Prof. dr. Pottel[/caption]
Prof. dr. Hans Pottel
KU Leuven Kulak
Department of Public Health and Primary Care
Belgium
MedicalResearch.com: What is the background for this study?
Response: The glomerular filtration rate (GFR) is used to diagnose patients with chronic kidney disease and is also used to adjust the dose of drugs that are eliminated by the kidneys. An accurate estimation of GFR is considered of importance in the management of kidney health in patients. In 2021 we published a new serum creatinine based equation, called the European Kidney Function Consortium (EKFC) equation (Pottel H. et al, Development and Validation of a Modified Full Age Spectrum Creatinine-Based Equation to Estimate Glomerular Filtration Rate : A Cross-sectional Analysis of Pooled Data. Ann Intern Med (2021) 174: 183-191):
EKFC-eGFR = 107.3 / [Biomarker/Q]a x [0.990(Age – 40) if age > 40 years]
With a = 0.322 if Biomarker/Q is less than 1, and a = 1.132 if Biomarker/Q is 1 or more.
The equation can easily be interpreted: the leading coefficient equals the glomerular filtration rate (GFR) of 107.3 mL/min/1.73m², which is the average GFR in healthy children (aged > 2 years), adolescents and young adults. The average healthy GFR remains constant until the age of 40 years, and starts decreasing beyond that age. The GFR is inversely related to the ‘rescaled’ biomarker. The rescaling factor (Q) is the average biomarker value for healthy people of a specific population (e.g. children, adult men, adult women, white people, black people, …). Biomarker/Q equals ‘1’ for the average healthy person, corresponding with eGFR = 107.3 mL/min/1.73m² (up to 40 years of age).
It should be noted that for serum creatinine, the Q-value depends on sex and race.
Our hypothesis was that the above equation is valid for any renal biomarker, on the condition that the biomarker is appropriately scaled. We showed that the same equation was able to estimate GFR from 2 years to oldest ages.
In the current study we tested and validated our hypothesis by applying the above formula for appropriately ‘rescaled’ cystatin C.
Dr. Grandahl[/caption]
Maria Grandahl, Associate Professor, PhD, Senior lecturer
Director of Education in Nursing and Midwifery programs
Uppsala University
Department of Women’s and Children’s Health
on behalf of authors:
Dr Jenny Stern, Dr Eva-Lotta Funkquist and Dr Maria Grandahl
MedicalResearch.com: What is the background for this study?
Response: Conflicting advice and non-evidence-based recommendations have a negative effect on breastfeeding. Since 2011, the National Food Agency in Sweden has informed parents that they can introduce tiny tastings (1 mL of solid food, i.e. other sources of nutrition than breastmilk/formula) to infants from four months of age. It is unknown how national recommendations, which differ from the Word Health Organization’s recommendation, affect breastfeeding.
Neeraj Patel[/caption]
Neeraj Patel
Medical Student (MS-2), Yale School of Medicine
New Haven, CT
MedicalResearch.com: What is the background for this study?
Response: Direct-to-consumer pharmaceutical advertising has been increasing in popularity for the past two decades or so, particularly via television. But it’s highly controversial. Only two high-income countries (the U.S. and New Zealand) widely permit this type of advertising for prescription drugs. Critics have pointed to a growing body of literature that suggests that direct-to-consumer advertising for prescription drugs can be misleading, lead to inappropriate prescribing, and inflate healthcare costs. Proponents have argued that it improves public health by promoting clinically beneficial prescribing.
Dr. Hussain[/caption]
Dr Monira Hussain
Senior Research Fellow &
ECF Clinical Research Australian Fellow
Public Health and Preventive Medicine
Monash University
Melbourne VIC
MedicalResearch.com: What is the background for this study?
Response: 25% of males and 44% of females aged 60 years or over experience minimal trauma fractures. Minimal trauma fractures are a clinical outcome of osteoporosis and may occur following little or no trauma i.e. fractures following a fall from standing height or less. Minimal trauma fractures are silent, people may not notice that they are at high risk of the disease until a bone is broken.
I was aware of previous studies reporting that high-density lipoprotein cholesterol (HDL-C) was elevated in patients with osteoporosis. Two animal studies showing that HDL-C reduces bone mineral density by reducing osteoblast number and function provide a plausible explanation for why high HDL-C may increase the risk of fractures.
Our study, the ASPirin in Reducing Events in the Elderly (ASPREE), and the ASPREE fracture substudy provide unique data that could determine whether these findings might apply to fracture risk in healthy older adults. The study collected data including HDL-C levels and fractures from more than 16,000 community-dwelling older adults. These participants were followed-up for a median of 4 years.
Dr. Caraballo-Cordovez[/caption]
César Caraballo-Cordovez, MD
Postdoctoral Associate
Yale/YNHH Center for Outcomes Research and Evaluation (CORE)
New Haven, CT 06511
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our group has been interested in how patients’ experience during hospitalization impacts their recovery and their health for a while. In 2013, Dr. Harlan Krumholz (senior author of the current study) identified that patients who were recently hospitalized experienced a period of generalized risk for myriad adverse health events, a condition that he named ‘post-hospital syndrome’. One of the possible explanations for this observation is that the stress from being hospitalized negatively impacts patients’ health during their stay in the hospital and after being discharged. The stress in a hospital may come from different sources–including sleep deprivation.
Sleep is fundamental for recovery, and there are many challenges for patients to have adequate sleep while being hospitalized. Among the many sources of sleep interruption are early morning blood draws. Blood draws are often performed in the early morning in order to have recent lab tests results available during morning medical rounds. However, this common practice may disrupt patients’ recovery by interrupting their sleep. We were interested in determining to what extent blood draws contribute to early morning sleep disruptions and whether there has been recent progress in reducing them.
We used data from Yale New Haven Hospital from 2016 to 2019 and found that nearly 4 in 10 of total daily blood draws were collected between 4:00am and 7:00am–a proportion that was persistently high over the 3 years we studied. Importantly, we found that this occurred across patients with different sociodemographic characteristics, including older individuals who are at highest risk of adverse health events from sleep deprivation.
One way to stay motivated and on track is by setting small, achievable goals for yourself....
Casey Hribar[/caption]
Casey Hribar
Fourth-year medical student
University of North Carolina
MedicalResearch.com: What is the background for this study?
Response: Several great pieces of literature already exist about patient perception of doctors wearing white coats, formal attire, business attire, and the like. But recently, scrubs are garnering favor, especially as a result of the COVID-19 pandemic.
While there has been some interest in what is worn over scrubs (jackets, vests, name tags, etc.), to our knowledge, there has not been any investigation into scrub color. Scrubs are a highly variable article of clothing, from fit, to pockets, pattern, and color, and it makes sense that these variations could have their own associated perceptions. Our study served as a way to open up the conversation around scrubs and the potential impact of their color on patients.
Dr. Huang[/caption]
Alison R. Huang, PhD MPH
Senior Research Associate
Cochlear Center for Hearing & Public Health
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Hearing loss is a critical public health issue affecting two-thirds of older adults over 70 years old. There is growing understanding of a strong link between hearing loss and dementia, which impacts millions of Americans.
Our main findings are that in a nationally representative sample of older adults in the United States from the National Health and Aging Trends Study, every 10 decibel increase in hearing loss was associated with 16% greater prevalence of dementia, such that prevalence of dementia in older adults with moderate or greater hearing loss was 61% higher than prevalence in those with normal hearing.
We also found that in older adults with moderate or greater hearing loss, hearing aid use was associated with a 32% lower prevalence of dementia.
There are four stages of bedsores, progressively life-threatening as they advance...
Alden Mileto, BA
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton, PA
MedicalResearch.com: What is the background for this study?
Response: The drug buprenorphine is a partial opioid agonist, originally developed in the 1960s as an alternative to the stronger full opioid mu receptor agonists like morphine. Today, the drug is sometimes used for pain, but is more often used as a treatment for Opioid Use Disorder (OUD). Since the 2002 federal approval for buprenorphine use in treatment of OUD, there has been an increase in buprenorphine prescription across all states.
However recent studies have showed a disproportionate increase in buprenorphine prescriptions to rural/ less populated areas in comparison to urban/densely populated areas. The objective of this study [1] was to analyze the trends in buprenorphine distribution, overall and by three-digit zip codes, in Pennsylvania from 2010-2020.
Anxiety, poor quality of sleep, and sleep apnea are all interrelated in many cases....
Dr. Hayek[/caption]
Salim S. Hayek MD
Assistant Professor
Medical Director of the Frankel Cardiovascular Center Clinics
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Essentially, immune checkpoint myocarditis is a rare but deadly complication of immune checkpoint inhibitors – amazing drugs that are increasingly used for the treatment of various cancers. Most patients present late, and when they do, they’re very ill and have a 50% chance of death.
Diagnosing ICI myocarditis is challenging, given there is no one test that can differentiate it from other causes of cardiac injury. It is important to diagnose it fast, early and accurately in order to start immunosuppressive therapy as soon as possible.
What we did in this study was look at commonly measured biomarkers in all patients receiving ICI at the University of Michigan.
What we found was that patients who developed ICI myocarditis had early signs of muscle destruction (rise in CPK) levels and hepatitis (rise in AST, ALT), and that all patients who had myocarditis with bad outcomes had rises in all of the aforementioned biomarkers. Creatinine phosphokinase was the most sensitive.
Autoimmune skin conditions like Psoriasis can lead to a lifetime of problems. Treatments are one of the many steps professionals take to reduce the symptoms....
Regina Blye[/caption]
Regina Blye, Chief Program and Policy Officer
Discusses the Living with Paralysis & Caregiver National Survey
Conducted by the Christopher and Dana Reeve Foundation
MedicalResearch.com: How large is the population of Americans living with paralysis?
Response: There is a significant population of Americans living with paralysis. To note, a 2013 study by the Christopher & Dana Reeve Foundation found that 1 in 50 people in the US are living with paralysis. This is approximately 5.4 million people. I, myself, have lived with a spinal cord injury (SCI) for over 35 years. While some progress has been made over the past few decades, there is still work to be done.
In a new survey conducted by the Christopher & Dana Reeve Foundation called “Living with Paralysis & Caregiver National Survey,” we learned that a majority of Americans (69%) underestimate the prevalence of those living with paralysis in the U.S. - about two out of every 100 individuals.
Given the notable size of the population, we must work together to educate and inform families, business leaders, advocates, policymakers and the general public to help improve the quality of life for those living with, or impacted by paralysis.
The Christopher & Dana Reeve Foundation is dedicated to curing spinal cord injury by advancing innovative research and improving the quality of life for individuals and families impacted by paralysis. While we’ve been fortunate to make advancements with significant support from the community, we must all unite to accelerate comprehensive information, resources, referral services, and innovative research together.
Dr. Goldman[/caption]
Anna L. Goldman, M.D., M.P.A., M.P.H
Assistant Professor of Medicine
General Internal Medicine
Boston University Chobanian & Avedisian School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Experts on the healthcare labor market have long debated the existence and magnitude of a physician shortage. Physician work hours are a major contributor to physician supply issues, but little research is available on recent trends in work hours by physicians. In addition, no available studies have rigorously estimated changes in the physician workforce size during the pandemic.
Prof. Isaacs[/caption]
Lyle Isaacs, Professor
University of Maryland Department of Chemistry and BiochemistryCollege Park, MD 20742
MedicalResearch.com: What is the background for this study?
Response: The Isaacs laboratory has a long-standing interest in molecular containers compounds and their molecular recognition properties toward chemically and biologically important targets. Molecular containers include well known pharmaceutical excipients that help dissolve and deliver drugs (e.g. sulfobutyl-beta-cyclodextrin (SBE-b-CD)) and even sequester active pharmaceutical ingredients (e.g. Sugammadex reverses the effects of neuromuscular blockers).
Our lab has previously studied a class of molecular containers called cucurbiturils and found that they bind tightly (nanomolar Kd) to hydrophobic cations in aqueous solution. Recently, we translated our knowledge of tight binding to design and synthesize a novel tight binding molecular container known as Pillar[6]MaxQ and showed that it has superior binding affinity toward hydrophobic cations.[reference = Angewandte Chemie International Edition 2020, 59, 13313]
In an intensive outpatient program, patients have the opportunity to meet with their therapist or case manager multiple times per week for extended periods of time. This increased contact can help ensure that patients are complying with their treatment plan and making progress toward their goals....
Dr. Grashow[/caption]
Rachel Grashow PhD
Research Scientist
Department of Environmental Health
Football Players Health Study at Harvard University
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Anecdotally, we heard from former NFL players that they felt older than their chronological age. At the same time, doctors and medical care providers treating former players also observed that players appeared clinically older in some health domains. These observations motivated us to ask: despite superior fitness and success as young men, are football players experiencing early aging and living with illness and disability for more years than their non-football peers?
Dr. Harris[/caption]
MedicalResearch.com Interview with:
Rebecca Arden Harris, MD, MSc
Assistant Professor of Family Medicine and Community Health at the Hospital of the University of Pennsylvania
Senior Fellow, Leonard Davis Institute of Health Economics
Perelman School of Medicine, University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: The impact of the nationwide overdose epidemic on Black women has received little attention from policy-makers, researchers, or the press.
MedicalResearch.com: What are the main findings?
Response: Over the 7-year study period, preventable overdose deaths among Black women resulted in nearly 0.75 million years of life lost (YLL). Women aged 25-34 have suffered a rising proportion of this burden.
Dr. Hatchwell[/caption]
Dr. Eli Hatchwell, MA MB BChir (Cantab) DPhil (Oxon) BA (OU)
Chief Scientific Officer
Population Bio UK, Inc.
Begbroke Science Park Begbroke Hill
Begbroke, Oxfordshire
United Kingdom
MedicalResearch.com: What is the background for this study?
Response: Progressive Multifocal Leukoencephalopathy (PML) is a devastating condition that is associated with a number of clinical situations, including treatment with a variety of drugs. Of these, the best known is natalizumab (Tysabri), which is a very successful drug in the treatment of MS (multiple sclerosis). Only a small proportion of patients treated with natalizumab develop PML and this has always been a mystery. The study was based on a hypothesis that some individuals have an underlying susceptibility to developing PML, based on the presence of variants in genes that are important in the immune system. The study identified several of these variants.
Dr. Guttman-Yassky[/caption]
Dr. Emma Guttman-Yassky, MD, PhD
Waldman Professor and System Chair
The Kimberly and Eric J. Waldman Department of Dermatology
Director, Center of Excellence in Eczema
Director, Laboratory of Inflammatory Skin Diseases
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background for this study are studies that show that OX40 is a pathway that is upregulated in patients with atopic dermatitis (or eczema). OX40 is involved in activation of immune molecules associated with allergy and atopy, and also with formation of memory immune cells that are required for disease recurrence. The hypothesis to the study was that giving an OX40 antagonist will not only ameliorate the disease but perhaps have a remittive effect in that the disease will not come back.
Indeed all drug doses were significantly effective at week 16, the primary endpoint compared to placebo and continued to improve towards week 36, the secondary endpoint. In addition, the responders to treatment maintained their responses for an additional 20 weeks, which is unusual, suggesting a potential for disease modification.