Alzheimer's - Dementia, Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, JAMA / 25.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47146" align="alignleft" width="153"]Dr-Jeff Douglas Williamson Dr. Williamson[/caption] Jeff D. Williamson, MD Geriatric Medicine - Sticht Center Wake Forest Baptist Medical Center MedicalResearch.com: What is the background for this study? Response: A growing amount of epidemiologic research has suggested that higher blood pressure is associated with higher risk for dementia, including Alzheimer’s dementia. MedicalResearch.com: What are the main findings? Response: More than 9,300 ambulatory, community dwelling persons over age 50, 30% of whom were over the age of 75, were randomly assigned to a blood pressure goal of 120 vs 140.  Persons in the 120 group had a 19% lower risk for developing MCI an transitional stage between normal and dementia (P<.008).  There was a 17% lower risk for developing dementia but this only achieved a p value = 0.10.  The combined risk for both MCI and dementia was 15% lower in the 120 group (p<0.04).  The dementia outcome was the primary outcome but all the outcomes were pre-specified in the protocol at the beginning of the trial.  Unfortunately the blood pressure intervention was stopped after only 3.3 years due to CVD and mortality benefit and this may well have influenced the ability to reach the expected number of dementia cases. 
Author Interviews, Flu - Influenza, Infections, PLoS, University of Michigan / 25.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47142" align="alignleft" width="135"]Betsy Foxman PhD Hunein F. and Hilda Maassab Endowed Professor of Epidemiology Director, Center for Molecular and Clinical Epidemiology of Infectious Diseases Ann Arbor, Michigan 48109-2029 Dr. Foxman[/caption] Betsy Foxman PhD Hunein F. and Hilda Maassab Endowed Professor of Epidemiology Director, Center for Molecular and Clinical Epidemiology of Infectious Diseases Ann Arbor, Michigan 48109-2029 MedicalResearch.com: What is the background for this study? Response: Influenza is a major cause of human illness and death worldwide. Vaccines are the best available means of prevention. However, vaccine effectiveness has been low to moderate in recent years and coverage remains low in many countries. There is increasing evidence suggesting the microbiome plays an important role in shaping host immunity and may be a potential target for reducing disease. In our study, we used a household transmission study to explore whether the respiratory microbiome was associated with influenza susceptibility. 
Author Interviews, Cancer Research, HPV, Infections / 25.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47138" align="alignleft" width="151"]Prof. J. (Hans) Berkhof PhD Vrije Universiteit Amsterdam  Prof. Berkhof[/caption] Prof. J. (Hans) Berkhof PhD Vrije Universiteit Amsterdam  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In most countries, the Pap test is used for cervical cancer screening but recently several countries have switched from Pap testing to HPV testing. Like the Pap test, the HPV test requires a cervical sample to be taken by a clinician. Vaginal self-sampling is also used, but only in underscreened women. We know that self-sampling increases screening participation in underscreened women and it is likely that many women that attend screening also prefer self-sampling if it had been offered to them. We studied whether an HPV self-sampling test is an accurate alternative to a regular HPV test in women invited for routine screening. We randomized about 14,000 women, invited for screening, to self-sampling or clinician-sampling. Women with a positive HPV test result also received the other HPV test. We found that the HPV self-sampling test yielded similar performance as the regular HPV test for detection of cervical pre-cancerous lesions (CIN3 and CIN2). 
Accidents & Violence, Author Interviews, Emergency Care, JAMA, Yale / 24.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47133" align="alignleft" width="142"]Edouard Coupet Jr, MD, MS Assistant Professor Department of Emergency Medicine Yale School of Medicine Dr. Coupet[/caption] Edouard Coupet Jr, MD, MS Assistant Professor Department of Emergency Medicine Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: For many individuals with nonfatal firearm injuries, their only point of contact with the healthcare system may be the emergency department. Both hospital-based violence intervention programs and counseling and safe firearm storage have shown promise in reducing the burden of firearm injury. In this study, one third of individuals with firearm injuries presented to non-trauma centers. Only 1 out of 5 firearm injuries were assault injuries that led to admission to trauma centers, the population most likely to receive interventions to reduce re-injury. 
Aging, Author Interviews, Neurological Disorders / 24.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47107" align="alignleft" width="133"]Rachael D. Seidler, PhD Professor, Applied Physiology & Kinesiology University of Florida Dr. Seidler[/caption] Rachael D. Seidler, PhD Professor, Applied Physiology & Kinesiology University of Florida MedicalResearch.com: What is the background for this study? Response: There is accumulating evidence that spaceflight impacts the human brain: the brain is shifted higher within the skull and there are some regions of gray matter increases and decreases. To date, no studies have looked at the impact of spaceflight on human brain white matter pathways. Rodents flown in space show decreased myelination of white matter pathways. Here, we analyzed brain MRI scans pre and post spaceflight to quantify fluid shifts and white matter changes.
Author Interviews, Cancer Research, Genetic Research, Weight Research / 24.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47128" align="alignleft" width="200"]Brian R. Lane MD PhD Division of Urology Spectrum Health Grand Rapids, Michigan Dr. Lane[/caption] Brian R. Lane MD PhD Division of Urology Spectrum Health Grand Rapids, Michigan MedicalResearch.com: Can you explain how you conducted your study, and what the main findings were? Response:  We used large-scale genome-wide association studies (GWAS) to identify genetic variants associated with obesity measures, blood pressure, lipids, type 2 diabetes, insulin, and glucose. these genetic variants were used as proxies for the above-mentioned risk factors and evaluated in relation to renal cell carcinoma risk (kidney cancer) using GWAS data from 10,000 RCC patients and 20,000 control participants. -          Based on these genetic data, we found that multiple measures of obesity, as well as diastolic blood pressure (DBP) and fasting insulin, are associated with renal cell carcinoma risk. In contrast, we found little evidence for an association with RCC risk for systolic blood pressure (SBP), circulating lipids, overall diabetes, or fasting glucose. 
Author Interviews / 23.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47123" align="alignleft" width="184"]Dr-Byron Caughey Dr-Caughey[/caption] Byron Caughey, Ph.D.  Senior Investigator Chief, TSE/prion Biochemistry Section Laboratory of Persistent Viral Diseases NIH/NIAID Rocky Mountain Laboratories . Hamilton, MT 59840 USA MedicalResearch.com: What is the background for this study? Would you briefly explain the significance of prion-induced diseases and why they have been difficult to diagnosis?  Response: Although prion diseases such as Creutzfeldt-Jakob disease (CJD) are rarer than many other neurodegenerative diseases in humans, they are rapidly fatal, untreatable and transmissible. Therefore it is important to be able to diagnose prion diseases as early as possible, not only to accurately inform patients, families and caregivers, but also to reduce risks of transmission and  improve prospects for developing therapeutics. Toward these goals, we have shown that our RT-QuIC prion seed amplification assays are highly accurate for diagnosing sporadic CJD using patients’ spinal fluid and/or nasal brushings in the clinical phase of disease. However, these particular specimens may not always be available, and it remains unclear how early they become RT-QuIC-positive in infected individuals in the months or years prior to the onset of overt clinical signs. We also showed recently that skin samples obtained post-mortem from sCJD patients are RT-QuIC positive. In the current study, we determined how early prion seeds appear in the rodents infected with prions in order to gain clues as to whether analyses of skin biopsies might provide a means of early preclinical detection of prion infections in humans.
Author Interviews, Hospital Acquired, Infections, Technology / 23.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47120" align="alignleft" width="142"]Donna Armellino RN, DNP, CIC Vice President, Infection Prevention Northwell Health, Infection Prevention Lake Success, N. Y. Dr. Armellino[/caption] Donna Armellino RN, DNP, CIC Vice President, Infection Prevention Northwell Health, Infection Prevention Lake Success, N. Y. MedicalResearch.com: What is the background for this study?  Response: The background for initiating this study was to assess frequently used equipment within the patient care environment following standard manual cleaning and disinfection compared to disinfection with PurpleSun’s shadowless 90-second cycle focused multivector ultraviolet (FMUV) delivery system. Microbes exist within the environment. Cleaning followed by disinfection, regardless of method, is intended to decrease levels of these microbes to minimize exposure and the risk of infection. To measure the effectiveness of the two methods of disinfection a five-point culturing method was used to assess microbial burden. This method was used to assess patient care equipment cleanliness after manual cleaning/disinfection and following the use of FMUV after an operative case and was used to sample equipment deemed cleaned/disinfected and ready for use outside the operative environment. Microbial burden was reported as colony forming units (CFUs). Comparison of the CFUs before cleaning/disinfection, after cleaning/disinfection, and after the use of FMUV allowed efficacy of the disinfection methods to be compared. 
Author Interviews, Cognitive Issues / 23.01.2019

MedicalResearch.com Interview with: Bryan D. James, PhD Assistant Professor Rush Alzheimer's Disease Center Chicago, IL 60612  MedicalResearch.com: What is the background for this study? Response: It has long been reported by patients, their family members, and physicians that many older adults experience long-term declines in their memory and thinking abilities after hospitalization. Studies have recently begun to confirm these reports by following older patients for years after hospitalization and repeatedly testing their cognitive abilities. A number of questions have yet to be answered, including which types of hospitalizations are most strongly related to cognitive decline. In this study, we sought to answer whether going to the hospital for elective procedures was as risky to the cognitive health of older adults as urgent or emergency (that is, non-elective) hospitalizations.
Author Interviews, Duke, JAMA, Mental Health Research, Pediatrics, Toxin Research / 23.01.2019

MedicalResearch.com Interview with: Aaron Reuben, MEM Department of Psychology and Neuroscience Duke University, Durham, North Carolina MedicalResearch.com: What is the background for this study? What are the main findings? (1)  Study members with greater lead exposure in childhood tended to endorse more psychiatric symptoms when assessed for psychiatric disorders in adulthood (between 18 and 38 years of age).
  1. These individuals tended to report more internalizing (e.g., depression, anxiety) and thought disorder (e.g., OCD, schizophrenia, mania) symptoms.
  2. Compared to other findings from this sample, the associations reported in this article are similar to those reported for lead and IQ, and are stronger than those reported for lead and criminal offending.
    1. Informants who knew Study members well reported higher levels of difficult adult personality traits among Study members with greater lead exposure in childhood.
    2. Specifically, Study members with greater blood lead levels at age 11 were rated as more neurotic, less agreeable, and less conscientious by 38 years of age.
    3. These personality traits have been previously linked to a number of poor life outcomes, including greater psychopathology, worse physical health, less job satisfaction, and troubled interpersonal relationships
  3. Psychiatric problems related to lead exposure could be detected as early as 11 years of age. In the 1980’s, parents and teachers of children with higher blood-lead levels had described them as displaying more antisocial behavior, hyperactivity, and negative emotions (e.g., sadness, anxiety).
Author Interviews, Gastrointestinal Disease, JAMA, Nutrition, Sugar / 23.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47100" align="alignleft" width="133"]Miriam Vos, MD, MSPH Assistant professor of Pediatrics Emory University School of Medicine Physician on staff, Children’s Healthcare of Atlanta Dr. Vos[/caption] Miriam Vos, MD, MSPH Associate Professor of Pediatrics and Director Pediatric Fatty Liver Program Emory and Children’s Healthcare of Atlanta MedicalResearch.com: What is the background for this study? What are the main findings? Response: Fatty liver disease has quickly become a common problem in children and adolescents, affecting an estimated 7 million children in the U.S.  This study resulted from our previous research demonstrating that fructose increases cardiometabolic risk factors in children with NAFLD in addition to other research that had demonstrated associations between NAFLD and sugar.   
Author Interviews, Infections, Vaccine Studies / 23.01.2019

MedicalResearch.com Interview with: ValnevaThomas Lingelbach President & CEO of Valneva MedicalResearch.com: What is the background for this study? Would you briefly explain the significance of Chikungunya disease? Response: Chikungunya is a mosquito-borne viral disease caused by the Chikungunya virus (CHIKV), a Togaviridae virus, transmitted by Aedes mosquitoes. The chikungunya virus causes clinical illness in 72-92% of infected humans around four to seven days after an infected mosquito bite. People infected with chikungunya may suffer from acute onset of fever, debilitating joint and muscle pain, headache, nausea and rash, potentially developing into long-term, serious health impairments such as visual, neurological, heart and gastrointestinal manifestations that in some extreme cases can lead to fatalities. [caption id="attachment_47097" align="alignleft" width="300"]This photograph depicts a female Aedes albopictus mosquito as she was feeding on a human host. You can see the red, needle-like proboscis that had penetrated the skin, and was filled with the host’s blood, which had filled her abdomen. Ae. albopictus is known to be a vector for a number of arboviral diseases, including yellow fever, dengue fever, and Chikungunya fever. CDC/ James Gathany This photograph depicts a female Aedes albopictus mosquito as she was feeding on a human host. You can see the red, needle-like proboscis that had penetrated the skin, and was filled with the host’s blood, which had filled her abdomen. Ae. albopictus is known to be a vector for a number of arboviral diseases, including yellow fever, dengue fever, and Chikungunya fever.
CDC/ James Gathany[/caption] Chikungunya outbreaks have been reported in Asia, Africa, the Americas and Europe. As of 2017, there have been more than one million reported cases in the Americas. The medical burden is expected to grow as the CHIKV primary mosquito vectors continue to further spread geographically. Currently there are no preventive vaccines against Chikungunya making it a major threat to public health. We set out to develop VLA1553, a live-attenuated vaccine candidate, as a potential solution to the growing unmet need chikungunya poses. Our hope is that having a preventative vaccine for chikungunya will allow people living in endemic areas to have peace of mind while enjoying the outdoors.
Author Interviews, End of Life Care, JAMA, Kidney Disease / 22.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47065" align="alignleft" width="174"]Susan P. Y. Wong, MD MS Assistant Professor Division of Nephrology University of Washington VA Puget Sound Health Care System  Dr. Wong[/caption] Susan P. Y. Wong, MD MS Assistant Professor Division of Nephrology University of Washington VA Puget Sound Health Care System  MedicalResearch.com: What is the background for this study? Response: Patients who reach the advanced stages of kidney disease  must often face the difficult decision of whether to undergo maintenance dialysis. While maintenance dialysis is a remarkable therapy that has extended the lives of many patients, its benefits do not necessarily accrue in older patients with significant comorbidity and functional impairment. It is also a very demanding form of therapy that comes with its own burdens and complications. Based on our prior research in the national VA health system, 1 in 7 patients with very advanced kidney disease (or their decision makers) do not pursue dialysis. We wanted to understand how these decisions to forgo initiation of maintenance dialysis unfold.
Microbiome, Nutrition, Weight Research / 22.01.2019

The obesity rate has climbed steadily for men in the United States, currently rolling in at nearly 38% and still rising. That’s far from good news, and it’s doing nothing to help with the growing cardiovascular and heart disease statistics. Fighting obesity can be incredibly difficult, especially with our increasingly sedentary lifestyles brought on by modern conveniences. With diets popping up every day, it can be hard to pick, but one diet has arisen with a focus on digestive and general body health rather than strict weight loss: fiber-high diets. What is it? Fiber-high diets are exactly what they sound like, in that they’re dietary plans based on consuming fiber heavy foods to help promote a healthy digestive system. Our gut is home to massive colonies of helpful bacteria that work to aid us in breaking down our food and keep our body healthy. Fiber-high diets focus on feeding these bacteria the best possible fuel to promote a healthy body system, commonly referred to as the microbiome.
Author Interviews, Diabetes, Infections, JAMA, Pediatrics, Vaccine Studies / 22.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47077" align="alignleft" width="200"]Dr Kirsten Perrett MBBS FRACP PhD Team Leader / Clinician-Scientist Fellow, Population Allergy, Murdoch Children's Research Institute Consultant Paediatrician, Department of Allergy and Immunology and General Medicine The Royal Children's Hospital Fellow, School of Population and Global Health, The University of Melbourne Murdoch Children's Research Institute Parkville, Victoria  Australia Dr. Kirsten Perrett[/caption] Dr Kirsten Perrett MBBS FRACP PhD Team Leader / Clinician-Scientist Fellow, Population Allergy, Murdoch Children's Research Institute Consultant Paediatrician, Department of Allergy and Immunology and General Medicine The Royal Children's Hospital Fellow, School of Population and Global Health The University of Melbourne Parkville, Victoria  Australia MedicalResearch.com: What is the background for this study? Response: Before rotavirus vaccines were available, rotavirus infection was the most common cause of severe gastroenteritis in infants and young children. Because it is so contagious, infection in childhood is thought to be universal in unvaccinated children. Previous studies indicated that rotavirus infection of infants might be an environmental promoter of type 1 diabetes. Therefore, we anticipated that the introduction of the rotavirus vaccine might alter the disease incidence in young children. 
Aging, Author Interviews, Exercise - Fitness, Gender Differences / 22.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47073" align="alignleft" width="200"]Lloyd Brandts PhD Candidate Maastricht University Maastricht, the Netherlands Lloyd Brandts[/caption] Lloyd Brandts PhD Candidate Maastricht University Maastricht, the Netherlands MedicalResearch.com: What is the background for this study? Response: Although the number of people who reached old age has increased over the past few decades, in some developing countries it has been observed that the increase in life expectancy started to plateau. One commonly used argument to explain this plateauing is the growing number of obese and physically inactive individuals. Therefore, we assessed whether there is an association between these factors and the chance of reaching the age of 90 years.
Author Interviews, Breast Cancer, Cancer Research, JAMA, Leukemia / 21.01.2019

MedicalResearch.com Interview with: medicalresearch.comDr. Marie Joelle Jabagi, PharmD, MPH University of Paris Sud, Paris-Saclay University, Paris Health Product Epidemiology Department French National Agency for Medicines and Health Products Safety Saint-Denis, France MedicalResearch.com: What is the background for this study? Response: Secondary hematologic malignant neoplasms that develop months or years after the diagnosis of breast cancer may be a consequence of genetic predisposition, environmental factors, previous cancer treatments or a combination of all those factors. These secondary malignant neoplasms are increasingly becoming a concern given that the population of breast cancer survivors is growing substantially. However, their frequency in real life has been poorly investigated to date. The aims of our research were to estimate the frequency of various types of hematologic malignant neoplasm following a diagnosis of primary breast cancer among women aged 20 to 85 years in France during the past decade, and to compare it to the corresponding frequency in women of the French general population.
Author Interviews, Genetic Research, Hearing Loss, JAMA, Karolinski Institute / 21.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46982" align="alignleft" width="200"]Christopher R. Cederroth | Ph.D. Docent Associate Professor Experimental Audiology | Department of Physiology and Pharmacology Karolinska Institutet  Sweden Dr. Cederroth[/caption] Christopher R. Cederroth | Ph.D. Docent Associate Professor Experimental Audiology | Department of Physiology and Pharmacology Karolinska Institutet Sweden MedicalResearch.com: What is the background for this study? Response: Tinnitus is experienced is experienced by a large proportion of the population and affects more than 15% of the population worldwide (estimated 70 million people in Europe). However, for near 3% of the population, tinnitus becomes a chronic bothersome and incapacitating symptom. Severe tinnitus interferes with sleep, mood, and concentration and thus impacts life quality, ultimately leading to sick leave and disability pension. A high cost to society has been reported, and since the prevalence of tinnitus has been predicted to double in Europe by 2050, there is an important need for an effective treatment. And today there are none, with the exception of cognitive behavioral therapy, which helps coping with it but does not remove the tinnitus. There has been a number of innovative treatment approaches, but they are overall not successful and it is now agreed that it is likely because tinnitus is a heterogeneous condition – meaning that we cannot consider tinnitus a single entity but an ensemble of different forms or subtypes, which need to be defined. Tinnitus has always been considered a condition influenced by environmental factors, but our initial studies suggested the opposite. Adoption studies are excellent in showing the influence of shared-environment effects and establish a genetic basis for a disease or a trait. It allows to test the transmission of a trait between the adoptee and their biological or their adoptive parent. Transmission via the biological parent is expected to be due to a heritable genetic effect, while transmission via the adoptive parent is associated with home-environment, the so-called shared-environmental effect. We used medical registry data to identify tinnitus patients and adoptees.
Author Interviews, Brain Injury, Orthopedics, Pediatrics, PNAS / 21.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47062" align="alignleft" width="200"]Kelly Russell PhD Department of Pediatrics and Child Health University of Manitoba Dr. Russell[/caption] Kelly Russell PhD Department of Pediatrics and Child Health University of Manitoba MedicalResearch.com: What is the background for this study? Response: Health-related quality of life (HRQOL) is an important patient-reported outcome that measures the patient’s perception on how their condition effects various aspects of their life, such as their physical, emotional, social and school quality of life.  HRQOL can measure the more subtle or hidden consequences of a condition, such as concussion.  Patient reported outcomes are important because they give a more complete picture of the patient’s condition than just reporting symptoms or outcomes that are only measured by their clinician.  We wanted to compare the effects of sport-related concussions versus sport-related limb fractures on HRQOL in adolescents after their injury and during their recovery. We chose to compare adolescents with sport-related concussions to a sport-related limb fracture group because we wanted to be able to attribute the results to having a concussion since not being able to play sports with their friends and teammates may decrease HRQOL regardless of the actual type of injury.  We also wanted to identify which clinical variables were associated with worse HRQOL in adolescent patients with sports-related concussion.
Author Interviews, Cancer Research, Cost of Health Care / 21.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47059" align="alignleft" width="200"]Zhiyuan "Jason" Zheng PhD Director, Economics and Healthcare Delivery Research American Cancer Society, Inc. Atlanta, GA 30303 Dr. Zheng[/caption] Zhiyuan "Jason" Zheng PhD Director, Economics and Healthcare Delivery Research American Cancer Society, Inc. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Historically, the cost of healthcare can be a substantial burden for cancer survivors and their families in the US. Even with health insurance, a cancer diagnosis can impose significant out-of-pocket costs for medical care.  These are partially due to the rising costs of cancer treatments in recent years, moreover, the increasing levels of coinsurance, copayments, and deductibles also shift a significant portion of the burden to cancer patients. We found that younger cancer survivors, those aged 18-49 years, bear a higher burden than their older counterparts. We also found that two-thirds of cancer survivors enrolled in high-deductible health plans did not have health savings accounts, and they are more vulnerable to financial hardship than those in high-deductible health plans with health savings accounts and those covered by low-deductible plans. These findings are important to patients because although cancer patents have benefited from newer and more advanced treatments, financial hardship may lead to emotional distress, cause changes in health behaviors, and jeopardize treatment adherence and health outcomes. 
Author Interviews, Depression, Dermatology, JAMA, Mental Health Research / 21.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47053" align="alignleft" width="200"]Isabelle Vallerand, PhD Epidemiologist, MD Student Department of Community Health Sciences Cumming School of Medicine University of Calgary Dr. Vallerand[/caption] Isabelle Vallerand, PhD Epidemiologist, MD Student Department of Community Health Sciences Cumming School of Medicine University of Calgary MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that patients with alopecia areata, a form of autoimmune hair loss, are at a higher risk of suffering from depression than the general population. But in practice, we often hear patients tell us that they believe their hair loss developed as a result of stress or problems with mental health – certainly the phrase “so stressed your hair is falling out” is something most people have heard of. Despite this, there has actually been very little research investigating the role that mental health may have on development of alopecia areata. Interestingly, depression has recently been associated with increased systemic inflammatory markers, so there is biologic plausibility that depression could increase the risk of alopecia areata. Our group was interested in addressing this question, and used a large population-level health records database with up to 26 years of follow-up to study it. We ultimately found that not only does depression increase one’s risk of alopecia areata, but that it increases their risk by nearly 90% compared to people who have never had depression. We also found that using antidepressants can significantly decrease the risk of developing alopecia areata in patients with depression. So there appears to be an important link between mental health and development of hair loss from alopecia areata.
Author Interviews, Global Health, JAMA, Mental Health Research, Pediatrics, UCLA, Zika / 21.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47036" align="alignleft" width="200"]Karin Nielsen-Saines, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases  David Geffen School of Medicine at UCLA Dr. Nielsen[/caption] Karin Nielsen-Saines, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? Response: Our study used a very simple evaluation called GMA (General Movement Assessment tool) which checks baby movements at approximately 3 to 5 months of age. We examined 111 babies exposed to maternal illness during the Zika epidemic in Brazil and 333 control babies without this exposure by GMA at 3 months  and then tested them through standard neurodevelopmental tests at the age of 12 months. We found that this simple evaluation, which consists of filming a baby lying down on their back for one minute and studying their movements worked extremely well in predicting which babies would or would not have future problems in their neurodevelopment. The study advances knowledge in the area because a simple one minute video of a baby can predict neurodevelopment, something that is extremely hard to determine in young babies.  This is true even in places where sophisticated brain scans are available. By identifying which babies are at risk of developmental problems early on, professionals can rapidly refer these babies to  stimulation programs when they are very young, which increases their chances of having better outcomes. Because the brains of young children respond much better  to stimulation, the timing of interventions to improve their development is very important, that is why they need to be identified early.
Addiction, Author Interviews, Mental Health Research / 21.01.2019

gambling addictionAn addiction to gambling can be an isolating ordeal that causes havoc among someone’s personal relationships, destroys personal finances, and exacerbates any mental health issues that a person may have. Addiction is rarely an isolated incident. Typically there are many factors at play that can manifest themselves in the form of gambling. By tackling these underlying causes one can treat their addiction and eliminate the toxic habits that created it. In addition to confronting this by oneself, it is important for those who suffer from this to confide in those close to them as well as seeking advice from their doctor. One major issue brought on by any kind of addiction is the sense of alienation that someone can experience. This is where it is important for them to open up to those who are close to them, like a loved one or a close friend. It will help alleviate the burden of struggling alone and will help others to understand what they are going through. Getting in touch with self-help groups can be another means of alleviating the feelings of alienation that addicts can experience while they are treating their compulsive gambling. This provides an outlet for an addict to express what they are going through while simultaneously getting the perspective of others who have struggled in a similar fashion. One of the most important steps to take is the very first one. That is to be able to admit that there is a problem with gambling. Once this has been done, the problem becomes tangible and the addiction can be confronted directly.
Author Interviews, Health Care Systems, JAMA / 21.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47027" align="alignleft" width="160"]David Shulkin, MD Ninth Secretary, U.S. Department of Veterans Affairs Washington, District Of Columbia Shulkin Solutions LLC Gladwyne, Pennsylvania Dr. Shulkin[/caption] David Shulkin, MD Ninth Secretary, U.S. Department of Veterans Affairs Washington, District Of Columbia Shulkin Solutions LLC Gladwyne, Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings?  Response: I came to VA in 2015 as Under Secretary for Health, as a result of the 2014 wait time crisis.  At that time, it was determined that in some locations, veterans had been waiting for care for too long and there were allegations that this had resulted in harm to a number of veterans.  I was in the private sector at the time, but was asked by President Obama to come and help improve the situation. Upon my arrival we created systems to determine which veterans were waiting for urgent healthcare and which ones for routine care.  From here, we established same day services for all veterans waiting for urgent care through primary care and behavioral health access points.  This goal was achieved nationwide at the end of 2016.  When I became Secretary in 2017,  we began publishing our wait time data for all to see, so that veterans had accurate information on which to base their choices on and to provide transparency into where we were improving and where we needed to focus our efforts.  In addition, through programmatic and legislative efforts, we expanded our utilization of private sector options so that veterans with clinical needs would be able to get better access to care. This study was meant to determine whether our efforts from 2014 had resulted in improvements to access and in addition how access to care in the VA compared to access in the private sector.   Despite limitations in the data available from the private sector (since others do not publish their actual wait time data similar to VA) we used a data set that we felt had some applicability for these comparisons. We found that for the most part, VA wait times are often shorter than in the private sector,  and that VA wait times had improved since 2014 while the private sectors access had stayed the same. 
Author Interviews, Circadian Rhythm, Gender Differences / 18.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47020" align="alignleft" width="200"]Lauren Douma, Ph.D. Postdoctoral Fellow University of Florida Department of Medicine Division of Nephrology, Hypertension, and Renal Transplantation Gainesville, FL 32610 Dr. Douma[/caption] Lauren Douma, Ph.D. Postdoctoral Fellow University of Florida Department of Medicine Division of Nephrology, Hypertension, and Renal Transplantation Gainesville, FL 32610 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Our internal circadian clock not only controls our sleep/wake cycle, but also many other physiological functions including rhythms in body temperature, heart rate, and blood pressure. During the day when we are active our blood pressure peaks and at night when we are asleep our blood pressure dips. Certain individuals do not experience this dip in their blood pressure at night and are referred to as non-dippers. Non-dippers have an increased risk for heart and kidney disease. Previously, our lab has shown that if we knock out a core circadian clock gene (PER1) in male mice, they develop non-dipping hypertension on a treatment that mimics salt-sensitive hypertension. In the current study, we examined the effect of knocking out this circadian clock gene in female mice. We found that female mice without the PER1 gene do not develop the non-dipping hypertension that the males develop. Female mice without PER1 maintain their circadian rhythms of blood pressure, including the dip in their blood pressure at night even with the same treatment that the males received to mimic salt-sensitive hypertension.
Allergies, Author Interviews, JAMA / 18.01.2019

MedicalResearch.com Interview with: [caption id="attachment_47008" align="alignleft" width="150"]ESS= Erica S. Shenoy, MD, PhD Harvard Medical School Dr. Shenoy[/caption] ESS= Erica S. Shenoy, MD, PhD Harvard Medical School Division of Infectious Diseases, Department of Medicine Massachusetts General Hospital, Boston [caption id="attachment_47011" align="alignleft" width="150"]Kimberly G. Blumenthal MD, MSc Division of Rheumatology, Allergy and Immunology Department of Medicine, Massachusetts General Hospital, Boston Dr. Blumenthal[/caption] KGB= Kimberly G. Blumenthal MD, MSc Division of Rheumatology, Allergy and Immunology Department of Medicine, Massachusetts General Hospital,Boston   [caption id="attachment_47012" align="alignleft" width="100"]EMM= Eric M. Macy MD, MS Department of Allergy Southern California Permanente Medical Group San Diego Medical Center Dr. Macy[/caption] EMM= Eric M. Macy MD, MS Department of Allergy Southern California Permanente Medical Group San Diego Medical Center [caption id="attachment_47013" align="alignleft" width="150"]TR= Theresa Rowe, DO, MS General Internal Medicine and Geriatrics Feinberg School of Medicine Northwestern University, Chicago, Illinois Dr. Rowe[/caption] TR= Theresa Rowe, DO, MS General Internal Medicine and Geriatrics Feinberg School of Medicine Northwestern University, Chicago, Illinois MedicalResearch.com: What is the background for this review? ESS: A key component of reducing antimicrobial resistance is improving how antimicrobials are prescribed—both reducing inappropriate use (i.e., not prescribing when not needed) and favoring the use of narrow-spectrum agents that are less likely to contribute to the development of antimicrobial resistance. KGB: Because unverified penicillin allergy labels are so prevalent with greater than 32 million Americans affected, and these labels lead to the use of alternative antibiotics that are often more broad-spectrum, we now know that penicillin allergy evaluations are an emerging important component of antibiotic stewardship.  When patients with a reported penicillin allergy are tested, more than 95% of them are not allergic, and thus could (and should) receive penicillins, and often related drugs, when appropriate.