Author Interviews, Brigham & Women's - Harvard, Gender Differences, JAMA, Mental Health Research / 05.06.2017

MedicalResearch.com Interview with: Carl G Streed Jr. M.D. Pronouns: he, him, his, himself Fellow, Division General Internal Medicine & Primary Care  Brigham & Women’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: The National Institutes of Health (NIH) has underscored the need to better understand the health of gender minorities, including transgender and gender non-conforming individuals. Prior investigations of gender minorities are limited by the lack of national gender identity data. In 2013, the Centers for Disease Control and Prevention (CDC) developed a gender identity question for the Behavioral Risk Factors Surveillance System (BRFSS); states had the option to administer this module beginning 2014. Our study aims to examine the health status of gender minorities in the US compared to cisgender peers. Compared to cisgender adults, gender minority adults are younger, less likely to be non-Hispanic white, married or living with a partner, have a minor child in the household, or be English speaking; but are more likely to have lower income, be unemployed, be uninsured, have unmet medical care due to cost, be overweight, and report depression. Gender minority adults, compared to cisgender adults, are more likely to report: poor or fair health; difficulty concentrating, remembering, or making decisions; and being limited in any way. These outcomes remained significant after adjustment. (more…)
Author Interviews, JAMA, Salt-Sodium / 05.06.2017

MedicalResearch.com Interview with: Jennifer Poti, PhD Research Assistant Professor Nutritional Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill MedicalResearch.com: What is the background for this study? Response: Although strong evidence links excessive sodium intake to hypertension, a leading risk factor for cardiovascular disease, the majority of American children and adults have sodium intake that exceeds the recommended upper limit for daily sodium intake. To lower sodium intake at the population-level, the Institute of Medicine has recommended that reducing sodium in packaged foods will be essential and has emphasized the need to monitor sodium in the US food supply. However, little is known about whether sodium in packaged foods has changed during the past 15 years. (more…)
Author Interviews, Hand Washing, Infections / 05.06.2017

MedicalResearch.com Interview with: Donald Schaffner, PhD Extension Specialist in Food Science and Distinguished Professor Rutgers-New Brunswick MedicalResearch.com: What is the background for this study? Response: We been interested in handwashing and cross-contamination research for more than 15 years. About 10 years after I started as a faculty member I was approached about doing research in this area. The first paper republished has turned into my most highly cited paper. I think it was mostly a matter of being in the right place at the right time, with the right idea. This latest bit of research came out of my ongoing participation in the Conference for Food Protection. This is an unusual meeting, and unlike any other scientific conference. It’s a group of industry scientists, government regulators, and academics would get together every two years to help the FDA Center for Food Safety and Applied Nutrition update a document called the Model Food Code. The code has no regulatory standing, but it is used by state health agencies as the basis for state food codes that regulate restaurants, supermarkets, and other food service establishments. There are several provisions in the code that we wanted to try to impact with our research. The code currently states that hands must be washed in warm water. The plumbing section of the code also states that hand wash sinks must be capable of dispensing water at 100°F. We wanted to explore whether there was any scientific basis statements. In some recent survey-based research, graduate student that is also the first author on this manuscript surveyed the Internet for the kind of advice was offered on handwashing posters that provide advice on how to wash your hands. He found that the recommendations varied widely including recommendations on how long to wash your hands. (more…)
Author Interviews, Dermatology, Genetic Research, Yale / 05.06.2017

MedicalResearch.com Interview with: Keith Adam Choate, MD, PhD, FAAD Associate Professor of Dermatology, Genetics and Pathology Director of Research, Dermatology Yale University School of Medicine New Haven, CT MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Over the last 10 years, we have systematically been examining patients with ichthyosis to identify new genetic causes of this group of disorders.  We found that autosomal recessive mutations in KDSR cause ichthyosis and that the resulting skin disease is effectively treated with isotretinoin. (more…)
Author Interviews, Gender Differences, Pediatrics / 05.06.2017

MedicalResearch.com Interview with: Michael S. Dunbar, PhD Associate Behavioral Scientist RAND Corporation MedicalResearch.com: What is the background for this study? Response: Sexual minority college students suffer from mental health problems like anxiety and depression at higher rates than their heterosexual peers. If they aren’t addressed, these types of issues can have serious negative effects on things like academic achievement, employment, and quality of life –among others. This study analyzed information from a survey about mental health needs and use of mental health services. The survey was completed by over 33,000 students from nine University of California campuses, nine California State University campuses and 15 California community colleges. The results were weighted to help reflect California’s college student population. (more…)
ASCO, Author Interviews, Cancer Research / 05.06.2017

MedicalResearch.com Interview with: Dr. Kelly Garneski Paulson, MD, PHD Fred Hutchinson Cancer Research Center Seattle, WA   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Merkel cell carcinoma (MCC) is an aggressive skin cancer with increasing impact. Currently, there are more than 2000 new cases of MCC diagnosed each year in the US. Over one third of patients will develop metastatic disease. Most cases of Merkel cell carcinoma are caused by a virus (Merkel cell polyomavirus). In these cancers, the viral oncoproteins (cancer causing proteins) are highly expressed (exclusively on tumor tissue), immunogenic and are necessary for cancer growth.  These oncoproteins are thus ideal targets for cancer immunotherapy, making MCC a great cancer in which to study and develop immunotherapy.  Indeed, immunotherapies are effective in MCC, with observed response to checkpoint inhibitor mono therapy on the order of 35-55%, although complete responses remain rare. In our first trial, we treated four patients with metastatic Merkel cell carcinoma with endogenous T cell therapy (ex vivo expanded polyclonal T cells recognizing Merkel cell polyomavirus). One patient developed a complete response, but three patients rapidly progressed. Interestingly, we observed that the patient with the complete response had low levels of PD-1 expression on the virus specific transferred T cells. We thus hypothesized adding adding an immune checkpoint inhibitor (avelumab, anti-PD-L1) to the transferred T cells would be acceptably safe and potentially improve clinical effectiveness. (more…)
Author Interviews, Pharmacology / 05.06.2017

MedicalResearch.com Interview with: William D. Chey, M.D., F.A.C.G. Director, Division of Gastroenterology Michigan Medicine Gastroenterology Clinic Ann Arbor, Michigan MedicalResearch.com: What is the background for this study? Response: Functional Dyspepsia (FD), which is persistent or recurring upper abdominal pain, burning, or fullness with no known organic cause, is a relatively common and often frustrating condition. The precise causes of this condition are unknown, but problems with mild inflammation, leakiness of the lining of the gut, overactive sensation, and abnormal contractions of the upper digestive tract are thought to play a role in many patients. FD often reoccurs over time and it is an area of high unmet medical need. Functional Dyspepsia can have a significant impact on quality of life. Currently, off-label medications are used to treat FD, as there is no U.S. Food and Drug Administration (FDA)-approved pharmaceutical product for the condition. An estimated 62 percent of FD patients suffer from Epigastric Pain Syndrome (EPS, which is epigastric pain or burning), while an estimated 73 percent of FD patients suffer from Postprandial Distress Syndrome (PDS, which is early fullness, pressure and heaviness); 35 percent suffer from both. In this study, we compared the efficacy of a unique encapsulated formulation of caraway oil and l-Menthol, the primary component in peppermint oil), (COLM-SST) to placebo in patients taking their usual Functional Dyspepsia medications. Caraway oil contains carvone and d-limonene, which have gastroprotective and prokinetic effects; l-Menthol has anti-inflammatory, prokinetic, analgesic and gastroprotective effects. (more…)
ASCO, Author Interviews, Cancer Research, NYU / 05.06.2017

MedicalResearch.com Interview with: Prof Francisco J Esteva MD PhD Director of the breast medical oncology program at Perlmutter Cancer Center. NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Trastuzumab is a monoclonal antibody directed against the human epidermal growth factor receptor 2 (HER-2). Trastuzumab therapy has been shown to improve survival in patients with early-stage and metastatic her-2 positive breast cancer. In this study, we compared the safety and efficacy of the trastuzumab originator (Herceptin) to a trastuzumab biosimilar (CT-P6) in patients with stage I-III HER-2 positive breast cancer receiving neoadjuvant chemotherapy. The study was a randomized phase III trial. We found the pathological complete response rates were similar in both groups. Both antibodies were safe. Pharmacokinetic studies showed similar plasma concentrations for the trastuzumab originator and the proposed biosimilar. (more…)
Author Interviews, Autism, Mineral Metabolism, Nature, Pediatrics / 05.06.2017

MedicalResearch.com Interview with: Manish Arora, PhD Associate Professor Environmental Medicine & Public Health Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: Autism has both genetic and environmental risk factors. Our aim was to study if exposure to toxic metals, such as lead, or disruptions in the uptake of essential nutrient elements such as manganese or zinc would be related to autism risk. Furthermore, we were interested in not only understanding how much exposure had taken place but also which developmental periods were associated with increased susceptibility to autism risk. Researchers suspect that the risk factors for autism start early in life, even prenatally, but measuring in utero exposures is technically very challenging. We used a newly developed technique that uses lasers to map growth rings in baby teeth (like growth rings in trees) to reconstruct the history of toxic metal and essential nutrient uptake. We applied this technology in samples collected from twins, including twins who were discordant for autism. This allowed us to have some control over genetic factors. We found that twins with autism had higher levels of lead in their teeth compared to their unaffected twin siblings. They also had lower levels of zinc and manganese. The lower uptake of zinc was restricted to approximately 10 weeks before birth to a few weeks after birth, indicating that as a critical developmental period. (more…)
Accidents & Violence, Author Interviews, Pediatrics / 04.06.2017

MedicalResearch.com Interview with: Gary 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: Lawn mowers continue to be an important source of serious pediatric morbidity in the United States (US) with initial treatment of pediatric lawn mower-related injuries costing about $90 million annually. The long-term physical, psychological, and financial effects of these traumatic injuries can be devastating for those injured and for their families. This study comprehensively analyzes data over a 25-year period using a nationally representative database to evaluate the epidemiologic characteristics, including mechanism of injury, of lawn mower-related injuries to children in the US. It also provides a discussion of relevant injury prevention strategies. (more…)
AHA Journals, Author Interviews, Depression, Stroke / 04.06.2017

MedicalResearch.com Interview with: Chung-Yen Lu, MD, PhD Assistant Professor Department of Sport and Health Management, Da-Yeh University, Changhua, Taiwan; Department of Chinese Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei, Taiwan  MedicalResearch.com: What is the background for this study? Response: Post-stroke depression is a common mood complication of patients with stroke and may deteriorate motor function and cognitive function. Acupuncture therapy is an alternative and supplementary medical care often used worldwide. Previous studies have reported that acupuncture therapy for post-stroke depression may involve multiple therapeuticeffects including treating neurological disorders and physical disabilities following stroke, which are predictors of post-stroke depression. However, population-based evaluations on the association between acupuncture treatment and prevention of post-stroke depression are rare.  (more…)
AHRQ, Author Interviews, Cost of Health Care / 02.06.2017

MedicalResearch.com Interview with: Anita Soni, PhD, MBA Survey Analyst/Statistician Agency for Healthcare Research and Quality MedicalResearch.com: What is the background for this study? Response: This statistical brief uses the data from the Medical Expenditure Panel Survey (MEPS), which collects a broad range of data related to the health care of the U.S. civilian noninstitutionalized population including health insurance coverage, the number and types of health care events and the sources of payment and payment amounts for those events. The survey also gathers information on which medical conditions are associated with the reported health care events. Condition-specific health care expenditure information derived from MEPS data is useful for policy makers in determining where to focus health policies to improve the quality and efficiency of the health care system from the perspective of disease treatment and management. This Statistical Brief presents data regarding medical expenditures for nine conditions for which an estimated 10 percent or more of the U.S. civilian noninstitutionalized population (individuals age 18 and older) received health care in 2013. (more…)
Aging, Author Interviews, Depression / 02.06.2017

MedicalResearch.com Interview with: Miranda T. Schram PhD Associate professor Department of Medicine Maastrich MedicalResearch.com: What is the background for this study? What are the main findings? Response: Late-life depression, also called vascular depression, is highly prevalent, recurrent and difficult to treat. Anti-depressants only relieve symptoms in about 50% of the patients. So we urgently need new treatment targets for this disease. In this study we found that microvascular dysfunction, irrespective if you measure this by biomarkers in the blood or in the brain, is associated with an increased risk for depression. Moreover, we found evidence from longitudinal studies that microvascular dysfunction, at least of the brain, may actually be a cause of depression. To investigate this, we undertook a meta-analyses of data from over 40,000 individuals of whom over 9,000 had a depression. (more…)
Author Interviews, Breast Cancer, Race/Ethnic Diversity, Surgical Research, University of Michigan / 01.06.2017

MedicalResearch.com Interview with: Elham Mahmoudi, PhD, MS Section of Plastic Surgery, University of Michigan Medical School Ann Arbor, Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: About one-third of all women diagnosed with breast cancer undergo mastectomy. In recent years, owing to advancements in screening and treatment, life expectancy after being diagnosed with breast cancer has increased. Research has shown that for patients who undergo mastectomy, breast reconstruction offers many psychological benefits such as improved self-esteem, reduced sexual dysfunction, decreased anxiety, and overall improvement in quality of life. After the passage of the Women’s Health and Cancer Rights Act in 1998, the coverage of post-mastectomy breast reconstruction (PBR) by any type of health insurance became mandatory. However, there are large and widening racial and ethnic disparities in PBR, with White women having a higher rate of PBR than women from other racial and ethnic groups. In 2011, the State of New York enacted a law mandating that surgeons advise their patients undergoing mastectomy about available breast reconstruction options, insurance coverage, and referral to a plastic surgeon. We evaluated the effect of this law on racial/ethnic disparities in immediate PBR. Our results did not show any effect on the overall rate of immediate  post-mastectomy breast reconstruction or on disparities between white and African-American women; however, we found that White-Hispanic and White-other racial/ethnic group disparities in immediate PBR were reduced by 9 and 13 percentage points, respectively. This is a substantial reduction in disparity within only a year after the passage of the law, which demonstrates the importance of physician-patient communication. (more…)
Author Interviews, Dermatology / 01.06.2017

MedicalResearch.com Interview with: Jean-François Cailhier, M.D., Ph.D., FRCP(c) Professeur Agrégé de Clinique/ Associate Professor Département de Médecine, Faculté de Médecine Université de Montreal MedicalResearch.com: What is the background for this study? What are the main findings? Response: Milk Fat Globule Epidermal Growth Factor-8 (MFG-E8) is released by apoptotic cells and activated cells in the skin. Its effect on endothelial cells and pericytes was previously reported to accelerate wound healing. In our wound healing model, we demonstrated that MFG-E8 was important to reprogram skin macrophages into pro-repair cells. Moreover, we demonstrated that administration of exogenous MFG-E8 was able to accelerate wound healing in WT and MFG-E8 KO mice by generating M2 macrophages. Furthermore, to highlight to importance of MFG-E8 on macrophage reprogramming, adoptive transfer of MFG-E8-treated macrophages also promoted wound healing. These pro-repair effects seem to be dependent on the production of a crucial fibroblast growth factor, basic Fibroblast Growth Factor (bFGF), by macrophages which promoted fibroblast migration and proliferation. (more…)
Author Interviews, Hepatitis - Liver Disease, Kidney Disease, Lancet, Merck / 01.06.2017

MedicalResearch.com Interview with: Annette Bruchfeld MD, PhD Senior Consultant Associate Professor Karolinska Institute Dept of Renal Medicine, M99 Karolinska University Hospital Huddinge Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: In patients with stage 4–5 chronic kidney disease(CKD), hepatitis C virus (HCV) infection can accelerate the decline in kidney function, impair health-related quality of life (HRQOL), and decrease survival chances of both patients and grafts in transplantation recipients. In this study additional data from patients with stage 4–5 chronic kidney disease undergoing treatment for HCV infection in the C-SURFER study, including HRQOL and resistance analyses was presented not previously reported for this patient population with gwnotype 1 infection. The final virological analysis of this study indicated a high cure rate with sustained virological response at 12 weeks after the end of treatment (SVR12) in more than 98% of all treated patients. Even in patients with resistance-associated substitutions (RASs) the SVR was high in 11 (84·6%) of 13 patients genotype 1a infection. (more…)
Author Interviews, Brain Cancer - Brain Tumors, JAMA, Radiation Therapy / 01.06.2017

MedicalResearch.com Interview with: Professor Rakesh Jalali, MD Professor of Radiation Oncology President, Indian Society of Neuro-Oncology Tata Memorial Parel, Mumbai India  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Randomized controlled trials to test the efficacy of radiotherapy techniques are challenging to perform. High-precision conformal techniques such as stereotactic radiosurgery/radiotherapy, intensity modulated radiotherapy (IMRT) and particle therapy, etc have been incorporated into routine clinical practice including for brain tumors without always being supported by level-1 evidence. We therefore conducted a prospective, randomized, controlled trial of stereotactic conformal radiotherapy compared to conventional radiotherapy in young patients with residual/progressive bening and low grade brain tumors requiring radiotherapy for optimal disease control. (more…)
Author Interviews, Mental Health Research, Microbiome / 01.06.2017

MedicalResearch.com Interview with: Dr. Gerard Clarke PhD APC Microbiome Institute Department of Psychiatry and Neurobehavioural Science University College Cork, Cork, Ireland MedicalResearch.com: What is the background for this study? Response: Over the last decade or so, we and others have shown that the gut microbiome exerts a broad influence on the central nervous system, reflected in a range of abnormal behaviours and altered brain function in germ-free animals. These germ-free animals grow up in a sterile bubble and allow us to see what aspects of brain and behaviour could be under the influence of the microorganisms in our gastrointestinal tract. One of the most consistent findings to emerge relates to anxiety-like behaviours. (more…)
Author Interviews, JAMA, Mental Health Research / 31.05.2017

MedicalResearch.com Interview with: Michael Large, BSc, MBBS, FRANZCP, DMedSci School of Psychiatry, University of New South Wales,  The Prince of Wales Hospitals, Randwick New South Wales, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been increasingly recognized that recently discharged patients have an increased suicide risk. We synthesized the global research over the last half century finding a dramatically elevated suicide rate in the months post discharge and a surprisingly high and enduring rate over much longer periods. (more…)
Author Interviews, Infections, JAMA, UCLA / 31.05.2017

MedicalResearch.com Interview with: Gregory John Moran, MD, FACEP Emergency Medicine Dept. & Infectious Diseases Service UCLA Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The bacterial etiology of cellulitis is difficult to determine because there is usually no material for culture, but streptococci are believed to be the most common etiology. Since the emergence of MRSA as a common cause of skin infections in the community, many clinicians add a second antibiotic with MRSA activity to an oral cephalosporin, such as a combination of cephalexin plus trimethoprim-sulfamethoxazole. It is unknown if there is an additional benefit to adding MRSA activity for treatment of cellulitis. This randomized, blinded trial compared cephalexin plus placebo to cephalexin plus trimethoprim-sulfamethoxazole for outpatient treatment of cellulitis without an abscess or wound. Bottom line: We did not find a benefit from addition of trimethoprim-sulfamethoxazole. (more…)
Author Interviews, Hepatitis - Liver Disease, NEJM / 31.05.2017

MedicalResearch.com Interview with: Dr Marc Bourlière Professeur Associé CHP (Associate Professor PHC) Chef de service (Head of Department) Hôpital Saint Joseph Hépato-Gastroentérologie MedicalResearch.com: What is the background for this study? What are the main findings? Response: The majority of HCV patients can be cured with combinations of direct-acting antivirals (DAAs); however, there is still 5 to 10% of patients who relapse after treatment with DAAs for whom there are currently no approved therapeutic options available. In these two international phase 3 studies, we have demonstrated that a single tablet triple regimen combining sofosbuvir, velpastasvir and voxilaprevir (a pangenotypic protease inhibitor) for 12 weeks cured 96% of the patients who had relapsed following prior treatment with DAA regimens including NS5A inhibitors and 98% of the patients who had relapsed following prior treatment with DAA regimens without an NS5A inhibitor. These two studies demonstrate that a pangenotypic retreatment option for this patient population could be soon available. (more…)
Author Interviews, Exercise - Fitness, Orthopedics, Pediatrics / 31.05.2017

MedicalResearch.com Interview with: Jacqueline Pasulka, OMS II Des Moines University College of Osteopathic Medicine , Des Moines , IA Division of Pediatric Orthopaedic Surgery & Sports Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago , Chicago , IL MedicalResearch.com: What is the background for this study? What are the main findings? Response: In this study young athletes were recruited from both sports medicine and general practice clinics and were asked to complete surveys reporting on their sports participation, training patterns, and any sports-related injuries they had over the previous six months. We focused this study on the subset of athletes who met the criteria for being a single-sport specialized athlete based on their reported participation in only one sport and training for eight months or more during the year for that sport. Athletes participating in individual sports were more likely to be single-sport specialized than their team sport peers, and they also reported an earlier age at which they began specializing in their sport. Additionally, injury types differed among these two groups as single-sport specialized athletes in individual sport athletes had a greater proportion of overuse injuries, while single-sport specialized athletes in team sport athletes had a greater proportion of acute injuries. (more…)
Author Interviews, Blood Pressure - Hypertension, Compliance, Cost of Health Care, University Texas / 31.05.2017

MedicalResearch.com Interview with: Kalyani B. Sonawane, PhD Assistant Professor/ PhD Program Director Department of Health Services Research, Management and Policy College of Public Health and Health Professions University of Florida Gainesville, FL 32610 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Almost one-third of Americans have high blood pressure. Of those patients who are prescribed medication to control their blood pressure, about 30 percent have problems with side effects and nearly 50 percent will not have their blood pressure controlled within the first year of taking medication. In such scenarios, physicians have the option to either add a medication, such as fixed-dose combination, to the patient’s regimen or gradually increase a patient’s dose of their current drug to achieve blood pressure control; and gradually decrease the dose of their current drug or switch to a different drug to resolve side effects. Using healthcare claims data, we compared the economic impact of these alternative treatment modification strategies. (more…)
Aging, Author Interviews, Science / 31.05.2017

MedicalResearch.com Interview with: Kan Cao PhD Associate professor of cell biology and molecular genetics University of Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2015, our group demonstrated a surprising positive effect of methylene blue in treating fibroblast cells from progeria patients, a severe premature aging disease. Interestingly, we also noticed a beneficial effect of methylene blue in protecting normal skin cells. In this study, we followed the initial observation, compared methylene blue with other popular antioxidants, and conducted further analysis of the effects of methylene blue in 3d reconstructed skin. The take home message is that we believe methylene blue has a great anti-aging potential. As it is also super safe, we suggest it a potent ingredient for skin care products. (more…)
Author Interviews, Cost of Health Care, HIV, Opiods, PLoS / 31.05.2017

MedicalResearch.com Interview with: Cora Bernard, MS, PhD candidate Pre-doctoral Student in Management Science and Enginnering Affiliate, Center for Health Policy and the Center for Primary Care and Outcomes Research Stanford Health Policy MedicalResearch.com: What is the background for this study? Response: The US opioid epidemic is leading to an increase in the US drug-injecting population, which also increases the risks of HIV transmission. It is critical to public health that the US invests in a coherent and cost-effective suite of HIV prevention programs. In our model-based analysis, we considered programs that have the potential both to prevent HIV and to improve long-term health outcomes for people who inject drugs. Specifically, we evaluated opioid agonist therapy, which reduces the frequency of injection; needle and syringe exchange programs, which reduce the frequency of injecting equipment sharing; enhanced HIV screening and antiretroviral therapy programs, which virally suppress individuals and decrease downstream transmission; and oral HIV pre-exposure prophylaxis (PrEP), which is taken by an uninfected individual and lowers the risk of infection. (more…)
Author Interviews, CDC, Flu - Influenza, OBGYNE, Vaccine Studies / 31.05.2017

MedicalResearch.com Interview with: Dr. Elyse Olshen Kharbanda, MD MPH HealthPartners Institute Minneapolis, MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pregnant women who get the flu are at an increased risk for severe illness. To protect pregnant women, the Advisory Committee on Immunization Practices recommends women receive inactivated influenza vaccine (IIV) during any trimester of their pregnancy. This study used data from the Vaccine Safety Datalink to evaluate if there was an increased risk for selected major structural birth defects for infants whose mothers received IIV in the first trimester of pregnancy versus infants who were unexposed to IIV. Among over 425,000 live births, including 52,856 whose mothers received IIV during first trimester, we evaluated risks for major structural birth defects.  In this large observational study, we did not observe increased risks for major structural birth defects in offspring following first trimester maternal inactivated influenza vaccine exposure. (more…)
Allergies, Asthma, Author Interviews, Brigham & Women's - Harvard, Social Issues / 31.05.2017

MedicalResearch.com Interview with: Wanda Phipatanakul, MD, MS Associate Professor of Pediatrics Harvard Medical School Director, Asthma Clinical Research Center Boston Children's Hospital Asthma, Allergy and Immunology Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Observational studies have limitations in their ability to examine disparities in asthma, as these studies have relied on self-reported measures of medication use, asthma diagnosis, severity, outcomes, and access to care. Using data collected from a randomized controlled trial, we found that subjects with lower income had a significantly higher number of asthma treatment failures and asthma exacerbations, independent of race, BMI, education, perceived stress, baseline lung function, hospitalizations, inhaled corticosteroid adherence, inhaled corticosteroid dose, environmental allergen sensitization, and second-hand smoke exposure. (more…)
Author Interviews, OBGYNE, PLoS / 31.05.2017

MedicalResearch.com Interview with: Sarka Lisonkova, MD, PhD Assistant Professor, Department of Obstetrics and Gynaecology, University of British Columbia. Children’s and Women’s Health Centre MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adverse fetal and infant outcomes associated with maternal age were known and our study confirms that the risk of fetal and neonatal death and severe neonatal morbidity increases among mothers over 30 years. We also knew that older mothers are more likely to have hypertension, diabetes, and other chronic diseases, and they are more likely to develop gestational diabetes, hypertension during pregnancy, and preeclampsia. These complications may put the fetus or newborn at risk, but are generally not considered to be potentially life threatening to the mother. Our study adds new information on the rates of severe maternal morbidities that have a high case-fatality rate, lead to organ damage, or have serious health implications such as hysterectomy. Our study also adds the information on the rates of any severe adverse birth outcome - for baby or mom - in the association with maternal age, which is important for counseling. Women usually want to know ‘what are the chances that anything bad happens’. (more…)
Author Interviews, Diabetes, Kidney Disease, Transplantation / 30.05.2017

MedicalResearch.com Interview with: Deborah Evans, MA, MSW, LCSW Manager, Social Work Services DaVita Kidney Care MedicalResearch.com: What is the background for this study? What are the main findings? Response: For patients with end-stage renal disease (ESRD) receiving dialysis, receipt of a transplant offers the best possible long-term treatment option. However, the process of becoming qualified to receive a transplant involves many steps, beginning with the patient’s statement of interest. In this study, we sought to characterize transplant interest among patients in a large dialysis organization in the U.S. and to explore reasons identified by the patients for lack of interest in transplant when applicable. As of November 2016, of the 182,906 patients with available transplant status information in the LDO database, 58,057 (31.7%) expressed that they were not interested in transplant. Among patients not interested in transplant, the most frequently identified reasons for lack of interest were:
  • Advanced age (25.7%)
  • Perceived poor health (12.0%)
  • Comfortable with current modality (12.0%)
  • Uninterested in further surgeries (11.9%)
  • 13.2% of patients not interested in transplant indicated that “other” factors were responsible for their lack of interest. At the time of the study, we didn’t have any further insight into what might account for these “other” factors.
Compared to patients with transplant status listed as active, those not interested in transplant were:
  • Older (21.4% < 60 years vs 64.6%)
  • More likely to be female (47.7% vs 36.6%)
  • More likely to be white (43.9% vs 30.4%) and less likely to be Hispanic (14.7% vs 22.2%)
  • More likely to be receiving in-center hemodialysis (92.0% vs 73.7%)
  • More likely to have Medicare/Medicaid as primary insurance (91.3% vs. 77.3%)
(more…)