Author Interviews, Health Care Systems, JAMA, Social Issues / 14.01.2020

MedicalResearch.com Interview with: Elizabeth Tung MD MS Section of General Internal Medicine Instructor of Medicine University of Chicago MedicalResearch.com: What is the background for this study? Response: Medicare provides hospital ratings for all Medicare-certified hospitals in the U.S. based on quality metrics, including mortality, patient experience, hospital readmissions, and others. While ratings are important for comparing hospitals, there's been some concern that some of these quality metrics are outside a hospital's control, especially for hospitals taking care of vulnerable or socially complex patient populations. Take "timeliness of care" as a quality metric, for instance--this measure includes emergency room wait times. But in places that are medically underserved and have very few emergency rooms, these wait times will inevitably be much higher. What this means is that hospitals taking care of medically underserved populations end up getting lower quality ratings, even though they're addressing health disparities by filling an access gap. (more…)
Author Interviews, JAMA, Surgical Research, Technology, University of Michigan / 13.01.2020

MedicalResearch.com Interview with: Kyle Sheetz, MD Clinical Year 4 Resident, General Surgery Michigan Medicine MedicalResearch.com: What is the background for this study? Response: There are concerns that robotic surgery is increasing for common surgical procedures with limited evidence and unclear clinical benefit. Prior studies describing the use of robotic surgery relied upon claims or billing data to identify robotic operations from laparoscopic or open ones. This may lead to inaccuracies as claims data may not provide specific codes for robotic operations. (more…)
Author Interviews, CMAJ, Hematology / 13.01.2020

MedicalResearch.com Interview with: Stig E Bojesen Professor, chief physician, dr.med.sci. Dept of Clinical Biochemistry, Herlev Gentofte Hospital Copenhagen University Hospital Department of Clinical Medicine University of Copenhagen MedicalResearch.com: What is the background for this study? Response: Before this study, we did not know the value of an incidental finding of lymphopenia of an otherwise healthy individual from the general population. This is curious since lymphocyte count is a very simple measurement done almost every time you have a blood test done. (more…)
Author Interviews, Cost of Health Care, Emergency Care, Neurology / 10.01.2020

MedicalResearch.com Interview with: Simon Borghs MSc RWE Strategy Lead of Neurology UCB:  Union Chimique Belge MedicalResearch.com: What is the background for this study? Response: Epilepsy is an episodic disease and so is associated with a more or less unpredictable occurrence of health care encounters. These encounters are costly and so reducing them, or their unpredictability, could be cost saving. The objective was to assess one half of this equation, that is the actual cost of those encounters to insurers. This could prompt insurers to consider addressing possible interventions in epilepsy to reduce the number of encounters (more…)
Author Interviews / 10.01.2020

MedicalResearch.com Interview with: Xinyan Wang Department of Epidemiology Fuwai Hospital, National Center for Cardiovascular Disease Peking Union Medical College & Chinese Academy of Medical Sciences Beijing,  China MedicalResearch.com: What is the background for this study? Does the type of tea matter (green vs black etc.)? Response: Tea is one of the most popular beverages globally and has attracted great interest from both the public and scientific researchers due to its potential benefits for cardiovascular system and people’s general health as well. However, previous results from population-based studies remained inconsistent. Thus, we aimed to investigate the association between tea and cardiovascular disease, the leading cause of disease burden, using our unique long-term cohort data with multiple follow-up visits.  (more…)
Author Interviews, Breast Cancer, Cost of Health Care, JAMA, Race/Ethnic Diversity / 09.01.2020

MedicalResearch.com Interview with: Naomi Y Ko, MD Director, Inpatient Medical Operations Assistant Professor of Medicine, Department of Medicine Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is to help understand the association between risk of more advanced cancer in racial minorities and insurance.   (more…)
Author Interviews, Cancer Research, Radiation Therapy, University of Pennsylvania / 09.01.2020

MedicalResearch.com Interview with: Keith A. Cengel, M.D., Ph.D. Associate Professor of Radiation Oncology Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: FLASH radiotherapy involves delivering the treatment dose at a rate that is 1000s of times faster than standard radiotherapy.  Scientists have studied the differential biological effects of various dose rates for dose rates for the past ~80 years, but the unique effects of FLASH dose rates have only been appreciated in the last few years. While the mechanism(s) and applications of FLASH radiotherapy remain an area of active investigation,  t is clear so far that FLASH dose rates can provide similar levels of tumor control with less toxicity to normal tissues when compared to the same dose of radiotherapy delivered at a standard dose rate. (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA, UCLA / 09.01.2020

MedicalResearch.com Interview with: Olujimi A. Ajijola, MD, PhD Neurocardiology Research Center of Excellence Cardiac Arrhythmia Center University of California, Los Angeles MedicalResearch.com: What is the background for this study? Response: It hadn’t been understood why some people with basic heart failure might live longer than others despite receiving the same medications and medical device therapy. Through this research we set out to determine whether a biomarker of the nervous system could help explain the difference. This study revealed a biomarker that can specifically predict which patients with “stable” heart failure have a higher risk of dying within one to three years. (more…)
Author Interviews, Bipolar Disorder, Depression, JAMA, Schizophrenia, Weight Research / 08.01.2020

MedicalResearch.com Interview with: Shahram Bahrami, PhD NORMENT Centre, Institute of Clinical Medicine Division of Mental Health and Addiction Oslo University Hospital Oslo, Norway  MedicalResearch.com: What is the background for this study? Response: We know that patients with severe mental disorders such as schizophrenia, bipolar disorder and major depression have shorter life span than the rest of the population, largely due to comorbid cardiovascular diseases. The increased risk seems related to lifestyle including diet and physical activity and medicines, while the mechanisms are not fully understood. Different studies have shown increased weight (high body mass index) in many people with mental disorders. Yet very little is known about genetic variants jointly in influencing major psychiatric disorders and body mass index. Thus, we investigated if there are overlapping genetic risk variants between body mass index and the mental disorders schizophrenia, bipolar disorders and major depression.  (more…)
Author Interviews, Dermatology, Education, Gender Differences, JAMA, Race/Ethnic Diversity / 08.01.2020

MedicalResearch.com Interview with: Imam Xierali, PhD Associate Professor / UT Southwestern Medical Center Dallas, Texas MedicalResearch.com: What is the background for this study? Response: Despite the continued efforts in academic medicine to increase the representation of women and minorities underrepresented in medicine (URM), there is a lack of information on trends in dermatology department faculty diversity and how they compare with those in other clinical departments. (more…)
Author Interviews, Genetic Research, Heart Disease, JAMA, Weight Research / 08.01.2020

MedicalResearch.com Interview with: Ravi V. Shah, MD Cardiology Division, Department of Medicine Massachusetts General Hospital Boston, MA Venkatesh L. Murthy MD, PhD Division of Cardiovascular Medicine Department of Medicine and Frankel Cardiovascular Center University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: We were interested in evaluating how added information like fitness assessed on a treadmill exercise test, physical activity questionnaires and genetic risk scores could inform patients and doctors’ understanding of how an individuals BMI might change over time. We used one of the latest and broadest polygenic risk scores. We investigated the CARDIA cohort, a study sponsored by the National Heart, Lung, and Blood Institute, who were young adults aged 18 to 30 and have been followed serially for 25 years. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, JAMA, Surgical Research / 08.01.2020

MedicalResearch.com Interview with: Mehra Golshan, MD, MBA Dr. Abdul Mohsen & Sultana Al-Tuwaijri Distinguished Chair Surgical OncologyDirector of Breast Surgical Oncology Fellowship Associate Professor, Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Triple negative breast cancer is an aggressive form of breast cancer that often requires chemotherapy. In this study we provided neoadjuvant chemotherapy with or without a PARP inhibitor and showed that many women who were originally ineligible for breast conservation (lumpectomy) became eligible after treatment. If lumpectomy was tried it was usually successful.  Many more women in the US compared to Europe and Asia chose mastectomy when lumpectomy was an option even when genetics is negative. (more…)
Author Interviews, Dermatology, HPV, Infections, JAMA, OBGYNE / 08.01.2020

MedicalResearch.com Interview with: Niklas Worm Andersson, MD Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen NV, Denmark MedicalResearch.com: What is the background for this study? What is Podophyllotoxin used for? Response: Podophyllotoxin is an antimitotic agent primarily used in the local treatment of anogenital warts, which are among the most prevalent sexually transmitted diseases worldwide. Most women affected by anogenital warts are of childbearing age and during pregnancy, they may become symptomatic, enlarge, or multiply. While podophyllotoxin is part of first-line treatment of anogenital warts for the non-pregnant population, it is contraindicated during pregnancy. Fetal safety data are limited and to our knowledge, no previous human data exist to help inform on this issue. (more…)
Author Interviews, Fertility, NIH, Supplements / 08.01.2020

MedicalResearch.com Interview with: Enrique Schisterman, Ph.D. Chief, Epidemiology Branch, DIPHR Eunice Kennedy Shriver National Institute of Child Health and Human Development NICHD MedicalResearch.com: What is the background for this study? Response: Small studies indicated that zinc and folic acid supplements for men might improve semen quality as both zinc and folic acid are involved in DNA transcription and have antioxidant functions. But no large-scale randomized trials have been done to assess efficacy, which is important since dietary supplements are largely unregulated, and FDA cannot regulate supplements until after they come to market. Some male fertility-targeted supplements are already among the most commonly sold supplement products, despite the lack of data to guide their use.  (more…)
Accidents & Violence, Author Interviews, Brain Injury, JAMA, Pediatrics, UCSF / 08.01.2020

MedicalResearch.com Interview with: Benjamin N. Breyer MD, MAS, FACS Associate Professor Departments of Urology and Epidemiology and Biostatistics University of California, San Francisco Vice-Chair of Urology Chief of Urology, Zuckerberg San Francisco General Hospital and Trauma Center Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship MedicalResearch.com: What is the background for this study? Response: There has been a large increase in upright scooter usage among adults as a mode of transportation. It's convenient for commuters and may encourage greater use of public transit leading to less car traffic in cities. (more…)
Author Interviews, C. difficile, Hospital Acquired / 08.01.2020

MedicalResearch.com Interview with: Alexandre R. Marra, MD PhD Iowa Infection Prevention Research Group University of Iowa Carver College of Medicine Division of Medical Practice, Hospital Israelita Albert Einstein São Paulo, Brazil MedicalResearch.com: What is the background for this study? Response: This is a comprehensive systematic literature review evaluating the burden of C. difficile infections in the U.S healthcare system. The literature has diverse studies with variable outcomes. Thus, we only included incidence estimates derived from multicenter studies. In our meta-analysis to calculate incidence, data were pooled only with denominators using the same unit (patient-days) to avoid comparisons with different denominators. For length of stay (LOS), we only included studies that used advanced statistical methods (e.g., propensity score matching). (more…)
Aging, Author Interviews, Exercise - Fitness, Heart Disease, JACC / 08.01.2020

MedicalResearch.com Interview with: Dr Charlotte Manisty PhD MRCP Senior Lecturer Consultant Cardiologist Barts Heart Centre and University College University College Hospitals, London MedicalResearch.com: What is the background for this study? Response: The normal ageing process results in vascular stiffening which in turn contributes to adverse cardiovascular events including heart attacks and strokes.  We know that trained athletes have more compliant blood vessels than their peers, and previous small studies of supervised exercise training have shown that such interventions can reduce blood pressure. We aimed to assess the impact of unsupervised exercise training on cardiovascular physiology in novice runners preparing for a first-time marathon using advanced noninvasive imaging in order to better understand whether it is possible to ‘reverse’ vascular ageing. (more…)
Author Interviews, Diabetes, Supplements / 08.01.2020

MedicalResearch.com Interview with: Jonathan P. Little PhD Associate Professor Canadian Institutes of Health Research New Investigator Michael Smith Foundation for Health Research Scholar Faculty of Health and Social Development School of Health and Exercise Sciences The University of British Columbia Syilx Okanagan Nation Territory Kelowna, BC  Canada MedicalResearch.com: What is the background for this study? Response: Ketones are energy-yielding molecules that are bodies naturally produce during periods of starvation or when we restrict carbohydrate intake. Recently, scientists from Oxford and the NIH have created exogenous ketone supplements, which now enable us to be able to drink ketones. This puts our body into a unique state – we can consume a drink that raises blood levels of ketones without having to starve or restrict carbohydrate intake. Some are even touting ketone supplements as a “fourth macronutrient”. Ketone supplements are primarily marketed for athletes to provide an alternative fuel for improving endurance exercise performance. We were actually studying how ketone supplements impacted exercise performance when we noticed that they consistently lowered blood glucose after participants consumed them. We went to the literature and found some classic papers where it was shown that infusing ketones did in fact lower glucose and the mechanism seemed to involve reducing liver glucose output. This was very exciting to us because we also study type 2 diabetes, a condition where blood sugars are too high and elevated liver glucose output is one of the major reasons. So we came up with the hypothesis that ketone supplements might be a unique strategy to help with blood glucose control. In the recent study, we tested this out in a randomized crossover experiment in 15 participants with overweight/obesity who were at risk for type 2 diabetes. Participants drank the ketone monoester supplement or a placebo and 30 minutes later they consumed an oral glucose tolerance test drink containing 75 grams of sugar. Blood samples were collected for 2 hours after the glucose test drink. (more…)
Alzheimer's - Dementia, Author Interviews, Technology / 08.01.2020

MedicalResearch.com Interview with: Dr.med.univ. Roland Beisteiner Department of Neurology Laboratory for Functional Brain Diagnostics and Therapy High Field MR Center, Medical University of Vienna Vienna, Austria MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is the development of a new brain therapy which allows to support brain regeneration by activation of neurons with pulsed ultrasound. Main findings are that Alzheimer's patients improve their memory up to 3 months. (more…)
Author Interviews, Heart Disease, Race/Ethnic Diversity / 07.01.2020

MedicalResearch.com Interview with: Robert H. Schneider, MD, FACC Director, Institute for Natural Medicine and Prevention Dean, College of Integrative Medicine Maharishi University of Management Fairfield, Iowa 52556 MedicalResearch.com: What is the background for this study? Response: Abnormal enlargement of heart, known as left ventricular hypertrophy (LVH), is an important risk factor for cardiovascular disease (CVD). It doubles the risk for heart attacks, heart failure, arrhythmias, stroke, and mortality. African Americans have twice the rate of LVH compared to whites. This may partly explain the disproportionally high CVD death rates in blacks. Psychosocial stress contributes the development of LVH and CVD. African Americans are exposed to excess psychosocial stress imposed by socioeconomic disparities and racism. However, there is little known about the potential role of stress reduction in the prevention of LVH in the general population or African Americans in particular. Therefore, this study was conducted to assess if stress reduction with Transcendental Meditation could prevent left ventricular hypertrophy in African Americans and thereby help to prevent subsequent heart disease. (more…)
Author Interviews, JAMA, Opiods, Pediatrics / 06.01.2020

MedicalResearch.com Interview with: Rachel H. Alinsky, MD, MPH Adolescent Medicine and Addiction Medicine Fellow Division of General Pediatrics and Adolescent Medicine Johns Hopkins University School of Medicine MedicalResearch.com: What is the background for this study? Response: We know that over 4,000 adolescents and young adults between the ages of 15-24 are dying from an opioid overdose every year. Nonfatal opioid overdose has been identified as a potential touchpoint with the healthcare system when individuals can be drawn into treatment, yet very little is known about health care use following opioid overdose in youth. We were interested in figuring out the extent to which adolescents and young adults are receiving evidence-based treatment after an opioid overdose. (more…)
Alzheimer's - Dementia, Author Interviews, Brain Injury, Medical Imaging, UCSF / 06.01.2020

MedicalResearch.com Interview with: William G. Mantyh, MD Clinical Fellow, UCSF Memory and Aging Center Weill Institute for Neurosciences UCSF MedicalResearch.com: What is the background for this study? Response: Similar to Alzheimer’s disease (AD) and other dementing illnesses, Chronic Traumatic Encephalopathy (CTE) is a progressive neurodegenerative condition associated with abnormally folded tau protein in the brain. CTE is thought to be caused by exposure to repetitive head trauma, and recently has been the subject of intense media coverage given the frequency of CTE found in brains of deceased former American professional football players. CTE is almost impossible to confidently diagnose during life as the symptoms are diverse and vary from patient-to-patient. Symptoms can include impairments in memory, multi-tasking, behavioral/mood regulation, and movement. As there are no blood, imaging, or other tests for this disease, one active area of research is developing a test to help doctors diagnose this condition. As tau tangles in CTE are similar in many respects to those in Alzheimer’s disease, there was hope that PET tracers that detect tau in AD might also work in CTE. Flortaucipir (FTP) is probably the most widely used tau tracer in AD. Recent work has reported some signal from FTP-PET in symptomatic former NFL players and other patients at risk for CTE (Stern et al. New Engl Jour Med 2019; Lesman-Segev et al. Neuroimage Clinical 2019). The overall signal was lower than that observed in Alzheimer’s disease, and, in lieu of correlations with post-mortem findings, it was unclear how well FTP binds to tau pathology in CTE. (more…)
Addiction, Alcohol, Author Interviews, JAMA, Methamphetamine / 06.01.2020

MedicalResearch.com Interview with: Dr. Eric Dawson, PharmD Vice President, Clinical Affairs Millennium Health MedicalResearch.com: What is the background for this study? Response: The US Centers for Disease Control and Prevention has projected a drop in the number of overdose deaths for 2018; the first reported decline since 1990. They cite a decrease in prescription opioid deaths as the leading contributor to the overall reduction, but caution that deaths associated with synthetic opioids, primarily fentanyl, as well as stimulants appear to be increasing. In 2019, we reported a 798% increase in urine drug test positivity rates for nonprescribed fentanyl among results positive for methamphetamine and an 1850% increase among results positive for cocaine. In an effort to conduct ongoing surveillance of the polysubstance use landscape and help characterize these evolving trends in a more timely manner, we examined our UDT data as close to real-time as possible to observe trends in positivity for methamphetamine, cocaine, and heroin, with and without illicit fentanyl. (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, Science / 05.01.2020

MedicalResearch.com Interview with: Dr. D. Branch Moody, MD Principal Investigator Associate Physician, Brigham and Women's Hospital Professor of Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? Is the CD1a molecule found on the skin's Langerhans cells? Response: With increasing industrialization worldwide, people apply cosmetics and other consumer products to the skin, leading to contact dermatitis, which is becoming increasingly common. Immunologists know that T cells participate in dermatitis reactions. However, T cells usually recognize and respond to antigens that are peptides rather than the non-peptide antigens that cause contact dermatitis. (more…)
Author Interviews, Gender Differences, JAMA, Occupational Health, Surgical Research / 05.01.2020

MedicalResearch.com Interview with: Matilda Anderson MBBS MBS General Surgery Trainee/Public Health/Researcher Footscray, Victoria, Australia MedicalResearch.com: What is the background for this study? Response: Female representation in the surgical workforce is increasing.  Previous studies have shown higher infertility rates and adverse pregnancy outcomes in this population.  We aimed to accurately define the available research in this area and provide some basic recommendations about how workplaces can support their female surgical residents and surgeons. On a more personal note- Dr Anderson is a female surgical resident and have seen countless pregnant colleagues remove themselves from operating rooms with the concern about how the conditions may affect their pregnancies.  Dr. Anderson met Associate Professor Goldman at Harvard University (a leading expert on occupational reproductive hazards) and collaborated to explore this area further. (more…)
Author Interviews, Johns Hopkins, NEJM, Weight Research / 02.01.2020

MedicalResearch.com Interview with: Mark P. Mattson, Ph.D. Adjunct Professor of Neuroscience Johns Hopkins University School of Medicine  MedicalResearch.com: What is the background for this study? Response: The usual eating pattern of most people in modern societies is breakfast, lunch, dinner plus a snack(s) every day.   Animals used for most biomedical research – rats and mice – are usually fed ‘ad libitum’ (food is always available for them to eat).    During the past 25 years, myself and the many scientists who trained in my laboratory discovered that when rats or mice are fed intermittently such that they have no food every other day or eat only during a 4-6 hour time period each day, their overall health improves in many ways.  Animals on such intermittent fasting (IF) regimens exhibit signs of slowed aging and they live much longer than those fed ad libitum. The editors of the New England Journal of Medicine invited me and Rafa de Cabo (a former postdoc in my laboratory at the National Institute on Aging) to write this review article for two main reasons.   First, there have been a sufficient number of studies demonstrating the health benefits of IF in humans and knowledge of the underlying mechanisms to justify a review article.  Second, many physicians are being asked about IF by their patients and the physicians are not privy as to if they should recommend IF and how to prescribe specific IF eating patterns and follow-up to increase the likelihood that the patient will be successful in changing their eating pattern.  (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, OBGYNE, Pediatrics, Weight Research / 02.01.2020

MedicalResearch.com Interview with: Elvira Isganaitis, M.D., M.P.H. Pediatric Endocrinologist, Joslin Diabetes Center Assistant Professor of Pediatrics, Harvard Medical School Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response: The concept that a mother's nutrition prior to and during pregnancy is important for health outcomes in the offspring is now well accepted. For example, women intending to get pregnant must take prenatal vitamins, and are encouraged to attain a healthy weight before conception. However, much less is known about how a father's nutritional status may influence childhood health outcomes.  Based on studies in animals, exposure to undernutrition, high-fat diet, or stressful experiences in fathers can result in increased risk of obesity and diabetes in the offspring. These effects are mediated in part by epigenetic mechanisms (i.e. changes in gene expression due to differences in DNA methylation, histones, or other non-genetic mechanisms). (more…)
Alcohol, Author Interviews, Heart Disease, NEJM / 02.01.2020

MedicalResearch.com Interview with: Professor Peter M Kistler MBBS, PhD, FRACP Head of Clinical Electrophysiology Research Baker Heart and Diabetes Institute Head of Electrophysiology at The Alfred hospital Professor of Medicine University of Melbourne. MedicalResearch.com: What is the background for this study? Response: There is a well known association between alcohol intake and atrial fibrillation form population based studies which demonstrate that for every 1 standard drink the incidence of AFib increases by 8%. This is the first randomised study to determine of alcohol reduction/abstinence leads to a reduction in AFib episodes and time to recurrence. (more…)
Author Interviews, Health Care Systems, JAMA / 30.12.2019

MedicalResearch.com Interview with: Maryam Guiahi MD, MSc Associate Professor of Obstetrics and Gynecology University of Colorado Denver School of Medicine MedicalResearch.com: What is the background for this study? Response: The composition of the U.S health care system is shifting; between 2001 to 2016 the number of Catholic-owned or affiliated health facilities grew by 22% in contrast to the overall number of acute care hospitals that decreased by 6% and the number of other nonprofit religious hospitals that decreased by 38%. This is relevant as Catholic health care systems enforce religious directives that restrict many aspects of reproductive care and certain aspects of end-of-life care.  Yet little is known about the extent to which U.S. patients consider religious affiliation when selecting a health care facility.  (more…)
Author Interviews, Opiods, Surgical Research / 30.12.2019

MedicalResearch.com Interview with: Sunil Agarwal, MD Michigan Opioid Prescribing Engagement Network Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: Excess opioid prescribing after surgery often leads to misuse and diversion into the community. To prevent excessive prescribing for acute pain, 31 states have implemented legislation that limits the duration of opioid prescriptions. Our study examined the effect of prescribing limits and postoperative opioid prescribing on surgical patients in Massachusetts and Connecticut, the first two states to implement opioid prescribing limits for acute pain after the CDC guidelines were released.  (more…)