07 Mar Maternal Cancer During Pregnancy Linked To Stillbirths and Infant Mortality
Posted at 21:26h
in Author Interviews, Cancer Research, Journal Clinical Oncology, Karolinski Institute, OBGYNE
MedicalResearch.com Interview with: [caption id="attachment_32727" align="alignleft" width="150"] Dr. Donghao Lu[/caption] Donghao Lu PhD student Department of Medical Epidemiology and Biostatistics Karolinska Institute MedicalResearch.com: What is the background for this study? Response: Cancer during pregnancy is a rare event. Whether prenatal exposure to a maternal malignancy and its treatment during pregnancy impair fetal development and neonatal health...
07 Mar Indoor Tanning By High School Students Drops By Half
MedicalResearch.com Interview with: [caption id="attachment_32722" align="alignleft" width="200"]
Dr. Gery Guy[/caption]
Gery P. Guy Jr., PhD, MPH
Senior Health Economist
Division of Unintentional Injury
CDC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The incidence of skin cancer is increasing in the United States, and individuals who indoor tan are at an increased risk of skin cancer. Treating skin cancer costs $8.1 billion annually.
The number of high school students who indoor tan dropped by half from 2009 to 2015. In 2015, 1.2 million high school students indoor tanned, down from 2.5 million in 2009. This is a much bigger decrease than we have seen in the past and is an encouraging finding. We also found that 82% of indoor tanners reported sunburn in the past year compared with 54% of those who did not engage in indoor tanning.
07 Mar Intensive Therapy Facilitates Language Recovery in Chronic Aphasia After Stroke
MedicalResearch.com Interview with: Caterina Breitenstein, PhD Department of General Neurology, University of Muenster, Germany Annette Baumgärtner, PhD Faculty of Health and Social Sciences, Fresenius University of Applied Sciences, Hamburg, Germany MedicalResearch.com : What is the background for this study? What are the main findings? Response: For a long time, it has been assumed that language recovery is limited to the first months after the initial stroke. During the past two decades, however, several clinical studies and systematic reviews have challenged this dogma by demonstrating functional gains in stroke survivors during the chronic post-stroke stage (at least 6 months post the initial stroke) whenever speech and language therapy (SLT) intensity was sufficiently high (i.e., at least 5 h/week for several weeks). These studies, however, lacked the methodological quality required for evidence-based interventions (for criteria, please refer to http://www.cebm.net/ocebm-levels-of-evidence). Until now, this lack in evidence severely hampers stroke survivors’ access to language rehabilitation services . The present multicenter randomized controlled healthcare trial FCET2EC (acronym stands for "From Controlled Experimental Trial to=2 Everyday Communication) is the first study worldwide to compare three weeks of intensive SLT provided under routine clinical conditions to an equally long period of no (or low intensity) SLT. After 3 weeks of intensive individualized therapy, the 156 stroke survivors with chronic aphasia verbally expressed themselves more effectively in daily-life communicative situations, like changing a doctor’s appointment by a telephone call. Additionally, patients and their significant other rated their communication-related quality of life as significantly improved. Last but not least, therapy effects remained stable over a follow-up period of six months after the intensive intervention.07 Mar Skin Diseases A Major Cause of Disability Worldwide
MedicalResearch.com Interview with: [caption id="attachment_32732" align="alignleft" width="136"]
Dr. Karimkhani[/caption]
Chante Karimkhani, MD
University Hospitals Case Western Medical Center, Cleveland, Ohio
now with Department of Dermatology
University of Colorado, Denver
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Ranging from benign inflammatory to infectious, autoimmune, and malignant conditions, skin diseases cause significant disfigurement, pain, and psychological morbidity. The Global Burden of Disease (GBD) Study 2013 is a large-scale epidemiological assessment of burden from 306 diseases in 195 countries, both sexes, and 14 age groups. Disease burden is measured by combining morbidity and mortality into a single metric of disability-adjusted life years (DALYs), where one DALY is equivalent to one year of healthy life lost. Skin diseases contributed 1.79% of the total global burden from all diseases.
The skin diseases arranged in order of decreasing global DALYs are: dermatitis (atopic, contact, seborrheic), acne vulgaris, urticaria, psoriasis, viral skin diseases, fungal skin diseases, fungal skin diseases, scabies, melanoma, pyoderma, cellulitis, keratinocyte carcinoma (basal and squamous cell carcinomas), decubitus ulcer, and alopecia areata. Younger populations had the greatest burden from infectious skin conditions, while acne caused the greatest burden in the second and third decades of life. Elderly populations had the greatest DALY rates from melanoma and keratinocyte carcinoma. Skin conditions also exhibit distinct geographical patterns of disease burden.
07 Mar Over-the-Counter Hearing Aids Had Similar Outcomes to More Expensive Devices
MedicalResearch.com Interview with: [caption id="attachment_32744" align="alignleft" width="182"]
Dr. Larry Humes[/caption]
Larry Humes, PhD, CCC-A
Department of Speech and Hearing Sciences
Indiana University Bloomington
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: About 40% of adults over the age of 60 have significant hearing loss, yet only about 20% of these older Americans seek help and eventually purchase hearing aids. There have been several national calls for improvements in the accessibility and affordability of hearing health care for adults, especially older adults, including a 2015 report by the President’s Council of Advisors in Science and Technology and a 2016 report by the National Academies of Science, Engineering and Medicine. One strategy in common to both of these recent reports is to make hearing aids available directly to the consumer via over-the-counter service delivery.
This study was a double-blind placebo-controlled randomized clinical trial investigating two different service-delivery approaches, best-practices and over-the-counter, and two different purchase prices for the hearing aids ($600/pair, $3600/pair). For the most part, purchase price had no influence on outcomes. Hearing aids delivered via the best-practices service-delivery model were confirmed to be efficacious, but almost identical positive outcomes were obtained via the over-the-counter service-delivery approach.
07 Mar Genetic Variants Tied To Kidney Disease in African Americans
Posted at 01:55h
in Author Interviews, Blood Pressure - Hypertension, Genetic Research, Kidney Disease, Nature, Race/Ethnic Diversity, University of Pennsylvania
MedicalResearch.com Interview with:
[caption id="attachment_32695" align="alignleft" width="148"]
Dr. Susztak[/caption]
Katalin Susztak MD, PhD
Associate Professor of Medicine
Perelman School of Medicine
University of Pennsylvania
Philadelphia, PA 19104
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous studies showed an association between genetic variants in the APOL1 gene and kidney disease development, but it has not been confidently shown that this genetic variant is actually causal for kidney disease. For this reason we developed a mouse model that recapitulates the human phenotype.
07 Mar Most Patients Do Not Know Their Doctors Receive Industry Payments
MedicalResearch.com Interview with: [caption id="attachment_32691" align="alignleft" width="140"]
Dr. Kanter[/caption]
Genevieve Kanter, PhD Assistant Professor
Department of Health Management and Policy
Drexel University Dornsife School of Public Health
Philadelphia, PA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We were interested in the exposure of patients to doctors who accept industry payments. Previous research on physician payments has focused on the percentage of doctors who accepted payments, but these estimates can give a partial or misleading picture of the reach of industry payments in relation to the typical patient. No studies had previously taken a population-based approach to estimate the reach of industry payments.
We conducted a nationally representative survey of 3542 Americans. We asked respondents about their awareness of industry payments and if they knew whether their own doctor had received an industry payment. We also asked them to identify the doctor they had visited most frequently in the previous 12 months and linked this information to Open Payments, a government website that reports payments made to doctors by prescription drug and device manufacturers.
We found that 65%, or almost two-thirds, of patients had seen--in the past 12 months--a physician who had received an industry payment. For some specialties, patient contact with doctors who had industry contact was much higher; 77% of patients who saw an obstetrician/gynecologist visited a doctor who had accepted payments, and 85% of patients who saw an orthopedic surgeon visited a doctor who had accepted payments.
At the same time, very few people knew whether their own doctor had received payments; only 5% of respondents reported knowing whether their doctor had received an industry payment.
07 Mar Vitamin D During Fetal Life and Bone Health in Children at Age 6
MedicalResearch.com Interview with: Audry H. Garcia PhD Scientist Department of Epidemiology Erasmus MC, University Medical Center Rotterdam Rotterdam, the Netherlands MedicalResearch.com: What is the background for this study? Response: Fetal bone mineralisation requires an adequate transfer of calcium to the fetus by the end of the pregnancy. Considering that vitamin D is required to maintain normal blood concentrations of calcium, adequate 25-hydroxyvitamin D (25[OH]D) concentrations in pregnant women seem to be crucial for bone development of the offspring. Maternal vitamin D deficiency during pregnancy has been associated with abnormal early skeletal growth in offspring and might be a risk factor for decreased bone mass in later life. Several studies have linked vitamin D deficiency in fetal life to congenital rickets, craniotabes, wide skull sutures and osteomalacia. However, the evidence of long-lasting effects of maternal vitamin D deficiency during pregnancy on offspring’s skeletal development is scarce and inconsistent, and has led to contradictory recommendations on vitamin D supplementation during pregnancy.07 Mar Cedars-Sinai Study Will Address How Doctors Communicate With Patients About Chronic Pain
MedicalResearch.com Interview with: Michelle S. Keller, MPH, PhD Candidate Health Policy and Management Cedars-Sinai Los Angeles CA 90048 MedicalResearch.com: What is the background for this new funding award? Response: Research shows that treating and managing chronic pain is tough, and it can be hard for patients and their physicians to be on the same page. Chronic pain touches so many facets of people’s lives—relationships, mental health, sleep, work—that treating it in a 15-minute visit can lead to a lot of frustration and disappointment. Our hope is that by arming patients and clinicians with evidence-based tools, we can help foster a better dialogue about what is ultimately important to patients, how to achieve fully functional lives while managing chronic pain. We’re testing two different types of communication tools: electronic health record alerts pointing physicians to guidelines when they write opioid prescriptions and patient portal-based tools that can help patients prepare for visits and become active, engaged partners in their care.06 Mar Membership In Medical Schools’ Honor Society Skews Toward White Students
MedicalResearch.com Interview with: [caption id="attachment_32681" align="alignleft" width="175"]
Dr. Dowin Boatright[/caption]
Dowin Boatright, MD, MBA
Department of Emergency Medicine
Yale School of Medicine
New Haven, Connecticut
Fellow, Robert Wood Johnson Clinical Scholars Program
Veterans Affairs Scholar
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Studies have demonstrated racial and ethnic inequities in medicine, including disparities in the receipt of awards, research funding, and promotions. Yet few studies have examined the link between race and ethnicity and opportunities for medical school students.
Our results show that black and Asian medical school students are less likely to be selected for membership in a prestigious medical honor society, Alpha Omega Alpha (AΩA), than white medical school students.
06 Mar Vagus Nerve Stimulation Safe and Feasible For Stroke Rehabilitation
MedicalResearch.com Interview with: [caption id="attachment_32677" align="alignleft" width="280"]
Dr. Jesse Dawson[/caption]
Jesse Dawson MD, BSc (Hons), FRCP, FESO
Clinical Reader / Honorary Consultant
Clinical Lead Scottish Stroke Research Network / NRS Stroke Research Champion
Chair MVLS Research Ethics Committee
Institute of Cardiovascular and Medical Sciences
College of Medical, Veterinary & Life Sciences
University of Glasgow
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Many patients suffer long term arm weakness after stroke and there are few effective treatments. We are assessing whether stimulation of the vagus nerve can improve recovery after stroke. Stimulation of the vagus nerve, called VNS for short, triggers the release of neurotransmitters in the brain. These neurotransmitters are important for learning and memory. Pre-clinical studies have shown that combining vagus nerve stimulation with movement or rehabilitation tasks enhances brain plasticity, improves motor learning and leads to better recovery after stroke.
Based on this, we performed a clinical trial in patients with arm weakness after stroke and found promising changes in the patients treated with VNS paired with rehabilitation compared to rehabilitation alone.
In this study we performed a double blind sham stimulation controlled study of VNS paired with rehabilitation vs sham stimulation in patients with long term arm weakness due to ischaemic stroke. All participants were implanted with a VNS device and underwent a course of therapy. We didn’t see a statistically significant difference after 6 weeks of intensive in-clinic therapy but saw a large and significant difference after a further 60 days home exercise treatment with VNS. There were differences on several measures, including the clinical response rate which was 88% with VNS and 33% with controls.
06 Mar Only a Quarter of Medical Grand Round Speakers Are Women
MedicalResearch.com Interview with: Julie R. Boiko, MD, MS Resident Physician, PGY1 Department of Pediatrics University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Grand rounds is an over 100-year-old tradition in US medical school clinical departments of recurring, expert-delivered lectures to update physicians and physicians-in-training on recent advances in relevant medicine. We wanted to determine whether gender representation of speakers at grand rounds aligns with the gender distribution of people typically represented in grand rounds audiences -- faculty, residents, and medical students -- by clinical specialty according to national academic medical trainee and workforce statistics. We chose to focus on grand rounds speakers as visible representations of women in academic medicine. This is important because, despite women and men entering medicine at comparable rates, women are much more likely to depart academic medical careers. As current and recent medical students, we considered that consistent exposure to successful female role models in grand rounds speaking venues may positively reinforce women trainees’ desires to continue in academic medical careers. We found that the people at the podiums do not resemble the people in the audience. Only 26% of grand rounds speakers are women. Even accounting that some clinical specialties contain few women faculty and residents, grand rounds speakers in most specialties we studied were statistically less likely to be women as compared to faculty and residents. Across the specialties, grand rounds speakers are 44% less likely than medical students, 39% less likely than residents, and 21% less likely than faculty to be women.06 Mar Without Paid Sick Leave Workers Less Likely To Get Flu Shots and Preventive Care
MedicalResearch.com Interview with: Dr. LeaAnne DeRigne Associate Professor School of Social Work Florida Atlantic University Boca Raton, FL 33431 MedicalResearch.com: What is the background for this study? What are the main findings? Response: “Compared to 22 similarly developed countries, the United States is the only one that does not mandate employers to provide paid sick leave benefits or include paid sick leave in a universal social insurance plan,” said LeaAnne DeRigne, Ph.D., lead author and an associate professor in the School of Social Work within FAU’s College for Design and Social Inquiry. For the study, DeRigne and collaborators used cross-sectional data from a sample of 13,545 adults aged 18-64 with current paid employment from the 2015 National Health Interview Survey (NHIS). They examined the relationship between having paid sick leave and obtaining eight preventive care services: blood pressure check; cholesterol check; fasting blood sugar check; getting a flu shot; being seen by a medical doctor or health care provider; getting a Pap test (females only); getting a mammogram (females only); and getting tested for colon cancer. The analysis controlled for demographic and other important predictor variables including gender, marital status, education, race/ethnicity, full time work, insurance coverage, health status, limiting health conditions, family income, age, and family size.06 Mar Number of Adults With Hearing Loss Expected To Rise Dramatically
MedicalResearch.com Interview with: Dr. Adele Gorman PhD Johns Hopkins Center on Aging & Health The Johns Hopkins University Baltimore, Maryland MedicalResearch.com: What is the background for this study? Response: Hearing loss affects many people, especially older adults. We have previously estimated how common hearing loss is across different age groups and how many adults have hearing loss today. However, we did not know the number of people that are expected to have hearing loss in the coming decades. This is important to know in order to appropriately plan for future hearing health care needs. Recently the National Academies of Sciences, Engineering and Medicine highlighted the crucial need to address hearing loss and made recommendations to improve hearing health care services. However, these recommendations should be considered by policy makers in the context of the number of adults with hearing loss in the coming years.04 Mar Drug-Induced Sleep Endoscopy With Cardiorespiratory Monitoring For OSA
MedicalResearch.com Interview with: [caption id="attachment_32672" align="alignleft" width="150"]
Dr. Simone Baiardi[/caption]
Dr. Simone Baiardi MD
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum
University of Bologna
MedicalResearch.com: What is the background for this study?
Response: Drug-induced sleep endoscopy (DISE) is an useful tool for studying the upper airway dynamic in patients with obstructive sleep apnea syndrome (OSAS), and it’s crucial for the therapeutic choice (especially for non ventilatory treatment, such as surgery). The main limits of DISE are the lack of standardization of procedure and the low inter-observer reliability among non-experienced ENT surgeons.
04 Mar No Decrease In Incidence of Dementia Over Past Decades
MedicalResearch.com Interview with: [caption id="attachment_32653" align="alignleft" width="173"]
Dr. Emma van Bussel[/caption]
Emma van Bussel MD, MSc
Academic Medical Center | University of Amsterdam
Amsterdam | The Netherlands
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Dementia forms a high social and economic burden on society. Since there is a growing number of older people, the occurrence of dementia is expected to increase over the years to come. For future planning of care, it is important to have reliable predictions on new dementia cases for the population at large. Studies in Western countries suggested that the incidence per 1000 person years is declining.
We studied the incidence trend of dementia in the Netherlands in primary care registry data, in a population of over 800,000 older people (60 years and over) for the years 1992 to 2014. Our results indicate a small increase of 2.1% (95% CI 0.5% to 3.8%) per year in dementia incidence over the past decades. The trend did not change in the years after 2003, when a national program was developed to support dementia care and research, compared to the years prior to 2003.
04 Mar Anorexia Nervosa: So Brain Changes Persist After Weight Restoration
MedicalResearch.com Interview with: [caption id="attachment_32649" align="alignleft" width="143"]
Dr. Guido Frank[/caption]
Guido K.W. Frank, M.D., FAED
Associate Professor of Psychiatry and Neuroscience
Associate Director, Eating Disorder Program
Director, Developmental Brain Research Program
Pediatric Mental Health Institute | Children’s Hospital | University of Colorado Anschutz Medical Campus Colorado
MedicalResearch.com: What is the background for this study?
Response: Anorexia nervosa is an eating disorder that primarily affects young females and is associated with high mortality. The diagnostic criteria include restriction of energy intake that leads to significantly low body weight and an intense fear of gaining weight or becoming fat. The etiology of anorexia nervosa is complex, and only recently have we begun to better understand its underlying neurobiology. Brain scans of anorexia nervosa patients have implicated brain reward circuits in the disease, brain regions that govern food intake. On the other hand, how much we eat also affects over time reward system response and eating too much or too little has important implications on brain reward function.
Previous studies from our lab as well as basic science research suggest that underweight is associated with heightened reward system response. In this study wanted to test whether we would find heightened brain activity in adolescents with anorexia nervosa and whether this would normalize once the patient regained weight.
04 Mar Pediatric Asthma Costs Over $5 Billion Per Year In Health Care Expenses
MedicalResearch.com Interview with: [caption id="attachment_32645" align="alignleft" width="132"]
Dr. Sullivan[/caption]
Patrick W. Sullivan, Ph.D.
Professor
Regis University School of Pharmacy
Denver, CO 80221
MedicalResearch.com: What is the background for this study?
Response: Asthma is one of the most common chronic disorders among children. It affects 7.1 million children in the U.S. Of these, 4.1 million children suffered an asthma attack in 2011. An asthma attack is an acute period of extreme difficulty breathing. It can be life threatening and is always very frightening for children. Because asthma can be dangerous and frightening, it ends up costing a lot because patients need to go the doctor, hospital or take medications to try to control it.
Asthma also has a negative effect on the patient’s health and outlook about their health – both mentally and physically. Previous studies have focused on adults with asthma and have found that it is very expensive – it costs $18 billion in the U.S. to manage adults with asthma. Those studies also showed that adults with asthma have lower quality of life. However, there is not a lot of good evidence on the burden of asthma in children. This study was designed to quantify the cost and mental and physical health of children with asthma in the U.S.
04 Mar Is Trust in Mental Health Clinicians Affected Among Patients Who Access Clinical Notes Online?
MedicalResearch.com Interview with: [caption id="attachment_32640" align="alignleft" width="79"]
Dr. Dobscha[/caption]
Steven K. Dobscha, M.D.
Professor, Department of Psychiatry, OHSU
Director, VAPORHCS Center to Improve Veteran Involvement in Care
Oregon Health & Science University
MedicalResearch.com: What is the background for this study?
Response: Several health care systems across the United States now offer patients online access to all of their clinical notes (sometimes referred to as progress notes) through electronic health record portals; this type of access has been referred to as OpenNotes (see www.opennotes.org for more information on the national OpenNotes initiative). Veterans have been able to use OpenNotes in the Veterans Health Care (VHA) system since 2013. However, some individuals have expressed concern that online access to clinical notes related to mental health could cause some patient harms.
We are conducting a VA-funded research project with several objectives:
1) to examine benefits and unintended negative consequences of OpenNotes use as perceived by veterans receiving VHA mental health care and by VHA mental health clinicians, and
2) to develop and evaluate brief web-based courses designed to help veterans and clinicians use OpenNotes in ways that optimize Veteran-clinician collaboration and minimize unintended consequences.
04 Mar Pradaxa: Compared To Warfarin, Lower Risk of Stroke and Bleeding in Non-Valvular AFib
MedicalResearch.com Interview with: [caption id="attachment_32635" align="alignleft" width="200"] Dr. Sabine Luik[/caption] Sabine Luik, M.D. Senior vice president, Medicine & Regulatory Affairs Boehringer Ingelheim Pharmaceuticals, Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Data from more than 20,000 patients with non-valvular atrial fibrillation (NVAF) were included in this study and the...
04 Mar More than a Feeling: Emotions Determine What You Remember
MedicalResearch.com Interview with: [caption id="attachment_32628" align="alignleft" width="200"]
Dr. Signy Sheldon[/caption]
Signy Sheldon, PhD
Assistant Professor
Department of Psychology
McGill University
Montreal, QC, CAN
MedicalResearch.com: What is the background for this study?
Response: It is clear to most people that emotion and memory are strongly linked - thinking about our past experiences is often accompanied with a strong feelings, sometimes good and sometimes bad.
In psychological research, many investigations have looked at how emotional memories are remembered differently than non-emotional memories. A lot of this research has found that the valence of a memory, whether it is positive or negative, will impact how detailed a past event can be recalled. Much less research as looked at how the emotions we feel at the time of remembering can also influence the way that memory is recalled. This is a very important area of research. If emotions during remembering can influence what memories are accessed and how we experience these memories, this would suggest that our memories are tagged and organized according to emotions.
In this study, we looked at how different aspects of emotion can affect the types of past experiences we bring to mind to further investigate how emotions direct memory retrieval.
To do this, we had participants listen to unfamiliar excerpts of music that ranged in both memory valence (positive and negative) and arousal (high or low levels). To each piece of music, participants were asked to think of a past memory and then describe their experience of that event they were remembering.
03 Mar Intermittent Explosive Disorder Linked To Higher Risk of Substance Abuse
MedicalResearch.com Interview with: [caption id="attachment_32622" align="alignleft" width="175"]
Dr. Emil Coccaro[/caption]
Emil F. Coccaro, M.D.
Ellen C. Manning Professor
Department of Psychiatry and Behavioral Neuroscience
The University of Chicago
Chicago, Illinois 60637
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Aggressive behavior and drug use have been related for years but this study shows people with problematic aggression (Intermittent Explosive Disorder: IED) are in fact at risk for developing alcohol, tobacco, and cannabis use disorders and that the onset of problematic aggression (IED) begins before the onset of the drug use.
The increased risk for alcohol use disorder was nearly six-fold higher, the increased risk for cannabis use disorder was seven-fold higher, and the increased risk for tobacco use disorder was four-fold higher. In addition, the presence of IED increased the severity of the substance use disorder.
03 Mar Neonatal Morbidity and 1-Year Survival of Extremely Preterm Infants
MedicalResearch.com Interview with: Dr. Hans Jorgen Stensvold, M.D and Dr. Arild Ronnestad, MD PhD Neonatal Department, Oslo University Hospital and the Norwegian Neonatal Network, Oslo, Norway MedicalResearch.com: What is the background for this study? Response: Over the last decades, advances in perinatal care have led to improved survival of extremely preterm infants in most countries. Still, the decision to initiate or withhold active care for infants at the border of viability is challenging. Different attitudes and traditions in perinatal care influence the rates of stillbirths, admissions to intensive care and outcomes. Consequently, there is a continuous need for up-to-date results to guide caregivers and parents in decision making, and to evaluate current medical practices.03 Mar Regional Variation in Chemotherapy Prescriptions For Metastatic Prostate Cancer
Posted at 14:43h
in ASCO, Author Interviews, Outcomes & Safety, Pharmacology, Prostate Cancer, University of Michigan
MedicalResearch.com Interview with:
[caption id="attachment_32608" align="alignleft" width="128"]
Dr. Caram[/caption]
Megan Elizabeth Veresh Caram MD
Clinical Lecturer
Internal Medicine, Hematology & Oncology
University of Michigan
MedicalResearch.com: What is the background for this study?
Response: Abiraterone and enzalutamide are oral medications that were approved by the Food & Drug Administration in 2011 and 2012 to treat men with metastatic castration-resistant prostate cancer. Most men with advanced prostate cancer are over age 65 and thus eligible for Medicare Part D. We conducted a study to better understand the early dissemination of these drugs across the United States using national Medicare Part D and Dartmouth Atlas data.
02 Mar Fentanyl Laced Heroin Contributing To Spike In Heroin Overdoses in Miami-Dade County
MedicalResearch.com Interview with: Alexander Diaz Bode M.D. Candidate University of Miami Leonard M. Miller School of Medicine Miami, FL MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our country is in the midst of an opiate epidemic. This is particularly evident in the emergency department (ED), which continues to see an alarmingly large number heroin overdose. With the shutdown of “pill-mills”, where opioid prescriptions would be prescribed indiscriminately, Florida has seen particularly large increases in opiate use and overdose. In Miami, we noticed that during the summer of 2016, there was a disproportionate increase in heroin overdose being treated at our hospital relative to previous years. Our recently published study showed that fentanyl or fentanyl analog laced heroin likely contributed to this massive spike in heroin overdose observed during the summer of 2016. Fentanyl and its synthetic analogs are opioid receptor agonists that bind with hundreds of times higher affinity than diamorphine, aka heroin. Naloxone, better known by the brand name Narcan®, is used to reverse heroin overdose in the ED. This drug works by competitively inhibiting the opioid receptor, effectively “knocking off” the bound heroin. Using naloxone dosing as a surrogate marker of heroin purity, our study found that during the investigated spike there was a disproportionate increase in the amount of naloxone used in our ED to reverse overdose relative to the increase in opiate overdose. This indicated that a stronger opioid receptor agonist, such as fentanyl or fentanyl analogs, likely was involved in the massive spike in overdose observed during the summer of 2016.02 Mar Many Eligible Groups Not Receiving Recommended Statin Therapy
MedicalResearch.com Interview with: Dr. Yashashwi Pokharel MD, MSCR Department of Cardiovascular Research Saint Luke’s Mid-America Heart Institute Kansas City, Missouri and Salim S. Virani, MD PhD, FACC, FAHA Associate Professor, Section of Cardiovascular Research Associate Director for Research, Cardiology Fellowship Training Program Baylor College of Medicine Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Houston, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unlike the previous cholesterol management guideline that recommended use of either statin and non-statin therapy to achieve low density lipoprotein cholesterol (LDL-C) target, the 2013 American College of Cardiology/American Heart Association cholesterol management guideline made a major paradigm shift by recommending statin focused treatment in 4 specific patient groups and replaced LDL-C target with fixed statin intensity treatment (moderate to high intensity statin therapy). With this change, it was speculated that a large number of patients would be eligible for statin treatment (in one study, up to 11.1% additional patients were expected to be eligible for statin therapy). Our study provided the real world trends in the use of statin and non-statin lipid lowering therapy (LLT) from a national sample of cardiology practices in 1.1 million patients 14 months before and 14 months after the release of the 2013 guideline. We found a modest, but significant increasing trend in the use of statin therapy in only 1 of the 4 patient groups eligible for statin therapy (i.e., 4.3% increase in the use of moderate to high intensity statin therapy in patients with established atherosclerotic cardiovascular disease). We did not find any significant change in non-statin LLT use. Importantly, about a third to half of patients in statin eligible groups were not receiving moderate to high intensity statin therapy even after the publication of the 2013 guideline.02 Mar Environmental Pyrethroids May Be Associated With Behavioral Problems in Children
Posted at 12:28h
in Author Interviews, BMJ, Environmental Risks, Mental Health Research, Pediatrics, Toxin Research
MedicalResearch.com Interview with:
Professor Jean-Francois Viel
Department of Epidemiology and Public Health
University Hospital
Rennes, France
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The use of pyrethroid insecticides has increased substantially throughout the world over the past several decades, replacing organophosphate and carbamate insecticides, because of their chemical potency against many pests, their relatively low mammalian toxicity and their favorable environmental profiles. However, despite the neurotoxicity of these insecticides at high doses, the potential impact of environmental exposure to pyrethroid insecticides on child neurodevelopment has only just started to receive attention.
Using a longitudinal design (PELAGIE mother-child cohort), we were able to assess pyrethroid exposure (trough urine concentrations) both prenatally and during childhood (at 6 years of age). We showed that increased prenatal concentrations of one pyrethroid metabolite (cis-DCCA, a metabolite of permethrin, cypermethrin and cyfluthrin) were associated with internalising difficulties (children showing behaviours that are inhibited and over-controlled).
Moreover, for childhood 3-PBA (a common metabolite of up to 20 synthetic pyrethroid insecticides) concentrations, a positive association was observed with externalising difficulties (children showing behaviours that are under-controlled and having generally a more challenging temperament).
02 Mar Hospital Floors May Be Underappreciated Source Of Hospital Infections
MedicalResearch.com Interview with: [caption id="attachment_32590" align="alignleft" width="200"]
Dr. Curtis J. Donskey[/caption]
Curtis J. Donskey, MD
Geriatric Research, Education, and Clinical Center
Cleveland Veterans Affairs Medical Center
Cleveland, OH 44106
MedicalResearch.com: What is the background for this study?
Response: Many hospitals are making efforts to improve cleaning to reduce the risk for transmission of infection from contaminated environmental surfaces. Most of these efforts focus on surfaces like bed rails that are frequently touched by staff and patients. Despite the fact that floors have consistently been the most heavily contaminated surfaces in hospitals, they have not been a focus of cleaning interventions because they are rarely touched. However, it is plausible that bacteria on floors could picked up by shoes and socks and then transferred onto hands. In a recent study, we found that when a nonpathogenic virus was inoculated onto floors in hospital rooms, it did spread to the hands of patients and to surfaces inside and outside the room. Based on those results, we assessed the frequency of floor contamination in 5 hospitals and examined the potential for transfer of bacteria from the floor to hands.
02 Mar Obstructive Sleep Apnea More Common In Obese Adolescents With Enlarged Tonsils
Posted at 00:15h
in Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Sleep Disorders, UT Southwestern
MedicalResearch.com Interview with:
[caption id="attachment_32582" align="alignleft" width="132"]
Dr. Ron Mitchell[/caption]
Ron B. Mitchell, MD
Professor and Vice Chairman,
Department of Otolaryngology, Head and Neck Surgery
William Beckner Distinguished Chair in Otolaryngology
Chief of Pediatric Otolaryngology
UT Southwestern and Children's Medical Center Dallas
Dallas, TX 75207
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Obstructive Sleep Apnea (OSA) has not been widely studies in adolescents. This is one of a few studies that was targeted at 12-17 year olds who were referred for a sleep study for possible OSA. The study included 224 adolescents (53% male). aged 12 to 17 years. The mean BMI was 33.4 and most were either Hispanic or African American (85.3%). A total of 148 (66.1%) were obese. Most adolescents referred for a sleep study (68%), had Obstructive Sleep Apnea. Normal-weight adolescents were least likely to have OSA at 48%, while obese children were most likely at 77%. Severe OSA was most likely in obese males with tonsillar hypertrophy.