Voice Changes Common After Thyroid Cancer Surgery

MedicalResearch.com Interview with:

Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine

Dr. Haymart

Megan Rist Haymart MD
Associate Professor
Metabolism, Endocrinology and Diabetes Clinic
Michigan Medicine

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

Response: Thyroid cancer is a common malignancy with surgery considered one of the primary treatments. Complications from thyroid surgery can lead to long-term voice problems. However, few studies have used validated scales to quantify the impact of thyroid surgery on patient voice. Prior work has largely focused on single institution studies with high volume surgeons or claims data with reports of specific nerve injury.

We surveyed a diverse cohort of patients affiliated with SEER sites Georgia and Los Angeles to identify the prevalence, severity and correlates of poor voice outcomes following surgery for differentiated thyroid cancer.

We found that out of 2,325 patients 25.8% reported voice changes lasting greater than 3 months after surgery, 12.7% had abnormal voice per a validated voice scale (Voice Handicap Index- 10), and 4.7% reported a diagnosis of vocal fold motion impairment. We also identified patient factors associated with abnormal voice 2-4 years post op.

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Do New Medical Marijuana Laws Reduce Opioid Prescriptions?

MedicalResearch.com Interview with:

Silvia S. Martins, MD, PHD Associate Professor of Epidemiology Department of Epidemiology Mailman School Of Public Health Columbia University New York, NY 10032

Dr. Silvia Martins

Silvia S. Martins, MD, PHD
Associate Professor of Epidemiology
Department of Epidemiology
Mailman School Of Public Health
Columbia University 

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

Response: Prior studies have suggested t6hat medical marijuana legalization might play a role in decreasing opioid use.

We aimed to test this hypothesis using individual level data on nonmedical use of prescription opioids and opioid use disorder  from the US National Survey on Drug Use and Health.  Continue reading

Medicaid Expansion Increased Insurance Access For Those With Disabilities

MedicalResearch.com Interview with:

Jim Stimpson, PhD Professor, Associate Dean for Academic Affairs  Health Management and Policy Drexel Dornsife School of Public Health

Dr. Stimpson

Jim Stimpson, PhD
Professor, Associate Dean for Academic Affairs
Health Management and Policy
Drexel Dornsife School of Public Health 

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

Response: We have limited information on the impact of the ACA on persons with a disability, even though nearly 1 in 5 persons in the US has a physical or mental disability.

Prior to the ACA, persons with a disability had complications accessing health insurance for a variety of reasons including lower likelihood of employer-based coverage, reduced access to private insurance due to pre-existing conditions, and income-restrictions for Medicaid coverage that are on average below the poverty threshold across the country.

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Teens: Nonmedical Prescription Opioid Use Associated With Subsequent Heroin Use

MedicalResearch.com Interview with:

Lorraine Kelley-Quon, MD, MSHS, FAAP Assistant Professor | Division of Pediatric Surgery Children's Hospital Los Angeles Department of Surgery & Preventive Medicine Keck School of Medicine of USC

Dr. Kelley-Quon

Lorraine Kelley-Quon, MD, MSHS, FAAP
Assistant Professor | Division of Pediatric Surgery
Children’s Hospital Los Angeles
Department of Surgery & Preventive Medicine
Keck School of Medicine of USC 

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

Response: Prescription opioids are pharmacologically similar to heroin, and previous research has shown an association between nonmedical opioid use and heroin use.

This is the first study to follow a group of teenagers through all 4 years of high school and identify an association between nonmedical prescription opioid use and later heroin use.

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Do Flexible Family Visitation Hours Reduce Delirium in ICU Patients?

MedicalResearch.com Interview with:
MedicalResearch.com Interview with: Regis Goulart Rosa, MD, PhD Responsabilidade Social - PROADI Hospital Moinhos de Vento MedicalResearch.com: What is the background for this study? Response: The debate about visiting policies in adult ICUs is of broad and current interest in critical care, with strong advocacy in favour of flexible family visitation models in order to promote patient- and family-centred care. However, the proportion of adult ICUs with unrestricted visiting hours is very low. Data from the literature show that 80% of hospitals in the United Kingdom and USA adopt restrictive ICU visiting policies. Among ICUs with restrictive visiting hours, published studies show that the daily visiting time ranges from a median of 1 hour in Italy to a mean of 4.7 hours in France. In agreement with this scenario, most adult ICUs in Brazil follow a restrictive visitation model, in which family members are allowed to visit the critically ill patient from 30 minutes to 1 hour, once or twice a day. These restrictive visitation models have been justified by the theoretical risks associated with unrestricted visiting hours, mainly infectious complications, disorganization of care, and burnout. Controversially, these risks have not been consistently confirmed by the scarce literature on the subject, and flexible ICU visiting hours have been proposed as a means to prevent delirium among patients and improve family satisfaction. MedicalResearch.com: What are the main findings? Response: Disappointingly, studies evaluating the effectiveness and safety of flexible ICU visiting hours are scarce. To date, no large randomized trials have assessed the impact of a flexible visiting model on patients, family members, and ICU staff, and this evidence gap may constitute a barrier to the understanding of the best way to implement and improve ICU visiting policies. In the present pragmatic cluster-randomized crossover trial (The ICU Visits Study), we engaged 1,685 patients, 1,295 family members, and 826 ICU professionals from 36 adult ICUs in Brazil to compare a flexible visitation model (12 hours/day plus family education) vs. the standard restricted visitation model (median 90 minutes per day). We found that the flexible visitation did not significantly reduce the incidence of delirium among patients, but was associated with fewer symptoms of anxiety and depression and higher satisfaction with care among family members in comparison to the usual restricted visitation. Also, the flexible visitation did not increase the incidence of ICU-acquired infections and ICU staff burnout, which are major concerns when adopting this intervention. MedicalResearch.com: What should readers take away from your report? Response: Considering the evidence suggesting that most adult ICUs restrict the presence of family members, our results provide useful and relevant information that may influence the debate about current ICU visitation policies around the world. First, a flexible visitation policy that permits flexible family visitation in ICU (up to 12 hour per day) is feasible, given the high adherence of participant ICUs to implementation in The ICU Visits Study. Second, the flexible family supported by family education is safe regarding the occurrence of infections, disorganization of care or staff burnout. Third, family members - a commonly missing piece of the critical care puzzle - seem to benefit from the flexible visitation model through higher satisfaction with care and less symptoms of anxiety and depression. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Future research might focus on the following topics: 1) methods of implementation of flexible visiting models in ICUs; 2) Family support interventions in the context of flexible ICU visiting hours (e.g.: psychological and social support, support for shared decision making, peer support, and comfort); and 3) How flexible ICU visiting hours affects patient, family member and staff outcome at long-term. Disclosures: The ICU Visits study was funded by the Brazilian Ministry of Health through the Brazilian Unified Health System Institutional Development Program (PROADI-SUS). Citation: Effect of Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit  [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.
Regis Goulart Rosa, MD, PhD
Responsabilidade Social – PROADI
Hospital Moinhos de Vento 

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

Response: The debate about visiting policies in adult ICUs is of broad and current interest in critical care, with strong advocacy in favour of flexible family visitation models in order to promote patient- and family-centred care. However, the proportion of adult ICUs with unrestricted visiting hours is very low. Data from the literature show that 80% of hospitals in the United Kingdom and USA adopt restrictive ICU visiting policies. Among ICUs with restrictive visiting hours, published studies show that the daily visiting time ranges from a median of 1 hour in Italy to a mean of 4.7 hours in France. In agreement with this scenario, most adult ICUs in Brazil follow a restrictive visitation model, in which family members are allowed to visit the critically ill patient from 30 minutes to 1 hour, once or twice a day. These restrictive visitation models have been justified by the theoretical risks associated with unrestricted visiting hours, mainly infectious complications, disorganization of care, and burnout. Controversially, these risks have not been consistently confirmed by the scarce literature on the subject, and flexible ICU visiting hours have been proposed as a means to prevent delirium among patients and improve family satisfaction. 

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Prostate Cancer: Effects of Hormone Therapy on Cognitive Function Addressed in Large Study

MedicalResearch.com Interview with:

Ravi Jayadevappa, PhD, MS Department of Medicine Perelman School of Medicine University of Pennsylvania Philadelphia, PA 19104-2676 

Dr. Jayadevappa

Ravi Jayadevappa, PhD, MS
Department of Medicine
Perelman School of Medicine
University of Pennsylvania
Philadelphia, PA 19104-2676 

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

Response: In the US, prostate cancer is the most commonly diagnosed non-skin cancer and the second leading cause of cancer death among men. Research shows that hormone therapy or ADT reduces the levels of male hormones in the body, called androgens, to stop them from stimulating cancer cells to grow., and thus is effective in reducing the spread and progression of prostate cancer.

At the same time, some research has suggested that decreasing androgen levels may increase the risk factors for Alzheimer’s and dementia, including loss of lean body mass, diabetes, cardiovascular disease, and depression. The ADT therapy may lead to impaired neuron growth and the regeneration of axons, thus affecting the cognitive function. Thus there is growing interest in the possible association between exposure to ADT and cognitive dysfunction.

Our study investigates the association between exposure to ADT and subsequent diagnosis of Alzheimer’s or dementia in elderly, fee-for-service Medicare enrollees using SEER-Medicare linked databases.

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Preterm Babies Less Likely To Have Romantic Relationships as Adults

MedicalResearch.com Interview with:

Dr. Marina Mendonca PhD RECAP project (Research on European Children and Adults Born Preterm) Department of Psychology University of Warwick, UK

Dr. Mendonca

Dr. Marina Mendonca PhD
RECAP project (Research on European Children and Adults Born Preterm)
Department of Psychology
University of Warwick, UK

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

Response: Previous research on the social lives of adults born preterm (under 37 weeks gestation) was inconsistent. This meta-analysis brought together data from up to 4.4m adult participants and has shown that those who were born preterm are less likely to form romantic relationships, to have had sexual relations or experience parenthood than full terms. For example, those born preterm were 28% less likely to form romantic relationships and 22% less likely to become parents, when compared to those born full term. When looking at sexual relations, preterm born adults were 2.3 times (or 57%) less likely to ever have a sexual partner.

These associations were found for both men and women, and were stronger the lower gestational age. This means that the chances of finding a romantic partner or having children were lower for those born very (<28 weeks gestation) or extremely preterm (<28 weeks gestation), with the extremely pre-term born adults being for example 3.2 times (78%) less likely to ever having had sexual relations when compared to their full term peers.

Despite having fewer relationships, we found that when adults who were born preterm had friends or a partner, the quality of these relationships was at least as good as those born full term. 

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Genetic Variants Linked to Life-threatening Cardiac Arrhythmias in Patients With Dilated Cardiomyopathy and Implanted Defibrillators

MedicalResearch.com Interview with:

Ben Cordon, PhD NIHR Post-doctoral Academic Clinical Fellow Specialist Registrar training in cardiology

Dr. Cordon

Ben Cordon, PhD
NIHR Post-doctoral Academic Clinical Fellow
Specialist Registrar training in cardiology 

James S. Ware, PhD, MRCP  Reader in Genomic Medicine Group head within the Cardiovascular Genetics & Genomics Unit Imperial College London

Dr. Ware

James SWarePhD, MRCP
 Reader in Genomic Medicine
Group head within the Cardiovascular Genetics & Genomics Unit
Imperial College London

 

 

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

Response: Non-ischaemic dilated cardiomyopathy is a common cause of heart failure and carries the risk of life-threatening ventricular arrhythmia. An implantable cardioverter defibrillator (ICD) can be life-saving in this condition. However, the decision to implant an ICD is not one that can be taken lightly – ICD insertion carries its own risks, such as infection or inappropriate shocks, and our ability to predict who will benefit from a device is currently far from perfect. Genetic sequencing is affordable and widely available and for DCM, like many diseases, it is hoped that genetic stratification may one day help deliver personalised management. In DCM, variants in the Lamin A/C gene for example are known to cause a phenotype with early and severe arrhythmias and, as a result, international guidelines advocate a lower threshold for ICD insertion in these patients. However, Lamin A/C is an infrequent cause of DCM. The commonest known genetic cause of DCM are protein-truncating variants in the gene encoding Titin (TTNtv), accounting for ~15% of DCM cases. We wanted to know if this group had a higher risk of arrhythmia than the general DCM population.

Earlier work from our group on this topic found that patients with TTNtv-associated DCM were more likely to have a clinical history of arrhythmia (composite of atrial and ventricular arrhythmia, including NSVT), at the time of their initial DCM diagnosis. But it was unclear if this was driven by ventricular arrhythmia, atrial arrhythmia, or both or if it would translate into a long-term risk of potentially dangerous ventricular arrhythmia of the sort for which an ICD can be life-saving. In another study we analysed a larger cohort of ambulant DCM patients but did not find an increased risk of ventricular arrhythmia – but this was a relatively low-risk group, with comparatively mild symptoms (NHYA I/II heart failure) and moderately impaired LV function. As a result, the overall arrhythmic event rate was low, meaning that the power to detect differences between the TTNtv and non-TTNtv groups was reduced.

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Elevated Systolic Blood Pressure Linked to Increase in Valvular Heart Disease

MedicalResearch.com Interview with:

Prof-Kazem Rahimi

Prof. Rahimi

Dr Kazem Rahimi
Deputy Director of the George Centre for Healthcare Innovation
James Martin Senior Fellow in Essential Healthcare
Honorary Consultant Cardiologist at the John Radcliffe Hospital
Deputy Director of the George Institute for Global Health

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

Response: In the last century, we have witnessed a dramatic change in the spectrum of valvular heart disease and the prevalence of this condition has been rapidly increasing, due to population ageing, with poor patient outcomes and high healthcare costs associated with the only effective treatment available, which is valve repair or replacement. However, modifiable risk factors for valvular heart disease remain largely unknown, which limits prevention and treatment. We used a state-of-the-art, gene-based method called Mendelian randomization to determine the causality of the association between systolic blood pressure and risk of valvular heart diseases.  Continue reading

Heart Failure: Low Iron Storage vs Defective Iron Utilization

MedicalResearch.com Interview with:

Dr. Niels Grote Beverborg, MD PhD Post-doctoral research fellow Department of experimental cardiology University Medical Center Groningen, Groningen, The Netherlands Integrated CardioMetabolic Center Karolinska Institutet, Stockholm Sweden

Dr. Grote Beverborg

Dr. Niels Grote Beverborg, MD PhD
Post-doctoral research fellow
Department of experimental cardiology
University Medical Center Groningen,
Groningen, The Netherlands
Integrated CardioMetabolic Center
Karolinska Institutet, Stockholm
Sweden 

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

Response: Iron deficiency is very prevalent worldwide and a significant cause of morbidity and mortality, especially in vulnerable populations such as patients with heart failure. It is well known that iron deficiency can be a consequence of an insufficient iron uptake or increased iron loss (termed low iron storage), or of a chronic low inflammatory state (defective iron utilization). However, so far, we had no tools to distinguish these causes from each other in patients and have not been able to assess their potential consequences.

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Food Placement and Traffic Light Labeling To Reduce Caloric Intake in Employee Cafeteria

MedicalResearch.com Interview with:

Anne Thorndike, MD, MPH Massachusetts General Hospital General Internal Medicine Division Boston, MA 02114

Dr. Thorndike

Anne Thorndike, MD, MPH
Massachusetts General Hospital
General Internal Medicine Division
Boston, MA 02114

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

Response: Nearly one-third of the 150 million US adults who are employed are obese. Employees frequently eat meals acquired at work, and workplace food is often high in calories. Effective strategies for reducing non-nutritive energy intake during the workday could help address the rising prevalence of obesity.

Simplified labeling, such as traffic-light labels, provide understandable information about the relative healthfulness of food and can be placed on menu boards, shelf labels, and individual packages to help employees make healthier choices. Choice architecture (e.g., product placement) interventions make it easier and more convenient for employees to choose a healthy item. It is unknown if labeling interventions are associated with sustained reductions in calorie intake, or if there are only temporary effects after which most people revert to higher-calorie choices.

A previous study demonstrated that a hospital cafeteria traffic-light labeling and choice architecture program resulted in a higher proportion of healthy green-labeled purchases and lower proportion of unhealthy red-labeled purchases over two years. The current study analyzed calories purchased by a longitudinal cohort of 5,695 hospital employees who used the cafeteria regularly. The study examined changes in calories purchased over time and hypothesized the effect of the change in calorie intake on employees’ weight.

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Does Short-term Treatment of Internet and Computer Game Addiction Work?

MedicalResearch.com Interview with:
video-gamesDr. Klaus Wölfling
Psychologische Leitung – Ambulanz für Spielsucht
Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie
Universitätsmedizin der Johannes Gutenberg-Universität Mainz
Mainz

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

Response:  Our institution, the outpatient clinic of Behavioral Addictions at the Department of Psychosomatic Medicine, University Medical Center Mainz started as a pilot project, which was funded by Rhineland-Palatine, our federal state in Germany. We rapidly noticed the need for treatment in the population. We revealed insights of the disease during the last decade. During this time, we developed and refined therapeutic processes addressing Internet Addiction and Gaming Disorder. We conducted a pilot study, which tested the feasibility of a CBT-treatment approach for Internet Addiction in an RCT. We learned a lot from therapy research and noticed that it was important to conduct a study, which indicates an effective treatment for this disease.

STICA found a strong remission rate for Internet and Computer game Addiction of treatment group vs. WLC (OR=10.10; 94% CI 3.69 to 27.65).

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Link Between Skin Disease Hidradenitis Suppurativa and Inflammatory Bowel Disease

MedicalResearch.com Interview with:

Hidradenitis suppurativa- DermNetNZ

Hidradenitis suppurativa- DermNetNZ

Prof Ching-Chi Chi, MD, MMS, DPhil (Oxford)
Department of Dermatology
Chang Gung Memorial Hospital, Linkou
Guishan Dist, Taoyuan 33305
Taiwan

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

Response: Hidradenitis suppurativa (HS) and inflammatory bowel disease (IBD) are inflammatory diseases that share common clinical manifestations, genetic susceptibility, and immunologic features. For example, both diseases have similar clinical manifestations in the skin and gut, characterized by sterile abscesses in perineal and inguinal areas, scarring, and sinus tract formation. Both diseases have been associated with an increased prevalence of spondyloarthropathy, have common risk factors (smoking and obesity), and respond well to tumor necrosis factor-inhibitors. Some studies have suggested a link between HS and IBD, but data on the association of HS and IBD remain inconsistent and unclear. Therefore, we conducted a meta-analysis to investigate the association of hidradenitis suppurativ with IBD.

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Do New Medical Marijuana Laws Increase Teen Use of Cannabis?

MedicalResearch.com Interview with:

D. Mark Anderson, Ph.D. Associate Professor Department of Agricultural Economics and Economics Montana State University, IZA, and NBER

Dr. Anderson

D. Mark Anderson, Ph.D.
Associate Professor
Department of Agricultural Economics and Economics
Montana State University, IZA, and NBER

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

Response: Using data from the Youth Risk Behavior Surveys for the period 1993-2017, we explore the effect medical and recreational marijuana laws have on teen use.

We find that medical marijuana laws (MMLs) are not associated with teen marijuana consumption, but recreational marijuana laws (RMLs) are actually negatively associated with teen use. 

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Many Dialysis Patients Do Not Think of Themselves As Having a Life Limiting Condition

MedicalResearch.com Interview with:

Dr. Ann M. O’Hare, MD Professor,Division of Nephrology University of Washington Investigator, VA HSR&D Center of Excellence Affiliate Investigator, Group Health Research Institute Seattle, WA 

Prof. O’Hare

Dr. Ann M. O’Hare, MD
Professor,Division of Nephrology
University of Washington
Investigator, VA HSR&D Center of Excellence
Affiliate Investigator, Group Health Research Institute
Seattle, WA

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

Response: We know that survival for people undergoing dialysis is generally quite limited.  Only a few studies have attempted to elicit how patients undergoing dialysis understand prognosis and how their prognostic awareness might be related to their interest in planning for the future, their preferences for resuscitation and the kind of care they would want if they were seriously ill or dying.

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Brain Aging in Women Linked to Obesity and Lower Estradiol Levels

MedicalResearch.com Interview with:

Rachel Zsido PhD student Department of Neurology  International Max Planck 

Rachel Zsido

Rachel Zsido
PhD student
Department of Neurology
International Max Planck

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

Response: We integrated measures of brain network structure, visceral adipose tissue (VAT), serum estradiol levels, and cognitive performance from 974 participants in order to shed light on potential mechanisms underlying cognitive health. We believe it is imperative to assess sex-specific risk trajectories in brain aging and cognitive decline, especially given the known sex differences in both VAT accumulation patterns and estradiol fluctuations across the lifespan.

Thus, we aimed to answer three questions in men and in women:

1) Does visceral adipose tissue exacerbate the association between age and brain network structure,
2) Does estradiol mitigate the negative association between VAT and brain network structure, and
3) What does this imply for healthy cognitive aging in men and women?  Continue reading

Latinos, But Not African Americans, Report Less Discrimination in California Health Care

MedicalResearch.com Interview with:

Lucy Schulson, MD MPH Section of General Internal Medicine Boston University School of Medicine Boston, Massachusetts

Dr. Schulson

Lucy Schulson, MD MPH
Section of General Internal Medicine
Boston University School of Medicine
Boston, Massachusetts

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

Response: Research in the early 2000s in California demonstrated that racial and ethnic minorities, immigrants, and those with limited English proficiency (LEP) experienced high rates of discrimination in healthcare. Since those studies were published, California has made concerted efforts at the state and local level to address health equity; these efforts may have impacted perceptions of discrimination in health care. However, it is not known how perceptions of discrimination in healthcare have changed over the last ten years overall and for specific groups. This study sought to compare perceptions of discrimination in health care in 2003-2005 compared to 2015-2017 overall, for racial and ethnic minorities, among immigrants, and among those with Limited English Proficiency (LEP).  Continue reading

US Cancer Deaths Cost Society Billions in Lost Earnings

MedicalResearch.com Interview with:

Farhad Islami, MD PhD Scientific Director, Surveillance Research American Cancer Society, Inc. Atlanta, GA 30303

Dr. Islami

Farhad Islami, MD PhD
Scientific Director, Surveillance Research
American Cancer Society, Inc

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

Response: In the United States, cancer is the second leading cause of death, and premature cancer deaths impose significant economic burden. Contemporary information on the economic burden of cancer mortality can inform policies and help prioritize resources for cancer prevention and control, but this information is lacking.

In our study, we provide contemporary estimates for the loss of future earnings (lost earnings) due to cancer death at national and state levels for all cancers combined and for major cancers.

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How Well Did California’s Interventions to Improve Vaccination Rates Work?

MedicalResearch.com Interview with:
Ms. Cassandra Pingali

Ms. Pingali worked on this paper while a a graduate student at Emory University, and completed it post-graduation.
She is currently an ORISE fellow at Centers for Disease Control and Prevention
Immunization Services Division

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

Response: Despite high overall immunization coverage in the United States, we are currently experiencing the largest measles outbreak since measles was declared eliminated in 2000. In 2014, California grappled with a very large measles outbreak known as the “Disneyland” outbreak. Later investigation revealed that most of the affected children were unvaccinated against measles despite the availability of a safe and effective vaccine.

In order to prevent future outbreaks, California officials wanted to improve their declining childhood vaccination coverage. California passed two laws and implemented an educational program for school staff to increase vaccination rates in the state. We felt it was important to take a systematic look at these interventions and examine if public health initiatives such as these are working to improve vaccination rates.

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High-Intensity Binge Drinking Linked to Abnormal Lipids and Liver Function Tests

MedicalResearch.com Interview with:

Falk W. Lohoff, MD Chief, Section on Clinical Genomics and Experimental Therapeutics (CGET) Lasker Clinical Research Scholar National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Institutes of Health (NIH) Bethesda, MD 20892-1540

Dr. Lohoff

Falk W. Lohoff, MD
Chief, Section on Clinical Genomics and Experimental Therapeutics (CGET)
Lasker Clinical Research Scholar
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
National Institutes of Health (NIH)
Bethesda, MD 20892-1540 

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

Response: More than 32 million adults in the United States report engaging in high-intensity binge drinking (consuming two- and three- times the traditional binge thresholds of 5 drinks per occasion for men and 4 drinks per occasion for women) and associated adverse health effects represent a significant public health problem in the US.

While alcohol consumption has been associated with changes in cardiovascular risk factors like high-density lipoprotein cholesterol (HDL-C) and triglycerides as well as liver function enzymes, previous studies were not able to study these associations among those reporting recent high-intensity binge drinking. We utilized a cross-sectional dataset containing both sufficiently detailed alcohol consumption data, cholesterol, and liver function enzyme levels to examine these associations. 

MedicalResearch.com: What are the main findings? 

Response: Our main finding showed high-intensity binge drinking was associated with a dose-dependent 2- to 8-fold increased odds for clinically high levels of HDL-C, total cholesterol, triglycerides, and all liver function enzymes (gamma-glutamytransferase, aspartate aminotransferase, and alanine aminotransferase). In a separate analysis of drinking patterns, we found each additional day of high-intensity binging also increased the odds of clinically high biomarkers. 

MedicalResearch.com: What should readers take away from your report?

Response: Our study highlights the possible negative cardiovascular and hepatic impact associated with high-intensity binge drinking. Given that high-intensity binge drinking is common on weekends, special events, and holidays, it is alarming that even one additional day of high-intensity binge drinking may increase cardiometabolic risk factor levels.

When combined with previous work showing normalization of cholesterol and liver enzyme levels with alcohol reduction, these findings suggest that drinking reduction intervention strategies aimed at reducing high-intensity binge drinking may be associated with improved health outcomes.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Our cross-sectional study evaluated only cardiometabolic risk factors. Therefore, future research is needed to examine the impact of high-intensity binge drinking on cardiometabolic disease outcomes, such as myocardial infarction, atherosclerosis, and stroke as well as liver disease. These findings need also to be replicated in larger, population-based cohorts.

MedicalResearch.com: Is there anything else you would like to add? 

Response: These findings emphasize the importance of future research evaluating the health impact of this increasingly common hazardous alcohol consumption pattern. Further, these data suggest that inquiring about recent high-intensity binge drinking may be useful in clinical settings if the elevated cholesterol and liver levels are present.

Disclosures: The authors have no disclosures relevant to the manuscript

This study was supported by the National Institute on Alcohol Abuse and Alcoholism

Citation:

 

Rosoff DB, Charlet K, Jung J, et al. Association of High-Intensity Binge Drinking With Lipid and Liver Function Enzyme Levels. JAMA Netw Open. Published online June 14, 20192(6):e195844. doi:10.1001/jamanetworkopen.2019.5844

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2735766 

 

[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.

 

Trends in Health Equity by Race/Ethnicity, Sex, and Income

MedicalResearch.com Interview with:

Frederick J. Zimmerman PhD Professor Department of Health Policy and Management & Center for Health Advancement UCLA Fielding School of Public Health

Dr. Zimmerman

Frederick J. Zimmerman PhD
Professor
Department of Health Policy and Management &
Center for Health Advancement
UCLA Fielding School of Public Health 

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

Response: We’ve known that health equity is a priority, and we’ve known that we’re probably not doing well.  This new study quantifies the decline.

MedicalResearch.com: What should readers take away from your report? 

Response:  Looking at self-reported health status measures (general health and healthy days) from the Behavioral Risk Factor Surveillance System over 25 years, we found that while there have been small improvements in the disparities between White and African-American respondents over this period, several other measures of health equity show that we’re going backward.  In particular, while Black-White disparities slightly declined (0.5 standard deviations), income disparities increased markedly (1.5 SD) and a concept of Health Justice declines by 2 standard deviations over the 25 years.  An overall measure of health equity that integrates all of these perspectives was stagnant (self-reported general health) or declined by 1.0 standard deviations (healthy days).

While Black-White disparities have improved modestly since 1993, these gains have been more than wiped out by increasing income disparities in health. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: If we want serious progress on health equity, we need serious research on its causes.  That means tracking a single measure of health equity over time and across places to see what works and what doesn’t to improve performance in health equity.  

  • I’d like to acknowledge the generous support of the Robert Wood Johnson Foundations uclafsphfor partial funding for this research. 

Citation:

Zimmerman FJ, Anderson NW. Trends in Health Equity in the United States by Race/Ethnicity, Sex, and Income, 1993-2017. JAMA Netw Open. Published online June 28, 20192(6):e196386. doi:10.1001/jamanetworkopen.2019.6386

 

[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.

 

Limited Opioid Addiction Treatment Resources Should Be Geared Towards Most Affected Counties

MedicalResearch.com Interview with:

Rebecca L. Haffajee, J.D., Ph.D., M.P.H. Assistant Professor Department of Health Management & Policy University of Michigan School of Public Health

Dr. Haffajee

Rebecca L. Haffajee, J.D., Ph.D., M.P.H.
Assistant Professor
Department of Health Management & Policy
umichsphumichsph

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

Response: Evidence suggests that the availability of medications to treat opioid use disorder (OUD) has been slow to expand, particularly in rural areas, despite the efficacy and effectiveness of these medications in reducing overdose deaths and other adverse life outcomes. We were interested in understanding the characteristics of counties both with high need (as measured by above-national rates in opioid overdose deaths) AND low provider capacity to deliver medications to treat OUD in 2017.

We found that such “opioid high-risk” counties were likely to be in the East North Central (e.g., Michigan, Ohio, Illinois, Indiana), South Atlantic (e.g., North Carolina, South Carolina, Virginia, West Virginia), and Mountain (e.g., New Mexico, Arizona, Nevada) regions.

We also found that these opioid high-risk counties were more likely to have higher rates of unemployment and less likely to have fewer primary care clinicians or be micropolitan Continue reading

Spirometry Threshold Establishes Diagnosis of Clinically Significant COPD

MedicalResearch.com Interview with:

Elizabeth C. Oelsner, MD, MPH Irving Assistant Professor of Medicine Division of General Medicine New York Presbyterian Columbia University

Dr. Oelsner

Elizabeth C. Oelsner, MD, MPH
Irving Assistant Professor of Medicine
Division of General Medicine
New York Presbyterian
Columbia University

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

Response: Uncertainty regarding how to diagnose chronic obstructive pulmonary disease (COPD) has posed significant problems for early detection and treatment of this common disease. Simplifying and standardizing the diagnosis of COPD has the potential to improve diagnosis, clinical care, and clinical research for this common and under-diagnosed chronic lung disease.

We therefore aimed to provide robust evidence for the best threshold to diagnose COPD by comparing how well various thresholds predict hospitalizations and deaths from COPD.

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Sexting Linked to Increased Sexual Activity and Substance Abuse Among Teenagers

MedicalResearch.com Interview with:
texting, sextingCamille Mori, B.A. (hons)
M.Sc. candidate
Clinical Psychology Program
Determinants of Child Development Lab
University of Calgary 

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

Response: Sexting, which is the sharing of sexual messages, images, or videos over technological devices, has recently become a cause for concern among parents, teachers, and policy makers. However, the research on sexting among youth is still in early stages, and evidence of the risks associated with sexting is inconsistent. One way to resolve discrepancies in the field is to conduct a meta-analysis, which statistically summarizes existing research. We conducted a meta-analysis in order to examine the association between sexting and sexual activity (having sex, multiple sexual partners, and lack of contraception use). The associations between sexting and mental health related variables, including delinquent behaviour, substance use, and depression/anxiety were also examined.

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Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurologic Diseases

MedicalResearch.com Interview with:

Charlotte E. Teunissen,

Prof. Teunissen

Charlotte E. Teunissen, PhD
Neurochemistry Laboratory, Department of Clinical Chemistry
VU University Medical Centre, Neuroscience Campus Amsterdam
Amsterdam, the Netherlands

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

Response: Several reports have shown increased in NfL in various neurological disorders, separately. We wanted to know how the levels are in these disorders relative to each other. Moreover, some reports showed absence of age effects in Multiple Sclerosis (MS) patients, which is normally present in controls. So, we thought that it would be good to study age effects in a large group of controls, and if these effects are absent in other diseases, similarly as in MS.

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Statins May Double Risk of Diabetes

MedicalResearch.com Interview with:

Victoria A. Zigmont, PhD MPH Southern Connecticut State University/ Department of Public Health Assistant Professor New Haven, CT

Dr. Zigmont

Victoria A. Zigmont, PhD MPH
Southern Connecticut State University
Department of Public Health
Assistant Professor
New Haven, CT

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

  • We were interested in conducting this study to better understand the diabetogenic risks (dysglycemia (measured using elevated HbA1c) and new diagnoses of diabetes) associated with statin use for everyday people in the general population.
  • We conducted a retrospective cohort study and compared new users of statins to equivalent nonusers of statins. All of the study participants had indications for statin use in their electronic medical records for the primary (patients without a history of cardiovascular disease (CVD)) or secondary prevention (patients who have had CVD) of CVD. This study used pharmacy and medical claims, and biometric data as well as data from a health survey.

MedicalResearch.com: What are the main findings?

Response: After adjusting for confounding factors (age, gender, education level, ethnicity, cholesterol and triglyceride readings, body mass index, waist circumference and the number of visits to the doctor) statin users had at least double the risk for developing type 2 diabetes mellitus compared to statin nonusers. Individuals who used statins for the longest period of time (more than 2 years) had an even greater risk (3 times greater) for developing type 2 diabetes mellitus, after adjusting for confounding factors.

MedicalResearch.com: What should readers take away from your report?

  • These study findings indicate that statin users should receive special guidance on diet and physical activity for diabetes prevention from their medical care team. These individuals should also receive close monitoring to detect changes in glucose metabolism.
  • Statins are a well-established way to prevent heart attacks and strokes. It could be harmful if patients stopped taking their statins, and they should talk to their physicians if they have concerns about side effects associated with their medications.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Further research is needed to understand which statins and doses lead to a greater risk of diabetes, and well as the impact of statins on human metabolism. Clinical studies testing new medications should report on the risks and benefits in addition to the desired clinical outcomes.

This study was conducted as part of my doctoral dissertation at the Ohio State University. I am now an assistant professor at Southern Connecticut State University (New Haven). The study co-authors were Drs. Susan Olivo-Marston (dissertation advisor), Abigail Shoben, Bo Lu, Steven Clinton, Randall Harris and Gail Kaye. 

Citation:

Victoria A. Zigmont, Abigail B. Shoben, Bo Lu, Gail L. Kaye, Steven K. Clinton, Randall E. Harris, Susan E. Olivo‐Marston. Statin users have an elevated risk of dysglycemia and new‐onset‐diabetes. Diabetes/Metabolism Research and Reviews, 2019; e3189 DOI: 1002/dmrr.3189

 

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Do Decision Aids Make a Difference in Prostate Cancer Screening?

MedicalResearch.com Interview with:

Kari Tikkinen, MD, PhD, Adjunct Professor Departments of Urology and Public Health University of Helsinki and Helsinki University Hospital Helsinki, Finland

Dr. Tikkinen

Kari Tikkinen, MD, PhD, Adjunct Professor
Departments of Urology and Public Health
University of Helsinki and Helsinki University Hospital
Helsinki, Finland

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

Response: Men’s choice of whether to undergo screening is value and preference sensitive: fully informed men will make different choices depending on their experience and perspective. For such decisions, shared decision-making represents an ideal approach to decision making. In shared decision-making both the patient and health care provider contribute to the medical decision-making process. The health care provider explains alternatives to patients, informs them of the best evidence regarding the anticipated consequences of a decision for or against the intervention, and helps them choose the option that best aligns with their preferences. All major guidelines of prostate cancer screening acknowledge the importance of informing men about risks and benefits of PSA screening.

Shared decision-making is challenging because it requires time, knowledge, and specific skills. Prostate cancer screening decisions aids may, by summarizing the current best evidence and by supporting conversations that address what matters most to men, address these challenges. The impact of decision aids on the decision-making process is, however, uncertain. We therefore undertook a systematic review and meta-analysis of the randomized trials that have addressed the impact of decision aids in the context of prostate cancer screening.  Continue reading

Lowered Price of Repatha® (evolocumab) Translates to Cost Effectiveness for Range of Heart Conditions in Some High Risk Patients

MedicalResearch.com Interview with:

Gregg C. Fonarow, MD, FACC, FAHA Eliot Corday Professor of Cardiovascular Medicine and Science Director, Ahmanson-UCLA Cardiomyopathy Center Co-Chief of Clinical Cardiology, UCLA Division of Cardiology Co-Director, UCLA Preventative Cardiology Program David Geffen School of Medicine at UCLA Los Angeles, CA, 90095-1679

Dr. Gregg Fonarow

Gregg C. Fonarow, MD, FACC, FAHA
Eliot Corday Professor of Cardiovascular Medicine and Science
Director, Ahmanson-UCLA Cardiomyopathy Center
Co-Chief of Clinical Cardiology, UCLA Division of Cardiology
Co-Director, UCLA Preventative Cardiology Program
David Geffen School of Medicine at UCLA
Los Angeles, CA 

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

Response: Last year, Amgen made the PCSK-9 inhibitor evolocumab available at a reduced list price of $5,850 per year This 60% reduction was aimed at improving patient access by lowering patient copays, especially for Medicare beneficiaries.

Additionally, the treatment landscape for PCSK9 inhibitors was further defined in 2018 when the American College of Cardiology/American Heart Association Multisociety Clinical Guideline on the Management of Blood Cholesterol recommended PCSK9 inhibitors for, among other patient populations, patients with very high-risk (VHR) ASCVD whose low-density lipoprotein cholesterol levels remain at 70 mg/dL or more  despite a heart-healthy lifestyle and treatment with standard background therapy.

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Decrease in Obesity Among Young US Children Enrolled in Special Supplemental Nutrition Program 2010-2016

MedicalResearch.com Interview with:

Liping Pan, MD, MPH Epidemiologist Division of Nutrition, Physical Activity, and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention

Dr. Pan

Liping Pan, MD, MPH
Epidemiologist
Division of Nutrition, Physical Activity, and Obesity
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention

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

Response: Children with severe obesity face significant health and social challenges. Children with obesity are at higher risk for having other chronic health conditions and diseases, such as asthma, sleep apnea, bone and joint problems, and type 2 diabetes. They also have more risk factors for heart disease such as high blood pressure, impaired glucose tolerance, and high cholesterol than their healthyweight peers. Children with obesity can be bullied and teased more than their healthyweight peers. They are also more likely to suffer from social isolation, depression, and lower self-esteem. Children with obesity are also more likely to have obesity as adults. This can lead to lifelong physical and mental health problems. Adult obesity is associated with a higher risk of type 2 diabetes, heart disease, and many types of cancers. 

Childhood obesity is more common among children from lower-income families, as many lack access to healthy, affordable foods and beverages and opportunities for low-cost physical activity.

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Most Older Adults Have Eyes Examined, But Disparities Remain

MedicalResearch.com Interview with:

Joshua R. Ehrlich, MD, MPH Assistant Professor, Ophthalmology and Visual Sciences Kellogg Eye Center Department of Ophthalmology and Visual Sciences University of Michigan

Dr. Ehrlich

Joshua R. Ehrlich, MD, MPH
Assistant Professor, Ophthalmology and Visual Sciences
Kellogg Eye Center
Department of Ophthalmology and Visual Sciences
University of Michigan 

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

Response: This study came out of data collected as part of the National Poll on Healthy Aging (NPHA). The NPHA is funded by AARP and the Institute for Healthcare Policy and Innovation at the University of Michigan to inform the public, healthcare providers, and policymakers on a variety issues related to health. The vision survey, conducted in March 2018, was just one of many NPHA surveys.

Due to aging of the population, the number of older U.S. adults with blindness and vision impairment is expected to double over the next 30 years. Thus, this study was designed to provide crucial data  on contemporary data on patterns of eye care utilization in older adults.

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