Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, JAMA / 13.12.2021

MedicalResearch.com Interview with: Liise-anne Pirofski, M.D. Mitrani Professor of Biomedical Research Chief, Division of Infectious Diseases Albert Einstein College of Medicine and Montefiore Medical Center Liise-anne Pirofski, MD on behalf of lead authors Mila Ortigoza MD, PhD, Assistant professor at NYU Langone Health and Hyunah Yoon MD, Assistant Professor, Albert Einstein Medical Center and the CONTAIN COVID-19 trial authors and team MedicalResearch.com: What is the background for this study? Response: The study was designed to determine the efficacy of COVID-19 convalescent plasma (CCP) in hospitalized patients with COVID-19. It was designed and launched in New York City in April 2020 during the height of the first COVID-19 pandemic wave and later extended to sites in Miami, Houston, and other regions affected by subsequent waves of the pandemic. At that time, there were no validated therapeutic options for COVID-19, and there was clinical equipoise for CCP use in hospitalized patients. COVID-19 convalescent plasma was considered worthy of investigation because of the historical success of convalescent plasma in prior pandemics and epidemics dating to the beginning of the 20th century, and importantly, biological plausibility because convalescent plasma contains antibodies to agents from which people have recovered, and case series and observational studies showing signals of CCP efficacy in patients with COVID-19. The trial was designed to focus on patients with moderate to severe COVID-19 who required supplemental oxygen, but not mechanical intubation. At the time the trial was designed, hospitals in New York City were overwhelmed with severely and critically ill patients with COVID-19, an entirely new disease about which more and more was learned over the 11 months the trial was conducted.  (more…)
Author Interviews, COVID -19 Coronavirus, NEJM, Vaccine Studies / 13.12.2021

MedicalResearch.com Interview with: Ronen Arbel, PhD Outcomes Research, Community Medical Services Division Clalit Health Service Tel Aviv, Israel Director, Maximizing Health Outcomes Research Lab Sapir College, Sderot, Israel.  MedicalResearch.com: What is the background for this study? Response: The emergence of the SARS-CoV-2 delta variant and reduced effectiveness over time of the BNT162b2 vaccine (Pfizer-BioNTech) led to a recent Coronavirus 2019 disease (Covid-19) resurgence in early vaccinated populations. The Israeli Ministry of Health was the first in the world to approve a third (booster) dose of BNT162b2 to cope with this resurgence. (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare / 12.12.2021

MedicalResearch.com Interview with: Jeanne Madden, PhD Associate Professor Department of Pharmacy and Health Systems Sciences School of Pharmacy and Pharmaceutical Sciences Bouvé College of Health Science Northeastern University MedicalResearch.com: What is the background for this study? Response: Medicare is the US public insurance program mainly serving people 65 years and older, but also some younger adults who have long-term disabling conditions. As such, on average, the Medicare population bears a heavy burden of illness and has high health care needs, compared to the general US population. The under-65 group for the most part has quite low incomes, while the older group represents a wide spectrum, from poor to well-off. Medicare beneficiaries also differ a great deal in terms of whether they have access to supplemental insurance that can help with patient cost-sharing requirements. I’m referring to Medicaid assistance, or a self-purchased Medigap plan, or retiree health benefits, etc. The cost-sharing requirements in traditional Medicare are substantial — e.g., 20% for doctor visits — and there is no annual cap on patient out-of-pocket spending. That’s in contrast to commercial insurance and Medicare Advantage managed care plans — all of those have an annual cap on patient out-of-pocket costs. There’s a good amount of existing research on whether people in Medicare can afford their drugs, and on the affordability of medical care among younger groups such as working-aged uninsured people and those in ACA exchange plans. But there hasn’t been much research into medical care affordability among older Americans. (more…)
Author Interviews, Dental Research, JAMA, Pediatrics, USPSTF / 10.12.2021

MedicalResearch.com Interview with: Michael Cabana, M.D., M.A., M.P.H Professor of Pediatrics Albert Einstein College of Medicine. Physician-in-chief , Children's Hospital at Montefiore Chair of the Department of Pediatrics Albert Einstein College of Medicine Member, U.S. Preventive Services Task Force  MedicalResearch.com: What is the background for this study and recommendation statement?  Response: Dental caries, also known as cavities or tooth decay, is the most common chronic disease in children in the United States and can develop in any child whose teeth have come in. Many young children under five years old do not visit a dentist, so the Task Force reviewed the latest evidence on how primary care clinicians can help prevent tooth decay in young children. The Task Force’s research led to two important findings: all young children whose teeth have come in should have fluoride varnish applied by their clinician, and all children six months and older whose water supply doesn’t contain enough fluoride should receive fluoride supplements. Both approaches can help prevent cavities in kids. The Task Force also determined that there is not enough evidence to recommend for or against screening for tooth decay in the primary care setting for children under five. This is consistent with the Task Force’s 2014 recommendation on dental caries. (more…)
Author Interviews, Gender Differences, JAMA / 09.12.2021

MedicalResearch.com Interview with: Christopher J. D. Wallis, MD, PhD Assistant Professor, Division of Urology University of Toronto Urologic Oncologist, Division of Urology Mount Sinai Hospital and University Health Network MedicalResearch.com: What is the background for this study? Response: Previous research has shown that female and male physicians communicate differently with patients. Further, there is evidence that female physicians, including surgeons, spend more time with patients. This, coupled with evidence that female patients may experience disparities in the management of their pain, led us to consider that communication differences may underpin differences in surgical outcomes previously noted (eg. Wallis et al, BMJ 2017) between male and female physicians. We postulated that there may be a differential association between surgeon sex and patient sex in behaviours that would translate into clinically important outcomes. (more…)
Author Interviews, COVID -19 Coronavirus, Dental Research / 09.12.2021

MedicalResearch.com Interview with: Dr. Henry Daniell Ph.D W. D. Miller Professor & Director of Translational Research, Vice Chair, Department of Basic and Translational Sciences, Editor in Chief, Plant Biotechnology Journal, Oxford, UK School of Dental Medicine, University of Pennsylvania, Philadelphia PA 19104-6030  MedicalResearch.com: What is the background for this study?  Response: ACE2 is a human protein present in human cells, blood and saliva.  In COVID-19 patients this protein is inactivated.  SARS-CoV-2 virus enters human cells using receptor of this protein.  ACE2 chewing gum utilizes two different mechanisms.  ACE2 enzyme directly binds to the spike protein on SARS-CoV-2 and traps virus in the chewing gum.  In addition, ACE2 enzyme binds to its own receptor on oral epithelial cells, thereby blocks entry of any virus that is not trapped in the chewing gum (more…)
Author Interviews, Electronic Records, Pharmacology / 08.12.2021

MedicalResearch.com Interview with: Bernard Esquivel Zavala, MD, PhD, MHA GenXys Chief Medical Officer MedicalResearch.com: What is the mission of GenXys? Response: Our mission at GenXys is to tailor the right treatment for each individual patient at the right time. GenXys founders, including Professors Pieter Cullis and Martin Dawes, were heavily involved in the precision medicine field from the very beginning, and they noticed a functional gap between the expectations and the actual clinical implementation of precision medicine Particularly, when it came to, at the time, the new field of pharmacogenetics. Their solution was to provide a comprehensive, user-friendly platform that organizes all patient data relevant to prescribing to provide the safest and most appropriate personalized prescribing options. Simply put, GenXys’ solutions were made by clinicians, for clinicians. The GenXys software suite collects patient information and categorizes that information, including pharmacogenetic data, based on clinical relevance and runs it through advanced condition -based algorithms to provide real time accurate prescribing options. It makes my life as a clinician easier and safer and gives me the confidence that I am not practicing ‘trial and error’ prescribing. Ideally, every healthcare provider should be using a real time medication decision support solution like ours, and not just for pharmacogenetic test results. Pharmacogenomics is just one piece. In fact, our core product, TreatGx™ can run with or without pharmacogenomics. Let's say that you've run it without pharmacogenomics, meaning that you are using this tool to organize and rapidly identify how biophysical factors, liver function, kidney function, comorbidities, and drug-drug interactions may impact the medication you're about to prescribe to your patient. This functionality alone is incredibly helpful. In fact, the factors I just mentioned likely account for 95% of the reasons why a patient does not respond to a particular medication or might have an adverse drug reaction. But the TreatGx platform will also highlight when the evidence supports bringing pharmacogenomic information into the mix. The right approach is bringing all those relevant clinical, biochemical, and molecular factors closer to the provider which will ultimately foster personalization. We will start treating the individual instead of the disease(s). As with any new technology, there are barriers to precision prescribing. This includes educational and emotional barriers. It’s important to educate providers and keep them up to date to help them understand the power that precision prescribing can bring into their practice—and the limitations—to set the right level of expectation. The Human Genome Project was finished in 2000, and there was a lot of buzz about pharmacogenomics even back in 2003. The field got a lot of traction in 2015. So, everyone thought, "Oh, this is going to be groundbreaking and quite disruptive. From now on my prescription is going to be a hundred percent accurate and safe." But it's not quite the whole story. Pharmacogenomics has to be considered as another piece of the puzzle. It's like saying that by having an MRI, you're curing cancer. It's just another piece of the treatment puzzle. There are also emotional barriers, where ego can factor into a decision. It can be uncomfortable for a physician to say, "I don't know this. Let me check it out. Let me explore it further, review, and come back to you." It's easier to say if I don't know it, that it doesn't work or isn’t relevant, rather than exposing yourself. And so that, in terms of the emotional piece, I would say is a big component. We can tackle the emotional component that element by fostering education and bringing education closer to providers. (more…)
Asthma, Author Interviews, NEJM, Pediatrics, Pulmonary Disease, Vanderbilt / 08.12.2021

MedicalResearch.com Interview with: Leonard B. Bacharier, MD Janie Robinson and John Moore Lee Chair in Pediatrics Professor of Pediatrics Director - Center for Pediatric Asthma Research Scientific Director - Center for Clinical and Translational Research Section Chief - Pediatric Allergy and Immunology Division of Allergy, Immunology and Pulmonary Medicine Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center  MedicalResearch.com: What is the background for this study?  Is Dupilumab used for other atopic conditions, ie eczema/atopic dermatitis?   Response: Many children with moderate-severe asthma continue to experience asthma exacerbations and poor asthma control despite use of controller therapies.  Dupilumab has been shown to reduce asthma exacerbations in adolescents and adults, as well as to improve atopic dermatitis in children and adults. (more…)
Author Interviews, CDC, Infections / 07.12.2021

MedicalResearch.com Interview with: Michael Craig MPP Director, Antibiotic Resistance Coordination and Strategy CDC  MedicalResearch.com: What is the mission of the Global Action in Healthcare Network (GAIHN)? How will it work to coordinate detection and response efforts across multiple countries and cultures? 
  • Health care can often be an epicenter of infectious disease outbreaks that can spread within a facility, between facilities, and beyond the facility into the community. CDC’s Global Action in Healthcare Network (GAIHN) consists of countries, healthcare facilities, and public health partners working together to prevent, detect, and respond to infectious disease threats in the healthcare setting. GAIHN will target health care threats like antimicrobial-resistant infections, healthcare-associated infections (HAIs), and COVID-19 through infection prevention and control.
  • Close coordination across experts at CDC, and strong relationships and communications with our funded partners, international colleagues, ministries of health and country leadership, will make GAIHN successful and ensure collaboration, minimize duplication, and maximize advancements across countries and cultures.
  • Find more information about the 2021 GAIHN projects: https://www.cdc.gov/infectioncontrol/global/GAIHN.html 
(more…)
Author Interviews, Brigham & Women's - Harvard, Circadian Rhythm, Diabetes, Occupational Health, Science, Weight Research / 06.12.2021

MedicalResearch.com Interview with: Sarah L. Chellappa, MD PhD Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA Department of Nuclear Medicine Faculty of Medicine and University Hospital Cologne University of Cologne, Cologne, Germany. Frank A.J.L. Scheer, M.Sc., Ph.D. Professor of Medicine. Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA MedicalResearch.com: What is the background for this study? Would you explain the difference between the central circadian ‘clock’ and endogenous circadian glucose rhythms?  Response: Night work increases diabetes risk. This increased risk is not fully explained by differences in lifestyle, family history, and/or socioeconomic status, thus other mechanisms are likely involved. Laboratory studies in humans have shown glucose intolerance in both non-shift workers and shift workers exposed to simulated night work. Animal experimental data suggests that this may be in part due to a misalignment between central and peripheral rhythms. Central circadian rhythms (e.g., body temperature) are primarily modulated by the central circadian “clock”, which is located in the brain’s suprachiasmatic nucleus and is responsible for synchronizing our physiology and behavior with the 24-hour cycle. Peripheral rhythms, including endogenous circadian glucose rhythms, are likely modulated by peripheral “clocks” across the body that play an integral role in modulating the circadian expression of physiology, including metabolic functions. These central and peripheral clocks share a common molecular mechanism underlying their circadian rhythm generating capacity, including transcription-translation feedback loops of circadian “clock” genes.  (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Ophthalmology / 06.12.2021

MedicalResearch.com Interview with: Cecilia S. Lee, MD, MS Associate Professor,Director, Clinical Research Department of Ophthalmology Harborview Medical Center University of Washington Seattle, WA MedicalResearch.com: What is the background for this study? Response: Cataract is a natural aging process of the eye and affects the majority of older adults who are at risk for dementia. Sensory loss, including vision and hearing, is of interest to the research community as a possible risk factor for dementia, and also as a potential point of intervention. Because cataract surgery improves visual function, we hypothesized that older people who undergo cataract surgery may have a decreased risk of developing Alzheimer disease and dementia. We used the longitudinal data from an ongoing, prospective, community based cohort, Adult Changes in Thought (ACT) study. The ACT study includes over 5000 participants to date who are dementia free at recruitment and followed until they develop Alzheimer disease or dementia. We had access to their extensive medical history including comprehensive ophthalmology visit data. We investigated whether cataract surgery was associated with a decreased risk of developing Alzheimer disease and dementia.  (more…)
Author Interviews, Mental Health Research, Stroke / 06.12.2021

MedicalResearch.com Interview with: Professor Andrew Smyth MB, BCh, BAO, MMedSc, MRCPI, PhD Professor of Clinical Epidemiology NUI Galway Director of the HRB-Clinical Research Facility Galway Consultant Nephrologist at Galway University Hospitals MedicalResearch.com: What is the background for this study? Response: We know that there are multiple medium to long-term risk factors for stroke, as people with conditions such as hypertension (high blood pressure) or diabetes mellitus (high blood glucose levels) and those with risk factors (such as smoking, obesity, poor diet quality and others) are at increased risk of stroke. However, we still find it difficult to predict who will have a stroke. We were interested in exploring if short-term exposures to anger or emotional upset or a period of heavy physical exertion might lead to, or ‘trigger’ a stroke. We looked at this previously for myocardial infarction (heart attack) in a study called INTERHEART. Some smaller studies have looked at this before, with less people experiencing a stroke and often confined to one country or geographical region. Here, in INTERSTROKE, we included over 13,000 people who had a stroke and asked about the one hour period before the onset of the stroke and also about the same period on the day before.  (more…)
Author Interviews, Coffee, Ophthalmology / 04.12.2021

MedicalResearch.com Interview with: Kristine Dalton PhD FAAO, FBCLA School of Optometry & Vision Science University of Waterloo Waterloo, Canada MedicalResearch.com: What is the background for this study? Response: Dynamic visual acuity refers to the ability to detect and perceive small details in objects that are moving relative to an observer.  Dynamic visual acuity is a complex visual function, that involves a number of different aspects of vision, including detecting the target, moving the eyes appropriately to observe the target, and processing the visual information from the target in the brain to interpret what we are seeing.   What makes dynamic visual acuity so interesting to study, is that as a visual function, it appears to play an important role in a number of real-world situations, including playing sports, driving, and piloting, and it may provide us more information about how the visual system is functioning compared to the more traditional, static vision tests alone. Previous research has demonstrated that consumption of caffeine has been shown to benefit physiological, psychomotor, and cognitive performance.  More recently there has been an increased interest in studying the impacts of caffeine on the vision system, however the impact of caffeine on dynamic visual acuity has not been studied.  This study was designed to address this limitation in the literature, particularly because dynamic visual acuity appears to be such an important visual function for real-world activities.   (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, NEJM, Vaccine Studies / 02.12.2021

MedicalResearch.com Interview with: Dr. Barbra Dickerman, PhD CAUSALab investigator and instructor Department of Epidemiology Harvard T.H. Chan School of Public Health  MedicalResearch.com: What is the background for this study? Response: Early randomized trials showed that the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines were both remarkably effective at preventing symptomatic disease, when comparing each vaccine with no vaccine. However, head-to-head comparisons of these vaccines have been lacking, leaving open the question of which vaccine is more effective.  In this study, we analyzed the VA’s high-quality databases in a way that emulated the design of the hypothetical trial that would have answered this question. Specifically, we used the findings from the original trials to benchmark our methods and then extended them to provide novel evidence for the comparative effectiveness of these two vaccines in a real-world setting and across diverse subgroups and different time periods. (more…)
Author Interviews / 30.11.2021

Below are some of the top ophthalmological advances for 2021:

       1. Optical Coherence Tomography Optical Coherence Tomography or OCT is a noninvasive imaging technique that is used to secure cross-sectional, high-resolution imaging of the retina. The retina’s layers are differentiated while its thickness is measured to help detect and identify retinal conditions in its early stages. These retinal diseases may include macular degeneration, which is typically age-related, and diabetic retinopathy or diabetic eye disease. OCT testing is now a standard practice to assess and decide on specific treatments for many retinal problems. It utilizes light rays to measure the thickness of the retina without radiation and x-rays, a painless test that does not cause discomfort to the patient. The technology of OCT is similar to ultrasound though it uses light instead of sound, giving it a much clearer resolution. (more…)
Author Interviews, Cannabis, Fertility / 30.11.2021

MedicalResearch.com Interview with: Kanako Hayashi PhD Associate Professor Associate Director, Center for Reproductive Biology Washington State University MedicalResearch.com: What is the background for this study? Response: There have been several correlative reports showing statistical associations between cannabis use and low sperm counts, dysregulated menstruation, abnormal placentation, preterm birth, stillbirth and offspring psychosis etc. However, the long-term consequences of cannabis use on reproductive functions and how it might impact the next generation have not been examined. In the present study, we examined the generational effects of cannabis vapor exposure on male reproductive function. Vaporization is the most common route of cannabis administration in humans. Therefore, in order to understand the generational effects of cannabis exposure on male reproductive functions, the present study was performed using an inhalation method as an administration route, by which adult male mice were exposed to dry cannabis plants to assess the toxicological effects of cannabis on F0, F1 and F2 male reproductive functions. (more…)
Author Interviews, BMJ, Cognitive Issues, Exercise - Fitness / 30.11.2021

MedicalResearch.com Interview with: Wee Shiou Liang, PhD Associate Professor | Health and Social Sciences, Singapore Institute of Technology Faculty | Geriatric Education and Research Institute Singapore MedicalResearch.com: What is the background for this study? Response: This study was funded by Singapore’s Ministry of Health Geriatric Education and Research Institute. We randomly recruited 500+ adults aged 21-90+ from the residential town of Yishun. We performed detailed assessments of physical and cognitive performance, body composition using DEXA, and participants also provided information on their levels and frequencies of physical activities (PA) including recreational PA/exercise, commuting, housework and other occupational related PA. The demographics of the sample of participants is the same as that of Singapore in terms of age and ethnic composition. Comparing the results of those aged 21-<65 and those >=65 years, only around a third (36%; 90) of those in the younger group and only around half (48%;116) of those in the older age group, met guidelines recommended physical activity quota exclusively from recreational PA/exercise. But nearly two thirds (61% younger; 152 and 66% older; 159) met this target exclusively through housework. (more…)
Allergies, Author Interviews, COVID -19 Coronavirus, Dermatology, UCSF / 27.11.2021

MedicalResearch.com Interview with: Carina M. Woodruff, MD Department of Dermatolog University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Rigorous hand hygiene has been an important component of the CDC's COVID-19 guidelines. With millions of Americans now using hand sanitizers regularly, we are seeing many more cases of hand dermatitis. Our study evaluated the key product features and most common allergens in the top-reviewed, commercial hand sanitizers sold by major US retailers. We found that the most common potential allergens were tocopherol, fragrance, propylene glycol and phenoxyethanol. Our study also showed that nearly 1 in 5 marketing claims on these products was misleading. For example, 70% of sanitizers with the marketing claim "hypoallergenic" included at least one common allergen in its formulation. (more…)
Author Interviews, JAMA, Johns Hopkins, Weight Research / 25.11.2021

MedicalResearch.com Interview with: Alejandra Ellison-Barnes, MD MPH General Internal Medicine Johns Hopkins Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Emerging adulthood is a unique period of development that ultimately leads to the formation of adult identity, but how this stage contributes to obesity is relatively understudied. The prevalence of obesity has been increasing in the United States population as a whole, and we wanted to know how mean body mass index and the prevalence of obesity have changed over the past several decades specifically among emerging adults. We found that among emerging adults aged 18 through 25, mean BMI has increased from 23.1 kg/m2 in 1976-1980 to 27.7 kg/m2 in 2017-2018. In the same period, the prevalence of obesity increased from 6.2% to 32.7%. (more…)
Author Interviews / 25.11.2021

MedicalResearch.com Interview with: Ariel Israel, M.D., Ph.D. Director, Leumit Health Services Tel Aviv, Israel  MedicalResearch.com: What is the background for this study? Response: As a research institute of Leumit, one of the four state mandated health funds in Israel, we pursue research projects aimed at improving the health of our members, and  reducing the burden of disease. For this purpose, we harness the unique resource of the electronic health records of our members, that is available in a central data warehouse for research purposes. Israel was one of the first countries to roll-out a large-scale vaccination campaign, and to achieve control of the pandemics through vaccination. Nevertheless, since the middle of June '21, we have observed a gradual increase in the rate of COVID-19 infections among our members, even among the vaccinated. This increase was first believed to be due to the emergence of the delta strain, but when we compared vaccinated individuals who suffered from breakthrough infections to other vaccinated individuals, we found that the time that has elapsed since vaccination was significantly longer for individuals who got infected with COVID-19, in  each of the age groups. This prompted us to investigate the issue of a possible waning effect of the vaccine protection with time, that we present in this report, using the test negative study design. We examined the electronic health records for 80,057 adults (average age 44 years) who received a PCR test at least three weeks after their second injection, and had no evidence of previous covid-19 infection. Of these 80,057 participants, 7,973 (9.6%) had a positive test result. These individuals were then matched to negative controls of the same age and ethnic group who were tested in the same week. (more…)
Alzheimer's - Dementia, Author Interviews, Clots - Coagulation, Heart Disease / 23.11.2021

MedicalResearch.com Interview with: Bruno Caramelli MD PhD Associate Professor of Medicine University of Sao Paulo, Brasil Director, Interdisciplinary Medicine in Cardiology Unit Chairman of the PhD program in Medical Sciences at the University of Sao Paulo, Brazil. President of the Department of Clinical Cardiology at the Brazilian Society of Cardiology FESC: Fellow of the European Society of Cardiology MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation is the most common cardiac arrhythmia in older adults, and it is associated with an increased risk of stroke, cognitive impairment, and dementia. Stroke can occur when a blood clot blocks blood flow to the brain, and oral anticoagulants, such as dabigatran and warfarin, are typically prescribed to prevent stroke. Dabigatran has been found to be comparable to warfarin for the prevention of stroke and also has a lower risk of major bleeding complications. Previous research has shown that people with atrial fibrillation taking oral anticoagulation therapy have a lower risk of dementia, however, the mechanism involved in this benefit is unknown, and previous clinical trials have not evaluated cognitive and functional impairment outcomes among patients. It’s possible that cognitive decline is related to the formation of small blood clots in the brain, which is treated by effective medications that prevent blood clots. Since dabigatran offers a more stable anticoagulation status, we investigated whether it would be more effective than warfarin for the prevention of cognitive decline in patients with atrial fibrillation. Previous studies were retrospective and observational studies and considered tests that evaluate global cognitive function in a generic, global, and non-specific way. In that way its not possible to exclude different causes of dementia as Alzheimer's disease and others making it difficult to establish an effect directly related to atrial fibrillation or the anticoagulation treatment. (more…)
Author Interviews, JAMA, Mayo Clinic, Race/Ethnic Diversity, USPSTF / 20.11.2021

MedicalResearch.com Interview with: Chyke A. Doubeni, M.D., M.P.H. Member of the U.S. Preventive Services Task Force since 2017 Director, the Mayo Clinic Center Health Equity and Community Engagement Research Department of Family Medicine Mayo Clinic in Rochester, MN  MedicalResearch.com: What is the background for this study? What are the main findings? Response: People who experience systemic racism generally have shorter life expectancies and experience more health problems. Racism can increase the chances of getting preventable conditions, limit access to health information, and restrict access to actual preventive care. To confront these issues and promote antiracism and health equity, the Task Force commissioned a review of the evidence around how systemic racism currently undermines preventive healthcare. Based on that review, the Task Force has developed an initial set of strategies to reduce the effects of systemic racism, which includes prioritizing topics that are likely to advance health equity, assessing the Task Force’s language to ensure it is culturally appropriate, and calling for more research in people of color.  (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 18.11.2021

MedicalResearch.com Interview with: Ashwin Nathan, MD, MSHP Assistant Professor, Medicine, Perelman School of Medicine Interventional Cardiologist Hospital of the University of Pennsylvania and at the Corporal Michael C. Crescenz VA Medical Center in Philadelphia Penn Cardiovascular Outcomes, Quality & Evaluative Research Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: We found that the rates of TAVR were lower in areas with higher proportions of Black, Hispanic and socioeconomically disadvantaged patients. Inequities in access in areas with higher proportions of Black and Hispanic patients existed despite adjusting for socioeconomic status. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lipids / 16.11.2021

MedicalResearch.com Interview with: Nicholas A. Marston, MD, MPH Thrombolysis in Myocardial Infarction (TIMI) Study Group Brigham and Women’s Hospital Harvard Medical School Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: There has been recent debate about how much of lipid-associated cardiovascular risk is from LDL cholesterol versus triglycerides. However, genetic studies suggest that apolipoprotein B is actually the primary driver of atherosclerotic risk. Since there is exactly one apoB lipoprotein on each lipid particle (LDL, IDL, VLDL), its measurement is a surrgate for the total number of apoB-containing lipoproteins. So in this study, we asked the question: Do common measures of cholesterol concentration, triglyceride concentration, or their ratio carry predictive value for cardiovascular risk beyond the number of apo-B containing lipoproteins? (more…)
Alzheimer's - Dementia, Author Interviews, Biomarkers / 11.11.2021

MedicalResearch.com Interview with: Joshua D. Grill, PhD Professor, Psychiatry & Human Behavior School of Medicine Professor, Neurobiology and Behavior School of Biological Sciences University of California, Irvine MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease is a major public health challenge. More than 6 million Americans have the disease, which causes cognitive problems and eventual dependence on others for daily function. Scientists understand that the disease begins in the brain years before memory and other thinking problems begin and the AHEAD Study aims to intervene in this window of time, to see if a drug that targets these brain changes can delay or prevent symptoms of the disease.   (more…)
Author Interviews, Cancer Research, Dermatology, Lancet, Melanoma, Technology / 11.11.2021

MedicalResearch.com Interview with: Dr David Wen BM BCh NIHR Academic Clinical Fellow in Dermatology University of Oxford MedicalResearch.com: What is the background for this study? Response: Publicly available skin image datasets are commonly used to develop machine learning (ML) algorithms for skin cancer diagnosis. These datasets are often utilised as they circumvent many of the barriers associated with large scale skin lesion image acquisition. Furthermore, publicly available datasets can be used as a benchmark for direct comparison of algorithm performance. Dataset and image metadata provide information about the disease and population upon which the algorithm was trained or validated on. This is important to know because machine learning algorithms heavily depend on the data used to train them; algorithms used for skin lesion classification frequently underperform when tested on independent datasets to which they were trained on. Detailing dataset composition is essential for extrapolating assumptions of generalisability of algorithm performance to other populations. At the time this review was conducted, the total number of publicly available datasets globally and their respective content had not previously been characterised. Therefore, we aimed to identify publicly available skin image datasets used to develop ML algorithms for skin cancer diagnosis, to categorise their data access requirements, and to systematically evaluate their characteristics including associated metadata.   (more…)
Author Interviews, Genetic Research, NEJM / 10.11.2021

MedicalResearch.com Interview with: Professor Sir Mark Caulfield Professor of Clinical Pharmacology William Harvey Research Institute Queen Mary University of London  MedicalResearch.com: What is the background for this study? Response: Rare diseases affect 6% of the population in western nations and there are approximately 10,000 different disorders and many remain without a genomic diagnosis after usual testing during their life time. In 2013 the UK Government launched the 100,000 Genomes Project and created Genomics England to investigate the role of whole genome sequencing in rare disease, cancer and infection. Whole genome sequencing gives the most comprehensive read out of the entire genome. To do this we partnered with the National Institute for Health Research (NIHR) BioResource and 9 hospitals across England1. Our New England Journal of Medicine paper published on the 11th November 2021 reports findings on the early rare disease participants who helped us pilot procedures and processes that would be used to enrol at scale across the NHS and revealed the potential benefits for rare disease1. (more…)
Anesthesiology, Author Interviews, COVID -19 Coronavirus, Science, UCSF / 10.11.2021

MedicalResearch.com Interview with: Art Wallace, M.D., Ph.D. Professor Emeritus, Anesthesia School of Medicine, UCSF Chief of the Anesthesia Service Veterans Affairs Medical Center in San Francisco MedicalResearch.com: What is the background for this study? Response: I have spent the last 30 years working on perioperative risk reduction, developing medications and approaches to risk reduction. Part of this work utilized epidemiologic analysis of medication patterns of use to test if they are associated with reductions in morbidity and mortality. This work analyzed data in the VA Corporate Data Warehouse (CDW) which provides access to the VA, best in the world electronic health care record system, VISTA.  With the COVID-19 pandemic I realized that the analytic techniques we had utilized for perioperative cardiac risk reduction could be used to search for medications to reduce the risks for acute COVID-19 infection. We identified four classes of medications that reduced the risk of death in acute COVID-19 infection. We then turned our attention to medications to reduce the incidence, severity, and duration of long-term sequelae of COVID-19 infection also known as Long COVID or COVID Long Hauler Syndrome. One of the questions that people were asking was what was the effect of vaccination on Long COVID? We began that work by looking at the effect of vaccination on COVID infections and found the dramatic decrease in efficacy of vaccines with the spread of the Delta Variant. We published this work to notify the public and public health community of the decreased efficacy of the vaccines in the face of the Delta variant and reiterate the need for secondary public health prevention measures such as masks, social distancing, vaccination, and boosters. (more…)
Author Interviews, Rheumatology / 10.11.2021

MedicalResearch.com Interview with: Kelly Gavigan, MPH Manager, Research and Data Science CreakyJoints and Global Healthy Living Foundation MedicalResearch.com: What is the background for this study? Response: We understood that COVID-19 is of particular concern for people living with autoimmune and rheumatic disease because they are at increased risk of infection, and this created a heightened sense of isolation due to the strict social distancing protocols that so many patients have followed. As a result, we wanted to better understand if symptoms among the autoimmune and rheumatic disease patients in our ArthritisPower research registry were impacted throughout the COVID-19 pandemic. We analyzed patient reported outcome scores for mental, social, and physical health measures between the months of January 2020 and April 2021. We tested the null hypothesis that there was no change in monthly average assessment scores across the 15-month observation period. (more…)
Author Interviews, COVID -19 Coronavirus, Rheumatology / 10.11.2021

MedicalResearch.com Interview with: Courtney K. Wells, PhD, MSW, MPH, LGSW Assistant Professor & Field Coordinator Department of Social Work University of Wisconsin-River Falls and member of CreakyJoints MedicalResearch.com: What is the background for this study? Response: This study was initiated because early in the pandemic there was little information available regarding quality of life and the day-to-day activities of patients with rheumatic conditions. We were particularly interested in patients’ psychosocial experiences and how they made decisions about their health. We found that participants’ understanding of their risk for COVID-19 played a key role in their decision making processes. At the beginning of the pandemic, many participants viewed themselves as being high risk because of their condition and/or medications and took extreme precautions. These precautions isolated them from their family, friends, and healthcare, all of which negatively affected their physical and mental health. As the pandemic went on, participants described an exhausting balancing act between their risk for COVID-19, their rheumatic condition, and their mental health. Because we did interviews over 6 months, we saw participants shifting their priorities towards their mental health as more information became available and the vaccine emerged. We also learned that rheumatology patients from BIPOC ( Black, Indigenous, People of Color) and immigrant communities experienced unique stressors during the pandemic such as barriers to accessible and trusted healthcare providers and increased experiences of racism. (more…)