Author Interviews, Dermatology / 11.03.2017

MedicalResearch.com Interview with: Hywel C. Williams DSc, FMedSci, NIHR Senior Investigator Director of the NIHR Health Technology Assessment Programme Professor of Dermato-Epidemiology and Co-Director of the Centre of Evidence-Based Dermatology, University of Nottingham Queen’s Medical Centre Nottingham University Hospitals NHS Trust, Nottingham, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pemphigoid is a potentially serious skin condition characterised by the appearance of large tense blisters appearing on the skin. These blisters are itchy and eventually burst, leaving raw areas of skin that can become infected. Pemphigoid is much commoner in the elderly, and is on the increase. It is due to the body’s own immune system attaching certain structures in the skin ie an auto-immune disease. The main treatment for pemphigoid is oral steroids (prednisolone). Prednisolone is usually quite good at clearing the blisters, but when given for long periods as is needed for people with pemphigoid, they cause serious side effects such as diabetes, infection, raised blood pressure and fractures, so safer oral treatments are needed for this disease. Tetracycline antibiotics are one such possible treatment – they have been used by some for pemphigoid for many years, but our Cochrane review did not find any good evidence to show that it works. So we applied to the UK National Institute of Health Research Health Technology Programme to do a definitive evaluation of treating pemphigoid with one of the tetracyclines called doxycycline. We tested the strategy of staring patients with pemphigoid with doxycycline versus standard treatment with oral prednisolone. If those starting on doxycycline did not achieve good enough control, they could switch to prednisolone as would happen in clinical practice. Our main outcomes were blister control at 6 weeks, and severe, life threatening and fatal treatment related adverse events at 52 weeks. The study was designed as a non-inferiority study – by that we mean that we never expected doxycycline to be as good as prednisolone for blister control, so we agreed to put up with a degree of lower effectiveness provided that there were clear long term safety gains. (more…)
Author Interviews, Dermatology, JAMA, Race/Ethnic Diversity, Transplantation / 10.03.2017

MedicalResearch.com Interview with: Christina Lee Chung, MD, FAAD Associate Professor of Dermatology Director, Center for Transplant Patients Drexel University College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: It’s long been recognized immunosuppressed organ transplant recipients are at significantly increased risk for skin cancer and other types of skin disease. But despite advances to improve skin cancer prevention for these patients, little is known about how skin conditions affect African-American, Asian and Hispanic transplant recipients. This is problematic given that, according to the U.S. Department of Health and Human Services, more than half of the 120,000 Americans on the waiting list for organs identify as nonwhite. We compared medical records of 412 organ transplant recipients — including 154 white patients and 258 nonwhite (black, Asian or Hispanic) — who were referred to the Drexel Dermatology Center for Transplant Patients between 2011 and 2016. As one of the only models of its kind in the country, the center provides post-transplant dermatological care to every patient who is transplanted by and/or followed by the Drexel University and Hahnemann University Hospital Transplant Programs. That means that every patient, regardless of race, is screened annually for skin cancer, which provided a unique dataset for us to analyze. Two hundred eighty-nine transplant recipients exhibited malignant, infectious or inflammatory conditions during their evaluation, but their primary acute diagnoses differed greatly by race. In 82 white patients, skin cancer was the most common acute problem requiring attention at first visit. Black and Hispanic patients, by contrast, were most often diagnosed with inflammatory or infectious processes, such as fungal infections, warts, eczema, psoriasis, and rashes that required immediate medical attention. Overall, squamous cell carcinoma in situ was the most common type of skin cancer diagnosed in each racial or ethnic group. But the location of the cancerous lesions again depended on the race of the patient. Most lesions in white and Asian patients occurred in sun-exposed areas of the body, like the scalp, neck, chest and back. For black patients, the lesions were primarily found in the groin.  Moreover, six of the nine lesions found on black patients tested positive for high-risk HPV strains, suggesting an association between the virus and skin cancer for African Americans. We also provided questionnaires to 66 organ transplant recipients to find out more about the patients’ awareness of skin cancer prevention. Seventy-seven percent of white patients were aware their skin cancer risk was increased, compared to 68 percent of nonwhites. Only 11 percent of nonwhite patients reported having regular dermatologic examinations, compared to 36 percent of whites. Finally, 45 percent of white patients but only 25 percent of nonwhite reported knowing the signs of skin cancer. (more…)
Addiction, Author Interviews, Mental Health Research / 10.03.2017

MedicalResearch.com Interview with: Carl Stevenson, PhD Assistant Professor of Neuroscience BSc Animal Science Admissions Tutor Local Group Rep, British Neuroscience Association School of Biosciences University of Nottingham Loughborough, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Anxiety-related and substance abuse disorders can be serious forms of mental illness that are not always treated effectively by psychological therapies or medications. One strategy to enhance their treatment is to boost the effects of psychological therapy by combining it with medication. This study reviewed the literature on the effects of cannabidiol, a chemical found in the cannabis plant, in preclinical models of these disorders. Cannabidiol is safe to use in humans and doesn’t cause the ‘high’ associated with cannabis. This means that cannabidiol might be useful for treating certain symptoms without the unwanted side effects linked to medical cannabis. Our review confirmed that cannabidiol reduces fear and anxiety in various preclinical models, when given on its own or in conjunction with behavioural interventions that model psychological treatment for anxiety-related disorders. This could show that exploring the option of cbd for anxiety could be a step forward in treating the condition. Our review suggested that it can also reduce relapse in some preclinical models of addiction, although research looking at the effects of cannabidiol in substance abuse disorders is still in its infancy. (more…)
Author Interviews, Sexual Health, Social Issues / 09.03.2017

MedicalResearch.com Interview with: Brooke E. Wells, Ph.D. Associate Professor & PhD Program Director Center for Human Sexuality Studies Widener University One University Place Chester, PA 19013 MedicalResearch.com: What is the background for this study? Response: It is widely believed that Americans today are more sexually liberated and open than ever before. While research indicates that Americans do indeed have more liberal attitudes about a range of sexual behaviors, Americans are actually reporting fewer sexual partners and higher rates of adult sexual abstinence. But are Americans reporting similar levels of sexual frequency with fewer partners? Our research set out to examine changes over time in sexual frequency to better understand our changing sexual landscape. (more…)
Author Interviews, Psychological Science, Technology / 09.03.2017

MedicalResearch.com Interview with: Indrajeet Patil PhD former PhD student at SISSA, Trieste and currently a postdoctoral researcher at Harvard University MedicalResearch.com: What is the background for this study? Response: Human societies are built on mutually beneficial cooperation, which relies on our prosocial and altruistic impulses to help each other out. Psychologists have been trying to understand the psychological basis of altruistic behavior for a while now, but studying costly altruism - a kind of helping behavior in which the altruist pays a heavy price to help others - has been difficult to study in lab settings given the ethical problems associated with creating any paradigm where participants stand to get hurt. Thus, the question is how do you study the motivation behind acts that involve a very high risk of physical injury to the self while helping others? Such situations are common in emergency contexts where people can be faced with the choice of either saving their own life or risking it to save someone else's life. (more…)
Allergies, Author Interviews, Pediatrics / 09.03.2017

MedicalResearch.com Interview with: Margaret T. Redmond, MD Nationwide Children's Hospital Columbus, Ohio  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Food allergies are becoming more prevalent and can cause a life threatening reaction if not managed correctly. Much of the previous focus has been on food allergy in the school setting and little was known about the camp setting. Analysis of survey data from camp directors, medical personnel and staff reveal that there are deficiencies of training and policy at camps that could place food allergic campers at increased risk of reaction. A prospective registry of epinephrine administration from 51 camps revealed an increased rate of epinephrine administration compared to school data. (more…)
Author Interviews, JAMA, Surgical Research / 09.03.2017

MedicalResearch.com Interview with: Daniel Dante Yeh, MD FACC Assistant Professor of Surgery Harvard Medical School Course Director General/GI Surgery sub-internship Associate Course Director, Surgery Core Clerkship Associate Director, Surgical Intensive Care Unit Co-Director, Nutrition Support Unit Department of Surgery Division of Trauma, Massachusetts General Hospital Emergency Surgery, and Surgical Critical Care Boston, MA 02114 MedicalResearch.com: What is the background for this study?  Response: High Fresh Frozen Plasma to Red Blood Cells FFP:RBC transfusion ratio is a strategy which has emerged in the trauma literature as the preferred method of resuscitation for massively bleeding injured patients.  However, this strategy has now spread to other patient populations which have never been formally studied.   These populations include elective operations and even non-surgical patients.  Giving excess FFP when it is not needed is not only wasteful, but may be harmful, as other studies have reported that FFP can cause problems with lung function, heart function, and immune function. (more…)
Author Interviews, Social Issues / 09.03.2017

MedicalResearch.com Interview with: Ella Daniel, PhD Department of School Counseling and Special Education Constantiner School of Education Tel Aviv University MedicalResearch.com: What is the background for this study? Response: The development of disruptive behavior in early childhood is extremely important, as disruptive behavior starts early in life and behavioral patterns may become stable and resistant to influence later on. Siblings have a high potential to influence each other's behavior, as they spend a considerable amount of time together, are close in age and likely to become role models. However, the role of siblings in disruptive behavior development was mostly studied among adolescents, and hardly among young children. In the current study, conducted in collaboration with Dr. Jennifer Jenkins and colleagues at the University of Toronto and funded by the Canadian Institute for Health Research, we asked parents in some 400 families in and around Toronto, about the behavior of their young children. Both mothers and fathers reported the frequency of disruptive behaviors among their children, including violence, disobedience, destruction of property etc.. At the time of the study, the youngest children in the family were only 18 months of age. They all had an older sibling who was less that 5.5 years of age, and some had additional older siblings, up to four children in a  amily. Using advanced statistical models, we aimed to identify the role of siblings in the development of each child's disruptive behavior over time, taking into account heredity, parenting, social environment and shared history. (more…)
Author Interviews, Breast Cancer, Science / 09.03.2017

MedicalResearch.com Interview with: Chenfang Dong Department of Pathology and Pathophysiology Zhejiang Key Laboratory for Disease Proteomics Zhejiang University School of Medicine Hangzhou China  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Basal-like breast cancer (BLBC), which generally falls into the triple-negative breast cancer subtype, is associated with an aggressive clinical history, early recurrence, distant metastasis and shorter survival. The treatment of BLBC is an unmet medical need due to the absence of effective targeted therapies and poor response to standard chemotherapy. Therefore, elucidating the determinants of aggressiveness and identifying the relevant targets in BLBC are urgently needed. In this study, we report that aldo-keto reductase 1 member B1 (AKR1B1) overexpression occurs specifically in BLBC and predicts poor prognosis in breast cancer patients. Our data reveal that AKR1B1 as a key modulator of tumor aggressiveness provides tumorigenic and metastatic advantage in basal-like breast cancer through a positive regulatory feedback loop that activates the EMT program and enhances CSC-like properties. Interestingly, epalrestat, the only AKR1B1 inhibitor that has been approved in Japan for the targeted treatment of diabetic complications, significantly inhibited cancer cell migration and invasion in vitro, suppressed tumorigenicity and metastasis of BLBC cells in mice models, displaying potent efficacy against BLBC. (more…)
Allergies, Asthma, Author Interviews, JAMA, Pediatrics / 09.03.2017

MedicalResearch.com Interview with: Elizabeth C. Matsui, MD MHS Professor of Pediatrics, Epidemiology, and Environmental Health Sciences Johns Hopkins University Baltimore, MD 21287  MedicalResearch.com: What is the background for this study? Response: We designed this study after our previous work indicated that mouse allergy was common among low-income children living in some urban neighborhoods in the US, that these children also had high levels of mouse allergen exposure in their homes, and that children who are both allergic to mice and exposed to high levels of mouse allergen are at greater risk of asthma symptoms, emergency room visits and hospitalization.   Given this background, we designed a randomized clinical trial to determine if an intensive professionally delivered mouse intervention was better than education about mouse control in reducing asthma symptoms and lowering home mouse allergen levels. (more…)
AHA Journals, Author Interviews, Stroke / 08.03.2017

MedicalResearch.com Interview with: Dr. Miikka Korja Chief Innovation Officer Neurosurgeon Associate Professor of Neurosurgery HUS, Helsinki University Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Helsinki University Hospital, one of the largest hospital organizations in industrialized countries, has a very long history in conducting studies on brain aneurysms and aneurysmal subarachnoid hemorrhage. The one and only study on the natural history of ruptured aneurysms has also been conducted in Helsinki 50 years ago (published in 1967). The term “natural history” refers to an approach where the cause of a patient’s disease is not treated at all. In this case, it means that ruptured aneurysms in patients with devastating brain hemorrhage, aneurysmal subarachnoid hemorrhage, were left untreated. Therefore, these patients have a high risk of a rebleeding from the once ruptured aneurysm. As ruptured aneurysms are nowadays unexceptionally treated, if the patient survives the primary bleeding event, such natural history studies are impractical to conduct. We wanted to update the 50 years old data by using a historical patient registry. Back in the old days, many of aneurysmal subarachnoid hemorrhage patients were not treated because for example surgery was considered too risky or patients were classified as too old for surgery. By using the historical data, we showed that aneurysmal SAH, if not treated, is even more devastating disease than believed. Based on our results, we can state that 75-89% of today’s patients die in a year without treatments. (more…)
Author Interviews, JAMA, Sugar / 08.03.2017

MedicalResearch.com Interview with: Marlene B. Schwartz PhD Director, Rudd Center for Obesity & Food Policy (Principal Investigator) Professor, Department of Human Development and Family Studies University of Connecticut Hartford, CT 06103 MedicalResearch.com: What is the background for this study?  Response: The aim of this study was to evaluate the impact of a community-wide campaign to reduce consumption of sugary beverages in Howard County, Maryland. We measured the retail sales of sugary drinks in supermarkets in the target community and a set of matched control supermarkets in another state. The campaign included multiple components over three years, including television advertising, digital marketing, direct mail, outdoor advertising, social media and earned media, creating 17 million impressions. The community partners successfully advocated for public policies to encourage healthy beverage consumption in schools, child care, health care and government settings. (more…)
Aging, Author Interviews / 08.03.2017

MedicalResearch.com Interview with: Ana O'Loghlen Group Leader Epigenetics & Cellular Senescence Blizard Institute Queen Mary University of London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: The activation of senescence is an important cellular response to a stress signal. The senescent cell stops proliferating and this avoid that damaged cells propagate in our body, creating tissue damage. Our study has found a particular protein, integrin beta 3 subunit, regulating this cellular phenotype, senescence. We have further provided details of the mechanism of how this integrin does this. We have found that the activation of the TGF beta pathway is important for integrin beta 3 to induce senescence and that this integrin is regulated by epigenetically by the polycomb protein CBX7. Interestingly, although we have not provided functional studies, we find that integrin beta 3 is highly expressed during aging in human and mouse. (more…)
AHRQ, Author Interviews, Electronic Records, Outcomes & Safety / 08.03.2017

MedicalResearch.com Interview with: Michael Furukawa, Ph.D. Senior Economist Agency for Healthcare Research and Quality  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite some progress, patient safety remains a serious concern in U.S. health care delivery, particularly in acute care hospitals. In part to support safety improvement, the Health Information Technology for Economic and Clinical Health (HITECH) Act promoted widespread adoption and use of certified electronic health record technology. To meet Meaningful Use (MU) requirements in the law, hospitals are required to adopt specific capabilities, such as computerized physician order entry, which are expected to reduce errors and promote safer care. We found that, after the HITECH Act was made law, the occurrence of in-hospital adverse drug events (ADEs) declined significantly from 2010 to 2013, a decline of 19%. Hospital adoption of medication-related MU capabilities was associated with 11% lower odds of ADEs occurring, but the effects did not vary by the number of years of experience with these capabilities. Interoperability capability was associated with 19% lower odds of adverse drug events occurring. Greater exposure to MU capabilities explained about one-fifth of the observed reduction in ADEs. (more…)
Author Interviews, Genetic Research, Social Issues, Weight Research / 08.03.2017

MedicalResearch.com Interview with: Professor Don Haider-Markel Chair, Department of Political Science University of Kansas Lawrence, KS 66045 MedicalResearch.com: What is the background for this study? Response: We have studied causal attributions for conditions and problems in society for some time. We noticed that public debate over obesity had increased and new policy proposals were being proposed to address what was deemed as a growing public health problem. As the salience of the issue increased so too did partisan views on the topic. Based on these observations, we wanted to explore individual beliefs about the causes, or attributions for, obesity. Existing research and theory suggested that Republicans following a conservative philosophy would be more likely to attribute obesity to personal choices, such as eating habits and lack of exercise—in short, putting the locus of control on individuals. Meanwhile liberal leaning Democrats, with a known predisposition to suggest conditions or problems are outside of the control of the individual, would be more likely to attribute obesity to either genetic or other biological factors, or the broader context of widely available low-cost high-fat food sources. Additionally, we know that individuals tend to make attributions that are self-serving. In other words, people tend to make attributions that put themselves in a positive light. Thus, personal weight should factor into obesity attributions. Here we expected that overweight people would be more likely to make attributions that removed personal blame, such as pointing to a genetic cause. People closer to an ideal weight would, on the other hand, be more likely to attribute weight-level to personal choices. (more…)
Author Interviews, Boehringer Ingelheim, Dermatology, Pharmacology / 08.03.2017

MedicalResearch.com Interview with: Andrew Blauvelt, M.D., M.B.A. President and Investigator Oregon Medical Research Center  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Findings from the Phase 3 VOYAGE 1 study showed that patients with moderate to severe plaque psoriasis receiving guselkumab, an human anti-interleukin (IL)-23 monoclonal antibody, achieved significant improvement in skin clearance and in comparison with Humira® (adalimumab), a TNF blocker.  The Phase 3 study and head-to-head analysis of guselkumab vs. adalimumab showed the significant and durable efficacy of guselkumab as maintained through one year when compared with adalimumab, and the robust efficacy of this novel IL-23 targeted therapy in meeting all primary and major secondary endpoints. (more…)
Author Interviews, JAMA, Pain Research, Stroke / 08.03.2017

MedicalResearch.com Interview with: Alessandro Pezzini, MD, FESO Professore Associato di Neurologia Dipartimento di Scienze Cliniche e Sperimentali Clinica Neurologica Università degli Studi di Brescia Italia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Scarce reports have suggested that a relation might exist between migraine and cervical artery dissection (CEAD), the most frequent cause of ischemic stroke in young adults in Western countries. However, data available so far were obtained from few studies conducted on small cohorts of patients, which limits the generalizability of their findings. In our study we analysed the data from the Italian Project on Stroke in Young Adults (IPSYS) project, one of the largest registries of young ischemic stroke patients, and observed that migraine, especially the subtype without aura was strongly and independently associated to CEAD. This seems particularly true for men and for people younger than 39 years. (more…)
Author Interviews, Colon Cancer / 08.03.2017

MedicalResearch.com Interview with: Rebecca L. Siegel, MPH Surveillance and Health Services Research American Cancer Society Atlanta, GA  MedicalResearch.com: What are the main findings? Response: It was known that colorectal cancer incidence rates are declining rapidly in people 50 years and older, but curiously increasing in people younger than 50 years. For a more comprehensive understanding of incidence patterns, we examined CRC incidence trends by 5-year age group and year of birth using age-period cohort analysis. This modeling technique helps enhance the understanding of disease trends by disentangling factors that influence all ages (period effects) from those that vary by generation (birth cohort effects). In incidence data for almost 500,000  colorectal cancer patients during 1974-2013, we found both period and cohort effects. However, the period effects were dwarfed by the cohort effects. The age-specific risk of colorectal cancer declined during the first half of the 20thcentury, but has increased for subsequent generations since around 1950, such that those born in 1990 have twice the risk of colon cancer and 4 times the risk of rectal cancer compared to people born in 1950. Said another way, someone in their 20s today is 4 times more likely to be diagnosed with rectal cancer than someone who was in their 20s in 1970. The risk for contemporary generations has escalated back to that of people born circa 1890. (more…)
Author Interviews, Cost of Health Care, Diabetes / 07.03.2017

MedicalResearch.com Interview with: Maria L. Alva, DPhil Public Health Economics Program RTI International 701 13 Street, NW, Suite 750 Washington, DC 20005  MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Diabetes affects more than 25 percent of Americans over 65. The estimated economic cost of diagnosed diabetes is $245 billion a year. In spite of this we have almost no evidence of the impact of programs geared to stave off the cost of diabetes. The Y-USA received a Health Care Innovation Award of $11.8 million from the Centers for Medicare & Medicaid Services to offer a diabetes prevention program to individuals 65 and over with prediabetes. The goal of the Y-USA model is to get participants to lose 5 percent or more of their body weight and gradually increase their physical activity to 150 minutes per week.  The program lasts a year. The curriculum comprises sixteen weekly core sessions about healthy eating, exercise and motivation followed by eight monthly maintenance sessions. Epidemiological data from other studies have shown that the risk of diabetes increases with increased levels of BMI. There is mounting evidence that it is possible to prevent or delay diabetes through life-style intervention. It is unclear, however, whether weight-loss interventions can yield reductions in medical spending. The objective of our analysis was to establish whether the -USA Diabetes Prevention Program reduces health care spending and utilization among fee-for-service Medicare beneficiaries. (more…)
Author Interviews, Biomarkers, Cancer Research, Genetic Research, Nature, UCSD / 07.03.2017

MedicalResearch.com Interview with: Kun Zhang, PhD Professor UCSD Department of Bioengineering La Jolla, CA 92093-0412 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have been interested in a type of chemical modification on the DNA, called CpG methylation, for years. This is like a decoration of DNA molecules that is specific to the cell type or tissue type. We were particularly interested in studying how such decoration spread along the DNA molecules. In this study, we did a very comprehensive search of the entire human genome for various human cell types and tissue types, and found close to 150,000 regions (called MHB in this study) in which adjacent CpG share the same decoration. We then went on to find out how many of such regions are unique to each normal cell/tissue type, and how many are specific to cancers. Then we took some of these highly informative regions as “biomarkers”, and showed that we can detect the absence or presence of cancer, and, in the latter case, where the tumor grow, in a patient’s blood. (more…)
Author Interviews, CT Scanning, Heart Disease, JACC / 07.03.2017

MedicalResearch.com Interview with: Won Young Kim, MD Department of Emergency Medicine Ulsan University College of Medicine Asan Medical Center Seoul, Korea MedicalResearch.com: What is the background for this study? Response: The current advanced cardiac life support guidelines recommended emergent percutaneous intervention for out-of-hospital cardiac arrest (OHCA) survivors with ST-segment elevation and suspected cardiac origin without ST-segment elevation. However, spontaneous subarachnoid hemorrhage (SAH) is a well-known cause of cardiac arrest, and its electrocardiogram may mimic myocardial infarction or ischemia. The need and timing for brain computed tomography in non-traumatic OHCA remain controversial. The present study aimed at determining the role of the post-resuscitation ECG in patients with significant ST-segment changes on initial ECG to investigate the difference in post-resuscitation ECG characteristics between OHCA patients with SAH and those with suspected cardiac origin of OHCA. (more…)
Allergies, Asthma, Author Interviews, Biomarkers, Sleep Disorders / 07.03.2017

MedicalResearch.com Interview with: Rauno Joks, MD Associate Professor of Clinical Medicine Chief, Division of Allergy & Immunology Program Director, Allergy &Immunology Fellowship SUNY Downstate Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are circadian and circannular patterns to many diseases, including allergy and asthma. Humans spend roughly one-third of their lifetimes asleep. Your immune system never sleeps, but shifts its activity when you sleep. It is known that asthma disease activity can be worse at night - the reasons for this are complex, and may involve changes in allergic responses. We found, in a preliminary study of both adults with and without asthma, that longer duration of nighttime sleep was associated with lower levels of exhaled nitric oxide, a biomarker which is elevated in exhaled breath of those with allergic asthma. This may carry over into the afternoon as well, but the sample size was too small to fully conclude that. (more…)
Author Interviews, CDC, Dermatology, Environmental Risks, JAMA, Melanoma / 07.03.2017

MedicalResearch.com Interview with: Gery P. Guy Jr., PhD, MPH Senior Health Economist Division of Unintentional Injury CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: The incidence of skin cancer is increasing in the United States, and individuals who indoor tan are at an increased risk of skin cancer. Treating skin cancer costs $8.1 billion annually. The number of high school students who indoor tan dropped by half from 2009 to 2015. In 2015, 1.2 million high school students indoor tanned, down from 2.5 million in 2009. This is a much bigger decrease than we have seen in the past and is an encouraging finding. We also found that 82% of indoor tanners reported sunburn in the past year compared with 54% of those who did not engage in indoor tanning. (more…)
Author Interviews, Lancet, Stroke / 07.03.2017

MedicalResearch.com Interview with: Caterina Breitenstein, PhD Department of General Neurology, University of Muenster, Germany Annette Baumgärtner, PhD Faculty of Health and Social Sciences, Fresenius University of Applied Sciences, Hamburg, Germany MedicalResearch.com : What is the background for this study? What are the main findings? Response: For a long time, it has been assumed that language recovery is limited to the first months after the initial stroke. During the past two decades, however, several clinical studies and systematic reviews have challenged this dogma by demonstrating functional gains in stroke survivors during the chronic post-stroke stage (at least 6 months post the initial stroke) whenever speech and language therapy (SLT) intensity was sufficiently high (i.e., at least 5 h/week for several weeks). These studies, however, lacked the methodological quality required for evidence-based interventions (for criteria, please refer to http://www.cebm.net/ocebm-levels-of-evidence). Until now, this lack in evidence severely hampers stroke survivors’ access to language rehabilitation services . The present multicenter randomized controlled healthcare trial FCET2EC (acronym stands for "From Controlled Experimental Trial to=2 Everyday Communication) is the first study worldwide to compare three weeks of intensive SLT provided under routine clinical conditions to an equally long period of no (or low intensity) SLT. After 3 weeks of intensive individualized therapy, the 156 stroke survivors with chronic aphasia verbally expressed themselves more effectively in daily-life communicative situations, like changing a doctor’s appointment by a telephone call. Additionally, patients and their significant other rated their communication-related quality of life as significantly improved. Last but not least, therapy effects remained stable over a follow-up period of six months after the intensive intervention. (more…)
Author Interviews, Dermatology, Global Health, JAMA / 07.03.2017

MedicalResearch.com Interview with: Chante Karimkhani, MD University Hospitals Case Western Medical Center, Cleveland, Ohio now with Department of Dermatology University of Colorado, Denver MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ranging from benign inflammatory to infectious, autoimmune, and malignant conditions, skin diseases cause significant disfigurement, pain, and psychological morbidity. The Global Burden of Disease (GBD) Study 2013 is a large-scale epidemiological assessment of burden from 306 diseases in 195 countries, both sexes, and 14 age groups. Disease burden is measured by combining morbidity and mortality into a single metric of disability-adjusted life years (DALYs), where one DALY is equivalent to one year of healthy life lost. Skin diseases contributed 1.79% of the total global burden from all diseases. The skin diseases arranged in order of decreasing global DALYs are: dermatitis (atopic, contact, seborrheic), acne vulgaris, urticaria, psoriasis, viral skin diseases, fungal skin diseases, fungal skin diseases, scabies, melanoma, pyoderma, cellulitis, keratinocyte carcinoma (basal and squamous cell carcinomas), decubitus ulcer, and alopecia areata. Younger populations had the greatest burden from infectious skin conditions, while acne caused the greatest burden in the second and third decades of life. Elderly populations had the greatest DALY rates from melanoma and keratinocyte carcinoma. Skin conditions also exhibit distinct geographical patterns of disease burden. (more…)
Author Interviews, Cost of Health Care, Hearing Loss / 07.03.2017

MedicalResearch.com Interview with: Larry Humes, PhD, CCC-A Department of Speech and Hearing Sciences Indiana University Bloomington MedicalResearch.com: What is the background for this study? What are the main findings? Response: About 40% of adults over the age of 60 have significant hearing loss, yet only about 20% of these older Americans seek help and eventually purchase hearing aids.  There have been several national calls for improvements in the accessibility and affordability of hearing health care for adults, especially older adults, including a 2015 report by the President’s Council of Advisors in Science and Technology and a 2016 report by the National Academies of Science, Engineering and Medicine.  One strategy in common to both of these recent reports is to make hearing aids available directly to the consumer via over-the-counter service delivery. This study was a double-blind placebo-controlled randomized clinical trial investigating two different service-delivery approaches, best-practices and over-the-counter, and two different purchase prices for the hearing aids ($600/pair, $3600/pair).  For the most part, purchase price had no influence on outcomes.  Hearing aids delivered via the best-practices service-delivery model were confirmed to be efficacious, but almost identical positive outcomes were obtained via the over-the-counter service-delivery approach. (more…)
Author Interviews, Blood Pressure - Hypertension, Genetic Research, Kidney Disease, Nature, Race/Ethnic Diversity, University of Pennsylvania / 07.03.2017

MedicalResearch.com Interview with: Katalin Susztak MD, PhD Associate Professor of Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies showed an association between genetic variants in the APOL1 gene and kidney disease development, but it has not been confidently shown that this genetic variant is actually causal for kidney disease. For this reason we developed a mouse model that recapitulates the human phenotype. (more…)