Author Interviews, Exercise - Fitness, Gastrointestinal Disease, Microbiome / 10.04.2017

MedicalResearch.com Interview with: Dr. Orla O’Sullivan Computational Biologist, Teagasc Food Research Centre, Moorepark, Co. Cork, Ireland  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previously we had demonstrated that professional rugby players had significantly increased microbial diversity compared to both low and high BMI controls. This microbial diversity correlated with creatine kinase levels in the blood (which we had used as a proxy for exercise) and protein intake. In this present study we went a step further and demonstrated that these same athletes had distinct functional potential in their gut microbes compared to controls and furthermore both the host derived ( urine) and bacterial derived ( faecal water) metabolites were also distinct in the athlete group. In particular we found that the athlete’s microbiome is primed for tissue repair and to harness energy from the diet, reflecting the significant energy demands and high cell-turnover evident in elite sport. Thus, the state of physical fitness is not limited to the host alone; it appears to also include conditioning of the microbiota. (more…)
Author Interviews, Johns Hopkins, Microbiome, Probiotics, Schizophrenia / 10.04.2017

MedicalResearch.com Interview with: Emily G. Severance PhD Stanley Division of Developmental Neurovirology Department of Pediatrics Johns Hopkins University School of Medicine Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previously, we found that people with schizophrenia and bipolar disorder had an increased susceptibility to Candida albicans yeast infections, which was sex specific and associated with memory deficits. Also in an earlier placebo-controlled probiotic study, we found that although probiotics improved the overall bowel function of people with schizophrenia, there was no effect by this treatment on psychiatric symptoms.  Given that C. albicans infections can upset the dynamics of the human microbiome, we decided to re-evaluate the potential benefit of probiotics in the context of a patient’s C. albicans yeast status.  Not only was bowel function again enhanced following intake of probiotics, but yeast antibody levels were decreased by this treatment. Furthermore, psychiatric symptoms were actually improved over time for men receiving probiotics who did not have elevated C. albicans antibodies. Men who were positive for C. albicans exposure, however, consistently presented with worse psychiatric symptoms irrespective of probiotic or placebo treatment. (more…)
Author Interviews, End of Life Care, JAMA / 10.04.2017

MedicalResearch.com Interview with: Charles D. Blanke, M.D., F.A.C.P., F.A.S.C.O. CHAIR, SWOG Professor, OHSU Knight Cancer Institute Marquam II MedicalResearch.com: What is the background for this study? What are the main findings? Response: Oregon’s Death with Dignity Act as a voter initiative which law in 1997 – the first of its kind in the nation. Now, physician aid-in-dying is spreading quickly, with the states of Washington, Vermont, Colorado, and California passing similar legislation, as well as the District of Columbia, and Montana (through a court ruling). Millions of Americans lives in states where they would have the opportunity, if they were terminally ill, to take a lethal dose of medication with a doctor’s prescription. My team here at SWOG, a global cancer research community that designs and conducts publicly funded clinical trials, wanted to look at Oregon’s 18 years of aid-in-dying data and answer some simple questions: Who is using the law? Why? Are the drugs effective? What are the trends in actually taking the prescribed medications? We found that use of law has mostly increased over time – and substantially increased in 2014 and 2015. We found that predominantly white, older, well-educated people, take advantage of the law, and many of them – 77 percent – have underlying terminal cancer. The medication is also 99.4 percent effective. (more…)
Author Interviews, NYU, Orthopedics, Pediatrics, Radiology / 10.04.2017

MedicalResearch.com Interview with: Ayesha Rahman, MD Chief Orthopaedic Surgery Resident NYU Langone Medical Center. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children are more vulnerable and susceptible to lifetime adverse events from radiation exposure, caused by imaging . We reviewed literature and found certain pediatric orthopaedic patients are at greater risk for radiation exposure, namely those who have surgery for hip dysplasia, scoliosis, and leg length discrepancy, as they are among those most likely to undergo CT imaging. After reviewing all types of imaging studies performed in orthopedics and how much radiation is involved in each test, we developed several recommendations that pediatric orthopaedic surgeons should follow. Among those recommendations are: utilize low-dose CT protocols or technology that uses less imaging (like EOS), limit CT scans of the spine and pelvis, know that female patients are more susceptible to adverse risk and plan accordingly, and follow the the “as low as reasonably achievable,”principle to limit exposure to parts of the body that are necessary for diagnosis. (more…)
Author Interviews / 10.04.2017

MedicalResearch.com Interview with: Amrut V. Ambardekar, MD Medical Director Cardiac Transplant Program Division of Cardiology, Section of Advanced Heart Failure-Transplant Cardiology University of Colorado MedicalResearch.com: What is the background for this study? What are the main findings? Response: As left ventricular assist device (LVAD) technology has improved, the appropriate timing for implant of these devices (essential a form of an artificial heart pump) in patients with advanced heart failure is unknown. The goal of the MedaMACS study was to describe the prognosis of a group of patients with advanced heart failure who currently do not require intravenous therapies, and determine how they compare to a similar group of patients who received a LVAD. The main finding from this study is that the “sickest” group of patients with advanced heart failure on oral medical therapy (known as INTERMACS profile 4 patients) have very poor outcomes with a strong trend for improvement in survival with LVAD therapy. The other take home message is that among all of the patients enrolled in the study on medical therapy, only approximately half were alive after an average of 12 months of follow up without needing a heart transplant or LVAD placement. (more…)
Author Interviews, Autism, Environmental Risks, JAMA, Toxin Research / 10.04.2017

MedicalResearch.com Interview with: Keith Fluegge BS Institute of Health and Environmental Research (IHER) Cleveland Graduate School, The Ohio State University, Columbus Ohio MedicalResearch.com: What is the background for this study? What are the main findings? Response: The research letter discusses the possible link between rainfall precipitation and risk of autism. Earlier research suggested a link, although there remained quite a bit of skepticism surrounding the findings at the time. The purpose of the study was to briefly highlight the role of environmental exposure to the agricultural and combustion pollutant, nitrous oxide (N2O), as a possible etiological factor in neurodevelopmental disorders. We have published a series of epidemiological investigations, reviews, and correspondences discussing this possibility. In my continued research on this topic, I learned that rainfall and extreme weather-related events, like hurricanes, drive N2O emissions, especially from nitrogen amended soils. Exposure to this particular air pollutant may, therefore, plausibly undergird the relationship between rainfall precipitation and risk of autism. (more…)
Author Interviews, Cost of Health Care, JAMA, Primary Care, UCLA / 10.04.2017

MedicalResearch.com Interview with: John N. Mafi, MD, MPH Assistant Professor of Medicine Division of General Internal Medicine and Health Services Research UCLA David Geffen School of Medicine Los Angeles, CA 90024 Affiliated Natural Scientist in Health Policy RAND Corporation 1776 Main St, Santa Monica, CA 90401 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Between 10-30% of healthcare costs are due to low value care, or patient care that provides little to no benefit to patients, and can sometimes cause harm (e.g., radiation exposure from diagnostic imaging tests). In this study, we found that hospital-based primary care practice provide more low value care than community-based primary care practices across the United States. Understanding where and why low value care occurs is going to be essential if we want to get serious about eliminating it. (more…)
Author Interviews, CDC, JAMA, Stroke / 10.04.2017

MedicalResearch.com Interview with: Mary G. George, MD, MSPH Division for Heart Disease and Stroke Prevention National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: What is the background for this study? Response: Stroke is the fifth leading cause of death in the United States, killing more than 130,000 Americans each year—that’s 1 of every 20 deaths—and costs the nation $33 billion annually, including the cost of health care services, medications, and lost productivity. And, stroke is leading cause of serious disability. An ischemic stroke, sometimes called a brain attack, is a stroke that occurs when there is a blockage of the blood supply to the brain. (more…)
Author Interviews, CDC, Global Health, Vaccine Studies / 10.04.2017

MedicalResearch.com Interview with: Deborah Lee, MPH Division of Global Migration and Quarantine Centers for Disease Control and Prevention, Atlanta, GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to assess whether documentation for vaccines provided to refugees overseas was received by clinicians in the US and if doses of measles-mumps-rubella (MMR) vaccine were integrated into the vaccine schedule as recommended for adults and children by the US Advisory Committee on Immunization Practices. CDC recommends that US-bound refugees receive vaccinations prior to arrival in the United States. Vaccinations are documented on the Vaccination Documentation Worksheet (DS-3025), which refugees bring with them to the United States, and made available to state and local refugee health programs through CDC’s Electronic Disease Notification (EDN) system. Thirty to 90 days after arrival, most refugees have a post-arrival health assessment performed by clinicians affiliated with the state and local refugee health programs. Our assessment indicated that most refugees had overseas vaccination documentation available at the post-arrival health assessments (87%), and that MMR vaccine was given when needed (83%). Furthermore, many refugees (90%) in our assessment did not require an additional MMR dose because they had received vaccination before entering the United States. (more…)
Author Interviews, Gastrointestinal Disease, Pediatrics, PLoS, Vitamin D / 10.04.2017

MedicalResearch.com Interview with: Benjamin Udoka Nwosu, MD, FAAP Associate Professor of Pediatrics Division of Endocrinology University of Massachusetts Medical School Worcester, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vitamin D deficiency has been reported in various gastrointestinal disorders but the vitamin D status of children and adolescents with irritable bowel syndrome (IBS) has not been previously characterized. Secondly, the vitamin D status in IBS has not been compared to those of other malabsorption syndromes such as irritable bowel syndrome, lactose intolerance, and celiac disease. (more…)
Author Interviews, Endocrinology, Heart Disease, Thyroid Disease / 09.04.2017

MedicalResearch.com Interview with: Arjola Bano, MD, DSc PhD candidate Departments of Internal Medicine and Epidemiology Erasmus Medical Center, Rotterdam, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atherosclerosis is a chronic condition, characterized by the accumulation of lipids and fibrous elements in the arterial walls. It can progress insidiously from an asymptomatic narrowing of the arterial lumen (subclinical phase) to the clinical onset of vascular events (as coronary heart disease or stroke) and death. Despite advances in prevention and treatment, atherosclerotic diseases remain a leading cause of mortality worldwide. Therefore, identifying additional modifiable risk factors for atherosclerosis is of major importance. So far, the role of thyroid hormone on atherosclerosis remains unclear. Moreover, a comprehensive investigation exploring the link of thyroid function with the wide spectrum of atherosclerosis, including subclinical atherosclerosis, clinical atherosclerosis and atherosclerotic mortality, within the same population is lacking. Therefore, in a prospective study of 9231 middle-aged and elderly people, we explored the association of thyroid function with subclinical atherosclerosis (coronary artery calcification), atherosclerotic events (fatal and nonfatal coronary heart disease or stroke) and atherosclerotic mortality (death from coronary heart disease, cerebrovascular or other atherosclerotic disease). Higher free thyroxine (FT4) levels were associated with higher risk of subclinical atherosclerosis, atherosclerotic events and atherosclerotic mortality, independently of cardiovascular risk factors. The risk of atherosclerotic mortality increased with higher FT4 levels (HR; CI: 2.35; 1.61-3.41 per 1 ng/dl) and lower thyroid-stimulating hormone (TSH) levels (HR; CI: 0.92; 0.84-1.00 per 1 logTSH), with stronger estimates among participants with a history of atherosclerotic disease (HR; CI: 5.76; 2.79-11.89 for FT4 and 0.81; 0.69-0.95 for TSH). (more…)
Author Interviews, Compliance, Primary Care, Stroke / 09.04.2017

MedicalResearch.com Interview with: Anna De Simoni NIHR Academic Clinical Lecturer in Primary Care Research Centre for Primary Care and Public Health Barts and The London School of Medicine and Dentistry London E1 2AB MedicalResearch.com: What is the background for this study? Response: Three in 10 stroke survivors will go on to have a further stroke, which causes greater disability or even death. Secondary prevention medications, including antihypertensives, blood thinning and lipid lowering agents, such as statins, can reduce risk of stroke recurrence by up to 75 per cent. However, patients’ persistence with these medications decreases over time because a minority of people experience side effects, which are mild in most cases. The analysis, involving Queen Mary University of London and the University of Cambridge and published in the journal Family Practice, was performed on the archives from TalkStroke, a UK online forum hosted by the Stroke Association. The forum is used by patients with stroke and their carers, and generated 21,596 posts during 2004-2011. 50 participants were found to discuss GP advice on prevention medications in 43 discussion threads. (more…)
Author Interviews, Hematology, Lancet / 09.04.2017

MedicalResearch.com Interview with: Dr. med. Kathleen Selleng, OÄ, QB Hämotherapie Universitätsmedizin Greifswald Institut für Immunologie und Transfusionsmedizin, Abt. Transfusionsmedizin Sauerbruchstraße Greifswald Deutschland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Red blood cell concentrates (RBCs) of blood group O RhD negative are frequently used as universal blood for emergency transfusions in patients with unknown blood type. This leads to an over-proportional use of these red blood cell concentrates and regular shortages of O RhD negative RBCs. Due to these shortages, patients with known RhD negative blood type sometimes have to be transfused with RhD positive RBCs. The present study shows that the overall risk to induce an anti-D by transfusing all emergency patients with unknown blood type with O RhD positive RBCs is in the range of 3 to 6%, while this risk is much higher (20-30%) in RhD negative patients which have to be transfused with RhD positive RBCs due to RhD negative RBC shortages. (more…)
Author Interviews, Surgical Research / 08.04.2017

MedicalResearch.com Interview with: Sang W. Kim, MD Diplomate, American Board of Facial Plastic and Reconstructive Surgery Diplomate, American Board of Otolaryngology - Head and Neck Surgery Natural Face Clinics East Syracuse, NY MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are extensive volume of studies and descriptions in literature describing ideal proportions and measurement of facial features, objective measurements for what constitute "artificial" and "overdone" facial appearance have not been studied extensively. But as elective and cosmetic treatment for face become more mainstream and push its limits, we felt it is important to investigate objective measurement to determine when certain facial features appear to be "artificial" and "overdone". We decided to study the lips because compared to other features of the face, it is more practical to translate in 2-dimension and alter objective measurements such as the height of the lips or the shapes of the curvature. (more…)
Author Interviews, Pharmacology, Thyroid Disease, UCLA / 07.04.2017

MedicalResearch.com Interview with: Deborah Chon MD Endocrinology fellow UCLA David Geffen School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study shows that drinking cow's milk concurrently with oral levothyroxine significantly reduces the absorption of the medication. Levothyroxine is used for the physiologic replacement of thyroid hormone in patients with hypothyroidism and for serum TSH suppression in patients with thyroid cancer. It is the mostly commonly prescribed medication in the United States as of 2014. Frequent dose adjustments of levothyroxine have been shown to be a costly burden to the national healthcare system. Previous studies have shown that certain foods and medication, such as calcium supplements, can interfere with levothyroxine absorption. However, this is the first study to demonstrate that ingesting cow?s milk, a common breakfast staple, affects oral levothyroxine absorption. To determine the possible effect of cow's milk ingestion, we measured levothyroxine absorption in humans with and without concurrent milk consumption. Pharmacokinetic studies were conducted in healthy adults without allergies to milk or levothyroxine, and who were not pregnant nor using oral contraceptives. All subjects had no history of known thyroid disease and normal thyroid hormone function at baseline. Following an overnight fast, serum total thyroxine T4 (TT4) concentrations were measured at baseline and at 1, 2, 4, and 6 hours after ingestion of 1,000 ?g of oral levothyroxine alone or when co-administered with 12 oz. of milk (2% fat). There was a four-week washout period between the two study visits. Ten subjects (mean age 33.7?10.2 years, 60% male) completed the study. The serum total T4 absorption over six hours, calculated as area under the curve (AUC), was significantly lower when taking cow?s milk concurrently with levothyroxine compared levothyroxine alone (mean?SD: 67.26?12.13 vs. 73.48?16.96; p = 0.02). Also, peak serum TT4 concentrations were significantly lower in those who ingested levothyroxine concurrently with milk, compared to taking levothyroxine alone (p=0.04). (more…)
Author Interviews, Nutrition, Weight Research / 06.04.2017

MedicalResearch.com Interview with: Corrine I. Voils, PhD Research Career Scientist, William S Middleton Veterans Memorial Hospital Professor of Surgery, University of Wisconsin-Madison MedicalResearch.com: What is the background for this study? What are the main findings? Response: Keeping weight off is hard due to physical and behavioral factors. When people lose weight, their metabolism slows down a bit, making it difficult to keep off the weight. It is also difficult to keep off the weight because people don’t continually engage in behavioral skills such weighing yourself regularly. Our study focused on the behavioral component of weight loss maintenance. After losing an average of 16 pounds initially, the maintenance group regained less than 2 pounds (net weight loss around 14 pounds), whereas the usual care group regained more than 5 pounds (net weight loss less than 11 pounds). (more…)
Author Interviews, Biomarkers, Brain Injury / 06.04.2017

MedicalResearch.com Interview with: Sergey A. Dryga, PhD, MBA Chief Scientific Officer BioDirection, Inc.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: When patients have suffered a head injury, they typically undergo a series of subjective cognitive tests to confirm a diagnosis of a concussion or other traumatic brain injury. In many cases these tests are inaccurate and inconsistent, increasing the risk of misdiagnosis. In other cases, patients may undergo an unnecessary CT scan, which is costly and exposes them to radiation. Early, objective diagnostic testing of patients who have experienced a head injury can support more rapid and appropriate treatment decisions while potentially reducing the use of unnecessary CT scans or other forms of intervention. We know that protein biomarkers, including S100 calcium binding protein beta (S100β) and glial fibrillary acidic protein (GFAP), are released from the brain into the bloodstream immediately following a concussion or other traumatic brain injury. The Tbit™ System is a new medical device based on a nanotechnology biosensor that rapidly detects and accurately measures these protein biomarkers. The system includes a disposable cartridge and portable analyzer designed for testing using a single drop of blood at the earliest stages of a concussion. This pre-clinical study was designed to evaluate the ability of the Tbit System to screen traumatic brain injury patients for a CT positive or CT negative test. Frozen plasma samples were collected from a total of 100 patients who had undergone CT scans post hospital admission. The Tbit System demonstrated 100% sensitivity with no false negative results, and a 41% specificity level. (more…)
Author Interviews, Depression, Genetic Research / 06.04.2017

MedicalResearch.com Interview with: Najaf Amin, PhD Erasmus University Medical Center Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Identifying genetic risk factors for depression has not been easy. Over a decade of genetic research did not yield a single replicable genetic factor for depression. It was only recently that 15 common genetic variants mostly in the non-coding parts of the genome were identified through a large genome-wide association study performed by 23andMe. All of these variants add a very small risk to depression individually (odds ratio < 1.05). These common variants cannot explain the cases that have a family history of depression. Our hypothesis is that such familial cases are enriched for variants that are rare, lie in the coding region of the genome and thus have a large effect on depression. Such variants are enriched in families and isolated populations and therefore have a higher chance of being discovered compared to more cosmopolitan populations. Through gene-based analysis of rare coding variants we have identified a novel gene NKPD1 that may be relevant for depression. Further, we have noticed that the more deleterious the effect of the variant is on the protein, the larger the effect is on depressive symptoms. (more…)
Accidents & Violence, Author Interviews, JAMA, Karolinski Institute, Mental Health Research / 06.04.2017

MedicalResearch.com Interview with: Hanna Sahlin MSc, Lic psychologist, Lic psychotherapist Specialist in clinical psychology PhD-student Departement of Clinical Neuroscience Karolinska Institutet National Self-harm project Centre for Psychiatry Research, CPF Stockholm, Sweden What is the background for this study? What are the main findings? Response: This study is the result of wanting to find a more conclusive answer to whether individuals who engage in non-fatal deliberate self-harm are more prone to aggression towards others. There has long been a debate on whether aggression to oneself and aggression towards others co-occur, but the studies that have been conducted thus far have been on smaller samples or with clinical or forensic cohorts. Also, the studies have had great variability regarding the definition of both “deliberate self-harm” and “violence”. Thus, it has been difficult to establish an ”overall” effect size for this association, or to draw firmer conclusions on how and if this association plays out in the general population. We had the opportunity to study this association in several large nationwide population-based registries including all Swedish citizens, and with high specificity regarding the ingoing variables of interest – i.e., non-fatal deliberate self-harm (as registered in the National Patient Register) and violent crime convictions (as registered in the National Crime Register). We found a five times increased crude risk (hazard) of being convicted of a violent crime if one had received self-harm associated clinical care, and vice-versa, that there was an equally increased risk of self-harm if one had been convicted of a violent crime. After controlling for relevant psychiatric comorbidities and socio-economic status, an almost doubled risk of violent crime conviction remained among self-harming men and women compared to individuals not exposed to self-harm. It is important to notice that our study did not find any evidence suggesting that self-harm behaviours cause violent criminality. Therefore, we conclude that the engagement in violence towards oneself and towards others share an underlying vulnerability to impulsive and aggressive behaviours. (more…)
AACR, Author Interviews, Biomarkers, Cancer Research / 06.04.2017

MedicalResearch.com Interview with: Poulikos I. Poulikakos, PhD Assistant Professor Department of Oncological Sciences Department of Dermatology The Tisch Cancer Institute Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Mutations in the oncoprotein kinase BRAF are found in about 8% of human tumors, including more than 50% of melanomas. Small molecule RAF inhibitors prolonged survival of melanoma patients with mutant-BRAF tumors, but resistance limits their effectiveness. Further, RAF inhibitors showed only modest efficacy in patients with colorectal and thyroid mutant-BRAF tumors. Previous studies have suggested that the complex biochemical mechanisms of action of RAF inhibitors account for both sensitivity and major mechanisms of resistance to these drugs. Recently, a number of next generation RAF inhibitors have entered preclinical or clinical development, but the most appropriate clinical context for their use remained elusive. (more…)
Author Interviews, Global Health, JAMA, Pediatrics / 06.04.2017

MedicalResearch.com Interview with: Dr. Nicholas Kassebaum, MD Assistant Professor Institute for Health Metrics and Evaluation University of Washington MedicalResearch.com: What is the background for this study? Response: Reducing deaths of young children has been an international priority over the past few decades, and much progress has been made in this regard. Comprehensive and timely measurement of death and disease burden among children and adolescents is essential for improving the health of young people. Analyzing the latest estimates from the Global Burden of Disease (GBD), the current study quantifies and describes levels and trends of mortality and disease burden among children and adolescents under the age of 19 from 1990 to 2015. (more…)
Author Interviews, Epilepsy, JAMA, Karolinski Institute, OBGYNE, Pediatrics, Weight Research / 06.04.2017

MedicalResearch.com Interview with: Neda Razaz-Vandyke, PhD, MPH Postdoctoral Fellow Reproductive Epidemiology Unit Karolinska Institutet   MedicalResearch.com: What is the background for this study? What are the main findings? Response:   There is a growing concern about long-term neurological effects of prenatal exposure to maternal overweight and obesity. The etiology of epilepsy is poorly understood and in more than 60% of cases no definitive cause can be determined. We found that maternal overweight and obesity increased the risks of childhood epilepsy in a dose-response pattern. (more…)
AACR, Author Interviews, Lung Cancer, Surgical Research / 06.04.2017

MedicalResearch.com Interview with: Emanuela Taioli MD PhD Professor, Population Health Science and Policy, and Thoracic Surgery Director, Institute for Translational Epidemiology Director, Center for the Study of Thoracic Diseases Outcome Director, Division of Social Epidemiology Icahn Medical Institute, New York, NY 10029  MedicalResearch.com: What is the background for this study? Response: Extensive literature documenting the relationship between hospital volume and clinical outcomes has resulted in the centralization of cancer care advocating patients to seek cancer surgical procedures at high-volume (HV) hospitals. Lung resection and cystectomy have been specifically recommended for centralization, but improvements in outcomes are not shared equally among racial groups. It has also been reported that black patients more commonly undergo surgery at low-volume and lower-quality hospitals, despite living in close proximity to higher quality hospitals. We investigated the effects of centralization on HV hospital utilization and surgical outcomes for lung (n = 28,047 White; n = 2,638 Black) and bladder (n = 7,593 White; n = 567 Black) cancer patients over a 15 year time span (1997-2011) in New York State. We hypothesized that centralization has improved utilization of HV hospitals and outcomes for both black and white patients, but significant disparities remain between black and white patients. (more…)
Author Interviews, Pediatrics / 06.04.2017

MedicalResearch.com Interview with: Prof. Olivier Baud MD Chef de Service, Réanimation et Pédiatrie Néonatales Team leader, INSERM U1141 Université Paris-Diderot, Sorbonne Paris Cité Département Hospitalo-Universitaire "PROTECT" Hôpital Robert Debré, Paris, France MedicalResearch.com: What is the background for this study? Response: Preterm birth is frequently associated with perinatal inflammation, a major risk factor for bronchopulmonary dysplasia (BPD). Because glucocorticoids alleviate systemic inflammation, they have been proposed as a therapeutic option in very preterm infants. Early dexamethasone therapy led to short-term benefits but was associated with cerebral palsy and other adverse neurodevelopmental events. Early treatment with low-dose hydrocortisone has been reported to improve short-term outcomes in extremely preterm infants. However, its safety remains to be assessed with regard to the long-term neurodevelopmental outcomes. (more…)
Author Interviews, Education, Electronic Records, JAMA, Johns Hopkins / 06.04.2017

MedicalResearch.com Interview with: Ge Bai, PhD, CPA Assistant Professor The Johns Hopkins Carey Business School Washington, DC 20036 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We examined the hospital data breaches between 2009 and 2016 and found that larger hospitals and hospitals that have a major teaching mission have a higher risk of data breaches. (more…)
Author Interviews, Brain Injury, Neurological Disorders, Pediatrics / 06.04.2017

MedicalResearch.com Interview with: Emily Dennis PhD Postdoctoral Scholar Imaging Genetics Center Mark and Mary Stevens Neuroimaging and Informatics Institute USC MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that there is heterogeneity in outcome post-traumatic brain injury (TBI), but we generally think of this as a continuous variable - with most patients falling in the middle and only a few at the extremes in terms of recovery process and outcome. Our main finding was that interhemispheric transfer time (IHTT - the time it takes for information to move from one hemisphere of the brain to the other) identified 2 subgroups of TBI patients - those with slow IHTT and those with normal IHTT. These two groups show differences in cognitive function and brain structure, with the IHTT slow group showing structural disruptions that become progressively worse while the IHTT normal group seems to be recovering from the injury. (more…)
Author Interviews, Cost of Health Care, JAMA, Surgical Research, Thyroid / 05.04.2017

MedicalResearch.com Interview with: Benjamin James, MD MS Assistant Professor of Surgery Adjunct Assistant Professor of Otolaryngology Section of Endocrine Surgery IU Division of General Surgery Indiana University Hospital Indianapolis, IN 46202 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over the few decades, there has been a substantial increase in the incidence of thyroid cancer. It is the fastest growing cancer and a recent study in JAMA found that the mortality rate has been rising. In 2006, Massachusetts passed healthcare reform, which expanded Medicaid, created new subsidized insurance programs for those ineligible for Medicaid and extended young adults eligibility on parental plans until the age of 26. The aim of our study was to evaluate the impact this has had on the treatment of thyroid cancer. To address this question, we used the Hospital Cost and Utilization Project State Inpatient Databases for Massachusetts, New Jersey, New York, and Florida, which included a cohort of 56,581 inpatient admissions from 2001 to 2011. We then compared these states before and after the healthcare reform in Massachusetts to evaluate the effect the healthcare reform had on the treatment of thyroid cancer. (more…)
Author Interviews, Biomarkers, Multiple Sclerosis / 05.04.2017

MedicalResearch.com Interview with: Dr. Chase Spurlock, Ph.D. Executive Officer at IQuity, Inc Nashville, Tennessee IQuity is working to further develop RNA technologies that can be used to diagnose and treat Multiple Sclerosis. IQuity hopes to develop a ‘disease activity test’, which would help physicians determine when a patient is likely to relapse so that treatments can be timed for best effect.   MedicalResearch.com: What is the background for IQuity? What are its goals and mission? Response: IQuity, Inc. is a biotechnology company that focuses on the research and development of innovative specialty diagnostic technology, specifically for autoimmune diseases. Our research has shown that autoimmune patients have distinct RNA expression patterns in their blood, and we have figured out how to leverage machine learning methods to analyze these RNA expression patterns and test for the presence of diseases like multiple sclerosis, IBS/IBD (Crohn’s and ulcerative colitis) and fibromyalgia. We collected patient samples from around the globe to match their RNA profiles against healthy and sick patient profiles we identified through our previous research. These tests led to the development of IQIsolate, our technology that informs the suite of tests which, when used even at the earliest onset of symptoms, can give providers information to rule in or rule out a suspected autoimmune disease with more than 90% accuracy. Our mission is to relentlessly pursue innovation in specialized diagnostic and analytic technology, identifying complicated autoimmune and autoimmune-related diseases at the earliest signs of symptoms. We strive to enable providers to diagnose early and treat sooner in the disease progression to improve long-term outcomes, lower the overall cost of lifelong autoimmune diseases and minimize the uncertainty and fear patients experience during prolonged diagnosis periods. (more…)