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Author Interviews, OBGYNE, Race/Ethnic Diversity / 16.01.2020

MedicalResearch.com Interview with: Elizabeth A. Howell, MD, MPP Director of The Blavatnik Family Women’s Health Research Institute Mount Sinai Health System Vice Chair for Research Professor in the Department of Obstetrics, Gynecology, and Reproductive Science Associate Dean for Academic Development Professor Department of Population Health Science and Policy Icahn Mount Sinai, New York MedicalResearch.com: What is the background for this study? Response: Previous research has demonstrated racial and ethnic disparities in severe maternal morbidity rates in hospitals and that between-hospital differences -- i.e., Black and Latina mothers receiving care at hospitals with worse outcomes -- explain a sizable portion of these disparities.  However, less attention has been paid to within-hospital disparities -- whether Black and Latina mothers have worse outcomes than White mothers who deliver in the SAME hospital. In this paper, we set out to measure within-hospital racial and ethnic disparities and to evaluate the potential contribution of insurance type to these disparities.  Our study question was based on the observation that women with Medicaid can follow different care pathways than women with private insurance. Pregnant women insured by Medicaid are often seen by resident physicians with attending coverage that may differ from attending physicians caring for commercially insured women. In addition, Medicaid reimbursement for delivery hospitalization is far less than that for commercially insured.  (more…)
Author Interviews, Cancer Research, Nature / 16.01.2020

MedicalResearch.com Interview with: Augusto Villanueva Rodriguez, MD, PhD Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com: What is the background for this study? Response: There is limited understanding of the extent of molecular heterogeneity in liver cancer. This cancer is the second most lethal tumor and the fourth cause of cancer-related mortality worldwide. Most patients diagnosed at advanced stages have a dismal survival, as most of them will develop resistance to systemic therapies. One of the potential mechanisms for this relates to the presence of different tumor clones within the same tumor nodule. This heterogeneity has been barely studied in liver cancer and our study provides a comprehensive analysis of the extent and potential clinical implications of intra-tumoral heterogeneity (ITH) in liver cancer. (more…)
Author Interviews, JAMA, Surgical Research, Weight Research / 15.01.2020

MedicalResearch.com Interview with: Anita P. Courcoulas MD, MPH, FACS Anthony M. Harrison MD Chair and Professor of Surgery Chief, MIS Bariatric & General Surgery University of Pittsburgh Medical Center  MedicalResearch.com: What is the background for this study? Response: Fewer published studies in bariatric surgery address long term adverse outcomes or problems that can occur after different operations.  In addition, a lack of standardized reporting of potential adverse events limits the understanding of these issues. This paper results from one of the largest studies of bariatric surgery ever undertaken and includes both gastric bypass and gastric sleeve, the 2 most common operations performed in the U.S. and worldwide at the current time.  This study leverages large data sets from the electronic health record linked to insurance claims and death indices.  This is real-world data coming from a population-based cohort of 33,560 adults at 10 sites in 4 clinical data research networks throughout the U.S., so it may be different from data that accrues from a longitudinal observational study or randomized trial.  Patients and other important stakeholders in bariatric surgery were critical to the design, conduct, and dissemination of results from this study. (more…)
Author Interviews, Heart Disease, JAMA / 15.01.2020

MedicalResearch.com Interview with: Mandeep R. Mehra, MD, MSc, FRCP The William Harvey Distinguished Chair in Advanced Cardiovascular Medicine Medical Director, Heart and Vascular Center Brigham and Women’s Hospital Executive Director Center for Advanced Heart Disease Brigham and Women’s Hospital Professor of Medicine, Harvard Medical School    MedicalResearch.com: What is the background for this study? Response: Left Ventricular assist devices meaningfully prolong survival in patients with heart failure who are no longer responsive to guideline-directed medications. The MOMENTUM 3 trial tested a new generation device, the HeartMate 3 pump, to a more commonly used pump, the HeartMate II device. This trial showed the superiority of the new heart pump and found that survival free of a disabling stroke or need to place a second pump is improved considerably. In this prespecified analysis of the trial, we compared patients who were considered as eligible for transplantation to those considered ineligible for heart transplantation. We showed that these categories are associated with similar superiority of the HeartMate 3 pump compared to the control pump despite the categorization into these discrete buckets. (more…)
Author Interviews, Opiods / 15.01.2020

MedicalResearch.com Interview with: Paul Christine, MD, PhD University of Michigan MedicalResearch.com: What is the background for this study? Response: In an effort to increase employment and "community engagement" among Medicaid enrollees, several states are seeking to implement new Medicaid work requirements. While many proposals make exemptions for individuals with substance use disorders, some require active treatment to qualify for an exemption and maintain Medicaid eligibility. Since many enrollees with substance use disorder would thus need to access treatment to maintain coverage, we sought to quantify the availability of treatment resources in states with and without Medicaid work requirements. (more…)
Author Interviews, Cognitive Issues, Genetic Research / 15.01.2020

MedicalResearch.com Interview with: Haining Zhu, PhD Department of Molecular and Cellular Biochemistry University of Kentucky, Lexington, Kentucky MedicalResearch.com: What is the background for this study? Response: Frontotemporal dementia is the most common type of early onset dementia impacting people between ages 40 and 65. It affects the frontal and temporal lobes of the brain, which leads to behavior and personality changes, difficulty speaking and writing, and eventual memory deterioration. A subgroup of patients with frontotemporal dementia have a specific genetic mutation that prevents brain cells from making a protein called progranulin. Although progranulin is not well understood, its absence is linked to the disease. (more…)
Author Interviews, Dermatology, Mental Health Research, Pediatrics / 15.01.2020

MedicalResearch.com Interview with: Lucia Diaz, M.D., is chief of pediatric dermatology, dermatology residency associate program director and assistant professor of medicine and pediatrics at Dell Medical School. She is also co-director of the dermatology-rheumatology combined clinic at Dell Children’s Medical Center. Sasha Jaquez, Ph.D. is a pediatric psychologist at Dell Children's Medical School/Dell Children's Medical Center and specializes in seeing children with chronic medical illness, including skin disorders.     MedicalResearch.com: What is the background for this study? Response: Trichotillomania (TTM) can be an extremely disabling chronic condition that impacts the psychosocial development of children. It is classified by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an obsessive-compulsive disorder, where a person recurrently pulls out hair from any region of their body resulting in hair loss. Recognizing this disorder and being informed of treatment options allows medical providers to correctly diagnose and intervene early in the disease course. We reviewed the psychosocial impacts of pediatric trichotillomania and the current evidence-based interventions used in the population.  (more…)
Author Interviews, Nutrition, Weight Research / 15.01.2020

MedicalResearch.com Interview with: Leigh Frame, PhD, MHS Director for the Integrative Medicine Program School of Medicine and Health Sciences George Washington University MedicalResearch.com: What is the background for this study? Response: As food consumed in the U.S. becomes more and more processed, obesity may become more prevalent. Through reviewing overall trends in food, we concluded that detailed recommendations to improve diet quality and overall nutrition are needed for consumers, who are prioritizing food that is cheaper and more convenient, but also highly processed. When comparing the U.S. diet to the diet of those who live in "blue zones" - areas with populations living to age 100 without chronic disease - the differences are stark. Many of the food trends we reviewed are tied directly to a fast-paced U.S. lifestyle that contributes to the obesity epidemic we are now facing. (more…)
Author Interviews, Melanoma / 14.01.2020

MedicalResearch.com Interview with: Prof. Victoria Sanz-Moreno Professor of Cancer Cell Biology Cancer Research UK Senior Fellow and Cancer Research UK Werth Trust Fellow Barts Cancer Institute- a Cancer Research UK Centre of Excellence Queen Mary University of London MedicalResearch.com: What is the background for this study? Response: Malignant melanoma- a cancer of the skin- has very poor survival rates despite being at the forefront of personalised medicine. This is mostly due to therapy resistance. Our current study indicates that melanoma cells escape anti-cancer drugs by changing their internal skeleton (cytoskeleton) – opening up new therapeutic venues for melanoma. (more…)
Author Interviews, Nutrition, Supplements, UCSD / 14.01.2020

MedicalResearch.com Interview with: Kellogg Parsons, MD, MHS Professor of Urology Moores UC San Diego Comprehensive Cancer Center MedicalResearch.com: What is the background for this study? Response: Clinical guidelines for prostate cancer, circulated widely in the public domain, endorse the consumption of diets high in micronutrient-enriched vegetables. Drawing on expert opinion, epidemiological studies, and small preclinical experiments, these recommendations propose that vegetable-enriched diets may decrease cancer progression and death among prostate cancer survivors. However, data from randomized clinical trials focused on actionable clinical endpoints has been lacking. We utilized a specific behavioral intervention, grounded in the field of social psychology, to “nudge” patients with prostate cancer toward healthier food choices. The intervention is telephone-based, like a call center: patient-focused, convenient, and simple. (more…)
Author Interviews, Health Care Systems, JAMA, Social Issues / 14.01.2020

MedicalResearch.com Interview with: Elizabeth Tung MD MS Section of General Internal Medicine Instructor of Medicine University of Chicago MedicalResearch.com: What is the background for this study? Response: Medicare provides hospital ratings for all Medicare-certified hospitals in the U.S. based on quality metrics, including mortality, patient experience, hospital readmissions, and others. While ratings are important for comparing hospitals, there's been some concern that some of these quality metrics are outside a hospital's control, especially for hospitals taking care of vulnerable or socially complex patient populations. Take "timeliness of care" as a quality metric, for instance--this measure includes emergency room wait times. But in places that are medically underserved and have very few emergency rooms, these wait times will inevitably be much higher. What this means is that hospitals taking care of medically underserved populations end up getting lower quality ratings, even though they're addressing health disparities by filling an access gap. (more…)
Author Interviews, JAMA, Surgical Research, Technology, University of Michigan / 13.01.2020

MedicalResearch.com Interview with: Kyle Sheetz, MD Clinical Year 4 Resident, General Surgery Michigan Medicine MedicalResearch.com: What is the background for this study? Response: There are concerns that robotic surgery is increasing for common surgical procedures with limited evidence and unclear clinical benefit. Prior studies describing the use of robotic surgery relied upon claims or billing data to identify robotic operations from laparoscopic or open ones. This may lead to inaccuracies as claims data may not provide specific codes for robotic operations. (more…)
Author Interviews, CMAJ, Hematology / 13.01.2020

MedicalResearch.com Interview with: Stig E Bojesen Professor, chief physician, dr.med.sci. Dept of Clinical Biochemistry, Herlev Gentofte Hospital Copenhagen University Hospital Department of Clinical Medicine University of Copenhagen MedicalResearch.com: What is the background for this study? Response: Before this study, we did not know the value of an incidental finding of lymphopenia of an otherwise healthy individual from the general population. This is curious since lymphocyte count is a very simple measurement done almost every time you have a blood test done. (more…)
Author Interviews, Cost of Health Care, Emergency Care, Neurology / 10.01.2020

MedicalResearch.com Interview with: Simon Borghs MSc RWE Strategy Lead of Neurology UCB:  Union Chimique Belge MedicalResearch.com: What is the background for this study? Response: Epilepsy is an episodic disease and so is associated with a more or less unpredictable occurrence of health care encounters. These encounters are costly and so reducing them, or their unpredictability, could be cost saving. The objective was to assess one half of this equation, that is the actual cost of those encounters to insurers. This could prompt insurers to consider addressing possible interventions in epilepsy to reduce the number of encounters (more…)
Author Interviews / 10.01.2020

MedicalResearch.com Interview with: Xinyan Wang Department of Epidemiology Fuwai Hospital, National Center for Cardiovascular Disease Peking Union Medical College & Chinese Academy of Medical Sciences Beijing,  China MedicalResearch.com: What is the background for this study? Does the type of tea matter (green vs black etc.)? Response: Tea is one of the most popular beverages globally and has attracted great interest from both the public and scientific researchers due to its potential benefits for cardiovascular system and people’s general health as well. However, previous results from population-based studies remained inconsistent. Thus, we aimed to investigate the association between tea and cardiovascular disease, the leading cause of disease burden, using our unique long-term cohort data with multiple follow-up visits.  (more…)
Author Interviews, Breast Cancer, Cost of Health Care, JAMA, Race/Ethnic Diversity / 09.01.2020

MedicalResearch.com Interview with: Naomi Y Ko, MD Director, Inpatient Medical Operations Assistant Professor of Medicine, Department of Medicine Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is to help understand the association between risk of more advanced cancer in racial minorities and insurance.   (more…)
Author Interviews, Cancer Research, Radiation Therapy, University of Pennsylvania / 09.01.2020

MedicalResearch.com Interview with: Keith A. Cengel, M.D., Ph.D. Associate Professor of Radiation Oncology Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: FLASH radiotherapy involves delivering the treatment dose at a rate that is 1000s of times faster than standard radiotherapy.  Scientists have studied the differential biological effects of various dose rates for dose rates for the past ~80 years, but the unique effects of FLASH dose rates have only been appreciated in the last few years. While the mechanism(s) and applications of FLASH radiotherapy remain an area of active investigation,  t is clear so far that FLASH dose rates can provide similar levels of tumor control with less toxicity to normal tissues when compared to the same dose of radiotherapy delivered at a standard dose rate. (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA, UCLA / 09.01.2020

MedicalResearch.com Interview with: Olujimi A. Ajijola, MD, PhD Neurocardiology Research Center of Excellence Cardiac Arrhythmia Center University of California, Los Angeles MedicalResearch.com: What is the background for this study? Response: It hadn’t been understood why some people with basic heart failure might live longer than others despite receiving the same medications and medical device therapy. Through this research we set out to determine whether a biomarker of the nervous system could help explain the difference. This study revealed a biomarker that can specifically predict which patients with “stable” heart failure have a higher risk of dying within one to three years. (more…)
Author Interviews, Bipolar Disorder, Depression, JAMA, Schizophrenia, Weight Research / 08.01.2020

MedicalResearch.com Interview with: Shahram Bahrami, PhD NORMENT Centre, Institute of Clinical Medicine Division of Mental Health and Addiction Oslo University Hospital Oslo, Norway  MedicalResearch.com: What is the background for this study? Response: We know that patients with severe mental disorders such as schizophrenia, bipolar disorder and major depression have shorter life span than the rest of the population, largely due to comorbid cardiovascular diseases. The increased risk seems related to lifestyle including diet and physical activity and medicines, while the mechanisms are not fully understood. Different studies have shown increased weight (high body mass index) in many people with mental disorders. Yet very little is known about genetic variants jointly in influencing major psychiatric disorders and body mass index. Thus, we investigated if there are overlapping genetic risk variants between body mass index and the mental disorders schizophrenia, bipolar disorders and major depression.  (more…)
Author Interviews, Dermatology, Education, Gender Differences, JAMA, Race/Ethnic Diversity / 08.01.2020

MedicalResearch.com Interview with: Imam Xierali, PhD Associate Professor / UT Southwestern Medical Center Dallas, Texas MedicalResearch.com: What is the background for this study? Response: Despite the continued efforts in academic medicine to increase the representation of women and minorities underrepresented in medicine (URM), there is a lack of information on trends in dermatology department faculty diversity and how they compare with those in other clinical departments. (more…)
Author Interviews, Genetic Research, Heart Disease, JAMA, Weight Research / 08.01.2020

MedicalResearch.com Interview with: Ravi V. Shah, MD Cardiology Division, Department of Medicine Massachusetts General Hospital Boston, MA Venkatesh L. Murthy MD, PhD Division of Cardiovascular Medicine Department of Medicine and Frankel Cardiovascular Center University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: We were interested in evaluating how added information like fitness assessed on a treadmill exercise test, physical activity questionnaires and genetic risk scores could inform patients and doctors’ understanding of how an individuals BMI might change over time. We used one of the latest and broadest polygenic risk scores. We investigated the CARDIA cohort, a study sponsored by the National Heart, Lung, and Blood Institute, who were young adults aged 18 to 30 and have been followed serially for 25 years. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, JAMA, Surgical Research / 08.01.2020

MedicalResearch.com Interview with: Mehra Golshan, MD, MBA Dr. Abdul Mohsen & Sultana Al-Tuwaijri Distinguished Chair Surgical OncologyDirector of Breast Surgical Oncology Fellowship Associate Professor, Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Triple negative breast cancer is an aggressive form of breast cancer that often requires chemotherapy. In this study we provided neoadjuvant chemotherapy with or without a PARP inhibitor and showed that many women who were originally ineligible for breast conservation (lumpectomy) became eligible after treatment. If lumpectomy was tried it was usually successful.  Many more women in the US compared to Europe and Asia chose mastectomy when lumpectomy was an option even when genetics is negative. (more…)
Author Interviews, Dermatology, HPV, Infections, JAMA, OBGYNE / 08.01.2020

MedicalResearch.com Interview with: Niklas Worm Andersson, MD Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen NV, Denmark MedicalResearch.com: What is the background for this study? What is Podophyllotoxin used for? Response: Podophyllotoxin is an antimitotic agent primarily used in the local treatment of anogenital warts, which are among the most prevalent sexually transmitted diseases worldwide. Most women affected by anogenital warts are of childbearing age and during pregnancy, they may become symptomatic, enlarge, or multiply. While podophyllotoxin is part of first-line treatment of anogenital warts for the non-pregnant population, it is contraindicated during pregnancy. Fetal safety data are limited and to our knowledge, no previous human data exist to help inform on this issue. (more…)
Author Interviews, Fertility, NIH, Supplements / 08.01.2020

MedicalResearch.com Interview with: Enrique Schisterman, Ph.D. Chief, Epidemiology Branch, DIPHR Eunice Kennedy Shriver National Institute of Child Health and Human Development NICHD MedicalResearch.com: What is the background for this study? Response: Small studies indicated that zinc and folic acid supplements for men might improve semen quality as both zinc and folic acid are involved in DNA transcription and have antioxidant functions. But no large-scale randomized trials have been done to assess efficacy, which is important since dietary supplements are largely unregulated, and FDA cannot regulate supplements until after they come to market. Some male fertility-targeted supplements are already among the most commonly sold supplement products, despite the lack of data to guide their use.  (more…)
Accidents & Violence, Author Interviews, Brain Injury, JAMA, Pediatrics, UCSF / 08.01.2020

MedicalResearch.com Interview with: Benjamin N. Breyer MD, MAS, FACS Associate Professor Departments of Urology and Epidemiology and Biostatistics University of California, San Francisco Vice-Chair of Urology Chief of Urology, Zuckerberg San Francisco General Hospital and Trauma Center Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship MedicalResearch.com: What is the background for this study? Response: There has been a large increase in upright scooter usage among adults as a mode of transportation. It's convenient for commuters and may encourage greater use of public transit leading to less car traffic in cities. (more…)
Author Interviews, C. difficile, Hospital Acquired / 08.01.2020

MedicalResearch.com Interview with: Alexandre R. Marra, MD PhD Iowa Infection Prevention Research Group University of Iowa Carver College of Medicine Division of Medical Practice, Hospital Israelita Albert Einstein São Paulo, Brazil MedicalResearch.com: What is the background for this study? Response: This is a comprehensive systematic literature review evaluating the burden of C. difficile infections in the U.S healthcare system. The literature has diverse studies with variable outcomes. Thus, we only included incidence estimates derived from multicenter studies. In our meta-analysis to calculate incidence, data were pooled only with denominators using the same unit (patient-days) to avoid comparisons with different denominators. For length of stay (LOS), we only included studies that used advanced statistical methods (e.g., propensity score matching). (more…)
Aging, Author Interviews, Exercise - Fitness, Heart Disease, JACC / 08.01.2020

MedicalResearch.com Interview with: Dr Charlotte Manisty PhD MRCP Senior Lecturer Consultant Cardiologist Barts Heart Centre and University College University College Hospitals, London MedicalResearch.com: What is the background for this study? Response: The normal ageing process results in vascular stiffening which in turn contributes to adverse cardiovascular events including heart attacks and strokes.  We know that trained athletes have more compliant blood vessels than their peers, and previous small studies of supervised exercise training have shown that such interventions can reduce blood pressure. We aimed to assess the impact of unsupervised exercise training on cardiovascular physiology in novice runners preparing for a first-time marathon using advanced noninvasive imaging in order to better understand whether it is possible to ‘reverse’ vascular ageing. (more…)
Author Interviews, Diabetes, Supplements / 08.01.2020

MedicalResearch.com Interview with: Jonathan P. Little PhD Associate Professor Canadian Institutes of Health Research New Investigator Michael Smith Foundation for Health Research Scholar Faculty of Health and Social Development School of Health and Exercise Sciences The University of British Columbia Syilx Okanagan Nation Territory Kelowna, BC  Canada MedicalResearch.com: What is the background for this study? Response: Ketones are energy-yielding molecules that are bodies naturally produce during periods of starvation or when we restrict carbohydrate intake. Recently, scientists from Oxford and the NIH have created exogenous ketone supplements, which now enable us to be able to drink ketones. This puts our body into a unique state – we can consume a drink that raises blood levels of ketones without having to starve or restrict carbohydrate intake. Some are even touting ketone supplements as a “fourth macronutrient”. Ketone supplements are primarily marketed for athletes to provide an alternative fuel for improving endurance exercise performance. We were actually studying how ketone supplements impacted exercise performance when we noticed that they consistently lowered blood glucose after participants consumed them. We went to the literature and found some classic papers where it was shown that infusing ketones did in fact lower glucose and the mechanism seemed to involve reducing liver glucose output. This was very exciting to us because we also study type 2 diabetes, a condition where blood sugars are too high and elevated liver glucose output is one of the major reasons. So we came up with the hypothesis that ketone supplements might be a unique strategy to help with blood glucose control. In the recent study, we tested this out in a randomized crossover experiment in 15 participants with overweight/obesity who were at risk for type 2 diabetes. Participants drank the ketone monoester supplement or a placebo and 30 minutes later they consumed an oral glucose tolerance test drink containing 75 grams of sugar. Blood samples were collected for 2 hours after the glucose test drink. (more…)
Alzheimer's - Dementia, Author Interviews, Technology / 08.01.2020

MedicalResearch.com Interview with: Dr.med.univ. Roland Beisteiner Department of Neurology Laboratory for Functional Brain Diagnostics and Therapy High Field MR Center, Medical University of Vienna Vienna, Austria MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is the development of a new brain therapy which allows to support brain regeneration by activation of neurons with pulsed ultrasound. Main findings are that Alzheimer's patients improve their memory up to 3 months. (more…)
Author Interviews, Heart Disease, Race/Ethnic Diversity / 07.01.2020

MedicalResearch.com Interview with: Robert H. Schneider, MD, FACC Director, Institute for Natural Medicine and Prevention Dean, College of Integrative Medicine Maharishi University of Management Fairfield, Iowa 52556 MedicalResearch.com: What is the background for this study? Response: Abnormal enlargement of heart, known as left ventricular hypertrophy (LVH), is an important risk factor for cardiovascular disease (CVD). It doubles the risk for heart attacks, heart failure, arrhythmias, stroke, and mortality. African Americans have twice the rate of LVH compared to whites. This may partly explain the disproportionally high CVD death rates in blacks. Psychosocial stress contributes the development of LVH and CVD. African Americans are exposed to excess psychosocial stress imposed by socioeconomic disparities and racism. However, there is little known about the potential role of stress reduction in the prevention of LVH in the general population or African Americans in particular. Therefore, this study was conducted to assess if stress reduction with Transcendental Meditation could prevent left ventricular hypertrophy in African Americans and thereby help to prevent subsequent heart disease. (more…)