Author Interviews, Cost of Health Care, Dartmouth, JAMA, Pharmaceutical Companies / 09.01.2019

MedicalResearch.com Interview with: Steven Woloshin, MD, MS Professor Co-director of the Center for Medicine and Media The Dartmouth InstituteSteven Woloshin, MD, MS Professor Co-director of the Center for Medicine and Media The Dartmouth Institute MedicalResearch.com: What is the background for this study? What are the main findings? What influence does medical marketing have on medical care and drug prices? Response: There are published studies looking at promotional spending mostly for drugs (DTC and professional).  This paper is unique because it is such a broad look including not just drugs but also marketing of disease (in "awareness campaigns"), health services and laboratory tests. What is new here is the size and scope of marketing.  For context, $29.9 billion spent on promoting prescription drugs, disease awareness campaigns, health services, and laboratory tests corresponds approximately to $1000 per American.    For context, FDA's total budget is around $5 billion – and NIH's total budget is about $30 billion. This figure is up from $17.7 billion in 1997, with the most rapid increase in DTC promotion of prescription drugs and health services.   Pharmaceutical marketing to professionals (detailing visits and samples) accounted for most spending and remained high despite policies to limit industry influence. $30 billion is of an underestimate (egg, we did not include monies spent on professional marketing (detailing) of laboratory tests, health services or devices, the value of drug coupons/discounts/rebates, company marketing budgets, lobbying or campaign contributions). Further it is just the tip of the iceberg – marketing works so promotional spending is an important driver of why medical care is so expensive:  it leads to more – and more expensive - tests and treatments.
Alcohol, Author Interviews, Depression, JAMA / 09.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46863" align="alignleft" width="200"]Dr. Ingunn Olea Lund, PhD The Norwegian Institute of Public Health Oslo, Norway Dr. Ingunn Olea Lund[/caption] Dr. Ingunn Olea Lund, PhD The Norwegian Institute of Public Health Oslo, Norway MedicalResearch.com: What is the background for this study? Response: There are significant amounts of research on children of parents with alcohol use disorders – where the children are shown to be at risk of several adverse outcomes, including mental disorders, substance use disorders, suicide, impaired school performance, and employment problems. There is very little previous research on how other, more normal levels of parental drinking may influence child outcomes, such as mental health. This is a grave oversight, as there are vastly more parents with normal drinking patterns than there are parents who suffer from an alcohol use disorder. This means that there are potentially a lot more cases of adverse effect for children, and the number of children at risk may be higher than previously assumed. In addition to parents' alcohol use, several other risk factors in the family that may affect child mental health outcomes, such as parents' mental health and socio-economic status. Researchers have tended to look at these risk factors separately, but as these risks tend to co-occur, it may be more informative to consider them together. To our knowledge, this is the first study that examines possible harm from normal levels of parental drinking, alone or in combination with other parental risk factors, on children’s anxiety and depression. The sample consists of more than 8700 triads: children and both their parents. We combined information from three health registries with survey data where both adolescents and their parents provided information about health and social conditions. The health registers include information about the children 's actual contact with the health care system; we used information about whether children received diagnoses and/or treatment for anxiety and/or depression.
Author Interviews, C. difficile, Microbiome, Pain Research / 09.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46859" align="alignleft" width="133"]MedicalResearch.com Interview with: David M. Aronoff, MD, FIDSA, FAAM Professor & Addison B. Scoville Jr. Chair in Medicine Director, Division of Infectious Diseases Department of Medicine Vanderbilt University Medical Center MedicalResearch.com: What is the background for this study? Response: Clostridium difficile infection (CDI) is a major cause of antibiotic-associated colitis and diarrhea and a leading cause of hospital-acquired infection. It is caused by the toxin-producing, anaerobic, spore-forming bacterium Clostridium difficile. Antibiotic use is a major risk factor for CDI but epidemiological studies suggest that other factors, some modifiable, some not, can also increase the risk for CDI. Older age is an example of a non-modifiable risk factor for CDI. Some epidemiological studies suggested that taking the prostaglandin synthesis inhibiting drugs called non-steroidal anti-inflammatory drugs (NSAIDs) might also increase the risk for CDI. NSAIDs include medications such as ibuprofen, naproxen, indomethacin, and others. Because NSAID use is so common, if it is a risk factor for the acquisition of, or severity of, CDI, that would be important because that would be a modifiable risk factor. We therefore sought to determine the impact of NSAID exposure on CDI severity in a mouse model of antibiotic-associated CDI. We also sought evidence for possible mechanisms whereby NSAIDs might increase the risk for CDI. MedicalResearch.com: What are the main findings? Response: Exposure of mice to indomethacin (an NSAID) for two days prior to infection with Clostridium difficile in antibiotic-exposed mice increased the severity of disease and this was associated with severe inflammation, changes to the bacterial populations in the colon and increased damage to the protective epithelial lining of the colon. MedicalResearch.com: What should readers take away from your report? Response: Our studies provide evidence in a mouse model of CDI that support human epidemiological studies linking NSAID use with CDI. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Studies in humans are needed to see if NSAID use is indeed a causal risk factor for CDI acquisition or severity. MedicalResearch.com: Is there anything else you would like to add? Response: This work was funded by the National Institutes of Health and the Crohn’s and Colitis Foundation of America. Dr. Aronoff has served as Consultant for Synthetic Biologics, Inc, Biocidium, NAEJA-RGM and BLC-USA on projects unrelated to this study. He also has research funding from Pfizer unrelated to this study. Citation: Damian Maseda, Joseph P. Zackular, Bruno Trindade, Leslie Kirk, Jennifer Lising Roxas, Lisa M. Rogers, Mary K. Washington, Liping Du, Tatsuki Koyama, V. K. Viswanathan, Gayatri Vedantam, Patrick D. Schloss, Leslie J. Crofford, Eric P. Skaar, David M. Aronoff. Nonsteroidal Anti-inflammatory Drugs Alter the Microbiota and Exacerbate Clostridium difficile Colitis while Dysregulating the Inflammatory Response. mBio, 2019; 10 (1) DOI: 10.1128/mBio.02282-18 [wysija_form id="3"] [last-modified] The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. Dr. Aronoff[/caption]David M. Aronoff, MD, FIDSA, FAAM Professor & Addison B. Scoville Jr. Chair in Medicine Director, Division of Infectious Diseases Department of Medicine Vanderbilt University Medical Center MedicalResearch.com: What is the background for this study? Response: Clostridium difficile infection (CDI) is a major cause of antibiotic-associated colitis and diarrhea and a leading cause of hospital-acquired infection. It is caused by the toxin-producing, anaerobic, spore-forming bacterium Clostridium difficile. Antibiotic use is a major risk factor for CDI but epidemiological studies suggest that other factors, some modifiable, some not, can also increase the risk for CDI. Older age is an example of a non-modifiable risk factor for CDI. Some epidemiological studies suggested that taking the prostaglandin synthesis inhibiting drugs called non-steroidal anti-inflammatory drugs (NSAIDs) might also increase the risk for CDI. NSAIDs include medications such as ibuprofen, naproxen, indomethacin, and others. Because NSAID use is so common, if it is a risk factor for the acquisition of, or severity of, CDI, that would be important because that would be a modifiable risk factor. We therefore sought to determine the impact of NSAID exposure on CDI severity in a mouse model of antibiotic-associated CDI. We also sought evidence for possible mechanisms whereby NSAIDs might increase the risk for CDI.
Author Interviews, JAMA, Orthopedics, Pain Research, University of Pittsburgh / 09.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46849" align="alignleft" width="200"]Dr. Michael Schneider DC, PhD Associate Professor School of Health and Rehabilitation Sciences  University of Pittsburgh Dr. Schneider[/caption] Dr. Michael Schneider DC, PhD Associate Professor School of Health and Rehabilitation Sciences University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: Lumbar spinal stenosis (LSS) is one of the fastest growing problems in the country due to its aging population. One third of Medicare users have the condition, and it is the number one reason for spine surgery in this population. Existing research evaluates the benefits of nonsurgical treatment options compared to surgery, but there was no existing research that compared the available nonsurgical options to each other to determine the best course of treatment for each patient. We studied three nonsurgical treatments for LSS: medical management with medications and/or epidural injections, individualized care with a physical therapist or chiropractor, and group exercise. We assessed each of these treatment methods with a questionnaire, a walking distance test, and a physical activity monitor. 
Author Interviews, Cancer Research, Cost of Health Care, JAMA / 08.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46845" align="alignleft" width="200"]Kiu Tay-Teo, PhD World Health Organization Geneva, Switzerland Dr. Kiu Tay-Teo[/caption] Kiu Tay-Teo, PhD World Health Organization Geneva, Switzerland MedicalResearch.com: What are the main findings? Response: High costs and high risks of R&D for drugs have been presented to justify high drug prices, especially for cancer drugs. However, it is unclear whether prices are in fact justifiable compared to the overall return on R&D investment. In this paper, we systematically compared incomes from the sales of cancer drugs with the R&D costs. We quantified the incomes generated from the sales of 99 cancer drugs approved by FDA from 1989–2017. This was based on sales figures reported in the originator companies’ annual financial reports, and where necessary, estimates deduced from the reported figures. The sales incomes were net of rebates and discounts, but without accounting for expenses and taxes. For the R&D costs of bringing one new cancer drug to the market, the literature reported a typical costs of between $219 million and $2.9 billion, after accounting for the costs of failed products that were investigated but not marketed and the opportunity costs. For the main analysis, we used a median cost of $794 million, as reported in the literature. To be clear, this analysis did not estimate profit return because we do not have information about the costs and year-to-year variations in costs (i.e. expenses and taxes) specific to cancer drugs.
Author Interviews, Columbia, Depression, Hearing Loss, JAMA / 08.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46841" align="alignleft" width="147"]Justin S. Golub, MD, MS Assistant Professor Otology, Neurotology, and Skull Base Surgery Department of Otolaryngology-Head and Neck Surgery Columbia University Vagelos College of Physicians and Surgeons NewYork-Presbyterian/Columbia University Irving Medical Center Dr. Golub[/caption] Justin S. Golub, MD, MS Assistant Professor Otology, Neurotology, and Skull Base Surgery Department of Otolaryngology-Head and Neck Surgery Columbia University Vagelos College of Physicians and Surgeons NewYork-Presbyterian/Columbia University Irving Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Age-related hearing loss is extremely common, yet few people do anything about it. We studied a population of over 5,000 individuals and found that hearing loss was related to feelings of depression. The worse the hearing loss, the worse the symptoms of depression. Even people with just mild hearing loss had nearly two times the odds of depressive symptoms compared to normal hearing people. Among people with moderate hearing loss, the odds of depressive symptoms were four times as high. These statistics take into account various factors that can cause both hearing loss and depression, such as age and demographic background. 
Author Interviews, Cost of Health Care, University of Pittsburgh / 08.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46836" align="alignleft" width="132"]MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy Dr. Hernandez[/caption] Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of our study was to answer a research question of high policy relevance: to what extent are rising drug costs due to inflation in the prices of existing products versus the market entry of new, more expensive drugs. We found that rising prices of brand-name drugs are largely driven by manufacturers increasing prices of medications that are already in the market rather than to the entry of new products. In contrast, increases in costs of specialty and generic drugs were driven by the entry of new drugs.
ALS, Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, JAMA, Multiple Sclerosis / 08.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46832" align="alignleft" width="200"]Michael Fralick, MD, FRCPC, SM, PhD (Cand) Clinical Associate, General Internal Medicine, St Michael’s Hospital Phillipson Scholar, Clinician Scientist Program, University of Toronto  PhD Candidate, IHPME, University of Toronto Affiliated Faculty, Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital, Harvard University Dr. Fralick[/caption] Michael Fralick, MD, FRCPC, SM, PhD (Cand) Clinical Associate, General Internal Medicine St Michael’s Hospital Phillipson Scholar, Clinician Scientist Program, University of Toronto PhD Candidate, IHPME, University of Toronto Affiliated Faculty, Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital, Harvard University MedicalResearch.com: What is the background for this study? What are the main findings? Response: This medication is a pill that combines two ingredients: dextromethorphan (the active ingredient in cough syrup) and quinidine (used to increase the concentration of dextromethorphan). The medication was primarily studied and evaluated in patients with amyotrophic lateral sclerosis (ALS)   or (multiple sclerosis) MS, but anecdotal evidence suggested it was being prescribed to patients with dementia. We used data from two nationwide healthcare databases to understand how the medication was being used in routine care.
Author Interviews, JAMA, Pediatrics, Smoking, Tobacco, Tobacco Research / 07.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46793" align="alignleft" width="165"]Dr. Hongying Dai, PhD Associate Professor at the College of Public Health University of Nebraska Medical Center. Dr. Dai[/caption] Dr. Hongying Dai, PhD Associate Professor at the College of Public Health University of Nebraska Medical Center. MedicalResearch.com: What is the background for this study? Response: The 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA) banned cigarettes with characterizing flavors (e.g., candy, fruit, clove) except menthol. However, there are no restrictions on the marketing and sales of flavored non-cigarette tobacco products. This has led to a proliferation of flavored tobacco products in the marketplace. Flavoring has become one of the leading reasons for current tobacco use among youth. It is reported that 81% of e-cigarette users, 79% of hookah users, 74% of cigar users, 69% of smokeless tobacco users, and 67% of snus users attributed the availability of appealing flavors for their tobacco use in 2013–2014 among teenagers aged 12 to 17 years. In November 2018, the FDA proposed new restrictions on flavored tobacco products.
Author Interviews, CMAJ, Heart Disease, Occupational Health, Social Issues, Stroke / 07.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46787" align="alignleft" width="150"]Allan Garland, MD,  MA  Professor of Medicine & Community Health Sciences Co-Head, Section of Critical Care Medicine University of Manitoba Dr. Garland[/caption] Allan Garland, MD,  MA  Professor of Medicine & Community Health Sciences Co-Head, Section of Critical Care Medicine University of Manitoba MedicalResearch.com: What is the background for this study? Response: Heart attacks, strokes and cardiac arrest are common acute health events.  Most studies of serious acute health events look at outcomes such as death and how long is spent in the hospital.  But for working age people, the ability to work and earn income are very important outcomes that have rarely been studied. We set out to carefully measure, across Canada, how much heart attacks, strokes and cardiac arrests affect the ability of working age people to work and earn.
Accidents & Violence, Author Interviews, Sexual Health / 06.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46812" align="alignleft" width="190"]Angie Kennedy, PhD Associate Professor School of Social Work Michigan State University East Lansing, MI 48824 Dr. Kennedy[/caption] Angie Kennedy, PhD Associate Professor School of Social Work Michigan State University East Lansing, MI 48824  MedicalResearch.com: What is the background for this study?   Response: Nearly half of women (44%) experience physical or sexual partner violence by young adulthood, with 1 in 5 girls in high school reporting abuse within the last year. Sexual violence typically co-occurs with other forms of partner violence; co-occurring sexual and physical violence among adolescent girls is linked to health-risk behaviors including alcohol and drug use, unhealthy weight control, sexual risk-taking, and suicidality. As such, it represents a serious public health problem. To better understand this issue, we wanted to explore risk factors for sexual violence during young women’s adolescent and young adult relationships, i.e., what predicts attempted rape and rape by a partner during this vulnerable period? We took a novel approach: We examined predictors across multiple relationships, beginning with the first one, and we recruited a diverse sample of young women from a four-year research university, a two-year community college, and community sites serving low-income young women.
Accidents & Violence, Author Interviews, JAMA, Social Issues / 06.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46819" align="alignleft" width="125"]Rebecca R. Thompson, Ph.D. Postdoctoral Scholar Department of Psychological Science University of California, Irvine Dr. Thompson[/caption] Rebecca R. Thompson, Ph.D. Postdoctoral Scholar Department of Psychological Science University of California, Irvine MedicalResearch.com: What is the background for this study? Response: Our research team has been interested in how people respond to the repeated threat of disaster exposure for many years. We recently published a review of the literature on evacuation from natural disasters, and one of our main findings was that there have been no studies that include assessments of individuals’ intentions, perceptions, and psychological states assessed prior to an approaching storm’s landfall – all prior research has been retrospective, and recall is undoubtedly biased and unreliable.  Our goal in undertaking this study was to fill this hole in the literature. We sought to assess individuals' responses to Hurricane Irma in the days leading up to and immediately after its landfall in the State of Florida.
Author Interviews, Methamphetamine / 06.01.2019

MedicalResearch.com Interview with: [caption id="attachment_43644" align="alignleft" width="200"]Brian J. Piper, PhD, MS Department of Basic Sciences Geisinger Commonwealth School of Medicine Scranton, PA 18509 Dr. Piper[/caption] Brian J. Piper, PhD, MS Assistant Professor of Neuroscience Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton PA 18509  MedicalResearch.com: What is the background for this study? Response: The U.S. accounts for five percent of the world population but more than 92 percent of the world’s spending on pharmacotherapies for Attention Deficit Hyperactivity Disorder (ADHD). According to the 2011 National Survey of Children’s Health, ADHD increased to 11.0 percent of U.S. children, seven percent of girls and 15 percent of boys. Interestingly, ADHD rates were much lower among Hispanic children. The 2013 revision to the Diagnostic and Statistical Manual of Mental Disorders broadened the criteria such that it became easier to diagnose adult ADHD. Together, we hypothesized that use of amphetamine (Adderall), methylphenidate (Ritalin), and lisdexamfetamine (Vyvanse) would be increasing. We also predicted that there would be some regional differences in stimulant use.
Author Interviews, JAMA, Johns Hopkins, Social Issues / 06.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46800" align="alignleft" width="120"]Megan Wallace, DrPH Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland Dr. Wallace[/caption] Megan Wallace, DrPH Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Local health departments are often evaluated on a nationwide or statewide basis, however, given diversity among counties that exists even at the state level, we felt there might be a better way to group health departments for evaluation. In this study, we created county-level clusters using local characteristics most associated with the outcomes of interest, which were smoking, motor vehicle crash deaths, and obesity. We then compared county-level percentile rankings for the outcomes within sociodemographic peer clusters vs nationwide rankings. We identified 8 groups of counties with similar local characteristics. Percentile ranks for the outcomes of interest often differed when counties were compared within their peer groups in comparison with a nationwide scale. 
Author Interviews, OBGYNE, Weight Research / 04.01.2019

MedicalResearch.com Interview with: "Breast feeding... Like its her job." by Jason Lander is licensed under CC BY 2.0 <a href="https://creativecommons.org/licenses/by/2.0"> CC BY 2.0</a>Gabrielle G. Snyder, MPH Department of Epidemiology Graduate School of Public Health University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although previous studies have investigated the association between breastfeeding duration and maternal weight change, we still do not know if there is an optimal duration of breastfeeding for mothers in order to realize potential health benefits. Furthermore, these studies were unable to determine whether health outcomes were due to breastfeeding or other health-promoting behaviors, like better diet and more physical activity. Our study aims to address both points. To test the association between breastfeeding duration and maternal waist circumference, we used traditional regression models as well as two additional statistical methods that allowed us to control for factors that may influence if a woman would breastfeed and for how long. We found that women who breastfed more than 6 months had smaller waist circumference, as well as lower body mass index, one decade after delivery compared to women who breastfed 6 months or less. These results were consistent across all statistical methods. 
Author Interviews, Autism, Cognitive Issues, JAMA / 04.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46784" align="alignleft" width="158"]Tjasa Velikonja, PhD Department of Psychiatry The Seaver Autism Center for Research and Treatment Icahn School of Medicine at Mount Sinai New York, New York Dr. Velikonja[/caption] Tjasa Velikonja, PhD Department of Psychiatry The Seaver Autism Center for Research and Treatment Icahn School of Medicine at Mount Sinai New York, New York MedicalResearch.com: What is the background for this study? What are the main findings? Response: Autism is a lifelong condition, and challenges associated with autism persist from childhood into adulthood. Despite this, research and treatment have been largely dedicated to children. Because of that, we had very little understanding of what areas – what cognitive domains - are most severely impacted in adults with autism. Importantly, the lack of such information also limits treatment development in this area. What is known already is that adults with autism display deficits in social cognition (which refers to the role that cognitive processes play in our social interactions). Although our meta-analysis supported these theories, it also highlighted several other challenges in cognitive processing, such as deficits in processing speed and verbal learning and memory. And these impairments were observed in adults with autism without an overall intellectual disability.
Author Interviews, Brain Injury / 03.01.2019

MedicalResearch.com Interview with: Robert Ross, Ph.D. Assistant Professor McConnell Hall, Room 424 University of New Hampshire  MedicalResearch.com: What is the background for this study? Response: In the United States, 1.5-2 million people suffer from mild traumatic brain injuries, more commonly referred to as concussions, per year. There is a large body of work illustrating the cognitive impairments associated with concussions in the immediate aftermath of the concussive event. However, it is not clear whether concussions can change cognition more long-term and how concussions might change how the brain functions during specific types of cognition. In our study, we examined executive function, which is a cognitive process that helps control or manage other cognitive functions, in a group of healthy young adults aged 18-24 that had suffered at least two concussions and compared their performance and their brain oscillations to a group that had not suffered any concussions. Brain oscillations help the brain coordinate the activity of the thousands of neurons necessary for any sort of cognitive process to occur. The participants in the study self-reported their concussions with all concussions occurring at least one month prior to participating in the experiment.
Author Interviews, Columbia, Genetic Research, Kidney Disease / 03.01.2019

MedicalResearch.com Interview with: Emily E. Groopman, B.A Departments of Medicine Hammer Health Sciences, and the Department of Epidemiology Columbia University, New York MedicalResearch.com: What is the background for this study? Response: Exome sequencing (ES), targeted capture of the protein-coding segments of the human genome, is quickly becoming a first-line diagnostic tool in clinical medicine, particularly for pediatric disorders and cancer. However, the utility of ES has not been investigated for the majority of constitutional disorders in adults, including for chronic kidney disease (CKD), which collectively affects more than 1 in 10 individuals worldwide. Thus, we performed ES in 3,315 patients with CKD drawn from two independent cohorts, and evaluated the diagnostic yield and the clinical implications of genetic findings. The cohort was predominantly adult (91.6% of patients aged >21 years), ethnically diverse, and encompassed the major CKD subtypes, broadly reflective of the demographic and clinical features of United States CKD patient population.
Addiction, Author Interviews, Cocaine, Opiods, Primary Care / 03.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46771" align="alignleft" width="184"]Sarah M. Bagley MD, MSc Assistant Professor of Medicine and Pediatrics Director, CATALYST Clinic Boston University School of Medicine/Boston Medical Center Boston, MA Dr. Bagley[/caption] Sarah M. Bagley MD, MSc Assistant Professor of Medicine and Pediatrics Director, CATALYST Clinic Boston University School of Medicine/Boston Medical Center Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Urine drug testing is a routine part of the management of primary care patients with opioid use disorder treated with medications such as buprenorphine. In addition, most providers also ask patients about recent drug use. The point of this study was to see the agreement between the urine drug testing and what patients told a nurse and whether that changed the longer a patient was in treatment. We found that truthful disclosure of opioid and cocaine use increased with time in treatment and that urine drug tests are a useful tool to monitor patients. 
Annals Internal Medicine, Author Interviews, Beth Israel Deaconess, Cost of Health Care, Heart Disease, Lipids / 02.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46753" align="alignleft" width="150"]Dhruv S. Kazi, MD, MSc, MS Associate Directo Richard A. and Susan F. Smith Center for Outcomes Research Boston MA 02215 Associate Director Cardiac Critical Care Unit Beth Israel Deaconess Medical Center Dr. Kazi[/caption] Dhruv S. Kazi, MD, MSc, MS Associate Director Richard A. and Susan F. Smith Center for Outcomes Research Boston MA 02215 Associate Director Cardiac Critical Care Unit Beth Israel Deaconess Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The ODYSSEY Outcomes trial found that addition of alirocumab to statin therapy reduces the incidence of a composite of cardiovascular death, myocardial infarction, and stroke among patients with a recent history of a myocardial infarction and elevated low-density lipoprotein cholesterol. We modeled the cost-effectiveness of alirocumab and found that, at the March 2018 price of the drug, it would not be cost-effective (either relative to statin alone or statin + ezetimibe) for this indication. We found that a large price-reduction would be required to meet the cost-effectiveness threshold of $100,000 per quality-adjusted life year. Shortly after the preliminary findings of this study were released, both manufacturers of PCSK9 inhibitors announced large price reductions in order to improve access to these drugs.
Author Interviews, Cancer Research, Chemotherapy, Menopause, Mental Health Research / 02.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46764" align="alignleft" width="128"]Nicole J. Gervais, Ph.D. Postdoctoral fellow | Einstein lab University of Toronto, Department of Psychology Toronto, ON Dr. Gervais[/caption] Nicole J. Gervais, Ph.D. Postdoctoral fellow | Einstein lab University of Toronto, Department of Psychology Toronto, ON  MedicalResearch.com: What is the background for this study?   Response: Aromatase inhibitors (AIs) including letrozole are given as an adjuvant therapy for postmenopausal women with hormone receptor positive breast cancer. Women taking this drug have reported a number of symptoms including hot flashes, memory complaints and mood changes. However, not all studies report memory issues. This might be due to the fact that studies in this population are hampered by confounds, such as chemotherapy/radiotherapy, stress and disease stage, all of which can also adversely impact memory. These confounds make it challenging to observe the independent effects of AIs on memory. By using a non-human primate model, we were able to examine the effects of aromatase inhibition on these symptoms as well as brain function without these confounding effects.
Author Interviews, Occupational Health, Social Issues / 02.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46761" align="alignleft" width="149"]Christiane Spitzmueller, Ph.D. Professor, Psychology Industrial Organizational Psychology University of Houston Dr. Spitzmueller[/caption] Christiane Spitzmueller, Ph.D. Professor, Psychology Industrial Organizational Psychology University of Houston MedicalResearch.com: What is the background for this study?   Response: We generally conduct research on how parents' work experiences affect the health and well-being of family systems. Many families struggle to successfully reconcile work and family demands, and we were wondering what specific work experiences were most likely to relate to negative outcomes for children. We also wanted to know how the impact of parents' stressful work experiences' with the happiness and health of their children could be addressed. Hence the study!
Author Interviews, Johns Hopkins, Kidney Disease, Sugar / 02.01.2019

MedicalResearch.com Interview with: [caption id="attachment_46756" align="alignleft" width="142"]Casey M. Rebholz, PhD, MS, MNSP, MPH, FAHA Assistant Professor, Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Core Faculty, Welch Center for Prevention, Epidemiology, and Clinical Research Baltimore, MD 21287 Dr. Rebholz[/caption] Casey M. Rebholz, PhD, MS, MNSP, MPH, FAHA Assistant Professor, Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Core Faculty, Welch Center for Prevention, Epidemiology, and Clinical Research Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Individual beverages have been previously shown to influence risk of a wide range of cardiometabolic diseases. Less is known about beverage consumption and kidney disease risk. In this study population, we found that one such beverage pattern consisted of soda, sugar-sweetened beverages, and water, and that higher adherence to the sugar-sweetened beverage pattern was associated with greater odds of developing incident kidney disease, even after accounting for demographic characteristics and established risk factors. 
Author Interviews, NEJM, Pediatrics, Smoking, Tobacco, Tobacco Research, University of Michigan / 30.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46749" align="alignleft" width="159"]Richard Miech Ph.D Professor Principal Investigator, Monitoring the Future Institute for Social Research University of Michigan Dr. Miech[/caption] Richard Miech Ph.D Professor Principal Investigator, Monitoring the Future Institute for Social Research University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Every year Monitoring the Future conducts a survey to examine trends in adolescent substance use.  We draw a random sample of schools from a list of all schools in the United States and conduct our survey in ~400 schools.  Our survey is representative of U.S. 8th, 10th, and 12th grade students.  In other words, our results are what you would find if you surveyed every single 8th, 10th, and 12th graders in the United States, within the bounds of a small sampling error of a few percentage points. An increase in vaping is the big news for 2018.  In 10th and 12th grade the increase in nicotine vaping was the largest we've ever seen for any substance in the past 43 years.  As a result of this increase in nicotine vaping, overall use of nicotine increased as well, which suggests that vaping is drawing youth into nicotine use.  We also saw a significant increase in marijuana vaping.
Alcohol, Author Interviews, Heart Disease, JAMA / 29.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46714" align="alignleft" width="145"]David L. Brown, MD, FACC Professor of Medicine Cardiovascular Division Washington University School of Medicine St. Louis, MO 63110 Dr. Brown[/caption] David L. Brown, MD, FACC Professor of Medicine Cardiovascular Division Washington University School of Medicine St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The genesis of this study was a patient asking me if he could continue to have a nightly cocktail or two after he was hospitalized with the new diagnosis of heart failure. The main findings are that moderate drinking after the diagnosis of heart failure in older adults is probably safe and is associated with longer survival. These types of studies can not prove a causal relationship between alcohol consumption and survival. 
Alcohol, Author Interviews, Smoking / 28.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46740" align="alignleft" width="200"]Dr. Sarah Dermody, PhD Assistant Professor School of Psychological Science Oregon State University Corvallis Oregon Dr. Dermody[/caption] Dr. Sarah Dermody, PhD Assistant Professor School of Psychological Science Oregon State University Corvallis Oregon  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Drinking alcohol is a risk factor for sustained smoking. In a sample of daily cigarette smokers receiving treatment for alcohol use disorder, we examined if reductions in drinking corresponded with reductions in nicotine metabolism as indexed by the nicotine metabolite ratio. The nicotine metabolite ratio is important because it is associated with smoking level and lapses. We found that for men, alcohol use and the nicotine metabolite ratio reduced significantly; however, for women, neither drinking nor nicotine metabolite ratio changed.
Author Interviews, JAMA, Pediatrics, Social Issues / 28.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46736" align="alignleft" width="133"]Dr. Richard E. Tremblay, PhD, Professor Department of Pediatrics and Department of Psychology University of Montreal, Montreal, Quebec, Canada School of Public Health, University College Dublin, Dublin, Ireland Dr. Tremblay[/caption] Dr. Richard E. Tremblay, PhD, Professor Department of Pediatrics and Department of Psychology University of Montreal, Montreal, Quebec, Canada School of Public Health, University College Dublin, Dublin, Ireland MedicalResearch.com: What is the background for this study?   Response: Adolescent who have frequently use physical aggression are at high risk of school failure, criminal behavior, as well as physical and mental health problems. A major limit to preventive interventions is our ability to trace the developmental trajectories of physical aggression from infancy to adolescence using a uniform source of information.
Author Interviews, Cancer Research, JAMA, Weight Research / 28.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46733" align="alignleft" width="120"]Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303 Dr. Islami[/caption] Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study?
Response: Despite variations in excess body weight (EBW) prevalence among states in the United States, there was little information on the proportion of incident cancers attributable to EBW (or population attributable fraction, PAF) by state. This information would be useful to help states set priorities for cancer control initiatives. In this paper, we estimated the PAF and number of incident cancer cases attributable to EBW by sex in all 50 states and the District of Columbia using representative exposure and cancer occurrence data. To provide more accurate estimates, we adjusted state-level data on body mass index (BMI) based on self-reported weight and height from the Behavioral Risk Factor Surveillance System by sex, age group, race/ethnicity, and education level (162 strata) using BMI values from the National Health and Nutrition Examination Survey, a nationally representative survey with objectively-measured height and weight.
Author Interviews, Dermatology, Global Health, Infections, PLoS / 28.12.2018

MedicalResearch.com Interview with: Michael Marks MRCP DTM&H PhD Clinical Research Department, Faculty of Infectious & Tropical Diseases London School of Hygiene and Tropical Medicine Hospital for Tropical Diseases London, United Kingdom Twitter @dr_michaelmarks Daniel Engelman MBBS; BMedSci; MPHTM; FRACP; PhD Centre for International Child Health, University of Melbourne, Tropical Diseases Research Group Murdoch Children’s Research Institute Melbourne, Australia Twitter @Dan_Engelman [caption id="attachment_46726" align="alignleft" width="400"]The lateral aspect of the left hand depicted here, reveals the presence of papules due to an infestation of the human itch mite, Sarcoptes scabiei var. hominis, in a case of what is commonly referred to as scabies. The lateral aspect of the left hand depicted here, reveals the presence of papules due to an infestation of the human itch mite, Sarcoptes scabiei var. hominis, in a case of what is commonly referred to as scabies.CDC image[/caption]                   MedicalResearch.com: What is the background for this study? MM: Scabies is extremely common. Globally in the region of 100-200 million people are believed to be affected by scabies annually. Recently the WHO has recognised Scabies as a ‘Neglected Tropical Disease’ in response to this burden of disease. There has been increasing interest in using Mass Drug Administration (treating whole communities) as a strategy to control scabies in communities. In order to make this practical countries need an easy mechanism for establishing if scabies is a significant problem in their communities. In general when treating an individual, clinicians would conduct a full body examination to diagnose scabies – however this may not be practical or necessary when making decisions about whether to treat whole communities. DE: Despite the fact that Scabies is a very common condition that causes a great deal of health problems, it has been largely neglected by health, research and funding agencies – but pleasingly, the WHO has now started to take action on scabies control, starting with the recognition of scabies as a "Neglected Tropical Disease"
Alzheimer's - Dementia, Author Interviews, Cost of Health Care, JAMA / 27.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46720" align="alignleft" width="200"]Lee A. Jennings, MD, MSHS Assistant Professor of Medicine Director, Oklahoma Healthy Aging Initiative Reynolds Department of Geriatric Medicine University of Oklahoma Health Sciences Center Oklahoma City, OK 73117 Dr. Jennings[/caption] Lee A. Jennings, MD, MSHS Assistant Professor of Medicine Director, Oklahoma Healthy Aging Initiative Reynolds Department of Geriatric Medicine University of Oklahoma Health Sciences Center Oklahoma City, OK 73117 MedicalResearch.com: What is the background for this study? Response: The research study focused on a novel model of care for persons living with Alzheimer’s disease and other types of dementia, the UCLA Alzheimer’s and Dementia Care Program. In the program, people with dementia and their caregivers meet with a nurse practitioner specializing in dementia care for a 90-minute in-person assessment and then receive a personalized dementia care plan that addresses the medical, mental health and social needs of both people. The nurse practitioners work collaboratively with the patient’s primary care provider and specialist physicians to implement the care plan, including adjustments as needs change over time. The research was designed to evaluate the costs of administering the program, as well as the health care services used by program participants, including hospitalizations, emergency room visits, hospital readmissions and long-term nursing home placement. A total of 1,083 Medicare beneficiaries with dementia were enrolled in the program and were followed for three years. The study compared them to a similar group of patients living in the same ZIP codes who did not participate in the program.