Laypeople Perceive Facelift To Give More Youthful, Healthier Appearance

MedicalResearch.com Interview with:
Lisa E. Ishii, MD, MHS
Associate Professor of Otolaryngology – Head and Neck Surgery
John Hopkins Medicine

Lisa Earnest Ishii, M.D. Associate Professor of Otolaryngology - Head and Neck Surgery Johns Hopkins Medicine

Dr. Ishii

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

Response: There was a gap in our knowledge about what the average lay person thought about the impact of a facelift.  We had information about what experts thought, and some about what patients themselves thought, but nothing about lay people.
Patients who choose to have a facelift are typically concerned about the opinions of:

1) Themselves when they look in the mirror, and

2) Laypeople they encounter socially in society.

Our study showed for the first time that laypeople find people who have had a facelift to appear more attractive, more youthful, healthier and more successful than they were before their facelift.

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Should Teenagers Be Able To Get Oral Contraceptives Over The Counter?

MedicalResearch.com Interview with:

Krishna K. Upadhya, M.D., M.P.H. Division of General Pediatrics & Adolescent Medicine Department of Pediatrics Johns Hopkins University School of Medicine Baltimore, MD 21287

Dr. Upadhya

Krishna K. Upadhya, M.D., M.P.H.
Division of General Pediatrics & Adolescent Medicine
Department of Pediatrics
Johns Hopkins University School of Medicine
Baltimore, MD 21287

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

Response: Our study reviewed medical literature to examine the question of whether minor teens should be treated differently from older women with regard to a future over the counter oral contraceptive product.  Our analysis found that oral contraceptive pills are safe and effective for teens and there is no scientific rationale to restrict access to a future oral contraceptive pill based on age.

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Number of Adults With Hearing Loss Expected To Rise Dramatically

MedicalResearch.com Interview with:
Dr. Adele Gorman PhD
Johns Hopkins Center on Aging & Health
The Johns Hopkins University
Baltimore, Maryland

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

Response: Hearing loss affects many people, especially older adults. We have previously estimated how common hearing loss is across different age groups and how many adults have hearing loss today. However, we did not know the number of people that are expected to have hearing loss in the coming decades. This is important to know in order to appropriately plan for future hearing health care needs. Recently the National Academies of Sciences, Engineering and Medicine highlighted the crucial need to address hearing loss and made recommendations to improve hearing health care services. However, these recommendations should be considered by policy makers in the context of the number of adults with hearing loss in the coming years.

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Leaky Gate Model Connects Intense Itch With Pain

MedicalResearch.com Interview with:

Xinzhong Dong PhD The Solomon H. Snyder Department of Neuroscience and Center for Sensory Biology Howard Hughes Medical Institute Johns Hopkins University School of Medicine Baltimore, MD 21205

Dr. Xinzhong Dong

Xinzhong Dong PhD
The Solomon H. Snyder Department of Neuroscience and Center for Sensory Biology
Howard Hughes Medical Institute
Johns Hopkins University School of Medicine
Baltimore, MD 21205

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

Response: It is a puzzle that troubles the field for many years that how pain and itch, two closely related sensations (once thought as one sensation), are differentiated by the nervous systems. Coding of pain and itch are heatedly debated for decades. The current specificity theory suggests that these two kinds of signals are carried by separate pathways, with some interactions, for example pain can inhibit itch and that explains why we all scratch to inhibit pain. It is true in the periphery (our previous study indicate a small population of neurons in the periphery only codes for itch sensation), but now our study suggests that there could be more crosstalk between these two sensations in the central than we expected.

People might not notice in real life, but in human psychophysical studies, well-isolated experimental environments, when human subjects are given itchy substances, they typically report intense itch sensations accompanied by minor noxious sensations, such as pricking, stinging and burning. Our new leaky gate model suggest in certain circumstances intense itch signals can trigger minor pain sensations, which can explain such phenomenon.

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State Same-Sex Marriage Policies Associated With Reduced Adolescent Suicide Attempts

MedicalResearch.com Interview with:
Julia R.G. Raifman, ScD

Post-doctoral fellow
Johns Hopkins Bloomberg School of Public Health 

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

Response: Suicide is the second leading cause of death among adolescents between the ages of 15 and 24 years old in the United States. Gay, lesbian, and bisexual adolescents have elevated rates of suicide attempts. In our study, we found that 29% of gay, lesbian, and bisexual adolescents reported attempting suicide in the past year relative to 6% of heterosexual adolescents.

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Arriving Late To Appointment Can Shorten Your Visit With The Doctor

MedicalResearch.com Interview with:
Chester G. Chambers, Ph.D.
Director, Enterprise Risk Management Program, Johns Hopkins Carey Business School
Joint Appointment in Anesthesiology and Critical Care Medicine
Maqbool Dada, Ph.D.
Joint Appointment in Anesthesiology and Critical Care Medicine
John Hopkins Medicine
Kayode Ayodele Williams, M.B.A., M.B.B.S., M.D
Medical Director : Blaustein Pain Treatment Center
Associate Professor of Anesthesiology and Critical Care Medicine
John Hopkins Medicine

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

Response: The result is based on a retrospective analysis of three specialty clinics in the Johns Hopkins System: a private practice low-volume clinic with one physician and no residents; a medium volume clinic that used one attending physician for each clinic session and included residents; and a high-volume clinic with multiple attending physicians and several residents.

Our main finding is that physicians adjust face time based on congestion in the clinic, and seem to do this without always knowing they are doing it. Patients who arrive early and whose service begins before their appointment times, tend to get more face-time then other patients. This is similar to other service systems in which first-line providers speed-up when they see long queues at their stations.This is important because most of the prior research in this setting assumed that this never takes place. We verified that it does happen in multiple settings and the changes in processing rates are statistically significant. This means we need to rethink many earlier conclusions about how clinics run.

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When Patients Can’t Choose: Out-of-Network Care Can Be Costly

MedicalResearch.com Interview with:

Ge Bai, PhD, CPA Assistant Professor The Johns Hopkins Carey Business School Washington, DC 20036

Dr. Ge Bai

Ge Bai, PhD, CPA
Assistant Professor
The Johns Hopkins Carey Business School
Washington, DC 20036 

MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The average anesthesiologist, emergency physician, pathologist and radiologist charge more than four times what Medicare pays for similar services, often leaving privately-insured out-of-network patients stuck with surprise medical bills that are much higher than they anticipated.

The average physician charged roughly 2.5 times what Medicare pays for the same service. There are also regional differences in excess charges. Doctors in Wisconsin, for example, have almost twice the markups of doctors in Michigan (3.8 vs. two).

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Physicians Perceive Health Insurance as Barrier to Weight Management Efforts

MedicalResearch.com Interview with:
Ruchi Doshi, MPH
MD Candidate 2017 | Johns Hopkins University School of Medicine

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

Response: Current guidelines recommend that physicians collaborate with non-physician health professionals to deliver weight management care. While several studies have looked at barriers physicians face in providing these services, few studies have looked at the barriers that the non-physician health professionals face. Ultimately, we found that one quarter of these health professionals found insurance coverage to be a current challenge to providing weight management care, and that over half of them felt improved coverage would help facilitate weight loss. These findings were consistent regardless of the income level of the patient populations.

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Cancer Can Mean High Out-of-Pocket Expenses For Seniors With Only Medicare

MedicalResearch.com Interview with:

Dr. Amol K. Narang, MD Instructor of Radiation Oncology and Molecular Radiation Sciences Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

Dr. Amol  Narang

Dr. Amol K. Narang, MD
Instructor of Radiation Oncology and Molecular Radiation Sciences
Johns Hopkins Sidney Kimmel Comprehensive Cancer Center

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

Response: We know that cancer care is becoming increasingly expensive in the U.S., but the financial impact on patients in the form of out-of-pocket expenses is not well understood, in part because of the lack of data sources that track this information. As such, we used the Health and Retirement study, a national panel study that closely tracks the out-of-pocket medical expenditures of older Americans, to understand the level of financial strain that Medicare patients experience after a new diagnosis of cancer. We further investigated what factors were associated with high financial strain and what type of health services were driving high costs in this population.

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Barriers to Healthful Eating Linked to More Rapid Kidney Function Decline

MedicalResearch.com Interview with:

Deidra C. Crews, MD, ScM, FASN, FACP Associate Professor of Medicine, Division of Nephrology Associate Vice Chair for Diversity and Inclusion, Department of Medicine Director, Doctoral Diversity Program Johns Hopkins University School of Medicine Baltimore MD 21224

Dr. Deidra Crews

Deidra C. Crews, MD, ScM, FASN, FACP
Associate Professor of Medicine, Division of Nephrology
Associate Vice Chair for Diversity and Inclusion, Department of Medicine
Director, Doctoral Diversity Program
Johns Hopkins University School of Medicine
Baltimore MD 21224

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

Response: Studies suggest that dietary patterns influence risk of kidney function decline. Barriers may hinder urban African Americans’ following healthful diets that could mitigate their increased risk of kidney function decline.

In this study, we characterized contextual barriers to healthful eating among urban African Africans with hypertension and examined the association of these barriers to kidney function decline over 1 year. We examined the presence of healthy foods in neighborhood stores of study participants.

We also assessed them for food insecurity (the inability to afford nutritionally adequate and safe foods), directly observed and documented the presence of fruits and vegetables in their homes, and examined their fruit and vegetable intake via questionnaire.

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DASH Diet For Hypertension May Also Lower Uric Acid in Gout Patients

MedicalResearch.com Interview with:

Stephen P. Juraschek, MD, PhD Fellow, Division of General Internal Medicine Johns Hopkins Hospital

Dr. Stephen Juraschek

Stephen P. Juraschek, MD, PhD
Fellow, Division of General Internal Medicine
Johns Hopkins Hospital

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

Response: Diet has long been viewed as an important way to lower uric acid levels to prevent gout attacks; however, there is little evidence about whether a particular dietary pattern might be effective for lowering uric acid. For the first time we show that the DASH diet, an effective diet for lowering blood pressure, it lowers uric acid levels substantially in people with abnormally high uric acid levels.

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Patients With Newly Diagnosed DCIS Breast Cancer May Not Need Their Core Needle Biopsy Tested for Hormone Receptors

MedicalResearch.com Interview with:

Pedram Argani, M.D. Professor of Pathology and Principal consultant of the Breast Pathology Service Johns Hopkins Medicine

Dr. Pedram Argani

Pedram Argani, M.D.
Professor of Pathology and
Principal consultant of the Breast Pathology Service
Johns Hopkins Medicine

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

Response: Most pathology laboratories, at the request if clinicians, automatically (reflexively) test needle core biopsies containing ductal carcinoma in situ (DCIS) for estrogen receptor (ER) and progesterone receptor (PR). The logic for testing DCIS for these hormone receptors is that, for patients who have pure DCIS that is ER positive after surgical excision, treatment with estrogen blockers like Tamoxifen can decrease the recurrence of DCIS by a small amount, though overall survival (which is excellent) is not impacted.

However, there are several factors which suggest that this reflex testing unnecessarily increases costs.
• First, the ER/PR results on core needle biopsy do not impact the next step in therapy; namely, surgical excision.
• Second, a subset of excisions performed for DCIS diagnosed on core needle biopsy will harbor invasive breast carcinoma, which would than need to be retested for ER/PR.
• Third, because ER and PR labeling is often variable in DCIS, negative results for ER/PR in a small core biopsy specimen should logically be repeated in a surgical excision specimen with larger amounts of DICS to be sure that the result is truly negative.
• Fourth, many patients with pure DCIS which is ER/PR positive after surgical excision will decline hormone therapy, so any ER/PR testing of their DCIS is unnecessary.
• Fifth, PR status in DCIS has no independent value.

We reviewed the Johns Hopkins experience with reflex ER/PR testing of DCIS on core needle biopsies over 2 years. We found that reflex core needle biopsy specimen testing unnecessarily increased costs by approximately $140.00 per patient. We found that ER/PR testing in the excision impacted management in only approximately one third of cases, creating an unnecessary increased cost of approximately $440.00 per patient. Extrapolating the increased cost of reflex ER/PR testing of DCIS to the 60,000 new cases of DCIS in the United States each year, reflex core needle biopsy ER/PR testing unnecessarily increased costs by approximately 35 million dollars.

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