Alzheimer's - Dementia, Author Interviews, Cost of Health Care, JAMA / 27.12.2018

MedicalResearch.com Interview with: Lee A. Jennings, MD, MSHS Assistant Professor of Medicine Director, Oklahoma Healthy Aging Initiative Reynolds Department of Geriatric Medicine University of Oklahoma Health Sciences Center Oklahoma City, OK 73117 MedicalResearch.com: What is the background for this study? Response: The research study focused on a novel model of care for persons living with Alzheimer’s disease and other types of dementia, the UCLA Alzheimer’s and Dementia Care Program. In the program, people with dementia and their caregivers meet with a nurse practitioner specializing in dementia care for a 90-minute in-person assessment and then receive a personalized dementia care plan that addresses the medical, mental health and social needs of both people. The nurse practitioners work collaboratively with the patient’s primary care provider and specialist physicians to implement the care plan, including adjustments as needs change over time. The research was designed to evaluate the costs of administering the program, as well as the health care services used by program participants, including hospitalizations, emergency room visits, hospital readmissions and long-term nursing home placement. A total of 1,083 Medicare beneficiaries with dementia were enrolled in the program and were followed for three years. The study compared them to a similar group of patients living in the same ZIP codes who did not participate in the program. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, UCSF / 27.12.2018

MedicalResearch.com Interview with: Oanh Kieu Nguyen, MD, MA Assistant Professor Division of Hospital Medicine Zuckerberg San Francisco General Hospital UCSF MedicalResearch.com: What is the background for this study? Response: In U.S. citizens and permanent residents with kidney failure or end-stage renal disease (ESRD), having health insurance, Medicare, or Medicaid guarantees access to regularly scheduled hemodialysis 2-3 times per week, the evidence-based standard of care for ESRD. This treatment helps people live relatively normal lives. In 40 of 50 U.S. states, undocumented immigrants with ESRD have limited access to hemodialysis because they are not eligible for any form of federal assistance including Medicare or Medicaid, and must wait until they are life-threateningly ill to receive dialysis through a hospital emergency department, a situation called “emergency-only hemodialysis.” There are an estimated 6,500 undocumented individuals in the U.S. suffering from ESRD. A unique opportunity made it feasible for uninsured undocumented immigrants with ESRD receiving emergency-only dialysis in Dallas, Texas, to enroll in private, commercial health insurance plans in 2015 and made it possible for researchers to compare scheduled vs. emergency-only dialysis among undocumented immigrants with ESRD. This natural experiment included 181 undocumented immigrants, 105 of whom received insurance coverage and enrolled in scheduled dialysis and 76 of whom remained uninsured.  (more…)
Author Interviews, Breast Cancer, NIH, OBGYNE / 27.12.2018

MedicalResearch.com Interview with: Dale P. Sandler, Ph.D. Chief, Epidemiology Branch National Institute of Environmental Health Sciences NIH MedicalResearch.com: What is the background for this study? Response: Not having children is a well-established risk factor for breast cancer, but most of this evidence comes from studies of postmenopausal women since breast cancer before menopause is relatively uncommon. There is growing evidence that some risk factors differ for premenopausal and postmenopausal breast cancer – for example obesity which increases risk for breast cancer after menopause but appears to be protective before menopause. There was some evidence that breast cancer risk increased shortly after pregnancy. It was thought that this risk lasted for 5 to ten years. Studies were unable to fully characterize the duration of this increase in risk or evaluate factors such as breast feeding, age at birth, or family history of breast cancer that could modify the relationship between recent pregnancy and breast cancer risk. Breast cancer before menopause or age 55 is relatively rare, and few individual studies are large enough to answer these questions. To answer these questions, we formed the Breast Cancer Collaborative Group, a pooling project involving 20 prospective cohort studies. We included 890,000 women from 15 of these long-term studies across three continents, including over 18,000 incident breast cancer cases.  (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, Stanford / 26.12.2018

MedicalResearch.com Interview with: Fatima Rodriguez, MD, MPH, FACC Assistant Professor Cardiovascular Medicine Stanford University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The “Hispanic Paradox” is an idea based on some epidemiological observations that Hispanics have lower disease prevalence and mortality (across a wide spectrum of disease states), despite adverse risk profiles and lower socioeconomic status than their non-Hispanic white counterparts. Our study is unique in that it includes a Hispanic population with overall high educational attainment followed longitudinally. In contrast to prior work in this area, we found no evidence in support of the Hispanic paradox for estimated atherosclerotic cardiovascular disease risk, atherosclerotic disease (as measured by CAC), or overall mortality. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA / 26.12.2018

MedicalResearch.com Interview with: Dr. Jianguo Xu, MD West China Hospital, Sichuan University Chengdu, Sichuan, China MedicalResearch.com: What is the background for this study? Response: Since the mid-20th century, corticosteroids have been used as adjuvant therapy in the context of sepsis. Although evaluated in numerous randomized clinical trials and meta-analyses, both the safety and efficacy of corticosteroids remain controversial. (more…)
Author Interviews, Global Health, Stroke / 26.12.2018

MedicalResearch.com Interview with: Gregory A. Roth MD MPH Assistant Professor, Medicine - Cardiology Adjunct Assistant Professor, Global Health Adjunct Assistant Professor, Health Metrics Sciences School of Public Health University of Washington Seattle, WA MedicalResearch.com: What is the background for this study? What are the main findings?   Response:  We found that globally, one in four people over age 25 is at risk for stroke during their lifetime. But we also found large geographic variation, including a nearly five-fold difference in lifetime stroke risk worldwide, with the highest risk in East Asia (38.8%), Central Europe (31.7%), and Eastern Europe (31.6%), and the lowest risk in eastern sub-Saharan Africa (11.8%). Chinese men and Latvian women had the world’s highest estimated lifetime stroke risk in 2016. The lifetime stroke risk on average for 25-year-olds in 2016 ranges from 8% to 39%, depending on the country in which they live. This is the first time a study has produced estimates of lifetime stroke risk starting at age 25, whereas previous studies begin at age 45. These findings suggest that adults need to think about their long-term health risks, including stroke, at a much younger age. Additionally, one’s risk of stroke over the course of your lifetime depends on where you live. Given the burden of stroke among adults is dependent on modifiable risk factors and the characteristics of health systems, our findings may be useful for long-term planning, especially in terms of prevention and public education.  (more…)
Accidents & Violence, Author Interviews, JAMA, Sexual Health, UCSD / 26.12.2018

MedicalResearch.com Interview with: John W. Ayers, PhD, MA Vice Chief of Innovation | Assoc. Professor Div. Infectious Disease & Global Public Health University of California San Diego MedicalResearch.com: What is the background for this study?   Response: The greatest barrier to understanding trends around sexual violence is they are largely hidden because victims are unable speak up publicly. Moreover, ongoing monitoring relies on proxies that underreport the scale of the problem such as police or medical records where only the most severe instances or a fraction of all instances of sexual violence are represented. As a result, we know very little about the scale of America's sexual violence problem. It was this backdrop that inspired #MeToo to call on victims to publicly voice their stories thereby revealing the scale of the problem. Our goal was to, for the first time, assess how this change inspired the public to engage with sexual violence issues. By tracking private aggregate internet search query trends we can begin to understand the scale of public engagement with issues around sexual violence including the precise motivation for a search, such as reporting episodes of sexual violence or learning how to prevent sexual violence. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Emory, Obstructive Sleep Apnea, Race/Ethnic Diversity, Sleep Disorders / 26.12.2018

MedicalResearch.com Interview with: Dayna A. Johnson PhD Department of Epidemiology Emory University Atlanta, GA MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are several studies that have determined that African Americans have the highest prevalence of hypertension and are the most likely to have uncontrolled hypertension compared to other racial/ethnic groups. We were interested in studying whether sleep apnea contributed to hypertension control among African Americans. We found that participants with sleep apnea were more likely to have resistant hypertension than those without sleep apnea. In particular, individuals with severe sleep apnea had the highest risk of resistant hypertension. Most of the participants with measured sleep apnea were undiagnosed (96%).  (more…)
Author Interviews, HIV, Immunotherapy / 21.12.2018

MedicalResearch.com Interview with: Tatiana Garcia-Bates, Ph.D. Research Assistant Professor Department of Infectious Diseases and Microbiology Graduate School of Public Health University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: Human immunodeficiency virus (HIV) infection is now a manageable disease with the advent and availability of highly effective, combination antiretroviral therapy (ART). Unfortunately, as soon as ART is interrupted, the virus quickly rebounds to high levels and again targets the immune system. Therefore, new immunotherapeutic treatments are sought to re-program the immune system to control the virus after ART interruption. In many ways, chronic HIV infection, even when controlled, resembles cancer in how it impacts the immune system. Both conditions for example are associated with immune dysfunction, where the immune cells (specifically T cells) that are supposed to protect our bodies against invading microorganisms or cancers become exhausted and fail to respond effectively. In cancer, effective immunotherapies have been developed to reverse this immune exhaustion to extend the fighting capacity of the T cells. An example of this is drugs that target immune checkpoints, or “shut down” proteins, expressed on activated T cells, such as the programmed death-1 (PD-1) receptor. When engaged, PD-1 sends a negative signal to deactivate the T cell, and this contributes to the immune exhaustion seen in both cancer and in chronic infections. Some cancers express the ligand or the “trigger” for this shut down receptor, called PD-1 ligand (PD-L1). When this interaction between PD-1 and PD-L1 is interrupted, for example by using a blocking antibody, T cells can regain their killing capacity and destroy infected cells or cancer cells. This anti-PD-1 therapy has demonstrated high success against a variety of tumors. Therefore, we tested this approach in the context of HIV infection using a well-characterized cohort of HIV-positive individuals to see if we could improve their T cell responses to HIV in a laboratory setting. (more…)
Author Interviews, Education, JAMA, OBGYNE, Pediatrics, Social Issues / 21.12.2018

MedicalResearch.com Interview with "Pregnancy 1" by operalynn is licensed under CC BY 2.0Josephine Funck Bilsteen, MSc Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Section of Epidemiology, Department of Public Health University of Copenhagen Copenhagen, Denmark MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The background of this study is that there is increasing recognition of the longer-term health and social outcomes associated with preterm birth such as independent living, quality of life, self-perception and socioeconomic achievements. However, much less is known about differences in education and income among adults born at different gestational weeks in the term period. In this study shorter gestational duration, even within the term range, was associated with lower chances of having a high personal income and having completed a secondary or tertiary education at age 28 years. This is the first study to show that adults born at 37 and 38 completed weeks of gestation had slightly lower chances of having a high income and educational level than adults born at 40 completed weeks of gestation.  (more…)
Author Interviews, Cancer Research, NEJM, Pancreatic / 21.12.2018

MedicalResearch.com Interview with: Prof. Thierry Conroy MD, Director Department of Medical Oncology Institut de Cancérologie de Lorraine Vandoeuvre-lès-Nancy CEDEX MedicalResearch.com: What is the background for this study? Response:  Surgery of pancreatic cancer offers the only chance of cure. Despite the low response rate (5% - 9%) of gemcitabine in metastatic disease, a 6-month regimen of adjuvant therapy with gemcitabine increases 5-year survival from 10% to 20% and is recognized as standard of care. However, recurrence rate remain high despite adjuvant treatment with 69-75% of patients relapsing within 2 years. -       The combination of bolus and continuous infusion Fluorouracil, Folinic Acid, Irinotecan and Oxaliplatin (Folfirinox) was shown to increase response rate (31.6% versus 9.4%) in metastatic disease as compared to Gemcitabine and increase survival (11.1 versus 6.8 months). -       Deletion of bolus Fluorouracil in the Folfirinox regimen (mFOLFIRINOX) decreased toxicity and do not reduce efficacy in advanced disease. -       We performed a randomized trial in patients with good performance status, ECOG 0-1 CA 19.9 ≤ 180 U/L and no cardiac contraindication to fluorouracil. (more…)
Author Interviews, Bone Density, NEJM, Orthopedics / 21.12.2018

MedicalResearch.com Interview with: Prof Ian Reid MD Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand MedicalResearch.com: What is the background for this study?  Response: Bisphosphonates prevent fractures in patients with osteoporosis, but their efficacy in women with osteopenia is unknown. Most fractures in postmenopausal women occur in osteopenic patients, so therapies with efficacy in osteopenia are needed. (more…)
Author Interviews / 20.12.2018

By: The Experts at Child Safety Store
  • It is recommended that the majority of your childproofing be done at one time. This insures that it is completed before a new capability results in a preventable injury.
  • All lower drawers and cabinets in the kitchen and bathrooms should be latched before he ever learns he can open them. Accessible electrical outlets (both dormant and in-use) protected, vertical cords raised, pool fence installed, stairway gates in place, sharp corners protected, etc. Other items can be added as the need becomes apparent; door alarms, appliance latches, medicine cabinet latches, door knob covers, deadbolt locks, etc.
  • Get down on your child’s level (that’s hands, knees, roll over on your back to get under furniture) and look up. Look around each room carefully as if seeing it for the first time. Crawl around and try to stick your head behind furniture, reach under furniture and feel around to see what is there (sharp springs or staples sticking out, plastic tags, etc.). Get under tables and look up; what would your child’s head hit if he stood up (sharp corners, manufacturer’s labels attached with staples sticking out, glass in the center of an end stand or coffee table).
(more…)
Author Interviews, Dermatology, JAMA, NYU / 19.12.2018

MedicalResearch.com Interview with: Nicholas A. Soter, MD The Ronald O. Perelman Department of Dermatology New York University School of Medicine New York, New York MedicalResearch.com: What is the background for this study? Response: Nearly 50% of patients with chronic spontaneous urticarial (CSU) (hives) incompletely respond to first-line therapy with H-1 antihistamines. However, in the current literature, there is limited evidence to guide the treatment of CSU after maximal therapy with antihistamines fails.  Two small, randomized, controlled trials suggest that dapsone, which is an antimicrobial therapeutic agent with anti-inflammatory properties, may be a useful second-line therapeutic agent. (more…)
Author Interviews, Orthopedics, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: Dana L. Duren, PhD Professor, Director of Orthopaedic Research Director of Skeletal Morphology Laboratory Thompson Laboratory for Regenerative Orthopaedics Department of Orthopaedic Surgery Missouri Orthopaedic Institute, University of Missouri Columbia, MO 6521 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The motivation for this study is the apparent accelerated maturity in children in the United States.   We previously demonstrated that skeletal maturity (bone age) is more advanced in today’s children compared to children born in the first half of the 20thCentury (Duren et al., 2015). n the current study (Boeyer et al., 2018) we show that a significant component of this advanced maturity status is the timing of epiphyseal fusion. In our study, nearly half of the epiphyses of the hand and wrist began or completed fusion significantly earlier in children born after 1995 than those born in the early part of the century, with differences as great as six to ten months for some bones, and mean differences on the order of 4 months in boys and 6 months in girls.  (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, OBGYNE, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: Krista F. Huybrechts, MS PhD Associate Professor of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02120  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Pregnant women often experience nausea and vomiting, particularly during the first trimester.  Early treatment is recommended to relieve symptoms and prevent progression to hyperemesis gravidarum.  Although not formally approved for this indication, ondansetron is the most frequently prescribed treatment for nausea and vomiting in pregnancy in the US: 22% of pregnant women reportedly used ondansetron in the US in 2014. Despite this common use, the available evidence on the fetal safety of ondansetron is limited and conflicting, and the possibility of a doubling in risk of cleft palate and cardiac malformations has been raised. We therefore evaluated the association between ondansetron exposure during the first trimester of pregnancy, the period of organogenesis, and the risk of congenital malformations in a cohort of 1,816,414,publicly insured pregnancies using the nationwide Medicaid Analytic eXtract data for 2000-2013.  A total of 88,467 women (4.9%) were exposed to ondansetron during the first trimester.  After adjusting for a broad range of potential confounding variables, we found no association with cardiac malformations (RR = 0.99; 95% CI, 0.93 – 1.06)  and congenital malformations overall (RR = 1.01; 95% CI, 0.98 – 1.05). For oral clefts, we found a 24% increase in risk (RR=1.24; 95% CI, 1.03 – 1.48), which corresponds to an absolute risk of 2.7 per 10,000 births (95% CI, 0.2 – 5.2 per 10,000 births).  These findings were consistent across sensitivity analyses, conducted to address potential misclassification and confounding bias.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cannabis, JAMA, Mental Health Research, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: Sharon Levy, MD, MPH Director, Adolescent Substance Use and Addiction Program Boston Children's Hospital Associate Professor of Pediatrics Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​For this study we analyzed data that were collected as part of a larger survey study that recruited a sample of adolescents who were coming to the doctor's office for routine medical care.  We asked them a lot of questions about their health, school, extracurricular activities, plans for the future, substance use patterns and problems associated with use among other things. The main finding was that among the participants who reported marijuana use in the past year, many of them, more than 40%, said that they had experienced either an hallucination, or paranoia/anxiety related to their use. Kids who used more frequently and those who met criteria for a substance use disorder were more likely to experience these symptoms, as were those who had symptoms of depression (more…)
Author Interviews, Heart Disease, Women's Heart Health / 19.12.2018

MedicalResearch.com Interview with: Dr. Sarah Perman MD, M.S.C.E. Assistant professor of Emergency Medicine University of Colorado School of Medicine Denver  MedicalResearch.com: What is the background for this study? Response: Women who suffer an out-of-hospital cardiac arrest have been observed to receive less bystander cardiopulmonary resuscitation (B-CPR) than men, and the potential reasons were largely unknown. We asked 54 people online to explain – with no word limit – why women might be less likely to get CPR when they collapse in public. (more…)
Allergies, Author Interviews, OBGYNE, Pediatrics / 18.12.2018

MedicalResearch.com Interview with:  Karen Robbins, M.D. Allergist at Children’s National Health System  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that mothers are often concerned that something they did contributed to their children developing food allergies. Many will relate that they ate a lot of one specific food allergen while pregnant, and question how this could have impacted their unborn child. We realized that we hear a lot of anecdotal stories in clinic, but were not sure how frequently mothers try to alter their diet in the hopes of preventing food allergy in their children. We also were not sure where families get information or guidance on this topic. (more…)
Author Interviews, Electronic Records, Mental Health Research / 18.12.2018

MedicalResearch.com Interview with: Katharine Phillips, M.D. Professor of Psychiatry DeWitt Wallace Senior Scholar Residency Research Director Department of Psychiatry Weill Cornell Medical College, Cornell University Attending Psychiatrist, New York-Presbyterian Hospital Adjunct Professor of Psychiatry and Human Behavior Alpert Medical School of Brown University Weill Cornell Psychiatry Specialty Center Weill Cornell Medicine I NewYork-Presbyterian MedicalResearch.com: What is the background for this study? What are the main findings?
  • Electronic prescribing of medication by clinicians is widespread; it is required in many institutions and in some states. Electronic prescribing systems commonly use computerized decision support algorithms that give prescribers automated warnings or alerts at the time of prescribing if the system identifies a potential prescribing error.
  • Some prior studies suggest that electronic prescribing warnings/alerts may reduce prescribing errors and thus can be clinically useful. However, other prior studies caution that these alerts may have substantial limitations.
  • Despite the importance of this topic, relatively few studies have examined the accuracy of automated prescribing warnings in electronic prescribing systems; to our knowledge, no prior study has focused primarily on prescribing of medications for psychiatric conditions.
  • This report presents results from a survey of members of the American Society of Clinical Psychopharmacology (ASCP), a specialty society that advances the science and practice of clinical psychopharmacology, regarding automated warnings generated by electronic prescribing systems.
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Author Interviews, Cancer Research, Herpes Viruses / 18.12.2018

MedicalResearch.com Interview with: Jiahui Qian, MPH School of Public Health and Community Medicine University of New South Wales Sydney Australia     MedicalResearch.com: What is the background for this study? Response: Herpes zoster is a neurocutaneous disease caused by the reactivation of latent varicella zoster virus and its risk is related to the cell-mediated immunity. Previous studies have reported a higher zoster risk among patients with haematological cancer and cancer patients receiving chemotherapy. However, the role of the cancer itself and the receipt of cancer treatment is not clearly separated, we therefore started this study and tried to separate the risk of zoster associated with the cancer itself from cancer treatment.  (more…)
Author Interviews, Social Issues / 18.12.2018

MedicalResearch.com Interview with: Alice Verstaen, PhD VA Puget Sound Health Care System  MedicalResearch.com: What is the background for this study? Response: The study began in the 1980s in Dr. Levenson’s laboratory at the University of California, Berkeley in collaboration with Dr. John Gottman of the University of Washington and Dr. Laura Carstensen at Stanford University. Prior to this study, most research on marriage had focused on younger marriages that ended in separation and divorce. Our study was designed to focus on marriages that had lasted for many years. The idea was that these successful longer-term marriages could provide important clues as to what makes marriages succeed and stay together over time.  (more…)
Author Interviews, Compliance, Electronic Records, JAMA, Ophthalmology / 18.12.2018

MedicalResearch.com Interview with: Michael Vincent Boland, M.D., Ph.D. Glaucoma Center of Excellence Director of Information Technology, Wilmer Eye Institute Associate Professor of Ophthalmology Johns Hopkins University School of Medicine Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Effective medications are available to treat glaucoma and prevent or stop vision loss.
Unfortunately, patients frequently do not use the eye drops as prescribed, oftentimes simply
because they forget to. Since patient medications are now managed via electronic health
records (EHRs), we built a system to deliver automated reminders to patients using the patient
portal to our EHR. We found that the majority (75%, 66 of 88) of participants that received these reminders found them to be useful, and about half (47%, 41 of 88) the participants wanted to
continue using the reminders after the study ended
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Author Interviews, Johns Hopkins, Kidney Disease, Transplantation / 18.12.2018

MedicalResearch.com Interview with: Chirag R Parikh, M.B.B.S., Ph.D. Director,Division of Nephrology Professor of Medicine School of Medicine, Johns Hopkins University Baltimore, Maryland 21287  MedicalResearch.com: What is the background for this study? Response: The initial study idea stemmed from our earlier cohort studies of predictors of delayed graft function after kidney transplantation.  We previously found that kidneys from donors with Acute Kidney Injury (AKI) were more often discarded than kidneys from donors without AKI, and transplanted donor AKI kidneys were at increased risk for delayed graft function. It was important to determine whether that increased risk for delayed graft function also translated into worse long-term outcomes for recipients of kidneys from donors with AKI. (more…)
Author Interviews, Genetic Research, Nutrition / 18.12.2018

MedicalResearch.com Interview with: Denny Vågerö  PhD MSc CHESS, Centre for Health Equity Studies Department of Public Health Sciences Stockholm University, Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transgenerational, epigenetic, response, has been shown in studies of animals and plants. Does it apply to humans? Previous findings of associations between grandparents early nutrition and grandchildren’s mortality have been controversial.  Two reasons for this: evidence in human studies has been based on rather small numbers and potential mechanisms are not very well understood. We have tested the hypothesis that there is “a male line transgenerational response” to nutritional events in pre-puberty in a study much larger than previous ones. We find support for this hypothesis in that boys who enjoyed unusually good access to food during their “slow growth period” (aged 9-12 years) seem to transmit a mortality risk on their grandsons but not granddaughters, in particular for cancer. (more…)
Author Interviews, Diabetes, JAMA, Pain Research / 17.12.2018

MedicalResearch.com Interview with: Guy Fagherazzi, MSc, PhD, HDR Senior Research Scientist in Digital & Diabetes Epidemiology Center of Research in Epidemiology and Population Health Inserm, Paris-South Paris-Saclay University MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Migraine has further been associated with increased risk of overall and specific cardiovascular disease events. Because migraine has also been associated with factors related with insulin resistance and type 2 diabetes, an association between migraine and diabetes has been hypothesized. We observed a lower risk of type 2 diabetes in women with active migraine. We also show a linear decrease of migraine prevalence long before and a plateau long after type 2 diabetes diagnosis.  (more…)
Author Interviews, Blood Pressure - Hypertension, Critical Care - Intensive Care - ICUs, Emergency Care, JAMA / 17.12.2018

MedicalResearch.com Interview with:
"intravenous" by thorney torkelson is licensed under CC BY-NC-ND 2.0 <a href="https://creativecommons.org/licenses/by-nc-nd/2.0"> CC BY-NC-ND 2.0</a>Daniel J. Lane PhD
Institute of Health Policy, Management and Evaluation
Dalla Lana School of Public Health, University of Toronto
Rescu, Li Ka Shing Knowledge Institute, St Michael’s Hospital
Toronto, Ontario, Canada

MedicalResearch.com:  What is the background for this study?  What are the main findings?

Response: Early resuscitation and early antibiotics have become the mainstay treatment for patients with sepsis. The time to initiation of these treatments is thought to be an important factor in patients surviving their disease; however, the independent benefits or harms of intravenous fluid resuscitation, in particular a more aggressive versus more conservative approach to this therapy, remains difficult to evaluate given the concurrent use of these therapies in hospital.

To gain a better understanding of this treatment independent of antibiotic use, we assessed intravenous fluid resuscitation by paramedics on the in-hospital mortality of patients with sepsis. By accounting for the interaction between initial systolic blood pressure and the treatment, we found that earlier resuscitation by paramedics was associated with decreased mortality in patients with low initial blood pressures but not associated with mortality for patients with normal or higher initial blood pressures. 

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