Author Interviews, Cost of Health Care, JAMA, Kidney Disease / 31.10.2018

MedicalResearch.com Interview with: "Plugged into dialysis" by Dan is licensed under CC BY 2.0Amal Trivedi, MD, MPH Associate Professor of Health Services, Policy and Practice Associate Professor of Medicine Brown University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Affordable Care Act Medicaid expansion gave states the option to expand coverage to low-income adults. Prior research has reported that these expansions have been associated with increased coverage, improved access to care, and in some studies better self-rated health. To date the impact of Medicaid expansion on mortality rates, particularly for persons with serious chronic illness, remains unknown. Our study found an association between Medicaid expansion and lower death rates for patients with end-stage renal disease in the first year after initiating dialysis.  Specifically, we found an absolute reduction in 1-year mortality in expansion states of -0.6 percentage points, which represents a 9% relative reduction in 1-year mortality.      (more…)
Author Interviews, Pharmacology, Schizophrenia / 31.10.2018

MedicalResearch.com Interview with: Jelena Kunovac, M.D., M.S. Founder and Chief Executive Chief Medical Officer Altea Research Las Vegas, Nevada MedicalResearch.com: What is the background for this study? Response: We conducted the study to confirm that the addition of samidorphan to olanzapine does not have an effect on the antipsychotic efficacy of olanzapine in subjects with an acute exacerbation of schizophrenia. (more…)
Accidents & Violence, Author Interviews, JAMA / 31.10.2018

MedicalResearch.com Interview with: "Halloween Parade 2014" by GoToVan is licensed under CC BY 2.0Dr. John A. Staples, MD Clinical Assistant Professor University of British Columbia MedicalResearch.com: What is the background for this study? What are the main findings? Response: At this time last year, my co-author Candace Yip and I noticed an impressive number of advertisements for Halloween-themed parties at bars taped to lamp-posts. We wondered if the combination of dark costumes, dark evenings, alcohol and trick-or-treaters made the streets more dangerous for pedestrians. To see if our hunch was correct, we examined 42 years of data on all fatal vehicle crashes in the United States between 1975 and 2016. We compared the number of pedestrian fatalities between 5 p.m. and midnight on Halloween with the number during the same hours on control days one week earlier and one week later. We found that 14 pedestrian deaths occurred on the average Halloween, while only 10 pedestrian deaths occurred on the average control evening. This corresponded to a 43% increase in the relative risk of pedestrian fatality on Halloween. Among children aged 4 to 8 years of age, the risk of death was ten times higher on Halloween evening compared to control evenings. Risks were highest around 6pm, which is prime trick-or-treating time. Absolute risks were small and declined throughout the four decades of the study, but the relative risk increase on Halloween persisted throughout the entire study interval.  (more…)
Author Interviews, Flu - Influenza, Genentech / 30.10.2018

MedicalResearch.com Interview with: Mark D. Eisner, MD, MPH Vice PresidentProduct Development Immunology, Infectious Disease and Ophthalmology Genentech Dr. Eisner discusses the announcement that the FDA has approved XOFLUZA™ (baloxavir marboxil) for the treatment of acute, uncomplicated influenza. MedicalResearch.com: What is the background for this announcement? Response: Each year, an estimated 3-11 percent of the U.S. population gets the flu, and it can be very serious, resulting in hospitalization or even death. Since 2010, the Centers for Disease Control and Prevention (CDC) estimates that the flu has resulted annually in 9.2 to 35.6 million illnesses, 140,000 to 900,000 hospitalizations and 12,000 to 80,000 deaths. The severity of last year’s flu season underscores the need for new medical options beyond currently available antivirals. XOFLUZA was granted Priority Review in June 2018 based on results from the Phase III CAPSTONE-1 study of a single dose of XOFLUZA compared with placebo or oseltamivir 75 mg, twice daily for five days, in otherwise healthy people with the flu, as well as results from a placebo-controlled Phase II study in otherwise healthy people with the flu. (more…)
Author Interviews, Cost of Health Care, JAMA / 30.10.2018

MedicalResearch.com Interview with: Samir C. Grover MD, MEd, FRCPC Division of Gastroenterology Program Director Division of Gastroenterology Education Program University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that physician-industry interactions are commonplace. Because of this, there has been a movement to make the presence of these relationships more transparent. For clinical practice guidelines, this is especially important as these documents are meant to be objectively created, evidence based, and intended to guide clinical practice. The standard in the US come from the National Academy of Medicine report, "Clinical Practice Guidelines We Can Trust", which suggests that guideline chairs should be free of conflicts of interest, less than half of the guideline committee should have conflicts, and that guideline panel members should declare conflicts transparently. Other studies, however, have shown that some guidelines don't adhere to this advice and have committee members who don't disclose all conflicts. We thought to look at this topic among medications that generate the most revenue, hypothesizing that undeclared conflicts would be especially prevalent in this setting. We found that, among 18 guidelines from 10 high revenue medications written by 160 authors, more than (57%) had a financial conflict of interest, meaning they received payments from pharmaceutical companies that make or market medications recommended in that guideline. About a quarter of authors also received, and didn't disclose payments from one of these companies. Almost all the guidelines did not adhere to National Academy of Medicine standards. (more…)
Accidents & Violence, Author Interviews, JAMA, Johns Hopkins, Surgical Research / 30.10.2018

MedicalResearch.com Interview with: “Me holding USP gun” by Nghị Trần is licensed under CC BY 2.0Faiz Gani, PhD Postdoctoral research fellow Department of Surgery Johns Hopkins University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Firearm related injuries are a leading cause of injury and death in the United States, yet, due to combination of factors, limited data exist that evaluate these injuries, particularly among younger patients (patients younger than 18 years). The objective of this study was to describe emergency department utilization for firearm related injuries and to quantitate the financial burden associated with these injuries. In our study of over 75,000 emergency department visits, we observed that each year, over 8,300 children and adolescents present to the emergency department for the treatment / management of a gunshot injury. Within this sub-population of patients, we observed that these injuries are most frequent among patients aged 15-17 years and while these injuries decreased over time initially, were observed to increase again towards the end of the time period studied. In addition to describing the clinical burden of these injuries, we also sought to describe the financial burden associated with these injuries. For patients discharged from the emergency department, the average (median) charge associated with their care was $2,445, while for patients admitted as inpatients for further care, the average (median) charge was $44,966. Collectively these injuries resulted in $2.5 billion in emergency department and hospital charges over the time period studied. This translates to an annual financial burden of approximately $270 million. (more…)
Anesthesiology, Author Interviews, Opiods, Pain Research, Surgical Research / 29.10.2018

MedicalResearch.com Interview with: "Surgery" by Army Medicine is licensed under CC BY 2.0Dr. Nirmal B. Shah Anesthesia Resident PGY-IV (CA-III) Thomas Jefferson University Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: With the ongoing opioid epidemic, we believe it is important to understand patients’ perceptions of pain medications and pain control after surgery. We believe patients’ expectations and perceptions regarding perioperative pain medications has not been well understood. We were hoping to understand patients’ knowledge, concerns, and biases of pain medication along with information to optimize acute pain management. The goal of this survey study was to understand patient expectations regarding pain medications including opioids and non- opioids.  In the United States, over 100 million surgical procedures are performed every year. Nearly 80% of these patients will experience post-operative pain. Adequate treatment of post-operative pain has been shown to improve clinical and economic outcomes, thus there has been an increased effort towards improving post-operative pain control. Through our research, we demonstrated that patients expect to experience postoperative pain after a surgical procedure and expect to be prescribed a pain medication. Patients believe that opioid medications will be most effective in treating postoperative pain compared to non-opioid medications, which could be contributing to the opioid epidemic. 503 patients presenting for elective surgery at Thomas Jefferson University Hospital in Philadelphia, PA were sampled during this survey. 76% of patients expected to be prescribed an opioid pain medication at discharge, 47% of patients expected to be prescribed acetaminophen (Tylenol) pain medication at discharge, while 30% of patients expected to be prescribed an NSAID (Motrin) pain medication at discharge. 94% of patients expecting to receive an opioid pain medication believe it would be effective in controlling their post-operative pain. This difference was not observed in patients expecting prescriptions for non-opioid pain medications. Overall, patients expect to experience pain after surgery and be prescribed analgesics they perceived to be most effective, opioids. (more…)
Author Interviews, Biomarkers, Infections, JAMA, Stanford / 29.10.2018

MedicalResearch.com Interview with: "Mycobacterium tuberculosis Bacteria, the Cause of TB" by NIAID is licensed under CC BY 2.0Purvesh Khatri, Ph.D. Associate Professor Stanford Institute for Immunity, Transplantation and Infection (ITI) Stanford Center for Biomedical Informatics Research (BMIR) Department of Medicine Stanford University Stanford, CA 94305 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have previously described a 3-gene signature for distinguishing patients with active tuberculosis (ATB) from those with other diseases, latent mycobacterium tuberculosis (LTB) infection, and healthy controls (Sweeney et al. Lancet Respir Med 2016). The current study in JAMA Network Open is a follow up study to validate the 3-gene signature in 3 additional independent cohorts that were prospectively collected. Using these 3 cohorts we have now showed that the 3-gene signature (1) can identify patients with LTB that will progress to ATB about 6 months prior to diagnosis of active tuberculosis. (2) can identify patients with ATB in active screening, and (3) can identify patients with ATB at diagnosis that have higher likelihood of persistent lung inflammation due to subclinical ATB at the end of treatment.  (more…)
Aging, Author Interviews, Geriatrics, Social Issues / 29.10.2018

MedicalResearch.com Interview with: "Elderly woman speaks about Water Supply and Sanitation program in Nepal" by World Bank Photo Collection is licensed under CC BY-NC-ND 2.0Dr Sharon Leitch | MBChB, DCH, PGDipGP, FRNZCGP General Practitioner, Clinical Research Training Fellow Department of General Practice and Rural Health University of Otago New Zealand MedicalResearch.com: What is the background for this study? Response: Loneliness is associated with poor health, reduced quality of life, and increased mortality. Loneliness typically worsens with age. We were curious to learn what the prevalence of loneliness was among older New Zealanders, if there were age-specific associations with loneliness, whether there were any associations between demographic and psychosocial variables and loneliness, and we also wanted to compare centenarians (100 years or older) with elderly people (aged 65-99 years). Centenarians are a particularly interesting group to study because they are a model of successful ageing. The international Resident Assessment Instrument-Home Care (interRAI-HC) assessment has been mandatory in New Zealand for anyone undergoing assessment for publically funded support services or residential care since 2012, providing us with a comprehensive data set. We conducted a retrospective, observational, cross-sectional review of the interRAI-HC data from over 70,000 people living in the community who had their first assessment during the study period (January 2013-November 2017). We analysed eight items from the interRAI-HC data set to describe the population and evaluate the core psychosocial components of aging; age, gender, ethnicity, marital status, living arrangements, family support, depression and loneliness. (more…)
Author Interviews, Kidney Disease, Mineral Metabolism, Pharmacology / 29.10.2018

MedicalResearch.com Interview with: Dr Mattias Ivarsson PhD CEO, Inositec, co-author of data MedicalResearch.com: What is the background for this study? Response: When control of factors in the blood that regulate mineral balance in the body is lost, the subsequent build-up of calcium deposits in the arterial walls and cardiac valves lead to an increase in cardiac events, particularly in patients with chronic kidney disease or diabetes, as well as all-cause mortality. There is a significant unmet need for therapeutic agents capable of reducing pathological mineral accumulation regardless of their root cause. To date, there is no approved therapy for treating calcification-dependent cardiovascular disease.  (more…)
Author Interviews, Cannabis, Kidney Disease / 29.10.2018

MedicalResearch.com Interview with: "Big bags of medical #marijuana on Cannabis Culture News LIVE - watch now on www.pot.tv" by Cannabis Culture is licensed under CC BY 2.0Praveen Kumar Potukuchi, B.Pharm, MS The University of Tennessee Health Science Center MedicalResearch.com: What is the background for this study? Response: Several case reports have indicated that synthetic cannabinoid use is associated with acute kidney injury (AKI). However, it is unclear whether similar adverse effects could occur with medicinal or recreational cannabis use. Previous research has shown that the use of medical marijuana /cannabis for an average of two weeks resulted in no serious adverse effects and no incidence of AKI. However, there are no studies which investigated the effects of marijuana/cannabis use on the incidence of AKI in patients with advanced CKD. (more…)
Author Interviews, Pediatrics / 28.10.2018

MedicalResearch.com Interview with: Michael Snape, Ph.D. Chief executive officer Chief scientific officer AMO Pharma  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This is a further analysis of the Phase II Proof of Concept study that was described in March.  We have extended the findings from that study by performing further analyses of the data obtained and also commencing an analysis of the relationship between the levels of AMO-02 involved and the clinical response seen. The main finding is a confirmation that our previously reported conclusions are supported.  The concordant trend analysis revealed a clear dose-response relationship that favored the 1000 mg over 400 mg dose for four of the 10 response variables differed in favor of 1000 mg over 400 mg dose on key clinician and caregiver measures, autism scores and grip strength.  (more…)
Author Interviews, Biomarkers, Cancer Research, Prostate Cancer / 28.10.2018

MedicalResearch.com Interview with: Davide Pellacani Ph.D. Postdoctoral Fellow, Eaves' Lab Terry Fox Laboratory, BC Cancer Research Centre Vancouver, BC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer is characterized by frequent DNA methylation changes compared to normal tissue. Nevertheless, understanding which of those changes lead to the acquisition of malignant proprieties is complicated by the predominance of cells with luminal features in prostate cancers. In this study we generated DNA methylation maps of two distinct cell populations found within prostate cancer samples (called basal and luminal) and their normal counterparts. These datasets clearly showed that many of the common DNA methylation changes found in prostate cancer are present in luminal cells from both cancer and normal tissues. These changes are not necessarily cancer-specific, and are likely due to the bias associated with analyzing tissues in bulk, where most cancer cells have luminal-like features. We used these datasets to derive two cancer-specific and phenotype-independent DNA methylation signatures: one specific to prostate cancer luminal cells, and one composed of changes measured in both luminal and basal cancer cells. We then validated the potential clinical utility of these signatures by testing their ability to distinguish prostate cancer from normal samples, and tumours that have already escaped the prostate from those that have not, using the publicly available dataset from The Cancer Genome Atlas. (more…)
Accidents & Violence, Author Interviews, Cannabis / 28.10.2018

MedicalResearch.com Interview with: Prof. Mark A. R. Kleiman PhD Affiliated Faculty, NYU Wagner; Professor of Public Policy NYU Marron Institute of Urban Management MedicalResearch.com: What is the background for this study? What are the main findings?  Response: As state after state legalizes the sale of cannabis, the question of cannabis-impaired driving is getting more attention. There is evidence that the practice has become more common, both because cannabis use - and especially heavy, frequent use - has increased and because a distressingly large fraction of cannabis users believe, falsely, that stoned driving is safe. The natural response to the problem is to treat cannabis on a par with alcohol: fairly severe criminal penalties for impaired driving, with impairment defined by a specific level of the drug in the body. The paper argues that this would be a mistake, for four independent reasons: - While cannabis makes driving riskier, it does so by about a factor of two, with no strongly observed dependency on dosage. Alcohol, by contrast, has a steep dose-effect curve. At the legal limit of 0.08% blood alcohol content by weight, the relative risk of drunk driving is at least eight; at 0.15%, which is fairly common, the relative risk has been estimated at 30-50. So there is no justification for punishing stoned driving as severely as we punish drunk driving. - The lack of evidence of a strong dose-effect relationship suggests that a legal standard based on the content of cannabinoids in blood may not be appropriate. - Even if a blood standard were valid, the lack of a breath test would make enforcing that standard nearly impossible as a practical matter. - The long and unpredictable course of cannabis metabolism means that frequent users will be at risk of failing a drug test even when they are neither subjectively intoxicated nor objectively impaired. Worse, they would have no way of judging in advance whether or not driving would be legal. The result would be a re-criminalization of cannabis use through the back door.  (more…)
Author Interviews, Weight Research / 27.10.2018

MedicalResearch.com Interview with: Dr. Kaitlin Wade PhD Research Associate and Early Career Researcher Representative Integrative Epidemiology Unit (IEU) Bristol Medical School (Population Health Sciences) Faculty of Health Sciences University of Bristol  MedicalResearch.com: What is the background for this study? Response: Whilst severe obesity increases the risk of death in the population, there are conflicting results in the literature with some papers suggesting a protective effect of being overweight. Many observational studies also report a J-shaped association between body mass index – a measure of weight accounting for a person’s height – and mortality, where individuals who are underweight also have an increased risk of mortality compared to those within the ‘normal’ range. Such controversial findings are not without limitation, as bias by age, ill-health and other lifestyle factors are likely. One method to overcome the limitations of observational studies – Mendelian randomization – uses genetic variation in a person’s DNA to help understand the causal relationships between risk factors and health outcomes to provide a more accurate estimate of relationships by removing confounding factors (such as smoking, income and physical activity) and reverse causation (where people lose weight due to ill-health), which can explain conflicting findings in previous studies. Until now, no study has used such a genetic-based approach to explore the link between body mass index and mortality. (more…)
AHA Journals, Author Interviews, Imperial College, Mineral Metabolism, Stroke / 27.10.2018

MedicalResearch.com Interview with: Dipender Gill Imperial College Healthcare NHS Trust London, United Kingdon  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Iron status has previously been associated with risk of various types of cardiovascular disease, including stroke. However, the observational research methodologies that identified these associations can be affected by confounding from environmental factors and reverse causation. We used randomly allocated genetic variants that affect iron status to investigate its effect on risk of different types of ischemic stroke, and found evidence to support that higher iron status increases risk of cardioembolic stroke. (more…)
Author Interviews, OBGYNE, Pediatrics, Vaccine Studies / 27.10.2018

MedicalResearch.com Interview with: Anna Beavis, MD, MPH Assistant Professor The Kelly Gynecologic Oncology Service Department of Gynecology and Obstetrics Johns Hopkins Medicine Baltimore, MD 21287-128 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to look at reasons parents don’t vaccinate their children against HPV, including how those reasons have changed over time from 2010-2016 and how those reasons are different between boys and girls in the most recent data from 2016. We used a nationwide dataset which is publically available from the CDC (Centers for Disease Control) – the National Immunization Survey-Teen, or NIS-Teen - which surveys parents of teens ages 13-17 years old every year to determine rates of all recommended vaccinations. In parents who report that they don’t intend to vaccinate their child against HPV , the survey asks parents why. We found that from 2010 to 2016, the percentage of parents reporting concerns about their child not being sexually active yet went down significantly for both boys and girls. Also, in boys specifically, parents reported male gender as a less common reason for not vaccinating. For both boys and girls, we found that concerns about safety and side effects, necessity, and lack of knowledge about the vaccine were common reasons for not planning to vaccinate.  Also, 10% of parents of girls vs. 20% of parents of boys reporting never having a provider recommendation for the vaccine as their primary reason for not vaccinating. These results may reflect the growing public understanding of the HPV vaccine as a vaccine which is best given before exposure, so before initiation of sexual activity between the ages of 11 and 12, and that it is recommended for both boys and girls. Also, over 80% of people will have an HPV infection in their lifetime, so everyone should get vaccinated regardless of anticipated sexual activity. Additionally, providers should focus their counseling and recommendation on improving knowledge about the HPV vaccine, including its decade-long track record of safety and necessity.    (more…)
Author Interviews, Infections, Lancet, Urinary Tract Infections / 27.10.2018

MedicalResearch.com Interview with: https://www.shionogi.com/Simon Portsmouth, MD Senior Medical Director Shionogi Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Antibiotics for multidrug resistant  Gram-negative infections are desperately needed. Cefiderocol is the first siderophore antibiotic to reach patients. Siderophore antibiotics bind to free iron and use the bacterial active iron transport channels to cross the outer membrane of Gram-negative bacteria. Laboratory studies have shown that cefiderocol is active against multi-drug resistant Gram-negative bacteria, often where no other antibiotics are active. It is able to overcome most types of antibiotic resistance due to its active transport into cells and stability against all carbapenemases. The need for antibiotics for carbapenem resistant Gram-negative infections is described as a critical need by the WHO. This trial was the first in humans with serious infections and demonstrated excellent efficacy in a complicated patient population where almost ¼ were over 75 years of age. Additionally cefiderocol did not appear to have any safety problems, and was well tolerated. (more…)
Accidents & Violence, Author Interviews, JAMA / 26.10.2018

MedicalResearch.com Interview with: John W. Epling, Jr., M.D., M.S.Ed Professor of Family and Community Medicine Virginia Tech Carilion School of Medicine Roanoke, VA USPSTF Task Force Member MedicalResearch.com: What is the background for this study? Response: Intimate partner violence, often known as domestic violence, can have devastating consequences to one’s health and wellbeing. It can lead to mental illness, substance abuse, unintended pregnancy, and even death. This is a serious public health issue in America: one in three men—and even more women—experience it in their lifetimes. Because this is such an important topic, and the last time we made a recommendation on it was in 2013, the U.S. Preventive Services Task Force reviewed the most recent evidence to determine how clinicians can help prevent the negative health effects of intimate partner violence. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Pediatrics / 26.10.2018

MedicalResearch.com Interview with: Sean C. Rose, MD Pediatric sports neurologist and co-director Complex Concussion Clinic Nationwide Children’s Hospital Assistant professor of Pediatrics The Ohio State UniversitySean C. Rose, MD Pediatric sports neurologist and co-director Complex Concussion Clinic Nationwide Children’s Hospital Assistant professor of Pediatrics The Ohio State University MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The link between sub-concussive head impacts and declines in neurocognitive function has been reported by some studies, yet refuted by others.  There is very little evidence that has been collected in children as they are sustaining these head impacts. We initiated a multi-year study of youth football players to provide a more in-depth look at the question.  We measured head impacts using helmet sensors during the 2016 football season.  112 players age 9-18 completed a battery of neurocognitive tests before and after the football season. We found that neither the total burden of head impacts nor the intensity of individual impacts were associated with changes in testing performance from pre to post-season. (more…)
Author Interviews, JAMA, Opiods, Pediatrics / 26.10.2018

MedicalResearch.com Interview with: Joshua Barocas, MD Assistant Professor of Medicine Section of Infectious Diseases Boston Medical Center / Boston University School of Medicine Joshua Barocas, MD Assistant Professor of Medicine Section of Infectious Diseases Boston Medical Center / Boston University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Massachusetts has been particularly hard hit by the opioid epidemic despite lower opioid prescribing rates, near universal health insurance, and availability of opioid treatment. That said, it is difficult to estimate the population with or at-risk for opioid use disorder. It is generally a highly stigmatized disease and typical methods to estimate of opioid use disorder relay on contact with the healthcare system and/or patient reporting. We used a unique and powerful methodology coupled with a first-in-the-nation linked database in Massachusetts to obtain both an accurate count of people with opioid use disorder who are known to the healthcare system and estimate the number who are out there but not yet known to the system. We found that more than 275,000 people – or 4.6 percent of people over the age of 11 in Massachusetts– have opioid use disorder, a figure nearly four times higher than previous estimates based on national data. In 2011 and 2012, the prevalence of opioid use disorder in Massachusetts for those over the age of 11 was 2.72 percent and 2.87 percent, respectively. That increased to 3.87 percent in 2013, and even more, to 4.6 percent in 2015. Those between the ages of 11 and 25 experienced the greatest increase in prevalence of all age groups. The number of “known” persons increased throughout the study period – from 63,989 in 2011 to 75,431 in 2012, and 93,878 in 2013 to 119,160 in 2015.  (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Toxin Research, University of Michigan / 26.10.2018

MedicalResearch.com Interview with: Sung Kyun Park Sc.D. M.P.H. Associate professor of epidemiology and environmental health sciences University of Michigan School of Public Health Ann Arbor, Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is poorly understood that why some patients need more drugs to control high blood pressure than others. Resistant hypertension is that blood pressure is not controlled with 3 medications of different classes including diuretics or is required 4 or more medications of different classes for blood pressure controls. Genes, obesity, physical inactivity, high salt diet, pain medications may do something. Lead is a widespread environmental toxin that can influence high blood pressure. In this study, we examined whether long-term exposure to lead, measured as bone lead, is associated with the risk of resistant hypertension. Bone lead offers a better method over blood lead measurement to discern long-term lead exposure and accumulation. The main finding of our study is that low-level lead exposure, measured in the tibia (hard bone), is associated with higher risk of development of resistant hypertension in a cohort of patients diagnosed with hypertension.  (more…)
Author Interviews, Columbia, Sugar / 25.10.2018

MedicalResearch.com Interview with: “Soda” by Jannes Pockele is licensed under CC BY 2.0Jennifer Woo Baidal, MD, MPH Assistant Professor of Pediatrics Director of Pediatric Weight Management, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Medical Center & New York-Presbyterian Morgan Stanley Children’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Childhood obesity prevalence is historically high, with most incident obesity among children occurring before age 5 years. Racial/ethnic and socioeconomic disparities in childhood obesity are already apparent by the first years of life. Latino/Hispanic children in low-income families are at-risk for obesity. Thus, understanding potentially effective ways to prevent childhood obesity, particularly in vulnerable populations, should focus on early life. Sugar-sweetened beverage (SSB) consumption is a modifiable risk factor for obesity and is linked to other adverse health outcomes. Maternal SSB consumption in pregnancy and infant sugar-sweetened beverage consumption in the first year of life are linked to later childhood obesity. We sought to describe beverage consumption in a modern cross-sectional cohort of 394 low-income, Latino families, and to examine the relationship of parental attitudes toward sugar-sweetened beverages with parental and infant SSB consumption. (more…)
Author Interviews, Cannabis / 25.10.2018

MedicalResearch.com Interview with: Jonathan Rothbard, MA, PhD Steinman Lab Stanford Medicine Co-founder Gold Bee – Pharmaceutical Grade CBD Products MedicalResearch.com: What is the background for this new company? How did Katexco get its name? Response: Researchers with Stanford University, Jonathan Rothbard and Lawrence Steinman, formed Katexco Pharmaceuticals. Katexco will focus on developing oral therapies for inflammatory diseases based on cannabis and nicotine receptors. Katexco will work to develop the first drug to focus on a key receptor on immune cells that are involved in inflammatory disease. The first primary target indications include gastrointestinal disorders like Crohn’s disease, gout and multiple sclerosis. Katexco is from the Greek word to restrain or regulate, and we are trying to restrain the immune system in inflammatory disease. We produce what Observer.com has ranked the #1 CBD oil for pain. In fact, our CBD oil is the best CBD oil for pain according to more than 300 independently verified reviews from consumers on TrustSpot. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 25.10.2018

MedicalResearch.com Interview with: Gary A. Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? Response: When residential fires happen at night while people are sleeping, deaths are more likely to occur. Smoke alarms are important for preventing these deaths, yet many young children don’t wake up to traditional high-pitch tone alarms. Children sleep longer and deeper than adults and require louder sounds to awaken than adults. For these reasons, children are less likely to awaken and escape a nighttime home fire. (more…)
Author Interviews, Dermatology, Gastrointestinal Disease, JAMA / 25.10.2018

MedicalResearch.com Interview with: Prof Ching-Chi Chi, MD, MMS, DPhil  Department of Dermatology Chang Gung Memorial Hospital, Linkou Guishan Dist, Taoyuan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown common genotypes, clinical course, and immunological features shared by psoriasis and inflammatory bowel disease. However, the relationship between psoriasis and inflammatory bowel disease was largely unclear. In this study, we found when compared to the general population, psoriatic patients are more likely to have concomitant inflammatory bowel disease.  (more…)
Author Interviews, Brain Injury, Critical Care - Intensive Care - ICUs, JAMA / 25.10.2018

MedicalResearch.com Interview with: Jamie Cooper AO BMBS MD FRACP FCICM FAHMS Professor of Intensive Care Medicine Monash University Deputy Director & Head of Research, Intensive Care & Hyperbaric Medicine The Alfred, Melbourne MedicalResearch.com: What is the background for this study? Response: 50-60 million people each year suffer a traumatic brain injury (TBI) . When the injury is severe only one half are able to live independently afterwards. Cooling the brain (hypothermia) is often used in intensive care units for decades to  decrease inflammation and brain swelling and hopefully to improve outcomes, but clinical staff have had uncertainty whether benefits outweigh complications. We conducted the largest randomised trial of hypothermia in TBI, in 500 patients, in 6 countries, called POLAR. We started cooling by ambulance staff, to give hypothermia the best chance to benefit patients. We continued for 3-7 days in hospital ind ICU. We measured functional outcomes at 6 months. (more…)
Author Interviews, Biomarkers, Endocrinology, JCEM, OBGYNE, Yale / 25.10.2018

MedicalResearch.com Interview with: Valerie A. Flores, MD Clinical Instructor Division of Reproductive Endocrinology & Infertility Department of Obstetrics, Gynecology & Reproductive Sciences Yale School of Medicine - Yale New Haven Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Endometriosis is a debilitating gynecologic disease that affects 1 in 10 reproductive-aged women, causing pain and infertility.  It is a hormonally dependent disorder— estrogens promote growth of endometriosis, while progesterone inhibits estrogen-dependent proliferation. Although progestin-based therapies (including combined oral contraceptives) are first-line therapy in the management of endometriosis-associated pain, response to progestins is variable and currently unpredictable. (more…)
Author Interviews, Genetic Research, NEJM, Pulmonary Disease, Rheumatology / 24.10.2018

MedicalResearch.com Interview with: Joyce S. Lee, MD Associate Professor Director, Interstitial Lung Disease Program Department of Medicine Division of Pulmonary Sciences and Critical Care Medicine University of Colorado School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Rheumatoid arthritis (RA) is a common inflammatory arthritis that can be complicated by interstitial lung disease (ILD). Patients with RA-ILD share clinical characteristics with another ILD called idiopathic pulmonary fibrosis (IPF). Given the similar clinical phenotype, our goal was to see if these lung diseases (IPF and RA-ILD) shared a common genetic risk factor. The MUC5B promoter variant is the most common risk factor (genetic and otherwise) for the development of IPF. Our findings demonstrate the MUC5B promoter variant is also a strong risk factor for the development of RA-ILD among patients with RA. (more…)
Author Interviews, Endocrinology, OBGYNE, Smoking / 24.10.2018

MedicalResearch.com Interview with: Nis Brix M.D., PhD Student Department of Public Health Department of Epidemiology Aarhus University Hospital Nis Brix M.D., PhD Student Department of Public Health Department of Epidemiology Aarhus University Hospital  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Several studies have indicated a secular trend towards earlier puberty. This is a potential concern as early puberty has been linked to an increased risk of a number of diseases, such as obesity, diabetes, cardiovascular diseases and certain types of cancer. For this reason, our research team are interested in identifying potential modifiable causes of early puberty. Smoking during pregnancy may be such a modifiable cause of early puberty in the children. Former studies have already linked smoking during pregnancy to earlier age at the daughters’ first menstrual period, a relatively late marker of pubertal development, but other markers of puberty are less studied, especially in the sons. We studied 15,819 sons and daughters. The mothers gave detailed information on smoking during their pregnancies, and the children gave information on a number of pubertal milestones half-yearly from the age of 11 years. The milestones for the sons were age at voice break, first ejaculation of semen, pubic hair and testicular growth, armpit hair growth and onset of acne. For the daughters the milestones were age at their first menstrual period, pubic hair growth, breast development, armpit hair growth and onset of acne. Our results suggested that the more cigarettes the mother smoked during her pregnancy the earlier her children, both sons and daughters, went through puberty. If the mother smoked more than ten cigarettes a day during pregnancy, the children appeared to go through puberty, on average, three to six months earlier than the children of non-smoking mothers. (more…)