Author Interviews, Electronic Records, Mental Health Research / 18.12.2018

MedicalResearch.com Interview with: Katharine Phillips, M.D. Professor of Psychiatry DeWitt Wallace Senior Scholar Residency Research Director Department of Psychiatry Weill Cornell Medical College, Cornell University Attending Psychiatrist, New York-Presbyterian Hospital Adjunct Professor of Psychiatry and Human Behavior Alpert Medical School of Brown University Weill Cornell Psychiatry Specialty Center Weill Cornell Medicine I NewYork-Presbyterian MedicalResearch.com: What is the background for this study? What are the main findings?
  • Electronic prescribing of medication by clinicians is widespread; it is required in many institutions and in some states. Electronic prescribing systems commonly use computerized decision support algorithms that give prescribers automated warnings or alerts at the time of prescribing if the system identifies a potential prescribing error.
  • Some prior studies suggest that electronic prescribing warnings/alerts may reduce prescribing errors and thus can be clinically useful. However, other prior studies caution that these alerts may have substantial limitations.
  • Despite the importance of this topic, relatively few studies have examined the accuracy of automated prescribing warnings in electronic prescribing systems; to our knowledge, no prior study has focused primarily on prescribing of medications for psychiatric conditions.
  • This report presents results from a survey of members of the American Society of Clinical Psychopharmacology (ASCP), a specialty society that advances the science and practice of clinical psychopharmacology, regarding automated warnings generated by electronic prescribing systems.
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Author Interviews, Cancer Research, Herpes Viruses / 18.12.2018

MedicalResearch.com Interview with: Jiahui Qian, MPH School of Public Health and Community Medicine University of New South Wales Sydney Australia     MedicalResearch.com: What is the background for this study? Response: Herpes zoster is a neurocutaneous disease caused by the reactivation of latent varicella zoster virus and its risk is related to the cell-mediated immunity. Previous studies have reported a higher zoster risk among patients with haematological cancer and cancer patients receiving chemotherapy. However, the role of the cancer itself and the receipt of cancer treatment is not clearly separated, we therefore started this study and tried to separate the risk of zoster associated with the cancer itself from cancer treatment.  (more…)
Author Interviews, Social Issues / 18.12.2018

MedicalResearch.com Interview with: Alice Verstaen, PhD VA Puget Sound Health Care System  MedicalResearch.com: What is the background for this study? Response: The study began in the 1980s in Dr. Levenson’s laboratory at the University of California, Berkeley in collaboration with Dr. John Gottman of the University of Washington and Dr. Laura Carstensen at Stanford University. Prior to this study, most research on marriage had focused on younger marriages that ended in separation and divorce. Our study was designed to focus on marriages that had lasted for many years. The idea was that these successful longer-term marriages could provide important clues as to what makes marriages succeed and stay together over time.  (more…)
Author Interviews, Compliance, Electronic Records, JAMA, Ophthalmology / 18.12.2018

MedicalResearch.com Interview with: Michael Vincent Boland, M.D., Ph.D. Glaucoma Center of Excellence Director of Information Technology, Wilmer Eye Institute Associate Professor of Ophthalmology Johns Hopkins University School of Medicine Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Effective medications are available to treat glaucoma and prevent or stop vision loss.
Unfortunately, patients frequently do not use the eye drops as prescribed, oftentimes simply
because they forget to. Since patient medications are now managed via electronic health
records (EHRs), we built a system to deliver automated reminders to patients using the patient
portal to our EHR. We found that the majority (75%, 66 of 88) of participants that received these reminders found them to be useful, and about half (47%, 41 of 88) the participants wanted to
continue using the reminders after the study ended
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Author Interviews, Johns Hopkins, Kidney Disease, Transplantation / 18.12.2018

MedicalResearch.com Interview with: Chirag R Parikh, M.B.B.S., Ph.D. Director,Division of Nephrology Professor of Medicine School of Medicine, Johns Hopkins University Baltimore, Maryland 21287  MedicalResearch.com: What is the background for this study? Response: The initial study idea stemmed from our earlier cohort studies of predictors of delayed graft function after kidney transplantation.  We previously found that kidneys from donors with Acute Kidney Injury (AKI) were more often discarded than kidneys from donors without AKI, and transplanted donor AKI kidneys were at increased risk for delayed graft function. It was important to determine whether that increased risk for delayed graft function also translated into worse long-term outcomes for recipients of kidneys from donors with AKI. (more…)
Author Interviews, Genetic Research, Nutrition / 18.12.2018

MedicalResearch.com Interview with: Denny Vågerö  PhD MSc CHESS, Centre for Health Equity Studies Department of Public Health Sciences Stockholm University, Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transgenerational, epigenetic, response, has been shown in studies of animals and plants. Does it apply to humans? Previous findings of associations between grandparents early nutrition and grandchildren’s mortality have been controversial.  Two reasons for this: evidence in human studies has been based on rather small numbers and potential mechanisms are not very well understood. We have tested the hypothesis that there is “a male line transgenerational response” to nutritional events in pre-puberty in a study much larger than previous ones. We find support for this hypothesis in that boys who enjoyed unusually good access to food during their “slow growth period” (aged 9-12 years) seem to transmit a mortality risk on their grandsons but not granddaughters, in particular for cancer. (more…)
Author Interviews, Diabetes, JAMA, Pain Research / 17.12.2018

MedicalResearch.com Interview with: Guy Fagherazzi, MSc, PhD, HDR Senior Research Scientist in Digital & Diabetes Epidemiology Center of Research in Epidemiology and Population Health Inserm, Paris-South Paris-Saclay University MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Migraine has further been associated with increased risk of overall and specific cardiovascular disease events. Because migraine has also been associated with factors related with insulin resistance and type 2 diabetes, an association between migraine and diabetes has been hypothesized. We observed a lower risk of type 2 diabetes in women with active migraine. We also show a linear decrease of migraine prevalence long before and a plateau long after type 2 diabetes diagnosis.  (more…)
Author Interviews, Blood Pressure - Hypertension, Critical Care - Intensive Care - ICUs, Emergency Care, JAMA / 17.12.2018

MedicalResearch.com Interview with:
"intravenous" by thorney torkelson is licensed under CC BY-NC-ND 2.0 <a href="https://creativecommons.org/licenses/by-nc-nd/2.0"> CC BY-NC-ND 2.0</a>Daniel J. Lane PhD
Institute of Health Policy, Management and Evaluation
Dalla Lana School of Public Health, University of Toronto
Rescu, Li Ka Shing Knowledge Institute, St Michael’s Hospital
Toronto, Ontario, Canada

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: Early resuscitation and early antibiotics have become the mainstay treatment for patients with sepsis. The time to initiation of these treatments is thought to be an important factor in patients surviving their disease; however, the independent benefits or harms of intravenous fluid resuscitation, in particular a more aggressive versus more conservative approach to this therapy, remains difficult to evaluate given the concurrent use of these therapies in hospital.

To gain a better understanding of this treatment independent of antibiotic use, we assessed intravenous fluid resuscitation by paramedics on the in-hospital mortality of patients with sepsis. By accounting for the interaction between initial systolic blood pressure and the treatment, we found that earlier resuscitation by paramedics was associated with decreased mortality in patients with low initial blood pressures but not associated with mortality for patients with normal or higher initial blood pressures. 

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Alcohol, Author Interviews / 16.12.2018

MedicalResearch.com Interview with: "Schott Zwiesel Wine Glasses" by Didriks is licensed under CC BY 2.0 <a href="https://creativecommons.org/licenses/by/2.0"> CC BY 2.0</a>Simona Costanzo MS, PhD Laboratory of Molecular and Nutritional Epidemiology, Department of Epidemiology and Prevention. IRCCS Istituto Neurologico Mediterraneo Neuromed, Italy MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We investigated how the different intake of alcohol relates to all-cause and cause-specific hospitalizations. In particular, we mainly investigated the association of alcohol consumption with total number of hospitalizations that occurred during 6 years of follow-up. We also examined cause-specific hospitalizations (e.g., alcohol-related diseases, vascular diseases, cancer, traumatic injury, and neurodegenerative diseases). (more…)
Author Interviews, Cancer Research, Dermatology / 15.12.2018

MedicalResearch.com Interview with: Dr. Kristine A. Romine MD CEO and Founder of Camelback Dermatology & Skin Surgery Phoenix, AZ MedicalResearch.com: Would you give a brief overview of the different types of skin cancer? Response: There are multiple types of skin cancer, including: melanoma, basal cell carcinoma, squamous cell carcinoma, and actinic keratosis. Known as the deadliest form of skin cancer, melanoma develops when irreparable DNA damage results in malignant transformation of melanocytes. This type of skin cancer is most commonly caused by intense UV exposure from the sun or tanning beds, which activate mutations that lead skin cells to rapidly multiply and form malignant tumors. Melanoma can range in color from dark brown to black and are rarely red or even skin colored. They are usually irregular and asymmetrical. In 2018, there were an estimated 91,270 new cases of melanoma (American Cancer Society, 2018). Basal cell carcinoma (BCC) is the most common type of skin cancer and cancer diagnosed. BCCs arise in the skins’ outermost layers. BCCs resemble open sores, red or pink plaques, pearly nodules with telangiectasia, or scars. It is estimated that 4.3 million BCCs are diagnosed in the U.S. every year (Skin Cancer Foundation, 2018). Squamous cell carcinoma (SCC), the second most common type of skin cancer, arises from the squamous cells in the skin that have been exposed to UV over long periods of time. SCCs appear as scaly red or pink macules, papules, or plaques. They can be crusted and appear eroded and can commonly arise within a solar keratosis. More than 1 million cases of SCC are diagnosed in the U.S. every year (Skin Cancer Foundation, 2018). Lastly, actinic keratoses (AKs) are the most common pre-cancerous skin growth that can develop into a SCC if left untreated. Similar to all other types, AKs are caused by exposure to UV light and, in rare cases, high exposures to x-rays. AKs can appear on sun-exposed areas, including the face, scalp, ears, shoulders, and legs. They resemble pink, scaly rough patches on the skin. (more…)
Author Interviews, Sleep Disorders / 14.12.2018

MedicalResearch.com Interview with: Brandon Hauer, Neuroscience PhD Student Neuroscience and Mental Health Institute Clayton Dickson, Professor Departments of Psychology, Physiology, and the Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our lab is interested in the dynamics of sleep and sleep-like rhythms in the forebrain. One particular interest relates to how the brain can spontaneously switch between very different states like rapid eye movement sleep (REM, or dreaming sleep) and slow-wave sleep (deep, restorative stage of sleep). We noticed that administering 100% oxygen to rats in an anesthetized preparation that closely models natural sleep produced an immediate and lasting switch into a slow-wave brain state. This happened as well in naturally sleeping rats. Interestingly, increasing carbon dioxide concentrations or decreasing oxygen in inspired air produced the opposite effect, namely a switch into activated or REM-like states.  (more…)
Author Interviews / 13.12.2018

MedicalResearch.comInterview with:

Hadi Shafiee, PhD Assistant Professor of Medicine Division of Engineering in Medicine Brigham and Women's Hospital

Hadi Shafiee, PhD
Harvard Medical School
Assistant Professor of Medicine
Division of Engineering in Medicine
Brigham and Women's Hospital
Harvard Medical School

 

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: Last year we developed a smartphone-based technology for male infertility testing at-home, which was published at Science Translational Medicine. This year, we developed a similar technology for ovulation testing at-home. Here, we developed a 3D printed smartphone-attachment similar to a cellphone case that literally turns the phone to a small microscope. 

This low-cost smartphone attachment magnifies the saliva fern structures dried on a reusable device that will be  recorded using the smartphone camera. The entire sample-to-answer time is only few minutes (~7 mins). The developed ovulation test is fully automated, simple, and easy-to-use. 

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Author Interviews, Blood Pressure - Hypertension / 13.12.2018

MedicalResearch.comInterview with:

Eric J. BELIN de Chantemèle, D.Sc. Associate Professor Department of Medicine, Cardiology Augusta University

Eric J. Belin de Chantemèle, D.Sc.
Associate Professor
Department of Medicine, Cardiology
Vascular Biology Center
Medical College of Georgia at Augusta University

Jessica L Faulkner, PhD
Post-doctoral Fellow
Vascular Biology Center
Medical College of Georgia at Augusta University

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: It is generally accepted in the medical community that women are more salt sensitive than men. By “salt sensitive” we mean that blood pressure increases with increases in salt in the diet.

While we have known for a long time that women are more likely to experience problems with their blood pressure that are associated with the salt that they eat, the reasons why remain largely unknown and, therefore, the best way to treat it is also unknown. With the average American eating roughly twice the salt recommended by the American Heart Association guidelines, the effects of dietary salt on blood pressure are very important. Our latest publication in the journal American Heart Association’s journal Hypertension shows that female mice are more prone to high blood pressure when on a high salt diet than males.

MedicalResearch.com: What should readers take away from your report?

Response: Our report begins to shed some light on why women may have a greater risk of developing high blood pressure due to eating too much salt. We recently found that a hormone, termed “aldosterone” is acting inappropriately in females in response to a lot of salt in the diet. In healthy individuals who are not salt sensitive, aldosterone is decreased by salt in the diet and is protective to the blood vessels. However, in female mice it is less likely that aldosterone will be decreased, and this lack of decrease of aldosterone leads to blood vessel damage and high blood pressure in our study.In contrast, our male mice in our study suppressed aldosterone when given a high salt diet, and did not develop blood vessel damage or high blood pressure.We believe this variation in aldosterone production in women may be a reason why they are clinically more likely to have a blood pressure response to high salt diets.

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Author Interviews / 12.12.2018

MedicalResearch.comInterview with:

Tetsuo Shoji, MD, PhD. Department of Vascular Medicine Osaka City University Graduate School of Medicine Osaka Japan
Dr. Shoji

Tetsuo Shoji, MD, PhD.
Department of Vascular Medicine
Osaka City University Graduate School of Medicine
Osaka Japan

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: Vitamin D is known to be associated with health and disease of various organs such as bone, heart, brain, and others. Vitamin D is activated by the liver and kidneys to a hormone called 1,25-dihydroxyvitamin D which binds to vitamin D receptor in cells to exert its functions.

Vitamin D activation is severely impaired in patients with kidney disease requiring hemodialysis therapy, leading to mineral and bone disorder(MBD). Therefore, active form of vitamin D is one of the standard choices of treatment for MBD caused by kidney function loss.

Previous observational cohort studies showed that the use of active vitamin D in hemodialysis patients was associated with lower likelihood of all-cause death, cardiovascular death, and incident cardiovascular disease.Potentially cardio-protective effects of active vitamin D were shown by basic studies using cultured cells and animal models. Then, many nephrologists began to believe that active vitamin D is a “longevity hormone” or a “panacea” for kidney patients requiring dialysis therapy, although there was no evidence by randomized clinical trials. 

To show evidence for it, we conducted a randomized clinical trial namedJ-DAVID in which 976 hemodialysis patients were randomly assigned to treatment with oral alfacalcidol or treatment without active vitamin D, and they were followed-up for new cardiovascular events during the four-year period. The risk of cardiovascular events was not significantly different between the two groups. The risk of all-cause death was not significantly different either.

To our surprise, the risk of cardiovascular event tended to be higher in the patients who continued treatment with active vitamin D than those who continued non-use of active vitamin D, although the difference was not statistically significant.

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Author Interviews, Cancer Research / 12.12.2018

MedicalResearch.comInterview with:
Alexandra Avgustinova PhD
Postdoctoral fellow at the Institute for Research in Biomedicine (IRBBarcelona)

Dr. Avgustinova
Dr. Avgustinova

MedicalResearch.com:  What is the background for this study?

Response: The basis of this study was the strong association between closed chromatin and high mutation rate reported several years ago. We were surprised to see this observation being widely interpreted as a causal association, as it was largely based on correlative studies without experimental backing. Therefore we decided to experimentally test for the first time whether indeed altering chromatin opening would affect mutation rate or distribution within tumours.

MedicalResearch.com: What are the main findings?

Response: We found that, despite significantly increasing chromatin opening, loss of the histone methyltransferase G9a did not have any major influence on the mutation rate or distribution within cutaneous squamous cell carcinomas. These results demonstrate that chromatin opening does not play a major role in determining the mutation rate within tumours, and we speculate that other, confounded factors (e.g. replication timing or H3K36me3 levels) are likely causal for the observed association. This, however, remains to be proven experimentally.

Another major conclusion of our study was that although tumour initiation was delayed and tumour burden decreased in the absence of G9a, the tumours that did develop were highly aggressive due to selection for more aggressive tumour clones. This finding was contrary to many published reports suggesting G9a as a good candidate for clinical targeting, highlighting the need for long-term follow-up in pre-clinical studies.

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Author Interviews / 12.12.2018

MedicalResearch.comInterview with:

Zhaohui Gu, PhD
Postdoctoral Research Associate
 St. Jude Children's Research Hospital, TN

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response:B-progenitor acute lymphoblastic leukemia (B-ALL) is the most common pediatric malignancy and the leading cause of childhood cancer death. B-ALL includes multiple subtypes that are defined by distinct genetic alterations and that play an important role in diagnosis, prognosis and therapy of patients.  Advances in transcriptome sequencing (RNA-seq)have helped researchers discover additional subtypes and driver mutations inB-ALL and identify possible new therapeutic targets.  Still, up to 30% of B-ALL cases do not fit into established subtypes. These patients lack targeted therapeutic approaches and commonly relapse.

Fort his study, we used integrated genomic analysis of 1,988 childhood and adult cases to revise the classification system of B-ALL. The system includes eight new subtypes and a total of 23 B-ALL subtypes. The subtypes are defined by chromosomal rearrangements, sequence mutations, or heterogeneous genomic alterations. Many show a marked variation in prevalence according to age.

The newly identified subtypes included one (n=18) defined by rearrangements of gene BCL2, MYC and/or BCL6 anda distinctive gene expression profile (GEP). Patients in this subtype were mostly adults (n=16) with very poor outcomes.

Another novel subtype was defined by IKZF1 N159Y missense mutation. N159Y is in the DNA-binding domain of IKZF1, and is known to disrupt IKZF1 function, with distinct nuclear mis-localization and induction of aberrant intercellular adhesion. There were eight cases in this subtype that shared highly similar GEPs.

We also identified two subtypes with distinct GEP and characterized by PAX5 alterations. One, PAX5 altered (PAX5alt), included 148 cases. PAX5alt was characterized by diverse PAX5 alterations including rearrangements (n=57), sequence mutations (n=46) and/or focal intragenic amplifications (n=8). These PAX5 alterations were found in 73.6% of PAX5alt cases. The second distinct subtype comprised 44 cases, all with PAX5 P80R missense mutations. Bi-allelic PAX5 alterations were commonly seen in this subtype in the form of PAX5 P80R coupled with a second sequence mutation or deletion of the wild-type PAX5 allele.

Adult PAX5 P80R cases showed better 5-year OS (61.9±13.4%) than those in PAX5alt subtype (42.1±10.2%). In addition, Pax5 P80R heterozygous and homozygous mice developed B lineage leukemia with a median latency of 166 and 87 days, respectively.  The heterozygous mice acquired alterations on the second allele, which faithfully recapitulated the condition of the patient leukemia.

MedicalResearch.com: What should readers take away from your report?

Response: Identification of subtypes accurately is very important for diagnosis, intensity-tailored therapy, and to identify targetable lesions. In this large scale genomic study, we demonstrated the power of using RNA-seq to classifying B-ALL and established a revised B-ALL taxonomy with 23 distinct subtypes. We identified 8 novel subtypes, including two defined by PAX5 alterations. Through in vitro and in vivo experiments, we demonstrated that PAX5 P80R could impair B cell differentiation and initiate leukemia.

Together with the subtype defined by IKZF1 N159Y mutation, we showed for the first time that transcription factor missense mutations could be a subtype defining genetic lesions.

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Author Interviews, Cancer Research / 12.12.2018

MedicalResearch.comInterview with:

Zhen Gu, Ph.D. Professor, Department of Bioengineering University of California, Los Angeles (UCLA)
Dr. Zhen Gu

Zhen Gu, Ph.D.
Professor, Department of Bioengineering
University of California, Los Angeles (UCLA)

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: Despite improvements in surgical techniques, local residual tumor micro infiltration and circulating tumor cells continue causing tumor recurrence after resection. 

Calcium carbonate nanoparticles could scavenge H+ in the surgical wound, reserving the immunosuppressive tumor microenvironment and promoting the antitumor immuneresponses. 

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Author Interviews, Education / 11.12.2018

MedicalResearch.com Interview with:

Kirti Magudia, MD, PhD Diagnostic RadiologyResident, Brigham and Women’s Hospital Clinical Fellow, Radiology, Harvard University
Dr. Magudia


Kirti Magudia, MD, PhD
Diagnostic RadiologyResident, Brigham and Women’s Hospital
Clinical Fellow, Radiology, Harvard University




Debra F. Weinstein, M.D.
Vice President, Graduate Medical Education, Partners Health Care
Associate Professor of Medicine, Harvard Medical School

Christina Mangurian, MD,MAS
Professor and Vice Chair at the UCSF Department of Psychiatry
Weill Institute for Neurosciences
Core Faculty, UCSF Center for Vulnerable Populations
Affiliate Faculty, UCSFPhilip R. Lee Institute for Health Policy Studies

Reshma Jagsi, MD, DPhil
Professor and DeputyChair, Department of Radiation Oncology
Director, Center for Bioethics and Social Sciences in Medicine
University of Michigan

MedicalResearch.com:  What is the background for this study? 
What are the main findings?

Response: Training lengths for medical specialties are increasing and many people are starting training later. Hence, many more trainees are having children during training, an especially difficult time due to long and inflexible work hours. Given the match system, trainees may not have complete control over where they end up in training and thus may not have an optimal support system nearby. Many of the top training institutions are also in high cost of living areas. Since trainees are essentially temporary employees, changing policies to their benefit is challenging. For all of these reasons, prospective and current trainee parents are especially vulnerable.

Parental leave is important to both male and female trainees. We found that just over half of the 15 top graduate medical education (GME) sponsoring institutions associated with the top 12 medical schools did not have parental leave policies. Without these policies, trainees are at the mercy of their departments and program directors. Those institutions that do have parental leave policies for trainees offer significantly less leave to trainees than to faculty. Even then, trainees may not be encouraged to take leave afforded by policy as, depending on specialty board regulations, the leave may extend training time.

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Author Interviews / 11.12.2018

MedicalResearch.comInterview with:

polarized-light-dermatoscope-wikipedia-image

Jac Dinnes PhD, MSc, MA, PGDip
Senior Researcher
Test Evaluation Research Group
Institute of Applied Health Research
University of Birmingham

MedicalResearch.com:  What is thebackground for this study? Would you briefly explain the benefits of dermoscopy?

Response: This systematic review was one of a series of Cochrane Reviews of studies evaluating different tests for diagnosing skin cancer. Within creasing rates of skin cancer and an increasing number of more specialised tests becoming available in both primary care and in specialist settings, a thorough review of all available evidence was timely.

The diagnosis of melanoma and other skin cancers fundamentally relies on clinical examination, including history taking, and visual inspection of the concerning skin lesion (mole or patch of skin) and surrounding skin (and other lesions). A dermatoscope is a handheld device using visible light (such as from incandescent or LED bulbs), that allows more detailed examination of the skin compared to examination by the naked eye alone.

Knowing the diagnostic accuracy of dermoscopy added to visual inspection alone, across a range of observers and settings, is critical to understanding its contribution for the diagnosis of melanoma and to future understanding of the potential role of the growing number of other high-resolution image analysis techniques.

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Author Interviews / 11.12.2018

MedicalResearch.com Interview with:

Virginia J. Howard,PhD, FAHA, FSCT   
 Professor of Epidemiology
The University of Alabama at Birmingham

MedicalResearch.com:  What is the background for this study?

Response: This study comes from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national cohort study of 30,239 non-Hispanic black and white community-dwelling participants aged 45 years and older who lived in the 48 contiguous US states. 

REGARDS was designed to study risk factors for the development of stroke, with a focus on black and white comparisons as well as comparisons across geographic regions of the US.

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Author Interviews / 11.12.2018

MedicalResearch.comInterview with:
Lisa M. Lines, PhD, MPH
University ofMassachusetts Medical School
Worcester
RTI International,Waltham, MA

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: The problem of potentially avoidable emergency department (ED) visits has been linked to barriers in access to high-quality, timely primary care. In Massachusetts ,about half of all ED visits were considered potentially avoidable, or primary-care sensitive (PCS), in the mid-2000s. Indeed, improving access to primary care was a prime motive for the state’s – and the nation’s – first universal coverage health insurance program in 2006. Now, the state has the highest coverage rate in the country.

We used Massachusetts All-Payer Claims Data to study characteristics of insured Massachusetts residents associated with primary-care sensitive ED use and compared such use among people under age 65 with public (Medicaid[MassHealth]) versus private insurance. We studied more than 2.2 million individuals in 2011-12; about 40% had public insurance in 2011, and the rest had private insurance. Our PCS ED measure included nonurgent, urgent but primary care treatable, and urgent but potentially avoidable ED visits.

We found that primary-care sensitive ED use was more than 4 times higher among the publicly insured (public insurees: 36.5 PCS ED visits per 100 person-years; private insurees: 9.0). After adjusting for a range of potential confounders, such as the vastly different morbidity burden of the two groups, public insurance in2011 was associated with about 150% more primary-care sensitive ED use. We also found that 70% of people with public insurance had at least 1 primary care visit, compared with 80% of those with private insurance. The public group also had fewer visits to their PCP of record, even though nearly all of them had an officially designated PCP.

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Author Interviews / 11.12.2018

MedicalResearch.com Interview with:

Kenneth H. Kraemer,M.D.
Chief DNA Repair Section
Laboratory of Cancer Biology and Genetics, Center for Cancer Research
National Cancer Institute

MedicalResearch.com:  What is the background for this study?

Response: At the National Cancer Institute, we have been examining patients with xeroderma pigmentosum (XP), a rare, recessively inherited, cancer-prone disease for many years. Therefore, with the increasing use of exome sequencing, we decided to see how closely"big data" corresponded with our clinical observations.  

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Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Mediterranean Diet, Women's Heart Health / 10.12.2018

MedicalResearch.com Interview with: Samia Mora, MD, MHS Associate Professor of Medicine Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Mediterranean diet is rich in plants (nuts, seeds, fruits, vegetables, whole grains, legumes) and olive oil, and includes moderate intake of fish, poultry, dairy, and eggs, and alcohol, and rare use of meats and sweets.The Mediterranean diet has been associated with lower risk of cardiovascular disease (CVD) events but the precise mechanisms through which Mediterranean diet intake may reduce long-term risk of CVD are not well understood. We aimed to investigate the biological mechanisms that may mediate this cardiovascular benefit. Using a prospective study of 25,994 initially healthy women enrolled in the Women’s Health Study who were followed up to 12-years, we evaluated potential mediating effects of a panel of biomarkers (in total 40 biomarkers) that represent different CVD pathways and clinical factors. Higher baseline intake of a Mediterranean-type diet was associated with approximately one quarter lower risk of CVD events during the 12 year follow up. For the MED-CVD risk reduction, biomarkers of inflammation, glucose-metabolism/insulin-resistance, and adiposity contributed most to explaining the association, with additional contributions from pathways related to blood pressure, lipids – in particular HDL or triglyceride-rich lipoprotein metabolism, and to a lesser extent LDL cholesterol, branched chain amino acids, and small molecule metabolites.  (more…)
ADHD, Author Interviews, Autism, JAMA, Pediatrics, UC Davis / 10.12.2018

MedicalResearch.com Interview with: Meghan Miller, Ph.D. Assistant Professor Department of Psychiatry & Behavioral Sciences UC Davis MIND Institute Sacramento, CA 95817 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study evaluated within-diagnosis sibling recurrence and sibling cross-aggregation of ADHD and autism spectrum disorder among later-born siblings of diagnosed children. We specifically chose to include only families who had at least one subsequent child after the diagnosis of an older child because failing to do so could bias recurrence risk estimates. We found that, compared to later-born siblings of non-diagnosed children, later-born siblings of children with autism were more likely to be diagnosed with autism or with ADHD. Likewise, compared to later-born siblings of non-diagnosed children, later-born siblings of children with ADHD were more likely to be diagnosed with ADHD or with autism. (more…)