Author Interviews
18 Jun Opioids During Hospitalization Linked to Post-Discharge Opioid Prescriptions
MedicalResearch.com Interview with: [caption id="attachment_49771" align="alignleft" width="130"] Dr. Donohue[/caption]
Dr. Julie Donohue, Ph.D.
Professor, Department of Health Policy and Management
Vice Chair for Research
Graduate School of Public Health
University of Pittsburgh
MedicalResearch.com: What is the background for this study?
Response: The opioid epidemic is exacting a significant burden on families, communities and health systems across the U.S. Prescription and illicit opioids are responsible for the highest drug overdose mortality rates ever recorded. We know from previous studies that some surgical and medical patients who fill opioid prescriptions immediately after leaving the hospital go on to have chronic opioid use. Until our study, however, little was known about how and if those patients were being introduced to the opioids while in the hospital.
My colleagues and I reviewed the electronic health records of 191,249 hospital admissions of patients who had not been prescribed opioids in the prior year and were admitted to a community or academic hospital in Pennsylvania between 2010 and 2014. Opioids were prescribed in 48% of the admissions, with those patients being given opioids for a little more than two-thirds of their hospital stay, on average.
17 Jun Older Women Need Screening For Hip Fracture Risk
MedicalResearch.com Interview with: [caption id="attachment_49813" align="alignleft" width="132"] Dr. Ensrud[/caption]
Kristine E. Ensrud MD MPH
Professor of Medicine and Epidemiology and Community Health
University of Minnesota
Core Investigator, Center for Care Delivery and Outcomes Research
Minneapolis VA Health Care System
MedicalResearch.com: What is the background for this study?
Response: Women aged 80 years and older, a rapidly growing segment of the population, account for the majority of hip fractures in the United States. Hip fractures account for 72% of fracture-related health care expenditures and lead to significant morbidity and mortality. However, many late-life women at high risk of hip fracture are undiagnosed. Clinicians have difficulty identifying late-life women most likely to benefit from osteoporosis screening and interventions to prevent hip fracture in part due to concerns about comorbidity burden and prognosis in this patient population.
17 Jun Keep Your Up Cosmetics and Out of Sight of of Kids
Posted at 18:25h
in Accidents & Violence, Author Interviews, Pediatrics, Toxin Research, Weight Research
Store all personal care products safely: up, away and out of sight - in a cabinet that can be locked or latched is best. Never leave personal care products out unattended and put them away immediately after use. ...
17 Jun Non-Invasive Echocardiograms Can Be Overused Leading To Increased Costs
MedicalResearch.com Interview with: [caption id="attachment_49804" align="alignleft" width="142"] Dr. Pack[/caption]
Quinn R Pack, MD
Assistant Professor of Medicine
University of Massachusetts Medical School -
Baystate Adjunct Assistant Professor of Medicine
Tufts University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Because echocardiograms are non-invasive, very low risk, and nearly universally available, it is easy to over-use this technique. In myocardial infarction, echo is also recommended in guidelines.
However, in our lab, we frequently find echocardiograms that are ordered purely out of routine, without any thought as to the likelihood of finding an abnormality. Prior studies also suggested that as many as 70% of echocardiograms provide no additional diagnostic value. When spread across the approximate 600,000 patients in the United States each year, this low diagnostic yield represents an opportunity to reduce costs by reducing echocardiograms.
16 Jun Head Tilt Can Assert Dominance
MedicalResearch.com Interview with: [caption id="attachment_49795" align="alignleft" width="200"]
Zachary Witkower[/caption]
Zachary Witkower
University of British Columbia
PhD Student
MedicalResearch.com: What is the background for this study?
Response: When we form judgments about other people –what their personality is like, or how they are feeling at the moment– we tend to focus our attention towards their face. This is not surprising, as facial shape and facial expressions contain all kinds of information that can be used to inform judgments.
However, faces are almost never viewed in isolation. Instead, faces are almost always viewed as they rest upon the face’s physical foundation: the head. Yet little is known about how head position might influence judgments about personality or social status, or – importantly – how head position might change the way faces are perceived. In the present research, we examined how and why head position might influence social judgments made from the face.
16 Jun Could Breast Milk from Overweight Moms Play a Role in Childhood Obesity?
MedicalResearch.com Interview with: [caption id="attachment_49782" align="alignleft" width="183"]
Dr. Nuss[/caption]
Henry J. Nuss, Ph.D.
Assistant Professor
Louisiana State University Health Sciences Center
School of Public Health
New Orleans, LA
MedicalResearch.com: What is the background for this study?
Response: Childhood obesity rates in the U.S. have been increasing within the past 30 years. We can point to things like sedentary lifestyle, energy-dense, nutrient-poor foods and savvy marketing techniques of large food corporations that target kids and their parents to buy food items that aren’t healthy. That said, we do know that women who have an unhealthy weight status (as measured by BMI ≥ 25) tend to have offspring that eventually attain an unhealthy weight status themselves. Aside from environmental factors, could this be due to maternal programming or perhaps something in the breastmilk? Or both? We saw some interesting research that showed breastfed infants/toddlers born to asthmatic moms were more likely to develop asthma. Furthermore, this association became stronger the longer the infants/toddlers were breastfed. The conclusion here is that it must be something in the breastmilk.
We knew that asthma and obesity are both inflammatory in nature and that there are specific pro- and anti-inflammatory and obesogenic bioactive compounds in human breastmilk. Some have been studied before but there were no studies at the time that tied all of the pieces together. If we could target specific compounds in the milk that were associated with unhealthy growth patterns in infants then we could perhaps be more specific in how we fight this problem.
16 Jun Insulin Costs Rise But Mostly Not Paid For Out-of-Pocket by Patients
The major driver for increases in average total payments for a 30-day supply of insulin were explained by increases in payments for existing products and not by changes in the market share of insulin types....
16 Jun Opioid ‘Deaths of Despair’ Don’t Explain Mortality Gap
MedicalResearch.com Interview with: [caption id="attachment_49776" align="alignleft" width="149"]
Dr. Geronimus[/caption]
Arline T. Geronimus Sc.D
Professor, Health Behavior and Health Education
School of Public Health
Research Professor
Population Studies Center
Institute for Social Research
University of Michigan
Member, National Academy of Medicine
MedicalResearch.com: What is the background for this study?
Response: The gap in life expectancy between less and more educated Americans grew over the last 30 years, a deeply troubling fact. We are alone among western nations in these trends. We aimed to determine what causes of death account for this growing educational gap in life expectancy and whether the gap has continued to grow in the most recent years.
Disturbingly, we found the educational gap in life expectancy has continued to grow.
Why? A common theory is that this growing inequality is due to the opioid epidemic. Some even speculate that the less educated are dying from a composite of what they call “deaths of despair” – opioid and other drug overdose, suicide and alcoholic liver disease – with the theory being that as less educated and working class Americans have faced job loss and stagnating wages, they experience hopelessness and despair and turn to drugs, alcohol, or even suicide to ease or end their pain and feelings of hopelessness.
However, while opioid, suicide and alcoholic liver disease deaths have increased among white youth and young adults and is cause for concern, this does not imply that these deaths should be grouped together as “deaths of despair” (DOD) or that they explain the growing educational gaps in life expectancy across all groups – men, women, whites, blacks, or older as well as younger adults.
16 Jun TAVR vs Surgical Aortic Valve Replacement Among Low-Risk Patients With Aortic Stenosis
MedicalResearch.com Interview with: [caption id="attachment_49721" align="alignleft" width="198"] Prof. Biancari[/caption]
Fausto Biancari, MD, PhD
Professor
University of Turku and University
Oulu, Finland
MedicalResearch.com: What is the background for this study?
Response: Current data is scarce regarding the short- and midterm benefit of transcatheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) in low-risk patients with severe aortic valve stenosis.
MedicalResearch.com: What are the main findings?
Response: In this observational study on 2841 low-risk patients with aortic valve stenosis from the Finnish nationwide FinnValve registry, propensity score matching analysis showed similar 30-day and three-year survival after TAVR and SAVR.
16 Jun Gender Differences in Bothersome Restless Legs Syndrome of Sleep
MedicalResearch.com Interview with: [caption id="attachment_49756" align="alignleft" width="128"] Dr. Stefani[/caption]
Ambra Stefani, MD
Sleep Disorders Clinic
Department of Neurology
Innsbruck Medical University
Innsbruck, Austria
MedicalResearch.com: What is the background for this study?
Response: Restless legs syndrome (RLS) is a common neurological disorder, affecting up to 10% of the general population in Europe and North America. It is a sensorimotor disorder characterized by unpleasant sensations and an urge to move, mainly involving the legs. These symptoms appear or worsen in the evening/at night and improve with movement.
Background for this study was the idea that there might be gender differences in the phenotypical presentation of RLS, as the pathogenesis of this disease is multifactorial and gender specific factors also play a role.
14 Jun Past and Present Smoking Raises Risk of Dermatology Surgery Complications
MedicalResearch.com Interview with: [caption id="attachment_49759" align="alignleft" width="144"] Dr. Maher[/caption]
Ian A. Maher, MD
Department of Dermatology
St Louis University, St Louis, Missouri
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: One of our wonderful trainees at Saint Louis University was interested in the role of smoking in flap failures. Dogma has been that smoking was a major risk factor for flap failures. Looking at our database as well as published data, flap failures are a rare event, so rare as to be difficult to definitively associate with anything. We decided to look more broadly at complications both acute (infections failures) and chronic (mainly cosmetic scarring associated) in flaps and grafts.
13 Jun Use of AV Grafts Drops in Dialysis Patients, But Still Room For Improvement
MedicalResearch.com Interview with: [caption id="attachment_49763" align="alignleft" width="80"] Dr. Hicks[/caption]
Caitlin W. Hicks, M.D., M.S.
Assistant Professor of Surgery
Recipient of the Department of Surgery
Rothman Early Career Development Award for Surgical Research
Johns Hopkins Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Arteriovenous fistula are associated with better long-term patency, lower rates of infection, and lower long-term costs compared to arteriovenous graft. As a result, the Fistula First Catheter Last Guidelines recommend placement of an arteriovenous fistula over an AVG whenever possible.
We looked at individual physician utilization of AVF vs AVG for first-time AV access in Medicare beneficiaries. We found that the median physician utilization rate for AVG was only 18%, but that 21% of physicians use AVG in more than 34% of cases, which is above currently recommended practice guidelines.
13 Jun Metagenomic Sequencing Enhanced Diagnosis of Meningitis and Encephalitis Infections
MedicalResearch.com Interview with: [caption id="attachment_49751" align="alignleft" width="150"] Dr. Chiu[/caption]
Dr. Charles Chiu, M.D./Ph.D.
Professor, Laboratory Medicine and Medicine / Infectious Diseases
Director, UCSF-Abbott Viral Diagnostics and Discovery Center
Associate Director, UCSF Clinical Microbiology Laboratory
UCSF School of Medicine
MedicalResearch.com: What is the background for this study? Would you describe what is meant by metagenomic sequencing?
Response: Metagenomic next-generation sequencing (mNGS) is the use of technology to generate millions of sequence reads to diagnose infection sin patients by characterizing the full range of potential pathogens (bacteria, viruses, fungi, and parasites) in a single sample. Although shown to be a promising diagnostic tool for infectious diseases in case reports and limited case series (Chiu and Miller Nature Reviews Genetics 20, 341-355 (2019)), to date the “real-life” utility of this approach for patient care has hitherto not been demonstrated. This study is the first prospective, multi-center study of clinical mNGS testing for the diagnosis of neurological infections in acutely ill hospitalized patients presenting with meningitis and/or encephalitis.
13 Jun PCSK9 Inhibitor (evolocumab) Added to Statin Lowered Risk of Cardiovascular Events in Kidney Disease Patients
MedicalResearch.com Interview with: [caption id="attachment_49703" align="alignleft" width="225"] Dr. Charytan[/caption]
David Charytan, MD MSc
Chief, Nephrology Division
NYU Langone Medical Center
New York, NY 10010
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Cardiovascular events are much more frequent in patients with impaired kidney function (chronic kidney disease), and cardiovascular disease is the most common cause of death in advanced chronic kidney disease. This risk remains high despite the use of standard medical therapies including statins, the most commonly used cholesterol lowering agents.
The PCSK9 inhibitor evolocumab is a new class of highly potent cholesterol lowering medications that can further reduce the risk of cardiovascular events in patients already taking statins. We analyzed data from the FOURIER trial, which randomized study patients with clinically evident atherosclerosis and an LDL cholesterol level >=70 mg/dL or HDL cholesterol level >= while on a statin, to assess the safety and efficacy of evolocumab, a PCSK9 inhibitor, compared with placebo in individuals with mild to moderate chronic kidney disease.
There were several major findings
- a) evolocumab appears to be equally safe in individuals with preserved and mild to moderately impaired kidney function
- b) evolocumab appears to have preserved efficacy at preventing cardiovascular events as kidney function declines.
- c) We were unable to detect any significant impact on kidney function.
- In addition, because the baseline risk of cardiovascular events is much higher in individuals with chronic kidney disease, the absolute benefits of treatment with evolocumab appear to be magnified as kidney function declines.
13 Jun PTSD: Comparative Effectiveness of Medications, Psychotherapeutic and Combination Treatments
MedicalResearch.com Interview with: [caption id="attachment_49746" align="alignleft" width="178"] Dr. Gerger[/caption]
Dr. Heike Gerger | Senior Postdoc
University of Basel | Faculty of Psychology | Clinical Psychology and Psychotherapy
Basel | Switzerland
MedicalResearch.com: What is the background for this study?
Response: Posttraumatic stress disorder (PTSD) is one of the most prevalent mental disorders, with a high risk of chronicity, comorbidity, and functional impairment. PTSD is complicated to treat, and the debate on the most efficacious treatment approach is ongoing. Treatment guidelines for the treatment of PTSD typically recommend different types of trauma-focused psychotherapeutic treatments as first-line PTSD treatment. However, concerning pharmacological therapies recommendations are inconsistent.
12 Jun Turn Off the Smartphone and TV at Night To Reduce Risk of Weight Gain
MedicalResearch.com Interview with: [caption id="attachment_49741" align="alignleft" width="100"]
Dr. Park[/caption]
Lead author: Yong-Moon (“Mark”) Park, MD, PhD
Postdoctoral fellow
Epidemiology Branch
National Institute of Environmental Health Sciences
[caption id="attachment_49742" align="alignleft" width="150"]
Dr. Sandler[/caption]
Senior author: Dale P. Sandler, PhD
Chief, Epidemiology Branch, National Institute of Environmental Health Sciences
National Institutes of Health
MedicalResearch.com: What is the background for this study?
Response: A few studies had suggested that exposure to artificial light while sleeping was associated with obesity. However, the previous studies were cross-sectional, so we really do not know which came first - exposure to artificial light while sleeping or obesity. Another problem was that previous studies did not fully account for other characteristics that could affect this association, such as sleep duration and quality, calorie intake and dietary patterns, and physical activity.
We studied nearly 44,000 women ages 35-74 from across the US who are enrolled in the Sister Study cohort. Women had body weight characteristics measured at baseline and provided self-reported information on weight at baseline and follow-up – on average 5.7 years later.
12 Jun Aspirin for Primary Prevention of Cardiovascular Events
MedicalResearch.com Interview with: [caption id="attachment_49654" align="alignleft" width="200"] Dr. Mehta[/caption]
J.L. Mehta, MD, PhD
Distinguished Professor of Medicine and Physiology and Biophysics
Stebbins Chair in Cardiology
University of Arkansas for Medical Sciences
Central Arkansas Veterans Healthcare System
Little Rock, AR 72205
MedicalResearch.com: What is the background for this study? What are the main findings? Response: Aspirin is commonly used for primary prevention of cardiovascular disease events in a variety of subjects around the world. Recent studies, however, show that routine use of aspirin without assessment of risk for cardiovascular disease events may not be appropriate, and may even be harmful.
12 Jun Are Younger People Really Addicted to Their Smartphones?
MedicalResearch.com Interview with: [caption id="attachment_49731" align="alignleft" width="200"]
Ms. Davidson[/caption]
Brittany I. Davidson MA
Doctoral Researcher in Information Systems
University of Bath
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Typically, research interested in the impact of technology, or more specifically, smartphones on people and society, use surveys to measure people’s usage. Almost always, these studies claim potential harms from using smartphones, like depression, anxiety, or poorer sleep. However, these studies simply ask people about their behaviour rather than actually measuring it.
In our study, we took 10 widely used surveys to measure screen time, which typically asks how often people use their smartphone or how problematic their usage is. We compared this to people’s objective smartphone usage from Apple Screen time (e.g., minutes spend on iPhone, number of times they picked up their phone, and the number of notifications received).
We found that there is a large discrepancy between what people self-report and what they actually do with their iPhone. This is highly problematic as the sweeping statements that claim smartphones (or technology more generally) have a negative impact on mental health are not based on solid and robust evidence at this time, which leaves much to be desired in terms of what we really know about the impacts of technology use on people.
12 Jun More Scooters Means More Head and Face Injuries
MedicalResearch.com Interview with: [caption id="attachment_49726" align="alignleft" width="144"]
Dr. Bresler[/caption]
Amishav Bresler MD
Department of Otolaryngology - Head and Neck Surgery
Rutgers - New Jersey Medical School
MedicalResearch.com: What is the background for this study?
Response: This study was inspired by a personal experience with the rental scooters.
The most recent American Academy of Otolaryngology-Head and Neck Surgery annual conference was in Atlanta this year. At the time of the conference, the scooter rental industry had recently entered the region. A friend of mine, another ENT resident, was encouraging others to use these scooters for transportation for both the novelty and convenience. However, he didn't even have a helmet!
Here was a well-educated doctor who takes call for craniofacial injuries, who was about to get on a scooter without a helmet. This experience made me wonder if scooters were dangerous scooters and their overall impact on public health.
In terms of the backgroud, the personal transportation industry is undergoing a revolution. The search for efficient and environmentally-friendly urban transportation ignited an ongoing debate in the United States regarding the role of motorized scooters. Although known to be a popular method of transportation in Europe and Asia, motorized scooters have only recently begun to make inroads in the United States. The gradual rise in popularity has been attributed to their convenience, affordability, and status as a “green” alternative to vehicles with combustion engines. These advantages combined with the fact electric scooters enable users to travel longer distances than conventional scooters present an attractive method of transportation to school, work, and leisure.
12 Jun Islet Cell Transplantation Can Give Some Diabetics Long Term Glucose Control
MedicalResearch.com Interview with: [caption id="attachment_49716" align="alignleft" width="200"] Dr. Alejandro[/caption]
Dr. Rodolfo Alejandro, MD
Professor of Medicine
University of Miami Miller School of Medicine
Co-Director of the Cell Transplant Center
Director/Attending Physician of the Clinical Cell Transplant Program
Diabetes Research Institute
www.DiabetesResearch.org
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In type 1 diabetes, the insulin-producing islets cells of the pancreas have been mistakenly destroyed by the immune system, requiring patients to manage their blood sugar levels through a daily regimen of insulin therapy. Islet transplantation has allowed some patients to live without the need for insulin injections after receiving a transplant of donor cells. Some patients who have received islet transplants have been insulin independent for more than a decade, as DRI researchers have published. Currently, islet transplantation remains an experimental procedure limited to a select group of adult patients with type 1 diabetes.Although not all subjects remain insulin independent, like the subjects described in this presentation, after an islet transplant a significant number of them continue with excellent graft function for over 10 years that allows them to have near-normal glucose metabolism in the absence of severe hypoglycemia on small doses of insulin.
In 2016, the National Institutes of Health-sponsored Clinical Islet Transplantation Consortium reported results from its Food and Drug Administration (FDA)-authorized Phase 3 multi-center trial, of which the DRI was a part, indicating that islet transplantation was effective in preventing severe hypoglycemia (low blood sugar levels), a particularly feared complication in type 1 diabetes that can lead to seizures, loss of consciousness and even death.
The study was a significant step toward making islet transplantation an approved treatment for people with type 1 diabetes and reimbursable through health insurance, as it is in several other countries around the world.
11 Jun Apple or Pear? Body Shape Not Determined Just by Fat
MedicalResearch.com Interview with: [caption id="attachment_49712" align="alignleft" width="133"]![MedicalResearch.com Interview with: Kalypso Karastergiou, MD, PhD Assistant Professor, Medicine, Endocrinology, Diabetes and Bone Disease Diabetes, Obesity and Metabolism Institute Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Multiple studies, epidemiological as well as clinical, have established that body shape is an important and independent predictor of cardiovascular and metabolic disease risk and ultimately total mortality. Subjects that preferentially store weight in the abdominal area (often described as android, upper-body or apple-shape obesity) are at increased risk, whereas those who preferentially store weight in the lower body, in the gluteofemoral area (gynoid, lower-body or pear-shape), appear to be protected. The former is more common in men, whereas the latter in women, especially premenopausal women. The overarching questions in the field are: •What factors determine body shape? • Why are subjects with lower-body shape protected? • Can we exploit the physiological and pathophysiological mechanisms involved to improve stratification, prevention or treatment of obesity and related diseases? MedicalResearch.com: What are the main findings? Response: Up to date, studies in body shape have focused on the distribution of the adipose (fat) tissue. This report seeks to expand the investigation to other tissues as well. During the period from 1999-2006, 14,005 participants in the National Health and Nutrition Examination Survey (which represents the United States population), 20-69 years old, had a DXA test that allows total and regional estimation of fat, lean and bone tissue mass. This preliminary analysis shows that body shape is determined by coordinated changes in the head, trunk and limbs that involve the fat, as well as the other tissues. MedicalResearch.com: What should readers take away from your report? Response: This is an observational study that doesn’t allow us to draw conclusion as to cause and effect or prediction of future risk. It does suggest that body shape is a whole-body feature with systematic, coordinated changes in all body compartments and tissues. The observations should be replicated in other populations and in prospective studies. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: This report generates more questions than it answers. • First of all, are there differences in the function of tissues that determine body shape between subjects with upper- versus lower body shape? • Which tissues drive differences in physiology and disease risk? • Can we identify the underlying molecular pathways? • Does any of these pathways represent a viable mechanistic target to prevent or treat disease and improve quality of life? Dislosures The study is partly funded by grants from the MSHS Translational Science Hub at Icahn School of Medicine at Mount Sinai (KL2TR001435) and the Einstein-Sinai Diabetes Research Center in New York City. Citation: ADA 2019 abstract 277-OR: Lean Tissues as Novel Determinants of Pear vs. Apple Body Shape and Metabolic Health in Humans KALYPSO KARASTERGIOU Diabetes 2019 Jun; 68(Supplement 1): -.https://doi.org/10.2337/db19-277-OR [wysija_form id="3"] [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/Dr-Kalypso-Karastergiou-1.jpg)
Dr. Karastergiou[/caption]Kalypso Karastergiou, MD, PhD
Assistant Professor, Medicine, Endocrinology, Diabetes and Bone Disease
Diabetes, Obesity and Metabolism Institute
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Multiple studies, epidemiological as well as clinical, have established that body shape is an important and independent predictor of cardiovascular and metabolic disease risk and ultimately total mortality. Subjects that preferentially store weight in the abdominal area (often described as android, upper-body or apple-shape obesity) are at increased risk, whereas those who preferentially store weight in the lower body, in the gluteofemoral area (gynoid, lower-body or pear-shape), appear to be protected. The former is more common in men, whereas the latter in women, especially premenopausal women.
The overarching questions in the field are:
- What factors determine body shape?
- Why are subjects with lower-body shape protected?
- Can we exploit the physiological and pathophysiological mechanisms involved to improve stratification, prevention or treatment of obesity and related diseases?
11 Jun Updated Expert Consensus Statement on Platelet Function/Genetic Testing for Guiding P2Y12 Receptor-Inhibitor Treatment in PCI
MedicalResearch.com Interview with: [caption id="attachment_49698" align="alignleft" width="200"] Prof. Sibbing[/caption]
Prof. Dr. med. Dirk Sibbing, MHBA, FESC
Oberarzt, Medizinische Klinik und Poliklinik I
Ludwig-Maximilians-Universität (LMU) München
Chairperson ESC Working Group on Thrombosis
München, Germany
MedicalResearch.com: What is the background for this consensus statement? What are the main findings that led to these conclusions?
Response: The availability of different P2Y12 receptor inhibitors (clopidogrel, prasugrel, ticagrelor) with varying levels of potency has enabled physicians to contemplate individualized treatment concepts. Such concepts may include escalation or de-escalation of P2Y12 inhibiting therapy.
Alternative DAPT strategies may be chosen according to the clinical setting (stable coronary artery disease vs. acute coronary syndrome), the stage of the disease (early vs. chronic treatment) and patient risk for ischemic and bleeding complications. As always in clinical medicine, guidance by means of biomarkers or risk scores is always helpful and warranted. Here specifically, a tailored DAPT approach may be potentially guided by platelet function (PFT) or genetic testing.
10 Jun Cardiac Radiation Can Increase Mortality in Lung Cancer Patients
Posted at 19:34h
in Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Lung Cancer, Radiation Therapy
MedicalResearch.com Interview with:
[caption id="attachment_49629" align="alignleft" width="200"]
Dr. Mak[/caption]
Raymond H Mak, MD
Assistant Professor of Radiation Oncology
Harvard Medical School
Radiation Oncology
Brigham and Women's Hospital
[caption id="attachment_49693" align="alignleft" width="200"] Dr. Atkins[/caption]
Katelyn M. Atkins MD PhD
Harvard Radiation Oncology Program
Dana-Farber Cancer Institute
Brigham and Women’s Hospital
Boston, Massachusetts
MedicalResearch.com: What is the background for this study? What are the main findings?
- Lung cancer remains the leading cause of cancer-related death worldwide and nearly half of patients will require radiation therapy as part of their care.
- Cardiac toxicity following radiotherapy has been well-studied in breast cancer and lymphomas, however the impact of cardiac toxicity following lung cancer radiotherapy has historically been under-appreciated due to the high risk of lung cancer death.
- Recent studies highlighting cardiac toxicity following lung cancer radiotherapy have been limited by small numbers of patients and, to our best knowledge, have not included validated cardiac event endpoints defined by the American Heart Association (AHA)/American College of Cardiology (ACC).
10 Jun Fat Distribution Linked to Advanced and Fatal Prostate Cancer
Posted at 17:54h
in Author Interviews, Brigham & Women's - Harvard, Prostate Cancer, Weight Research
MedicalResearch.com Interview with:
[caption id="attachment_49690" align="alignleft" width="200"] Dr. Dickerman[/caption]
Barbra Dickerman, PhD
Research Fellow
Department of Epidemiology
Harvard T.H. Chan School of Public Health
Boston, MA
MedicalResearch.com: What is the background for this study?
Response: Obesity is associated with a higher risk of advanced prostate cancer and poorer prognosis after diagnosis. However, emerging evidence suggests that the specific distribution of body fat may be an important prognostic factor for prostate cancer outcomes. In this original investigation, we analyzed body fat distribution on computed tomography imaging and the risk of being diagnosed with, and dying from, prostate cancer. This study was conducted among 1,832 Icelandic men with over a decade of follow-up in the Age, Gene/Environment Susceptibility-Reykjavik Study.
10 Jun FDgard® Combination of Caraway Oil and L-Menthol for Treatment of Functional Dyspepsia
MedicalResearch.com Interview with: [caption id="attachment_49661" align="alignleft" width="142"] Dr. Chey[/caption]
William D. Chey, M.D., F.A.C.G.
Director, Division of Gastroenterology
Michigan Medicine Gastroenterology Clinic
Ann Arbor, Michigan
MedicalResearch: What is the background for this study? Would you tell us what is meant by Functional Dyspepsia?
Response: Functional dyspepsia (FD or meal-triggered indigestion) is a very common disorder affecting 11 percent - 29.2 percent of the world’s population, making it comparable in prevalence to Irritable Bowel Syndrome (IBS). However, unlike IBS, there is no FDA approved product to treat FD. Sufferers are often treated off-label with prescribed proton pump inhibitors (PPIs), histamine type-2 receptor antagonists (H2RAs), antidepressants, and prokinetics. While offering relief to a portion of FD patients, some of these have been associated with adverse events. Functional dyspepsia can have a negative effect on workplace attendance and productivity, with associated costs estimated in excess of $18 billion annually.
In functional dyspepsia, which is typically recurring, meal-triggered indigestion with no known organic cause, the normal function and sensation of the stomach and intestines are altered. FD is accompanied by symptoms such as epigastric pain or discomfort, epigastric burning, postprandial fullness, inability to finish a normal sized meal, heaviness, pressure, bloating in the upper abdomen, nausea, and belching. When doctors diagnose FD, they often identify patients as those who have these symptoms for at least three months, with symptom onset six months previously.
Caraway oil and peppermint oil have a history of helping some patients with functional dyspepsia. In multiple clinical studies, the combination of caraway oil and peppermint oil has been shown to manage FD and its accompanying symptoms, such as reducing the intensity of epigastric pain, pain frequency, dyspeptic discomfort, and the intensity of sensations of pressure, abdominal heaviness and fullness significantly better than control
10 Jun Hepatitis C Treatment: Study Finds No Liver, Kidney or Cardiovascular Adverse Effects
Posted at 12:08h
in Author Interviews, Hepatitis - Liver Disease, JAMA, Kaiser Permanente, Pharmacology
MedicalResearch.com Interview with:
[caption id="attachment_49631" align="alignleft" width="200"] Dr. McGlynn[/caption]
Elizabeth A. McGlynn, PhD
Vice President for Kaiser Permanente Research
Executive Director
Kaiser Permanente Center for Effectiveness and Safety
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A report from the Institute for Safe Medication Practices based on FDA data and observations from a Kaiser Permanente physician leader raised questions about whether direct acting antiviral medications for the treatment of Hepatitis C posed any significant safety risks for patients. Since the decision to take medications requires making tradeoffs between benefits (which had been clearly established in clinical trials) and risks (which are often harder to ascertain until drugs are in widespread use in the real world) we decided this was an important question to pursue. We found no evidence of increased risks of significant side effects associated with taking these drugs. In this cohort study of 33,808 patients in three large health systems we found lower adjusted odds of experiencing the following adverse events: death, multiple organ failure, hepatic decompensation, acute-on-chronic liver event, and arrhythmia.
09 Jun The Vitamin D and Type 2 Diabetes Study
MedicalResearch.com Interview with: [caption id="attachment_49667" align="alignleft" width="142"] Dr. Pittas[/caption]
Anastassios G. Pittas, M.D MS
Professor
Co-Director, Diabetes and Lipid Center;
Tufts Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Observational studies have consistently reported an association between low blood vitamin D level and development of type 2 diabetes. However, whether vitamin D supplementation lowers risk of developing diabetes is not known. We designed and conducted the Vitamin D and diabetes (D2d) study to answer this question. We randomized 2,423 people with prediabetes to 4,000 IU/day of vitamin D3 or placebo and followed them for new-onset diabetes with blood tests every 6 months for an average of 2.5 years. About 80% of participants had sufficient vitamin D level at baseline (25-hydroxyvitamin D level >= 20 ng/mL). The trial was designed to show a reduction of 25% or more in diabetes risk with vitamin D.
The study was unable to show a reduction of 25% or more. At the end of the study, there was a 12% reduction in risk of developing diabetes with vitamin D, which missed statistical significance (hazard ration 0.88; 95% confidence interval 0.75 to 1.04). In a small subgroup of participants with vitamin D deficiency at baseline (25-hydroxyvitamin D level < 12 ng/mL) there was 62% reduction in risk of diabetes with vitamin D (hazard ration 0.38; 95% confidence interval 0.18 to 0.80).
09 Jun Midlife Type 2 Diabetes Mellitus Linked to Increased Risk of Ischemic Stroke
MedicalResearch.com Interview with: Rongrong Yang, PhD candidate Tianjin Medical University MedicalResearch.com: What is the background for this study? Response: Worldwide, cerebrovascular disease (CBD) and type 2 diabetes mellitus (T2DM) are common disorders that have become among the top ten leading causes of death, killing approximately 8 million people in 2016. Both T2DM and CBD are complex genetic and lifestyle-related disorders. Genetic and familial environmental factors (e.g. foetal environment, maternal smoking and childhood socioeconomic status) have been shown to be involved in the development of both conditions. Accumulating evidence from previous studies suggests that T2DM is independently associated with an increased risk of CBD, especially ischemic CBD.
07 Jun Some Patients Can Be Rechallenged After Immune Adverse Events from Checkpoint Inhibitors
MedicalResearch.com Interview with:Prof. Olivier Lambotte, MD, PHD
Professor of Internal Medicine
Paris XI University Medical School
Research Director
Control of Chronic Viral Infections Department
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Immune checkpoint inhibitors (ICIs) anti-programmed death-1 (PD-1) or anti-programmed death ligand-1 (PD-L1) have proven efficacy in the treatment of many cancers but patients may experience immune-related adverse events (irAEs). Immune checkpoint inhibitors is usually stopped when grade 2 or higher irAE occur. Data are very limited on the safety of resuming treatment after such an event.
We studied all adult patients referred to the ImmunoTOX toxicity review board at the Gustave Roussy cancer center (Villejuif, France) in 2015-2017 with irAE grade 2 or higher for whom the rechallenge was questioned. Among 93 patients with a broad spectrum of cancers, 40 patients (43%) were rechallenged with the same anti-PD-1 or anti-PD-L1. The rechallenged and non-rechallenged groups did not differ in terms of age, time to initial irAE, irAE severity, or steroid use. With a median follow-up period of 14 months, the same irAE or a different irAE occurred in 22 patients (55%). The second irAEs were not more severe than the first. Earlier initial toxicity was associated with more frequent irAE recurrence.