Author Interviews, CMAJ, COVID -19 Coronavirus, Kidney Disease / 05.02.2021
MedicalResearch.com Interview with: Peter G. Blake MD, FRCPC, FRCPI,MSc MB Professor of Medicine in the Division of Nephrology Ontario Renal Network University of Western Ontario and London Health Sciences Centre London, Ontario MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Covid-19 pandemic has been very difficult for people on dialysis with reports of high infection rates and high mortality. We prospectively collected data on SARS-CoV-2 infection every week from all renal programs in the province of Ontario, Canada from the start of the pandemic. Between March and August 2020, 187 people on dialysis, equivalent to 1.5% of all those in the province, were infected with the SARS-CoV-2 virus. Over 60% were hospitalized, 20% required ICU and the mortality rate was very high at over 28%. Risk factors for infection included center hemodialysis versus home dialysis, residing in long term care, black, south Asian and other non-white ethnicity, and low neighbourhood income. (more…)
Author Interviews, Heart Disease, JACC / 05.02.2021
MedicalResearch.com Interview with: Paaladinesh Thavendiranathan MD, SM Ted Rogers Centre for Heart Research and the Division of Cardiology Peter Munk Cardiac Center, University Health Network, Joint Department of Medical Imaging, , University Health Networ Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? Response: Anthracyclines are a common class of chemotherapy drugs used to treat patients with blood, breast, and many other cancers. Patients receiving anthracycline based cancer therapy who are deemed to be high cardiovascular risk either based on their age or presence of cardiovascular risk factors are at risk of developing heart failure. In high risk patients this risk of heart failure could be between 5-10% over a 5 year period depending on the treatment regimens used. Therefore it is possible that the cancer patient of today can become a heart failure patient of tomorrow. These cancer treatments are however very effective against the cancer. So it is important to find strategies to prevent the development of heart failure. Usually oncologists and cardiologists work together to monitor patients during and after cancer therapy using surveillance strategies. One such strategy is to repeat heart ultrasounds to identify heart dysfunction early followed by initiation of cardioprotective therapy. Traditional approaches measure left ventricular ejection (LVEF) as a metric of heart function. However, we have learned that with this approach it may be too late when a change in LVEF is identified. Global longitudinal strain (GLS) is a newer echocardiography method that appears to identify heart dysfunction earlier before a major change in LVEF occurs. However, whether initiation of cardioprotective therapy when a change in GLS is identified can prevent a reduction in heart function and development of cardiotoxicity (significant change to heart function) is unknown. The SUCCOUR trial is an international, multicenter randomized controlled trial that compared using an LVEF based approach to surveillance (arm 1) versus the addition of GLS based surveillance (arm 2) in high risk patients receiving anthracycline based therapy. The study enrolled 153 patients in the LVEF arm and 154 patients in the GLS arm. Majority of the patients (~90%) had breast cancer. (more…)
MedicalResearch.com Interview with: Sumeet S. Chugh MD Price Professor and Associate Director, Smidt Heart Institute Medical Director, Heart Rhythm Center Director, Center for Cardiac Arrest Prevention Director, Division of Artificial Intelligence in Medicine, Dept of Medicine Cedars-Sinai, Los Angeles MedicalResearch.com: What is the background for this study? Response: For a variety of reasons, sudden cardiac arrest during nighttime hours is the most perplexing and challenging form of this problem and needs to be investigated in detail. Patients are in a resting state, with decreased metabolism, heart rate, blood pressure, and in the absence of daytime triggers, presumably at the lowest likelihood of dying suddenly. The event can often go unrecognized, even by others sleeping in close proximity. Finally, survival from cardiac arrest at night is significantly lower compared to the daytime. There are no community-based studies out there. Small studies of rare heart disease conditions report that men are more likely to suffer this affliction but the reality is that there were not enough women in those studies to do justice to sex-specific analyses. (more…)
Author Interviews, COVID -19 Coronavirus, Education, Race/Ethnic Diversity, Social Issues / 04.02.2021
MedicalResearch.com Interview with: Ankur Dalsania Rutgers New Jersey Medical School (NJMS) M.D. Candidate 2021 MedicalResearch.com: What is the background for this study? Response: Similar to past pandemics, prior studies and news articles have highlighted the disproportionate impact of COVID-19 mortality in marginalized populations, especially Black Americans. Rather than biological differences, other factors like neighborhood conditions, educational attainment, economic stability, healthcare access, and social contexts have been hypothesized to influence the racial disparities. Using county-level data, we sought to quantitatively determine how these factors, collectively referred to as social determinants of health, impact COVID-19 mortality in Black Americans. (more…)
Author Interviews, Dengue, PLoS, Zika / 04.02.2021
MedicalResearch.com Interview with: Gregor J. Devine, Ph.D Mosquito Control LaboratoryQIMR Berghofer Medical Research Institute Brisbane, Queensland, Australia MedicalResearch.com: What is the background for this study? Scale of the problem: Dengue, Zika and chikungunya are all transmitted by the same mosquito species. That mosquito, Aedes aegypti, is superbly adapted to the human, urban environment – it lays its eggs and develops in the standing water that collects in the myriad containers associated with modern living (plastic bottles, food packaging, buckets, planters, crumpled tarpaulins etc.). Unusually they rely almost entirely on human blood for their nutritional requirements and they subsequently bite multiple times during each egg laying cycle. That reliance on human blood means that they are usually found resting indoors, a behaviour that also offers them some protection from weather extremes and predators. Once infected, and having incubated the virus until it is transmissible, a mosquito that survives for just a couple of weeks can infect many humans within the same and neighbouring households. In poorer tropical urban environments with dense human populations, unscreened houses, no air-conditioning, and innumerable rain-filled containers to develop in, Aedes aegypti proliferates and so do those diseases, causing ca 400M annual infections of dengue alone by some estimates. The economic impact of the dengue, which normally causes a high fever, muscle and joint pains and nausea, is pronounced; especially in poor households with few savings and no welfare system. Every year, about 500,000 of those dengue cases develop into severe dengue, or dengue haemorrhagic fever (typified by plasma leakage, severe bleeding and organ impairment). There are about 25,000 deaths annually. The Zika pandemic of 2015-2016 resulted in 1000s of babies born with microcephaly and damage to their brains and eyes. For 1000s of other children, the impacts of Zika on their cognitive development did not manifest in their first, formative years. Chikungunya is endemic in Asia and Africa but between 2010 and 2014, outbreaks and epidemics spread across the Indian Ocean, the Caribbean, the Americas and the Pacific Islands. It causes severe, often debilitating joint pain in infected patients. Those affected also suffer from headaches, fever, severe muscle pain and conjunctivitis. Joint pain can persist in subacute or chronic form for several months or even years, particularly in older patients. The ubiquity of the mosquito Aedes aegypti across the tropics and sub tropics ensures that further epidemics of Zika and chikungunya will occur, outside their usual ranges. It’s simply impossible to predict when that will occur. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Nature / 04.02.2021
MedicalResearch.com Interview with: Dr. Hugo Aerts, PhD Dana-Farber Cancer Institute Associate Professor, Brigham and Women's Hospital Harvard Medical School Director, Program for Artificial Intelligence in Medicine Brigham And Women's Hospital MedicalResearch.com: Deep convolutional neural networks to predict cardiovascular risk from computed tomography Response: Cardiovascular disease is the most common preventable cause of death in Europe and the United States. Effective lifestyle and pharmacological prevention is available, but identifying those who would benefit most remains an ongoing challenge. Hence, efforts are needed to further improve cardiovascular risk prediction and stratification on an individual basis. One of the strongest known predictors for adverse cardiovascular events is coronary artery calcification, which can be quantified on computed tomography (CT). The CT coronary calcium score is a measure of the burden of coronary atherosclerosis and is one of the most widely accepted measures of cardiovascular risk. Recent strides in artificial intelligence, deep learning in particular, have shown its viability in several medical applications such as medical diagnostic and imaging, risk management, or virtual assistants. A major advantage is that deep learning can automate complex assessments that previously could only be done by radiologists, but now is feasible at scale with a higher speed and lower cost. This makes deep learning a promising technology for automating cardiovascular event prediction from imaging. However, before clinical introduction can be considered, generalizability of these systems needs to be demonstrated as they need to be able to predict cardiovascular events of asymptomatic and symptomatic individuals across multiple clinical scenarios, and work robustly on data from multiple institutions. (more…)
Author Interviews, BMJ, COVID -19 Coronavirus, Gout, Rheumatology / 03.02.2021
MedicalResearch.com Interview with: Dr Rene Oliveira Department of Internal Medicine Ribeirao Preto Medical School University of Sao Paulo Ribeirao Preto, Brazil MedicalResearch.com: What is the background for this study? Response: As rheumatologists our background for testing colchicine for COVID-19 was the effect of the drug on gout, Behçet's disease and familial Mediterranean fever. For these diseases, the drug is able to reduce systemic inflammation by acting in some cytokine pathways which the first reports in COVID-19 suggested being the same. We found that colchicine was able to reduce systemic inflammation and diminish the length of need for supplemental oxygen and hospitalisation. (more…)
Author Interviews, CDC, JAMA, OBGYNE / 03.02.2021
MedicalResearch.com Interview with: Jiajia Chen, PhD Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention, Atlanta, Georgia MedicalResearch.com: What is the background for this study? Response: Severe maternal morbidity (SMM) includes a range of serious pregnancy complications that result in significant short-term or long-term consequences to a woman’s health. Most research and prevention efforts addressing SMM focus on the delivery hospitalization, but less is known about SMM diagnosed after delivery discharge. (more…)
Author Interviews, Cannabis / 03.02.2021
MedicalResearch.com Interview with: Benjamin J. Warnick, PhD Assistant Professor of Entrepreneurship Carson College of Business Washington State University Vancouver MedicalResearch.com: What is the background for this study? Response: Popular culture has perpetuated a notion that cannabis users are more creative. Along these lines, some successful CEOs and entrepreneurs—like Steve Jobs, for example—have claimed that cannabis use has benefitted their creativity at work. Despite such claims and increased legalization and use of cannabis, the implications of cannabis use for entrepreneurs’ creativity has yet to be rigorously tested. My coauthors and I were very intrigued to dive into the implications of cannabis use for entrepreneurs, whether good or bad. This seemed all the more relevant given the increasing legalization, destigmatization, and use of cannabis. (more…)
Author Interviews, Genetic Research / 03.02.2021
MedicalResearch.com Interview with: Igor Chesnokov, Ph.D Department of Biochemistry and Molecular Genetics School of Medicine University of Alabama at Birmingham, Alabama MedicalResearch.com: What is the background for this study? Response: DNA replication is fundamentally important for tissue development, growth and homeostasis. Impairments of the DNA replication machinery can have catastrophic consequences for genome stability and cell division. Meier-Gorlin Syndrome (MGS) is an autosomal recessive disorder that is also known as ear, patella, short stature syndrome and/or microtia, absent patella, micrognathia syndrome, traits highlighting the core clinical phenotypes. The genes affected by MGS mutations include many members of pre-replicative complex (pre-RC), such as Origin Recognition Complex (ORC) subunits (Orc1, Orc4, Orc6), Cdc6, Cdt1, CDC45, MCM5 as well as Geminin, suggesting that the clinical phenotype is caused by defects in DNA replication initiation. As the pre-RC complex is essential for DNA replication, the mutations in its components are expected to impair cell proliferation and reduce growth. The smallest subunit of ORC, Orc6, is the most divergent and enigmatic among ORC subunits. Orc6 is important for DNA replication in all species. Metazoan Orc6 proteins consist of two functional domains: a larger N-terminal domain important for binding of DNA and a smaller C-terminal domain important for protein-protein interactions. A mutation coding for a tyrosine 232 to serine alteration (Y232S) in the C-terminal domain of Orc6 is linked to MGS in humans. Recently, a new Orc6 mutation was described that also resulted in MGS. Unlike the previously described MGS mutation, this amino acid substitution, Lysine 23 to Glutamic acid (K23E), localizes in the N-terminal domain of Orc6. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA, Social Issues, University of Pennsylvania / 02.02.2021
MedicalResearch.com Interview with: Sameed Khatana MD, MPH Instructor, Cardiovascular Medicine Perelman School of Medicine, University of Pennsylvania Physician, Philadelphia VA Medical Center MedicalResearch.com: What is the background for this study? Response: After declining for decades, the fall in cardiovascular mortality rates in the US has started to slow down and rates may be rising in certain groups. This stagnation in mortality has been most start among middle-aged adults. These trends have occurred at the same time as growing economic inequality. Our analysis aimed to study the relationship between change in cardiovascular mortality rates between 2010 and 2017 for middle-aged adults across the US and change in economic prosperity levels. (more…)
Author Interviews, CMAJ, Orthopedics, Rheumatology, Surgical Research / 02.02.2021
MedicalResearch.com Interview with: Codie Primeau, MSc Physical Therapy Student & Ph.D. Candidate (Combined MPT/Ph.D.) Wolf Orthopaedic Biomechanics Lab, Fowler Kennedy Sport Medicine Clinic Western University London, ON, Canada MedicalResearch.com: What is the background for this study? Response: High tibial osteotomy (HTO) is a surgery for patients with varus alignment (bowed legs) and earlier-stage knee osteoarthritis. By correcting alignment, HTO shifts load to less diseased parts of the knee. One of the goals of HTO is to delay or even prevent the need for knee replacement surgery later. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, COVID -19 Coronavirus, Prostate, Prostate Cancer, Surgical Research, Urology / 01.02.2021
MedicalResearch.com Interview with: David-Dan Nguyen Research Fellow | Center for Surgery and Public Health, Brigham and Women's Hospital MPH (Health Policy) Student | Harvard T.H. Chan School of Public Health Medical Student | McGill University MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has forced hospitals to delay the definitive treatment of cancers via surgery or radiation therapy. While previous evidence has shown that delaying the treatment of low-risk prostate cancer is not associated with worse outcomes, treatment delays for intermediate-risk and high-risk prostate cancer are more controversial. As such, we sought to determine if delays for these disease states negatively impacted oncological outcomes. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Gender Differences, Pediatrics, University of Pennsylvania / 30.01.2021
MedicalResearch.com Interview with: Christina L. Master, MD, FAAP, CAQSM, FACSM Professor of Clinical Pediatrics Perelman School of Medicine at the University of Pennsylvania Co-Director, Minds Matter Concussion Program Pediatric and Adolescent Sports Medicine, Division of Pediatric Orthopedics Attending Physician, Care Network - Karabots Center The Children's Hospital of Philadelphia Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? Response: There have been multiple studies investigating potential sex differences in outcomes from concussion which have sometimes had conflicting results with some studies indicating that females take longer to recover than males and some studies reporting no difference in recovery between females and males, with most of these studies being conducted either retrospectively or prospectively in smaller cohorts. This large-scale multi-center prospective study in collegiate athletes provided an opportunity to compare females and males across comparable sports to examine both potential intrinsic or biologic factors (sex differences) or extrinsic (environmental or gender differences) that contribute to outcomes. (more…)
Author Interviews, BMJ, Cannabis, Opiods, Yale / 29.01.2021
MedicalResearch.com Interview with: Balázs Kovács PhD Associate Professor of Organizational Behavior Yale School of Management MedicalResearch.com: What is the background for this study? Response: Our study looks at the association between the prevalence of legal cannabis stores, called “dispensaries”, and opioid-related mortality rates in the U.S. We find that higher cannabis dispensary counts are associated with reduced opioid-related mortality rates. We find this relationship holds for both medical dispensaries, which only serve patients who have a state-approved medical card or doctor’s recommendation, as well as for recreational dispensaries, which sell to adults 21 years and older. The statistical associations we find appears most pronounced with the class of opioids that includes fentanyl and its analogs. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity, Social Issues / 29.01.2021
MedicalResearch.com Interview with: Renuka Tipirneni, MD, MSc, FACP Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine, Divisions of General Medicine and Hospital Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: As there have been significant racial/ethnic disparities in US COVID-19 infections and health outcomes including death, we investigated county-level social factors that may explain these inequities. Specifically, we examined the association between the Centers for Disease Control and Prevention’s Social Vulnerability Index (a composite measure of social disadvantage) and COVID-19 incidence and mortality rates. We found that with just a one-point increase in the ten-point scale, there was a 14% increase in incidence rate and 14% increase in mortality rate. This equated to approximately 87 excess COVID-19 infections and 3 deaths per 100,000 population. (more…)
Cancer occurs when cancerous cells in one area of the body reproduce rapidly and invade surrounding cells, tissue, and organs. Occasionally, these cells can spread to other parts of the body. Symptoms, treatments and the prognosis will depend on the type and stage of the cancer.
Give them emotional supportYour parent is probably as confused and overwhelmed as you are, if not more. Offer them a comforting ear and allow them to talk through how it is affecting them, their concerns, their treatment options, and their wishes. Offer assistance, but don’t force it. Being too helpful could end up with your parent feeling a loss of control or independence. Organize what type and level of support you can offer, sustainable to their wellbeing, and yours. Offer spontaneous and scheduled companionship to help them to feel a sense of normalcy and provide opportunities to spend time together. If you both decide you should accompany them to their physician’s appointments and treatments, take notes, and don’t be scared to speak up if you have a question.
Try to understand what they’re going throughTake the time to understand the individual symptoms that they are experiencing and suggest proven solutions to relieve and manage. For example, the symptoms of mouth or esophageal cancer will be very different from that of any other part of the body. Namely, these cancers can cause loss of the ability to chew and swallow (medically referred to as dysphagia), which are alleviated using a thickener in food and beverages. In contrast, individuals suffering from cancer of the spine are more likely to have trouble mobilizing, which would be improved by a walking aid. Managing conditions like cancer begin with a full understanding. Read about the origin of SimplyThick Easy Mix and see the value in understanding health conditions from a patient perspective. (more…)
As you age and get older, you need to make sure your health is at the forefront of everything you do. You need to focus on keeping healthy, ensuring you have a balanced diet that includes your recommended daily allowance of nutrition, fat, and carbohydrates. Having a balanced and healthy diet can keep you in good health and keep illnesses at bay. Exercising too is good for you, even if it just a brisk daily walk. Here's more info on how to maintain health as a senior. Stay Active Keeping and staying active physically is important. Nobody is saying you have to run marathons (unless, of course, you want to) but undertaking even 15 minutes of exercise a day will leave you feeling good and re-energized. If mobility is an issue, there are plenty of beneficial and fun sit-down exercises you can try from the comfort of your chair. Be Mentally Active You don't just need to keep your body in shape; you also have to focus on your mental strength and ability. Doing puzzles, crosswords, or having a game of chess can keep your brain stimulated and exercised. There are lots of single-player games, as well as multi-player games online and offline that can train your brain and keep it working as well as it can. (more…)
There are many types and levels of support available for senior citizens, ranging from wellness checks to full-time care. Start planning for your senior years and ensure you get the retirement you desire! Explore the possibilities and consider every option: test yourself with ‘what if?’ scenarios to help you make an informed and considerate choice.
Domiciliary careDomiciliary care provides support with activities and hygiene regimes within your own home. Typically, domiciliary care provides a set number of hours of care per day; however, live-in domiciliary carers are also available to provide more intensive care. Choose a domiciliary care provider to support you in your senior years.
What are the benefits?Domiciliary care promotes independent living and allows the service user to remain at home, which can be beneficial to wellbeing. The user also retains their independence with the ability to set their schedule (bathing, eating, and drinking) at a time that suits them. Implementing domiciliary care staff also has the advantage of both being a source of social interaction, as well as not interrupting your surrounding social life! In-home care is also very flexible, which means that your personalized plan can be adapted as needs change. (more…)
Author Interviews, JAMA, Primary Care, Smoking, USPSTF / 28.01.2021
MedicalResearch.com Interview with: Dr. Michael Silverstein M.D., M.P.H Professor of Pediatrics Director of the Division of General Academic Pediatrics Vice Chair of Research, Department of Pediatrics Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tobacco use is the leading preventable cause of disease, disability, and death in the United States and quitting is one of the best things people can do for their health. Additionally, smoking during pregnancy can cause serious harms to both the pregnant person and the baby. The Task Force continues to recommend that clinicians ask all adults and pregnant people about their tobacco use, advise those who use tobacco to quit, and connect them to proven, safe methods to help them quit. (more…)
Author Interviews, Blood Pressure - Hypertension, NEJM, OBGYNE / 28.01.2021
MedicalResearch.com Interview with: DAVID K. TUROK, MD, MPH, FACOG ASSOCIATE PROFESSOR OF OBSTETRICS AND GYNECOLOGY CHIEF OF THE DIVISION OF FAMILY PLANNING UNIVERSITY OF UTAH MedicalResearch.com: What is the background for this study? Response: Researchers and clinicians have long known that copper intrauterine devices (IUDs) work extremely well for emergency contraception, using contraception after sex to prevent pregnancy. However, the hormonal IUD (levonorgestrel 52 mg IUD) has distinct characteristics that many people prefer. Namely, it reliably reduces or eliminates menstrual bleeding and cramping. Until now we did not know if the levonorgestrel IUD worked for emergency contraception. Now we know. In a first-of-its-kind study, our team at the University of Utah Health and Planned Parenthood Association of Utah found that hormonal IUDs were comparable to copper IUDs for use as emergency contraceptives. (more…)
Author Interviews, Race/Ethnic Diversity, Weight Research / 26.01.2021
MedicalResearch.com Interview with: Raveena Chara Loma Linda University Loma Linda, CA MedicalResearch.com: What is the background for this study? Response: In a country struggling with an epidemic of obesity, Hispanics are one of the fastest growing population groups in the U.S. and have the highest prevalence of obesity. They are also least likely to enroll in weight reduction programs, complete them, and successfully lose weight (though reasons for this remain elusive). Obesity- a leading predisposing factor for many chronic diseases - is a complex biophysical phenomenon shaped by many factors, including a person’s social environment, health and culture. Culture permeates many aspects of one’s life including how a person views weight and behaviors associated with eating and physical activity. Indeed, for many values and norms about what is culturally acceptable and views on “body weight” vary culturally and affect their decisions about weight and weight loss. This too is the case within the Hispanic population in the US. Given the rising human and financial impact of obesity, preventing and reducing obesity, diabetes and other weight related medical conditions is a growing priority, especially for low income Hispanics. (more…)
One of the most difficult conversations that you will need to have with your aging parents throughout their retirement is about the future. Though no matter how difficult this conversation may be, it is vital that you can plan for what might happen as a family to ensure that you are prepared for anything that comes your way. If you are struggling to do this, here are some top tips to help you comprehensively plan for your parent's future, so they can have the most comfortable lives possible, and you do not have to worry for them.
1. Look at Assisted Living FacilitiesAlthough you might believe that your parents will always be healthy enough to live at home, this is not always the case. There are many common health conditions such as dementia, which may leave your parents needing round-the-clock care, as well as general ill health and frailty as they start to show the signs of aging. To make sure that you know that your parents are well-looked after when the time comes, you should consider researching assisted living facilities now. This will allow you to relax in knowing that both you and your loved one are happy with the home you have chosen for them. For instance, if you are looking for assisted living Fort Lauderdale, Belmont Village can offer your parents a range of care options, and you can rest in the knowledge that they are being cared for.
2. Sort Their FinancesMany adult children leave their parents to handle their finances for fear of taking over or looking greedy when it comes to their eventual passing. However, helping your parents sort their finances out now can ensure that they will be able to pay for all of the medical care they may need and ensure that they have enough money to live on until the end of their lives. Sorting these finances out early, such as looking at the pension schemes and organizing the assets they have to their name, will ensure that they do not come unstuck later and enable them to set a budget around their financial situation.
3. Create a WillAlthough it is easy to dismiss probate as something that you do not want to think about or discuss with your parents, helping them create a will and knowing what is inside of it is important if they pass away suddenly and unexpectedly, then you can help them to make a will by contacting a solicitor or encouraging them to complete a DIY will-making kit. You should always make sure that DIY wills are legally valid, though. Knowing what is inside of the will can be important so that you can make sure that their wishes are carried out on their death and that no forgery or other issues occur. (more…)
Author Interviews, Biomarkers, COVID -19 Coronavirus / 25.01.2021
MedicalResearch.com Interview with: Marlene Cano MD. PhD. Post-Doctoral Research Fellow in Pulmonary Transplant Immunology Division of Pulmonary and Critical Care Department of Medicine Washington University/Barnes-Jewish Hospital Saint Louis, MO MedicalResearch.com: What is the background for this study? How does this test differ from other tests for COVID-19? Response: We know COVID-19 causes a wide spectrum of disease, and that while many develop only mild uncomplicated illness, others develop severe respiratory failure, multi-organ failure and death. These patients often require prolonged hospitalization, ICU level care and even mechanical intubation for respiratory support. However, we still do not have a great way to identify which patients are likely to develop severe disease. We felt it was important to have a test that could act as sort of a ‘biomarker’ that we could measure early in COVID-19 patients and would help predict which patients would develop severe disease. From prior work, we knew that mitochondrial DNA, which are proinflammatory molecules that are released into the circulation from damaged organs could be this such ‘biomarker’. So, we measured the levels of mitochondrial DNA circulating in the plasma of patients with COVID-19 at the time they first presented to the hospital. Then we investigated if higher levels of mitochondrial DNA indeed predict the development of more severe disease. Currently there are no ‘biomarker’ tests specific for COVID-19. We do currently measure levels of other markers in the hospital that we feel might help us assess overall how sick patients may be, but these are very non-specific and assess only level of inflammation. This test instead can measure level of tissue injury. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Memory, Surgical Research / 23.01.2021
MedicalResearch.com Interview with: Pascual Sánchez-Juan, MD, PhD Servicio de Neurología Hospital Universitario "Marqués de Valdecilla" Unidad de Deterioro Cognitivo https://www.facebook.com/deteriorocognitivovaldecilla Director científico Biobanco Valdecilla Avda Marqués de Valdecilla s/n MedicalResearch.com: What is the background for this study? Response: Alzheimer's disease is one of the greatest public health challenges. From the moment the first lesions appear in the brain to the clinical manifestations, up to 20 years can pass. Today we can detect the presence of these initial lesions through biochemical markers such as amyloid-β, which is one of the main proteins accumulated in the brains of Alzheimer's patients. The prevalence of cerebral amyloid-β pathology in cognitively asymptomatic individuals increases with age. It has been estimated that 21.1% of the population at the age of 65 will have a positive amyloid scan or a pathological cerebrospinal fluid (CSF) amyloid-β determination, and which will double by the age of 90. Due to the aging of our societies and advances made in medical care, an increasing number of elderly and more fragile people are considered candidates for major surgery. In preoperative screenings, respiratory and cardiovascular functions are routinely checked; however, it is not commonly assessed how the brain is going to cope with the intervention. In the clinic, the patient’s relatives frequently tell us that the memory problems began after a surgical procedure or a hospital admission. This posed us the following question: is this just a recall bias or has surgery triggered the appearance of the symptoms in a previously affected brain?” (more…)
Author Interviews, Health Care Systems, JAMA / 22.01.2021
MedicalResearch.com Interview with: Sara Machado PhD Fellow at the Department of Health Policy London School of Economics and Political Science MedicalResearch.com: What is the background for this study? Response: Physician distribution is a determinant of health care access, so knowing how physician density patterns evolve over time is important if we are trying to address disparities in access to care. Moreover, the last 10 years have brought about changes in health care coverage, across the US. Recent evidence points to an uneven physician distribution between urban and rural communities. We examined recent trends in physician density by physician category across rural and urban US counties. MedicalResearch.com: What are the main findings? Response: We have two main findings.
- First, density of primary care physicians steadily decreased in more than half of rural counties (994 out of 1,976).
- Second, medical specialist density, which would care for cardiovascular and pulmonary disease, for example, has been largely stagnant in rural counties, at the lowest density levels (less than 10 physicians per 100,000), and increasing in metropolitan counties.
Author Interviews, Breast Cancer, Genetic Research, JAMA, Race/Ethnic Diversity / 22.01.2021
MedicalResearch.com Interview with: Kent Hoskins, MD Eileen Lindsay Heidrick Professor in Oncology Division of Hematology/Oncology University of Illinois at Chicago Director of Cancer Genetics Co-Leader, Breast Cancer Research Group University of Illinois Cancer Center MedicalResearch.com: What is the background for this study? Response: The racial disparity in breast cancer mortality emerged in the US in the late 1980s in the wake of widespread implementation of mammography screening and the development of successful systemic adjuvant therapies for early breast cancer. Unfortunately, more than three decades later, Black women in the US still have a 40% higher mortality rate from breast cancer compared with non-Hispanic White women despite similar disease incidence. Health disparities research has primarily focused on the fact that Black women have a higher incidence of the aggressive triple-negative subtype, and that they are more likely to present with more advanced stages of disease. As important as those factors are, in recent years our group and others reported that Black women with hormone receptor-positive breast cancer have worse survival than non-Hispanic white women even after adjustment for stage at diagnosis and treatment. Since nearly 2/3 of breast cancers in Black women are hormone receptor-positive, this is a significant contributor to the overall mortality disparity. Importantly, these studies also suggested that Black women disproportionately develop biologically aggressive forms of hormone-dependent breast cancer, which is typically considered a more favorable disease subtype. Using data on more than 70,000 patients from the SEER registry that is linked to data from Genomic Health Laboratory, which provides the Oncotype DX recurrence score (the most commonly ordered prognostic/predictive multi-gene expression assay for early breast cancer), we set out to address three questions: 1) is there evidence of disproportionately aggressive tumor biology among Black women with hormone receptor (HR)-positive breast cancer, as reflected in the Oncotype DX recurrence score? 2) Is there a racial survival disparity even among patients with early stage, axillary node-negative tumors with comparable recurrence scores on the Oncotype assay? and 3) Is there is a difference in the prognostic accuracy of the Oncotype assay between Black and non-Hispanic white patients, since there was limited representation of Black women in the development and validation of the Oncotype assay and other prognostic/predictive assays? (more…)
Author Interviews, NYU, Race/Ethnic Diversity, Rheumatology / 21.01.2021
MedicalResearch.com Interview with: Peter Izmirly, M.D. Associate Professor of Medicine, NYU School of Medicine Director of Inpatient Rheumatology, Bellevue Hospital Center co-Director, NYU-Hospital for Joint Diseases Lupus Clinic Research Office Address: NYU School of Medicine New York, NY 10016 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Knowing how many people have systemic lupus erythematosus (SLE) is limited, particularly for racial/ethnic subgroups in the United States. Our work provides accurate estimates of who has (SLE) among the major racial/ethnic groups in the United States and that our estimates for SLE approach the FDA’s definition or a rare disease. (more…)
Author Interviews, Infections, OBGYNE, Pharmaceutical Companies / 21.01.2021
MedicalResearch.com interview with: Dr. Stephen Brand, Chief Development Officer Mycovia Pharmaceuticals Dr. Stephen Brand discusses the results of Mycovia’s three Phase 3 studies for recurrent vaginal yeast infections (RVVC )and what’s next for the company. MedicalResearch.com: What is the background for these Phase 3 studies? Answer: Our Phase 3 clinical program for our oral therapy oteseconazole was comprised of three trials enrolling more than 870 patients at 176 sites across 11 different countries. Two of these trials, referred to as VIOLET were identical Phase 3 randomized, double-blind, placebo-controlled clinical trials to evaluate the safety of oteseconazole and its ability to prevent episodes of recurrent vulvovaginal candidiasis (RVVC), commonly referred to as chronic yeast infection. The trials took place over 48 weeks in subjects with an established disease history of at least three episodes of acute VVC in the past 12 months. More than 650 patients randomized at 125 sites across 11 countries. The VIOLET trials consisted of two parts: During the first part of the study which lasted two weeks after patients presented with an active VVC episode, patients were treated with three sequential 150mg doses of fluconazole. The second part consisted of 12 weeks, when the patient either took oteseconazole 150mg or a placebo once weekly (according to a random assignment), and then a 36-week follow-up period. In addition, subjects participating in the VIOLET trials in the U.S. who remained infection-free at their Week 48 visit were offered the opportunity to participate in an extension study and are being monitored for an additional 48 weeks to further define the long-term protection profile of oteseconazole. Eighty-five subjects are enrolled. The third Phase 3 study, called ultraVIOLET, was designed to complement and extend VIOLET as a 50-week randomized, double-blind, placebo-controlled clinical trial to evaluate the safety and efficacy of oteseconazole. In addition the study compared the effectiveness of oteseconazole compared to fluconazole, the current standard of care, to treat an acute VVC infection in the RVVC population. A total of 220 patients were randomized at 51 sites in the U.S. for the ultraVIOLET trial. The ultraVIOLET trial consisted of two parts: In the first part of the study RVVC subjects presenting with an active infection were randomized to receive either 2 days of dosing with oteseconazole or 3 sequential 150 mg doses of fluconazole (every 72 hours). The second part consisted of 11 weeks, when the patient took either oteseconazole or a placebo weekly (according to the random assignment from the first part of the study), and then a 37-week follow-up period. (more…)