Author Interviews, Brigham & Women's - Harvard, Cancer Research, Immunotherapy, Kidney Disease, NEJM / 18.08.2021

MedicalResearch.com Interview with: Toni K. Choueiri, MD Director, Lank Center for Genitourinary Oncology Director, Kidney Cancer Center Jerome and Nancy Kohlberg Chai Professor of Medicine, Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The standard of care for patients diagnosed with locoregional RCC is partial or total nephrectomy. Nearly half of patients will eventually experience disease recurrence following nephrectomy and no standard, globally approved adjuvant therapy options are currently available for this population. The phase 3 KEYNOTE-564 study met its primary objective of demonstrating a statistically significant and clinically meaningful improvement in disease-free survival with pembrolizumab vs placebo as adjuvant therapy for patients with RCC post nephrectomy, supporting pembrolizumab as a potential new standard of care for patients at high risk of disease recurrence following surgery. (more…)
Author Interviews, NEJM, Neurology, Pain Research / 18.08.2021

MedicalResearch.com Interview with: Jessica Ailani M.D. FAHS FAAN FANA Director Medstar Georgetown Headache Center Vice Co-Chair of Strategic Planning for MedStar Neurology Professor of Clinical Neurology MedStar Georgetown University Hospital MedicalResearch.com: What is the background for this study? Response: Migraine is a common neurological disease that causes disabling attacks that can be frequent. Preventive treatments can help reduce the frequency of attacks and improve patient function, reducing disease burden. (more…)
Anesthesiology, Author Interviews, Cost of Health Care, JAMA / 18.08.2021

MedicalResearch.com Interview with: Ambar La Forgia, PhD Assistant Professor of Health Policy & Management Columbia University Mailman School of Public Health MedicalResearch.com: What is the background for this study? Response: Over the past few years, there has been mounting pressure to protect consumers from surprise medical bills, which occur when a patient unknowingly receives care from an out-of-network practitioner at an in-network facility. In 2018, only six states had passed comprehensive surprise billing legislation, and by 2020, 17 states had passed legislation. In addition to protecting patients from financial liability for surprise medical bills, states adopted different methods for determining payments made by a patient’s insurer to the out-of-network practitioner. For example, some states, such as California and Florida, developed a payment standard that tied provider payments to median in-network rates, Medicare rates, or the usual and customary provider charges. Other states, such as New York, developed an independent dispute resolution process, which uses a third-party arbiter to resolve payment disputes between insurers and practitioners. However, little is known about how state laws influence the prices paid to out-of-network practitioners and whether spillovers existed to in-network prices. In this study, my co-authors and I study the association between the passage of surprise billing legislation in California, Florida, and New York, and prices paid to anesthesiologists in hospital outpatient departments and ambulatory surgery centers using commercial claims data from 2012-2017. We focused on anesthesiology because it is one of the specialties with the highest proportion of potential surprise bills since patients do not usually choose their anesthesiologist. (more…)
Author Interviews, Global Health, Nature / 18.08.2021

MedicalResearch.com Interview with: Dr. Weston B Anderson PhD Postdoctoral Reasearch Scientist International Research Institute for Climate and Society The Earth Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: We find that while drought continues to be a consistent trigger of food crises in Sub-Saharan Africa, protracted conflict has become relatively more important over the last decade. We furthermore find that pastoral livelihoods have taken longer to return to food secure conditions following droughts as compared to agricultural livelihoods. (more…)
Author Interviews, Dermatology, JAMA, Race/Ethnic Diversity / 16.08.2021

MedicalResearch.com Interview with: Joerg Albrecht, MD, PhD Dermatologist, Internist, Clinical Pharmacologist Division of Dermatology, Department of Medicine Attending Dermatologist, Chair Division of Dermatology Chair system-wide Pharmacy & Therapeutics Committee Cook County Health Chicago, IL  60612 MedicalResearch.com: What is the background for this study? Response: The study was stimulated by data that suggested that an unusually large proportion of inpatient with Hidradenitis suppurativa (HS) were African American. HS is an underdiagnosed disease and the total numbers of inpatients with HS in the year we looked at initially seemed small. So we wanted to test whether this finding held up when the period of observation was extended. Point estimates can be unreliable and we had followed another finding in the data that did not hold up when we looked at other years, so we felt one year was not enough to confirm a trend (more…)
Alzheimer's - Dementia, Author Interviews, Dermatology / 15.08.2021

MedicalResearch.com Interview with: Annakaisa Haapasalo, PhD Adjunct Professor Research Director (Associate Professor A.I. Virtanen Institute for Molecular Sciences Molecular Neurodegeneration University of Eastern Finland | UEF |   MedicalResearch.com: What is the background for this study? At what age might these changes be present? Response: Our research team is interested in understanding the underlying disease mechanisms and developing biomarkers for frontotemporal dementia (FTD). FTD is the second most common cause of dementia in the working age population. Presently, no efficient therapies exist for FTD, it is challenging to diagnose, and the disease mechanisms of different types of FTD remain largely unclear. We are especially interested in FTD associated with the C9orf72 repeat expansion because it is the most common genetic cause of frontotemporal dementia and exceptionally prevalent in Finnish FTD patients. Many current studies of FTD and C9orf72 repeat expansion have largely concentrated on examining neurons, as these are the principle CNS cells that are affected in neurodegeneration. Neurons are also one of our key research interests, but obtaining neurons directly from living patients is difficult in many ways. Therefore, we became interested in exploring the FTD patient skin fibroblasts with the idea in mind that they might represent more easily accessible patient-derived cells than neurons for trying to decipher disease mechanisms of FTD. Moreover, we were interested in finding out if these cells show any specific alterations or deficiencies that could be utilized later on in biomarker studies or testing drug effects.  (more…)
Author Interviews, Cancer Research, Gastrointestinal Disease, Science / 13.08.2021

MedicalResearch.com Interview with: Dr Lizhe Zhuang PhD Dr Karol Nowicki-Osuch PhD Dr. Rebecca C. Fitzgerald MD Medical Research Council Cancer Unit, Hutchison/Medical Research Council Research Centre, University of Cambridge, Cambridge UK MedicalResearch.com: What is the background for this study? Barrett’s oesophagus affects about one out of 100 people in the UK and is thought to be a precancerous lesion of a more deadline cancer, oesophageal adenocarcinoma. Barrett’s is a condition where the squamous cells in the lower part of oesophagus are replaced by a special type of columnar cells, which look like intestine, a far distant organ, raising a question where are these columnar cells come from. Many theories have been proposed in the past decades and no agreement was reached, and many conclusions were based on mouse models which do not recap the human condition. We therefore collected fresh samples of human tissues that correspond to all the possible theories and assessed them all together using state of the art technologies.  (more…)
Author Interviews, Education, Medical Imaging, Technology / 13.08.2021

MedicalResearch.com Interview with: Ryan C. Gibbons, MD, FAAEM, FACEP Associate Professor of Emergency Medicine Director of the Emergency Ultrasound Fellowship Associate Director of the Division of Emergency Ultrasound Department of Emergency Medicine Director of Ultrasound in Medical Education Lewis Katz School of Medicine at Temple University MedicalResearch.com: What is the background for this study?  How was the gift funded? Butterfly needle visualizatioResponse: Point-of-care ultrasound is one of the most significant advances in bedside patient care, and its use is expanding across nearly all fields of medicine. In order to best prepare medical students for residency and beyond, it is imperative to begin POCUS training as early as possible. At the Lewis Katz School of Medicine at Temple University, we introduced POCUS education over a decade ago and have expanded it since then. By providing each student with a Butterfly iQ device, we can augment our curriculum significantly. In addition to our robust pre-clinical sessions, now we will expand into the clinical years highlighting the utility of POCUS with actual patients. This gift was made possible by the incredible generosity of Dr. Ronald Salvitti, MD ’63.  (more…)
Author Interviews, Duke, JAMA, Nursing, Sexual Health, STD / 12.08.2021

MedicalResearch.com Interview with: Vincent Guilamo-Ramos, PhD MPH, LCSW, RN, ANP-BC, PMHNP-BC, AAHIVS, FAAN Vincent Guilamo-Ramos is dean and professor at the Duke University School of Nursing, vice chancellor for nursing affairs, Duke University, and director of the Center for Latino Adolescent and Family Health (CLAFH) at Duke. Dr. Guilamo-Ramos served as a member of the National Academies of Sciences, Engineering, and Medicine (National Academies) Committee on Prevention and Control of STIs in the U.S. that wrote the recent consensus study report. He also serves as a member of the Presidential Advisory Council on HIV/AIDS (PACHA) and the HHS Panel on Antiretroviral Guidelines for Adults and Adolescents. MedicalResearch.com: What is the background for this study? Response: The National Academies of Sciences, Engineering, and Medicine (National Academies) recently released a consensus study report on prevention and control of sexually transmitted infections (STIs) in the United States. The report entitled “Sexually Transmitted Infections: Adopting a Sexual Health Paradigm” includes a strong emphasis on adolescents and young adults as an important priority population for the response to record-level STI rates that have reached an all-time high for the sixth year in a row in 2019. The report also highlights the well-supported and crucial role of parents in addressing STIs and promoting sexual health among adolescents and young adults. In this new Viewpoint article, my co-authors and I, who contributed to the National Academies report as committee members or consultants, discuss the practical implications for health care professionals of engaging parents in adolescent sexual health services. (more…)
Author Interviews, Brain Injury / 12.08.2021

MedicalResearch.com Interview with: Henry Mahncke, PhD Chief Executive Officer Posit Science Dr. Mahncke earned his PhD at UCSF in the lab where lifelong brain plasticity as discovered. At the request of his academic mentor, he currently leads a global team of more than 400 brain scientists engaged in designing, testing, refining, and validating the computerized brain exercises found in the BrainHQ app from Posit Science, where he serves as CEO. This week, MedicalResearch.com interviews Dr. Mahncke about a new study, with breakthrough results for service members and Veterans grappling with the signature injury of recent wars. MedicalResearch.com: What makes this study newsworthy? Response: As the last troops come home from Afghanistan, the battle is not over for many who served and continue to grapple with the signature injury of recent conflicts — mild Traumatic Brain Injury (or mTBI). Typically, such injures were caused by blasts or concussions, and they’ve been diagnosed in more than 300,000 service members. Most recover within a couple days or weeks, but for many — some estimate fifteen percent — physical, psychological, emotional, and cognitive problems persist for years. Such injuries often go untreated, because treatments focus on in-person, customized, cognitive rehabilitation, which can be helpful, but is costly, time-consuming, requires travel for treatment, and relies on the craft and expertise of the healthcare provider. Up until now, there’s been no effective intervention that’s highly-scalable and that can be delivered remotely. This study showed that remotely-administered BrainHQ computerized exercises improved overall cognitive performance in a population with very persistent cognitive issues. On average, patients in this study had cognitive issues for more than seven years. That means we finally have a tool shown effective in a gold-standard study that practitioners can employ in treating this large and underserved population, who sacrificed so much to serve our nation. (more…)
Addiction, Author Interviews, Cocaine, Diabetes, Methamphetamine / 07.08.2021

MedicalResearch.com Interview with: Joy M. Schmitz, Ph.D. Professor of Psychiatry Faillace Chair McGovern Medical School The University of Texas Health Science Center at Houston Director, Center for Neurobehavioral Research on Addiction (CNRA)   Scott D. Lane Ph.D. McGovern Medical School Vice Chair For Research Director Of Neurobehavioral Laboratory Center For Neurobehavioral Research On Addiction Director Of Research University of Texas Health Science Center at Houston Houston, TX  MedicalResearch.com: What is the background for this study? Response: Addiction science has made considerable progress in understanding how cocaine and other addictive drugs impair the brain. Over time, cocaine can disrupt brain regions that help us think, plan, solve problems, and exert self-control. These disruptions in brain structure can be seen in neuroimaging studies that reveal impairment in the nerve fibers or white matter (WM) tracts in the central and front parts of the brain. We conducted two systematic meta-analytic reviews of the literature to document the robustness of evidence showing alterations in WM integrity of chronic stimulant users relative to healthy control subjects who did not use cocaine or other drugs of abuse (Beard et al., 2019; Suchting et al., 2020). Importantly, WM impairments negatively predict treatment outcome, meaning individuals with greater levels of WM impairment are less likely to benefit from treatment and more likely to experience deficits in attention, working memory, and impulse control. We reasoned that pharmacological interventions shown to protect WM integrity may help improve cognition and treatment outcomes in patients recovering from cocaine addiction. Pioglitazone, an approved medication for type 2 diabetes, has been shown to reduce inflammation and mediate protection after traumatic brain injury. The therapeutic potential of pioglitazone has prompted investigation of its role in neurodegenerative conditions, such as dementia, Alzheimer’s disease, and stroke. Similar to these brain diseases and injuries, pioglitazone might effectively protect the brain from the inflammatory damage created by cocaine use.  (more…)
Author Interviews, Dermatology, Geriatrics, Sleep Disorders / 07.08.2021

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Associate Professor Director of Clinical Research Director of Patch Testing George Washington University School of Medicine and Health Sciences Washington, DC  MedicalResearch.com: What is the background for this study? Response: Atopic dermatitis affects people of all ages, including geriatric patients. Previous studies found age-related differences in the clinical manifestations of atopic dermatitis between children and adults. Though, few studies examined whether there are age-related differences of AD severity between geriatric and younger adults. We performed a cross-sectional real-world observational study and found that geriatric age (≥65 years) was not associated with atopic dermatitis severity. However, geriatric age was associated with increased sleep disturbances, delays falling asleep and nighttime awakenings from itch, as well as fatigue. (more…)
COVID -19 Coronavirus, PLoS / 07.08.2021

MedicalResearch.com Interview with: Melanie Bell, PhD, MS Professor Mel and Enid Zuckerman College of Public Health The University of Arizona MedicalResearch.com: What is the background for this study? Response: In May 2020 my colleagues began a cohort study called CoVHORT, which  aimed to investigate the impacts of the SARS-Cov-2 pandemic among residents of Arizona. The current study on long covid is a sub-study which included all CoVHORT participants who had a confirmed positive COVID-19 test, were not hospitalized, and had symptom data 30 days are longer since the test. We wanted to investigate the prevalence of long covid, also known as post-acute sequalae of COVID-19 (PASC) amongst people who did not experience severe acute infection. Although the definition is still evolving in the research community, we defined PASC as continuing to experience at least one symptom 30 days or longer post-acute infection. (more…)
Author Interviews, Blood Pressure - Hypertension, Exercise - Fitness, Heart Disease, JAMA / 05.08.2021

MedicalResearch.com Interview with: Fernando Ribeiro PhD School of Health Sciences Institute of Biomedicine - iBiMED University of Aveiro Aveiro, Portugal MedicalResearch.com: What is the background for this study? What are the main findings? Response: Resistant hypertension is a puzzling problem without a clear solution. The available treatment options to lower blood pressure, namely medication and renal denervation, have had limited success, making nonpharmacological strategies good candidates to optimize the treatment of this condition. Exercise training is consistently recommended as adjuvant therapy for patients with hypertension, yet, it is with a great delay that the efficacy of exercise training is being tested in patients with resistant hypertension. Having that in mind, the EnRicH trial was designed to address whether the benefits of an exercise intervention with proven results in hypertensive individuals are extended to patients with resistant hypertension, a clinical population with low responsiveness to drug therapy. Exercise training was safe and associated with a significant and clinically relevant reduction in 24-hour, daytime ambulatory, and office blood pressure compared with control (usual care). (more…)
Author Interviews, JAMA, Smoking, Tobacco, Tobacco Research, UC Davis / 05.08.2021

MedicalResearch.com Interview with: John Pierce, PhD Professor Emeritus Department of Family Medicine and Public Health Moores Cancer Center Director for Population Sciences Co-leader of the Cancer Prevention program UC San Diego MedicalResearch.com: What is the background for this study? What are the main findings? Response: Graphic Warning Labels are to be implemented in the US in July 2022, depending on litigation. This will be about 10 years after they were first proposed.  Meanwhile, 120 other countries have implemented them already. The FDA states that their purpose for the warnings is to provide a constant reminder to smokers about the health consequences of smoking, not to force them to quit. In our study, 3 months of having cigarettes repackaged into graphic warning packs was associated with smokers thinking more about quitting and not getting as much pleasure out of their cigarettes.  However, thinking about quitting is only the first step to conquering a nicotine addiction. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Kidney Disease / 04.08.2021

MedicalResearch.com Interview with: Maria Luisa S. Sequeira Lopez, MD, FAHA Harrison Distinguished Professor in Pediatrics and Biology University of Virginia Charlottesville, VA 22908 MedicalResearch.com: What is the background for this study? Response: The renin-angiotensin system (RAS) is crucial in the regulation of the blood pressure (BP). Synthesis and secretion of renin is the key regulated event in the operation of the RAS. One of the main mechanisms that control renin synthesis and release is the baroreceptor mechanism whereby a decrease in blood pressure results in increased release of renin by juxtaglomerular (JG) cells. In spite of its enormous importance, the nature and location of the renal baroreceptor was still unknown. This was due in great part to the lack of appropriate in vitro and in vivo models to confidently allow tracking of the fate and isolation of renin cells, and the lack of tools to study the chromatin in scarce cells. (more…)
Author Interviews, Brain Injury, Exercise - Fitness / 04.08.2021

MedicalResearch.com Interview with: Willie Stewart, MBChB, PhD, DipFMS, FRCPath, FRCP Edin Consultant Neuropathologist Honorary Professor Department of Neuropathology Queen Elizabeth University Hospital Glasgow, UK MedicalResearch.com: What is the background for this study? Response: There is concern over the association between participation in contact sports and later life risk of dementia and associated neurodegenerative disease. Much of this comes from observations of a specific form of neurodegenerative pathology - chronic traumatic encephalopathy (CTE)- linked to history of traumatic brain injury (TBI) and repetitive head impacts in autopsy studies of relatively small numbers of former athletes, including boxers and soccer players. Nevertheless, although this brain injury linked pathology is described, surprisingly little is known about what this might mean for later life health, specifically risk of dementia. In a previous study published from our programme of research looking at "Football's Influence on Lifelong health and Dementia risk' (the FIELD Study), we demonstrated that former professional soccer players had an approximately three-and-a-half-fold higher mortality from neurodegenerative disease than matched general population controls. However, these mortality data did not allow us to consider the relationships between varying head injury/impact exposure variables, such as player position and career length, and risk of neurodegenerative disease.  (more…)
Author Interviews, COVID -19 Coronavirus, Occupational Health, Weight Research / 01.08.2021

MedicalResearch.com Interview with: https://www.newtopia.com/Jeff Ruby, JD, MBA, Founder and Chief Executive Officer Leonard Fensterheim, MPH Vice President of Analytics MedicalResearch.com: What is the background for this study? What are common weight-change findings during the pandemic?  Obesity has been linked to increased risk of serious complications and the need for costly medical utilization – all of which has been exacerbated by the COVID-19 pandemic. There has been an increase of imposed restrictions that impact healthy lifestyles – the closing of gyms as an example – leading to additional stress and the complete disruption of daily lives. It’s no surprise that many people have gained weight since the beginning of the pandemic. According to the Centers for Disease Control and Prevention (CDC), before the pandemic, about 40% of Americans had obesity in the United States. This was already an alarming figure, but given that the American Psychological Association found that 42% of U.S. adults report undesired weight gain, with an average gain of 29 lbs. since the start of the pandemic, we expect that percentage has continued to grow. Against this backdrop, Newtopia sought to evaluate the impact of a guided habit change program on weight loss for 12 months during the COVID-19 pandemic. Method:
  • This was a retrospective study that looked at 1436 participants who began participating in the Newtopia experience in early 2020.
  • This analysis focused on weight change and was restricted to those participants with a body mass index >
  • 52% of participants were female, and the average age of the total study population was 46.5 years old (±10.6).
  • The percentage of participants with a 4.3% weight reduction after 12 months was assessed. This has been shown to be associated with meaningful reduction in healthcare costs.
  • The average weight loss and the percentage BMI decrease was also assessed.
  Outcomes:
  • 77% of participants lost weight.
  • 44% of participants had a weight loss of >3%.
  • Average weight loss was 4.2% (p<.0001).
  • 22% of obese participants dropped a BMI category.
Despite the challenges of the Covid-19 pandemic, individuals participating in the Newtopia habit change experience still achieved impactful weight loss. (more…)
Author Interviews, Columbia, JAMA, Race/Ethnic Diversity, Telemedicine / 29.07.2021

MedicalResearch.com Interview with: Steffie Woolhandler MD MPH, FACP Professor of Public health and Health Policy CUNY School of Public Health at Hunter College Co-founder and board member Physicians for a National Health Program MedicalResearch.com: What is the background for this study? What are the main findings? Response:   We analzyed a national database of healthcare utilization. We found racial disparities exist in use of specialist MD services by Black- and Native-Americans relative to White-Americans, despite their greater needs.  Hispanic- and Asian-Americans also receive specialist care at low rates.   (more…)
Author Interviews, Cognitive Issues, COVID -19 Coronavirus, Imperial College, Lancet / 28.07.2021

MedicalResearch.com Interview with: Dr. Adam Hampshire PhD Faculty of Medicine Department of Brain Sciences Imperial College London MedicalResearch.com: What is the background for this study? Response: During 2020 I was leading a study that sought to map the distribution of cognitive abilities and aspects of mental health across the UK population. The study generated a lot of interest because it was a collaboration with BBC2 Horizon, leading to ~390,000 participants. When the pandemic began to escalate in the UK a number of my colleagues at Imperial and elsewhere contacted me to note that the study could be used to investigate the impact of both the pandemic and direct illness on daily life, mental health and cognition. I had been thinking along similar lines so decided to add questionnaires about peoples' experiences with the pandemic and Covid-19 illness. (more…)
Allergies, Author Interviews, COVID -19 Coronavirus, JAMA, Vaccine Studies, Vanderbilt / 27.07.2021

MedicalResearch.com Interview with: Kimberly G. Blumenthal, MD, MSc Massachusetts General Hospital The Mongan Institute Boston, MA 02114 Matthew S. Krantz, MD Division of Allergy, Pulmonary and Critical Care Medicine Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee   MedicalResearch.com: What is the background for this study? Response: During the initial COVID-19 vaccine campaign with healthcare workers in December 2020, there was an unexpected higher than anticipated rate of immediate allergic reactions after Pfizer and Moderna mRNA vaccines.  This prompted both patient and provider concerns, particularly in those with underlying allergic histories, on the associated risks for immediate allergic reactions with the mRNA vaccines. Because of the significantly improved effectiveness of two doses of an mRNA vaccine compared to one dose, it was important to determine if those who experienced immediate allergic reaction symptoms after their first dose could go on to tolerate a second dose safely.    (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Columbia / 27.07.2021

MedicalResearch.com Interview with: George Hripcsak, MD, MS. Chair and Vivian Beaumont Allen Professor of Biomedical Informatics Department of Biomedical Informatics, Columbia University Irving Medical Center New York, NY MedicalResearch.com: What is the background for this study? Response: ACE inhibitors and ARBs are anti-hypertension drugs that have related yet distinct mechanisms of action, and they are both recommended as first-line therapies for treating hypertension. There have been no large head-to-head comparisons of ACE inhibitors and ARBs, although there are several studies with limited size and often restricted (e.g., high-risk) populations. While there are some conflicting results in the literature, the current evidence seems to indicate that they are similar in effectiveness but that ACE inhibitors have more side effects (e.g., cough and angioedema). (more…)
Author Interviews, JAMA, Mental Health Research / 23.07.2021

This story explores suicide and conditions leading to despair. If you are at risk, please stop here and contact the National Suicide Prevention Lifeline for support. 800-273-8255 MedicalResearch.com Interview with: Daniel George, MSc, PhD Associate Professor, Department of Humanities Associate Professor, Department of Public Health Sciences Penn State MedicalResearch.com: What is the background for this study? What are the common diseases of despair?  Response: Last decade, two Princeton economists, Anne Case and Angus Deaton, noted a precipitous rise in self-harming deaths (suicide, alcoholism, accidental poisonings, i.e., overdose) especially among poor whites in midlife with low educational attainment since the 1990s. These deaths were intimately linked with economic changes over the past several decades that have created more despairing conditions for the working class, made people more susceptible to seeking escape, numbness, and relief from physical, mental, and emotional pain. In recent years, the crisis has broadened, and we've seen rising excess mortality in other groups of working-class Americans as overall life expectancy has consistently fallen. Our team at Penn State College of Medicine and Highmark Inc. has previously examined “diseases of despair”, these being patients who are experiencing suicidal ideation or substance use issues and seeking out clinical care before they convert to "deaths of despair". We published a study in BMJ in 2020 showing a marked rise in these clinical diseases of despair across a sample of 12 million insurance carriers in Appalachia and the Rust Belt, again spanning across demographic boundaries. For this study, we honed in on high prevalence census blocks we had identified in our hospital's service area in central Pennsylvania and organized 4 focus groups in both rural and urban areas. We wanted to learn more about what people felt was driving despair in their communities, and what solutions might look like  (more…)
Author Interviews, Cancer Research, COVID -19 Coronavirus, JAMA, Prostate Cancer, Race/Ethnic Diversity / 23.07.2021

MedicalResearch.com Interview with: Andres F. Correa, MD Assistant Professor Department of Surgical Oncology, and Adrien Bernstein, MD Second Year Urologic Oncology Fellow Fox Chase Cancer Center MedicalResearch.com: What is the background for this study? Response: Unfortunately, it has been well-established that historically Black Americans experience increased cancer specific mortality compared to white patients. In prostate cancer specifically studies have shown that when access to care is equitable this gap resolves. This suggests that biological factors are not driving these differences but rather the result of the complex interplay of social determinants and systemic inequities in our healthcare system. Early in the pandemic, multiple studies demonstrated that minority communities disproportionately shouldered poor COVID-19 outcomes.  On March 13th 2020, the American College of Surgeons recommended against elective procedures; however, the definition of an elective oncologic case was left to the discretion of the provider. As prostate cancer treatment can be safely deferred up to a year follow diagnosis, management of prostate cancer during the initial lockdown period of the COVID-19 Pandemic provided a useful analysis of the differential restrictions placed on non-emergent health care during the Pandemic. (more…)
Author Interviews, Cancer Research, Melanoma / 22.07.2021

  MedicalResearch.com Interview with: Eleonora Leucci, Ph.D Assistant Professor Laboratory for RNA Cancer Biology Department of Oncology KU Leuven   MedicalResearch.com: What is the background for this study? Response: Back in 2016, while I was characterising the RNA SAMMSON as essential for mitochondrial translation in melanoma, I noticed that its inhibition was causing cell death across a large spectrum of melanoma cell lines and models, irrespectively of their genetic background and cell state. At that time I still did not know why the effect was so pronounced on melanoma cells, but I knew that antibiotics of the tetracycline family could also block mitochondrial translation and I thought about repurposing them to treat melanoma. (more…)
Author Interviews, Education, JAMA / 20.07.2021

MedicalResearch.com Interview with: Arman Shahriar Medical Student University of Minnesota Medical School Research Consultant HealthPartners Institute MedicalResearch.com: What is the background for this study? What are the main findings? & What should readers take away from your report? Response: Financing medical school is an opaque and important topic because the cost of attendance of medical school has risen much faster than inflation for decades. Over the same time period, the racial wealth gap has widened. We found significant differences in how students of different socioeconomic and racial/ethnic backgrounds are planning to pay for medical school at the time of matriculation. Family or personal financing is far more common for high-income students. Among Black students, family or personal financing was markedly lower than other racial/ethnic groups, which could be a reflection of the wealth gap - which is rooted in structural racism.  This may create educational disparities as the field becomes increasingly racially, ethnically, and socioeconomically diverse; there are many costs outside of tuition and living that may be considered "variable" or "non-essential" but necessary for high-quality education, including expensive board prep materials and transportation during clinical rotations. Furthermore, the stark deficit in family financing may be one reason why Black students currently report the highest debt burden of all racial/ethnic groups.  (more…)
Author Interviews, Cancer Research, Dermatology, NEJM / 20.07.2021

MedicalResearch.com Interview with: Jane Fang, MD Clinical Athenex, Inc. MedicalResearch.com: What is the background for this study? Response: Tirbanibulin is a first-in-class synthetic molecule that has potent anti-proliferative activity by inhibiting tubulin polymerization and disrupting src kinase signaling. It has been formulated as an ointment for the treatment of actinic keratosis, a very common precancerous condition of UV-damaged skin that affects over 50 million people in the US. The most commonly adopted management approach is to remove AK lesions as it is hard to predict which lesion will become cancerous. Lesion-directed treatment like cryotherapy can effectively remove lesions one at a time but does not treat larger field of cancerization. Also, it is limited by associated pain and long term complication such as scarring. Currently approved topical treatments involve cumbersome application courses of weeks or months, and induce considerable local skin reactions that were not well tolerated by patients. The Phase 3 studies demonstrated that a short 5-day once daily course of tirbanibulin ointment 1% is an efficacious and safe topical treatment of actinic keratosis. (more…)
Author Interviews, Education, Gender Differences, JAMA / 17.07.2021

MedicalResearch.com Interview with: Anjali Sergeant McMaster Medicine Class of 2022 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This collaborative study from the University of Toronto and McMaster University found that inpatients in the Greater Toronto Area (GTA) cared for by female physicians had lower mortality rates compared to those cared for by male physicians. Specifically, a 0.47% difference in patient deaths was reported, which is significant in the context of thousands of deaths in Ontario hospitals each year. This supports similar findings from an American study (Tsugawa et. al) published in 2017. Our study also examined gender-based differences in medical practice, including lab and imaging tests ordered, and medications prescribed. Female doctors ordered significantly more imaging tests for their patients but this factor did not explain their lower patient death rates. The mortality difference shrank when accounting for the number of years that doctors were in practice. This suggests that patients of female doctors may have better outcomes partially because more women make up newer medical grads in Canada, who may be more up-to-date on clinical guidelines. (more…)
Author Interviews, JAMA, Kidney Disease, Race/Ethnic Diversity, UCSF / 17.07.2021

MedicalResearch.com Interview with: Chi-yuan Hsu, MD, MSc (he/him/his) Professor and Division Chief Division of Nephrology University of California, San Francisco San Francisco, CA 94143-0532 MedicalResearch.com: What is the background for this study? Response: There has been a great deal of controversy recently about how race should be considered in medicine, including its use in estimating kidney function (e.g. https://jamanetwork.com/journals/jama/fullarticle/2769035).  A recent paper published in JAMA Network Open by Zelnick et al suggested that removing the race coefficient improves the accuracy of estimating kidney function (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775076) in the Chronic Renal Insufficiency Cohort, a NIH-funded study (www.cristudy.org). We are core investigators of the Chronic Renal Insufficiency Cohort Study and were not involved in the Zelnick’s study that was based on a public use dataset.  Because we were surprised by the methodological approach they took and the conclusion they came to, we implemented our own analysis of the data. (more…)