Author Interviews, Cost of Health Care, Health Care Systems / 21.07.2016

Medicalresearch.com Interview with: Alex Mainor, JD, MPH Research Project Coordinator The Dartmouth Institute for Health Policy and Clinical Practice Lebanon, NH 03756 Carrie H. Colla, Alexander J. Mainor, Courtney Hargreaves, Thomas Sequist, Nancy Morden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Waste in the healthcare system is an important concern to healthcare providers, patients, policymakers, and taxpayers, and is estimated to account for 30% of all healthcare costs. Low-value care can expose patients to unnecessary costs for little or no medical benefit, or to potential harm from unnecessary tests and procedures. In recent years, the concept of low-value care has gained wider acknowledgement and acceptance as a pressing concern for the healthcare system, and many interventions have been studied to reduce the use of this wasteful care. However, the landscape of these interventions has not been studied in a systematic and comprehensive way. In this review, we found that interventions to reduce the use of wasteful medical care are often studied and published selectively. Findings suggest that interventions using clinical decision support, clinician education, patient education, and interventions combining elements from each have strong potential to reduce low-value care. (more…)
Author Interviews, Mental Health Research, Pharmacology, Schizophrenia / 21.07.2016

MedicalResearch.com Interview with: Glorimar Ortiz, MS Senior Researcher/Statistician NRI-National Association of State Mental Health Program Directors Research Institute Falls Church, VA 22042 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Despite the lack of empirical evidence that antipsychotic polypharmacy produces greater outcomes to antipsychotic monotherapy, and that several clinical guidelines recommend against it, patients with a diagnosis of schizophrenia continue to being discharged on polypharmacy. Over the past few years, attempts have been made to lower the rate of antipsychotic polypharmacy throughout the country. Most of the existing literature on this topic are based on Medicaid claims data which exclude data for patients discharged from state psychiatric inpatient hospitals. Our study is very important because it is the first time that data on the use of antipsychotic medications are analyzed using a large sample of discharges from state psychiatric inpatient hospitals. These hospitals now have the opportunity to benchmark their antipsychotic medication use rate with national rates more accurately, and therefore, develop and implement performance improvement activities that are more precise. The study found that 12% of all discharges were prescribed two or more antipsychotic medications. Of those patients discharged on at least one antipsychotic medication, 18% were prescribed two or more antipsychotics. The study also found that patients with a schizophrenia diagnosis and an inpatient hospital stay of 3 months or longer are more likely of being discharged on polypharmacy, and that the main reason for this was to reduce patient’s symptoms. Antipsychotic polypharmacy affects nearly 10,000 patients with schizophrenia annually in state psychiatric inpatient hospitals. (more…)
Author Interviews, Endocrinology, Genetic Research, NEJM, Weight Research / 21.07.2016

MedicalResearch.com Interview with: Dr. Peter Kühnen MD Institute for Experimental Pediatric Endocrinology Charité–Universitätsmedizin Berlin Berlin, Germany MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Kühnen: The patients, which were included in this study, are suffering from a genetic defect in a gene called POMC. This gene is cleaved into different hormones as e.g. MSH (melanocyte stimulating hormone). MSH is very important for the regulation of satiety by activation of the MC-4 receptor. For this reason these patients are persistent hyperphagic due to the lack of MSH and they gain weight very fast in the first months of their life. Setmelanotide activates the MC-4 receptor, which is important for the activation of satiety. By restoring the lost function Setmelanotide leads to a reduction of hyperphagia and to a reduction of body weight in this POMC deficient patients. (more…)
Author Interviews, Orthopedics, Science, Technology / 21.07.2016

MedicalResearch.com Interview with: Emilia Morosan PhD,  Professor Rice University Physics and Astronomy Houston TX 77005 MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Morosan: My group works mainly on searching for compounds with magnetic properties. The first step in the characterization of such compounds is powder X-ray diffraction, which requires grinding the samples to fine powder. When we discovered such a compound based on (titanium) Ti and (gold) Au, we were unable to grind it because of its apparent hardness. This prompted the hardness measurement on the magnetic compound (with equal amounts of Ti and Au) and also on other mixtures of the two metals. The main result of this study was that the particular compound beta-Ti3Au was the hardest among all Ti-Au mixture in our study and compared to previous hardness measurements on these binary alloys. Most remarkable was the four-fold increase in hardens in beta-Ti3Au over Ti, or most other biocompatible engineering alloys. Furthermore, beta-Ti3Au also has higher wear resistance, meaning its durability extends beyond that of other alloys. (more…)
Author Interviews, BMJ, Nutrition, Pediatrics / 21.07.2016

MedicalResearch.com Interview with: Sharon Carstairs PhD Student Public Health Research University of Aberdeen, Aberdeen MedicalResearch.com: What is the background for this study? Response: The introduction of solid foods is a key period when the milk diet is no longer able to meet all dietary needs, additionally it is a key time for food learning and development of eating preferences in a child’s life. It is vital that children are provided with nutritionally balanced foods as well as a variety of foods to meet dietary requirements and are exposed to different tastes and textures. Some parents provide home-cooked meals however, there is a large market of commercially available infant/toddler meals which can provide parents with a convenient alternative to home-cooking. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA / 21.07.2016

MedicalResearch.com Interview with: Dr Fiona Bragg Clinical Research Fellow Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population Health University of Oxford MedicalResearch.com: What is the background for this study? Response: Diabetes is known to be a risk factor for cardiovascular disease. It is less clear, however, whether higher blood glucose levels in individuals without diabetes are also associated with higher risk for cardiovascular diseases. It is important to examine this association because it may help us to understand the mechanisms underlying these diseases as well as appropriate approaches to preventing them. We therefore looked at this association in the China Kadoorie Biobank study of 0.5 million Chinese adults, examining the relationship between blood glucose levels and the subsequent risk for cardiovascular diseases among participants with no history of diabetes at the time of recruitment to the study. (more…)
Author Interviews, JAMA, Surgical Research / 21.07.2016

MedicalResearch.com Interview with: Dr. David A. Hyman, MD Division of Otolaryngology–Head and Neck Surgery Department of Surgery University of Wisconsin School of Medicine and Public Health Madison MedicalResearch.com: What is the background for this study? What are the main findings? Response: Motor vehicle collisions represent a significant source of facial fractures seen at US trauma centers. In the last few decades there have been significant advances in airbag technology as well as a national legislative push regarding seat belt use which has led to increased safety device use. With these trends, we sought to assess the incidence of facial fractures in patients who present to US trauma centers as well as to analyze what effect restraint devices have on the likelihood of facial fractures after motor vehicle collisions. This analysis was performed using National Trauma Data Bank data from 2007-2012. We found the incidence of at least one facial fracture after a motor vehicle collision was 10.9% with nasal fracture being the most common facial fracture. Based on our analysis of more than 56 thousand patients with a facial fracture, we found that use of an airbag alone reduced the likelihood of a facial fracture by 18% while use of a seat belt alone reduced likelihood by 43%. Use of both reduced the likelihood of facial fractures in a crash by 53%. Younger age, male sex, and use of alcohol increased the likelihood of facial fracture. (more…)
Alcohol, Author Interviews, Columbia, OBGYNE, Tobacco / 21.07.2016

MedicalResearch.com Interview with: Dr. Qiana L. Brown, PhD, MPH, LCSW Postdoctoral Research Fellow Columbia University Mailman School of Public Health Department of Epidemiology Substance Abuse Epidemiology Training Program MedicalResearch.com: What is the background for this study? Dr. Brown: Prenatal substance use is a major public health concern, and poses significant threats to maternal and child health. Tobacco and alcohol are the most commonly used substances among pregnant women and non-pregnant women of reproductive age, and are leading causes of preventable adverse health outcomes for both mother and baby. Women with health insurance have more prenatal visits, and present for prenatal care earlier than uninsured women, which may increase their exposure to health messaging around substance abuse prevention at prenatal visits. Additionally, treatment for substance use disorders and maternal and child health care are part of the Essential Health Benefits covered by the Affordable Care Act, which may encourage patients and providers to engage in discussions around alcohol and tobacco use prevention during pregnancy. Given these factors, we examined the relationship between health insurance coverage and both past month tobacco use and past month alcohol use among a nationally representative sample of reproductive age women in the United States. We sampled 97,788 women ages 12 to 44 years old who participated in the U.S. National Survey of Drug Use and Health in 2010 to 2014. Among these women, 3.28% (n=3,267) were pregnant. We specifically investigated whether the relationship between health insurance and alcohol or tobacco use differed between pregnant and non-pregnant women. (more…)
Author Interviews, Immunotherapy, Pulmonary Disease / 20.07.2016

MedicalResearch.com Interview with: Ganesh Raghu, M.D. FACP, FCCP Professor of Medicine Division of Pulmonary and Critical Care Medicine and Director of Center for Interstitial Lung Diseases Director, Interstitial Lung Disease/Sarcoid/Pulmonary Fibrosis Program University of Washington Medical Center Seattle, Washington MedicalResearch.com: What is the background for this study? Response: This is a new post-hoc analysis of the Phase III INPULSIS trials, including a total of 1,061 patients with idiopathic pulmonary fibrosis (IPF), which has been published in the American Journal of Respiratory and Critical Care Medicine. As background, achieving an accurate diagnosis of IPF in clinical practice is very complex and challenging. Physicians use an imaging technique called high resolution computed tomography (HRCT) to help them identify the presence of scarring (fibrosis) and, specifically, the presence of usual interstitial pneumonia (UIP) pattern in the lungs. The radiological changes called "honeycombing" are the key feature of the UIP pattern visible on HRCT and the pattern of UIP is the hallmark of the fibrosis in patients with IPF. In the absence of definitive UIP pattern on HRCT images of the lungs, the diagnosis of  idiopathic pulmonary fibrosis requires the microscopic features of UIP in the surgical lung biopsy (SLB) based on current guidelines for diagnosis of IPF. However, it can be challenging to confirm that scarring in the absence of honeycombing on HRCT meets the strict guideline criteria for a definitive diagnosis of IPF. For a large group of patients who do not receive a confirmed diagnosis of IPF according to guidelines, including those not eligible for surgical lung biopsy, the clinical course of their condition and the effectiveness of  idiopathic pulmonary fibrosis treatment remains unknown. Therefore, investigations into the behavior of the disease across diagnostic subgroups are important. (more…)
Author Interviews, Infections / 20.07.2016

MedicalResearch.com Interview with: Prof. Andrea Endimiani, MD, PhD Institute for Infectious Diseases University of Bern MedicalResearch.com: What is the background for this study? Response: The spread of multidrug-resistant Gram-negative bacteria represents a serious issue for the healthcare system worldwide because our antibiotic armamentarium is becoming too limited. These «superbugs» may cause serious infections with high morbidity and mortality rates – there are already 700,000 estimated deaths per year worldwide because common antimicrobial therapies have become ineffective. In this scenario, colistin has represented the last active antibiotic option able to cure many infected people. Unfortunately, in November 2015 a new mechanism of resistance against colistin was found with a high prevalence in Escherichia coli and Klebsiella pneumoniae strains detected in China among humans, food animals, and chicken meat; more recently, it has also been found in other countries. This mechanism is encoded by a gene (named mcr-1) that is plasmid-mediated, thus assuring its great ability to mobilize and spread between different enterobacteria, including those normally present in the human and animal intestinal tracts. (more…)
Author Interviews, Infections, NEJM, Vaccine Studies / 20.07.2016

MedicalResearch.com Interview with: Nicole E. Basta, PhD MPhil Assistant Professor Division of Epidemiology and Community Health School of Public Health University of Minnesota MedicalResearch.com: What is the background for this study? Response: Meningococcal disease is a serious and often life-threatening condition. In the past several years, multiple outbreaks caused by meningococcal serogroup B (MenB) have occurred on college campuses in the US. Recently, a new meningococcal B vaccine known as 4CMenB or Bexsero was developed. The FDA granted special approval to use the vaccine to control an outbreak at a University in New Jersey prior to its licensure. We took advantage of this unique opportunity to investigate the impact of Bexsero during the outbreak. In doing so, we conducted the first clinical study of Bexsero among teens and young adults in the US. (more…)
Author Interviews, Dermatology, Science / 20.07.2016

MedicalResearch.com Interview with: Dr. Devin M. Barry, PhD, postdoc fellow Center for the Study of Itch,. Department of Anesthesiology Washington University School of Medicine St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? Response: Our group is interested in understanding the molecular and cellular mechanisms that underly itch sensation. Our study focused on peripheral sensory neurons of the DRG that mediate responses to itch-inducing stimuli, in particular the inflammatory mediator histamine and the antimalarial drug chloroquine. It has been shown that histamine and chloroquine activate distinct G protein–coupled receptors (GPCRs) in sensory neurons innervating the skin. Two members of the transient receptor potential (TRP) family of ion channels, TRPV1 and TRPA1, have been found to be important mediators of histamine- and chloroquine-induced itch signaling, respectively. (more…)
Author Interviews, Cost of Health Care, Health Care Systems, Hospital Readmissions / 20.07.2016

MedicalResearch.com Interview with: Thomas P. Meehan, MD, MPH Associate Medical Director Harvard Pilgrim Health Care Qualidigm, Wethersfield Quinnipiac University, North Haven CT MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a national effort to decrease preventable hospital readmissions in order to improve both the quality and cost of healthcare. Part of this national effort includes local quality improvement projects which are organized and conducted by a variety of organizations working by themselves or with others. We describe one statewide quality improvement project which was led by a Medicare-funded Quality Improvement Organization and conducted with a hospital association and many other collaborators. We document our activities and a relative decrease in the statewide 30-day aggregate readmission rate among fee-for service Medicare beneficiaries of 20.3% over four and a half years. While we are extremely proud of our work and this outcome, we recognize that there are many factors that impacted the outcome and that we can’t claim sole credit. (more…)
Author Interviews, Dental Research, Stroke / 20.07.2016

MedicalResearch.com Interview with: Dr. Yago Leira, DDS Pre-Doc researcher at Health Research Institute of Santiago de Compostela (Spain) and Department of Periodontology, Faculty of Medicine and Dentistry University of Santiago de Compostela (Spain) MedicalResearch.com: What is the background for this study? Response: Periodontal disease is a chronic oral inflammatory disease caused by bacterial infection, which affects 20% to 50% of the adult population. Lacunar stroke, a type of cerebral small vessel disease, is responsible for almost 25% of the ischaemic strokes. It may be hypothesized that chronic periodontitis leads to a low-grade state of systemic inflammation altering endothelial function and blood vessels health, which could be related to the onset of atherosclerosis. Moreover, lacunar stroke could be linked with an inflammation process that can be associated with endothelial dysfunction. In the last decade, several observational studies have suggested an association between periodontal disease and ischaemic stroke. However, none of them have studied the relationship between chronic periodontitis and lacunar stroke independently of known vascular risk factors that both diseases may share (e.g., ageing, hypertension, diabetes mellitus or hypercholesterolemia). (more…)
Author Interviews, Karolinski Institute, Mental Health Research / 20.07.2016

MedicalResearch.com Interview with: Lorena Fernández de la Cruz | Assistant Professor Department of Clinical Neuroscience | Karolinska Institutet Child and Adolescent Psychiatry Research Center Stockholm MedicalResearch.com: What is OCD? Response: Obsessive-compulsive disorder (OCD) is one of the most common psychiatric disorders. OCD has a lifetime prevalence of about two per cent in the general population, generally runs a chronic course, and is often associated with a significantly reduced quality of life. Despite this, the risk of suicide in OCD has traditionally been considered low, probably due the particular personality profile of this patient group, typically described as “harm avoidant”. However, we have seen that the risk of suicide is higher than previously thought. (more…)
Author Interviews, Diabetes, JAMA, Pediatrics / 20.07.2016

MedicalResearch.com Interview with: Andy Menke PhD Social & Scientific Systems, Inc. Silver Spring, MD, 20910 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Limited information was available on the prevalence of diabetes among adolescents in the US, particularly the percentage that are undiagnosed and unaware of the condition. We found that 0.8% of adolescents 12-19 years of age had diabetes and 18% had prediabetes. Of those with diabetes, 29% overall were unaware of it and this increased to 40% among Hispanic adolescents and 50% among non-Hispanic black adolescents. (more…)
Author Interviews, Diabetes, Lipids, PLoS / 20.07.2016

MedicalResearch.com Interview with: Dr. Fumiaki Imamura Ph.D. MRC Epidemiology Unit University of Cambridge MedicalResearch.com: What is the background for this study? What are the main findings? Response: There was insufficient evidence for effects of polyunsaturated fatty acids (PUFA) intake or blood biomarkers on the development of type 2 diabetes. For instance, previous studies using PUFA biomarkers had a maximum of only 673 type 2 diabetes cases. In the EPIC-InterAct Study - a large European collaborative, prospective study where 12,132 diabetes cases were ascertained during its follow-up - we found diverse associations of blood levels of different types of PUFAs with incidence of type 2 diabetes. Despite this diversity, clinically relevant results were observed for major polyunsaturated fatty acids. Higher blood levels of total omega-6 PUFAs and the major omega-6 PUFA (linolenic acid) were associated with a lower risk of developing type 2 diabetes. Likewise, levels of alpha linolenic acid, known as a plant-origin omega-3 PUFA, were associated with lower type 2 diabetes risk. Marine-origin omega-3 PUFAs, including docosahexaenoic acid (DHA), showed inconsistent associations with type 2 diabetes risk. (more…)
Author Interviews, Breast Cancer, Fertility, JAMA, OBGYNE / 20.07.2016

MedicalResearch.com Interview with: Alexandra W. van den Belt-Dusebout, PhD Department of Epidemiology The Netherlands Cancer Institute The Netherlands MedicalResearch.com: What is the background for this study? Response: In vitro fertilization (IVF) is commonly used, but because of the relatively recent use of IVF, long-term breast cancer risk is not yet known. Female sex hormones have been shown to affect breast cancer risk. Because sex hormone levels during hormonal stimulation of the ovaries for IVF are up to 10 times higher than in natural cycles, IVF was expected to increase breast cancer risk. (more…)
Author Interviews, Biomarkers, Prostate Cancer / 20.07.2016

MedicalResearch.com Interview with: Dr. Adam Weiner MD Urology Resident Feinberg School of Medicine Northwestern University MedicalResearch.com: What is the background for this study?  Response: There has been a lot of controversy over the past decade regarding whether PSA screening for prostate cancer prevents death from prostate cancer. Accordingly, the US preventive services task force (USPSTF) recommended against PSA screening for older men in 2008 and for all men in 2012. This was mainly based on information from a large clinical trial in the US. Recently it was discovered that men in the non-screening part of this trial received even more PSA screens than men in the screening part of the trial, suggesting the results were likely diluted. In a large European trial, PSA screening was shown to reduce both death from prostate cancer and the number of men diagnosed with metastatic prostate cancer, an incurable and deadly form of prostate cancer. (more…)
Author Interviews, Menopause, University of Pittsburgh / 20.07.2016

MedicalResearch.com Interview with: Rebecca Thurston, Ph.D. Professor, University of Pittsburgh Department of Psychiatry and Epidemiologist, University of Pittsburgh Graduate School of Public Health MedicalResearch.com: What is the background for this study? Response: Vasomotor symptoms – or hot flashes and night sweats - are the “classic” symptom of the menopause transition. Most women will get vasomotor symptoms, yet there have been striking gaps in our knowledge about them, including what their natural history is. The traditional thinking has been that vasomotor symptoms last a few years around the final menstrual period for most women. However, in this and several other papers we have debunked this myth. (more…)
Author Interviews, Dermatology, Infections, Technology / 19.07.2016

MedicalResearch.com Interview with: Dr. Kerry Zang Founder of the Arizona Institute of Footcare and Dr. Robert Sullivan Clinical Director, Midleton Foot Clinic MedicalResearch.com Editor's note: Dr. Zang and Dr. Sullivan discuss the recent announcement of FDA approval of the Lunula Laser for the treatment of Onychomycosis. MedicalResearch.com: What is the background for this new technology? Response: “For two decades, Erchonia Corporation studied the clinical utility of low-level laser devices for the treatment of numerous medical ailments. Dr. Sullivan and I worked with Erchonia on the Lunula laser to revolutionize the way the medical community treats onychomycosis. Lunula underwent four independent clinical investigations for the treatment of onychomycosis. More than 500 subjects participated with increasingly effective results and each completed without a single adverse event.” - Dr. Kerry Zang Response: “There has never been a non-pharmaceutical treatment for onychomycosis. When I became aware that there was a small study completed by Dr. Zang, I became interested in the potential of this new technology. Erchonia was very helpful in bringing me up to speed with what this technology may do. The results of my extended study were unbelievable.” -Robert Sullivan (more…)
Alcohol, Author Interviews, Memory / 19.07.2016

MedicalResearch.com Interview with: Jeff Boissoneault, PhD Research Assistant Professor Center for Pain Research and Behavioral Health Department of Clinical and Health Psychology University of FloridaJeff Boissoneault, PhD Research Assistant Professor Center for Pain Research and Behavioral Health Department of Clinical and Health Psychology University of Florida MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many older adults are regular moderate drinkers. Although moderate drinking is considered to be a low risk behavior, growing evidence suggests older adults may be more susceptible to the cognitive and behavioral effects of moderate alcohol intake than younger people. We have previously shown that blood alcohol concentrations (BACs) below the legal limit for driving in the United States, 0.08 g/dL, affect working, or short-term, memory performance in older but not younger adults. For this study, we examined frontal theta power (FTP) and posterior alpha power (PAP), which are electrophysiological measures of brain activity associated with cognitive effort and maintenance of visual information, during a working memory task in both older and younger social drinkers. We found that during a nine-second delay period during which participants held briefly-displayed images in memory, moderate alcohol intake increased PAP in younger adults but decreased PAP in older adults. Examining the relationship between PAP and behavioral performance (accuracy and reaction time) suggested older adults may attempt to compensate for moderate alcohol-induced working memory impairment by prioritizing quick responding over the protection of their mental representation of the task images from environmental distractions. Younger adults did not show this effect. (more…)
Author Interviews, Microbiome, Pharmacology / 19.07.2016

MedicalResearch.com Interview with: Mark Pimentel, MD Associate Professor, Medicine Director, GI Motility Program Director, GI Motility Laboratory Cedars-Sinai IBS-C Clinical Advisory Board (Chair) at Synthetic Biologics Los Angeles, CA MedicalResearch.com: What is the background for this study? Dr. Pimentel: The SYN-010 program is based on research from my group at Cedars-Sinai Medical Center, and other researchers and collaborators worldwide, investigating the role of intestinal methane production in functional gastrointestinal disorders. Low levels of intestinal methane are a ubiquitous by-product of normal intestinal microbial digestion; however, elevated intestinal methane levels are correlated with decreased intestinal motility and increased symptom severity in patients with irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC). Methane in humans is produced almost exclusively by the intestinal microorganism Methanobrevibacter smithii (M. smithii). Highest levels of M. smithii are found in the colon; however, overgrowth of M. smithii into the small intestine has also been observed. Previous work from my laboratory demonstrated that methane production by M. smithii in stool samples from IBS-C patients is inhibited by the lactone form of lovastatin. Lovastatin lactone does not appear to eradicate microbial species in the intestine, which should reduce the risk of intestinal dysbiosis and/or the development of microbial resistance. SYN-010 is a proprietary, modified-release, oral formulation of lovastatin lactone, designed to protect lovastatin lactone from the stomach and release the active ingredient in two different locations of the intestinal tract where the M. smithii reside. SYN-010 exerts its therapeutic effect at the level of the intestinal microbiome and does not require absorption into the systemic circulation or conversion of the active ingredient (lovastatin lactone) to the cholesterol lowering β-hydroxyacid form. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA, Pharmacology / 19.07.2016

MedicalResearch.com Interview with: Principal investigator A/Prof Suetonia Palmer PhD University of Otago, New Zealand Senior investigator Prof. Giovanni Strippoli MD, PhD, MPH, MM University of Sydney, Australia and Diaverum, Sweden MedicalResearch.com: What is the background for this study? Response: Network meta-analysis is a new technique that allows us to evaluate ALL medical therapies for a specific clinical problem. We wondered whether any of the usual drugs used to treat glucose levels in people with diabetes were safest or most effective. (more…)
Annals Internal Medicine, Author Interviews, Breast Cancer, Mammograms / 19.07.2016

MedicalResearch.com Interview with: Dr-Brian-SpragueBrian L. Sprague, PhD Assistant Professor Department of Surgery Assistant Professor Department of Biochemistry University of Vermont MedicalResearch.com: What is the background for this study? Response: Having dense breasts makes mammography more difficult to interpret and is also an independent risk factor for developing breast cancer. About half of all U.S. states require that information on the density of a woman's breasts be made available to her after a mammogram, and in some states the report must also inform such women that there are additional tests, such as breast magnetic resonance imaging (MRI), that may detect breast cancer in women who have dense breasts and normal mammograms. Such laws are controversial because of the large number of women affected (around 40% of women aged 40-74) and due to a lack of consensus in the medical community regarding the benefits and harms of supplemental screening strategies. An additional concern is the subjective nature of breast density assessment, which is based on the Breast Imaging Reporting and Data System (BI-RADS) that provides four possible categories for breast density. (more…)
Author Interviews, Genetic Research, Melanoma / 19.07.2016

MedicalResearch.com Interview with: Adam Berger, MD, FACS Vice Chair for Clinical Research Thomas Jefferson University Hospital Philadelphia , PA MedicalResearch.com: What is the background for this study?  Dr. Berger: Perhaps the most important point for consideration in the adoption of a new diagnostic test is: “Will this test impact patient management decisions for the patient that is sitting in front of me?” If the answer is no, then I would not order the test. If this answer is yes, the next question is how does it alter or impact patient management. The DecisionDx-Melanoma test is a 31-gene expression profile test that has been shown to accurately separate or stratify patients with cutaneous melanoma identified to be at high risk of metastasis (“Class 2” test result) from those who are at an extremely low risk of disease progression (“Class 1” test result). In two peer-reviewed publications from 2015 and three studies presented between April and June of this year, the DecisionDx-Melanoma test showed a Negative Predictive Value of 98% or 99% for death from melanoma or disease free-survival in patients with Stage I and II melanoma. (more…)
Author Interviews, PTSD, Sleep Disorders / 19.07.2016

MedicalResearch.com Interview with: Jim Burch, MS, PhD Associate Professor Dept. of Epidemiology & Biostatistics Cancer Prevention & Control Program Arnold School of Public Health University of South Carolina, Columbia, SC and Health Science Specialist WJB Dorn Department of Veterans Affairs Medical Center Columbia, SC MedicalResearch.com: What is the background for this study? Response: Over 21 million Veterans live in the U.S., and nearly 9 million of them receive healthcare through the Veterans Health Administration, which is the largest integrated healthcare system in the U.S. The military population is particularly vulnerable to sleep disturbances due to their work schedules, living conditions, and other physical and psychological factors that accompany their jobs. However, previous studies have not comprehensively described the scope and characteristics of sleep disorders among Veterans. Sleep is considered a physiological necessity. Inadequate sleep has been associated with a wide range of adverse health outcomes, including an increased risk of chronic diseases such as heart disease and cancer, psychiatric disorders, reduced quality of life, and increased mortality. (more…)
Author Interviews, Infections, Technology / 18.07.2016

MedicalResearch.com Interview with: MedicalResearch.com: What is the background for this study? Response: For the past 5 years or so, my collaborators and I have been working on several issues leading to the realization of the so-called “Windows to the Brain (WttB)” platform. WttB are transparent nanocrystalline yttria-stabilized-zirconia (nc-YSZ) cranial implants capable of replacing portions of the skull to allow non-invasive optical interrogation of the brain on an ongoing recurring basis. This new technological advancement could eventually afford for: a) advancing understanding of the brain, by facilitating the clinical translation of emerging optogenetic neurotechnologies; and b) facilitating the diagnosis and treatment of a wide variety of brain pathologies and neurological disorders, such as traumatic brain injury, stroke, brain cancer, and others. (more…)
Author Interviews, Heart Disease, Race/Ethnic Diversity / 18.07.2016

MedicalResearch.com Interview with: Evan L. Thacker, PhD. Assistant Professor College of Life Sciences Brigham Young University Provo, UT MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) is diagnosed more commonly in whites than blacks in the United States. This seems paradoxical because blacks have higher prevalence of many risk factors for AF. Various explanations for this paradox have been proposed, including biological explanations as well as potential biases in research studies. We investigated one such bias – selection bias – as a potential explanation for the paradox. We did this by comparing the racial difference in atrial fibrillation prevalence among people who enrolled in an epidemiologic study versus people who were eligible to enroll in the study but did not enroll. (more…)
Asthma, Author Interviews, Environmental Risks, JAMA / 18.07.2016

MedicalResearch.com Interview with: Sara Rasmussen PhD Student Johns Hopkins School of Public Health Department of Environmental Health Sciences Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Residents of communities undergoing unconventional natural gas development (the “fracking” industry) and those nearby can be exposed to noise, light, vibration, heavy truck traffic, air pollution, social disruption, and anxiety related to rapid industrial development of one’s community. In Pennsylvania, development began in the mid-2000s and by 2012, 6,253 wells were drilled. In our study, we found increased odds of asthma hospitalizations, asthma emergency department visits, and asthma oral corticosteroid medication orders (a medication used for asthma exacerbations) among asthma patients residing near bigger or larger numbers of active unconventional natural gas wells compared to those residing farther away. (more…)