Author Interviews, JAMA, NIH, Race/Ethnic Diversity / 25.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50397" align="alignleft" width="200"]Lan N. Đoàn, MPH CPH PhD Candidate, School of Social and Behavioral Health Sciences College of College of Public Health and Human Sciences Oregon State University, Corvallis Lan N. Doan[/caption] Lan N. Đoàn, MPH CPH PhD Candidate, School of Social and Behavioral Health Sciences College of College of Public Health and Human Sciences Oregon State University, Corvallis MedicalResearch.com: What is the background for this study? Response: There is a prevailing stereotype that Asian American, Native Hawaiian, and Pacific Islander (AA/NHPI) populations are a model minority group - healthier than all other racial/ethnic groups. As a result, health researchers often consider AA/NHPI so similar that their data is typically grouped together which masks their cultural and health differences. However, AA/NHPI populations represent more than 50 countries or cultures of origin and 100 different languages and have unique health needs and cultural preferences. Prior research has found minimal financial investments in AA/NHPI populations by federal agencies and philanthropy, even though AA/NHPI individuals represent more than 5.0% of the total US population and are the fastest-growing racial/ethnic group in the United States. The purpose of study was to conduct a review of clinical research funded by the National Institutes of Health (NIH) for AA/NHPI populations and to determine the level of NIH investment in serving these populations. We queried the NIH Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) system for extramural AA/NHPI focused clinical research projects conducted in the United States from January 1, 1992, to December 31, 2018. We included clinical research funded under research project grants, centers, cooperative awards, research career awards, training grants, and fellowships was included, with an advanced text search for AA/NHPI countries and cultures of origin. 
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, ENT, Surgical Research / 25.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50402" align="alignleft" width="133"]Vinay K. Rathi, MD Otolaryngology Resident | Massachusetts Eye and Ear Project Manager | Partners Ambulatory Care MBA Candidate | Harvard Business School Dr. Rathi[/caption] Vinay K. Rathi, MD Otolaryngology Resident | Massachusetts Eye and Ear Project Manager | Partners Ambulatory Care MBA Candidate | Harvard Business School  MedicalResearch.com: What is the background for this study?  Response: This study is a secondary subgroup analysis that follows on the heels of a recently published study in The New England Journal of Medicine (NEJM) examining physician reimbursement for surgical procedures in the Medicare Physician Fee Schedule (PFS), which both public and private insurers use to determine payment rates for clinician services. Although it is widely understood that physician time (i.e., the amount of physician time required to perform a procedure) is perhaps the most important factor used to determine payment rates, the Centers for Medicare and Medicaid Services (CMS) has historically relied upon limited and potentially biased survey data to estimate physician time. Leveraging time data from American College of Surgeons National Quality Improvement Program, the authors of the recent NEJM study demonstrated that CMS does not appear to systematically misestimate intraoperative times, but there are substantial discrepancies that may result in over- or undercompensation for certain procedures and specialties.
Accidents & Violence, Author Interviews / 25.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50372" align="alignleft" width="138"]Aaron Kivisto, Ph.D., HSPP Licensed Psychologist Co-Director, Clinical Psychology Doctoral Program Associate Professor of Clinical Psychology  University of Indianapolis  Indianapolis, IN 46227 Dr. Kivisto[/caption] Aaron Kivisto, Ph.D., HSPP Licensed Psychologist Co-Director, Clinical Psychology Doctoral Program Associate Professor of Clinical Psychology University of Indianapolis Indianapolis, IN 46227 MedicalResearch.com: What is the background for this study? What are the main findings? Response: There’s a robust literature showing that increased gun ownership rates are associated with increased rates of firearm homicide and suicide. We sought to examine whether the increased risk of homicide attributable to firearms is equally distributed across the population of potential victims or whether the risk is localized to particular victim groups. Our findings showed that the risk of gun ownership is fairly localized to intimate partners and other family members; they’re bearing the bulk of the risk associated with gun ownership.
Author Interviews, Hepatitis - Liver Disease, JAMA, OBGYNE, USPSTF / 24.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50387" align="alignleft" width="170"]Melissa Simon, M.D., M.P.H.  George H. Gardner Professor of Clinical Gynecology Vice Chair of Clinical Research, Department of Obstetrics and Gynecology Professor of Preventive Medicine and Medical Social Sciences Northwestern University Feinberg School of Medicine Dr.Simon[/caption] Melissa Simon, M.D., M.P.H.  George H. Gardner Professor of Clinical Gynecology Vice Chair of Clinical Research, Department of Obstetrics and Gynecology Professor of Preventive Medicine and Medical Social Sciences Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hepatitis B is a viral infection of the liver caused by the hepatitis B virus, or HBV. HBV causes liver disease, which can be either a mild, short-term illness, or a serious, lifelong issue. The U.S. Preventive Services Task Force has reaffirmed its 2009 recommendation that clinicians screen all pregnant people for HBV at their first prenatal visit. This is an A recommendation.
Abuse and Neglect, Brain Injury / 24.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50390" align="alignleft" width="128"]Fanny Lecuyer Giguère, PhD candidate Centre de Recherche en Neuropsychologie et Cognition (CERNEC) Université de Montréal Fanny Lecuyer Giguere[/caption] Fanny Lecuyer Giguère, PhD candidate Centre de Recherche en Neuropsychologie et Cognition (CERNEC) Université de Montréal MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous work on moderate-severe traumatic brain injury (TBI) showed clear olfactory impairments (OI) months and years after the trauma. Within these impairments, hyposmia (partial loss of smell) and anosmia (total loss of smell) were the most described OI. Moreover, TBI patients with OI generally developed more long-term anxiety and depression symptoms, when compared to patients without OI. Almost no study evaluated such impairments after a mild TBI, which is none to be the most prevalent form of TBI (80% of all TBI). We evaluated quantitative olfactory scores, post-concussive symptoms, anxiety and depression, within the first 24 hours and one year after the trauma, on a cohort of 20 mild TBI patients and compared these results with a 22 patients control orthopaedic group. Results showed that, within the first 24-hour post-trauma, more than 50% of the mild TBI patients had clinical sing of reduced olfactory capacities (hyposmia) compared to only 5% (1 patient) within the control group. Consequently, patients with mild traumatic brain injury had lower olfactory threshold and had more difficulty to discriminate and identify different odors. Also, when comparing the mild TBI patients with OI (OI+) to the mild TBI patients without OI (OI-), we realized that OI+ mild TBI patients reported more anxiety and post-concussion symptoms 1 year after the trauma.  
Author Interviews, Epilepsy, Nutrition / 23.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50377" align="alignleft" width="168"]Geoffrey W. Abbott PhD Department of Physiology and Biophysics, Bioelectricity Laboratory, School of Medicine, University of California Dr. Abbott[/caption] Geoffrey W. Abbott PhD Department of Physiology and Biophysics, Bioelectricity Laboratory, School of Medicine, University of California MedicalResearch.com: What is the background for this study? Response: The main focus of my laboratory is the study of potassium ion channels - proteins that coordinate electrical activity in all organisms. When human potassium channels do not function properly, it can result in pathologically discordant electrical activity, and diseases such as cardiac arrhythmia, myotonia, and epilepsy - depending on whether the affected potassium channel is in the heart, skeletal muscle or brain, for example. T here are existing drugs that directly regulate ion channels for therapeutic benefits, including one - retigabine - that opens neuronal potassium channels in the KCNQ family, to treat epilepsy. Retigabine causes side effects including turning the skin blue, and was withdrawn from clinical use in 2017. Retigabine may make a comeback because a form of epilepsy was recently discovered, arising from mutations in the KCNQ2 gene, that is associated with severe developmental delay and seizures. In my lab, we are interested in discovering new therapeutic agents that might more safely fix dysfunction in KCNQ2 and other potassium channels. We turned to plants as a possible source of compounds. We are interested both in explaining the underlying mechanism of traditional botanical medicines, and also discovering unanticipated therapeutic chemicals synthesized naturally by plants. 
Author Interviews, Cancer Research, Dental Research, Opiods / 23.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50367" align="alignleft" width="200"]Praveen Arany, DDS, PhD Department of Oral Biology School of Dental Medicine University of Buffalo Dr. Arany[/caption] Praveen Arany, DDS, PhD Department of Oral Biology School of Dental Medicine University of Buffalo MedicalResearch.com: What is the background for this study? How is the light treatment delivered? Response: Cancers are usually treated with chemotherapy and/or radiation to destroy the tumor cells. However, an unfortunate side-effect of these treatments is pain and ulcers in the mouth due to breakdown of normal protective responses. Light has various applications in human health and normal physiology. Two good examples are vision and sunlight-Vitamin D for bone and health. The use of low dose light to alleviate pain or inflammation and promote tissue healing is termed Photobiomodulation (PBM) Therapy. This treatment can be provided with lasers or LED devices at specific wavelength (color) and dose (power). This treatment is currently being provided by a health care provider - usually a laser - either nurse or dentist prior or during the cancer treatments. There are several exciting innovation where take-home, self-use devices are becoming available.
Annals Thoracic Surgery, Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Geriatrics, Heart Disease, Primary Care / 23.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50354" align="alignleft" width="140"]Christina C. Wee, MD, MPH Associate Professor of Medicine Harvard Medical School Director , Obesity Research Program Division of General Medicine Beth Israel Deaconess Medical Center (BIDMC) Associate Program Director, Internal Medicine Program, BIDMC Deputy Editor of the Annals of Internal Medicine Dr. Wee[/caption] Christina C. Wee, MD, MPH Associate Professor of Medicine Harvard Medical School Director , Obesity Research Program Division of General Medicine Beth Israel Deaconess Medical Center (BIDMC) Associate Program Director, Internal Medicine Program, BIDMC Deputy Editor of the Annals of Internal Medicine MedicalResearch.com: What is the background for this study? Response: New research is showing that for many people without diagnosed heart disease, the risk of bleeding may outweigh the benefits of taking a daily aspirin particularly in adults over 70 years of age.  The American Heart Association and the American College of Cardiology recently updated their guidelines and now explicitly recommend against aspirin use among those over the age of 70 who do not have existing heart disease or stroke. Our study found that in 2017,  a quarter of adults aged 40 years or older without cardiovascular disease – approximately 29 million people – reported taking daily aspirin for prevention of heart disease. Of these, some 6.6. million people did so without a physician's recommendation.
Author Interviews, Brigham & Women's - Harvard, JAMA, Nutrition, Weight Research / 22.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50363" align="alignleft" width="128"]Frank Qian, MPH Department of Nutrition Harvard T. H. Chan School of Public Health Boston, Massachusetts Frank Qian[/caption] Frank Qian, MPH Department of Nutrition Harvard T. H. Chan School of Public Health Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: Plant-based diets have really grown in popularity in the last several years, particularly among the younger generation in the United States, many of whom are adopting a plant-based or vegetarian/vegan diet. However, the quality of such a diet can vary drastically. While many prior studies have demonstrated beneficial associations for risk of type 2 diabetes with healthful plant-based foods such as fruits, vegetables, nuts/seeds, whole grains, and legumes, the opposite is true for less healthful plant-based foods such as potatoes and refined grains such as white rice. In addition, some animal-based foods, such as dairy and fish, have shown protective associations against the development of type 2 diabetes, so strict vegetarian diets which exclude these foods may miss out on the potential benefits. Given these divergent findings, we sought to pool all the available data from prior cohort studies to analyze whether the overall association of a diet which emphasizes plant-based foods (both healthful and unhealthful) are related to risk of type 2 diabetes.
Author Interviews, Testosterone / 22.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50358" align="alignleft" width="133"]Christel Renoux,  MD, PhD Assistant Professor, Dept. of Neurology & Neurosurgery McGill University Centre For Clinical Epidemiology Jewish General Hospital - Lady Davis Research Institute Montreal Canada Dr. Renoux[/caption] Christel Renoux,  MD, PhD Assistant Professor, Dept. of Neurology & Neurosurgery McGill University Centre For Clinical Epidemiology Jewish General Hospital - Lady Davis Research Institute Montreal Canada MedicalResearch.com: What is the background for this study? Response: Testosterone replacement therapy is increasingly being prescribed for the treatment of non-specific symptoms among aging men. However, there are concerns regarding the cardiovascular safety of testosterone replacement therapy in aging men and warnings have been issued by health agencies.
Alcohol, Author Interviews, CMAJ, Emergency Care / 22.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50334" align="alignleft" width="200"]Daniel Myran, MD, MPH, CCFP Public Health & Preventive Medicine, PGY-5 University of Ottawa Daniel Myran[/caption] Daniel Myran, MD, MPH, CCFP Public Health & Preventive Medicine, PGY-5 University of Ottawa MedicalResearch.com: What is the background for this study? Response: We know that alcohol consumption results in enormous health and societal harms globally and in Canada. While several studies have looked at changes in alcohol harms, such as Emergency Department (ED) visits and Hospitalizations due alcohol, this study is the first to examine in detail how harms related to alcohol have been changing over time in Canada.
Author Interviews, Cancer Research, Coffee / 21.07.2019

MedicalResearch.com Interview with: coffee-smell caffeineMr Jue Sheng Ong,  PhD Student  QIMR Berghofer’s Statistical Genetics Group MedicalResearch.com: What is the background for this study? Response: Previous findings have shown conflicting results on whether coffee is associated with cancer risk. To evaluate whether there’s any evidence for a causal relationship between coffee and cancer outcomes, we performed two types of association analyses using data from the half a million participants in the UK.
  • We first studied whether an individual’s self-reported coffee consumption is related to their overall risk of developing or dying from any cancers.
  • Then, we repeated the analyses using genetically predicted coffee intake (using about 35 genetic markers related with coffee intake) instead of their self-reported consumption: a technique known as mendelian randomization which is commonly used in modern epidemiology to remove bias from environmental confounders.
Using both techniques, we found no evidence to support a relationship between coffee consumption and the risk of developing or dying from cancers.
Author Interviews, JAMA, Johns Hopkins, OBGYNE, Race/Ethnic Diversity / 20.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50337" align="alignleft" width="175"]Alison Gemmill, PhD Assistant Professor Johns Hopkins Bloomberg School of Public Health Dr. Gemmill[/caption] Alison Gemmill, PhD Assistant Professor Johns Hopkins Bloomberg School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A growing body of evidence suggests that the circumstances surrounding the 2016 presidential election may have had a uniquely negative impact on the health of U.S. Latino population. Few studies, however, have evaluated the population health implications of the election for Latina mothers and their children. We used national data and methods that control for temporal patterning to test the hypothesis that preterm birth rose above otherwise expected levels among Latina women in the U.S. following the election of Donald Trump. We find that the number of preterm births among Latina women increased above expected levels following the election. Specifically, we find 3.5 percent more preterm births among Latinas than projected for nine months following election.
Author Interviews, Dermatology, NIH / 19.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50340" align="alignleft" width="160"]Mark Hoon, PhD Senior Investigator,Molecular Genetics Unit Sensory Biology NIH NIDCR, Bethesda, MD Dr. Moon[/caption] Mark Hoon, PhD Senior Investigator,Molecular Genetics Unit Sensory Biology NIH NIDCR, Bethesda, MD MedicalResearch.com: What is the background for this study? Response: Itch is a condition that at some point effects all people. For most of us itch is not a major problem, but for some people with certain chronic conditions it severely effects their quality of life. Examples of diseases which cause chronic itch are atopic dermatitis, psoriasis, and renal failure. However, current therapies for chronic itch are mainly ineffective and there is a unmet clinical need.
Author Interviews, Geriatrics, Heart Disease, Lipids / 18.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50316" align="alignleft" width="145"]Richard G. Bach, MD FACC Professor of Medicine Washington University School of Medicine Director, Cardiac Intensive Care Unit Director, Hypertrophic Cardiomyopathy Center Barnes-Jewish Hospital St. Louis, MO 63110 Dr. Bach[/caption] Richard G. Bach, MD FACC Professor of Medicine Washington University School of Medicine Director, Cardiac Intensive Care Unit Director, Hypertrophic Cardiomyopathy Center Barnes-Jewish Hospital St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? Response: Elderly patients represent the largest group of those hospitalized for an acute coronary syndrome, and age is an important marker of increased risk. The risk of death and recurrent cardiovascular events is greatest among the elderly. High intensity lipid lowering by statins has been shown to reduce the incidence of recurrent cardiovascular events after an acute coronary syndrome in general, but there remains limited data on efficacy and safety of that treatment in the elderly, and guidelines do not routinely advocate higher intensity treatment for patients older than 75 years. In practice, older age has been associated with a lower likelihood of being prescribed intensive lipid lowering therapy. IMPROVE-IT evaluated the effect of higher-intensity lipid lowering with ezetimibe combined with simvastatin compared with simvastatin-placebo among patients after ACS, and observed that ezetimibe added to statin therapy incrementally lowered LDL-cholesterol level and improved CV outcomes. IMPROVE-IT enrolled patients with no upper age limit, which gave us the opportunity to examine the effect of age on outcome on the benefit of more intensive lipid lowering with ezetimibe combined with simvastatin vs. simvastatin monotherapy.
Author Interviews, Cancer Research, ENT, JAMA, Surgical Research / 18.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50301" align="alignleft" width="129"]Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine Dr. Haymart[/caption] Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Thyroid cancer is a common malignancy with surgery considered one of the primary treatments. Complications from thyroid surgery can lead to long-term voice problems. However, few studies have used validated scales to quantify the impact of thyroid surgery on patient voice. Prior work has largely focused on single institution studies with high volume surgeons or claims data with reports of specific nerve injury. We surveyed a diverse cohort of patients affiliated with SEER sites Georgia and Los Angeles to identify the prevalence, severity and correlates of poor voice outcomes following surgery for differentiated thyroid cancer. We found that out of 2,325 patients 25.8% reported voice changes lasting greater than 3 months after surgery, 12.7% had abnormal voice per a validated voice scale (Voice Handicap Index- 10), and 4.7% reported a diagnosis of vocal fold motion impairment. We also identified patient factors associated with abnormal voice 2-4 years post op.
Addiction, Author Interviews, Cannabis, Columbia, JAMA, Opiods / 18.07.2019

MedicalResearch.com Interview with: [caption id="attachment_28490" align="alignleft" width="165"]Silvia S. Martins, MD, PHD Associate Professor of Epidemiology Department of Epidemiology Mailman School Of Public Health Columbia University New York, NY 10032 Dr. Silvia Martins[/caption] Silvia S. Martins, MD, PHD Associate Professor of Epidemiology Department of Epidemiology Mailman School Of Public Health Columbia University  MedicalResearch.com: What is the background for this study? Response: Prior studies have suggested t6hat medical marijuana legalization might play a role in decreasing opioid use. We aimed to test this hypothesis using individual level data on nonmedical use of prescription opioids and opioid use disorder  from the US National Survey on Drug Use and Health. 
Author Interviews, Cost of Health Care, JAMA / 18.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50263" align="alignleft" width="140"]Jim Stimpson, PhD Professor, Associate Dean for Academic Affairs  Health Management and Policy Drexel Dornsife School of Public Health Dr. Stimpson[/caption] Jim Stimpson, PhD Professor, Associate Dean for Academic Affairs Health Management and Policy Drexel Dornsife School of Public Health  MedicalResearch.com: What is the background for this study? Response: We have limited information on the impact of the ACA on persons with a disability, even though nearly 1 in 5 persons in the US has a physical or mental disability. Prior to the ACA, persons with a disability had complications accessing health insurance for a variety of reasons including lower likelihood of employer-based coverage, reduced access to private insurance due to pre-existing conditions, and income-restrictions for Medicaid coverage that are on average below the poverty threshold across the country.
Author Interviews, Heart Disease, Lipids / 18.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50320" align="alignleft" width="150"]Guanmin Chen MD PhD MPH Senior Biostatistician Research Facilitation, Alberta Health Services Adjunct Research Assistant Professor University of Calgary Dr. Chen[/caption] Guanmin Chen MD PhD MPH Senior Biostatistician Research Facilitation, Alberta Health Services Adjunct Research Assistant Professor University of Calgary  Co-authors: Guanmin Chen, PhD, MD, MPH, Megan S. Farris, MSc, Tara Cowling, MA, MSc, Stephen M. Colgan, PhD, Pin Xiang, PharmD, Louisa Pericleous, PhD, Raina M. Rogoza, MSc, Ming-Hui Tai, MSc, PhD, and Todd Anderson, MD  MedicalResearch.com: What are the main findings? Response:
  • Atherosclerotic cardiovascular disease (ASCVD) remains a significant cause of morbidity and mortality in Canada (and worldwide). Despite the established benefits of treatment with statins, most Canadians fail to achieve dyslipidemia targets (a risk factor for ASCVD).
  • The objective of this study was to examine current treatment patterns of lipid-lowering therapies for the management of low-density lipoprotein cholesterol (LDL-C) in patients with ASCVD.
  • This was a retrospective cohort study conducted using province-wide administrative health data from Alberta, Canada. Datasets used included health services, pharmaceutical, and laboratory data, in addition to the Alberta population registry. The study population consisted of individuals aged 18 years or older diagnosed with ASCVD between 2011-2015, based on International Classification of Diseases (ICD) codes. The cohort was then restricted to individuals with an initial (index) LDL-C measurement after ASCVD diagnosis and at least one year of pre-index data and one year of follow-up data.
Author Interviews, Biomarkers, Heart Disease, JACC / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50312" align="alignleft" width="100"]Dr. Fred Apple, PhD, DABCC Medical director,Clinical Laboratories, Clinical Chemistry, Clinical and Forensic Toxicology and Point of Care Testing, Hennepin HealthCare Principal investigator, Minneapolis Medical Research Foundation Professor, Department of Laboratory Medicine and Pathology University of Minnesota Dr. Apple[/caption] Dr. Fred Apple, PhD, DABCC Medical director,Clinical Laboratories, Clinical Chemistry, Clinical and Forensic Toxicology and Point of Care Testing, Hennepin HealthCare Principal investigator, Minneapolis Medical Research Foundation Professor, Department of Laboratory Medicine and Pathology University of Minnesota  MedicalResearch.com: What is the background for this study? Response: Few studies have addressed the role of high sensitivity cardiac troponin (hs-cTn) assays in ruling out myocardial infarction (MI) based on the measurement of a single baseline specimen in US patients presenting to the emergency department with symptoms suggestive of ischemia. Most studies have been published predicated on patients in Europe, Australia, and New Zealand. As US emergency departments have different ordering practices for using cTn in triaging patients, it is important to validate the role of hs-cTn assays in US practices to assure providers of appropriate utilization. We have published two papers using the Abbott ARCHITECT hs-cTnI assay, the same one used outside the US in clinical practice (as this assay is not yet FDA cleared) in a US cohort (clinicialtrials.gov trial: UTROPIA - Sandoval Y, Smith SW, Shah ASV, Anand A, Chapman AR, Love SA, Schulz K, Cao J, Mills NL, Apple FS. Rapid rule-out of acute myocardial injury using a single high-sensitivity cardiac troponin I measurement. Clin Chem 2017;63:369-76. Sandoval Y, Smith SW, Love SA,  Sexter A, Schulz K, Apple FS. Single high-sensitivity cardiac troponin I to rule out myocardial infarction. Am J Med 2017;130:1076-1083) that have shown similar rule out capacities predicated on clinical presentation, a normal ECG and the role of hs-cTnI testing.
Author Interviews, Global Health, HIV, NEJM / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50304" align="alignleft" width="107"]Prof-Richard-Hayes.jpg Prof. Hayes[/caption] Dr. Richard J. Hayes, DSc, FMedSci Professor of Epidemiology and International Health London School of Hygiene and Tropical Medicine MedicalResearch.com: What is the background for this study? Response: HIV incidence rates remain at very high levels in many parts of southern Africa. Universal testing and treatment (i.e., ensuring that everyone in a community tests for HIV and that everyone diagnosed with HIV is started on treatment as soon as possible) has been proposed as a strategy to achieve steep reductions in HIV incidence in generalized epidemics. Prior trials have shown inconsistent results as to whether this strategy could be effective. HPTN 071 (PopART) was carried out in 21 urban communities in Zambia and South Africa, with individual communities randomly assigned into one of three arms: A, B or C. The 14 communities in Arms A and B received annual rounds of home-based HIV testing by community health workers who supported linkage to care, antiretroviral therapy (ART) adherence and other HIV services. The seven communities in Arm C received the local standard of care. We looked to see if the HIV incidence in the communities receiving universal testing and treatment would be lower (over time) compared to the incidence in the standard of care communities.
Author Interviews, Pharmacology / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50290" align="alignleft" width="200"]Craig A. Pedersen, RPh, PhD, FAPhA Manager, Sterile Compounding and Investigational Drug Service, Pharmacy Clinical Professor University of Washington Dr. Pedersen[/caption] Craig A. Pedersen, RPh, PhD, FAPhA Manager, Sterile Compounding and Investigational Drug Service, Pharmacy Clinical Professor University of Washington MedicalResearch.com: What is the background for this study? Response: The ASHP national survey of pharmacy practice in hospitals originated with the Mirror to Hospital pharmacy, the first comprehensive, national audit of pharmaceutical services in hospitals, published in 1964.  Since that time, ASHP has conducted national surveys to document practices and technologies for managing the improving the medication-use system and the role that pharmacist play in that effort.  Beginning in 1998, the national survey became an annual project by ASHP.  This survey provides important information to pharmacists, managers, and external stakeholders to document the current state of pharmacy practice.
Author Interviews, JAMA, Opiods, Pediatrics, UCSD / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50286" align="alignleft" width="200"]Lorraine Kelley-Quon, MD, MSHS, FAAP Assistant Professor | Division of Pediatric Surgery Children's Hospital Los Angeles Department of Surgery & Preventive Medicine Keck School of Medicine of USC Dr. Kelley-Quon[/caption] Lorraine Kelley-Quon, MD, MSHS, FAAP Assistant Professor | Division of Pediatric Surgery Children's Hospital Los Angeles Department of Surgery & Preventive Medicine Keck School of Medicine of USC  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Prescription opioids are pharmacologically similar to heroin, and previous research has shown an association between nonmedical opioid use and heroin use. This is the first study to follow a group of teenagers through all 4 years of high school and identify an association between nonmedical prescription opioid use and later heroin use.
Annals Internal Medicine, Author Interviews, OBGYNE, Rheumatology / 17.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50282" align="alignleft" width="155"]Bella Mehta, MBBS, MS  Assistant Attending Physician, Hospital for Special Surgery Instructor, Weill Cornell Medical College     Dr. Mehta[/caption] Bella Mehta, MBBS, MS Assistant Attending Physician, Hospital for Special Surgery Instructor, Weill Cornell Medical College MedicalResearch.com: What is the background for this study? What are the main findings? Response: For women with lupus, pregnancy has long been considered high-risk and associated with both medical and obstetric complications. In the 1960s and 1970s, pregnancy was thought to be contraindicated in lupus patients. Beginning in the 1980s, and especially in the 1990s, many studies identified specific risk factors for pregnancy complications and proposed best-practice management guidelines. We wished to see whether these advances improved pregnancy outcomes for lupus patients. Our study showed a decline in maternal mortality and other outcomes in lupus patients. The improvement in pregnancy outcomes was observed more so in lupus patients than those without lupus. 
Annals Internal Medicine, Author Interviews, Clots - Coagulation, Heart Disease, Kidney Stones / 16.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50193" align="alignleft" width="84"]Sunil Badve MBBS, MD, DNB, FRACP, PhD, FASN Senior Research Fellow, Renal & Metabolic Division Staff specialist nephrologist | St George Hospital University of New South Wales The George Institute for Global Health Australia Dr. Badve[/caption] Sunil Badve MBBS, MD, DNB, FRACP, PhD, FASN Senior Research Fellow, Renal & Metabolic Division Staff specialist nephrologist | St George Hospital University of New South Wales The George Institute for Global Health Australia MedicalResearch.com: What is the background for this study? Response: Despite the high prevalence of cardiovascular thrombotic events and venous thromboembolism (VTE) in chronic kidney disease (CKD), oral anticoagulant therapy is often underutilized in patients with advanced CKD and dialysis-dependent end-stage kidney disease (ESKD) due to uncertainty of benefit and potential bleeding complications. This comprehensive systematic review was performed to study the benefits and harms of oral anticoagulant therapy in patients with CKD.
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Mental Health Research, Outcomes & Safety / 16.07.2019

MedicalResearch.com Interview with: MedicalResearch.com Interview with: Regis Goulart Rosa, MD, PhD Responsabilidade Social - PROADI Hospital Moinhos de Vento MedicalResearch.com: What is the background for this study? Response: The debate about visiting policies in adult ICUs is of broad and current interest in critical care, with strong advocacy in favour of flexible family visitation models in order to promote patient- and family-centred care. However, the proportion of adult ICUs with unrestricted visiting hours is very low. Data from the literature show that 80% of hospitals in the United Kingdom and USA adopt restrictive ICU visiting policies. Among ICUs with restrictive visiting hours, published studies show that the daily visiting time ranges from a median of 1 hour in Italy to a mean of 4.7 hours in France. In agreement with this scenario, most adult ICUs in Brazil follow a restrictive visitation model, in which family members are allowed to visit the critically ill patient from 30 minutes to 1 hour, once or twice a day. These restrictive visitation models have been justified by the theoretical risks associated with unrestricted visiting hours, mainly infectious complications, disorganization of care, and burnout. Controversially, these risks have not been consistently confirmed by the scarce literature on the subject, and flexible ICU visiting hours have been proposed as a means to prevent delirium among patients and improve family satisfaction. MedicalResearch.com: What are the main findings? Response: Disappointingly, studies evaluating the effectiveness and safety of flexible ICU visiting hours are scarce. To date, no large randomized trials have assessed the impact of a flexible visiting model on patients, family members, and ICU staff, and this evidence gap may constitute a barrier to the understanding of the best way to implement and improve ICU visiting policies. In the present pragmatic cluster-randomized crossover trial (The ICU Visits Study), we engaged 1,685 patients, 1,295 family members, and 826 ICU professionals from 36 adult ICUs in Brazil to compare a flexible visitation model (12 hours/day plus family education) vs. the standard restricted visitation model (median 90 minutes per day). We found that the flexible visitation did not significantly reduce the incidence of delirium among patients, but was associated with fewer symptoms of anxiety and depression and higher satisfaction with care among family members in comparison to the usual restricted visitation. Also, the flexible visitation did not increase the incidence of ICU-acquired infections and ICU staff burnout, which are major concerns when adopting this intervention. MedicalResearch.com: What should readers take away from your report? Response: Considering the evidence suggesting that most adult ICUs restrict the presence of family members, our results provide useful and relevant information that may influence the debate about current ICU visitation policies around the world. First, a flexible visitation policy that permits flexible family visitation in ICU (up to 12 hour per day) is feasible, given the high adherence of participant ICUs to implementation in The ICU Visits Study. Second, the flexible family supported by family education is safe regarding the occurrence of infections, disorganization of care or staff burnout. Third, family members - a commonly missing piece of the critical care puzzle - seem to benefit from the flexible visitation model through higher satisfaction with care and less symptoms of anxiety and depression. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Future research might focus on the following topics: 1) methods of implementation of flexible visiting models in ICUs; 2) Family support interventions in the context of flexible ICU visiting hours (e.g.: psychological and social support, support for shared decision making, peer support, and comfort); and 3) How flexible ICU visiting hours affects patient, family member and staff outcome at long-term. Disclosures: The ICU Visits study was funded by the Brazilian Ministry of Health through the Brazilian Unified Health System Institutional Development Program (PROADI-SUS). Citation: Effect of Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit [wysija_form id="3"] [last-modified] The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.Regis Goulart Rosa, MD, PhD Responsabilidade Social - PROADI Hospital Moinhos de Vento  MedicalResearch.com: What is the background for this study? Response: The debate about visiting policies in adult ICUs is of broad and current interest in critical care, with strong advocacy in favour of flexible family visitation models in order to promote patient- and family-centred care. However, the proportion of adult ICUs with unrestricted visiting hours is very low. Data from the literature show that 80% of hospitals in the United Kingdom and USA adopt restrictive ICU visiting policies. Among ICUs with restrictive visiting hours, published studies show that the daily visiting time ranges from a median of 1 hour in Italy to a mean of 4.7 hours in France. In agreement with this scenario, most adult ICUs in Brazil follow a restrictive visitation model, in which family members are allowed to visit the critically ill patient from 30 minutes to 1 hour, once or twice a day. These restrictive visitation models have been justified by the theoretical risks associated with unrestricted visiting hours, mainly infectious complications, disorganization of care, and burnout. Controversially, these risks have not been consistently confirmed by the scarce literature on the subject, and flexible ICU visiting hours have been proposed as a means to prevent delirium among patients and improve family satisfaction. 
Author Interviews, Dermatology, Duke / 15.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50274" align="alignleft" width="80"]Luis Garza, M.D., Ph.D. Associate Professor of Dermatology Johns Hopkins University School of Medicine. Dr. Garza[/caption] Luis Garza, M.D., Ph.D. Associate Professor of Dermatology Johns Hopkins University School of Medicine. MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to find out what might stimulate regeneration in mice and humans. We find that in both species during wounding, released “loose” dsRNA induces production of retinoic acid that stimulates regeneration.
Author Interviews, HIV, University of Michigan / 15.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50266" align="alignleft" width="200"]Rogério Meireles Pinto, LCSW, Ph.D. Professor and Associate Dean for Research University of Michigan School of Social Work  Dr. Pinto[/caption] Rogério Meireles Pinto, LCSW, Ph.D. Professor and Associate Dean for Research University of Michigan School of Social Work MedicalResearch.com: What is the background for this study? Response: In order to decrease the rate of HIV infection, interventions to scale up PrEP will need to address identified barriers at multiple ecological levels. In the past decade, interventions proposed to address PrEP implementation barriers were limited to one ecological level or another (e.g., individual or community). The failure to consider interventions targeting multiple ecological levels simultaneously may help explain why PrEP implementation is lagging. This failure is also due to methodological limitations of PrEP implementation studies.This high-quality paper presents a thorough and theoretically grounded review of original research on HIV Pre-Exposure Prophylaxis (PrEP) implementation in the U.S.
Author Interviews, Lifestyle & Health, Mental Health Research, Opiods, University of Pennsylvania / 15.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50259" align="alignleft" width="145"]Samuel Preston, Ph.D. Professor of Sociology University of Pennsylvania  Dr. Preston[/caption] Samuel Preston, Ph.D. Professor of Sociology University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Life expectancy at birth in the United States is low by international standards and has been declining in recent years. Our study aimed to identify how these trends differed by age, sex, cause of death, metropolitan status, and region. We found that, over the period 2009-11 to 2014-16, mortality rose at ages 25-44 in large metropolitan areas and their suburbs as well as in smaller metropolitan areas and non-metropolitan areas. Mortality at ages 45-64 also rose in all of these areas except large metropolitan areas. These were the ages responsible for declining life expectancy. Changes in life expectancy were particularly adverse for non-metropolitan areas and for women. The metropolitan distinctions in mortality changes were similar from region to region. The cause of death contributing most strongly to mortality declines was drug overdose for males and mental and nervous system disorders for women.
Author Interviews, Cancer Research, Hormone Therapy, JAMA, Prostate Cancer, University of Pennsylvania / 15.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50254" align="alignleft" width="180"]Ravi Jayadevappa, PhD, MS Department of Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA 19104-2676  Dr. Jayadevappa[/caption] Ravi Jayadevappa, PhD, MS Department of Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA 19104-2676  MedicalResearch.com: What is the background for this study? Response: In the US, prostate cancer is the most commonly diagnosed non-skin cancer and the second leading cause of cancer death among men. Research shows that hormone therapy or ADT reduces the levels of male hormones in the body, called androgens, to stop them from stimulating cancer cells to grow., and thus is effective in reducing the spread and progression of prostate cancer. At the same time, some research has suggested that decreasing androgen levels may increase the risk factors for Alzheimer’s and dementia, including loss of lean body mass, diabetes, cardiovascular disease, and depression. The ADT therapy may lead to impaired neuron growth and the regeneration of axons, thus affecting the cognitive function. Thus there is growing interest in the possible association between exposure to ADT and cognitive dysfunction. Our study investigates the association between exposure to ADT and subsequent diagnosis of Alzheimer’s or dementia in elderly, fee-for-service Medicare enrollees using SEER-Medicare linked databases.