Aging, Author Interviews, Cannabis, Geriatrics, JAMA, NYU / 24.02.2020

MedicalResearch.com Interview with: Benjamin H. Han, MD MPH Assistant Professor Division of Geriatric Medicine and Palliative Care New York University School of Medicine MedicalResearch.com: What is the background for this study? Response: In the past, the prevalence of cannabis use (both for recreational and for medicinal purposes) was very low among adults age 65 and older. As a reference, the national prevalence rate of past-year cannabis use among adults age 65 and older in 2006-2007 was 0.4%, it has increased dramatically since then. (more…)
Author Interviews, Education, Gender Differences, JAMA, Race/Ethnic Diversity, Yale / 24.02.2020

MedicalResearch.com Interview with: Katherine A. Hill, BA, BS Yale School of Medicine New Haven, Connecticut MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that mistreatment is a common and damaging experience for medical students. However, there is little research on whether the prevalence of medical student mistreatment varies by demographic factors such as student sex, race/ethnicity, and sexual orientation.  (more…)
Author Interviews, Cancer Research, Cost of Health Care, JAMA, University of Pennsylvania / 20.02.2020

MedicalResearch.com Interview with: Samuel Takvorian, MD, MS Instructor in the Division of Hematology and Oncology LDI Associate Professor University of Pennsylvania Perelman School of Medicine MedicalResearch.com: What is the background for this study? Response: The Affordable Care Act’s Medicaid expansions have been associated with improved access to care, affordability, and for certain surgical and medical conditions, health outcomes. However, studies have also suggested unintended consequences such as lengthened wait times, and there is continued debate about the overall impact of the expansions. (more…)
Author Interviews, Genetic Research, Heart Disease, Imperial College, JAMA / 19.02.2020

MedicalResearch.com Interview with: Dr. Ioanna Tzoulaki Imperial College London MedicalResearch.com: What is the background for this study? Response: Considerable progress has been made in identifying genetic variants that are associated with heart disease. We aimed to investigate whether genetic information can be used to assess the risk of individuals developing heart disease in the future and whether genetic tests can improve current risk assessment strategies which are based on easy to measure factors such as age, sex, smoking status, cholesterol levels, blood pressure and presence of type 2 diabetes. (more…)
Author Interviews, Blood Pressure - Hypertension, Columbia, Heart Disease, JAMA / 17.02.2020

MedicalResearch.com Interview with: George Hripcsak, MD, MS Vivian Beaumont Allen Professor of Biomedical Informatics Chair, Department of Biomedical Informatics Columbia University Director, Medical Informatics Services NewYork-Presbyterian Hospital/Columbia MedicalResearch.com: What is the background for this study? Response: Diuretics are considered among the best drugs to treat hypertension, but there are no randomized studies to tell us which diuretic is best. Hydrochlorothiazide is the most frequently used diuretic for hypertension, but another drug, chlorthalidone, is gaining favor, with the most recent US hypertension guideline expressing a preference for it. Chlorthalidone is known to be longer acting and therefore perhaps more effective. Other (non-randomized) studies have been inconsistent, and some of them imply that chlorthalidone may be more effective. But other studies have shown that chlorthalidone may have more side effects. (more…)
Author Interviews, Brigham & Women's - Harvard, Hearing Loss / 14.02.2020

MedicalResearch.com Interview with: Aravindakshan Parthasarathy, PhD Researcher, Massachusetts Eye and Ear Instructor in Otolaryngology–Head and Neck Surgery Harvard Medical School  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Hidden Hearing Loss? Response: Our ears were not designed for the society our brains created. The World Health Organization estimates that 1 billion young adults are at risk for hearing loss due to prolonged exposure to excessive environmental noise. Anatomical analysis of human ears has shown that half of the nerve fibers connecting the ear to the brain have degenerated by the time we reach 40 years of age. Many of us experience the first symptoms of hearing loss as a difficulty following conversations in crowded places such as restaurants. Hidden hearing loss is an umbrella term used to describe such hearing difficulties experienced by people who show no abnormalities on any of the current tests of hearing used in the clinic. Approximately 10% of visitors to our hospital hearing clinic fit this profile, arriving with a primary complaint of poor hearing but being sent home with a clean bill of hearing health.  (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, Gender Differences, JAMA, Melanoma / 12.02.2020

MedicalResearch.com Interview with: Arash Mostaghimi, MD, MPA, MPH Director, Inpatient Dermatology , Brigham and Women's Hospital Instructor, Harvard Medical School Department of Dermatology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Smaller studies have demonstrated increased risk for skin cancer among gay men.  Prior to this study this data had not been confirmed in a nationally representative database. (more…)
Aging, Author Interviews, Cost of Health Care, JAMA, University of Michigan / 10.02.2020

MedicalResearch.com Interview with: Renuka Tipirneni, MD, MSc, FACP Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine Divisions of General Medicine and Hospital Medicine and Institute for Healthcare Policy & Innovation Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? Response: While U.S. adults age 50-64 previously had more limited options for health insurance before Medicare at age 65, the Affordable Care Act expanded the number of options, including Marketplace plans (e.g., through HealthCare.gov) and Medicaid. This expanded set of options may complicate decisions about health insurance near retirement. In addition, several policy challenges to the Affordable Care Act may add uncertainty to the decision-making process. (more…)
Asthma, Author Interviews, Brigham & Women's - Harvard, NEJM, Pediatrics, Vitamin D / 10.02.2020

MedicalResearch.com Interview with: Augusto A. Litonjua, M.D., M.P.H. Professor - Department of Pediatrics, Pulmonology Interim Chief - Department of Medicine , Pulmonary Diseases and Critical Care Professor - Department of Medicine , Pulmonary Diseases and Critical Care University of Rochester MedicalResearch.com: What is the background for this study? Response: Vitamin D deficiency and insufficiency is prevalent worldwide. Prior observational studies have shown that low vitamin D levels have been associated with the development of asthma. Animal studies have reported that antenatal vitamin D is important for lung development in utero. Thus, we conducted a randomized, double-blind, controlled trial of vitamin D supplementation in pregnant women to see if we could prevent the development of asthma and wheezing illnesses in young children. The initial report of the trial results showed that children born to mothers in the vitamin D supplementation arm had lower risks for developing either asthma or recurrent wheezing episodes over the first 3 years, but this was not statistically significant (p=0.051)(Litonjua et al. JAMA 2016). (more…)
AHA Journals, Author Interviews, Heart Disease, Menopause, Race/Ethnic Diversity, University of Pittsburgh / 05.02.2020

MedicalResearch.com Interview with: Samar R. El Khoudary, M.D., M.P.H. Associate Professor of Epidemiology and Saad Samargandy, M.P.H. Ph.D. Student University of Pittsburgh Graduate School of Public Health MedicalResearch.com: What is the background for this study? Response: Research findings suggest that women experience adverse changes in multiple clinical measures of their cardiovascular health during the menopause transition period. We were interested in evaluating the timing of critical changes in arterial stiffness and investigating potential racial differences in how arterial stiffness progresses during the menopause transition. Arterial stiffness refers to the elasticity of arteries and it measures the rate at which blood flows through arteries. Stiffer arteries can lead to dysfunction in how well the heart pumps and moves blood, and damage to the heart, kidneys and other organs. We used a subset of data from SWAN Heart, an ancillary study that enrolled women from Pittsburgh and Chicago between 2001 and 2003 and included two examinations of early markers of cardiovascular health over time. Ultimately, 339 women were included in this study, 36% black and the rest white. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, McGill, Neurology, Technology / 28.01.2020

MedicalResearch.com Interview with: Yasser Iturria-Medina PhD Assistant Professor, Department of Neurology and Neurosurgery Associate member of the Ludmer Centre for Neuroinformatics and Mental Health McConnell Brain Imaging Centre McGill University MedicalResearch.com: What is the background for this study? Response: As background, two main points:
  • Almost all molecular (gene expression) analyses performed in neurodegeneration are based on snapshots data, taking at one or a few time points covering the disease's large evolution. Because neurodegenerative diseases take decades to develop, until now we didn't have a dynamical characterization of these diseases. Our study tries to overcome such limitation, proposing a data-driven methodology to study long term dynamical changes associated to disease.
Also, we still lacked robust minimally invasive and low-cost biomarkers of individual neuropathological progression. Our method is able to offer both in-vivo and post-mortem disease staging highly predictive of neuropathological and clinical alterations. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Gout / 28.01.2020

MedicalResearch.com Interview with: Stephen P. Juraschek, MD, PhD Assistant Professor, Harvard Medical School Beth Israel Deaconess Medical Center Division of General Medicine, Section for Research Boston, MA  02215 MedicalResearch.com: What is the background for this study? Response: Gout is a common complication of blood pressure treatment. Furthermore, 75% of adults with gout have hypertension. There are several classes of medications uses to treat hypertension. While prior studies have reported that calcium channel blockers like amlodipine lower uric acid, its effects on gout risk compared to other common first-line antihypertensive agents are unknown.  (more…)
Author Interviews, Dartmouth, JAMA, Pharmaceutical Companies, Primary Care / 27.01.2020

MedicalResearch.com Interview with: Steven Woloshin, MD, MS Professor of Medicine and Community and Family Medicine Professor, The Dartmouth Institute for Health Policy and Clinical Practice MedicalResearch.com: What is the background for this study? Response: Industry spends more on detailing visits and free samples than any other form of prescription drug marketing.  There is good evidence that these activities can lead to more use of expensive new drugs over equally effective cheaper options.  Given these concerns there have been efforts by some hospitalls and practices to restrict these forms of marketing. We asked physicians in group practices delivering primary care about how often pharmaceutical reps visit their practice and whether they have a free sample closet.  (more…)
Author Interviews, Education, Gender Differences, Neurology, UC Davis / 27.01.2020

MedicalResearch.com Interview with: Allison Brashear, M.D., M.B.A. Dean, UC Davis School of Medicine MedicalResearch.com: What is the background for this study? Why is the demand for neurology services and neurologists increasing?  Response: The American Academy of Neurology estimates that by 2025 the number of neurologists in practice will increase to 18,060 but some 3,400 more will be needed to meet the demand for their services. The 58% increase in the number of residency positions in the National Resident Matching Program since 2008 also reflects the growing demand. The higher prevalence of neurologic conditions, aging U.S. population and more patients having access to the health care coverage are the major driving forces. (Note: source of NRMP neurology trend data comes from a physician/resident forum posted May 2019 https://forums.studentdoctor.net/threads/growth-trends-in-neurology-residency-positions.1375918/) MedicalResearch.com: Why is neurology included among the less desirable fields of medicine (similar to nephrology, infectious disease, endocrinology etc.) for medical students and residents to pursue?  Why is burnout and dissatisfaction so high? Response: According to the American Academy of Neurology, a minority of medical students choose to train in neurology each year, with approximately 3.1% matching into a neurology residency in 2018. The newer generations of neurologists value lifestyle and time off work more than their predecessors. According to a recent American Medical Association survey, neurology tied with critical care as the medical specialty with the highest stress levels and burnout. Too many administrative tasks, too many hours at work, increased computerization of practice and insufficient compensation were among the top causes of burnout. (more…)
Author Interviews, Blood Pressure - Hypertension, Duke, Pediatrics / 22.01.2020

MedicalResearch.com Interview with: Yuichiro Yano MD Assistant Professor in Family Medicine and Community Health Duke University  MedicalResearch.com: What is the background for this study? Response: The blood pressure (BP) guideline in the US recommend using an “average” of multiple BP measurements over time for screening for and management of high BP in young adults. While it is well known that BP varies across visits, that “variability” (i.e., visit-to-visit blood pressure variability) is dismissed as a random fluctuation in the clinical setting. Little is known regarding the clinical relevance of visit-to-visit blood pressure variability over time in young adults. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Nutrition / 22.01.2020

MedicalResearch.com Interview with: Zhilei Shan PhD Postdoctoral fellow on Nutritional Epidemiology Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Long-standing controversies have focused on the health consequences of dietary fat and carbohydrate. Previous evidence has shown that different types of carbohydrates and fats have varying effects on disease risk and health. For example, carbohydrates from refined grains and added sugars may contribute to insulin resistance and other metabolic problems while carbohydrates from whole grains and whole fruits appear to be beneficial. Likewise, replacing saturated fat with unsaturated fat was associated with lower risk of heart disease and mortality. Therefore, it is crucial to incorporate quality and types of carbohydrate and fat when investigating the associations of low-fat and low-carbohydrate diets with mortality. (more…)
Author Interviews, Cannabis, Columbia, Heart Disease, JACC / 21.01.2020

MedicalResearch.com Interview with: Ersilia DeFilippis, MD Second-year cardiology fellow Columbia University Irving Medical Center and NewYork-Presbyterian MedicalResearch.com: What is the background for this study? Response: Marijuana use has been increasing significantly and is the most commonly illicit drug used in the United States. In recent years, more states have been legalizing its use for both recreational and medicinal purposes. We have all seen news reports regarding the rise of vaping-related health hazards. Yet, data are limited regarding the cardiovascular effects of marijuana which is what drove us to explore this topic. (more…)
Author Interviews, Beth Israel Deaconess, Race/Ethnic Diversity / 17.01.2020

MedicalResearch.com Interview with: John Danziger, MD Harvard Medical Faculty Physicians, Nephrology Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: Racial health disparities have long been described, extending even into the highest levels of medical care, namely the Intensive Care Unit (ICU). Accordingly, we wanted to know whether improvements in ICU care seen over the last decade are equally observed in minority and non-minority serving hospitals. (more…)
Author Interviews, Nutrition, Supplements, UCSD / 14.01.2020

MedicalResearch.com Interview with: Kellogg Parsons, MD, MHS Professor of Urology Moores UC San Diego Comprehensive Cancer Center MedicalResearch.com: What is the background for this study? Response: Clinical guidelines for prostate cancer, circulated widely in the public domain, endorse the consumption of diets high in micronutrient-enriched vegetables. Drawing on expert opinion, epidemiological studies, and small preclinical experiments, these recommendations propose that vegetable-enriched diets may decrease cancer progression and death among prostate cancer survivors. However, data from randomized clinical trials focused on actionable clinical endpoints has been lacking. We utilized a specific behavioral intervention, grounded in the field of social psychology, to “nudge” patients with prostate cancer toward healthier food choices. The intervention is telephone-based, like a call center: patient-focused, convenient, and simple. (more…)
Author Interviews, JAMA, Surgical Research, Technology, University of Michigan / 13.01.2020

MedicalResearch.com Interview with: Kyle Sheetz, MD Clinical Year 4 Resident, General Surgery Michigan Medicine MedicalResearch.com: What is the background for this study? Response: There are concerns that robotic surgery is increasing for common surgical procedures with limited evidence and unclear clinical benefit. Prior studies describing the use of robotic surgery relied upon claims or billing data to identify robotic operations from laparoscopic or open ones. This may lead to inaccuracies as claims data may not provide specific codes for robotic operations. (more…)
Author Interviews, Cancer Research, Radiation Therapy, University of Pennsylvania / 09.01.2020

MedicalResearch.com Interview with: Keith A. Cengel, M.D., Ph.D. Associate Professor of Radiation Oncology Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: FLASH radiotherapy involves delivering the treatment dose at a rate that is 1000s of times faster than standard radiotherapy.  Scientists have studied the differential biological effects of various dose rates for dose rates for the past ~80 years, but the unique effects of FLASH dose rates have only been appreciated in the last few years. While the mechanism(s) and applications of FLASH radiotherapy remain an area of active investigation,  t is clear so far that FLASH dose rates can provide similar levels of tumor control with less toxicity to normal tissues when compared to the same dose of radiotherapy delivered at a standard dose rate. (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA, UCLA / 09.01.2020

MedicalResearch.com Interview with: Olujimi A. Ajijola, MD, PhD Neurocardiology Research Center of Excellence Cardiac Arrhythmia Center University of California, Los Angeles MedicalResearch.com: What is the background for this study? Response: It hadn’t been understood why some people with basic heart failure might live longer than others despite receiving the same medications and medical device therapy. Through this research we set out to determine whether a biomarker of the nervous system could help explain the difference. This study revealed a biomarker that can specifically predict which patients with “stable” heart failure have a higher risk of dying within one to three years. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, JAMA, Surgical Research / 08.01.2020

MedicalResearch.com Interview with: Mehra Golshan, MD, MBA Dr. Abdul Mohsen & Sultana Al-Tuwaijri Distinguished Chair Surgical OncologyDirector of Breast Surgical Oncology Fellowship Associate Professor, Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Triple negative breast cancer is an aggressive form of breast cancer that often requires chemotherapy. In this study we provided neoadjuvant chemotherapy with or without a PARP inhibitor and showed that many women who were originally ineligible for breast conservation (lumpectomy) became eligible after treatment. If lumpectomy was tried it was usually successful.  Many more women in the US compared to Europe and Asia chose mastectomy when lumpectomy was an option even when genetics is negative. (more…)
Author Interviews, Fertility, NIH, Supplements / 08.01.2020

MedicalResearch.com Interview with: Enrique Schisterman, Ph.D. Chief, Epidemiology Branch, DIPHR Eunice Kennedy Shriver National Institute of Child Health and Human Development NICHD MedicalResearch.com: What is the background for this study? Response: Small studies indicated that zinc and folic acid supplements for men might improve semen quality as both zinc and folic acid are involved in DNA transcription and have antioxidant functions. But no large-scale randomized trials have been done to assess efficacy, which is important since dietary supplements are largely unregulated, and FDA cannot regulate supplements until after they come to market. Some male fertility-targeted supplements are already among the most commonly sold supplement products, despite the lack of data to guide their use.  (more…)
Accidents & Violence, Author Interviews, Brain Injury, JAMA, Pediatrics, UCSF / 08.01.2020

MedicalResearch.com Interview with: Benjamin N. Breyer MD, MAS, FACS Associate Professor Departments of Urology and Epidemiology and Biostatistics University of California, San Francisco Vice-Chair of Urology Chief of Urology, Zuckerberg San Francisco General Hospital and Trauma Center Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship MedicalResearch.com: What is the background for this study? Response: There has been a large increase in upright scooter usage among adults as a mode of transportation. It's convenient for commuters and may encourage greater use of public transit leading to less car traffic in cities. (more…)
Alzheimer's - Dementia, Author Interviews, Brain Injury, Medical Imaging, UCSF / 06.01.2020

MedicalResearch.com Interview with: William G. Mantyh, MD Clinical Fellow, UCSF Memory and Aging Center Weill Institute for Neurosciences UCSF MedicalResearch.com: What is the background for this study? Response: Similar to Alzheimer’s disease (AD) and other dementing illnesses, Chronic Traumatic Encephalopathy (CTE) is a progressive neurodegenerative condition associated with abnormally folded tau protein in the brain. CTE is thought to be caused by exposure to repetitive head trauma, and recently has been the subject of intense media coverage given the frequency of CTE found in brains of deceased former American professional football players. CTE is almost impossible to confidently diagnose during life as the symptoms are diverse and vary from patient-to-patient. Symptoms can include impairments in memory, multi-tasking, behavioral/mood regulation, and movement. As there are no blood, imaging, or other tests for this disease, one active area of research is developing a test to help doctors diagnose this condition. As tau tangles in CTE are similar in many respects to those in Alzheimer’s disease, there was hope that PET tracers that detect tau in AD might also work in CTE. Flortaucipir (FTP) is probably the most widely used tau tracer in AD. Recent work has reported some signal from FTP-PET in symptomatic former NFL players and other patients at risk for CTE (Stern et al. New Engl Jour Med 2019; Lesman-Segev et al. Neuroimage Clinical 2019). The overall signal was lower than that observed in Alzheimer’s disease, and, in lieu of correlations with post-mortem findings, it was unclear how well FTP binds to tau pathology in CTE. (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, Science / 05.01.2020

MedicalResearch.com Interview with: Dr. D. Branch Moody, MD Principal Investigator Associate Physician, Brigham and Women's Hospital Professor of Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? Is the CD1a molecule found on the skin's Langerhans cells? Response: With increasing industrialization worldwide, people apply cosmetics and other consumer products to the skin, leading to contact dermatitis, which is becoming increasingly common. Immunologists know that T cells participate in dermatitis reactions. However, T cells usually recognize and respond to antigens that are peptides rather than the non-peptide antigens that cause contact dermatitis. (more…)
Author Interviews, Johns Hopkins, NEJM, Weight Research / 02.01.2020

MedicalResearch.com Interview with: Mark P. Mattson, Ph.D. Adjunct Professor of Neuroscience Johns Hopkins University School of Medicine  MedicalResearch.com: What is the background for this study? Response: The usual eating pattern of most people in modern societies is breakfast, lunch, dinner plus a snack(s) every day.   Animals used for most biomedical research – rats and mice – are usually fed ‘ad libitum’ (food is always available for them to eat).    During the past 25 years, myself and the many scientists who trained in my laboratory discovered that when rats or mice are fed intermittently such that they have no food every other day or eat only during a 4-6 hour time period each day, their overall health improves in many ways.  Animals on such intermittent fasting (IF) regimens exhibit signs of slowed aging and they live much longer than those fed ad libitum. The editors of the New England Journal of Medicine invited me and Rafa de Cabo (a former postdoc in my laboratory at the National Institute on Aging) to write this review article for two main reasons.   First, there have been a sufficient number of studies demonstrating the health benefits of IF in humans and knowledge of the underlying mechanisms to justify a review article.  Second, many physicians are being asked about IF by their patients and the physicians are not privy as to if they should recommend IF and how to prescribe specific IF eating patterns and follow-up to increase the likelihood that the patient will be successful in changing their eating pattern.  (more…)