Author Interviews, Cost of Health Care / 07.03.2017

MedicalResearch.com Interview with: Genevieve Kanter, PhD Assistant Professor Department of Health Management and Policy Drexel University Dornsife School of Public Health Philadelphia, PA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We were interested in the exposure of patients to doctors who accept industry payments. Previous research on physician payments has focused on the percentage of doctors who accepted payments, but these estimates can give a partial or misleading picture of the reach of industry payments in relation to the typical patient. No studies had previously taken a population-based approach to estimate the reach of industry payments. We conducted a nationally representative survey of 3542 Americans. We asked respondents about their awareness of industry payments and if they knew whether their own doctor had received an industry payment. We also asked them to identify the doctor they had visited most frequently in the previous 12 months and linked this information to Open Payments, a government website that reports payments made to doctors by prescription drug and device manufacturers. We found that 65%, or almost two-thirds, of patients had seen--in the past 12 months--a physician who had received an industry payment. For some specialties, patient contact with doctors who had industry contact was much higher; 77% of patients who saw an obstetrician/gynecologist visited a doctor who had accepted payments, and 85% of patients who saw an orthopedic surgeon visited a doctor who had accepted payments. At the same time, very few people knew whether their own doctor had received payments; only 5% of respondents reported knowing whether their doctor had received an industry payment. (more…)
Author Interviews, Endocrinology, Lancet, OBGYNE, Pediatrics, Vitamin D / 07.03.2017

MedicalResearch.com Interview with: Audry H. Garcia PhD Scientist Department of Epidemiology Erasmus MC, University Medical Center Rotterdam Rotterdam, the Netherlands  MedicalResearch.com: What is the background for this study? Response: Fetal bone mineralisation requires an adequate transfer of calcium to the fetus by the end of the pregnancy. Considering that vitamin D is required to maintain normal blood concentrations of calcium, adequate 25-hydroxyvitamin D (25[OH]D) concentrations in pregnant women seem to be crucial for bone development of the offspring. Maternal vitamin D deficiency during pregnancy has been associated with abnormal early skeletal growth in offspring and might be a risk factor for decreased bone mass in later life. Several studies have linked vitamin D deficiency in fetal life to congenital rickets, craniotabes, wide skull sutures and osteomalacia. However, the evidence of long-lasting effects of maternal vitamin D deficiency during pregnancy on offspring’s skeletal development is scarce and inconsistent, and has led to contradictory recommendations on vitamin D supplementation during pregnancy. (more…)
Author Interviews, Electronic Records, Opiods, Pain Research / 07.03.2017

MedicalResearch.com Interview with: Michelle S. Keller, MPH, PhD Candidate Health Policy and Management Cedars-Sinai Los Angeles CA 90048 MedicalResearch.com: What is the background for this new funding award? Response: Research shows that treating and managing chronic pain is tough, and it can be hard for patients and their physicians to be on the same page. Chronic pain touches so many facets of people’s lives—relationships, mental health, sleep, work—that treating it in a 15-minute visit can lead to a lot of frustration and disappointment. Our hope is that by arming patients and clinicians with evidence-based tools, we can help foster a better dialogue about what is ultimately important to patients, how to achieve fully functional lives while managing chronic pain. We’re testing two different types of communication tools: electronic health record alerts pointing physicians to guidelines when they write opioid prescriptions and patient portal-based tools that can help patients prepare for visits and become active, engaged partners in their care. (more…)
Author Interviews, Education, JAMA, Race/Ethnic Diversity, Yale / 06.03.2017

MedicalResearch.com Interview with: Dowin Boatright, MD, MBA Department of Emergency Medicine Yale School of Medicine New Haven, Connecticut Fellow, Robert Wood Johnson Clinical Scholars Program Veterans Affairs Scholar MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies have demonstrated racial and ethnic inequities in medicine, including disparities in the receipt of awards, research funding, and promotions. Yet few studies have examined the link between race and ethnicity and opportunities for medical school students. Our results show that black and Asian medical school students are less likely to be selected for membership in a prestigious medical honor society, Alpha Omega Alpha (AΩA), than white medical school students. (more…)
Author Interviews, Stroke / 06.03.2017

MedicalResearch.com Interview with: Jesse Dawson MD, BSc (Hons), FRCP, FESO Clinical Reader / Honorary Consultant Clinical Lead Scottish Stroke Research Network / NRS Stroke Research Champion Chair MVLS Research Ethics Committee Institute of Cardiovascular and Medical Sciences College of Medical, Veterinary & Life Sciences University of Glasgow MedicalResearch.com: What is the background for this study? What are the main findings? Response:    Many patients suffer long term arm weakness after stroke and there are few effective treatments. We are assessing whether stimulation of the vagus nerve can improve recovery after stroke. Stimulation of the vagus nerve, called VNS for short, triggers the release of neurotransmitters in the brain. These neurotransmitters are important for learning and memory. Pre-clinical studies have shown that combining vagus nerve stimulation with movement or rehabilitation tasks enhances brain plasticity, improves motor learning and leads to better recovery after stroke. Based on this, we performed a clinical trial in patients with arm weakness after stroke and found promising changes in the patients treated with VNS paired with rehabilitation compared to rehabilitation alone. In this study we performed a double blind sham stimulation controlled study of VNS paired with rehabilitation vs sham stimulation in patients with long term arm weakness due to ischaemic stroke. All participants were implanted with a VNS device and underwent a course of therapy. We didn’t see a statistically significant difference after 6 weeks of intensive in-clinic therapy but saw a large and significant difference after a further 60 days home exercise treatment with VNS.  There were differences on several measures, including the clinical response rate which was 88% with VNS and 33% with controls. (more…)
Author Interviews, Education, Gender Differences, JAMA, UCLA / 06.03.2017

MedicalResearch.com Interview with: Julie R. Boiko, MD, MS Resident Physician, PGY1 Department of Pediatrics University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Grand rounds is an over 100-year-old tradition in US medical school clinical departments of recurring, expert-delivered lectures to update physicians and physicians-in-training on recent advances in relevant medicine. We wanted to determine whether gender representation of speakers at grand rounds aligns with the gender distribution of people typically represented in grand rounds audiences -- faculty, residents, and medical students -- by clinical specialty according to national academic medical trainee and workforce statistics. We chose to focus on grand rounds speakers as visible representations of women in academic medicine. This is important because, despite women and men entering medicine at comparable rates, women are much more likely to depart academic medical careers. As current and recent medical students, we considered that consistent exposure to successful female role models in grand rounds speaking venues may positively reinforce women trainees’ desires to continue in academic medical careers. We found that the people at the podiums do not resemble the people in the audience. Only 26% of grand rounds speakers are women. Even accounting that some clinical specialties contain few women faculty and residents, grand rounds speakers in most specialties we studied were statistically less likely to be women as compared to faculty and residents. Across the specialties, grand rounds speakers are 44% less likely than medical students, 39% less likely than residents, and 21% less likely than faculty to be women. (more…)
Author Interviews, Cost of Health Care / 06.03.2017

MedicalResearch.com Interview with: Dr. LeaAnne DeRigne Associate Professor School of Social Work Florida Atlantic University Boca Raton, FL 33431 MedicalResearch.com: What is the background for this study? What are the main findings? Response: “Compared to 22 similarly developed countries, the United States is the only one that does not mandate employers to provide paid sick leave benefits or include paid sick leave in a universal social insurance plan,” said LeaAnne DeRigne, Ph.D., lead author and an associate professor in the School of Social Work within FAU’s College for Design and Social Inquiry. For the study, DeRigne and collaborators used cross-sectional data from a sample of 13,545 adults aged 18-64 with current paid employment from the 2015 National Health Interview Survey (NHIS). They examined the relationship between having paid sick leave and obtaining eight preventive care services: blood pressure check; cholesterol check; fasting blood sugar check; getting a flu shot; being seen by a medical doctor or health care provider; getting a Pap test (females only); getting a mammogram (females only); and getting tested for colon cancer. The analysis controlled for demographic and other important predictor variables including gender, marital status, education, race/ethnicity, full time work, insurance coverage, health status, limiting health conditions, family income, age, and family size. (more…)
Aging, Author Interviews, Hearing Loss, JAMA, Johns Hopkins / 06.03.2017

MedicalResearch.com Interview with: Dr. Adele Gorman PhD Johns Hopkins Center on Aging & Health The Johns Hopkins University Baltimore, Maryland MedicalResearch.com: What is the background for this study? Response: Hearing loss affects many people, especially older adults. We have previously estimated how common hearing loss is across different age groups and how many adults have hearing loss today. However, we did not know the number of people that are expected to have hearing loss in the coming decades. This is important to know in order to appropriately plan for future hearing health care needs. Recently the National Academies of Sciences, Engineering and Medicine highlighted the crucial need to address hearing loss and made recommendations to improve hearing health care services. However, these recommendations should be considered by policy makers in the context of the number of adults with hearing loss in the coming years. (more…)
Author Interviews, JAMA, Obstructive Sleep Apnea, Sleep Disorders / 04.03.2017

MedicalResearch.com Interview with: Dr. Simone Baiardi MD Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna MedicalResearch.com: What is the background for this study? Response: Drug-induced sleep endoscopy (DISE) is an useful tool for studying the upper airway dynamic in patients with obstructive sleep apnea syndrome (OSAS), and it’s crucial for the therapeutic choice (especially for non ventilatory treatment, such as surgery). The main limits of DISE are the lack of standardization of procedure and the low inter-observer reliability among non-experienced ENT surgeons. (more…)
Aging, Alzheimer's - Dementia, Author Interviews, PLoS / 04.03.2017

MedicalResearch.com Interview with: Emma van Bussel MD, MSc Academic Medical Center | University of Amsterdam Amsterdam | The Netherlands  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dementia forms a high social and economic burden on society. Since there is a growing number of older people, the occurrence of dementia is expected to increase over the years to come. For future planning of care, it is important to have reliable predictions on new dementia cases for the population at large. Studies in Western countries suggested that the incidence per 1000 person years is declining. We studied the incidence trend of dementia in the Netherlands in primary care registry data, in a population of over 800,000 older people (60 years and over) for the years 1992 to 2014. Our results indicate a small increase of 2.1% (95% CI 0.5% to 3.8%) per year in dementia incidence over the past decades. The trend did not change in the years after 2003, when a national program was developed to support dementia care and research, compared to the years prior to 2003. (more…)
Author Interviews, Eating Disorders / 04.03.2017

MedicalResearch.com Interview with: Guido K.W. Frank, M.D., FAED Associate Professor of Psychiatry and Neuroscience Associate Director, Eating Disorder Program Director, Developmental Brain Research Program Pediatric Mental Health Institute | Children’s Hospital | University of Colorado Anschutz Medical Campus Colorado MedicalResearch.com: What is the background for this study? Response: Anorexia nervosa is an eating disorder that primarily affects young females and is associated with high mortality. The diagnostic criteria include restriction of energy intake that leads to significantly low body weight and an intense fear of gaining weight or becoming fat. The etiology of anorexia nervosa is complex, and only recently have we begun to better understand its underlying neurobiology. Brain scans of anorexia nervosa patients have implicated brain reward circuits in the disease, brain regions that govern food intake. On the other hand, how much we eat also affects over time reward system response and eating too much or too little has important implications on brain reward function. Previous studies from our lab as well as basic science research suggest that underweight is associated with heightened reward system response. In this study wanted to test whether we would find heightened brain activity in adolescents with anorexia nervosa and whether this would normalize once the patient regained weight. (more…)
Asthma, Author Interviews, Cost of Health Care, Pediatrics / 04.03.2017

MedicalResearch.com Interview with: Patrick W. Sullivan, Ph.D. Professor Regis University School of Pharmacy Denver, CO 80221 MedicalResearch.com: What is the background for this study? Response: Asthma is one of the most common chronic disorders among children. It affects 7.1 million children in the U.S. Of these, 4.1 million children suffered an asthma attack in 2011. An asthma attack is an acute period of extreme difficulty breathing. It can be life threatening and is always very frightening for children. Because asthma can be dangerous and frightening, it ends up costing a lot because patients need to go the doctor, hospital or take medications to try to control it. Asthma also has a negative effect on the patient’s health and outlook about their health – both mentally and physically. Previous studies have focused on adults with asthma and have found that it is very expensive – it costs $18 billion in the U.S. to manage adults with asthma. Those studies also showed that adults with asthma have lower quality of life. However, there is not a lot of good evidence on the burden of asthma in children. This study was designed to quantify the cost and mental and physical health of children with asthma in the U.S. (more…)
Author Interviews, Electronic Records, Mental Health Research / 04.03.2017

MedicalResearch.com Interview with: Steven K. Dobscha, M.D. Professor, Department of Psychiatry, OHSU Director, VAPORHCS Center to Improve Veteran Involvement in Care Oregon Health & Science University MedicalResearch.com: What is the background for this study?  Response: Several health care systems across the United States now offer patients online access to all of their clinical notes (sometimes referred to as progress notes) through electronic health record portals; this type of access has been referred to as OpenNotes (see www.opennotes.org for more information on the national OpenNotes initiative). Veterans have been able to use OpenNotes in the Veterans Health Care (VHA) system since 2013. However, some individuals have expressed concern that online access to clinical notes related to mental health could cause some patient harms. We are conducting a VA-funded research project with several objectives: 1) to examine benefits and unintended negative consequences of OpenNotes use as perceived by veterans receiving VHA mental health care and by VHA mental health clinicians, and 2) to develop and evaluate brief web-based courses designed to help veterans and clinicians use OpenNotes in ways that optimize Veteran-clinician collaboration and minimize unintended consequences. (more…)
Author Interviews, Memory / 04.03.2017

MedicalResearch.com Interview with: Signy Sheldon, PhD Assistant Professor Department of Psychology McGill University Montreal, QC, CAN MedicalResearch.com: What is the background for this study? Response: It is clear to most people that emotion and memory are strongly linked - thinking about our past experiences is often accompanied with a strong feelings, sometimes good and sometimes bad. In psychological research, many investigations have looked at how emotional memories are remembered differently than non-emotional memories. A lot of this research has found that the valence of a memory, whether it is positive or negative, will impact how detailed a past event can be recalled. Much less research as looked at how the emotions we feel at the time of remembering can also influence the way that memory is recalled. This is a very important area of research. If emotions during remembering can influence what memories are accessed and how we experience these memories, this would suggest that our memories are tagged and organized according to emotions. In this study, we looked at how different aspects of emotion can affect the types of past experiences we bring to mind to further investigate how emotions direct memory retrieval. To do this, we had participants listen to unfamiliar excerpts of music that ranged in both memory valence (positive and negative) and arousal (high or low levels). To each piece of music, participants were asked to think of a past memory and then describe their experience of that event they were remembering. (more…)
Addiction, Alcohol, Author Interviews, Cannabis, Mental Health Research / 03.03.2017

MedicalResearch.com Interview with: Emil F. Coccaro, M.D. Ellen C. Manning Professor Department of Psychiatry and Behavioral Neuroscience The University of Chicago Chicago, Illinois 60637 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Aggressive behavior and drug use have been related for years but this study shows people with problematic aggression (Intermittent Explosive Disorder: IED) are in fact at risk for developing alcohol, tobacco, and cannabis use disorders and that the onset of problematic aggression (IED) begins before the onset of the drug use. The increased risk for alcohol use disorder was nearly six-fold higher, the increased risk for cannabis use disorder was seven-fold higher, and the increased risk for tobacco use disorder  was four-fold higher. In addition, the presence of IED increased the severity of the substance use disorder. (more…)
Author Interviews, Pediatrics / 03.03.2017

MedicalResearch.com Interview with: Dr. Hans Jorgen Stensvold, M.D and Dr. Arild Ronnestad, MD PhD Neonatal Department, Oslo University Hospital and the Norwegian Neonatal Network, Oslo, Norway MedicalResearch.com: What is the background for this study? Response:  Over the last decades, advances in perinatal care have led to improved survival of extremely preterm infants in most countries. Still, the decision to initiate or withhold active care for infants at the border of viability is challenging. Different attitudes and traditions in perinatal care influence the rates of stillbirths, admissions to intensive care and outcomes. Consequently, there is a continuous need for up-to-date results to guide caregivers and parents in decision making, and to evaluate current medical practices. (more…)
ASCO, Author Interviews, Outcomes & Safety, Pharmacology, Prostate Cancer, University of Michigan / 03.03.2017

MedicalResearch.com Interview with: Megan Elizabeth Veresh Caram MD Clinical Lecturer Internal Medicine, Hematology & Oncology University of Michigan   MedicalResearch.com: What is the background for this study? Response: Abiraterone and enzalutamide are oral medications that were approved by the Food & Drug Administration in 2011 and 2012 to treat men with metastatic castration-resistant prostate cancer. Most men with advanced prostate cancer are over age 65 and thus eligible for Medicare Part D. We conducted a study to better understand the early dissemination of these drugs across the United States using national Medicare Part D and Dartmouth Atlas data. (more…)
Addiction, Author Interviews, Emergency Care, Opiods / 02.03.2017

MedicalResearch.com Interview with: Alexander Diaz Bode M.D. Candidate University of Miami Leonard M. Miller School of Medicine Miami, FL MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our country is in the midst of an opiate epidemic. This is particularly evident in the emergency department (ED), which continues to see an alarmingly large number heroin overdose. With the shutdown of “pill-mills”, where opioid prescriptions would be prescribed indiscriminately, Florida has seen particularly large increases in opiate use and overdose. In Miami, we noticed that during the summer of 2016, there was a disproportionate increase in heroin overdose being treated at our hospital relative to previous years. Our recently published study showed that fentanyl or fentanyl analog laced heroin likely contributed to this massive spike in heroin overdose observed during the summer of 2016. Fentanyl and its synthetic analogs are opioid receptor agonists that bind with hundreds of times higher affinity than diamorphine, aka heroin. Naloxone, better known by the brand name Narcan®, is used to reverse heroin overdose in the ED. This drug works by competitively inhibiting the opioid receptor, effectively “knocking off” the bound heroin. Using naloxone dosing as a surrogate marker of heroin purity, our study found that during the investigated spike there was a disproportionate increase in the amount of naloxone used in our ED to reverse overdose relative to the increase in opiate overdose. This indicated that a stronger opioid receptor agonist, such as fentanyl or fentanyl analogs, likely was involved in the massive spike in overdose observed during the summer of 2016. (more…)
Author Interviews, Heart Disease, JAMA, Lipids / 02.03.2017

MedicalResearch.com Interview with: Dr. Yashashwi Pokharel MD, MSCR Department of Cardiovascular Research Saint Luke’s Mid-America Heart Institute Kansas City, Missouri and Salim S. Virani, MD PhD, FACC, FAHA Associate Professor, Section of Cardiovascular Research Associate Director for Research, Cardiology Fellowship Training Program Baylor College of Medicine Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Houston, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unlike the previous cholesterol management guideline that recommended use of either statin and non-statin therapy to achieve low density lipoprotein cholesterol (LDL-C) target, the 2013 American College of Cardiology/American Heart Association cholesterol management guideline made a major paradigm shift by recommending statin focused treatment in 4 specific patient groups and replaced LDL-C target with fixed statin intensity treatment (moderate to high intensity statin therapy). With this change, it was speculated that a large number of patients would be eligible for statin treatment (in one study, up to 11.1% additional patients were expected to be eligible for statin therapy). Our study provided the real world trends in the use of statin and non-statin lipid lowering therapy (LLT) from a national sample of cardiology practices in 1.1 million patients 14 months before and 14 months after the release of the 2013 guideline. We found a modest, but significant increasing trend in the use of statin therapy in only 1 of the 4 patient groups eligible for statin therapy (i.e., 4.3% increase in the use of moderate to high intensity statin therapy in patients with established atherosclerotic cardiovascular disease). We did not find any significant change in non-statin LLT use. Importantly, about a third to half of patients in statin eligible groups were not receiving moderate to high intensity statin therapy even after the publication of the 2013 guideline. (more…)
Author Interviews, BMJ, Environmental Risks, Mental Health Research, Pediatrics, Toxin Research / 02.03.2017

MedicalResearch.com Interview with: Professor Jean-Francois Viel Department of Epidemiology and Public Health University Hospital Rennes, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of pyrethroid insecticides has increased substantially throughout the world over the past several decades, replacing organophosphate and carbamate insecticides, because of their chemical potency against many pests, their relatively low mammalian toxicity and their favorable environmental profiles. However, despite the neurotoxicity of these insecticides at high doses, the potential impact of environmental exposure to pyrethroid insecticides on child neurodevelopment has only just started to receive attention. Using a longitudinal design (PELAGIE mother-child cohort), we were able to assess pyrethroid exposure (trough urine concentrations) both prenatally and during childhood (at 6 years of age). We showed that increased prenatal concentrations of one pyrethroid metabolite (cis-DCCA, a metabolite of permethrin, cypermethrin and cyfluthrin) were associated with internalising difficulties (children showing behaviours that are inhibited and over-controlled). Moreover, for childhood 3-PBA (a common metabolite of up to 20 synthetic pyrethroid insecticides) concentrations, a positive association was observed with externalising difficulties (children showing behaviours that are under-controlled and having generally a more challenging temperament). (more…)
Author Interviews, Hospital Acquired, Outcomes & Safety / 02.03.2017

MedicalResearch.com Interview with: Curtis J. Donskey, MD Geriatric Research, Education, and Clinical Center Cleveland Veterans Affairs Medical Center Cleveland, OH 44106 MedicalResearch.com: What is the background for this study?  Response: Many hospitals are making efforts to improve cleaning to reduce the risk for transmission of infection from contaminated environmental surfaces. Most of these efforts focus on surfaces like bed rails that are frequently touched by staff and patients. Despite the fact that floors have consistently been the most heavily contaminated surfaces in hospitals, they have not been a focus of cleaning interventions because they are rarely touched. However, it is plausible that bacteria on floors could picked up by shoes and socks and then transferred onto hands. In a recent study, we found that when a nonpathogenic virus was inoculated onto floors in hospital rooms, it did spread to the hands of patients and to surfaces inside and outside the room. Based on those results, we assessed the frequency of floor contamination in 5 hospitals and examined the potential for transfer of bacteria from the floor to hands. (more…)
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Sleep Disorders, UT Southwestern / 02.03.2017

MedicalResearch.com Interview with: Ron B. Mitchell, MD Professor and Vice Chairman, Department of Otolaryngology, Head and Neck Surgery William Beckner Distinguished Chair in Otolaryngology Chief of Pediatric Otolaryngology UT Southwestern and Children's Medical Center Dallas Dallas, TX 75207 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obstructive Sleep Apnea (OSA) has not been widely studies in adolescents. This is one of a few studies that was targeted at 12-17 year olds who were referred for a sleep study for possible OSA. The study included 224 adolescents (53% male). aged 12 to 17 years. The mean BMI was 33.4 and most were either Hispanic or African American (85.3%). A total of 148 (66.1%) were obese. Most adolescents referred for a sleep study (68%), had  Obstructive Sleep Apnea. Normal-weight adolescents were least likely to have OSA at 48%, while obese children were most likely at 77%. Severe OSA was most likely in obese males with tonsillar hypertrophy. (more…)
Author Interviews, Heart Disease, JAMA / 01.03.2017

MedicalResearch.com Interview with: Thomas Engstrøm  MD, PhD The Heart Center | Rigshospitalet | University of Copenhagen | Denmark Professor in cardiology | University of Lund | Sweden Adjunct professor in cardiology | University of Aalborg | Denmark  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Timely reperfusion by primary angioplasty (primary PCI) in patients with ST-elevation myocardial infarction is mandatory. However reperfusion it self can harm the myocardium - so called reperfusion injury. During a number of years ischemic postconditioning (iPOST) by repetitive interruptions of blood flow after reperfusion has been a promising technique to address reperfusion damage. The trial investigated the effect of iPOST in 1200 patients treated with primary PCI and in addition either iPOST or conventional angioplasty. (more…)
Author Interviews, NEJM, OBGYNE, Thyroid Disease, UT Southwestern / 01.03.2017

MedicalResearch.com Interview with: Professor Brian Casey, M.D. Gillette Professorship of Obstetrics and Gynecology UT Southwestern Medical Center  MedicalResearch.com: What is the background for this study? Response: For several decades now, subclinical thyroid disease, variously defined, has been associated with adverse pregnancy outcomes.  In 1999, two studies are responsible for increasing interest in subclinical thyroid disease during pregnancy because it was associated with impaired neuropsychological development in the fetus.  One study showed that children born to women with the highest TSH levels had lower IQ levels.  The other showed that children of women with isolated low free thyroid hormone levels performed worse on early psychomotor developmental tests. Together, these findings led several experts and professional organizations to recommend routine screening for and treatment of subclinical thyroid disease during pregnancy. Our study was designed to determine whether screening for either of these two diagnoses and treatment with thyroid hormone replacement during pregnancy actually improved IQ in children at 5 years of age. (more…)
ASCO, Author Interviews, Prostate Cancer, Radiation Therapy / 01.03.2017

MedicalResearch.com Interview with: Daniel A. Hamstra, MD PhD Radiation Oncologist Beaumont Hospital Dearborn Michigan MedicalResearch.com: What is the background for the The SpaceOAR phase 3 trial study and the hydrogel spacer? Response: External beam radiation therapy is commonly used to treat men with prostate cancer. As part of this treatment, side effects can occur involving bowel, urinary, and sexual symptoms. This study was performed to test if an absorbable hydrogel placed between the prostate and rectum (using a simple outpatient procedure) could move the rectum away from the prostate and thus result in sparing of the rectum and decreased bowel toxicity. The study randomized 222 men and the three-year data were just published (The International Journal of Radiation Oncology Biology and Physics). With three years of follow-up, we saw that the spacer did improve the radiation plans and decreased both rectal toxicity and urinary toxicity. (more…)
Author Interviews, CDC, Fertility, Sexual Health, STD / 01.03.2017

MedicalResearch.com Interview with: Dr. Kristen Kreisel PhD Epidemiologist at Centers for Disease Control and Prevention Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pelvic inflammatory disease (PID), an infection of the female reproductive tract often associated with STDs, is putting millions of women at risk for infertility, ectopic pregnancy and chronic pelvic pain. Our study looked at data from the National Health and Nutrition Examination Survey to estimate the national burden of PID. Findings show an estimated 4.4 percent of sexually-experienced women aged 18-44, or approximately 2.5 million woman nationwide reported a history of PID. (more…)
Author Interviews, Environmental Risks, Global Health / 01.03.2017

MedicalResearch.com Interview with: Dr. Meiyun Lin PhD Research  Scholar NOAA and Princeton University’s Cooperative Institute for Climate Science MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ground-level ozone, also known as smog, has climbed in the rural West over the past 25 years, even in such seemingly pristine places as Yellowstone National Park. We have found out why – and why cutting our own output of smog-forming chemicals such as nitrogen oxides by 50% hasn’t helped. This study found that increased pollution from Asia, which has tripled its nitrogen oxide emissions since 1990, contribute to the persistence of smog in the West. While ozone in the eastern U.S. has decreased overall, the levels can spike during heat waves, characterized by large-scale air stagnation, warm temperatures, and plentiful radiation needed for ozone formation locally. As heat waves appears to be on the rise due to global climate change, progress in reducing smog in the eastern US is likely to be slower in the coming decades. (more…)
AACR, Author Interviews, Diabetes, Genetic Research, Melanoma / 01.03.2017

MedicalResearch.com Interview with: Reeti Behera, Ph.D. Postdoctoral fellow in the Weeraratna lab The Wistar Institute Philadelphia PA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Malignant melanoma is an aggressive disease and is the cause of the majority of skin cancer deaths. In particular, older individuals have a much poorer prognosis for melanoma and are more resistant to targeted therapy than compared to young individuals. A recently published study from our lab has shown that age-related changes in secreted factors in the microenvironment can drive melanoma progression and therapy resistance. Klotho is a protein whose expression levels decreases with aging. In this study, we have shown that a decrease in klotho levels in the aged microenvironment drives melanoma aggression and therapy resistance by promoting the oncogenic signaling pathway Wnt5A. We also have shown that reconstituting klotho levels in the aged microenvironment by using rosiglitazone, an FDA-approved drug used to treat diabetes, can reduce tumor burden in aged mice. We also show that Klotho expression is decreased in therapy-resistant melanoma tumors. Reconstituting klotho levels in therapy-resistant melanoma cells by treating with rosiglitazone can inhibit Wnt5A levels and MAPK pathway. We also show that rosiglitazone can significantly decrease therapy-resistant tumor burden in the aged mice, but not in the young. (more…)
Author Interviews, Cognitive Issues, Multiple Sclerosis, NYU / 01.03.2017

MedicalResearch.com Interview with: Leigh E. Charvet, PhD Associate Professor, Department of Neurology Department of Neurology New York University Langone Medical Center New York, NY MedicalResearch.com: What is the background for transcranial direct current stimulation? What are the main findings of this study in multiple sclerosis patients? Response: The application of tDCS is a relatively recent therapeutic development that utilizes low amplitude direct currents to induce changes in cortical excitability. When paired with a rehabilitation activity, it may improve learning rates and outcomes. Multiple repeated sessions are needed for both tDCS and cognitive training sessions to see a benefit. Because it is not feasible to have participants come to clinic daily for treatments, we developed a method to deliver tDCS paired with cognitive training (using computer-based training games) to patients at home. Our protocol uses a telemedicine platform with videoconferencing to assist study participants with all the procedures and to ensure safety and consistency across treatment sessions. When testing our methods, we enrolled 25 participants with multiple sclerosis (MS) completed 10 sessions of tDCS (2.0 mA x 20 minutes, dorsolateral prefrontal cortex, left anodal) using the remotely-supervised telerehabilitation protocol. This group was compared to n=20 MS participants who completed 10 sessions of cognitive training only (also through remote supervision). We administered cognitive testing measures at baseline and study end. We found that both the tDCS and cognitive training only group had similar and slight improvements on composites of standard neuropsychological measures and basic attention. However, the tDCS group had a significantly greater gain on computer-based measures of complex attention and on a measure of intra-individual variability in response times. (more…)