Ulcerative colitis: Fecal Microbiota Transplantation Can Induce Remission

MedicalResearch.com Interview with:

Samuel P. Costello MBBS Inflammatory Bowel Disease Service, Department of Gastroenterology, The Queen Elizabeth Hospital Australia

Dr. Costello

Samuel P. Costello MBBS
Inflammatory Bowel Disease Service,
Department of Gastroenterology
The Queen Elizabeth Hospital
Australia

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

Response: Ulcerative colitis (UC) is an inflammatory bowel disease that has high rates of persistent or relapsing symptoms despite available therapies. Many of these therapies also have the potential for unacceptable side effects including allergy, intolerance, serious infection and malignancy due to long-term immunosuppression. It is for these reasons that new therapies for Ulcerative colitis are required; particularly therapies that target novel pathways and are not immune suppressing.

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Increase Risk of Blistering Disorder with Diabetes Medication

MedicalResearch.com Interview with:

Example of Bullous Pemphigoid Derm NZ image

Example of Bullous Pemphigoid
Derm NZ image

Dong Hyun Kim M.D.
Associate professor
Department of Dermatology
CHA Bundang Medical Center
CHA University School of Medicine

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

Response: As a dermatologist, we see many patients with newly diagnosed with bullous pemphigoid (BP), many of whom have diabetes.

The use of DPP-4 inhibitors is a common treatment for diabetes, we have noted previous case reports that DPP-4 inhibitors may be the cause of BP. For this reason, we started this study.

The most important thing in my article is DPP-4 inhibitors, particularly vildagliptin, may be associated with the development of bullous pemphigoid in male patients with diabetes. We have confirmed these points based on the nationwide, population-based study. It is very meaningful because there have been few studies using large sample sizes so far.

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Vaccine Preventable Infections Common After Pediatric Organ Transplantation

MedicalResearch.com Interview with:

Amy G. Feldman, MD, MSCS Assistant Professor, Pediatrics-Gastroenterology, Hepatology and Nutrition Program Director, Liver Transplant Fellowship Children's Hospital Colorado  University of Colorado Medicine

Dr. Feldman

Amy G. Feldman, MD, MSCS
Assistant Professor, Pediatrics-Gastroenterology, Hepatology and Nutrition
Program Director, Liver Transplant Fellowship
Children’s Hospital Colorado
University of Colorado Medicine

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

Response: Pediatric solid organ transplant recipients are at increased risk for vaccine preventable infections due to life-long immunosuppressive medications.  The objectives of this study were to 1) evaluate in pediatric    solid organ transplant recipients the number of hospitalizations for vaccine-preventable infections in the first five years post-transplantation and 2) determine the associated morbidity, mortality and costs.

In this multicenter cohort study of 6980 children who underwent solid organ transplantation from January 1, 2004, to December 31, 2011, at a center participating in Pediatric Health Information System (PHIS), 15% of individuals had at least 1 hospitalization for a vaccine-preventable infection in the first 5 years after transplant.  Children who received transplants when they were younger than 2 years and recipients of lung, intestine, heart, and multi-visceral organs were at increased risk for hospitalization with a vaccine-preventable infection.  Transplant hospitalizations complicated by a vaccine-preventable infection were $120,498 more expensive (median cost) and were on average 39 days longer than transplant hospitalizations not complicated by vaccine-preventable infections Continue reading

Group B Streptococcus Remain Significant Threat to US Infants

MedicalResearch.com Interview with:

Dr. Nanduri Srinivas Acharya, MBBS, MD, MPH Respiratory Diseases Branch, National Center for Immunizations and Respiratory Diseases Centers for Disease Control and Prevention Roybal Campus Atlanta, GA 30333

Dr. Nanduri

Dr. Srinivas Acharya Nanduri, MBBS, MD, MPH
Respiratory Diseases Branch, National Center for Immunizations and Respiratory Diseases
Centers for Disease Control and Prevention
Roybal Campus
Atlanta, GA 3033

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

Response: Group B Streptococcus (GBS) is a leading cause of serious illness such as meningitis and sepsis in infants. Among infants, there are two main types of GBS disease. Early-onset GBS disease occurs during the first week of life and late-onset GBS disease occurs from the first week through three months of life. Rates of early-onset disease in the United States have decreased significantly since the 1990s through widespread implementation of intrapartum antibiotic prophylaxis (IAP) guidelines. However, IAP does not prevent late-onset disease. Maternal immunization represents a nonantibiotic strategy to prevent both early and late-onset disease. Multivalent polysaccharide-protein conjugate vaccines are under development against GBS capsular types, with candidate vaccines in phase I and II trials.

Active Bacterial Core surveillance (ABCs) conducts active surveillance for early and late-onset GBS disease among infants in select counties of 10 states, covering about 10% of live births across the United States. We analyzed data from early and late-onset GBS cases identified from ABCs between 2006 and 2015 to describe their epidemiology, incidence trends, and associated strain characteristics. Continue reading

Reporters Covering Drugs Should Include 1-800-662-HELP In Their Stories

MedicalResearch.com Interview with:

Dr-John W. Ayers

Dr. Ayers

John W. Ayers, PhD MA
Division of Infectious Diseases and Global Public Health
Department of Medicine, University of California
San Diego, La Jolla

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

Response: The Substance Abuse and Mental Health Services Administration national helpline (1-800-662-HELP) is the only free, federally managed and endorsed US drug treatment referral service, helping callers find the best local services that match their needs. Are millions suffering simply because they are not aware that lifesaving help is a phone call away?

In our new study, published in JAMA Internal Medicine, Mark Dredze, Alicia Nobles and I delved into Americans’ engagement with 1-800-662-HELP following singer Demi Lovato’s July 24, 2018 hospitalization for a reported overdose that on-the-scene investigators originally linked to heroin. Lovato has since recovered.

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Midurethral Sling Complications May Be Associated with Psychological Stress, esp in Young Women

MedicalResearch.com Interview with:

Blayne Welk MD, MSc, FRCSC Associate Professor of Surgery St. Joseph's Hospital Western University

Dr. Welk

Blayne Welk MD, MSc, FRCSC
Associate Professor of Surgery
St. Joseph’s Hospital
Western University

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

Response: I found that when I was referred women with midurethral sling complications, they were often quite emotional and described a significant period of time when they struggled with the complications before they were referred to someone to assess them.

The study looked at the rate of depression and self-harm behavior of women who had surgery for midurethral sling complications compared to women who did not have midurethral sling complications.

I found that there was an increased risk of both of these outcomes among women who had surgery for complications, however this risk was primarily present in younger women.

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Diabetes: Study Find Statins Protect Against Vision Loss

MedicalResearch.com Interview with:

Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. Illustration depicting diabetic retinopathy

Illustration depicting diabetic retinopathy

Eugene Yu-Chuan Kang, MD.
House Staff,
Department of Ophthalmology
Chang Gung Memorial Hospital
Chang Gung University, School of Medicine

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

 

Response: More and more patients suffered from diabetes mellitus (DM) around the world, as well diabetic complications such as diabetic retinopathy (DR). DR is one of the major causes of blindness in working-age adults. In addition to the cost of treatment for patients with advanced DR, loss of visual function also yields a great burden to the family and society. For advanced DR, surgical interventions such as retinal laser, intravitreal injection, and vitrectomy are needed. However, those surgical interventions for severe DR can only retard or stop disease progression. If DR can be prevented or slowed by medical treatments, the burden of medical costs for treating severe DR may be decreased.

Statin, an HMG-CoA reductase inhibitor, was discussed frequently in the recent years. Multiple functions of statins besides their lipid lowering effect were discovered. Previous investigations have reported that statin therapy could reduce mortality rate and decrease risk of cardiovascular diseases.

In our study, we wanted to figure out if statin therapy may have any association between diabetic retinopathy.  Continue reading

Smoking Highlights Health Disparities Among US Cities

MedicalResearch.com Interview with:

Eric Leas PhD, MPH Stanford Prevention Research Center University of California, San Diego

Dr. Leas

Eric Leas PhD, MPH
Stanford Prevention Research Center
University of California, San Diego

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

Response: Recent research has demonstrated the importance that neighborhood context has on life opportunity, health and well-being that can perpetuate across generations. A strongly defining factor that leads to differences in health outcomes across neighborhoods, such as differences in chronic disease, is the concurrent-uneven distribution of modifiable risk factors for chronic disease.

The main goal of our study was to characterize inequities in smoking, the leading risk factor for chronic disease, between neighborhoods in America’s 500 largest cities. To accomplish this aim we used first-of-its-kind data generated from the 500 Cities Project—a collaboration between Robert Wood Johnson Foundation and the US Centers for Disease Control and Prevention—representing the largest effort to provide small-area estimates of modifiable risk factors for chronic disease.

We found that inequities in smoking prevalence are greater within cities than between cities, are highest in the nation’s capital, and are linked to inequities in chronic disease outcomes. We also found that inequities in smoking were associated to inequities in neighborhood characteristics, including race, median household income and the number of tobacco retailers. 

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More Nurse Practitioners in Rural Areas Help Offset Primary Care Shortage

MedicalResearch.com Interview with:

Ying Xue, DNSc, RN Associate Professor University of Rochester School of Nursing Rochester NY 14642

Dr. Ying Xue

Ying Xue, DNSc, RN
Associate Professor
University of Rochester School of Nursing
Rochester NY 14642

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

Response: Shortages of primary care physicians have been a national concern, and forecasts project worsening trends in the future.1 The shortfall of primary care physicians is particularly severe in rural and other underserved communities, and some evidence indicates that the shortage of primary care physicians is due to maldistribution rather than insufficient supply.2

Nurse practitioners (NPs) constitute the largest and fastest growing group of non-physician primary care providers. The Health Resources and Services Administration (HRSA) estimated that the number of primary care NPs will grow 93% from 2013 to 2025, and a projected shortage of 23,640 full-time equivalent primary care physicians in 2025 could be effectively mitigated with better utilization of NPs and physician assistants.1

As the primary care physician shortage persists, examination of trends in the distribution of primary care NP supply, particularly in relation to populations most in need, will inform strategies to strengthen primary care capacity. However, such evidence is limited, particularly in combination with physician workforce trends. We thus characterized the temporal trends in the distribution of primary care NPs in low-income and rural areas compared with the distribution of primary care physicians. Continue reading

Marketers Spend At Least Six Times FDA Budget on Promotion of Medical Services

MedicalResearch.com Interview with:
Steven Woloshin, MD, MS Professor Co-director of the Center for Medicine and Media The Dartmouth InstituteSteven Woloshin, MD, MS
Professor
Co-director of the Center for Medicine and Media
The Dartmouth Institute

MedicalResearch.com: What is the background for this study? What are the main findings? What influence does medical marketing have on medical care and drug prices?

Response: There are published studies looking at promotional spending mostly for drugs (DTC and professional).  This paper is unique because it is such a broad look including not just drugs but also marketing of disease (in “awareness campaigns”), health services and laboratory tests.

What is new here is the size and scope of marketing.  For context, $29.9 billion spent on promoting prescription drugs, disease awareness campaigns, health services, and laboratory tests corresponds approximately to $1000 per American.    For context, FDA’s total budget is around $5 billion – and NIH’s total budget is about $30 billion.

This figure is up from $17.7 billion in 1997, with the most rapid increase in DTC promotion of prescription drugs and health services.   Pharmaceutical marketing to professionals (detailing visits and samples) accounted for most spending and remained high despite policies to limit industry influence.

$30 billion is of an underestimate (egg, we did not include monies spent on professional marketing (detailing) of laboratory tests, health services or devices, the value of drug coupons/discounts/rebates, company marketing budgets, lobbying or campaign contributions).

Further it is just the tip of the iceberg – marketing works so promotional spending is an important driver of why medical care is so expensive:  it leads to more – and more expensive – tests and treatments.

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Parental Drinking Linked to Anxiety and Depression in Children

MedicalResearch.com Interview with:

Dr. Ingunn Olea Lund, PhD The Norwegian Institute of Public Health Oslo, Norway

Dr. Ingunn Olea Lund

Dr. Ingunn Olea Lund, PhD
The Norwegian Institute of Public Health
Oslo, Norway

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

Response: There are significant amounts of research on children of parents with alcohol use disorders – where the children are shown to be at risk of several adverse outcomes, including mental disorders, substance use disorders, suicide, impaired school performance, and employment problems. There is very little previous research on how other, more normal levels of parental drinking may influence child outcomes, such as mental health. This is a grave oversight, as there are vastly more parents with normal drinking patterns than there are parents who suffer from an alcohol use disorder. This means that there are potentially a lot more cases of adverse effect for children, and the number of children at risk may be higher than previously assumed.

In addition to parents’ alcohol use, several other risk factors in the family that may affect child mental health outcomes, such as parents’ mental health and socio-economic status. Researchers have tended to look at these risk factors separately, but as these risks tend to co-occur, it may be more informative to consider them together.

To our knowledge, this is the first study that examines possible harm from normal levels of parental drinking, alone or in combination with other parental risk factors, on children’s anxiety and depression.

The sample consists of more than 8700 triads: children and both their parents. We combined information from three health registries with survey data where both adolescents and their parents provided information about health and social conditions. The health registers include information about the children ‘s actual contact with the health care system; we used information about whether children received diagnoses and/or treatment for anxiety and/or depression.

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Lumbar Spinal Stenosis: Non-Surgical Options Compared

MedicalResearch.com Interview with:

Dr. Michael Schneider DC, PhD Associate Professor School of Health and Rehabilitation Sciences  University of Pittsburgh

Dr. Schneider

Dr. Michael Schneider DC, PhD
Associate Professor
School of Health and Rehabilitation Sciences
University of Pittsburgh

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

Response: Lumbar spinal stenosis (LSS) is one of the fastest growing problems in the country due to its aging population. One third of Medicare users have the condition, and it is the number one reason for spine surgery in this population. Existing research evaluates the benefits of nonsurgical treatment options compared to surgery, but there was no existing research that compared the available nonsurgical options to each other to determine the best course of treatment for each patient.

We studied three nonsurgical treatments for LSS: medical management with medications and/or epidural injections, individualized care with a physical therapist or chiropractor, and group exercise. We assessed each of these treatment methods with a questionnaire, a walking distance test, and a physical activity monitor. 

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WHO: Profits Outweigh R&D Costs of New Cancer Drugs

MedicalResearch.com Interview with:

Kiu Tay-Teo, PhD World Health Organization Geneva, Switzerland

Dr. Kiu Tay-Teo

Kiu Tay-Teo, PhD
World Health Organization
Geneva, Switzerland

MedicalResearch.com: What are the main findings?

Response: High costs and high risks of R&D for drugs have been presented to justify high drug prices, especially for cancer drugs. However, it is unclear whether prices are in fact justifiable compared to the overall return on R&D investment.

In this paper, we systematically compared incomes from the sales of cancer drugs with the R&D costs. We quantified the incomes generated from the sales of 99 cancer drugs approved by FDA from 1989–2017. This was based on sales figures reported in the originator companies’ annual financial reports, and where necessary, estimates deduced from the reported figures. The sales incomes were net of rebates and discounts, but without accounting for expenses and taxes. For the R&D costs of bringing one new cancer drug to the market, the literature reported a typical costs of between $219 million and $2.9 billion, after accounting for the costs of failed products that were investigated but not marketed and the opportunity costs. For the main analysis, we used a median cost of $794 million, as reported in the literature. To be clear, this analysis did not estimate profit return because we do not have information about the costs and year-to-year variations in costs (i.e. expenses and taxes) specific to cancer drugs.

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Depression Rates Climb with Hearing Loss

MedicalResearch.com Interview with:

Justin S. Golub, MD, MS Assistant Professor Otology, Neurotology, and Skull Base Surgery Department of Otolaryngology-Head and Neck Surgery Columbia University Vagelos College of Physicians and Surgeons NewYork-Presbyterian/Columbia University Irving Medical Center

Dr. Golub

Justin S. Golub, MD, MS
Assistant Professor
Otology, Neurotology, and Skull Base Surgery
Department of Otolaryngology-Head and Neck Surgery
Columbia University Vagelos College of Physicians and Surgeons
NewYork-Presbyterian/Columbia University Irving Medical Center

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

Response: Age-related hearing loss is extremely common, yet few people do anything about it. We studied a population of over 5,000 individuals and found that hearing loss was related to feelings of depression. The worse the hearing loss, the worse the symptoms of depression. Even people with just mild hearing loss had nearly two times the odds of depressive symptoms compared to normal hearing people. Among people with moderate hearing loss, the odds of depressive symptoms were four times as high. These statistics take into account various factors that can cause both hearing loss and depression, such as age and demographic background.  Continue reading

NUEDEXTA® (Dextromethorphan and Quinidine) Studied for ALS and MS but Primarily Use in Dementia

MedicalResearch.com Interview with:

Michael Fralick, MD, FRCPC, SM, PhD (Cand) Clinical Associate, General Internal Medicine, St Michael’s Hospital Phillipson Scholar, Clinician Scientist Program, University of Toronto  PhD Candidate, IHPME, University of Toronto Affiliated Faculty, Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital, Harvard University

Dr. Fralick

Michael Fralick, MD, FRCPC, SM, PhD (Cand)
Clinical Associate, General Internal Medicine
St Michael’s Hospital
Phillipson Scholar, Clinician Scientist Program, University of Toronto
PhD Candidate, IHPME, University of Toronto
Affiliated Faculty, Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics
Brigham and Women’s Hospital, Harvard University

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

Response: This medication is a pill that combines two ingredients: dextromethorphan (the active ingredient in cough syrup) and quinidine (used to increase the concentration of dextromethorphan). The medication was primarily studied and evaluated in patients with amyotrophic lateral sclerosis (ALS)   or (multiple sclerosis) MS, but anecdotal evidence suggested it was being prescribed to patients with dementia. We used data from two nationwide healthcare databases to understand how the medication was being used in routine care.

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Teen E-Cigarette Use Drives Flavored Tobacco Sales

MedicalResearch.com Interview with:

Dr. Hongying Dai, PhD Associate Professor at the College of Public Health University of Nebraska Medical Center.

Dr. Dai

Dr. Hongying Dai, PhD
Associate Professor at the College of Public Health
University of Nebraska Medical Center.

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

Response: The 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA) banned cigarettes with characterizing flavors (e.g., candy, fruit, clove) except menthol. However, there are no restrictions on the marketing and sales of flavored non-cigarette tobacco products. This has led to a proliferation of flavored tobacco products in the marketplace. Flavoring has become one of the leading reasons for current tobacco use among youth. It is reported that 81% of e-cigarette users, 79% of hookah users, 74% of cigar users, 69% of smokeless tobacco users, and 67% of snus users attributed the availability of appealing flavors for their tobacco use in 2013–2014 among teenagers aged 12 to 17 years. In November 2018, the FDA proposed new restrictions on flavored tobacco products.

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Disaster-Related Media Exposure Can Heighten Post-Storm Stress

MedicalResearch.com Interview with:

Rebecca R. Thompson, Ph.D. Postdoctoral Scholar Department of Psychological Science University of California, Irvine

Dr. Thompson

Rebecca R. Thompson, Ph.D.
Postdoctoral Scholar
Department of Psychological Science
University of California, Irvine

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

Response: Our research team has been interested in how people respond to the repeated threat of disaster exposure for many years. We recently published a review of the literature on evacuation from natural disasters, and one of our main findings was that there have been no studies that include assessments of individuals’ intentions, perceptions, and psychological states assessed prior to an approaching storm’s landfall – all prior research has been retrospective, and recall is undoubtedly biased and unreliable.  Our goal in undertaking this study was to fill this hole in the literature. We sought to assess individuals’ responses to Hurricane Irma in the days leading up to and immediately after its landfall in the State of Florida.

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Comparison of Local Public Health Departments Highlights Social Inequities

MedicalResearch.com Interview with:

Megan Wallace, DrPH Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore, Maryland

Dr. Wallace

Megan Wallace, DrPH
Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland

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

Response: Local health departments are often evaluated on a nationwide or statewide basis, however, given diversity among counties that exists even at the state level, we felt there might be a better way to group health departments for evaluation.

In this study, we created county-level clusters using local characteristics most associated with the outcomes of interest, which were smoking, motor vehicle crash deaths, and obesity. We then compared county-level percentile rankings for the outcomes within sociodemographic peer clusters vs nationwide rankings. We identified 8 groups of counties with similar local characteristics.

Percentile ranks for the outcomes of interest often differed when counties were compared within their peer groups in comparison with a nationwide scale.  Continue reading

Autistic Adults Also Display Non-Social Cognitive Deficits

MedicalResearch.com Interview with:

Tjasa Velikonja, PhD Department of Psychiatry The Seaver Autism Center for Research and Treatment Icahn School of Medicine at Mount Sinai New York, New York

Dr. Velikonja

Tjasa Velikonja, PhD
Department of Psychiatry
The Seaver Autism Center for Research and Treatment
Icahn School of Medicine at Mount Sinai
New York, New York

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

Response: Autism is a lifelong condition, and challenges associated with autism persist from childhood into adulthood. Despite this, research and treatment have been largely dedicated to children. Because of that, we had very little understanding of what areas – what cognitive domains – are most severely impacted in adults with autism. Importantly, the lack of such information also limits treatment development in this area.

What is known already is that adults with autism display deficits in social cognition (which refers to the role that cognitive processes play in our social interactions). Although our meta-analysis supported these theories, it also highlighted several other challenges in cognitive processing, such as deficits in processing speed and verbal learning and memory. And these impairments were observed in adults with autism without an overall intellectual disability.

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Can New Heart Failure Patients Drink Alcohol?

MedicalResearch.com Interview with:

David L. Brown, MD, FACC Professor of Medicine Cardiovascular Division Washington University School of Medicine St. Louis, MO 63110

Dr. Brown

David L. Brown, MD, FACC
Professor of Medicine
Cardiovascular Division
Washington University School of Medicine
St. Louis, MO 63110

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

Response: The genesis of this study was a patient asking me if he could continue to have a nightly cocktail or two after he was hospitalized with the new diagnosis of heart failure.

The main findings are that moderate drinking after the diagnosis of heart failure in older adults is probably safe and is associated with longer survival. These types of studies can not prove a causal relationship between alcohol consumption and survival. 

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Family Characteristics Linked to Aggressive Behaviors in Boys and Girls

MedicalResearch.com Interview with:

Dr. Richard E. Tremblay, PhD, Professor Department of Pediatrics and Department of Psychology University of Montreal, Montreal, Quebec, Canada School of Public Health, University College Dublin, Dublin, Ireland

Dr. Tremblay

Dr. Richard E. Tremblay, PhD, Professor
Department of Pediatrics and Department of Psychology
University of Montreal, Montreal, Quebec, Canada
School of Public Health, University College Dublin, Dublin, Ireland

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

Response: Adolescent who have frequently use physical aggression are at high risk of school failure, criminal behavior, as well as physical and mental health problems.

A major limit to preventive interventions is our ability to trace the developmental trajectories of physical aggression from infancy to adolescence using a uniform source of information.

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Cancers Attributable to Obesity Vary by State

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.
Atlanta, GA 30303

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

Response: Despite variations in excess body weight (EBW) prevalence among states in the United States, there was little information on the proportion of incident cancers attributable to EBW (or population attributable fraction, PAF) by state. This information would be useful to help states set priorities for cancer control initiatives.

In this paper, we estimated the PAF and number of incident cancer cases attributable to EBW by sex in all 50 states and the District of Columbia using representative exposure and cancer occurrence data. To provide more accurate estimates, we adjusted state-level data on body mass index (BMI) based on self-reported weight and height from the Behavioral Risk Factor Surveillance System by sex, age group, race/ethnicity, and education level (162 strata) using BMI values from the National Health and Nutrition Examination Survey, a nationally representative survey with objectively-measured height and weight.

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Coordinated Care Program For Dementia Patients Reduced Need For Nursing Home Placement

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

Dr. Jennings

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. Continue reading

Emergency-Only Dialysis For Undocumented Immigrants Costs More Money and Lives

MedicalResearch.com Interview with:

Oanh Kieu Nguyen, MD, MA Assistant Professor Division of Hospital Medicine Zuckerberg San Francisco General Hospital UCSF

Dr. Nguyen

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.  Continue reading

No Evidence to Support the “Hispanic Paradox” of Cardiovascular Disease

MedicalResearch.com Interview with:

Fatima Rodriguez, MD, MPH, FACC Assistant Professor Cardiovascular Medicine Stanford University School of Medicine

Dr. Rodriguez

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.

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