Addiction, Author Interviews, CDC, Pediatrics / 12.10.2016

MedicalResearch.com Interview with: Steven A. Sumner, MD, MSc Centers for Disease Control and Prevention National Center for Injury Prevention and Control, Division of Violence Prevention Atlanta GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2014, CDC was invited to Wilmington, Delaware, to conduct a study because the city had been experiencing a high level of homicides and shootings. Our investigation looked at multiple risk factors for youth violence involvement across a wide variety of areas of young people’s lives. For example, youth who had previously experienced a gunshot wound injury were 11 times more likely to later commit a gun crime than youth who had not been similarly injured. Study investigators looked at histories of violence victimization, educational problems, unemployment histories, child welfare experiences, and prior criminal involvement. The more adverse life experiences a young person had, the more likely they were to commit firearm violence. (more…)
Alcohol, Author Interviews, NIH, Pharmacology / 12.10.2016

MedicalResearch.com Interview with: Megan Ryan M.B.A. Clinical Program Director, DMD Technology Development Coordinator National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda, MD MedicalResearch.com: What is the background for this study? Response: Alcohol use disorder (AUD) has been linked to the dysregulation of the brain stress systems (e.g. corticotropin-releasing factor, glucocorticoids, and vasopressin) creating a negative emotional state leading to chronic relapsing behavior. Several pre-clinical studies have shown that by blocking the V1b receptor with a V1b receptor antagonist, dependence induced compulsive-like alcohol intake is also blocked. This is the first multi-site trial to assess the efficacy of the V1b receptor antagonist novel compound (ABT-436) for the treatment of alcohol dependence. (more…)
Addiction, Alcohol, Pediatrics, Tobacco Research / 12.10.2016

MedicalResearch.com Interview with: Dr Rebecca Lacey, PhD Research Associate Epidemiology & Public Health Institute of Epidemiology & Health Faculty of Pop Health Sciences University College London MedicalResearch.com: What is the background for this study? Response: We know from previous research that children who experience parental absence, whether due to death, divorce or some other reason, are more likely, on average, to have poorer health in later life. This includes being more likely to smoke and drink as an adult. However, what we didn’t know before we conducted our study was whether children who experienced parental absence were more likely to engage in the early uptake of risky health behaviours in childhood. This is what we looked at in our study. (more…)
Author Interviews, Cannabis, Cognitive Issues, Depression, Pediatrics / 12.10.2016

MedicalResearch.com Interview with: Elizabeth Osuch, M.D. Associate Professor; Rea Chair Department of Psychiatry FEMAP--London Health Sciences Centre London, ON    MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a researcher and psychiatrist doing clinical work in youth aged 16-25 with mood and anxiety disorders I often see patients who are depressed and believe that using marijuana (MJ) improves their mood.  Yet they remain depressed.  This was the clinical inspiration for this brain imaging study, where we investigated emerging adults with Major Depressive Disorder (MDD).  Subject groups included patients with MDD who did and did not use MJ frequently.  Our results showed that the MDD+MJ group did not have significantly less depression than the MDD alone group, and the brain abnormalities found in MDD were not corrected by MJ use in the MDD+MJ group.  In fact, some of the brain differences were worse with the addition of MJ, while others were just different. (more…)
Addiction, Author Interviews, NYU, Pediatrics, Tobacco, Tobacco Research / 08.10.2016

MedicalResearch.com Interview with: Professor Michael Weitzman MD New York University's College of Global Public Health and The Departments of Pediatrics and Population Health New York University School of Medicine NYU Langone Medical Center MedicalResearch.com: What is the background for this study? Response: There is a marked and rapidly increasing epidemic of hookah (waterpipe) use in the US. Hookah use appears to be as, or even more, dangerous than cigarette use. There are data suggesting that one hookah session is comparable to smoking 5 packs of cigarettes in terms of exposure to toxins. The CDC and WHO both have issued warnings that hookah pipe use may eradicate much or all of the progress of the past 50 years of tobacco control efforts. (more…)
Addiction, Author Interviews, Columbia, Opiods / 03.10.2016

MedicalResearch.com Interview with: Silvia S. Martins, MD, PHD Associate Professor of Epidemiology Department of Epidemiology Mailman School Of Public Health Columbia University New York, NY 10032 MedicalResearch.com: What is the background for this study? Response: Given the high probability of nonmedical use among adolescents and young adults, the potential development of prescription opioid use disorder secondary to nonmedical use among youth represents an important and growing public health concern. Still, no study had investigated time trends, specifically if prescription opioid use disorder has increased in the past decade among adolescents, emerging adults and young adults who are nonmedical users of prescription opioids. (more…)
Addiction, Author Interviews, Memory, University Texas, Weight Research / 27.09.2016

MedicalResearch.com Interview with: Ursala. H. Winzer-Serhan Ph.D. Associate Professor Department of Neuroscience and Experimental Therapeutics Texas A&M Health Science Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nicotine is a plant alkaloid that is naturally occurring in the tobacco plant. Smoking delivers nicotine to the brain where it acts as a stimulant. Tobacco and electronic cigarette smoking delivers many other chemicals to the body, which are harmful and can cause cancer. However, the drug nicotine by itself is relatively benign and poses few health risks for most people. Nicotine acts in the brain on nicotinic receptors, which are ion channels that are widely expressed in the brain. They play an important role in cognitive functions. Research with rodents and in humans has shown that nicotine can enhance learning and memory, and furthermore, can protect neurons during injuries and in the aging brain. With the increasingly older population, it becomes more and more important to delay cognitive decline in the elderly. Right now, there is no drug available that could delay aging of the brain. (more…)
Author Interviews, Cost of Health Care, Opiods, Pain Research / 26.09.2016

MedicalResearch.com Interview with: Jaren Howard, PharmD, BCPS Associate Director Medical Affairs Strategic Research Purdue Pharma L.P. MedicalResearch.com: What is the background for this study? Response: The existing scientific literature estimating the healthcare burden of opioid misuse disorders often combines all patients within the broad category of “opioid abuse,” defined as opioid abuse, dependence, or overdose/poisoning. Collectively, these three conditions can significantly increase healthcare costs among commercially insured patients. • Real world medical coding practices present challenges to researchers aiming to separately analyze excess costs by diagnosis, though combining these diagnoses may mask some variation in excess costs. • Furthermore, little is known about the specific drivers of excess costs in terms of medical conditions driving excess costs or places of service at the diagnosis-level. (more…)
Author Interviews, JAMA, Opiods / 21.09.2016

MedicalResearch.com Interview with: Bradley D. Stein, MD, MPH, PhD RAND Corporation University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: The United States is in the midst of a serious opioid abuse epidemic and we know that medically assisted treatment is one of the best ways to help people with addiction to opioids. The drug buprenorphine has advantages over methadone, the historic medical treatment, because it can be prescribed by physicians in the community who receive a waiver allowing them to prescribe it after undergoing eight hours of training.. Methadone is dispensed at special clinics that many people with opioid addition may be unable to get to with the frequency required by effective treatment. To better understand patterns of the use of buprenorphine, we examined treatment patterns in the states with the most buprenorphine-waivered physicians (California, Florida, Massachusetts, Michigan, New York, Pennsylvania and Texas). Our data came from a prescription records that account for over 80 percent of the retail pharmacies in the nation. We examined use patterns among 3,200 physicians who treated 250,000 patients. We had two surprising findings:  First, the median length of treatment with buprenorphine was 53 days, which is much shorter than the duration that most individuals are likely to need for optimal results. Second, despite concerns that federal limits on the number of patients and waivered physician can treat being a significant barrier for many individuals obtaining treatment, we found that most physicians were treating far fewer patients than would be allowed by the patient limits. In fact, 22 percent of the physicians treated an average of 3 patients per month and just 9 percent treated 75 or more patients per month. (more…)
Addiction, Author Interviews, Opiods, Pain Research / 21.09.2016

MedicalResearch.com Interview with: Thomas Alfieri, PhD Director, Medical Affairs Strategic Research Purdue Pharma L.P. MedicalResearch.com: What is the background for this study? Response: When researchers assess the abuse potential of opioids, they follow current FDA guidance, which stipulates that questions such as “Do you like this drug?” and “How much would you like to take this drug again?” be asked of recreational drug users. We think that assessing abuse potential among recreational users provides useful information, however, we believe that the questions designed to be asked of recreational users are not appropriate for use with pain patients. These items can confuse the liking of a drug for pain relief with the liking of a drug to get high – two very different reasons that a pain patient might want to take a drug again. In theory, abuse potential could be overestimated among pain patients because of the somewhat general nature of the items used in the survey instrument. (more…)
Author Interviews, Cost of Health Care, Opiods, Pain Research / 21.09.2016

MedicalResearch.com Interview with: Jaren Howard, PharmD, BCPS Associate Director, Medical Affairs Strategic Research Purdue Pharma L.P. MedicalResearch.com: What is the background for this study? Response: Opioid abuse, dependence, overdose, and poisoning (referred to collectively for the purposes of this study as “abuse”) represent a costly public health concern to payers. Excess annual costs for a diagnosed opioid abuser range from $10,000-$20,000 per patient. Current literature does not sufficiently address the drivers of excess costs in terms of medical conditions driving costs or places of service. (more…)
Author Interviews, Opiods, Pain Research / 21.09.2016

MedicalResearch.com Interview with: Angela DeVeaugh-Geiss, PhD Director, Epidemiology, Purdue Pharma L.P. MedicalResearch.com: What is the background for this study? Response: Due to widespread abuse, including abuse via non-oral routes (eg, snorting, injecting), OxyContin was reformulated with abuse deterrent properties in August 2010. In this study we explored changes in nonmedical use of OxyContin after the reformulation using public use data files from the National Survey on Drug Use and Health (NSDUH). NSDUH has included questions about nonmedical use of OxyContin (including pill images) since 2004. Nonmedical use is defined as use without a prescription or use that occurred simply for the experience or feeling the drug caused. (more…)
Accidents & Violence, Author Interviews, Cannabis, Columbia, Opiods / 17.09.2016

MedicalResearch.com Interview with: June H. Kim Doctoral candidate,Department of Epidemiology Mailman School Public Health Columbia University MedicalResearch.com: What is the background for this study? What are the main findings? Response: A previous study indicated that states with medical marijuana laws had a reduced rate of opioid overdoses. If this is true, we'd expect to see similar reductions in opioid use associated with these laws. For this study, we used data from the FARS, a national surveillance system that records any crash events on US public roads that result in a fatality. Some states provide uniform testing of the majority of their deceased drivers, year to year. Among these states, we found that there was a lower prevalence of positive opioid toxicology tests among drivers crashing in states with an operational medical marijuana versus drivers crashing in states before a future medical marijuana law is implemented, particularly among drivers aged 21-40. (more…)
Addiction, Alcohol, Author Interviews, Psychological Science / 16.09.2016

MedicalResearch.com Interview with: Kristina J. Berglund Department of Psychology University of Gothenburg MedicalResearch.com: What is the background for this study? What are the main findings? Response: In Sweden, care providers do offer different treatment strategies for individuals who have alcohol problems, where some offer a treatment where the goal is abstinence and other offer a treatment where the goal is low-risk consumption. We wanted to investigate how important it was for having a successful treatment when there was congruence between the patient’s goals and the advocated goal of the treatment, and when there was not. The main findings was that that if the patient had a goal of abstinence than it was much more likely to reach that goal if the patient went to a treatment that advocated abstinence. It was less likely to reach the goal if a patient had a goal of low-risk consumption and went to a treatment that advocated low-risk consumption. The treatment that advocated abstinence was also more effective when the patient were ambivalent of his/her own goal. (more…)
Author Interviews, CDC, Emory, Opiods / 15.09.2016

MedicalResearch.com Interview with: Curtis Florence, PhD National Center for Injury Prevention and Control and Assistant professor, Department of Health Policy Management Rollins School of Public Health Emory MedicalResearch.com: What is the background for this study? Response:
  • This study presents most recent CDC estimates of the economic burden of prescription opioid abuse, dependence and overdose in the United States.
  • In 2013, over 16,000 persons died of prescription opioid overdoses, and almost 2 million people met the diagnostic criteria for abuse and/or dependence.
(more…)
Author Interviews, Cannabis, Lancet, NIH / 06.09.2016

MedicalResearch.com Interview with: Dr. Wilson Compton MD, Deputy Director National Institute on Drug Abuse MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study found that overall past year marijuana use by adults in the U.S. increased by more than 30% in the past dozen years, and 10 million more people were using marijuana in 2014 than in 2002. Use of marijuana on a daily (or near daily) basis increased even more markedly. In 2002, 3.9 million adults in the U.S. reported using marijuana daily or nearly every day, and the number more than doubled to 8.4 million by 2014. Along with this increase in use, we found that U.S. adults perceptions of the potential harms from using marijuana greatly decreased. Despite scientific evidence of potential harms, adults are much less convinced about dangers associated with using marijuana. These reductions in perceived harm were strongly associated with the increases in use. (more…)
Addiction, Anesthesiology, Author Interviews, Opiods / 02.09.2016

MedicalResearch.com Interview with: N. Nick Knezevic, MD, PhD Vice Chair for Research and Education Associate Professor of Anesthesiology and Surgery at University of Illinois Advocate Illinois Masonic Medical Center Department of Anesthesiology Chicago, IL 60657 MedicalResearch.com: What is the background for this study? Response: Even though serious efforts have been undertaken by different medical societies to reduce opioid use for treating chronic non-cancer pain, still many Americans seek pain relief through opioid consumption. The purpose of this study was to accurately assess compliance of chronic opioid consuming patients in an outpatient setting and evaluate if utilizing repeated urine drug testing could improve compliance. (more…)
Author Interviews, Cocaine / 01.09.2016

MedicalResearch.com Interview with: Dr Stefania Fasano Cardiff University MedicalResearch.com: What is the background for this study? Response: Exposure to drugs of abuse such as cocaine produces intense and long-lasting memories that are critical in the transition from recreational drug-taking to uncontrolled drug use. In the brain, addictive drugs usurp cellular circuits and signalling molecules involved in normal memory processes; hence, these drug-related memories resist extinction and contribute to high rates of relapse. Despite almost five decades of experimental research, there are currently no approved medications for cocaine dependence. (more…)
Addiction, Author Interviews, CDC, Opiods / 30.08.2016

MedicalResearch.com Interview with: Alexis B. Peterson, PhD (Epidemic Intelligence Service Officer) R. Matthew Gladden, PhD (Behavioral Scientist) MedicalResearch.com What is the background for this study? Response: In March and October 2015, the Drug Enforcement Administration and the Centers for Disease Control and Prevention (CDC) issued nationwide alerts identifying fentanyl, particularly illicitly manufactured fentanyl, as a threat to public health and safety. During 2013-2014, Ohio and Florida reported significant increases in fentanyl-involved overdose deaths (fentanyl deaths) and fentanyl submissions (drug products obtained by law enforcement that tested positive for fentanyl). Fentanyl is a synthetic opioid 50-100 times more potent than morphine. The University of Florida and the Ohio Department of Public Health with CDC assistance compared trends in fentanyl deaths, fentanyl submissions, and fentanyl prescribing during January 2013–June 2015. In-depth review of medical examiner and coroner reports of fentanyl deaths occurring in Ohio’s 14 high-burden counties were performed to identify circumstances surrounding fentanyl overdose death. (more…)
Addiction, Author Interviews, CDC, Opiods / 29.08.2016

MedicalResearch.com Interview with: R. Matthew Gladden, PhD Surveillance and Epidemiology Team, Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: In March and October 2015, the Drug Enforcement Administration (DEA) and CDC, respectively, issued nationwide alerts identifying illicitly manufactured fentanyl (IMF) as a threat to public health and safety.IMF is unlawfully produced fentanyl, obtained through illicit drug markets, includes fentanyl analogs, and is commonly mixed with or sold as heroin. Starting in 2013, the production and distribution of IMF increased to unprecedented levels, fueled by increases in the global supply, processing, and distribution of fentanyl and fentanyl-precursor chemicals by criminal organizations. Fentanyl is a synthetic opioid 50?100 times more potent than morphine. Multiple states have reported increases in fentanyl-involved overdose (poisoning) deaths (fentanyl deaths). This report examined the number of drug products obtained by law enforcement that tested positive for fentanyl (fentanyl submissions) and synthetic opioid-involved deaths other than methadone (synthetic opioid deaths), which include fentanyl deaths and deaths involving other synthetic opioids (e.g., tramadol). (more…)
Addiction, Author Interviews, CDC, Opiods, Pain Research / 27.08.2016

MedicalResearch.com Interview with: John Halpin, MD, MPH, Medical officer Prescription Drug Overdose Epidemiology and Surveillance Team CDC Injury Center MedicalReseach.com editor’s note: Dr. Halpern discusses the CDC alert of August 25, 2016 regarding the increase in fentanyl-related unintentional overdose fatalities in multiple states. MedicalResearch.com: What is the background for this alert? Response: The current health alert is an update to a previous alert in October, 2015 from CDC which described the geographic spread of states in which forensic labs were increasingly detecting fentanyl in the drug submissions that they receive from law enforcement, and how many of these same states were beginning to report fentanyl-related overdose deaths by their departments of public health. Further investigation by CDC and DEA have revealed that the great majority of fentanyl now present in the illicit drugs market is clandestinely-produced, and most commonly mixed with and sold as heroin, and is responsible for the great majority of fentanyl-related overdose deaths. Indications at the time of that alert pointed to a likely continuous rise in the supply of illicitly-manufactured fentanyl, and the potential for increasing numbers of fentanyl-related overdose deaths, particularly among those who use heroin. (more…)
Addiction, Author Interviews, Compliance, Opiods, Pharmacology / 23.08.2016

MedicalResearch.com Interview with: F. Leland McClure III, MSci, PhD, F-ABFT Medical science liaison director Quest Diagnostics MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many physicians associate Quest Diagnostics with their lab service needs because of our leadership in laboratory testing. But Quest is more than a lab, which is why we refer to ourselves as a diagnostic information services provider. This means that we help providers, health plans and even patients use the insights we derive from our lab testing data to deliver better care, quality and outcomes, both for the patient and the managed population. Our 2016 Quest Diagnostics Health Trends(TM) Prescription Drug Monitoring Report is an example of how we provide important health insights from Quest's laboratory data. Prescription drug misuse is a major epidemic in the United States. Laboratory testing can help identify if a patient is using or misusing prescribed medications. For instance, lab tests can show evidence of additional medications and other drugs in a patient’s urine specimen, suggesting potentially dangerous drug combinations. Earlier this year, the CDC issued guidelines that call for laboratory testing for patients prescribed certain medications, such as opioids, that carry a risk of abuse. Quest's prescription drug monitoring services help the physician identify if a patient is taking or not taking up to about four dozen drugs, such as oxycodone, Adderall XR® and Percocet®. For the Quest analysis, we analyzed more than 3 million de-identified lab test results. In this report, we found that 54 percent of patients’ results tested in 2015 showed evidence of drug misuse, slightly above the 53 percent misuse rate in 2014. That is certainly unacceptably high, but it’s a significant decline from the high of 63 percent we observed in 2011. We also found that an increasing proportion of patients who misuse medications combine their prescription medication with non-prescribed drugs. Among patients with inconsistent test results, forty-five percent of these patients showed evidence of one or more other drug(s) in addition to their prescribed drug regimen. That’s much higher than our findings of 35 percent in 2014 and 2013, 33 percent in 2012, and 32 percent in 2011. Finally, we were alarmed by the data showing the connection between heroin and benzodiazepines misuse. Our data showed one in three heroin users combine their drug use with benzodiazepines, the vast majority of which were unprescribed. This is an extremely dangerous practice given that benzodiazepines can have strong respiratory depressant effects when combined with other substances. Drug combinations, but particularly of heroin with benzodiazepines, can be potentially very dangerous, leading to coma and even death in some cases. (more…)
Author Interviews, JAMA, Opiods, Toxin Research / 10.08.2016

MedicalResearch.com Interview with: Ann M. Arens, MD California Poison Control Center San Francisco, CA 94110 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prescription opioid abuse is a significant public health threat that has garnered the attention of health care providers throughout medicine. With efforts to curb the number of prescriptions for opioid pain medications, users may begin to purchase prescription medications from illegal sources. Our study reports a series of patients in the San Francisco Bay Area who were exposed to counterfeit alprazolam (Xanax®) tablets found to contain large amounts of fentanyl, an opioid 100 times more potent than morphine, and in some cases etizolam, a benzodiazepine. The California Poison Control System – San Francisco division identified eight patients with unexpected serious health effects after exposure to the tablets including respiratory depression requiring mechanical ventilation, pulmonary edema, cardiac arrest, and one fatality. Patients reportedly purchased the tablets from drug dealers, and were unaware of their true contents. In one case, a 7 month-old infant accidentally ingested a counterfeit tablet dropped on the floor by a family member. (more…)
Addiction, Author Interviews, Opiods, Primary Care / 04.08.2016

MedicalResearch.com Interview with: Richard A. Deyo MD, MPH Kaiser Permanente Professor of Evidence-Based Family Medicine Department of Family Medicine Department of Medicine Department of Public Health and Preventive Medicine Oregon Institute of Occupational Health Sciences Oregon Health and Science University Portland, OR 97239 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Doctors and other prescribers often wonder how much and for how long they can prescribe opioids before inadvertently promoting long-term use. Unfortunately, few data are available to guide initial prescribing. Long-term opioid use is problematic because of substantial rates of dependence and misuse, and because the efficacy of long-term therapy remains unproven. Development of drug tolerance and increasing sensitivity to pain may limit long-term efficacy. Several factors may explain the emergence of inadvertent long-term use, including opioid dependence, recreational use, addiction, and illicit diversion to other users. We studied the risk of long-term use (defined as filling 6 or more opioid prescriptions in the subsequent year) with data from Oregon's Prescription Drug Monitoring Program, which captures all opioid prescriptions filled in Oregon pharmacies, regardless of who wrote the prescription or who paid for the prescription. We identified patients who had not received opioid medication in the previous year, but now received an initial prescription. There were over half a million such patients during the one-year study. Our most informative analysis was among people under age 45, which excluded most patients with a diagnosis of cancer, who were near the end of life, or who had chronic painful conditions such as arthritis. In this group, a patient who received just a three day supply of a moderate dose of opioids (For example, 10 mg. of hydrocodone plus acetaminophen 4 times daily for 3 days) had about a 2% risk of becoming a long term user. Someone who filled two prescriptions jumped to a 7% risk. Patients receiving a long-acting opioid as the first prescription had a higher risk of becoming long term users than those receiving short-acting opioids. Patients receiving a single prescription for such medications had almost a 16% likelihood of becoming long-term users compared to just 2% for those receiving short-term opioids. In some cases, long-term use may have been intended, but our exclusion of patients with cancer and end-of-life care made this less likely. (more…)
Accidents & Violence, Addiction, ADHD, Author Interviews / 29.07.2016

MedicalResearch.com Interview with: Anna Chorniy PhD Postdoctoral Research Associate Center for Health and Wellbeing Princeton University Princeton NJ 08544 MedicalResearch.com: What is the background for this study? Response: Attention-deficit/hyperactivity disorder (ADHD) is one of the common chronic mental conditions affecting children. In the U.S., 11% of children ages 4–17 (6.4 million) are estimated to have an ADHD diagnosis and almost 70% of them report taking medication for the condition (e.g. Visser et al., 2014). However, little evidence exists on the effects of ADHD treatment on children’s outcomes. We use a panel data set of South Carolina Medicaid claims paid out in 2003–2013 to investigate the effects of ADHD medication treatment on a seldom studied set of outcomes associated with this condition: adolescent risky behaviors and the incidence of injuries. The occurrence of injuries allows us to evaluate short-term effects of ADHD treatment, while substance abuse and risky sexual behavior outcomes speak for the long-term effects of medication. Second, we use Medicaid spending on treatment of these negative events to evaluate the impact of ADHD drugs on the severity of ADHD, and compare the cost of ADHD treatment with the costs of negative health events. (more…)
Author Interviews, Global Health, Lancet, Methamphetamine, OBGYNE, STD / 29.07.2016

MedicalResearch.com Interview with: N. Saman Wijesooriya Public Health Advisor/Technical Advisor Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: The article Global burden of maternal and congenital syphilis in 2008 and 2012: a health systems modeling study by Wijesooriya, et al published in the August 2016 issue of The Lancet Global Health (Open source - http://dx.doi.org/10.1016/S2214-109X(16)30135-8) estimates the incidence and prevalence of maternal and congenital syphilis for both time periods and identifies gaps antenatal care access and syphilis testing and treatment services to assess progress in the global elimination of congenital syphilis, or mother-to-child transmission of syphilis, as a public health problem. Untreated maternal syphilis is understood to be transmitted from mother-to-child in utero in 50% of cases resulting in tragic adverse pregnancy outcomes, or congenital syphilis infections, including early fetal death, stillbirth, preterm birth, low birthweight, neonatal death, and congenital infections in infants. Since most maternal syphilis infections are asymptomatic, it is recommended that screening for syphilis use a combination of serological tests for pregnant women and treatment of syphilis seropositive women with at least 2.4 million units of benzathine penicillin intramuscularly early in pregnancy to prevent most congenital syphilis infections. In 2007, the World Health Organization responded to estimates indicating 2 million maternal and 1.5 congenital syphilis infections would occur annually without treatment and launched the global initiative for the Elimination of Congenital Syphilis (ECS). The strategy includes reducing the prevalence of syphilis in pregnant women and mother-to-child transmission of syphilis. The objective is for countries to achieve high performing antenatal care systems providing access to antenatal care to more than 95% of pregnant women, syphilis testing for more than 95% of pregnant women, and treatment for more than 95% of seropositive women to attain a congenital syphilis rate of 50 or fewer cases per 100,000 live births. (more…)
Accidents & Violence, Author Interviews, Cannabis, Pediatrics / 28.07.2016

MedicalResearch.com Interview with: Graeme Gordon CEO and Founder at SneakGuard - Home of Safe Responsible StorageGraeme Gordon CEO and Founder at SneakGuard - Home of Safe Responsible Storage MedicalResearch.com: What is the background for SneakGuard™? Response: SneakGuard™ creator and founder, Graeme Gordon recognized the urgent need to keep adventurous young snoopers from unintentionally ingesting cannabis. Founded in 2014, SneakGuard™ is a locking, vacuum and thermally insulated container that provides responsible storage of medications and cannabis, with the passion to protect, save and enhance everyday quality of life. Gordon explains “As a father of a 8 year old I understand how pressing it is for adults to protect children, teens, and even pets from unintended ingestion, so I created a unique storage unit to provide a solution.” (more…)
AHA Journals, Author Interviews, Cannabis, Pulmonary Disease, UCSF / 27.07.2016

MedicalResearch.com Interview with: Matthew L. Springer, Ph.D. Professor of Medicine Division of Cardiology University of California, San Francisco San Francisco, CA MedicalResearch.com: What is the background for this study? Response: We've known for many years that secondhand smoke from tobacco cigarettes is harmful, and the vast majority of deaths thought to result from secondhand smoke are from cardiovascular disease. However, very little has been known about cardiovascular consequences of exposure to secondhand smoke from marijuana, and people tend to mistake the lack of evidence that it is harmful, for evidence that is it not harmful. As a result, many people seem relatively unconcerned about smoking marijuana and being exposed (or exposing others) to marijuana secondhand smoke. Politicians and policy makers also seem less willing to limit where people can smoke marijuana (under legal circumstances) than tobacco. What has been lacking is research into how exposure to marijuana smoke affects cardiovascular health. It has been difficult to do such experiments because marijuana is illegal in the eyes of the federal government. However, we have been studying the harmful effects of secondhand tobacco smoke on the function of rat blood vessels, which is similar to its harmful effects on human blood vessels, and we now have studied how the function of rat blood vessels is affected by exposure to secondhand marijuana smoke. (more…)
Author Interviews, Cannabis, JAMA, Pediatrics / 25.07.2016

MedicalResearch.com Interview with: George Sam Wang MD FAAP Assistant Professor of Pediatrics Section of Emergency Medicine, Medical Toxicology Department of Pediatrics University of Colorado Anschutz Medical Campus Children's Hospital Colorado MedicalResearch.com: What is the background for this study? Response: Many states have allowed medical and now recreational marijuana. The impact on pediatric population has not been fully described. MedicalResearch.com: What are the main findings? Response: Unintentional exposures presenting to our children's hospital and calls to our regional poison center significantly increased after our state allowed recreational marijuana. MedicalResearch.com: What should readers take away from your report? Response: Exposures in children are increasing in our state that allows medical and recreational Marijuana, many were edible products. Marijuana products should be treated like medications and household products in home and properly and safely stored. States looking to legalize marijuana need to consider safety rules and regulations during rule making processes. (more…)
Alcohol, Author Interviews, Columbia, OBGYNE, Tobacco / 21.07.2016

MedicalResearch.com Interview with: Dr. Qiana L. Brown, PhD, MPH, LCSW Postdoctoral Research Fellow Columbia University Mailman School of Public Health Department of Epidemiology Substance Abuse Epidemiology Training Program MedicalResearch.com: What is the background for this study? Dr. Brown: Prenatal substance use is a major public health concern, and poses significant threats to maternal and child health. Tobacco and alcohol are the most commonly used substances among pregnant women and non-pregnant women of reproductive age, and are leading causes of preventable adverse health outcomes for both mother and baby. Women with health insurance have more prenatal visits, and present for prenatal care earlier than uninsured women, which may increase their exposure to health messaging around substance abuse prevention at prenatal visits. Additionally, treatment for substance use disorders and maternal and child health care are part of the Essential Health Benefits covered by the Affordable Care Act, which may encourage patients and providers to engage in discussions around alcohol and tobacco use prevention during pregnancy. Given these factors, we examined the relationship between health insurance coverage and both past month tobacco use and past month alcohol use among a nationally representative sample of reproductive age women in the United States. We sampled 97,788 women ages 12 to 44 years old who participated in the U.S. National Survey of Drug Use and Health in 2010 to 2014. Among these women, 3.28% (n=3,267) were pregnant. We specifically investigated whether the relationship between health insurance and alcohol or tobacco use differed between pregnant and non-pregnant women. (more…)