Alarming Increase in Violent and Unintentional Injuries Since 2014

MedicalResearch.com Interview with:

Dr. Angela Sauaia, MD, PhD Professor of Public Health and Surgery University of Colorado Denver Statistical Editor, Journal of Trauma and Acute Care Surgery Statistical Consultant, Department of Surgery Denver Health Medical Cente

Dr. Sauaia

Dr. Angela Sauaia, MD, PhD
Professor of Public Health and Surgery
University of Colorado Denver
Statistical Editor, Journal of Trauma and Acute Care Surgery
Statistical Consultant, Department of Surgery
Denver Health Medical Center 

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

Response: As injury researchers we monitor national trends in injury.

The CDC WISQARS (Web-based Injury Statistics Query and Reporting System) is one of the few available open sources of injury data we can use. During the 1980’s and 1990’s, we saw much improvement in deaths due to most injury mechanisms, such as car accidents fatalities. Our study shows, however, that recent trends seem to be eroding these promising survival gains.

Both violent and unintentional injuries alike seem to be increasing, especially since 2014. We are unclear about the causes of this recent increase in trauma-related deaths, but it is an alarming trend.

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When It Comes to LDL-C, “You Really Can’t Be Too Low”

MedicalResearch.com Interview with:

Marc S. Sabatine, MD, MPH  Chairman | TIMI Study Group  Lewis Dexter, MD, Distinguished Chair in Cardiovascular Medicine Brigham and Women's Hospital  Professor of Medicine | Harvard Medical School

Dr. Marc Sabatine

Marc S. Sabatine, MD, MPH
Chairman | TIMI Study Group
Lewis Dexter, MD, Distinguished Chair in Cardiovascular Medicine
Brigham and Women’s Hospital
Professor of Medicine | Harvard Medical School

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

Response: Low-density lipoprotein cholesterol (LDL-C) is a well-established risk factor for cardiovascular disease.

The initial statin trials studied patients with high levels of LDL-C, and showed a benefit by lowering LDL-C.

We and others did studies in patients with so-called “average” levels of LDL-C (120-130 mg/dL), and also showed clinical benefit with lowering.

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Few Programs Dedicated To Preventing Mistreatment of Medical Trainees

MedicalResearch.com Interview with:
“Doctors with patient, 1999” by Seattle Municipal Archives is licensed under CC BY 2.0Dr. Laura M. Mazer, MD
Goodman Surgical Education Center
Department of Surgery
Stanford University School of Medicine
Stanford, California

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

Response: There are numerous articles that clearly document the high prevalence of mistreatment of medical trainees. We have all seen and experienced the results of an “I’ll do unto you like they did unto me” attitude towards medical education. Our motivation for this study was to go beyond just documenting the problem, and start looking at what people are doing to help fix it.

Unfortunately, we found that there are comparatively few reports of programs dedicated to preventing or decreasing mistreatment of medical trainees. In those studies we did review, the study quality was generally poor. Most of the programs had no guiding conceptual framework, minimal literature review, and outcomes were almost exclusively learner-reported.

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Transitional Care Services from Hospital to Home Underutilized, Can Save Money and Readmissions

MedicalResearch.com Interview with:

Andrew B. Bindman, MD Professor of Medicine PRL- Institute for Health Policy Studies University of California San Francisco

Dr. Bindman


Andrew B. Bindman, MD

Professor of Medicine
PRL- Institute for Health Policy Studies
University of California San Francisco

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


Response:
The purpose of this study was to evaluate the use and impact of a payment code for transitional care management services which was implemented by Medicare in.

The transition of patients from hospitals or skilled nursing facilities back to the community often involves a change in a patient’s health care provider and introduces risks in communication which can contribute to lapses in health care quality and safety. Transitional care management services include contacting the patient within 2 business days after discharge and seeing the patient in the office within 7-14 days. Medicare implemented payment for transitional care management services with the hope that this would increase the delivery of these services believing that they could reduce readmissions, reduce costs and improve health outcomes.

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Rare Inflammatory Muscle Inflammation Increased With Statin Exposure

MedicalResearch.com Interview with:

Dr Gillian E. Caughey PhD Senior Research Fellow | School of Medicine | Discipline of Pharmacology THE UNIVERSITY OF ADELAIDE Australia

Dr. Caughey

Dr Gillian E. Caughey PhD
Senior Research Fellow | School of Medicine
Discipline of Pharmacology
THE UNIVERSITY OF ADELAIDE
Australia

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

Response: Statins are one of the most commonly prescribed medications worldwide.  Muscular adverse effects (myalgia and myopathy) are well recognised adverse effects and symptoms resolve with cessation of statins.

Idiopathic inflammatory myositis (IIM) is a heterogeneous group of autoimmune myopathies that may also be associated with statin use. IIM does not resolve with cessation of statin therapy, requires treatment with immunosuppressive agents and is a severe, debilitating condition. To date, there have been no epidemiological studies examining exposure to statins and the association of histologically confirmed IIM.

In our case control study of 221 cases o fIdiopathic inflammatory myositis, there was an almost 2-fold increased likelihood of statin exposure in patients with IIM compared with controls (adjusted odds ratio, 1.79; 95%CI, 1.23-2.60). After observing a significant association of statin exposure with IIM, we conducted a sensitivity analysis where we excluded those patients with necrotizing myositis as recent studies have reported this type of IIM to be associated with statin use and the presence of autoantibodies against HMG-CoA reductase. Exclusion of these specific cases from the analysis did not change our study findings and an increased risk of Idiopathic inflammatory myositis with statin exposure remained (adjusted OR, 1.92; 95% CI, 1.29-2.86).  This suggest the potential association of all types of Idiopathic inflammatory myositis with statin exposure.

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Children Undergoing Bone Marrow Transplant Remain At Risk For Premature Death

MedicalResearch.com Interview with:

Smita Bhatia, MD, MPH Gay and Bew White Endowed Chair in Pediatric Oncology Professor, Pediatric Oncology Vice Chair for Outcomes Research, Dept of Pediatrics Director, Institute for Cancer Outcomes and Survivorship School of Medicine University of Alabama at Birmingham Associate Director for Outcomes Research UAB Comprehensive Cancer Center 

Dr. Bhatia

Smita Bhatia, MD, MPH
Gay and Bew White Endowed Chair in Pediatric Oncology
Professor, Pediatric Oncology
Vice Chair for Outcomes Research, Dept of Pediatrics
Director, Institute for Cancer Outcomes and Survivorship
School of Medicine
University of Alabama at Birmingham
Associate Director for Outcomes Research
UAB Comprehensive Cancer Center 

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

Response: Allogeneic bone marrow transplantation BMT is used with a curative intent for life-threatening malignant and non-malignant diseases of childhood.

In this observational study, we describe the late mortality experienced by children undergoing BMT over the past 3 decades. Our cohort included 1388 BMT recipients who had undergone allogeneic BMT between 1974 and 2010 and survived 2 or more years.

We found that, conditional on surviving the first 2 years after bone marrow transplantation, the probability of surviving an additional 20 years approached 80%. Risk of dying from non-relapse-related causes exceeded the risk of dying from relapse-related causes.

The leading non-relapse-related causes of death were infection (with or without graft vs. host disease) and new cancers. Overall, the cohort was at a 14-fold greater risk of dying as compared with the general population (of similar age and sex). Further, this excess risk remained elevated even among those who had survived 25 years.

On a positive note, the risk of late mortality has continued to decline over the past 3 decades. 

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Most Young People Not Against Guns in the Home

MedicalResearch.com Interview with:
“GUNS” by Jessica Spengler is licensed under CC BY 2.0Kendrin R. Sonneville, ScD, RD

Assistant Professor
Department of Nutritional Sciences
University of Michigan School of Public Health

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

Response: The results from this come out of MyVoice, a text message cohort of youth ages 14-24 representing every state in the country (http://hearmyvoicenow.org/). Each week we ask the youth in our cohort a series of open-ended to questions, with the goal of gathering the real-time opinions and experiences of youth across the U.S. This study reports the results of questions we asked MyVoice paritpatns between 07/2017 and 01/2018 about guns and gun control. 

(1) What are your thoughts about having guns in your home?

(2) Do you think gun control laws would affect mass shootings? Why?

(3) Who, if anyone, should NOT be allowed to own guns?

We found that about one-third of youth in our diverse sample were “against” guns in the home, and the remaining two-thirds were either “pro” or “conditionally pro” guns in the home, stating that gun ownership is acceptable under certain conditions, such as proper storage, or kept away from children. Youth in our sample largely believed that gun control laws could decrease mass shootings, but one-third felt that gun control laws would not be enough to impact mass shootings. Continue reading

Statins May Reduce Need For Surgery in Chronic Subdural Hematoma

MedicalResearch.com Interview with:
Jianning Zhang MD, Ph.D Chairman, II, VII Chinese Medical Association of Neurosurgery President, Tianjin Medical University General Hospital, China  Jianning Zhang MD, Ph.D
Chairman, II, VII Chinese Medical Association of Neurosurgery
President, Tianjin Medical University General Hospital,
China  

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

Response: The elderly population is growing dramatically world widely, especially in China. The incidence of chronic subdural hematoma has been rising over the past years. Although the surgery is not a difficult process, the risk of death and recurrence persist, and the affliction and economic expenditure of the patients are relatively higher in the elderly. For these reasons, it is urgent to develop novel pharmacological therapies with sufficient safety and efficacy. 

It has been known that the high expression of VEGF and inflammatory factors in chronic subdural hematoma can lead to abundant angiogenesis of immature vessels on the wall of hematoma. In our previous study, patients with chronic subdural hematoma have impaired ability to promote vascular maturation. For example, the number of endothelial progenitor cells in circulating blood is about 67% of the healthy individuals with similar age. 

Atorvastatin can mobilize endothelial progenitor cells to reduce inflammation. It increases the number of circulating endothelial cells that are inversely correlated with the volume of hematoma. We have demonstrated that atorvastatin can promote endothelial cell formation and reduce the leakage of endothelial cell barrier in vitro. Results from in vivo experiments in animal models of subdural hematoma suggest that atorvastatin can promote the maturation of blood vessels and reduce inflammation on the margin of hematoma, and thus improve the neurological outcome. Continue reading

Lay Health Workers Reduce Costs and Improve Cancer Patients’ Satisfaction

MedicalResearch.com Interview with:

Manali Patel MD MPH Assistant Professor of Medicine, Oncology Stanford Palo Alto Veterans Affairs Health Care System 

Dr. Patel

Manali Patel MD MPH
Assistant Professor of Medicine, Oncology
Stanford
Palo Alto Veterans Affairs Health Care System  

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

Response: In prior work, many patients with advanced stages of cancer report a lack of understanding of their prognosis and receipt of care that differs from their preferences.

These gaps in care delivery along with the unsustainable rise in healthcare spending at the end-of-life and professional healthcare provider shortages led our team to consider new ways to deliver cancer care for patients.  Based on input from focus groups with patients, caregivers, oncology care providers and healthcare payers, we designed a novel model of cancer care to address these gaps in care delivery.  The intervention consisted of a well-trained lay health worker to assist patients with understanding and communicating their goals of care with their oncology providers and caregivers.

We found that patients who received the six-month intervention reported greater satisfaction with the care they received and their decision-making, had higher rates of hospice use, lower acute care use, and 95% lower total healthcare expenditures in the last month of life.  The intervention resulted in nearly $3 million dollars in healthcare savings.

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Liquid Biopsy for CTCs Can Predict Treatment Response in Advanced Prostate Cancer

MedicalResearch.com Interview with:

Alison L. Allan, PhD Department of Oncology, Western University London Regional Cancer Program, London Health Sciences Centre London, Ontario, Canada 

Dr. Allan

Alison L. Allan, PhD
Department of Oncology, Western University
London Regional Cancer Program, London Health Sciences Centre
London, Ontario, Canada 

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

Response: This was an international collaborative study between Lawson Health Research Institute (London, ON), Memorial Sloan Kettering Cancer Center (New York), the Royal Marsden (London, UK) and molecular diagnostics company Epic Sciences (San Diego, CA). The study used a liquid biopsy test developed by Epic Sciences that examines circulating tumour cells (CTCs) in blood samples from patients with advanced prostate cancer who are deciding whether to switch from hormone-targeting therapy to chemotherapy. CTCs are cancer cells that leave a tumour, enter the blood stream and invade other parts of the body, causing the spread of cancer. The test identifies whether or not a patient’s CTCs contain a protein in the nucleus called AR-V7. The research team set out to determine whether the presence of this protein predicted which treatment would best prolong a patient’s life.

They found that patients who tested positive for the protein responded best to taxane-based chemotherapy while those who tested negative for the protein responded best to hormone-targeting therapy with drugs called androgen-receptor signaling (ARS) inhibitors. These are the two most widely used drug classes to treat advanced prostate cancer.

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Cognitive Changes Mapped Over Time in Young Persons at Risk for Psychosis

MedicalResearch.com Interview with:

Richard Keefe PhD Professor in Psychiatry and Behavioral Sciences Duke Institute for Brains Sciences

Dr. Keefe

Richard Keefe PhD
Professor in Psychiatry and Behavioral Sciences
Duke Institute for Brains Sciences

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

Response: A lot of studies have shown that cognitive deficits are present in young people at risk for psychosis. There have been calls for investigations of the idea that cognition declines over time in the young people who are at highest risk, but longitudinal studies are hard to conduct so not much work has been done to address this question.

The main finding from our study is that the cognitive architecture – the way the various aspects of cognitive functioning appear to be organized in each individual’s brain based upon their pattern of performance – changes over time in those young people who are in the midst of developing psychosis. Interestingly, cognitive architecture also becomes more disorganized in those whose high-risk symptoms do not remit over a two year period, and is related to the functional difficulties they may be having. The young people whose high risk symptoms were present at the beginning of the study but remitted later actually improved cognitively over the two year period of the study. Continue reading

Metabolic Risk Factors Leading Up to Onset of Dementia

MedicalResearch.com Interview with:

Maude Wagner, PhD Student Biostatistics Team Lifelong Exposures, Health and Aging Team Bordeaux Population Health Research Center Inserm Univ. Bordeaux

Maude Wagner

Maude Wagner, PhD Student
Biostatistics Team
Lifelong Exposures, Health and Aging Team
Bordeaux Population Health Research Center
Inserm
Univ. Bordeaux

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

Response: Many studies haves shown associations between cardiometabolic health and dementia in midlife, but associations later in life remain inconclusive.

This study aimed to model concurrently and to compare the trajectories of major cardiometabolic risk factors in the 14 years before diagnosis among cases of dementia and controls.

This study showed that demented persons presented a BMI decline and lower blood pressure (specifically systolic blood pressure) several years before dementia diagnosis that might be a consequence of underlying disease. In contrast, cases presented consistently higher blood glucose levels up to 14 years before dementia suggesting that high glycemia is a strong risk factor for dementia.

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Treatment and Prevention of HIV Infection Recommendations Updated

MedicalResearch.com Interview with:

Michael S. Saag, MD Professor,Division of Infectious Diseases UAB

Dr. Saag

Michael S. Saag, MD
Professor,Division of Infectious Diseases
UAB

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

  • An update of prior recommendations made by the IAS-USA, which have been updated every 2 years since 1996
  • Cover ARVs for prevention and treatment of HIV infection
  • Developed by an international panel of 16 volunteer experts in HIV research and patient care appointed by the IAS–USA
    • Members receive no compensation and do not participate in industry promotional activities while on the panel
  • Primarily for clinicians in highly resourced settings; however, principles are universally applicable
  • Reviewed data published or presented from September 2016 through June 2018
  • Rated on strength of recommendation and quality of evidence

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Waiting Room App Uses Selfies To Show Patients Effects of Sun Damage

MedicalResearch.com Interview with:
Startup Screen Dermatology APPDr. med. Titus Brinker
Head of App-Development // Clinician Scientist
Department of Translational Oncology
National Center for Tumor Diseases (NCT)
Department of Dermatology
University Hospital Heidelberg
Heidelberg

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

Response: ​While everyone in the dermatologic community appears to agree on the importance of UV-protection for skin cancer prevention, busy clinicians often lack time to address it with their patients.

Thus, the aim of this study was to make use of waiting rooms that almost every patient visiting a clinic spends time in and address this topic in this setting by the means of modern technology rather than clinicians time.

We used our free photoaging app “Sunface” which shows the consequences of bad UV protection vs. good UV protection on the users’ own 3D-animated selfie 5 to 25 years in the future and installed it on an iPad. The iPad was then centrally placed into the waiting room of our outpatient clinic on a table and had the Sunface App running permanently. The mirroring of the screen lead to a setting where every patient in the waiting room would see and eventually react to the selfie taken by one individual patient which was altered by the Sunface App.

Thus, the intervention was able to reach a large proportion of patients visiting our clinic: 165 (60.7%) of the 272 patients visiting our waiting room in the seven days the intervention was implemented either tried it themselves (119/72,12%) or watched another patient try the app (46/27,9%) even though our outpatient clinic is well organized and patients have to wait less than 20 minutes on average. Longer waiting times should yield more exposure to the intervention. Of the 119 patients who tried the app, 105 (88.2%) indicated that the intervention motivated them to increase their sun protection (74 of 83 men [89.2%]; 31 of 34 women [91.2%]) and to avoid indoor tanning beds (73 men [87.9%]; 31 women [91.2%]) and that the intervention was perceived as fun (83 men [98.8%]; 34 women [97.1%]).

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“Rory’s Regulations” Improves Pediatric Sepsis Care

MedicalResearch.com Interview with:

Idris V.R. Evans, M.D.,MA Assistant Professor Department of Critical Care Medicine University of Pittsburgh

Dr. Evans

Idris V.R. Evans, M.D.,MA
Assistant Professor
Department of Critical Care Medicine
University of Pittsburgh

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

Response: New York State issued a state-wide mandate in 2013 for all hospitals to develop protocols for sepsis recognition and treatment. This mandate was called “Rory’s Regulations” in honor of Rory Staunton, a boy who died from sepsis in 2012.

Pediatric protocols involved a bundle of care that included blood cultures, antibiotics, and an intravenous fluid bolus within 1–hour. We analyzed data collected by the NYS Department of Health on 1,179 patients from 54 hospitals and found that the completion of the pediatric bundle within 1 hour was associated with a 40% decrease in the odds of mortality.  Continue reading

Ultra-Early Deterioration Predicts Poor Outcome in Stroke

MedicalResearch.com Interview with:

Kristina Shkirkova

Kristina Shkirkova

Kristina Shkirkova
Doctoral Student in Neuroscience
Zilkha Neurogenetic Institute
University of Southern California
Los Angeles, CA

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

Response: Stroke is the second leading cause of death and a leading cause of adult disability worldwide. Stroke onset is sudden with symptoms progressing rapidly in the first hours after onset. The course of symptom progression after stroke is not well studied in the ultra-early window before hospital arrival and during early postarrival period.

There is an urgent need to characterize the frequency, predictors, and outcomes of neurologic deterioration among stroke patients in the earliest time window.

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Two-Day Fast Per Week vs Daily Calorie Restriction in Diabetes

MedicalResearch.com Interview with:
“Diabetes Test” by Victor is licensed under CC BY 2.0Sharayah Carter
PhD candidate|BNutDiet|BMedPharmSc (Hons)|APD
School of Pharmacy and Medical Sciences
University of South Australia

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

Response: Intermittent energy restriction is a new popular diet method with promising effects on metabolic function but limited research exists on its effects on improving glycemic control in people with type 2 diabetes.

The findings of our research demonstrate that a diet with 2-days of severe energy restriction per week is comparable to a diet with daily moderate energy restriction for glycaemic control.  Continue reading

Higher Socioeconomic Status Linked to More Use of Complementary Medicine

MedicalResearch.com Interview with:

James Yu, MD, MHS Director of Yale Medicine's Prostate & Genitourinary Cancer Radiotherapy Program

Dr. James Yu

James YuMDMHS
Director of Yale Medicine’s Prostate & Genitourinary Cancer Radiotherapy Program

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

Response: We previously investigated alternative medicine (therapy used instead of conventional medicine) and showed its use (vs. non-use) was associated with an increased risk of death, but we did not investigate complementary medicine (non-medical therapy used in addition to conventional medicine).  Approximately two-thirds of cancer patients believe CM will prolong life and one-third expect it to cure their disease despite lack of evidence to support this.

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Most Pediatricians are Women, But Men’s Opinions are Valued More

MedicalResearch.com Interview with:

Julie Silver, MD Associate Professor and Associate Chair Department of Physical Medicine and Rehabilitation at Harvard Medical School and staff physician at Massachusetts General Brigham and Women’s and Spaulding Rehabilitation Hospitals

Dr. Silver

Julie Silver, MD
Associate Professor and Associate Chair
Department of Physical Medicine and Rehabilitation at Harvard Medical School and
Staff physician at Massachusetts General
Brigham and Women’s and Spaulding Rehabilitation Hospitals 

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

Response: There are many documented disparities for women in medicine that include promotion and compensation. For physicians in academic medicine, both promotion and compensation may be directly or indirectly linked to publishing. Similarly, opportunities that stem from publishing such as speaking engagements, may be affected by a physician’s ability to publish.

For more than twenty years, there have been reports of women being underrepresented on journal editorial boards and gaps in their publishing rates. For example, a report titled “Is There a Sex Bias in Choosing Editors?” by Dickersin et al was published in JAMA in 1998 and made a compelling case for bias. Moreover, the authors noted that “a selection process favoring men would have profound ramifications for the professional advancements and influence of women”. Despite a steady stream of reports over the years, gaps have not been sufficiently addressed, and in 2014 Roberts published an editorial in Academic Psychiatry titled “Where Are the Women Editors?”. The 2017 review by Hengel titled “Publishing While Female” highlights many of the gaps, disparities and barriers for women in medicine.

Conventional reasons for disparities, such as there are not enough women in the pipeline or women do not want to conduct research or pursue leadership positions, are simply not valid. Therefore, it is important to look at other barriers, such as unconscious (implicit) bias that may affect the editorial process.

In this study, we analyzed perspective type articles from four high impact pediatric journals. We selected pediatrics, because most pediatricians are women, and therefore there are plenty of highly accomplished women physicians. We found that women were underrepresented among physician first authors in all of the journals (140 of 336 [41.7%]).

We also found that underrepresentation was more pronounced in article categories that were described as more scholarly (range, 15.4%-44.1%) versus narrative (52.9%-65.6%).  Continue reading

Antibiotics Still Overprescribed in Many Outpatient Settings

MedicalResearch.com Interview with:

Dr. Katherine Fleming-Dutra, MD, senior author Deputy Director Office of Antibiotic Stewardship CDC

Dr. Fleming-Dutra

Dr. Katherine Fleming-Dutra MD
Deputy Director
Office of Antibiotic Stewardship
CDC

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

Response: Antibiotics are life-saving medications that treat bacterial infections. Any time antibiotics are used, they can lead to antibiotic resistance and could cause side effects such as rashes and adverse events, such as Clostridium difficile infection, which is a very serious and sometimes even fatal diarrheal disease. This is why it is so important to only use antibiotics when they are needed. When antibiotics aren’t needed, they won’t help you and the side effects could still hurt you.

A previous study* reported at least 30% of antibiotic prescriptions written in doctor’s offices and emergency departments were unnecessary. However, the data from that study did not include urgent care centers or retail health clinics. We conducted the current analysis to examine antibiotic prescribing patterns in urgent care centers, retail health clinics, emergency departments, and medical offices.

*Fleming-Dutra, K., et al. (2016). “Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011.” JAMA: the Journal of the American Medical Association 315(17): 1864-1873. https://jamanetwork.com/journals/jama/fullarticle/2518263

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Visual Problems Common in Children with Dyslexia

MedicalResearch.com Interview with:

Aparna Raghuram, OD, PhD Optometrist, Department of Ophthalmology Instructor, Harvard Medical School

Dr. Raghuram

Aparna Raghuram, OD, PhD
Optometrist, Department of Ophthalmology
Instructor, Harvard Medical School

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

Response: Developmental dyslexia is a specific learning disability of neurobiological origin whose core cognitive deficit is widely believed to involve language (phonological) processing. Although reading is also a visual task, the potential role of vision has been controversial, and experts have historically dismissed claims that visual processing might contribute meaningfully to the deficits seen in developmental dyslexia.

Nevertheless, behavioral optometrists have for decades offered vision therapy on the premise that correcting peripheral visual deficits will facilitate reading. Yet there is a surprising dearth of controlled studies documenting that such deficits are more common in children with developmental dyslexia, much less whether treating them could improve reading.

In the present study, we simply assessed the prevalence and nature of visual deficits in 29 school aged children with developmental dyslexia compared to 33 typically developing readers. We found that deficits in accommodation 6 times more frequent in the children with developmental dyslexia and deficits in ocular motor tracking were 4 times more frequent.

In all, more than three-quarters of the children with developmental dyslexia had a deficit in one or more domain of visual function domain compared to only one third of the typically reading group.

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Both State and Federal Marketplaces Expanded Medicaid/Chip Coverage to Eligible Patients

MedicalResearch.com Interview with:

Julie L. Hudson, PhD Center for Financing, Access, and Cost Trends Agency for Healthcare Research and Quality Rockville, Maryland

Dr. Hudson

Julie L. Hudson, PhD
Center for Financing, Access, and Cost Trends
Agency for Healthcare Research and Quality
Rockville, Maryland

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

Response: Since 2013, public coverage has increased not only among low-income adults newly eligible for Medicaid but also among children and adults who were previously eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Recent research has shown that growth in public coverage varied by state-level policy choices.

In this paper we study the growth in public coverage (Medicaid/CHIP) for three population samples living in Medicaid Expansion states between 2013 and 2015: previously eligible children, previously eligible parents, and newly eligible parents by state-level marketplace policies (Note: eligibility refers to eligible for Medicaid/CHIP, eligibility for marketplace subsidized coverage). All marketplaces are required to assess each applicants’ eligibility for both the marketplace and for Medicaid/CHIP. States running state-based marketplaces are required to enroll Medicaid-/CHIP-eligible applicants directly into public coverage (Medicaid or CHIP), but states using federally-facilitated marketplaces can opt to require their marketplace to forward these cases to state Medicaid/CHIP authorities for final eligibility determination and enrollment. We study the impact of marketplace policies on public coverage by observing changes in the probability Medicaid-/CHIP-eligible children and parents are enrolled in public coverage across three marketplace structures: state-based marketplaces that are required to enroll Medicaid-/CHIP-eligible applicants directly into public coverage, federally-facilitated marketplaces in states that enroll Medicaid-/CHIP-eligible applicants directly into public coverage, and federally-facilitated marketplaces with no authority to enroll Medicaid-/CHIP-eligible applicants into public coverage.

Supporting the existing literature, we find that public coverage grew between 2013-2015 for all three of our samples of Medicaid-/CHIP-eligible children and parents living in Medicaid expansion states. However, we show that growth in public coverage was smallest in expansion states that adopted a federally-facilitated marketplace and gave no authority to the marketplace to enroll Medicaid-/CHIP-eligible applicants directly into public coverage. Additionally, once we account for enrollment authority, we found no differences in growth of public coverage for eligible children and parents living in expansion states that adopted a state-based marketplace versus those in states that adopted a federally-facilitated marketplaces with the authority to directly enroll Medicaid-/CHIP-eligible applicants Continue reading

USPSTF and PAD: Uncertain if Nontraditional Risk Factors Can Predict Heart Disease or Stroke Risk

MedicalResearch.com Interview with:

Dr. Michael Barry MD Director of the Informed Medical Decisions Program Health Decision Sciences Center at Massachusetts General Hospital Physician at Massachusetts General Hospit Professor of Medicine,Harvard Medical School

Dr. Barry

Dr. Michael Barry MD
Director of the Informed Medical Decisions Program
Health Decision Sciences Center at Massachusetts General Hospital
Physician at Massachusetts General Hospit
Professor of Medicine,Harvard Medical School 

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

Response: Peripheral artery disease—which is known as PAD—is a disease that reduces blood flow to a person’s limbs, especially the legs. PAD can cause leg and foot pain when resting or walking, wounds to not heal properly, and loss of limbs. Additionally, people with PAD are more likely to experience a cardiovascular disease event, such as heart attack and stroke.

The U.S. Preventive Services Task Force looked at the latest research to see if screening people without signs or symptoms of PAD using the ankle brachial index (ABI) can prevent heart attack, stroke, or other adverse health effects. We found that more research is needed to determine if screening with ABI can help to identify PAD and/or prevent heart attack or stroke in people without signs or symptoms.

Additionally, in a separate recommendation statement, we looked into the effectiveness of what we call nontraditional risk factors for assessing a person’s risk of cardiovascular disease. Clinicians typically check someone’s risk for cardiovascular disease using traditional risk factors, such as age, race, and smoking status. The Task Force looked at the current evidence to see if three additional, nontraditional risk factors can help prevent heart disease or stroke. The nontraditional factors considered were ABI measurements, an elevated amount of high-sensitivity C-reactive protein (hsCRP) in the blood, and an elevated amount of calcium in the coronary arteries (CAC score).

In this recommendation, we also found that there is insufficient evidence to recommend for or against using nontraditional risk factors in addition to those normally used to assess cardiovascular disease risk in people without signs or symptoms.  Continue reading

Sunscreen Use During Childhood Reduces Melanoma Risk

MedicalResearch.com Interview with:
“Sunscreen” by Tom Newby is licensed under CC BY 2.0Dr Caroline Watts  PhD

Post-doctoral Researcher
The University of Sydney.

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

Response: The study analysed data collected from nearly 1700 young Australians who participated in the Australian Melanoma Family Study, a population-based case-control-family study that focused on people who had a melanoma under 40 years of age and compared them with people the same age who did not have a melanoma.

We examined sunscreen use during childhood and adulthood and its association with melanoma risk and found that compared to people who did not use sunscreen, regular sunscreen use during childhood reduced melanoma risk by 30-40 per cent.  Continue reading

Gym Tanners More Likely To Show Signs of “Tanning Addiction.”

MedicalResearch.com Interview with:
Sherry Pagoto, PhD
Director, UConn Center for mHealth and Social Media
President, Society of Behavioral Medicine
UConn Institute for Collaboration in Health, Interventions, and Policy
Professor, Department of Allied Health Sciences
University of Connecticut
Storrs, CT 06268

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

Response: Recent research has shown that while physical activity is associated with reduced risk for many cancers, it is associated with an increased risk for melanoma. We are not sure why this is the case, however, we have noticed that popular gym chains (e.g., Planet Fitness) often offer tanning beds, which are carcinogenic.

We surveyed over 600 people who had used a tanning bed at least once in their life to see how many had used tanning beds in gyms. About one-quarter had used tanning beds in gyms and those folks actually tanned significantly more than people who had not tanned in gyms.  Gym tanners were also more likely to show signs of “tanning addiction.”  We also found an association between tanning and physical activity, such that the people who were the most physically active were the heaviest tanners.  Continue reading