Addiction, Author Interviews, JAMA, Pediatrics, USPSTF / 20.06.2020
USPSTF: Insufficient Evidence To Recommend Routine Screening of Teens for Unhealthy Drug Use
MedicalResearch.com Interview with:
[caption id="attachment_54620" align="alignleft" width="133"] Dr. Davidson[/caption]
Dr. Karina Davidson, PhD
Senior Vice President of Research
Dean of Academic Affairs
Professor of Behavioral Medicine
Zucker School of Medicine
Hofstra University/Northwell Health
Vice Chairmam
US Preventive Services Task Force
MedicalResearch.com: What is the background for this study?
Response: Drug use is among the most common causes of preventable death, injury, and disability in the United States, with nearly 10 percent of adults reporting unhealthy drug use. This includes the use of illegal drugs, as well as using prescription drugs in ways that are not recommended by a doctor.
Dr. Davidson[/caption]
Dr. Karina Davidson, PhD
Senior Vice President of Research
Dean of Academic Affairs
Professor of Behavioral Medicine
Zucker School of Medicine
Hofstra University/Northwell Health
Vice Chairmam
US Preventive Services Task Force
MedicalResearch.com: What is the background for this study?
Response: Drug use is among the most common causes of preventable death, injury, and disability in the United States, with nearly 10 percent of adults reporting unhealthy drug use. This includes the use of illegal drugs, as well as using prescription drugs in ways that are not recommended by a doctor.
Dr. Hänggi[/caption]
MedicalResearch.com: What is the background for this study?
Response: Anti-MAG neuropathy is a rare form of acquired demyelinating neuropathy. The disease onset normally presents after the age of 50 years and is 2.7 times more frequent in men than in women, with a prevalence of about 1 in 100,000. It is caused by the production of monoclonal anti-MAG IgM antibodies that recognize the HNK-1 epitope. The myelin-associated glycoprotein MAG is a mediator for the formation and maintenance of the myelin sheaths. There is strong evidence that the binding and deposition of anti-MAG IgM autoantibodies on myelin sheath is responsible for the demyelination, which clinically manifests itself as a peripheral neuropathy affecting primarily sensory nerves. However, the causes and the exact mechanisms behind the expansion of anti-MAG IgM producing B-cell and plasma cell clones are not fully understood.
Most off-label treatments aim to reduce pathogenic autoantibody titers by depleting autoantibody-producing B cell clones which interfere with antibody-effector mechanisms, or physically remove autoantibodies from the circulation. Most frequently, the anti-CD20 monoclonal antibody rituximab is used to treat anti-MAG neuropathy patients. However, all of these treatment options often lack of selectivity, efficiency, or can induce severe adverse effects in some patients.
Polyneuron has designed PN-1007 to highly selectively target the IgM autoantibodies that cause anti-MAG neuropathy. PN-1007 is a glycopolymer that mimics the natural HNK-1 carbohydrate epitope found on myelin of peripheral nerves and binds to the circulating disease-causing antibodies. By eliminating these pathogenic antibodies, PN-1007 may protect the integrity of the neuronal myelin sheaths of anti-MAG neuropathy patients.
Prof. FAN Zhiyong PhD
University of California, Irvine
HKUST School of Engineering
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: According to the report of The World Health Organization, there are over 252 million people suffering from visual impairment globally and 15 million of them are difficult to cure by conventional medical methods. However, today, even the best bionic eyes have only 200 clinical trials, less than 1 ppm of all the patients, mainly due to their poor performance and high cost. The huge gap in supply and demand triggers the study of bionic eyes with performance comparable to human eyes. One important reason for their poor performance is the mismatch in shape between the flat bionic eyes and concave sclera. To protect the soft tissue in eyes from being damaged by the bionic surface, the implanted bionic eyes have to be small. This has limited the sensing area and further the electrodes number, and finally yielded poor image sensing characters with low resolution and narrow field-of-view.
In this work, we are trying to achieve high performance image sensing by biomimeticing human eyes. The high-density NWs are well aligned and embedded in a hemispherical template to serve as retina. The conformal attachment of bionic eyes with sclera enables the large sensing area and wide visual angle. In addition, each individual high-density nanowires can potentially work as an individual pixel. By addressing these challenges, our device design has huge potential to improve the image sensing performance of bionic eyes.
Dr. Al-Hendy[/caption]
MedicalResearch.com: What is the background for this approval?
Uterine fibroids, commonly referred to as uterine leiomyomas, are the most common type of non-cancerous tumor known to impact women of reproductive age (30-50 years old). In fact, studies show that uterine fibroids can occur in up to 70 percent of European American women and over 80 percent of African American women by age 50. As a result of uterine fibroids, women can experience a range of symptoms, the most common being heavy menstrual bleeding (i.e. prolonged and/or frequent bleeding), which can lead to other health effects such as anemia, fatigue, pelvic pain, urinary frequency etc.
Uterine fibroid treatment recommendations have historically been based on the size and location of the fibroid(s). When treating larger and more complicated fibroids, healthcare providers have typically believed that surgery is their best course of action, which has made uterine fibroids the leading reason for the hysterectomies performed in the U.S. The FDA approval of ORIAHNN was based on improving care for uterine fibroid sufferers who have had a negative impact on their quality of life due to disruptive symptoms. What makes the approval of ORIAHNN so exciting, is that women now have an oral therapy to directly address heavy menstrual bleeding due to uterine fibroids.
Dr. Kempe[/caption]
Allison Kempe, MD, MPH
Ergen Family Endowed Chair in Pediatric Outcomes Research
Professor of Pediatrics, University of Colorado School of Medicine
Director of ACCORDS (Adult and Child Consortium for Health Outcomes Research and Delivery Science)
University of Colorado School of Medicine | Children’s Hospital Colorado
MedicalResearch.com: What is the background for this study?
Response: In 2019 the WHO designated vaccine hesitancy as one of the ten leading threats to global health. Although studies have assessed parental vaccine hesitancy in different localities and estimated vaccine refusals nationally, there is little recent US national data on the prevalence of hesitancy about routine childhood vaccines and national hesitancy rates for influenza vaccine have never been assessed. We used a hesitancy scale developed by the WHO to estimate levels of parental hesitancy for both routine childhood and childhood influenza vaccination 
Dr. Crowley[/caption]
Matthew J. Crowley, MD
Core Investigator, Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT)
Affiliated Investigator, VA Office of Rural Health
Staff Physician, Endocrinology Section, Durham VA Health Care System
[caption id="attachment_54583" align="alignleft" width="144"]
Dr. Paller[/caption]
Amy S Paller, MD
Chair, Department of Dermatology
Director, Skin Biology and Diseases Resource-Based Center
Walter J. Hamlin Professor of Dermatology
Professor of Dermatology and Pediatrics (Dermatology)
Feinberg School of Medicine
Northwestern University
Dr. Paller discusses the FDA approval of Dupixent® (dupilumab) for children aged 6 to 11 years with moderate-to-severe atopic dermatitis (eczema), whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.
MedicalResearch.com: What is the background for this announcement? Would you briefly discuss what is meant by atopic dermatitis and how it affects children?
Response: “Atopic dermatitis, the most common form of eczema, is a chronic inflammatory disease that often appears as a rash on the skin. Moderate-to-severe atopic dermatitis is characterized by rashes that can potentially cover much of the body and can include intense, persistent itching, skin lesions and skin dryness, cracking, redness or darkness, crusting and oozing. Itch is one of the most burdensome symptoms for patients and can be debilitating.
This recent FDA approval expands the use of Dupilumab in the U.S. to include children aged 6 to 11 years with uncontrolled moderate-to-severe atopic dermatitis, making it the only biologic medicine approved for this use in this population. Dupilumab is also approved in the U.S. to treat patients aged 12 years and older with moderate-to-severe atopic dermatitis.
Moderate-to-severe atopic dermatitis can place a particularly substantial burden on young children aged 6 to 11 years and their families. Limited treatment options leave many of these children to cope with intense, unrelenting itch and skin lesions. Families of these children can spend countless hours helping them to manage their disease.”
Dr. Blume[/caption]
Dr. Christine Blume PhD
Centre for Chronobiology
Psychiatric Hospital of the University of Basel
Transfaculty Research Platform Molecular and Cognitive Neurosciences
Basel
MedicalResearch.com: What is the background for this study?
Response: In modern societies, human rest-activity rhythms and sleep are between the often-conflicting poles of external social time (e.g., work hours and leisure activities) and an individual’s internal biological time. This can lead to so-called “social jetlag”, which has repeatedly been associated with detrimental health effects. With the restrictions to control the pandemic, social timing relaxed as people many started working from home and public life came to a standstill. In an online survey with 435 respondents, we investigated the effects of the phase with the strictest COVID-19 restrictions on the relationship between social and biological rhythms as well as sleep during a six-week period (mid-March until end of April 2020) in three European societies (Austria, Germany, Switzerland).
Dr. LaMoreaux[/caption]
Brian LaMoreaux, M.D., M.S.
Medical Director, Medical Affairs
Horizon Therapeutics
MedicalResearch.com: What is the background for this study?
Response: Hyperuricemia is associated with non-alcoholic fatty liver disease (NAFLD) but the relationship to fibrosis remains uncertain. Moreover, it is not known whether lowering serum urate will affect the course of NAFLD.
Dr. Garstang[/caption]
Dr Joanna Garstang
Consultant Community Paediatrician / Designated Doctor for Child Death
Allenscroft Children's Centre
Kings Heath, Birmingham UK
MedicalResearch.com: What is the background for this study?
Response: Each year in England and Wales there around 3-400 babies die unexpectedly, in many cases the cause of death remains unexplained and these deaths are called Sudden Infant Death Syndrome (SIDS). Parents are understandably anxious about the risks for future children, the Care of Next Infant (CONI) programme was set up to offer support for families. In this study, we looked at records of families registered with CONI between 2000-2015 to determine the frequency and causes for repeat unexpected infant deaths.
![MedicalResearch.com Interview with: Sarah Messiah, PhD, MPH Professor of epidemiology, human genetics, and environmental sciences UTHealth School of Public Health Dallas MedicalResearch.com: What is the background for this study? Response: Given that obesity is a prevalent, serious, complex, chronic, and relapsing disease, and severe obesity is a deepening crisis, it is important to pay special attention to these challenges during the COVID-19 pandemic. This will avoid placing an even greater burden on individuals, health systems, and society in the post-COVID-19 recovery phase. Thus, it is critically important to document, in real time, how socioecological determinants of health are impacting behaviors among those with obesity. Before our study, how the COVID-19 pandemic is impacting weight management, health behaviors, and psychosocial health in particular among people with obesity was unknown. MedicalResearch.com: What are the main findings? Response: A total of 123 patients (87% female, mean age 51.2 years, mean BMI 40.2, 49.2% Non-Hispanic white, 28.7% Non-Hispanic black, 16.4% Hispanic, 7% other ethnicity, 33.1% completed bariatric surgery were included). -Two patients tested positive for SARS-CoV-2 and 14.6% reported symptoms. -10% lost their job since the beginning of the pandemic -25% reported food insecurity in that they sometimes, or always could not afford to eat balanced meals -72.8% reported increased anxiety and 83.6% increased depression since stay-at-home orders were initiated. -69.6% reported more difficultly in achieving weight loss goals -47.9% reported less exercise time and 55.8% reported less intensity -49.6% reported increased stockpiling of food -61.2% reported stress eating -61.2% reported following healthy diet plans more challenging - Hispanics were less likely to report anxiety versus non-Hispanic whites MedicalResearch.com: What should readers take away from your report? Response: In a relatively short period of time, our results show that there have been substantial perceptions in changes in health behaviors among patients with obesity. Our sample described a decreases in positive health behaviors, increases in deleterious behaviors and associated deterioration in mental health. Even though actual COVID-19 disease burden was low (1.7% tested positive for COVID-19 and another 14.6% reported symptoms), the pandemic is having a significant impact on those without infections. The major strength of this study is that it is the first snapshot into how the COVID-19 pandemic has influenced health behaviors for patients with obesity. Prior to the pandemic, it has been reported that Americans consume 20% of their calories from restaurants and that there are worsening disparities in fast food meal quality by race/ethnicity, education, and income. Due to recent economic challenges, patients may be more likely to select cheaper foods, which are often energy dense and nutrient poor. Therefore, even though we found more patients are cooking at home, the type of foods that are being stockpiled are likely to be processed foods due to their longer shelf life. These are associated with greater intake of fat, carbohydrate, and calories, which facilitate greater weight gain when compared to more balanced diets. It is possible Americans may be trading one pattern of low-quality consumption for another by choosing cheaper processed foods instead of eating out. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: These results have implications for clinical practice and management of patients with obesity as we now move into post-COVID-19 relief efforts. Due to the increase in obesogenic behaviors related to the COVID-19 pandemic that were found here, it is paramount that healthcare access is not disrupted for patients with obesity. Maintaining these vital services will prevent exacerbating the negative health and economic consequences of excess body weight. This includes access to primary care providers, Obesity Medicine specialists and bariatric surgery programs. In addition to asking about diet and exercise patterns, screening for indicators of mental health, loneliness, financial stressors and behaviors that may influence body weight should be implemented by healthcare teams to combat this problem. Disclosures: This work was funded by the National Institutes of Health, National Institute on Minority Health and Health Disparities (Grant #R01MD011686). This work was a joint collaboration among investigators from UTHealth School of Public Health, UT Southwestern Medical Center and Minimally Invasive Surgical Associates. Citation: Almandoz, J.P., Xie, L., Schellinger, J.N., Mathew, M.S., Gazda, C., Ofori, A., Kukreja, S. and Messiah, S.E. (2020), Impact of COVID ‐19 Stay‐at‐Home Orders on Weight‐Related Behaviors Among Patients with Obesity. Clin Obes. Accepted Author Manuscript. doi:10.1111/cob.12386 [subscribe] [last-modified] The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.](https://medicalresearch.com/wp-content/uploads/2020/06/Dr-Sarah-E.-Messiah.jpg)
