Author Interviews, BMC, Cost of Health Care, Diabetes, Yale / 28.09.2019

MedicalResearch.com Interview with: Phoebe Tran Doctoral Student Department of Chronic Disease Epidemiology Yale School of MedicinePhoebe Tran Doctoral Student Department of Chronic Disease Epidemiology Yale School of Medicine  MedicalResearch.com: What is the background for this study? Response: As the prevalence of diabetes risk factors such as obesity, high blood pressure, high cholesterol, and physical inactivity are considerably higher in US individuals residing in rural areas compared to their urban counterparts, rural residents face increased risk of developing diabetes. Diabetes screening is a useful tool that can be used to identify people with newly developed type 2 diabetes and offer them early treatment. In this study, we examined whether there are differences in diabetes screening levels between rural and urban areas across the US using nationally representative survey data from 2011, 2013, 2015, and 2017.   (more…)
Aging, Author Interviews, Genetic Research / 28.09.2019

MedicalResearch.com Interview with: Lara Puhlmann, PhD student International Max Planck Research School NeuroCom Research Group Social Stress and Family Health MedicalResearch.com: What is the background for this study? Response: Studies are increasingly investigating ways to influence the length of telomeres (i.e., protective chromosomal caps), with the aim of improving a person’s health and aging trajectory. There is evidence that telomere length can change faster than previously thought, possibly taking just one to six months of mental or physical training to elongate. However, the broader biological implications of such short-term change in telomere length remain unclear.  (more…)
Author Interviews, Chocolate, Ophthalmology / 26.09.2019

MedicalResearch.com Interview with: Dr. med. Jakob Siedlecki MD Department of Ophthalmology Ludwig-Maximilians-University Munich, Germany MedicalResearch.com: What is the background for this study? Response: The background is that a previous study has found beneficial effects of dark chocolate on visual function. This finding was attributed to improved blood supply due to vasodilation induced by Flavanols in dark chocolate. (more…)
AHA Journals, Author Interviews, Environmental Risks, Heart Disease, Stroke / 26.09.2019

MedicalResearch.com Interview with: Zara Berg, Ph.D Fort Peck Community College Poplar, Montana MedicalResearch.com: What is the background for this study? Response: This study is part of the cohort that consist of the Honolulu Heart Program (HHP) and what later became the Honolulu-Asia Aging study. HHP study cardiovascular research starting in the 1960’s, which is equivalent to the Framingham Study. This study was used to establish the epidemiology parameters for cardiovascular diseases and is one of the longest longitudinal (34 years of follow-up) study on cardiovascular diseases and other diseases that effect the elderly. The participants were all Japanese that fought in WWII which is a sample size of 8,006 participants. In additional, there is multiple studies based on this cohort for the last fifty plus years, ranging from occupational exposure, cancer, neurological diseases, and cardiovascular diseases.  (more…)
Author Interviews, Gastrointestinal Disease, Pediatrics, Personalized Medicine / 26.09.2019

MedicalResearch.com Interview with: James P. Franciosi, MD Chief of Gastroenterology, Hepatology and Nutrition Nemours Children's Hospital MedicalResearch.com: What is the background for this study? Response: Eosinophilic Esophagitis (EoE) is a chronic inflammation of the esophagus that is driven by eosinophils. A common class of medications used for this condition are called Proton Pump Inhibitors, or PPIs, which block the production of gastric acid in the stomach. Currently only 30 to 60 percent of children with EoE respond well when treated with PPIs. We hypothesized that genetic variants in the genes for CYP2C19 and STAT6 could plausibly be associated with response to PPI therapy for EoE. (more…)
Author Interviews, Nutrition, Pediatrics, Sugar, Weight Research / 26.09.2019

MedicalResearch.com Interview with: Professor Alex Bentley Head of Anthropology University of Tennessee Knoxville TN  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In recent years, considerable evidence has accumulated suggesting that excess sugar consumption, e.g. in sugar-sweetened beverages, has been a major driver of the U.S. obesity crisis. Critics of this idea, however, have asked: why did the rise in sugar consumption precede the U.S. obesity crises by a decade or more, and why did obesity continue to rise even after sugar consumption began declining the early 2000s? We modeled the delayed onset of obesity by assuming that diet is a cumulative process that begins in childhood. On average, each age cohort (birth year) has its own specific cumulative exposure to excess sugar in their diets.  The inherent delay in our model links childhood consumption of excess sugar with propensity for adult obesity as an adult. Our model explains a simple process by which excess sugar in diets of children of the 1970s and 1980s could explain the sharp increase of adult obesity that began in the 1990s. (more…)
Author Interviews, Dermatology, Pediatrics / 25.09.2019

MedicalResearch.com Interview with: Hal Flowers MD Assistant Professor of Dermatology University of Virginia Dr. Flowers specializes in autoimmune connective tissue disease (rheumatologic dermatology), phototherapy and blistering skin diseases  MedicalResearch.com: What is the background for this study? Response: Unfortunately, there really is not much literature at all addressing the treatment of atopic dermatitis with apple cider vinegar (ACV), even though we know that this is something our patients are doing. ACV is appealing as a “natural therapy” for treatment of skin disease. Since it’s an acid, it can theoretically correct the loss of acidity that occurs in the skin of our eczema patients. Plus, we know that high enough concentrations will kill certain bacteria that promote eczema, particularly Staphylococcus aureus. There are plenty of blogs and anecdotes as well as physicians who recommend this treatment, but as of yet, we don’t know the best concentration, safety or the benefit of ACV.  (more…)
ADHD, Author Interviews, Depression, Education, JAMA, Mental Health Research, Pediatrics / 25.09.2019

MedicalResearch.com Interview with: Jeremy Brown BA MSc RESEARCH DEGREE STUDENT IN PHARMACOEPIDEMIOLOGY London School of Hygiene & Tropical Medicine MedicalResearch.com: What is the background for this study? Response: Given the way schools typically work, children in the same year as each other can be almost a whole year apart in terms of age. We’ve known for a while that children who are young in their year at school are also more likely to be diagnosed as having hyperactivity disorders and tend to do less well academically than the older children in the year. They also seem to be at increased risk of suicide. This is thankfully an extremely rare occurrence in children, but there is little evidence about whether younger children are more likely to be diagnosed with depression. We used electronic health records for just over a million children in the UK to see if there was any association between how old the children were in their year and whether they got diagnosed with ADHD, intellectual disability and depression. (more…)
Author Interviews, Cognitive Issues, Menopause / 25.09.2019

MedicalResearch.com Interview with: John Bark, PhD Student Behavioral Neuroscience Program Department of Psychology University of Illinois at Chicago  MedicalResearch.com: What is the background for this study? Response: 80% of women undergoing menopause experience vasomotor symptoms such as hot flashes and night sweats.   40-60% of women in menopause experience sleep problem.  Both of these symptoms of menopause have been associated with cognitive difficulties, but to my knowledge, this is the first study to use objective assessments of sleep and vasomotor symptoms to understand their effects on the brain. (more…)
Author Interviews, Blood Pressure - Hypertension, Dental Research / 24.09.2019

MedicalResearch.com Interview with: Dr Eva Muñoz Aguilera BDS MFDS MClinDent (Dist) MPerio RCSEd EFP Diploma in Periodontology and Implant Dentistry Senior Clinical Teaching Fellow in Periodontology UCL Eastman Dental Institute, London MedicalResearch.com: What is the background for this study? Response: High blood pressure and periodontitis are highly prevalent conditions that affect more than one third of the adult population worldwide. High blood pressure is the leading global cause of premature death and is the main preventable cause of cardiovascular disease,  while gum disease - also known as periodontitis - leads to severe inflammation of the gums and tooth loss. It impairs aesthetics and function and reduces quality of life. Most importantly, there is increasing evidence that periodontitis increases risk for future cardiovascular disease. Both diseases share common risk factors such as obesity and smoking and are major health problems that significantly impact on health costs.  (more…)
AACR, Author Interviews, Pancreatic / 24.09.2019

MedicalResearch.com Interview with: Hadas Reuveni, PhD VP of Research and Development Kitov Pharma MedicalResearch.com: What is the background for this study? Response: Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related death worldwide. Current treatments fail to provide patients with an effective and long-lasting response, mostly given to the nature of the tumor microenvironment which hinders drug accessibility, the late stage on diagnosis and the rapid upregulation of compensatory alternative signaling pathways by the tumor cells that lead to cancer drug resistance. Two of the major parallel pathways regulating tumor survival and metastasis as well as the crosstalk of the tumor and its microenvironment are mediated by insulin receptor substrate (IRS) 1 and 2, and by the signal transducer and activator of transcription 3 (STAT3). Both IRS1 and STAT3 have been shown to play a significant role in development of drug resistance by tumor cells. NT219, the focus of the current study, is a small molecule that presents a new concept in cancer therapy. NT219 represents a new family of novel compounds acting as a dual inhibitor of both IRS1/2 and STAT3 signaling both directly in the tumor and its microenvironment. We have previously shown that simultaneous inhibition of these two pathways is crucial to overcome drug resistance, and to prolong the positive response of the anti-cancer activity of approved cancer drugs. NT219 targets IRS1/2 for degradation using a unique mechanism, supported by a feed-forward decrease in IRS gene expression. A long-term suppression of both IRS and STAT3 by NT-219 has been demonstrated in previous preclinical studies, which lasted days following removal of NT219 from the cancer cells, assuring a strong and prolonged anti-cancer activity. This study was designed to investigate the efficacy of NT219 at overcoming drug resistance to several approved oncology therapies using patient-derived xenograft (PDX) models of KRAS mutant pancreatic cancer, as well as to validate NT219's mechanism of action and optimal dose regimen.  (more…)
Annals Internal Medicine, Author Interviews, Electronic Records / 24.09.2019

MedicalResearch.com Interview with: John (Xuefeng) Jiang PhD Professor and Plante Moran Faculty Fellow Eli Broad College of Business Accounting & Information Systems Michigan State University East Lansing, MI MedicalResearch.com: How did you get interested in this issue? Response: This is the third project of our data breach trilogy. We first examined which healthcare providers (focusing on hospitals) more likely suffer from a data breach. We documented large hospitals, despite their resources, are more likely to experience a data breach. Some hospitals experienced multiple incidents (https://jamanetwork.altmetric.com/details/18464149). The findings made us wonder what happened? Besides size, what other factors contribute to data breaches? Based on detailed event descriptions, we documented the circumstances under which each data breach occurred (https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2715158). We found more than half of data breaches could be attributed to healthcare providers’ internal mistakes or negligence (e.g., forgot to encrypt laptop computers, used cc instead of bcc in emailing patients, didn’t revoke former employees’ login credentials after employment terminated) rather than external forces (e.g., hacking). We also found mobile devices (e.g. laptop computers, usb drives) are associated with most data breaches than paper records or network servers. Our results suggest if healthcare providers strengthen their internal control and limit the use of mobile device might be effective ways to reduce data breach risks.  (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Nutrition, Weight Research / 24.09.2019

MedicalResearch.com Interview with: Deirdre K Tobias, ScD Associate Epidemiologist, Brigham and Women’s Hospital Assistant Professor, Harvard Medical School nuts-nutrition-weight-obesityMedicalResearch.com: What is the background for this study? What types of nuts are helpful? Peanuts included?  Response: We did not have the granularity in our study to evaluate too many individual nut types, and did not perform head-to-head comparisons between types of nuts. All seemed to be better for long-term weight control compared with the snacks like potato chips that we know are not great for us on a regular basis. (more…)
Author Interviews, Education, Exercise - Fitness, Orthopedics, Pediatrics / 24.09.2019

MedicalResearch.com Interview with: Alison E. Field, ScD Professor and Chair of Epidemiology Brown University School of Public Heath Providence, RI  MedicalResearch.com: What is the background for this study? Response: Over past couple of decades there has been a large change in youth sports from playing different sports in each season to more and more specialization where children are playing the same sport for three or more seasons. The concern with that change is that specialization at young ages will lead to more injuries, as well as athlete burnout.   (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Duke, Neurology / 24.09.2019

MedicalResearch.com Interview with: Juan Helen Zhou, PhD, on behalf of the co-authors Associate Professor and Principal Investigator Neuroscience and Behavioural Disorders (NBD) Programme Duke-NUS Medical School, SingaporeJuan Helen Zhou, PhD, on behalf of the co-authors Associate Professor and Principal Investigator Neuroscience and Behavioural Disorders (NBD) Programme Duke-NUS Medical School, Singapore  MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease and cerebrovascular disease are among the leading disorders affecting the elderly, with up to 50 per cent of dementia patients showing co-occurrence of both disorders. It is therefore of great interest to understand the influence of co-occurring Alzheimer’s disease and cerebrovascular disease pathologies on brain changes, and examine if such changes are able to track early differential disease progression. Past cross-sectional studies have suggested that Alzheimer's disease and cerebrovascular disease pathologies contribute independently to brain functional and structural changes, and cognitive decline. Our study sought to demonstrate the independent contributions of both pathologies to brain functional networks in a longitudinal cohort of mild cognitive impairment patients, often regarded as early stage of the disease. (more…)
Author Interviews, Cost of Health Care, Diabetes, Diabetes Care, JAMA / 23.09.2019

MedicalResearch.com Interview with: Rebecca Myerson, PhD Assistant Professor, Population Health Sciences School of Medicine and Public Health University of Wisconsin, Madison MedicalResearch.com: What is the background for this study? Response: Many people with diabetes are undiagnosed, and those who are diagnosed often are untreated and uncontrolled. Increasing access to health insurance for patients with health care needs was a goal of the Affordable Care Act. We analyzed information from 11 years of the National Health and Nutrition Examination Survey, which gathers data that are nationally representative of the civilian population. The biennial survey includes biomarkers, including HbA1c, a measure of blood-sugar control. Using the NHANES data allowed the researchers to identify those with undiagnosed diabetes. (more…)
Author Interviews, CT Scanning, JAMA, Lung Cancer, UCSF / 23.09.2019

MedicalResearch.com Interview with: Joshua Demb, PhD, MPH Postdoctoral Scholar, Moores Cancer Center University of California, San Diego Health Science Research Specialist Veterans Affairs San Diego Healthcare System MedicalResearch.com: What is the background for this study? Response: Our study leveraged radiation dose data from 72 facilities performing CT scans around the United States to learn more about the radiation dose used for lung cancer screening scans, as well as possible institutional predictors that might be associated with higher dose.  Currently, the American College of Radiology has recommendations for how these low-dose lung cancer screening scans should be performed. However, it is unclear how much adherence there currently is to these guidelines. Our findings indicated that there is wide variation in the distribution of radiation doses for low-dose lung cancer screening scans both within- and between facilities in our sample—in some cases this variation led to doses higher than the ACR recommendations.   (more…)
Author Interviews, Cost of Health Care, JAMA, University of Pittsburgh / 23.09.2019

MedicalResearch.com Interview with: Coleman Drake, PhD Assistant Professor, Department of Health Policy and Management Affiliate faculty member Center for Pharmaceutical Policy and Prescribing University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: Every year, the Centers for Medicare and Medicaid Services puts out of notice of proposed changes to the rules governing the Health Insurance Marketplaces created by the Affordable Care Act (e.g., healthcare.gov). The most recent notice for 2020 (issued in 2019) considered eliminating automatic reenrollment for Marketplace enrollees. On the one hand, requiring that enrollees actively select a health plan to stay insured is a good thing because it forces them to consider their options – we know that people make better health plan choices when they consider their choices. On the other hand, creating an administrative barrier to staying insured could cause some people to become uninsured. Since 3.4 million Marketplace enrollees used automatic enrollment in 2019, eliminating it might cause a spike in the uninsured rate. (more…)
Author Interviews, Heart Disease, Pediatrics, Smoking, UCSF / 23.09.2019

MedicalResearch.com Interview with: Gregory M Marcus, MD, MAS Professor of Medicine in Residence Endowed Professor in Atrial Fibrillation Research University of California, San Francisco Associate Chief of Cardiology for Research, UCSF Health University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Smoking remains the most common preventable cause of death and disability. We previously found evidence that tobacco smoke exposure in the young may lead to atrial fibrillation, the most common heart rhythm disturbance, later in life. Here we leveraged the multi-generational nature of the Framingham Heart Study to demonstrate that parental smoking was a risk factor for offspring atrial fibrillation. At least some of this relationship was explained by a greater propensity to smoke in offspring of smoking parents. These findings demonstrate a potentially new harmful effect of smoking pertinent to the most vulnerable population, our children. It also demonstrates how parental behaviors can have meaningful adverse consequences to their children decades later. (more…)
Author Interviews, Herpes Viruses, Science, University of Pennsylvania, Vaccine Studies / 23.09.2019

MedicalResearch.com Interview with: Harvey M. Friedman, MD Professor of Medicine/Infectious Diseases University of Pennsylvania Philadelphia, PA 19104-6073  MedicalResearch.com: What is the background for this study? Response:  Mice and guinea pigs are the animal models used to evaluate candidate vaccines for preventing genital herpes. My lab has been working on such a vaccine. Our candidate vaccine contains 3 immunogens. One immunogen is a protein on the virus that is required for the virus to enter cells (viruses need to enter cells to replicate). The other two immunogens are proteins on the virus that help the virus escape immune attack. Our intent is to produce antibodies to these 3 proteins by immunization and that the antibodies will bind to the proteins on the virus and block the protein functions. The virus then will not be able to enter cells and will not be able to use its evasion strategies to avoid the immune responses generated by the vaccine. Our vaccine aimed at preventing immune evasion is novel as a component of a genital herpes vaccine.  (more…)
Author Interviews, JAMA, Smoking, Tobacco, Tobacco Research / 22.09.2019

MedicalResearch.com Interview with: Hongying (Daisy) Dai, PhD Associate Professor Department of Biostatistics | College of Public Health University of Nebraska Medical Center Omaha MedicalResearch.com: What is the background for this study? Response: Previous studies have reported a surge in e-cigarette use among youth during the 2017 - 2018. For instance, the prevalence of current (past 30-day) e-cigarette use increased by 77.8% (from 11.7% to 20.8%) among high school students and by 48.5% (from 3.3% to 4.9%) among middle school students. As a result, the Food and Drug Administration (FDA) warns that youth e-cigarette use is reaching an epidemic proportion in September 2018. Whether e-cigarette use prevalence also increased among young adults (aged 18-24 years), a population with high e-cigarette use rates and vulnerability to nicotine dependence, is unknown. (more…)
Author Interviews, Gastrointestinal Disease, Weight Research / 21.09.2019

MedicalResearch.com Interview with: Sarah Ballou, PhD Health Psychologist Division of Gastroenterology, Hepatology, and Nutrition Beth Israel Deaconess Medical Center Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obesity is known to be associated with an increased risk of gastrointestinal and liver diseases, but less is known about the relationship between obesity and constipation or diarrhea. We used a nationally representative sample of the US population to evaluate whether obesity was associated with abnormal bowel habits. We found that obese individuals were 60% more likely to have diarrhea, even after controlling for possible confounding factors such as dietary, lifestyle, psychological, and medical conditions. (more…)
Author Interviews, Dengue, Duke, Vaccine Studies / 21.09.2019

MedicalResearch.com Interview with: Dr Shee-Mei Lok, PhD Professor in the Emerging Infectious Disease program Duke-NUS, a school of National University of Singapore MedicalResearch.com: What is the background for this study? Response: Dengue virus consists of four different serotypes (DENV1-4) and within each serotypes, there are multiple strains. In terms of the viral particle shape, our previous research work using some laboratory adapted strains showed these DENV2 strains are very interesting in that it can change shape from the smooth spherical surface particles when grown at mosquito physiological temperature (29oC) and then becomes bumpy surfaced particles when incubated at human physiological temperature (37oC). This ability to transform into different virus surface structures helps the virus to escape from the immune system of the human host. Hence understanding the mechanism of how this occur is important for therapeutics and vaccine development. Here we also identified a laboratory adapted virus strain that do not showed this structural changes. We showed some differences in their amino acid sequences and We showed some differences in their amino acid sequences and mutating these residues coupled with observing their surface structures showed which residues are important for this temperature induced structural change. Results showed that subtle mutations at different places on the envelope protein can destabilize the virus allowing them to change in structure when temperature is elevated. Due to the poor selection pressure of the artificial laboratory tissue culture system, gradual mutations of the virus is accumulated causing the virus to have bumpy surface morphology. (more…)
Author Interviews, Dermatology, Environmental Risks / 19.09.2019

MedicalResearch.com Interview with: Dr. Ke Cheng, PhD Professor, Department of Molecular Biomedical Sciences, NCSU Professor, UNC/NCSU joint Department of Biomedical Engineering MedicalResearch.com: What is the background for this study? What are exosomes? Response: People are developing lots cosmetic products to keep a healthy and young appearance, like antioxidants, growth factors, peptides and more recently, stem cell products. Also, people are seeking more effective solutions for better absorption, like lotion, mask, laser and fillers. What is used for the treatment and how to deliver it are vitally important to the final effect and lasting time. Exosomes are nano-sized small vehicles containing proteins, nucleic acids, and they are messengers for cell communication and regulation. Here we use skin cell-secreted exosomes to fight skin aging. (more…)
Author Interviews, Cancer Research, End of Life Care, JAMA / 19.09.2019

MedicalResearch.com Interview with: Donald Sullivan, MD, MA, MCR Associate Professor of Medicine & Associate Fellowship Program Director Division of Pulmonary & Critical Care Medicine Oregon Health & Science University Investigator, Center to Improve Veteran Involvement in Care (CIVIC) VA-Portland Health Care System  MedicalResearch.com: What is the background for this study?
  • Patients with lung cancer suffer from considerable physical and psychological symptom burden and palliative care is underutilized or delivered too close to death to provide meaningful benefits for these patients. Palliative care is associated with improved quality of life for these patients, but the findings regarding a survival benefit are not clear.
  • Palliative care is distinct from hospice. Palliative care is meant to be delivered along with disease-modifying therapy and focuses on improving quality of life by addressing pain and other problems, including physical, psychosocial and spiritual for patients and their families. Hospice care is focused on reducing suffering, pain and anxiety at the very end of life; typically within a few months of death.
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Author Interviews, Electronic Records, Emergency Care, JAMA / 19.09.2019

MedicalResearch.com Interview with: Carl Berdahl, MD, MS Emergency Physician and Health Services Researcher CEDARS-SINAI West Hollywood CA MedicalResearch.com: What is the background for this study? Response: The length of a doctor’s note is taken account when determining how much a doctor or medical center is paid for a visit. However, in the digital era, a doctor can generate large amounts of text with just a few keystrokes. Given this incentive structure, we were concerned doctors’ notes might be inaccurate in certain sections of the chart that are important for billing. We used observers to determine how accurately doctors’ notes reflected the interactions between patients and physicians. (more…)
Author Interviews, Dermatology, Melanoma, Technology / 19.09.2019

SkinVision   MedicalResearch.com Interview with:  Andreea Udrea, PhD Associate Professor University Politehnica of Bucharest   MedicalResearch.com: What is the background for this study? The skin cancer incidence rate is increasing worldwide. Early diagnosis and prevention can reduce morbidity and are also linked to decreased healthcare costs. During the last years, efforts have been made in developing smartphone applications for skin lesion risk assessment to be used by laypersons. In parallel, as machine learning (ML) is on the rise, and medical image databases are increasing in size, a series of algorithms have been developed and compared in clinical studies to dermatologists for skin cancer diagnosis. The accuracy of the algorithms and experts were comparable. One drawback of these clinical studies is that they use images acquired by professionals in standardized conditions. So, there is little knowledge of what the accuracy will be when including an ML algorithm in an app and testing it in a non-clinical setup where the image quality may be lower, and the variability in image taking scenarios is higher as images are acquired by non-professionals using the smartphone camera. This study is one of the first that evaluates the accuracy of an app (SkinVision) when being used for risk assessment of skin lesions in the general population. (more…)
Author Interviews, Health Care Systems, Surgical Research / 19.09.2019

MedicalResearch.com Interview with: Gustav Tinghög, PhD Associate Professor Division of Economics Department of Management and Engineering, IEI JEDI-lab: JUDGEMENT, EMOTION, DECISION and INTUITION Linköping University MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that when we get tired, we make decisions without engaging in cognitively demanding reasoning, and we postpone risky or uncertain choices. Previous studies have explored this idea of “decision fatigue” in relation to parole hearing outcomes, failure of health services workers to wash their hands, and the likelihood of physicians prescribing antibiotics. In our study we wanted to investigate how patient ordering affected decisions scheduled patients for orthpedic surgery (excluding acute cases) (more…)
Author Interviews, Heart Disease, NEJM, Vanderbilt / 18.09.2019

MedicalResearch.com Interview with: Daniel Muñoz, M.D, M.P.A Assistant Professor of Medicine, Division of Cardiology Medical Director for Quality, Vanderbilt Heart & Vascular Institute Medical Director, Cardiovascular ICU Vanderbilt University Medical Center Nashville, Tennessee MedicalResearch.com: What is the background for this study? Response: Despite advances in the prevention and treatment of cardiovascular disease, it remains the number one global killer of both men and women. Patients face a variety of barriers to getting the care need, including cost and complexity of medication regimens. Innovative strategies are needed to improve the delivery of preventive care, especially when it comes to socio-economically vulnerable individuals. The polypill, a fixed-dose combination of 3 blood pressure lowering medications and a cholesterol lowering medication, may be a strategy for improving cardiovascular disease prevention. We enrolled 303 patients at a community health center in Mobile, Alabama. Half of the patients were assigned to take a daily polypill, while the other half received their usual medical care. Participants underwent a standard medical exam, blood pressure measurement, and blood cholesterol testing during their initial visit, a 2-month visit, and a 12-month visit. MedicalResearch.com: What are the main findings?
  • Participants in the polypill group experienced a greater reduction in both systolic blood pressure and LDL cholesterol level, as compared with participants in the usual care group. These differences translate to an approximate 25% reduction in the risk of experiencing a cardiovascular event.
  • At 12 months, adherence to the polypill regimen, as assessed based on pill counts, was 86%.
  • The vast majority of our study participants were African-American (96%), with three quarters reporting an annual income below $15,000.
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