Avoid stomach acid triggers like caffeine, alcohol, and fatty foods. Eating smaller meals and snacks throughout the day instead of three...
Avoid stomach acid triggers like caffeine, alcohol, and fatty foods. Eating smaller meals and snacks throughout the day instead of three...
Sneha Vaddadi[/caption]
Sneha Vaddadi, BS
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: The prescription stimulants methylphenidate, amphetamine, and lisdexamfetamine, classified as Schedule II substances, are sympathomimetic drugs with therapeutic use widely used in the US for Attention Deficit Hyperactivity Disorder. Changes in criteria for diagnosis of Attention Deficit Hyperactivity Disorder in 2013 and approval of lisdexamfetamine for binge eating disorder in 2015 may have impacted usage patterns.
The goal of this study1 was to extend upon past research2 to compare the pharmacoepidemiology of these stimulants in the United States from 2010–2017, including consideration to variation within geographic regions, the Hispanic population, and the Medicaid population.
Dr. Myran[/caption]
Daniel Myran, MD, MPH, CCFP, FRCPC
Family and Public Health and Preventive Medicine Physician
CIHR Fellow, Ottawa Hospital Research Institute
Department of Family Medicine Innovation Fellow
University of Ottawa
MedicalResearch.com: What is the background for this study?
Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Canada took phased approach to legalization initially only allowing flower-based cannabis products and oils and after one year permitting the sale of commercial cannabis edibles (e.g. THC containing candies, baked goods, and drinks). In this study we took advantage of this phased roll out of legal cannabis to understand the impact of legalization on cannabis exposures or poisonings in children aged 0-9 years and the contribution of different types of cannabis products to these events.
Dr. Dumitriu[/caption]
Dani Dumitriu, MD, PhD
Assistant Professor of Pediatrics (in Psychiatry)
The Sackler Institute for Developmental Psychobiology
Columbia University, New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A lot of research has focused on the effects of COVID-19 in various vulnerable populations, such as elderly individuals, immunocompromised patients, and individuals with severe comorbidities. However, one vulnerable population that has remained relatively understudied are the infants exposed to maternal COVID-19 disease during pregnancy.
While early on in the pandemic we and other groups showed reassuring data on low risk of vertical transmission, meaning the passing of the virus from mother-to-infant is rare, this does not necessarily mean that these infants wouldn't experience long-term consequences related to the maternal infection through other means. We know from other viral illness that maternal illness, most commonly through the activation of her immune system, can lead to a cascade of events that affect fetal development. This is why a large number of physicians and researchers at Columbia University spearheaded the COVID-19 Mother Baby Outcomes (COMBO) Initiative -- to look at potential long-term health effects on both infants and mothers.
Dr. Schummers[/caption]
Laura Schummers, ScD (she/her/hers)
Postdoctoral Fellow, Contraception and Abortion Research Team
CIHR Patient-Oriented Research Leadership Fellow
Post-doctoral Trainee, ICES McMaster
UBC - Department of Family Practice | Women's Health Research Institute
MedicalResearch.com: What is the background for this study?
Response: Canada was the first country in the world to remove all supplemental restrictions on the dispensing and administration of mifepristone, making the drug available as a normal prescription. This meant that the abortion pill could be prescribed by any doctor or nurse practitioner, dispensed by any pharmacist, and taken by patients when, where and if they choose.
Dr. Blank[/caption]
Dr. Thomas Blank PD Dr.
Institute of Neuropathology, Faculty of Medicine
University of Freiburg
Freiburg, Germany
MedicalResearch.com: What is the background for this study?
Response: There has been growing evidence of the benefits of fecal transplants in some medical conditions, like cancer, hypertension and obesity for several years. In fish, it’s been shown that their lifespan could be extended significantly after fecal transplant from young fish. When we found an impact on cognitive function in mice from a fecal transplant, we decided to research and isolate how that biological mechanism was implemented.
Sean C. Rose, MD
Child Neurology
Nationwide Children’s Hospital
The Ohio State University, Columbus
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is conflicting evidence regarding the association between repetitive head impacts during youth contact sports and worse neurocognitive outcomes. Most research has been conducted in older adults, while the research in children is mostly limited to 1-2 sports seasons.
Dr. O'Donnell[/caption]
Julie O’Donnell, PhD MPH
Division of Overdose Prevention
National Center for Injury Prevention and Control
CDC
National Network of Public Health Institutes
New Orleans, Louisiana
MedicalResearch.com: What is the background for this study?
Response: The estimated number of drug overdose deaths in the US surpassed 100,000 over a 12-month period for the first time during May 2020-April 2021, driven by the involvement of synthetic opioids other than methadone (mainly illicitly manufactured fentanyl (IMF)), according to data from the National Vital Statistics System.
The State Unintentional Drug Overdose Reporting System (SUDORS) is a CDC-funded surveillance program that has collected detailed data on unintentional and undetermined intent drug overdose deaths since 2016 from death certificates, medical examiner and coroner reports, and full postmortem toxicology reports. SUDORS data allow for the analysis specifically of deaths involving fentanyl (rather than the larger category of synthetic opioids), and contain information about decedent demographics and other characteristics, as well as circumstances surrounding the overdose that might help inform prevention.
Dr. Eberly[/caption]
Lauren A. Eberly, MD, MPH
Clinical Fellow, Cardiovascular Medicine
Perelman School of Medicine
Cardiovascular Division, Perelman School of Medicine
Center for Cardiovascular Outcomes, Quality, and Evaluative Research,
Cardiovascular Center for Health Equity and Social Justice,
Leonard Davis Institute of Health Economics
University of Pennsylvania, Philadelphia
MedicalResearch.com: What is the background for this study?
Response: Racial inequities are pervasive in our country, and cardiovascular therapeutics with proven benefit have been shown to be underutilized among Black and Latinx patients.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a recommended treatment option for glycemic control in patients with diabetes, have recently emerged as a cardioprotective therapy as multiple large randomized clinical trials have shown they prevent cardiovascular events among patients with Type 2 Diabetes (T2D), particularly patients with established atherosclerotic cardiovascular disease (ASCVD). Given this, they are now recommended therapy for patients with diabetes and established or high risk of ASCVD.
Given the known inequitable utilization of other therapies, along with the known higher burden of diabetes and cardiovascular disease among Black patients, the aim of this study was to evaluate the uptake of GLP-1 RA as well as for inequities in utilization.
Seeing a close friend or family member struggle with their mental health can be difficult. Mental health issues are incredibly personal and can have a wide-reaching effect on all aspects of a person's life. For this reason, you might be currently looking for the best ways in which to support a friend who is struggling with their mental health.
It is crucial to remember that there is only so much that you can do when it comes to supporting a friend with their mental health struggles. The reality of things is that they might not yet be ready to accept the help that they need to get better and cope with their mental health condition.
Regardless of this, though, you can still acquire as much information about the subject as possible so that you can be ready to support them as and when they are ready to accept the help.
Here are some of the best ways in which you can help support a friend who is struggling with their mental health.
Dr. Deshmukh[/caption]
Ashish A. Deshmukh, PhD, MPH
Associate Professor, Management, Policy & Community Health
Associate Director, Center for Health Services Research
Co-director, Clinical Analytics and Decision Science Lab
UTHealth School of Public Health
Houston, TX 77030
MedicalResearch.com: What is the background for this study?
Response: Oropharyngeal cancer is the most common cancer caused by human papillomavirus (HPV) in the United States (US). We know from previous studies that oropharyngeal cancer to be one of the fastest rising cancers in the US. However, trends (i.e., extent of change) in incidence rates among men and women in all 50 US states and trends according to tumor diagnostic characteristics (i.e., stage, size) have not been comprehensively studied. In addition, no prior study evaluated contemporary trends in oropharyngeal cancer mortality (death) rates in the US. Our study provides a comprehensive picture of oropharyngeal cancer incidence and mortality (according to age, stage, tumor size, and state of residence) in all 50 states and DC.
Jiawen Liu[/caption]
Jiawen Liu, PhD student
Department of Civil & Environmental Engineering
University of Washington
MedicalResearch.com: What is the background for this study?
Response: As previous literature has documented, racial/ethnic minority populations and lower-income populations in the US often experience higher-than-average burdens of air pollution and its associated health impacts.
The disparities vary by pollutant, location, and time. In 2014, Clark et al. found higher average NO2 exposure for nonwhites than for whites and for below-poverty-level than for above-poverty-level. Clark et al. (2017) expanded research for NO2 exposure by race-ethnicity and socioeconomic status to 2000 and 2010 and found that absolute racial-ethnic disparities decreased over time while relative racial-ethnic disparities persisted.
Dr. Ooi Eng Eong[/caption]
Professor Ooi Eng Eong
Programme in Emerging Infectious Diseases
Duke-NUS Medical School
Professor, Saw Swee Hock School of Public Health
National University of Singapore
Co-director, Viral Research And Experimental Medicine Centre
MedicalResearch.com: What is the background for this study?
Response: The emergence of Zika virus as a cause of fetal developmental disorder, or congenital Zika syndrome (CZS), mirrors the impact of congenital rubella syndrome on public health. Congenital rubella syndrome was controlled through the development of a live attenuated rubella virus vaccine that, when given to young children, elicited long-lasting immunity that protected against rubella well into adulthood.
Indeed, live viral vaccines cause subclinical infection to elicit immunity that approaches those that develop following wild-type viral infection. However, the boundary between attenuated and virulent Zika virus has not been clearly defined, making development of any live attenuated Zika virus vaccine risky.
Shuchi Anand, MD MS (she/her)
Assistant Professor in Medicine
Director, Center for Tubulointerstitial Kidney Disease
Stanford University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A majority of people on dialysis who completed vaccination as of September 2021 have had a decline in antibody response to levels that would render them vulnerable to infection. Antibody response immediately after vaccination and circulating antibody response is strongly associated with risk for breakthrough after the initial vaccination series.
Dr. Mapara[/caption]
Markus Y Mapara, MD
Professor of Medicine
Director of the Blood and Marrow Transplantation
Columbia University Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Sickle cell disease is caused by a point mutation in the beta-globin gene of hemoglobin resulting in the production of abnormal hemoglobin which leads to formation of sickle-shaped RBC under conditions of low oxygen. Sickle cell disease affects about 100,000 patients in the US which are predominantly African American. The only curative approach is to perform an allogeneic bone marrow transplant which is however fraught with significant treatment-related risks if a matched sibling donor is not available.
The current study describes the successful application of a novel gene therapy to treat patients with sickle cell disease. The strategy is based on a gene-addition approach to introduce the genetic information for a Hemoglobin F-like molecule termed HgAT87Q into hematopoietic stem cells. The expression of this novel hemoglobin prevents polymerization of HgbS and has now been demonstrated to prevent the occurrence of vaso-occlusive pain crises in sickle cell disease patients.
Dr. Thorsness[/caption]
Rebecca Thorsness, PhD
Research Associate
Department of Health Services, Policy, and Practice
Brown University School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In 2019, the President signed the Advancing American Kidney Health executive order, which included provisions to increase the use of home dialysis and kidney transplant for Americans living with kidney failure. To carry out this vision, the Centers for Medicare & Medicaid Services (CMS) developed the ESRD Treatment Choices (ETC) payment model, which uses financial incentives and penalties to incentivize dialysis facilities to pursue home dialysis or kidney transplant for their patients.
Transplant and home dialysis are optimal care for people with kidney failure, but there are social and clinical reasons that patients with high social risk (such as those exposed to racism, poverty, or housing instability) may not be candidates for these treatments. This means that facilities which serve a large number of patients with high social risk might be disproportionately penalized by this new payment model. Using data immediately prior to the implementation of the ETC model, we found that dialysis facilities that serve high proportions of patients with high social risk have lower rates of home dialysis and kidney transplantation than facilities that care for lower proportions of such patients.
Dr. Thakrar[/caption]
Ashish Thakrar, MD
Internal Medicine & Addiction Medicine
National Clinician Scholars Program
University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: About 1.8 million Americans are currently incarcerated, more than any other country in the world per capita. Of those 1.8 million, about 1 in 7 suffers from opioid addiction, putting them at high risk of overdose and death, particularly in the weeks following release.
Opioid use disorder is a treatable condition, particularly with the medications buprenorphine or methadone, but historically, prisons and jails have not offered treatment. Over the past five years, a few states and municipalities have enacted policies to provide access for OUD treatment. We examined whether these policies were actually improving access to treatment.
Dr. van Dalen[/caption]
Jan Willem van Dalen, PhD
Department of Neurology
Donders Institute for Brain, Behaviour and Cognition
Radboud University Medical Centre Nijmegen
Department of Neurology
The Netherlands3Department of Public and Occupational Health
Amsterdam UMC, University of Amsterdam, Amsterdam
MedicalResearch.com: What is the background for this study?
Response: Although high systolic blood pressure in midlife has consistently been reported as a condition that increases the risk of developing dementia in old age, reports regarding this relationship in older people have been inconsistent. One potential reason for this, is that the relationship between systolic blood pressure and dementia in later life may be U-shaped, meaning that both individuals with low and with high systolic blood pressure are at increased incident dementia risk.
This study combined data from several longitudinal cohort studies specifically designed to study incident dementia in older people, to investigate whether these U-shaped relationships exist, and in which age ranges they appear. We included more than 16,500 people aged 60 and older, with over 2,700 incident dementia cases.
Also, we aimed to investigate whether these observational associations might be caused by confounding, differences in mortality, or result from opposite relationships between certain subgroups of individuals.
Dr. Pirofski[/caption]
Liise-anne Pirofski, M.D.
Mitrani Professor of Biomedical Research
Chief, Division of Infectious Diseases
Albert Einstein College of Medicine and
Montefiore Medical Center
Liise-anne Pirofski, MD on behalf of lead authors Mila Ortigoza MD, PhD, Assistant professor at NYU Langone Health and Hyunah Yoon MD, Assistant Professor, Albert Einstein Medical Center
and the CONTAIN COVID-19 trial authors and team
MedicalResearch.com: What is the background for this study?
Response: The study was designed to determine the efficacy of COVID-19 convalescent plasma (CCP) in hospitalized patients with COVID-19. It was designed and launched in New York City in April 2020 during the height of the first COVID-19 pandemic wave and later extended to sites in Miami, Houston, and other regions affected by subsequent waves of the pandemic. At that time, there were no validated therapeutic options for COVID-19, and there was clinical equipoise for CCP use in hospitalized patients. COVID-19 convalescent plasma was considered worthy of investigation because of the historical success of convalescent plasma in prior pandemics and epidemics dating to the beginning of the 20th century, and importantly, biological plausibility because convalescent plasma contains antibodies to agents from which people have recovered, and case series and observational studies showing signals of CCP efficacy in patients with COVID-19. The trial was designed to focus on patients with moderate to severe COVID-19 who required supplemental oxygen, but not mechanical intubation. At the time the trial was designed, hospitals in New York City were overwhelmed with severely and critically ill patients with COVID-19, an entirely new disease about which more and more was learned over the 11 months the trial was conducted.
Dr. Arbel[/caption]
Ronen Arbel, PhD
Outcomes Research, Community Medical Services Division
Clalit Health Service
Tel Aviv, Israel
Director, Maximizing Health Outcomes Research Lab
Sapir College, Sderot, Israel.
MedicalResearch.com: What is the background for this study?
Response: The emergence of the SARS-CoV-2 delta variant and reduced effectiveness over time of the BNT162b2 vaccine (Pfizer-BioNTech) led to a recent Coronavirus 2019 disease (Covid-19) resurgence in early vaccinated populations.
The Israeli Ministry of Health was the first in the world to approve a third (booster) dose of BNT162b2 to cope with this resurgence.
Dr. Madden[/caption]
Jeanne Madden, PhD
Associate Professor
Department of Pharmacy and Health Systems Sciences
School of Pharmacy and Pharmaceutical Sciences
Bouvé College of Health Science
Northeastern University
MedicalResearch.com: What is the background for this study?
Response: Medicare is the US public insurance program mainly serving people 65 years and older, but also some younger adults who have long-term disabling conditions. As such, on average, the Medicare population bears a heavy burden of illness and has high health care needs, compared to the general US population. The under-65 group for the most part has quite low incomes, while the older group represents a wide spectrum, from poor to well-off. Medicare beneficiaries also differ a great deal in terms of whether they have access to supplemental insurance that can help with patient cost-sharing requirements. I’m referring to Medicaid assistance, or a self-purchased Medigap plan, or retiree health benefits, etc. The cost-sharing requirements in traditional Medicare are substantial — e.g., 20% for doctor visits — and there is no annual cap on patient out-of-pocket spending. That’s in contrast to commercial insurance and Medicare Advantage managed care plans — all of those have an annual cap on patient out-of-pocket costs.
There’s a good amount of existing research on whether people in Medicare can afford their drugs, and on the affordability of medical care among younger groups such as working-aged uninsured people and those in ACA exchange plans. But there hasn’t been much research into medical care affordability among older Americans.
Dr. Cabana[/caption]
Michael Cabana, M.D., M.A., M.P.H
Professor of Pediatrics
Albert Einstein College of Medicine.
Physician-in-chief , Children's Hospital at Montefiore
Chair of the Department of Pediatrics
Albert Einstein College of Medicine
Member, U.S. Preventive Services Task Force
MedicalResearch.com: What is the background for this study and recommendation statement?
Response: Dental caries, also known as cavities or tooth decay, is the most common chronic disease in children in the United States and can develop in any child whose teeth have come in. Many young children under five years old do not visit a dentist, so the Task Force reviewed the latest evidence on how primary care clinicians can help prevent tooth decay in young children.
The Task Force’s research led to two important findings: all young children whose teeth have come in should have fluoride varnish applied by their clinician, and all children six months and older whose water supply doesn’t contain enough fluoride should receive fluoride supplements. Both approaches can help prevent cavities in kids.
The Task Force also determined that there is not enough evidence to recommend for or against screening for tooth decay in the primary care setting for children under five. This is consistent with the Task Force’s 2014 recommendation on dental caries.
Dr. Wallis[/caption]
Christopher J. D. Wallis, MD, PhD
Assistant Professor, Division of Urology
University of Toronto
Urologic Oncologist, Division of Urology
Mount Sinai Hospital and University Health Network
MedicalResearch.com: What is the background for this study?
Response: Previous research has shown that female and male physicians communicate differently with patients. Further, there is evidence that female physicians, including surgeons, spend more time with patients. This, coupled with evidence that female patients may experience disparities in the management of their pain, led us to consider that communication differences may underpin differences in surgical outcomes previously noted (eg. Wallis et al, BMJ 2017) between male and female physicians. We postulated that there may be a differential association between surgeon sex and patient sex in behaviours that would translate into clinically important outcomes.
Dr. Daniell[/caption]
Dr. Henry Daniell Ph.D
W. D. Miller Professor & Director of Translational Research,
Vice Chair, Department of Basic and Translational Sciences,
Editor in Chief, Plant Biotechnology Journal, Oxford, UK
School of Dental Medicine,
University of Pennsylvania,
Philadelphia PA 19104-6030
MedicalResearch.com: What is the background for this study?
Response: ACE2 is a human protein present in human cells, blood and saliva. In COVID-19 patients this protein is inactivated. SARS-CoV-2 virus enters human cells using receptor of this protein. ACE2 chewing gum utilizes two different mechanisms. ACE2 enzyme directly binds to the spike protein on SARS-CoV-2 and traps virus in the chewing gum. In addition, ACE2 enzyme binds to its own receptor on oral epithelial cells, thereby blocks entry of any virus that is not trapped in the chewing gum
Dr. Esquivel[/caption]
Bernard Esquivel Zavala, MD, PhD, MHA
GenXys Chief Medical Officer
MedicalResearch.com: What is the mission of GenXys?
Response: Our mission at GenXys is to tailor the right treatment for each individual patient at the right time. GenXys founders, including Professors Pieter Cullis and Martin Dawes, were heavily involved in the precision medicine field from the very beginning, and they noticed a functional gap between the expectations and the actual clinical implementation of precision medicine Particularly, when it came to, at the time, the new field of pharmacogenetics. Their solution was to provide a comprehensive, user-friendly platform that organizes all patient data relevant to prescribing to provide the safest and most appropriate personalized prescribing options. Simply put, GenXys’ solutions were made by clinicians, for clinicians. The GenXys software suite collects patient information and categorizes that information, including pharmacogenetic data, based on clinical relevance and runs it through advanced condition -based algorithms to provide real time accurate prescribing options. It makes my life as a clinician easier and safer and gives me the confidence that I am not practicing ‘trial and error’ prescribing.
Ideally, every healthcare provider should be using a real time medication decision support solution like ours, and not just for pharmacogenetic test results. Pharmacogenomics is just one piece. In fact, our core product, TreatGx™ can run with or without pharmacogenomics. Let's say that you've run it without pharmacogenomics, meaning that you are using this tool to organize and rapidly identify how biophysical factors, liver function, kidney function, comorbidities, and drug-drug interactions may impact the medication you're about to prescribe to your patient. This functionality alone is incredibly helpful. In fact, the factors I just mentioned likely account for 95% of the reasons why a patient does not respond to a particular medication or might have an adverse drug reaction. But the TreatGx platform will also highlight when the evidence supports bringing pharmacogenomic information into the mix. The right approach is bringing all those relevant clinical, biochemical, and molecular factors closer to the provider which will ultimately foster personalization. We will start treating the individual instead of the disease(s).
As with any new technology, there are barriers to precision prescribing. This includes educational and emotional barriers. It’s important to educate providers and keep them up to date to help them understand the power that precision prescribing can bring into their practice—and the limitations—to set the right level of expectation. The Human Genome Project was finished in 2000, and there was a lot of buzz about pharmacogenomics even back in 2003. The field got a lot of traction in 2015. So, everyone thought, "Oh, this is going to be groundbreaking and quite disruptive. From now on my prescription is going to be a hundred percent accurate and safe." But it's not quite the whole story. Pharmacogenomics has to be considered as another piece of the puzzle. It's like saying that by having an MRI, you're curing cancer. It's just another piece of the treatment puzzle. There are also emotional barriers, where ego can factor into a decision. It can be uncomfortable for a physician to say, "I don't know this. Let me check it out. Let me explore it further, review, and come back to you." It's easier to say if I don't know it, that it doesn't work or isn’t relevant, rather than exposing yourself. And so that, in terms of the emotional piece, I would say is a big component. We can tackle the emotional component that element by fostering education and bringing education closer to providers.
Dr. Bacharier[/caption]
Leonard B. Bacharier, MD
Janie Robinson and John Moore Lee Chair in Pediatrics
Professor of Pediatrics
Director - Center for Pediatric Asthma Research
Scientific Director - Center for Clinical and Translational Research
Section Chief - Pediatric Allergy and Immunology
Division of Allergy, Immunology and Pulmonary Medicine
Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center
MedicalResearch.com: What is the background for this study? Is Dupilumab used for other atopic conditions, ie eczema/atopic dermatitis?
Response: Many children with moderate-severe asthma continue to experience asthma exacerbations and poor asthma control despite use of controller therapies. Dupilumab has been shown to reduce asthma exacerbations in adolescents and adults, as well as to improve atopic dermatitis in children and adults.