Author Interviews, Cost of Health Care / 19.05.2016

MedicalResearch.com Interview with: Mike Rosenbaum Founder and CEO Pegged Software Mr. Mike Rosenbaum Founder and CEO Pegged Software MedicalResearch.com editor’s note: As part of an ongoing series on changes in the health care landscape, we interviewed Mr. Mike Rosenbaum, founder of Pegged Software.  Pegged Software uses an advanced "analytics engine to selecting job candidates based on the actual determinants of high performance", specifically in the health care field. The Pegged team “serves a broad set of healthcare organizations, applying modern technology and data tools to workforce construction and talent identification”.  MedicalResearch.com: Can you tell us a little about yourself?  How did you get interested in this field? Mr. Rosenbaum: I was on a path to become an academic, and as a fellow at Harvard I was interested in, and doing research about, and writing on topics related to the application of data to the most subjective areas of human endeavor.  My interest in the application of predictive analytics to talent grew out of that work. I initially started a business that applied these concepts to the software engineering space, and in 2009 I met an executive at a hospital who explained to me the issue they were facing and asked if I could help.  We ended up making a copy of the same technology we used in the software engineering space and putting it in a new company, which we called Pegged Software, and built that technology specifically for the healthcare and hospital space.  We ran the technology in that hospital and several others for about two and a half years, and in that time our best deployment reduced turnover by 77% and our worst reduced turnover by 45%.  So in late 2012 we started building out the team, and today we are deployed into over 400 healthcare facilities and have a median impact of a turnover reduction of 38%. (more…)
Author Interviews, Diabetes, Environmental Risks / 19.05.2016

MedicalResearch.com Interview with: Kathryn Reid PhD Research associate Professor of Neurology Northwestern University Feinberg School of Medicine.  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Reid: There is increasing evidence that light and dark exposure patterns over time impact health outcomes such as body weight and food intake. This study found that bright light exposure increased insulin resistance compared to dim light exposure in both the morning and the evening. In the evening, bright light also caused higher peak glucose (blood sugar) levels. (more…)
Author Interviews, Exercise - Fitness, Orthopedics / 19.05.2016

MedicalResearch.com Interview with: Robert Keller, M.D., Chief resident Department of Orthopedic Surgery Henry Ford Hospital Detroit MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Keller:  Injuries to the medial ulnar collateral ligament (the ligament torn in pitchers requiring tommy john surgery) are common in overhead-throwing athletes. Recent data supports that the number of MLB pitchers requiring tommy john surgery continues to increase, with estimates near 25% of all MLB pitchers undergoing tommy john surgery.   Recent investigations have attempted to analyze factors that contribute to UCL injuries with the aim to decrease the rate of injury. Studies have suggested that possible risk factors include pitching mechanics, pitch type (curve ball, fastball, etc), g, pitching fatigue, chronic overuse, and pitch velocity, among other factors. Specifically, increased pitch velocity has been implicated as a risk factor for UCL injury.  However, no study has exclusively attempted to assess whether MLB pitchers who required Tommy John surgery pitch at a higher velocity than those that do not. Pitch type (fastball, curveball, slider, etc) is another significant factor that has been investigated as a contributor to UCL injuries. Various biomechanical studies have attempted to correlate pitch types with torque across the throwing elbow, with contrasting results: some suggest fastballs create more torque, whereas others found off-speed pitches produce increased stresses. Beyond not evaluating MLB pitchers, these previous studies also failed to evaluate the volume or amount of a specific pitch type thrown by these pitchers that may contribute to UCL injuries. (more…)
Author Interviews, Multiple Sclerosis, PLoS, Vitamin D / 19.05.2016

MedicalResearch.com Interview with: Ms Emily Weiss PhD student Centre for Population Health Sciences The University of Edinburgh

MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Vitamin D deficiency, a marker of low ultraviolet (UV) exposure, is common in Scotland; both have been shown to work independently as risk factors for multiple sclerosis (MS). Orkney, situated to the north of mainland Scotland has a very high prevalence of MS. We therefore wanted to understand how vitamin D in Orkney compares to mainland Scotland’s vitamin D, and also what may be determining vitamin D levels in Orkney. (more…)
Author Interviews, JAMA, Pediatrics / 19.05.2016

MedicalResearch.com Interview with: PD Dr. med. Giancarlo Natalucci OberarztKlinik für Neonatologie UniversitätsSpital Zürich MedicalResearch.com: What is the background for this study? Dr. Natalucci:: Survival of very preterm infants has increased over the last decades but still they are at risk of developing long-term neurodevelopmental delay. The underlying pathology is termed encephalopathy of prematurity where both structural lesions of the very fragile brain and the disturbance of the physiologic maturational processes are recognized as the main causative entities. Among many pharmacological candidates to prevent brain injury and improve development, erythropoietin has been shown to be among the most promising. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Columbia, Cost of Health Care / 19.05.2016

MedicalResearch.com Interview with: Nathalie Moise, MD, MS Assistant Professor Center for Behavioral Cardiovascular Health Department of Medicine Columbia University Medical Center New York, NY 10032 MedicalResearch.com: What is the background for this study? Dr. Moise:  Our research aimed to compare the number of lives saved and changes in medical costs expected if intensive blood pressure goals of less than 120 mmHg were implemented in high cardiovascular disease risk patients. In 2014, the 8th Joint National Committee (JNC8) on Detection, Evaluation, and Treatment of High Blood Pressure issued new guidelines recommending that physicians aim for a systolic blood pressure (SBP) of 140 mmHg in adults with diabetes and/or chronic kidney disease and 150 mmHg in healthy adults over age 60. The new guidelines represented a major departure from previous JNC7 guidelines recommending SBPs of 130 mmHg and 140, mmHg for these groups, respectively. Under the 2014 guidelines, over 5 million fewer individuals annually would receive drug treatment to lower their blood pressure, compared with the prior 2003 guidelines. Recently, the Systolic Blood Pressure Intervention Trial (SPRINT) found that having a more intensive systolic blood pressure (SBP) goal of 120 mmHg in patients at high risk for cardiovascular disease reduced both cardiovascular events and mortality by about one quarter, compared with the current goal of 140 mmHg. These recent studies and guidelines have created uncertainty about the safest, most effective and high-value blood pressure goals for U.S. adults with hypertension, but no prior study has compared the cost-effectiveness of adding more intensive blood pressure goals in high cardiovascular disease risk groups to standard national primary prevention hypertension guidelines like JNC8 and JNC7. Our team at Columbia University Medical Center conducted a computer simulation study to determine the value of adding the lower, life-saving  systolic blood pressure goal identified in SPRINT to the JNC7 and JNC8 guidelines for high-risk patients between the ages of 35 and 74 years. (High risk was defined as existing cardiovascular disease, chronic kidney disease, or a 10-year cardiovascular disease risk greater than 15 percent in patients older than 50 years and with a pre-treatment SBP greater than 130 mmHg) (more…)
Aging, Author Interviews, Blood Pressure - Hypertension, Melatonin / 19.05.2016

MedicalResearch.com Interview with: Dr. Denis Gubin The Tyumen Medical University Tyumen, Russia MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Gubin: The older we get, the more likely our circadian rhythms are disrupted. For example, blood pressure, BP, not only tends to increase but as well become more irregular. One of the possible causes is an age-dependent deficit of endogenous melatonin production. We have shown that exogenous melatonin helps to ameliorate both trends – lowers  blood pressure and also stabilizes and synchronizes blood pressure and heart rate variability. (more…)
Author Interviews, Microbiome / 19.05.2016

MedicalResearch.com Interview with: Martha Colin Founder of The BioCollectiveMartha Carlin Founder of The BioCollective MedicalResearch.com Editor’s Note: In recognition of the National Microbiome Initiative (NMI) announced by the White House Office of Science and Technology Policy, Martha Carlin, founder of the The BioCollective, discussed this research effort for the readers of MedicalResearch.com. ‘The BioCollective, is a direct-to-consumer microbiome marketplace where members receive a percentage of revenue from microbiome sample sales to scientists. By becoming a member of The BioCollective, individuals help advance microbiome research and learn about their own microbiome along the way.’  MedicalResearch.com: Would you tell us a little about yourself? How did you become interested in microbiomes? Martha Carlin: My husband was diagnosed with Parkinson’s Disease (PD) in 2002. At the time, John was 44 years old, a marathon runner and life-long athlete. He had always been healthy. We were both perplexed by both his diagnosis and wanted to do everything we could to maintain his quality of life as well as hinder the progression of the disease. Although I did not have a scientific background, I began studying the many fields of science so that I could piece together my observations of his health and his life history in my search for answers. After reading Dr. Martin Blaser’s Missing Microbes in 2014, I later connected it to Dr. Filip Scheperjans’ research showing a correlation between the presence or absence of specific gut bacteria and symptoms in Parkinson’s Disease. This accelerated my research and led me to Dr. Jack Gilbert at the University of Chicago who later became one of my co-founders. I started working with Jack on sequencing samples and learning more about the field of microbiome research. From this work, we saw a need for samples to accelerate the research and founded The BioCollective with our third co-founder, Dr. Suzanne Vernon. MedicalResearch.com: Can you briefly explain what a microbiome is? Does it just refer to the organisms in our intestines or are there other microbiomes? Are microbiomes unique to an individual or a community? Martha Carlin: The microbiome is the sum total of microbial life in your body - the bacteria, archaea, fungi and viruses that call you home. There are 100 trillion microbial cells in your body, and they collectively can influence your health in profound ways. The possibilities in microbiome research are exciting. It has the potential to create technologies as revolutionary as probiotics to prevent obesity and allergies; “living” buildings that reduce the spread of viruses or allergens in schools and offices; personalized diets to treat depression; growth-promoting animal feed that eliminates the need for growth-promoting antibiotics; bacteria to reduce methane production in cows and flooded soils; plant-microbiome interactions that suppress disease and improve productivity, and bacterial cocktails that restore the health of damaged aquatic ecosystems ranging from streams to oceans. (more…)
Author Interviews, Cannabis, OBGYNE, Pediatrics, Toxin Research / 18.05.2016

MedicalResearch.com Interview with: Professor Claire Roberts PhD Robinson Research Institute Adelaide University MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Roberts: Our research aimed to identify novel risk factors for the four main complications of pregnancy;
  • preeclampsia where the mother gets high blood pressure and her kidneys don’t work properly,
  • preterm birth which is delivery before 37 weeks of gestation,
  • small for gestational age and
  • gestational diabetes. We have studied over 5500 pregnant women in 6 centres in 4 countries, Australia, New Zealand, the UK and Ireland. We have identified a number of factors that contribute to these major pregnancy complications. However, in this paper we have focused on well known risk factors for pregnancy complications including maternal cigarette smoking, BMI and socioeconomic status. To these we added maternal use of marijuana before pregnancy, in first trimester, at 15 weeks and at 20 weeks gestation. After adjusting the data for the other factors, we found that continued maternal marijuana use at 20 weeks gestation is strongly associated with spontaneous pre-term birth independent of maternal cigarette smoking. Women who continued to use marijuana at 20 weeks’ gestation were over 5 times more likely to deliver preterm than women who did not use marijuana. Previous studies have shown conflicting evidence but none have accounted for maternal cigarette smoking.
Importantly, not only did continued use of marijuana increase risk for preterm birth but it also made these births 5 weeks earlier on average with a greater number of women delivering very preterm. That is much more dangerous for the baby who inevitably would require admission to a neonatal intensive care unit (NICU). Earlier delivery would be expected to increase the baby’s risk for dying and having long term disabilities. (more…)
Author Interviews, Pediatrics, Weight Research / 18.05.2016

MedicalResearch.com Interview with: Dr Gerda Pot Lecturer in Nutritional Sciences King’s College London | Faculty of Life Sciences & Medicine Diabetes & Nutritional Sciences Division | London UK MedicalResearch.com: What is the background for this study? Dr. Pot: Previous evidence suggested that the timing of food intake can have a significant impact on circadian rhythms (i.e. the body's internal clock) and therefore on metabolic processes within the body, potentially leading to an increased risk of being overweight or obese. However, the evidence from studies in children is very limited so we set out to establish whether this risk was also associated with the timing of children's evening meals.  MedicalResearch.com: What are the main findings? (more…)
Author Interviews, Columbia, Pediatrics, Toxin Research, Weight Research / 18.05.2016

MedicalResearch.com Interview with: Lori A. Hoepner, DrPH Department of Environmental Health Sciences Columbia University New York, NY 10032 MedicalResearch.com: What is the background for this study? Dr. Hoepner: The Columbia Center for Children’s Environmental Health was funded starting in 1998.  Pregnant African American and Dominican mothers residing in Northern Manhattan and the South Bronx were enrolled from 1998 to 2006, and mothers and their children have been followed since this time.  We collected urine samples from the pregnant mothers in their third trimester and from the children at ages 3 and 5.  At ages 5 and 7 we measured the height and weight of the children, and at age 7 we also measured body fat and waist circumference. MedicalResearch.com:  What are the main findings? Dr. Hoepner:  We found a significant association between increased prenatal exposure to Bisphenol A (BPA) and increases in childhood body fat measures of waist circumference and percent body fat at age 7.  Our research builds on earlier findings of an association between prenatal exposure to BPA and body fat in children up to age 4, and this is the first study to report an association at age 7. (more…)
Author Interviews, Heart Disease / 18.05.2016

MedicalResearch.com Interview with: Paul D. Loprinzi, PhD. Assistant Professor Health, Exercise Science & Recreation Management and Ovuokerie Addoh, MBBS. PhD Student: Health Behavior & Promotion. Graduate Asst: Cardiac Rehabilitation The University of Mississippi University, MS MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Pooled Cohort Risk (PCR) equations, developed by the American College of Cardiology/American Heart Association (ACC/AHA), were initially developed to predict an individual’s 10-year risk of a first atherosclerotic cardiovascular disease (ASCVD) event. Individuals with a PCR score of 7.5% or higher are considered to have an elevated risk of a first ASCVD event within 10 years. The PCR equation takes into consideration an individual’s age, gender, race-ethnicity, total cholesterol level, high density lipoprotein (HDL) cholesterol, treated or untreated blood pressure, diabetes status, and smoking status. The PCR equations have previously been utilized to predict an individual’s 10-year risk of a first ASCVD event; however, less research has evaluated the extent to which the equations can predict an individual’s risk for early mortality. Adults 40-79 years and free of cardiovascular disease (CVD) who had a higher score from the PCR equations had an increased risk of CVD-specific and all-cause mortality risk. Adults with a higher PCR score had a 47% to 77% increased risk of all-cause mortality. (more…)
Author Interviews, Gastrointestinal Disease, Infections, Technology / 18.05.2016

MedicalResearch.com Interview with: Sushanta K. Mitra, PhD, PEng Associate Vice-President Research Kaneff Professor in Micro & Nanotechnology for Social Innovation FCSME, FASME, FEIC, FRSC, FCAE, FAAAS Y York University Toronto  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Mitra: As a mechanical engineer I got interested in the water problem when I had discussions with Tata Consultancy Services (TCS), India and the tertiary public health centre doctors near Mumbai, where the doctors had to deal with large number of patients with water-borne diseases. This was hugely a challenge from resource point of view as the doctors would much preferred to have their attention focused on more pressing diseases. They approached me about developing tools for rapid detection of water-borne pathogen in drinking water. Hence, my journey started on water quality monitoring. MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Mitra: Here, we have developed a low-cost compact E. coli and total coliform detection system, which uses commercially available plunger-tube assembly. We incorporate a hydrogel (porous matrix) inside the tube so that the plunger-tube assembly act as a concentrator and a detector at the same time. Specially formulated enzymatic substrates are caged inside the hydrogel so that an E. coli cell trapped within the hydrogel will be lysed and react with the  enzymatic substrates to produce a red color. (more…)
Author Interviews, Breast Cancer, Weight Research, Women's Heart Health / 18.05.2016

MedicalResearch.com Interview with: Julie M. Kapp, MPH, PhD Associate Professor 2014 Baldrige Executive Fellow University of Missouri School of Medicine Department of Health Management and Informatics Columbia, MO 65212 MedicalResearch.com: What is the background for this study? Dr. Kapp: For the past several decades the U.S. has had the highest obesity rate compared to high-income peer countries, and for many years people in the U.S. have had a shorter life expectancy. For female life expectancy at birth, the U.S. ranked second to last. At the same time, the U.S. has the third highest rate of mammography screening among peer countries, and the pink ribbon is one of the most widely recognized symbols in the U.S. While the death rate in females for coronary heart disease is significantly higher than that for breast cancer, at 1 in 7.2 deaths compared to 1 in 30, respectively, women have higher levels of worry for getting breast cancer. (more…)
Author Interviews, Blood Pressure - Hypertension, BMJ, Brigham & Women's - Harvard, Nutrition / 18.05.2016

MedicalResearch.com Interview with: Lea Borgi, MD, MMSc Renal Division, Brigham and Women’s Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Borgi:   The association of potatoes intake with the risk of developing hypertension has not been studied. In our analyses of more than 187,000 participants without a diagnosis of high blood pressure at baseline, we observed that higher intakes of boiled, baked or mashed potatoes and French fries were associated with an increased risk of developing hypertension. Indeed, when participants consumed 4 or more than 4 servings per week of boiled, baked or mashed potatoes as compared to 1 or less than one serving per month, the risk of hypertension increased by 11% (and 17% when French fries were consumed 4 or more than 4 times a week as compared to 1 or less than 1 serving per month). We also found that replacing one serving of boiled, baked or mashed potatoes per day with one serving of a non-starchy vegetable was associated with a lower risk of developing hypertension. (more…)
Author Interviews, Cognitive Issues, Lifestyle & Health / 18.05.2016

MedicalResearch.com Interview with: Christian Benedict Ph.D Dept. of Neuroscience Uppsala University, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Benedict: A considerably large proportion of today’s workforce performs shift work. Both epidemiological and experimental studies have demonstrated that shift workers are at an increased risk for multiple diseases, such as cardiovascular diseases. However, knowledge regarding short- and long-term effects of shift work on parameters of brain health is still fragmentary. (more…)
Asthma, Author Interviews, NEJM, NIH, Pediatrics, Pulmonary Disease / 18.05.2016

MedicalResearch.com Interview with: Dr. James P. Kiley Ph.D National Institutes of Health Bethesda Maryland  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Kiley: While a higher proportion of children have asthma compared to adults, the disease is limited to childhood for many individuals who appear to be unaffected as adults. Regardless of whether asthma continues into adulthood or reoccurs during adulthood, the impact of childhood asthma on lung function later in life is unclear. This study demonstrated that in children with chronic persistent asthma at the age of 5-12 years who continued to be followed through their early twenties, 75% of them had some abnormality in the pattern of their lung growth. The study examined the trajectory of lung growth, and the decline from maximum growth, in a large cohort of persons who had persistent, mild-to-moderate asthma in childhood and determined the demographic and clinical factors associated with abnormal patterns of lung growth and decline. (more…)
Author Interviews, Diabetes, Diabetologia, Exercise - Fitness / 17.05.2016

MedicalResearch.com Interview with: Dr Lisa Chow MD MS University of Minnesota, Minnesota, MI  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Chow: A number of previous studies have shown people who maintain or increase their cardiac fitness (CRF) through adulthood have a lower risk of developing diabetes, abnormal metabolic measures, cardiovascular disease and cardiovascular mortality than those whose CRF declines. However, these previous studies are limited for several reasons, including use of a largely male population, measurement of fitness over a limited duration (5–7 years) or measurement of fitness at varying intervals prospectively. In this new research, the authors used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to objectively and rigorously analyse the link between cardiac fitness and development of either prediabetes or diabetes over a 20-year period. The main finding is that higher cardiac fitness  is associated with lower risk for developing prediabetes and diabetes, even when adjusting for prospective changes in body mass index. (more…)
Author Interviews, Education, JAMA, Sexual Health, University of Michigan / 17.05.2016

MedicalResearch.com Interview with: Reshma Jagsi, MD, DPhil Department of Radiation Oncology, University of Michigan Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Jagsi: There has recently been considerable media attention to certain egregious individual cases of sexual harassment, but it has been less clear whether these cases were isolated and uncommon incidents or whether they are indicative of situations more commonly experienced by academic medical faculty.  An excellent survey study had previously documented that 52% of female faculty in 1995 had experienced harassment, but many of those women had attended medical school when women were only a small minority of the medical students (let alone faculty).  More recent estimates of faculty experiences are necessary to guide ongoing policies to promote gender equity in an era when nearly half of all medical students are women. We found that in a modern sample of academic medical faculty, 30% of women and 4% of men had experienced harassment in their careers. (more…)
Author Interviews, Cost of Health Care, JAMA / 17.05.2016

MedicalResearch.com Interview with: Andrew M. Ibrahim, MD Robert Wood Johnson Clinical Scholar (VA Scholar), Institute for Healthcare Policy & Innovation, University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? Dr. Ibrahim: Critical access hospital designation was created to help ensure access to the more than 59 million people living in rural populations. Hospitals were eligible for critical access designation if they had less than 25 beds and were located more than 35 miles away from another hospital. With this designation they were paid above total cost for the care they provided. Previous reports suggest these centers provide lower quality of care for common medical admissions, however little was known about surgical conditions.  MedicalResearch.com: What are the main findings? Dr. Ibrahim: This study included a review of 1,631,904 Medicare beneficiary admissions to critical access hospitals (n = 828) and non-critical access hospitals (n = 3,676) for 1 of 4 common types of surgical procedures: appendectomy, gall bladder removal, removal of all or part of the colon, and hernia repair. Patient who underwent surgery at critical access hospitals were, on average, less medically complex. Compared to larger urban hospitals, these small rural hospitals (i.e. critical access hospitals) had the same 30-day mortality rates and lower complications rates. In addition, critical access hospitals costs on average $1400 less per patient to Medicare, despite being paid in an alternative payment system. These findings remained significant after accounting for the patient’s pre-operation health condition.   (more…)
Author Interviews, Brigham & Women's - Harvard, Ophthalmology, Technology / 17.05.2016

MedicalResearch.com Interview with: Sheldon J.J. Kwok MD/PhD Candidate Harvard-MIT Health Sciences and Technology | Harvard Medical School Yun Bio-Optics Lab Wellman Center for Photomedicine MGH MedicalResearch.com: What is the background for this study? Response: Corneal collagen crosslinking (CXL) using UV light and riboflavin has become a popular and effective technique for treating corneal ectatic disorders, such as keratoconus, by mechanically strengthening the corneal stroma. We were interested in enhancing the capabilities of CXL using the principle of two-photon excitation, which uses a femtosecond laser to confine crosslinking to only where the laser is focused.  By scanning the laser, this allows us to crosslink any arbitrary three-dimensional region deep inside tissue. With two-photon collagen crosslinking (2P-CXL), treatment of thin corneas is possible without affecting the underlying endothelium. Irradiation can also be patterned to improve keratocyte viability. Furthermore, selective crosslinking in three dimensions offers the possibility of modulating corneal curvature for refractive error correction. (more…)
Accidents & Violence, Author Interviews, BMJ, Mental Health Research, Pediatrics / 17.05.2016

MedicalResearch.com Interview with: Dr Edward Tyrrell NIHR In-Practice Research Fellow Division of Primary Care University Park Nottingham  MedicalResearch.com: What is the background for this study? Dr. Tyrrell: Poisonings are among the most common causes of death amongst adolescents across the world, many of them related to self-harm. Poisonings leading to death are just the tip of the iceberg with many more resulting in invasive treatment, time off school and long term health effects. Many adolescent self-harm episodes are linked to mental health problems, which are often predictive of mental health problems in adulthood, making adolescence a key window for preventative intervention. However, up to date rates and time trends for adolescent poisonings are lacking, hindering the development of evidence-informed policy and planning of services. To quantify this problem at a national level and provide recent time trends of poisonings, we used routinely collected primary care data from 1.3 million 10-17 year olds. We assessed how intentional, unintentional and alcohol-related poisonings for adolescent males and females vary by age, how these have changed between 1992 and 2012 and whether socioeconomic inequalities exist. (more…)
Author Interviews, CT Scanning, JAMA, Lung Cancer, NIH / 16.05.2016

MedicalResearch.com Interview with: Hormuzd A. Katki, PhD Division of Cancer Epidemiology and Genetics National Cancer Institute National Institutes of Health Department of Health and Human Services, Bethesda, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Katki: The National Lung Screening Trial (NLST) showed that 3 annual CT screens reduced lung cancer death by 20% in a subgroup of high-risk smokers.  However, selecting smokers for screening based on their individual lung cancer risk might improve the effectiveness and efficiency of screening.  We developed and validated new lung cancer risk tools, and used them to project the potential impact of different selection strategies for CT lung cancer screening. We found that risk-based selection might substantially increase the number of prevented lung cancer deaths versus current subgroup-based guidelines.  Risk-based screening might also improve the effectiveness of screening, as measured by reducing the number needed to screening to prevent 1 death.  Risk-based screening might also improve the efficiency of screening, as measured by reducing the number of false-positive CT screens per prevented death. (more…)
Author Interviews, Kidney Disease / 16.05.2016

MedicalResearch.com Interview with: Dr Laura E Niklason, MD PhD Department of Anesthesia & Biomedical Engineering Yale University, New Haven, CT  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Niklason:    For end stage renal disease patients who are not candidates for fistula, dialysis access grafts are the best option for chronic hemodialysis. However, polytetrafluoroethylene arteriovenous grafts suffer from high rates of thrombosis, infection and intimal hyperplasia at the venous anastomosis. We are conducting two, single arm Phase II trials where a novel bioengineered human acellular vessel (HAV) was implanted into the arms of patients for hemodialysis access. Primary endpoints were safety (freedom from immune response/infection, aneurysm, or mechanical failure, and incidence of adverse events), and efficacy as assessed by primary, primary assisted and secondary patencies at 6 months. Secondary endpoints included patency and intervention rates at 12, 18 and 24 months, and changes in panel reactive antibodies following implantation. All patients were followed for at least one year, or had a censoring event. Human acellular vessels were implanted into 60 patients at 6 centers in the US and Poland. The average duration of follow-up was 16 months (range 12 to 30); all patients have completed at least 12 months of follow-up (or been censored). (more…)
Antibiotic Resistance, Author Interviews, Gastrointestinal Disease, Infections / 16.05.2016

MedicalResearch.com Interview with: Andreas J. Bäumler, Ph.D Editor, Infection and Immunity Associate Editor, PLOS Pathogens Section Editor, EcoSal Plus Professor, Department of Medical Microbiology and Immunology Vice Chair of Research University of California, Davis School of Medicine Davis, California   MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Bäumler: Antibiotics are generally beneficial for treating bacterial infection, but paradoxically a history of antibiotic therapy is a risk factor for developing Salmonella food poisoning.  Our study reveals the mechanism by which antibiotics increase susceptibility to Salmonella infection. Antibiotics deplete beneficial microbes from the gut, which normally provide nutrition to the cells lining our large bowel, termed epithelial cells. Depletion of microbe-derived nutrients causes our epithelial cells to switch their energy metabolism from respiration to fermentation, which in turn increases the availability of oxygen at the epithelial surface. The resulting increase in oxygen diffusion into the gut lumen drives a luminal expansion of Salmonella by respiration. Through this mechanism, antibiotics help Salmonella to breath in the gut. (more…)
Author Interviews, Cost of Health Care, Gastrointestinal Disease, Hepatitis - Liver Disease / 16.05.2016

MedicalResearch.com Interview with: Darius Lakdawalla PhD Quintiles Chair in Pharmaceutical Development and Regulatory Innovation School of Pharmacy Professor in the Sol Price School of Public Policy University of Southern California  MedicalResearch.com: What is the background for this study? Dr. Lakdawalla: New treatments for hepatitis-C are highly effective but also involve high upfront costs.  Because they effectively cure the disease, all the costs of treatments are paid over a short period of time – about three months – but the benefits accrue for the rest of a patient’s life.  This creates problems for the private health insurance system, where patients switch insurers.  The insurer that pays the bill for the treatment might not be around to enjoy the benefits of averting liver damage, liver transplants, and other costly complications associated with hepatitis-C. (more…)
Author Interviews, Dermatology, JAMA, Telemedicine, UCSF / 16.05.2016

MedicalResearch.com Interview with: Jack Resneck, Jr, MD Professor and Vice-Chair of Dermatology Core Faculty, Philip R. Lee Institute for Health Policy Studies UCSF School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Resneck: Telemedicine, when done right, can improve access and offer convenience to patients.  We have seen proven high-quality care in telemedicine services where patients are using digital platforms to communicate with their existing doctors who know them, and where doctors are getting teleconsultations from other specialists about their patients.  But our study shows major quality problems with the rapidly growing corporate direct-to-consumer services where patients send consults via the web or phone apps to clinicians they don’t know. Most of these sites aren’t giving patients a choice of the clinician who will care for them or disclosing the credentials of those clinicians – patients should know whether their rash is being cared for by a board-certified dermatologist, a pain management specialist, or a nurse practitioner who usually works in an emergency department.  Some of these sites are even using doctors who aren’t licensed in the US.   We also found that these sites were regularly missing important diagnoses, and prescribing medications without discussing risks and side-effects, putting patients at risk.  We observed that if you upload photos of a highly contagious syphilis rash but state that you think you have psoriasis, most clinicians working for these direct-to-consumer sites will just agree with your self-diagnosis and prescribe psoriasis medications, leaving you with a contagious STD. Perhaps the biggest problem with many of these sites is the lack of coordinating care for patients – most of them didn’t offer to send records to a patient’s existing local doctors.  And when patients end up needing in-person care if their condition worsens, or they have a medication side-effect, those distant clinicians often don’t have local contacts, and are unable to facilitate needed appointments. (more…)
Author Interviews, CDC, Pediatrics, Weight Research / 16.05.2016

MedicalResearch.com Interview with: Chloe Barrera MPH ORISE Fellow Centers for Disease Control and PreventionChloe Barrera MPH ORISE Fellow Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have been inconsistent in whether introduction of solid foods to babies before 4 months may be associated with later obesity.  In our analysis of more than a thousand babies followed through the first year of life and contacted again at 6 years, we did not find this association. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Race/Ethnic Diversity / 16.05.2016

MedicalResearch.com Interview with: Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard T. H. Chan School of Public Health / Brigham & Women's Hospital Boston, MA 02115  Molly E. Frean Data Analyst Department of Health Policy and Management Harvard T.H. Chan School of Public Health Boston, MA 02115 MedicalResearch.com: What is the background for this study? Dr. Sommers: We conducted this study in an effort to see how Native Americans have fared under the Affordable Care Act. In addition to the law's expansion of coverage via Medicaid and tax credits for the health insurance marketplaces, the law also provided support for Native Americans’ health care specifically through continued funding of the Indian Health Service (IHS). We sought to see how both health insurance coverage patterns and IHS use changed in the first year of the law's implementation. (more…)