase on brain haemorrhage, did not clearly translate into clinical disability outcomes in any of the patient groups studied.
04 Oct Genetic Testing Reduces Risk Of Side Effects From Anticoagulation After Surgery
Posted at 23:06h
in Author Interviews, Clots - Coagulation, Genetic Research, JAMA, Surgical Research
MedicalResearch.com Interview with:
[caption id="attachment_37375" align="alignleft" width="140"]
Dr. Bass[/caption]
Anne R. Bass, MD
Associate Professor of Clinical Medicine
Weill Cornell Medical College
Rheumatology Fellowship Program Director
Hospital for Special Surgery
New York, NY 10021
MedicalResearch.com: What is the background for this study?
Response: Blood thinners are used after orthopedic surgery to prevent blood clots from forming in the legs and traveling to the lungs. They are also used in patients with certain heart diseases to prevent strokes. Blood thinners, like warfarin, are effective but can be associated with serious bleeding complications, especially if the wrong dose is given. Genetic testing can help doctors predict the right warfarin dose to use in an individual patient.
In this trial, ≈1600 elderly patients undergoing hip or knee replacement were randomly assigned to receive warfarin dosing based on genetics plus clinical factors (like height, weight and gender), or based on clinical factors alone. The specific genes tested wereVKORC1, CYP2C9, and CYP4F2 which influence warfarin metabolism and the body’s ability to produce clotting factors.
04 Oct Appendicitis May Be More Common After Colonoscopy
MedicalResearch.com Interview with: [caption id="attachment_37370" align="alignleft" width="132"]
Dr. Basson[/caption]
Marc D. Basson, MD, PhD, MBA
Professor of Surgery, Pathology, and Biomedical Science
Senior Associate Dean for Medicine and Research
University of North Dakota School of Medicine & Health Sciences
Grand Forks, ND 58202
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: I and other surgeons have previously had the experience of caring for patients with appendicitis who had recently undergone colonoscopy, and wondered if there might be a connection. However, colonoscopy and appendicitis are both common events, and so it would be difficult to tell whether they are linked or just coincidences from scattered occurrences.
After obtaining appropriate regulatory approvals, we identified almost 400,000 veterans from the US Department of Veterans Affairs database who had undergone screening colonoscopy and compared their rates of appendectomy and acute appendicitis in the week following colonoscopy to rates of appendectomy and appendicitis over each of the following 51 weeks. We asked the question in several different ways and verified our results by examining surgical and pathology reports. Depending on how the question was asked and appendicitis or appendectomy defined, rates of appendectomy and appendicitis were clearly 4-9 times higher in the first week after diagnostic colonoscopy. This wasn’t true when we asked whether appendectomy was more common after several other procedures that also required sedation and contact with the medical system.
04 Oct Almost $3 Billion Spent Per Year On Injuries From Firearms
MedicalResearch.com Interview with: Faiz Gani MD Postdoctoral research fellow Department of Surgery Johns Hopkins University School of Medicine Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: The current study sought to evaluate epidemiological trend in emergency department (ED) visits for firearm-related injuries in the US. In our study, we observed that 25.3 patients per 100,000 presented to the ED for a firearm-related injury. This translated to over 78,000 ED visits per year. Over time, while firearm injuries decreased from 2006-2013, an increase in the incidence of firearm-related injuries was observed in 2014. Additionally, over time injuries among older patients and those injured in an unintentional firearm injury increased. Injuries due to an assault decreased over time. The average ED and inpatient charges were $5,254 and $95,887, respectively, resulting in an overall financial burden of approximately $25 billion over the study or an annual $2.8 billion in ED and inpatients charges.04 Oct Studying Benign Pancreatic Tumors May Lead To Ability To Grow Beta Cells To Reverse Diabetes
MedicalResearch.com Interview with: [caption id="attachment_37356" align="alignleft" width="165"]
Dr. Stewart[/caption]
Andrew F. Stewart MD
Irene and Dr. Arthur M. Fishberg Professor of Medicine
Director, Diabetes, Obesity and Metabolism Institute
Institute at the Icahn School of Medicine at Mount Sinai
New York, NY 10029
MedicalResearch.com: What is the background for this study?
Response: Diabetes results ultimately from an inadequate number of insulin-producing “beta” cell in the pancreas. Ideally, these would regenerate when they are lost or damaged, but unfortunately inducing them to regenerate or proliferate has proven impossible until recently.
In 2015 and others we identified the first class of drugs – the harmine analogues - that are able to induce human beta cells to proliferate. In this study, we wanted to identify additional pathways that can lead to human beta cell proliferation at higher rates than we had been able to induce with harmine. For this we turned to a rare type of benign (i.e., not malignant, not cancer) tumor of the beta cells in the pancreas called “insulinomas”. These tiny tumors overproduce insulin and cause hypoglycemia (low blood glucose) which in turn causes seizures, loss of consciousness and confusion. Once they are discovered, then can easily be removed via laparoscopic surgery, and the person is cured. Since they are so rare, and since they are benign and easily cured, insulinomas have not been included in large genome sequencing studies of patients wit cancer. However, we reasoned that they must hold the genomic recipe or wiring diagram for inducing human beta cells to replicate, so we perfumed next-generation DNA and RNA sequencing on a large series (38) of insulinomas.
04 Oct Adulterated Proprietary Chinese Medicines Pose Serious Health Hazards
MedicalResearch.com Interview with:
Tony Wing Lai Mak , MBChB, MBA, FRCPath, FRCPA, FHKCPath, FHKAM(Path
Hospital Authority Toxicology Reference Laboratory
Princess Margaret Hospital, Hong Kong
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Proprietary Chinese medicines (pCMs) and health products are generally believed to be natural and safe. However, the safety of pCMs and health products has been compromised by the illicit practice of adulteration with undeclared drugs. Such adulteration can have serious and even fatal consequences. Previous reports of pCM and health product adulteration were mainly routine surveillance data or case reports/series with a small number of affected patients.
The present study in Hong Kong, to our knowledge, is the largest case series that reports an overview of the use of various adulterated Proprietary Chinese medicine and health products and the resulting adverse effects. From 2005 to 2015, we have identified 404 cases involving the use of 487 adulterated pCMs or health products with a total of 1234 adulterants detected. The adulterants consisted of approved drugs, banned drugs, drug analogues and animal thyroid tissue.
The six most common categories of adulterants detected were nonsteroidal ant-inflammatory drugs (18%), anorectics (15%), corticosteroids (14%), diuretics and laxatives (11%), oral antidiabetic agents (10%), and erectile dysfunction drugs (6%). Sibutramine, an anorectic that has been withdrawn from the market owing to its association with increased cardiovascular events and strokes, was the most common adulterant identified. A significant proportion of patients (65.1%) had adverse effects that were attributable to these illicit products, including 14 severe and two fatal cases. These illicit Proprietary Chinese medicine and health products pose severe health hazards to the public.
04 Oct Is RICE Best After Injury? Study Suggests Rest Prolongs Recovery
MedicalResearch.com Interview with: [caption id="attachment_37336" align="alignleft" width="116"]
Dr. Bayer[/caption]
Monika Bayer PhD.
Institute of Sports Medicine Copenhagen
Bispebjerg Hospital
Denmark
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Acute muscle strain injuries display a major clinical problem with a high incidence rate for both professional and amateur athletes and are associated with substantial risk for recurrence. Common clinical practice advices to follow the RICE (Rest – Ice – Compression – Elevation) principle after strain injuries but it has not been investigated whether patients really benefit from a period of rest or whether an early of loading following the injury would improve recovery.
In this study, amateur athletes were divided into two groups: one group started rehabilitation two days after the trauma, the other group waited for one week and began rehabilitation after nine days. All athletes had a clear structural defect of the muscle-connective tissue unit following explosive movements. We found that protraction of rehabilitation onset caused a three-week delay in pain-free recovery. In all athletes included, only one suffered from a re-injury.
04 Oct Vitamin D May Have a Role In Reducing Risk of Severe Asthma Attacks
MedicalResearch.com Interview with: [caption id="attachment_37294" align="alignleft" width="125"]
Dr. Jolliffe[/caption]
David Jolliffe, PhD
Centre for Primary Care and Public Health
Blizard Institute
Barts and the London School of Medicine and Dentistry
London
MedicalResearch.com: What is the background for this study?
Response: Asthma affects more than 300 million people worldwide and is estimated to cause almost 400,000 deaths annually. Asthma deaths arise primarily during episodes of acute worsening of symptoms, known as attacks or ‘exacerbations’, which are commonly triggered by viral upper respiratory infections. Vitamin D is thought to protect against such attacks by boosting immune responses to respiratory viruses and dampening down harmful airway inflammation.
Several clinical trials have tested whether vitamin D supplementation might protect against asthma attacks, but individually their results are inconclusive. In the current study, we pooled raw data from 955 asthma patients who took part in 7 separate trials, which allowed us to answer two questions:
1, Does vitamin D protects against asthma attacks overall, when data from all trials are pooled?
2, Do people who have lower vitamin D levels to start with particularly benefit from supplementation?
04 Oct MRSA Contamination of Home and Pets May Contribute To Reinfection and Resistance
MedicalResearch.com Interview with: [caption id="attachment_37331" align="alignleft" width="139"]
Mr. Shahbazian[/caption]
Mr. Jonathan Shahbazian, MPH
Johns Hopkins Bloomberg School of Public Health
Baltimore
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our study was designed to investigate risk factors for drug resistance in MRSA found in dust on surfaces in the home. We undertook this investigation because we were concerned first that people living in the home could pick up MRSA from these surfaces, and second, that if they picked up drug-resistant MRSA, it would be more difficult to treat them.
Our main finding was that use of antibiotics by either people or pets in the home, as well as use of biocidal cleaning products, was associated with multidrug resistance (MDR) in home MRSA. This study is the first to report that use clindamycin in either humans or domestic animals was not associated with risk of MDR in the home environment.
We also found that mupirocin treatment was associated with a slight increase in mupirocin resistance in the household environment, which could complicate decolonization efforts that rely on use of nasal mupirocin ointment. We found that 100% of our MRSA isolates from rural homes were MDR, suggesting living in a rural household may be a risk factor. We also found the presence of domestic pets was associated with MDR MRSA in the home environment while the presence of unwanted pests, such as mice or cockroaches, was associated with non-MDR MRSA strains at the three-month visit.
03 Oct Drinking Coffee Reduced Mortality in Treated HIV-Hepatitis C Co-Infected Patients
MedicalResearch.com Interview with: [caption id="attachment_37320" align="alignleft" width="200"]
CoffeeWikipedia image[/caption] Patrizia Carrieri PhD INSERM U912 - ORS PACA IHU - Faculté de Médecine Marseille, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is based on the longitudinal data of the French ANRS HEPAVIH cohort of patients with HIV and Hepatitis C co-infection. This cohort was set up thanks to a collaboration between INSERM (National Institute of health and medical research) UMR912 in Marseille, the ISPED (public health and epidemiology institute) in Bordeaux and several hospital/university sites. Our INSERM team in Marseille is specialized in the study of the impact of behaviors on HIV and HCV outcomes, including mortality. We could think that HCV cure was enough to reduce mortality in HIV-HCV patients as the mortality risk was 80% lower in those who were cured of (i.e. who “cleared”) Hepatitis C thanks to treatment. However, our study showed that, even after HCV cure, sociobehavioral factors still matter: drinking at least 3 cups of coffee a day was associated with a 50% reduction in mortality risk as well as not smoking which was also associated with a reduced mortality risk. This association between elevated coffee intake and reduced mortality risk is probably due to the properties of polyphenols contained in coffee which can protect the liver and also reduce inflammation.
03 Oct Coordination Program Reduced ER Visits and Readmissions in Medicaid Population
Posted at 20:59h
in Author Interviews, Cost of Health Care, Emergency Care, Health Care Systems, Hospital Readmissions, Primary Care
MedicalResearch.com Interview with:
[caption id="attachment_37314" align="alignleft" width="134"]
Dr. Capp[/caption]
Roberta Capp MD
Assistant Professor
Director for Care Transitions in the Department of Emergency Medicine
University of Colorado School of Medicine
Medical Director of Colorado Access Medicaid
Aurora Colorado
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Medicaid clients are at highest risk for utilizing the hospital system due to barriers in accessing outpatient services and social determinants.
We have found that providing care management services improves primary care utilization, which leads to better chronic disease management and reductions in emergency department use and hospital admissions.