Medical Research Centers

12 Mar

Posted at 01:27h in Author Interviews, Brigham & Women's - Harvard, Critical Care - Intensive Care - ICUs, Infections, JAMA
MedicalResearch.com Interview with: [caption id="attachment_47886" align="alignleft" width="125"]Chanu Rhee, MD,MPHAssistant Professor of Population MedicineHarvard Medical School / Harvard Pilgrim Health Care InstituteAssistant Hospital EpidemiologistBrigham and Women’s Hospital Dr. Rhee[/caption] Chanu Rhee, MD,MPH Assistant Professor of Population Medicine Harvard Medical School / Harvard Pilgrim Health Care Institute Assistant Hospital Epidemiologist Brigham and Women’s Hospital  MedicalResearch.com: What is the background for this study? Response: Sepsis is the body’s reaction to a serious infection that results a cascade of inflammation in the body and organ dysfunction, such as low blood pressure, confusion, or failure of the lungs, kidneys, or liver.   Sepsis is a major cause of death, disability, and cost in the U.S. and around the world.  Growing recognition of this problem has led to numerous sepsis performance improvement initiatives in hospitals around the country.  Some of these efforts have also been catalyzed by high-profile tragic cases of missed sepsis leading to death, which may have contributed to a perception that most sepsis deaths are preventable if doctors and hospitals were only better at recognizing it. However, the extent to which sepsis-related deaths might be preventable with better hospital-based care is unknown.  In my own experience as a critical care physician, a lot of sepsis patients we treat are extremely sick and even when they receive timely and optimal medical care, many do not survive.  This led myself and my colleagues to conduct this study to better understand what types of patients are dying from sepsis and how preventable these deaths might be. 

07 Mar

Posted at 12:13h in Author Interviews, Education, Health Care Systems, Outcomes & Safety, University of Pennsylvania
MedicalResearch.com Interview with: [caption id="attachment_47812" align="alignleft" width="179"]Jeffrey H. Silber, MD, PhDDirector, Center for Outcomes ResearchNancy Abramson Wolfson Endowed Chair in Health Services ResearchChildren's Hospital of PhiladelphiaProfessor of Pediatrics, Anesthesiology and Critical CarePerelman School of Medicine, University of PennsylvaniaProfessor of Health Care ManagementWharton School, University of Pennsylvania Dr. Silber[/caption] Jeffrey H. Silber, MD, PhD Director, Center for Outcomes Research Nancy Abramson Wolfson Endowed Chair Health Services Research Children's Hospital of Philadelphia Professor of Pediatrics, Anesthesiology and Critical Care Perelman School of Medicine, University of Pennsylvania Professor of Health Care Management Wharton School, University of Pennsylvania  MedicalResearch.com: What is the background for this study? Response: This was a year-long randomized trial that involved 63 internal medicine residency programs from around the US.  In 2015-2016, about half of the programs were randomized to follow the existing rules about resident duty hours that included restrictions on the lengths of shifts and the rest time required between shifts (the standard arm of the trial) and the other half of the programs didn’t have those shift length or rest period rules (the flexible arm of the trial).  We measured what happened to the patients cared for in those programs (the safety study), and other studies examined how much sleep the residents received, and how alert they were at the end of shifts (the sleep study), and previously we published on the educational outcomes of the interns. To measure the impact on patient outcomes when allowing program directors the ability to use a flexible shift length for their interns, we compared patient outcomes after the flexible regimen went into place to outcomes the year before in the same program. We did the same comparison for the standard arm. Then we compared the difference between these comparisons. Comparing before and after the implementation of the trial within the same program allowed us to be more confident that a particularly strong or weak program, or a program with especially sick or healthy patients, would not throw off the results of the study. The trial was designed to determine, with 95% confidence, if the flexible arm did not do more than 1% worse than the standard arm. If this were true for the flexible arm, we could say the flexible regimen was “non-inferior” to the standard regimen.

06 Mar

Posted at 20:16h in Author Interviews, FDA, JAMA
MedicalResearch.com Interview with: [caption id="attachment_47817" align="alignleft" width="200"]Craig Alexander Garmendia, PhDOffice of Bioresearch Monitoring Operations, Office of Regulatory AffairUS Food and Drug AdministrationMiami, Florida Dr. Garmendia[/caption] Craig Alexander Garmendia, PhD Office of Bioresearch Monitoring Operations Office of Regulatory Affairs US Food and Drug Administration Miami, Florida MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Clinical trials under the U.S. Food and Drug Administration’s (FDA) purview have been shown to suffer from falsified data. While the FDA warns researchers when falsified data are discovered, these data still make their way into medical literature. In this novel study, Dr. Garmendia and colleagues conducted a systematic review to examine the effects of publications containing falsified data on meta-analyses using sensitivity analyses. Almost half of all meta-analyses had conclusions altered by publications containing falsified data, while nearly one-third of all analyses had considerable changes in outcomes.

05 Mar

Posted at 02:03h in AACR, Author Interviews, Biomarkers, MD Anderson
MedicalResearch.com Interview with: [caption id="attachment_47785" align="alignleft" width="200"]Vassiliki Papadimitrakopoulou, MDProfessor of MedicineDepartment of Thoracic/Head and Neck Medical OncologyMD Anderson Cancer Center in Houston Dr. Papadimitrakopoulou[/caption] Vassiliki Papadimitrakopoulou, MD Professor of Medicine Department of Thoracic/Head and Neck Medical Oncology MD Anderson Cancer Center in Houston MedicalResearch.com: What is the background for this study? What are the main findings? Response: 30% of patients with newly diagnosed advanced NSCLC can be treated successfully with targeted therapies, often yielding higher response rates than chemotherapy or immune checkpoint inhibitors. Selecting first-line therapy for patients with NSCLC requires assessment of an expanding list of guideline-recommended genomic biomarkers (EGFR, ALK, ROS1, BRAF, RET, MET amplification and exon 14 skipping, and ERBB2, with NTRK newly added) Standard-of-care (SOC) testing relies on tissue, which is limited by biopsy-related risks, specimen insufficiency, and lab processing duration, which hamper timely optimal treatment selection -          NILE is a large, prospective, multicenter, head-to-head study of SOC tissue-based genomic testing to plasma-based comprehensive cfDNA genomic testing (Guardant360®). For the four biomarkers with FDA approved therapies, up to 34% of patients were tested by SOC tissue testing versus 95% with cfDNA testing. NILE met its primary endpoint - cfDNA performed similar to tissue in the detection of guideline-recommended biomarkers and cfDNA results were delivered significantly faster than SOC tissue testing (median 9 days vs. 15 days).Using cfDNA testing first, 87% of patients with a guideline-recommended biomarker would have been detected, compared to 67% if SOC tissue testing was first.

04 Mar

Posted at 19:41h in Author Interviews, Columbia, Nutrition
MedicalResearch.com Interview with: [caption id="attachment_47779" align="alignleft" width="200"]Sonia Y. Angell, MD MPHDivision of General MedicineDepartment of Medicine, Columbia University Irving Medical CenterNew York, NY   Dr. Angell[/caption] Sonia Y. Angell, MD MPH Division of General Medicine Department of Medicine, Columbia University Irving Medical Center New York, NY   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Trans fatty acid in the diet increases the incidence of coronary heart disease in the population. In 2006, a policy restricting restaurant use of trans fat went into effect in NYC. This study measured the change in trans fatty acid serum concentration among a representative sample of the NYC population between 2004 and 2013-2014, and whether the change varied by frequency of restaurant food dining. Overall, blood trans fatty acid serum concentration went down by 57%. Among people who dined out less than one time a week, it went down 51% and in those who dined out 4 or more times a week, it went down 61.6%.  In fact, in 2013-2014 there was no longer a significant increase in the serum trans fatty acid concentrations among those who ate restaurant foods frequently compared with those who ate out rarely. 

04 Mar

Posted at 19:33h in Author Interviews, Brigham & Women's - Harvard, Health Care Systems, JAMA, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_47775" align="alignleft" width="125"]Mark S. Bauer, M.D.Professor of Psychiatry, EmeritusHarvard Medical SchoolCenter for Healthcare Organization and Implementation Research (CHOIR)VA Boston Healthcare System-152MBoston, MA 02130 Dr. Bauer[/caption] Mark S. Bauer, M.D. Professor of Psychiatry, Emeritus Harvard Medical School Center for Healthcare Organization and Implementation Research VA Boston Healthcare System-152M Boston, MA 02130 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Collaborative Chronic Care Models (CCMs) have extensive evidence for their effectiveness in a wide variety of mental health conditions.  CCMs are frameworks of care that include several or all of the following six elements:  work role redesign for anticipatory, continuous care; self-management support for individuals in treatment; provider decision support; information system support for population-based and measurement-guided care; linkage to community resources; and organization and leadership support. However, evidence for Collaborative Chronic Care Model effectiveness comes almost exclusively from highly structured clinical trials.  Little is known about whether CCMs can be implemented in general clinical practice settings, and the implementation evidence that does exist derives primarily from studies of the CCM used in primary care settings to treat depression. We conducted a randomized, stepped wedge implementation trial using implementation facilitation to establish CCMs in general mental health teams in nine US Department of Veterans Affairs medical centers. We found that establishing Collaborative Chronic Care Models was associated with reduced mental health hospitalization rates and, for individuals with complex clinical presentations, improvements in mental health status.  Additionally, standardized assessment of team clinicians indicated that facilitation improved clinician role clarity and increased focus on team goals.

01 Mar

Posted at 20:45h in Alzheimer's - Dementia, Author Interviews, JAMA, Pharmacology, University of Pittsburgh
MedicalResearch.com Interview with: [caption id="attachment_47508" align="alignleft" width="150"]Alvaro San-Juan-Rodriguez Alvaro San-Juan-Rodriguez[/caption] Alvaro San-Juan-Rodriguez, PharmD Pharmacoeconomics, Outcomes and Pharmacoanalytics Research Fellow Pharmacy and Therapeutics School of Pharmacy University of Pittsburgh MedicalResearch.com: What are the main findings? Response: Currently, there are 4 antidementia drugs approved by the FDA for the treatment of Alzheimer’s disease, including 3 acetylcholinesterase inhibitors (AChEIs)—donepezil, rivastigmine, and galantamine—and the N-methyl-D-aspartic receptor antagonist memantine. On the one hand, evidence about the effect of these drugs at delaying nursing home admission is still sparse and conflicting. On the other, all these antidementia medications have been associated with several cardiovascular side effects, such as bradycardia, ventricular tachycardia, syncope, QT interval prolongation, atrioventricular block or even myocardial infarction. In this study, we aimed to compare time to nursing home admission and time to cardiovascular side effects across all drug therapies available for the treatment of Alzheimer’s disease. In doing so, we used 2006-2014 medical and pharmacy claims data from Medicare Part D beneficiaries with a new diagnosis Alzheimer’s disease who initiated antidementia drug therapy.

24 Feb

Posted at 15:09h in Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Chemotherapy, NEJM
MedicalResearch.com Interview with: [caption id="attachment_47551" align="alignleft" width="135"]Aditya Bardia, MBBS, MPH Director, Precision Medicine, Center for Breast Cancer, Attending Physician, Massachusetts General Hospital Cancer Center Harvard Medical School, Boston, MA 02114 Dr. Bardia[/caption] Aditya Bardia, MBBS, MPH Director, Precision Medicine, Center for Breast Cancer, Attending Physician Massachusetts General Hospital Cancer Center Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: Metastatic triple negative breast cancer is associated with aggressive tumor biology, and tends to affect younger patients and African Amerians. The response rate with standard chemotherapy regimens in patients with pre-treated metastatic TNBC ranges from 10-15%, and median progression-free survival ranges from 3-4 months. The median survival of metastatic TNBC is around 12 months and has not changed in the past 20 years. Thus, treatment of metastatic triple negative breast cancer represents an unmet clinical need.  

24 Feb

Posted at 14:50h in Author Interviews, JAMA, Karolinski Institute, Pharmacology, Schizophrenia
MedicalResearch.com Interview with: [caption id="attachment_47554" align="alignleft" width="200"]Jari Tiihonen, MD, PhD Professor, Department of Clinical Neuroscience Karolinska Institutet Stockholm, Sweden Dr. Tiihonen[/caption] Jari Tiihonen, MD, PhD Professor, Department of Clinical Neuroscience Karolinska Institutet Stockholm, Sweden  MedicalResearch.com: What is the background for this study? Response: The effectiveness of antipsychotic combination therapy in schizophrenia relapse prevention is controversial, and use of multiple agents is generally believed to impair physical well-being. But the evidence for this are weak and antipsychotic polypharmacy is widely used.

24 Feb

Posted at 02:30h in Author Interviews, Exercise - Fitness, Kidney Disease, Nutrition, UT Southwestern
MedicalResearch.com Interview with: [caption id="attachment_34742" align="alignleft" width="132"]Wanpen Vongpatanasin, M.D. Professor of Medicine Norman & Audrey Kaplan Chair in Hypertension Fredric L. Coe Professorship in Nephrolithiasis and Mineral Metabolism Research Director, Hypertension Section, Cardiology Division, UT Southwestern Medical Center Dallas, TX 75390-8586 Dr. Vongpatanasin[/caption] Dr. Wanpen Vongpatanasin, M.D. Professor of Medicine Norman & Audrey Kaplan Chair in Hypertension Fredric L. Coe Professorship in Nephrolithiasis and Mineral Metabolism Research Director, Hypertension Section, Cardiology Division, UT Southwestern Medical Center    MedicalResearch.com: What is the background for this study? Response: Increased sedentary activity is commonly seen in people who regularly consume fast food but previously studies have not identified potential mechanisms beyond increased obesity and lack of motivation. Our study seeks to determine if inorganic phosphate, a commonly used food additives that are present in up to 70% of foods in the American diet, maybe the culprit. These food additives (which may come in the form of monocalcium phosphate, phosphoric acid, or tetrasodium phosphate, etc. are used to make the food taste better and/or last longer. It is found mostly in prepackaged foods, cola drinks, and bakery items (cookies, cake, and bread). This is very different from organic phosphates that are found naturally in many healthful foods, such as fruits and vegetables, which are not not readily absorbed from the GI tract. In the Dallas Heart Study, a multiethnic population-based study, we found that serum phosphate is significantly associated with sedentary time and increased time spent in moderate-to-vigorous physical activity which was measured by wrist actigraphy device. This is not explained by reduce cardiac function as ejection fraction remains normal at higher serum phosphate.

24 Feb

Posted at 00:02h in Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Surgical Research, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_47635" align="alignleft" width="125"]Jagpreet Chhatwal PhDAssistant Professor, Harvard Medical SchoolSenior Scientist, Institute for Technology AssessmentMassachusetts General Hospital Dr. Jagpreet Chhatwal[/caption] Jagpreet Chhatwal PhD Assistant Professor, Harvard Medical School Senior Scientist, Institute for Technology Assessment Massachusetts General Hospital [caption id="attachment_47636" align="alignleft" width="125"]Chin Hur, MDAssociate Professor of MedicineHarvard Medical School Dr. Chin Hur[/caption] Chin Hur, MD Associate Professor of Medicine Harvard Medical School       MedicalResearch.com: What is the background for this study? Response: Nonalcoholic steatohepatitis (NASH), a severe form of nonalcoholic fatty liver disease, is one of the leading causes of liver transplantation. Because of increasing prevalence of obesity in the United States, NASH-related cirrhosis cases are expected to increase in the near future. Unfortunately, there are few pharmacological treatments for NASH, and none with proven long-term benefit. Weight loss can be effective in managing NASH but not many patients can lose the sufficient weight necessary to impact NASH and/or maintain long-term weight loss. In contrast, bariatric surgery can provide long-term weight loss and thus potentially reverse liver damage in cirrhosis. However, bariatric surgery is associated with mortality and morbidity associated with the procedure.

22 Feb

Posted at 00:43h in Author Interviews, Brigham & Women's - Harvard, Cancer Research, Hepatitis - Liver Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_47600" align="alignleft" width="200"]Xuehong Zhang, MD, ScD Assistant Professor in Medicine | Harvard Medical School Associate Epidemiologist | Brigham and Women's Hospital Boston, MA Dr. Xuehong Zhang[/caption] Xuehong Zhang, MD, ScD Assistant Professor in Medicine Harvard Medical School Associate Epidemiologist Brigham and Women's Hospital Boston, MA MedicalResearch.com: What is the background for this study? Response: In the United States., liver cancer incidence is rapidly increasing and over 42,200 new cases were projected to be diagnosed in 2018. The majority of individuals with liver cancer are diagnosed at a late stage, are not eligible for curative therapy, and die within 1 year of diagnosis. Established risk factors for liver cancer are limited to hepatitis B and C virus (HBV/HCV) infections, metabolic disorders, and smoking. Clearly, identification of novel risk factors, particularly those that are modifiable, is urgently needed. Dietary factors have been suspected as important, but only excessive alcohol use and aflatoxin-contaminated foods are considered to be established dietary risk factors for hepatocellular carcinoma (HCC). Consumption of whole grains and dietary fiber, especially cereal fiber, have been associated with lower risk of obesity, type 2 diabetes, and nonalcoholic fatty liver disease, which are known predisposing factors for HCC. We thus hypothesized that long-term intake of whole grains and dietary fiber may lower the risk of developing hepatocellular carcinoma (HCC) and tested this hypothesis using data from two large prospective cohort studies, the Nurses’ Health Study (NHS) and the Health Professionals Follow-up Study (HPFS).

21 Feb

Posted at 02:32h in Author Interviews, Columbia, Depression, JAMA, OBGYNE, USPSTF
MedicalResearch.com Interview with: [caption id="attachment_47579" align="alignleft" width="134"]Dr. Karina Davidson, PhD Professor of Behavioral Medicine (in Medicine and Psychiatry) Executive Director, Center for Behavioral Cardiovascular Health Columbia University Medical Center Dr. Davidson[/caption] Dr. Karina Davidson, PhD Professor of Behavioral Medicine (in Medicine and Psychiatry) Executive Director, Center for Behavioral Cardiovascular Health Columbia University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Perinatal depression, which includes depression that develops during pregnancy or after childbirth, is one of the most common complications of pregnancy and the postpartum period, affecting as many as 1 in 7 pregnant women. The Task Force found that counseling can help those who are at increased risk of developing perinatal depression, and clinicians should provide or refer pregnant and postpartum individuals who are at increased risk to counseling. Clinicians can determine who might be at increased risk of perinatal depression by looking at someone’s history of depression, current depressive symptoms, socioeconomic risk factors, recent intimate partner violence, and other mental-health related factors.

20 Feb

Posted at 12:53h in Author Interviews, McGill, PNAS
MedicalResearch.com Interview with: [caption id="attachment_47561" align="alignleft" width="128"]Ben Gold, a PhD candidate Lab of Robert Zatorre The Neuro (Montreal Neurological Institute and Hospital) McGill University Ben Gold[/caption] Ben Gold, a PhD candidate Lab of Robert Zatorre The Neuro (Montreal Neurological Institute and Hospital) McGill University MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Music is just sound in air, but it carries considerable power. It captivates our brain’s reward system, we devote an enormous amount of time and money to it, and we're just beginning to tap its therapeutic potential. We wanted to explore how something so abstract could have such an impact, and since music is so well suited to establishing and manipulating patterns of sound as it unfolds, we focused on how it manipulates expectations. Previous research has shown that surprises are often the most emotional and pleasurable moments in music listening, but whether and how this engaged the brain's reward system was unclear. So we adapted an experimental protocol designed for studying learning and surprise about more concrete rewards like food or money, and applied it to a musical context during brain imaging. This protocol relies on participants making decisions from which we could infer their expectations, allowing us to estimate how surprised they were by each outcome whenever it occurred. In our case, we asked participants to make choices about colors and directions that were associated with different musical outcomes, but we didn't tell them what those associations were so that they they started with no expectations and learned as they went. We found that our participants could learn about music just like they would learn about how to find food or win money, and that the same neural process was involved. Specifically, we saw that the activity of the nucleus accumbens -- a central hub of the reward system -- reflected both how pleasant and how surprising each musical outcome was: a computation known as a reward prediction error. Across individuals, those who better represented these reward prediction errors in their nucleus accumbens also learned better about the music in the experiment, making more decisions over time to find the music they preferred. 

19 Feb

Posted at 19:04h in Author Interviews, Cost of Health Care, JAMA, Pharmacology, University of Pittsburgh
MedicalResearch.com Interview with: [caption id="attachment_47508" align="alignleft" width="150"]Alvaro San-Juan-Rodriguez Alvaro San-Juan-Rodriguez[/caption] Alvaro San-Juan-Rodriguez, PharmD Pharmacoeconomics, Outcomes and Pharmacoanalytics Research Fellow Pharmacy and Therapeutics School of Pharmacy University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: Before 2009, etanercept (Enbrel®), infliximab (Remicade®), and adalimumab (Humira®) were the only tumor necrosis factor (TNF) inhibitors approved by the FDA for rheumatoid arthritis. Subsequently, 3 therapies gained FDA approval: subcutaneous golimumab (Simponi®) in April 2009, certolizumab pegol (Cimzia®) in May 2009, and intravenous golimumab (Simponi Aria®) in July 2013. All 6 agents are brand-name drugs. Our study aimed to evaluate how the prices of existing TNF inhibitors (Enbrel®, Remicade® and Humira®) changed in response to the market entry of new TNF inhibitors. 

16 Feb

Posted at 01:34h in Author Interviews, Inflammation, JAMA, Kidney Disease, Pain Research, Stanford
MedicalResearch.com Interview with: Alan Nelson, MPAS, PhD Division of Primary Care and Population Health, Department of Medicine Stanford University School of Medicine Stanford, California  MedicalResearch.com: What is the background for this study?   Response: The past research literature has provided relatively little information on the appropriate level of concern regarding non-steroidal anti-inflammatory drugs (NSAIDs) and kidney disease risk among younger, apparently healthy patients. Clinicians are generally most concerned about the effects of these medications on the kidneys among patients with existing renal impairment and persons at risk for it, especially older patients. Given that NSAID use appears to be high and rising in the US, we were interested in developing evidence on this topic in a population of working-age adults.

16 Feb

Posted at 01:20h in Author Interviews, Brigham & Women's - Harvard, Heart Disease, Sleep Disorders
MedicalResearch.com Interview with: [caption id="attachment_47525" align="alignleft" width="225"]Cameron S. McAlpine, Ph.D. Banting Postdoctoral Fellow Center for Systems Biology Massachusetts General Hospital Harvard Medical School Boston, MA, 02114 Dr. McAlpine[/caption] Cameron S. McAlpine, Ph.D. Banting Postdoctoral Fellow Center for Systems Biology Massachusetts General Hospital Harvard Medical School Boston, MA, 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cardiovascular disease is caused by the build up of white blood cells and fat in arteries. We have known for a long time that poor sleep is associated with an increased risk of developing cardiovascular disease. A number of human observational studies have found this correlation. However, the reasons for this correlation have been largely unknown. Our study, performed in mice, provides one possible explanation. We found that when we disturbed the sleep of mice they produced more inflammatory white blood cells. These cells caused larger lesions in their arteries and more advanced cardiovascular disease. We found that his phenomenon is controlled by a hormone produced in the brain that normally suppresses the production of white blood cells. When mice have their sleep disturbed this pathway breakdown causing the increased production of white blood cells.

15 Feb

Posted at 16:22h in Author Interviews, Emory, JAMA, Prostate Cancer, Radiation Therapy
MedicalResearch.com Interview with: [caption id="attachment_47492" align="alignleft" width="200"]Deborah Watkins Bruner RN, PhD, FAAN Senior Vice President of Research Emory University Professor and Robert W. Woodruff Chair in Nursing Nell Hodgson Woodruff School of Nursing Professor, Department of Radiation Oncology Emory University School of Medicine Dr. Bruner[/caption] Deborah Watkins Bruner RN, PhD, FAAN Senior Vice President of Research Emory University Professor and Robert W. Woodruff Chair in Nursing Nell Hodgson Woodruff School of Nursing Professor, Department of Radiation Oncology Emory University School of Medicine MedicalResearch.com: What is the background for this study? Response: In a randomized clinical trial entitled, “Quality of Life in Patients With Low-Risk Prostate Cancer Treated With Hypofractionated vs Conventional Radiotherapy” the NRG Oncology Group previously demonstrated that men with low risk prostate cancer had  similar 5-year disease- free survival of about 85%  when treated with either conventional radiotherapy  (C-RT) of 73.8 Gy in 41 fractions over 8.2 weeks, or with  hypofractionated radiotherapy (H-RT) of 70 Gy in 28 fractions over 5.6  weeks. However, late physician reported side effects of mild bowel and bladder symptoms were increased in patients treated  with H-RT and raised questions if the H-RT arm is acceptable to patients. The current study asked the patient’s directly about their bowel, bladder, sexual function, anxiety, depression and general quality of life using valid patient reported questionnaires. These questionnaires have been found to be more accurate for reporting patient symptoms than physician report alone.

15 Feb

Posted at 16:12h in Author Interviews, Dermatology, JAMA, Johns Hopkins, Microbiome
MedicalResearch.com Interview with: [caption id="attachment_47435" align="alignleft" width="80"]Dr-Luis Garza Dr. Garza[/caption] Luis Garza, MD-PhD Associate Professor Department of Dermatology Johns Hopkins School of Medicine Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings?  Do you think these findings would be similar with other antibiotics (oral or topical) or with isotretinoin for acne? Response: We prescribe antibiotics frequently for acne. We certainly know it affects our normal and abnormal bacteria on our skin. But we don’t fully understand how well or not people recover from antibiotics. 

13 Feb

Posted at 11:49h in Annals Internal Medicine, Author Interviews, Exercise - Fitness, Heart Disease, Karolinski Institute, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_47415" align="alignleft" width="150"]Pontus Henriksson | PhD and Registered Dietitian Postdoctoral Researcher | SFO-V Fellow Department of Biosciences and Nutrition Karolinska Institutet Dr. Henriksson[/caption] Pontus Henriksson | PhD and Registered Dietitian Postdoctoral Researcher | SFO-V Fellow Department of Biosciences and Nutrition Karolinska Institutet  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In many countries, disability pensions are granted to working-aged persons who are likely to never work full-time again because of a chronic disease or injury diagnosed by a physician. In addition to serving as an important indicator of chronic disease, disability pensions are associated with high societal costs. Hence, we examined whether cardiorespiratory fitness and obesity (two potentially modifiable factors) were associated with disability pension later in life. Our main findings were that low physical fitness and/or obesity during adolescence, were strongly associated with disability pension later in life due to a wide range of diseases and causes. 

13 Feb

Posted at 11:44h in Author Interviews, Beth Israel Deaconess, Blood Pressure - Hypertension, Salt-Sodium
MedicalResearch.com Interview with: [caption id="attachment_47471" align="alignleft" width="160"]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 Dr. Juraschek[/caption] 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? What are the main findings? Response: Lightheadedness with standing is an important risk factor for falls. Sodium is often considered a treatment for lightheadedness with standing. We examined this in the setting of a monitored feeding study where adults ate each of 3 different sodium levels for 4 weeks at a time. Participants took 5 day breaks between sodium levels and ate the sodium levels in random order. We tested the hypothesis that lowering sodium would worsen how much lightheadedness the study participants reported.

11 Feb

Posted at 15:33h in Author Interviews, Health Care Systems, JAMA, Stroke, University Texas
MedicalResearch.com Interview with: [caption id="attachment_47423" align="alignleft" width="139"]Amrou Sarraj, MD, Associate Professor Department of Neurology Dr. Sarraj[/caption] Amrou Sarraj, MD, Associate Professor Department of Neurology McGovern Medical School The University of Texas Health Science Center at Houston. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Secondary analyses of trials showing efficacy and safety of thrombectomy within 6-8 hours of stroke onset showed that patients who were transferred to centers performing thrombectomy from another hospital had worse outcomes than patients who presented directly to the thrombectomy centers. We wanted to assess if the thrombectomy outcomes differ between transferred patients and patients directly coming to the thrombectomy centers when patients are selected with advanced perfusion imaging. We found that thrombectomy outcome rates were similar between patients who presented directly vs transferred from another hospital, including functional independence and safety outcomes. 

05 Feb

Posted at 01:16h in Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Frailty, Heart Disease, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_47274" align="alignleft" width="173"]Dae Hyun Kim, MD, MPH, ScD Assistant Professor of Medicine, Harvard Medical School Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center Dr. Dae Hyun Kim[/caption] Dae Hyun Kim, MD, MPH, ScD Assistant Professor of Medicine, Harvard Medical School Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The number of older adults undergoing aortic valve replacement is increasing.  Since these patients are at high risk for complications and functional decline due to preexisting multimorbidity and frailty, the latest guideline (Otto et al. J Am Coll Cardiol 2017;69:1313–46) emphasizes shared decision-making based on patient-centered outcomes.  Despite this recommendation, we witness many decision-making processes are cardio-centric—mainly informed by expected benefit in terms of cardiac-specific measures.  Many patients are not adequately informed about what their daily life would be like after the procedure. In this single-center prospective cohort study, we examined functional status trajectories via assessments of global functional status at 1, 3, 6, 9, and 12 months in 246 patients who underwent transcatheter and surgical aortic valve replacement.  We identified 5 clinically meaningful functional trajectories, ranging from high baseline function-early complete recovery to low baseline function-large and persistent decline.  We were able to predict most likely trajectory as well as best possible and worse possible trajectories using the preoperative frailty index.  Delirium and postoperative complications were also strongly associated with undesirable functional trajectories. 

04 Feb

Posted at 12:44h in Author Interviews, CMAJ, Fertility, McGill, OBGYNE
MedicalResearch.com Interview with: [caption id="attachment_47256" align="alignleft" width="142"]Natalie Dayan MD MSc FRCPC General Internal Medicine and Obstetric Medicine, Clinician-Scientist, Research Institute Centre for Outcomes Research and Evaluation (CORE) McGill University Health Centre  Montréal QC Dr. Dayan[/caption] Natalie Dayan MD MSc FRCPC General Internal Medicine and Obstetric Medicine, Clinician-Scientist, Research Institute Centre for Outcomes Research and Evaluation (CORE) McGill University Health Centre Montréal QC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infertility treatment is rising in use and has been linked with maternal and perinatal complications in pregnancy, but the extent to which it is associated with severe maternal morbidity (SMM), a composite outcome of public health importance, has been less well studied. In addition, whether the effect is due to treatment or to maternal factors is unclear. We conducted a propensity matched cohort study in Ontario between 2006 and 2012. We included 11 546 women who had an infertility-treated pregnancy and a singleton live or stillborn delivery beyond 20 weeks. Each woman exposed to infertility treatment was then matched using a propensity score to approximately 5 untreated pregnancies (n=47 553) in order to address confounding by indication. Poisson regression revealed on overall 40% increase in the risk of a composite of SMM (one of 44 previously validated indicators using ICD-10CA codes and CCI procedure codes) (30.3 per 1000 births vs. 22.8 per 1000 births, adjusted relative risk 1.39, 95% CI 1.23-1.56). When stratified according to invasive (eg., IVF) and non-invasive treatments (eg. IUI or pharmacological ovulation induction), women who were treated with IVF had an elevated risk of having any severe maternal morbidity, and of having 3 or more SMM indicators (adjusted odds ratio 2.28, 95% CI 1.56 – 3.33), when compared with untreated women, whereas women who were treated with non-invasive treatments had no increase in these risks.

31 Jan

Posted at 13:16h in Author Interviews, Gender Differences, JAMA, Mental Health Research, UCSF
MedicalResearch.com Interview with: [caption id="attachment_47241" align="alignleft" width="142"]Christina Mangurian, MD MAS Professor Department of Psychiatry, Weill Institute for Neurosciences Center for Vulnerable Populations, University of California, San Francisco Dr. Mangurian[/caption] Christina Mangurian, MD MAS Professor Department of Psychiatry, Weill Institute for Neurosciences Center for Vulnerable Populations, University of California, San Francisco [caption id="attachment_47238" align="alignleft" width="150"]Veronica Yank, MD Division of General Internal Medicine Department of Medicine University of California, San Francisco Dr. Yank[/caption] Veronica Yank, MD Assistant Professor Division of General Internal Medicine Department of Medicine University of California San Francisco MedicalResearch.com: What is the background for this study? Response: This article is about the behavioral health and burnout consequences among physician mothers who are caring for seriously ill loved ones. Our work was inspired, in part, by some of the authors’ own experiences caring for loved ones with serious illnesses while also being physician mothers themselves.  We sought to determine the proportion of physician mothers with such caregiving responsibilities beyond their patients and children and the how these additional responsibilities affected the women’s health and practice.

29 Jan

Posted at 16:45h in Author Interviews, Biomarkers, Johns Hopkins, NIH, Pulmonary Disease, Transplantation
MedicalResearch.com Interview with: [caption id="attachment_47206" align="alignleft" width="142"]Sean Agbor-Enoh, M.D., Ph.D. Co-Director/Staff Clinician Laboratory of Transplantation Genomics National Heart, Lung, and Blood Institute National Institutes of Health Dr. Agbor-Enoh[/caption] Sean Agbor-Enoh, M.D., Ph.D. Co-Director/Staff Clinician Laboratory of Transplantation Genomics National Heart, Lung, and Blood Institute National Institutes of Health MedicalResearch.com: What is the background for this study? Response: People who receive organ transplants may develop acute or chronic rejection, in which the body’s immune system attacks the transplanted organ. While acute rejection is treatable and reversible, chronic rejection is not and remains the most common cause for organ transplant loss. Lung transplant recipients have the shortest survival rates among patients who get solid organ transplantation of any kind—only about half live past five years. This poor survival rate among lung transplant recipients is due in part to a high incidence of chronic rejection. Existing tools for detecting signs of rejection, such as biopsy, either require the removal of small amounts of lung tissue or are not sensitive enough to discern the severity of the rejection. Building upon earlier work, our research team developed a simple blood test that can detect when a newly transplanted lung is being rejected by a patient, even when no outward signs of the rejection are evident.  The test could make it possible for doctors to intervene faster to prevent or slow down so-called chronic rejection—which is severe, irreversible, and often deadly—in those first critical months after lung transplantation. This same test might also be useful for monitoring rejection in other types of organ transplants. Called the donor-derived cell-free DNA test, the experimental test begins with obtaining a few blood droplets taken from the arm of the transplant recipient. A special set of machines then sorts the DNA fragments in the blood sample, and in combination with computer analysis, determines whether the fragments are from the recipient or the donor and how many of each type are present.  Because injured or dying cells from the donor release lots of donor DNA fragments into the bloodstream compared to normal donor cells, higher amounts of donor DNA indicate a higher risk for transplant rejection in the recipient.

27 Jan

Posted at 21:37h in Author Interviews, Heart Disease, JAMA, Thyroid Disease, Vanderbilt
MedicalResearch.com Interview with: [caption id="attachment_47159" align="alignleft" width="150"]Joe-Elie Salem, MD, PhD Associate Professor - MCU-PH, Sorbonne Université - INSERM - CIC, Clinical Pharmacology, Cardio-oncology, APHP, La Pitié-Salpêtrière, Paris, France Adjunct Associate Professor, Vanderbilt University Medical Center, Cardio-oncology Clinical Pharmacology, Nashville, TN Dr. Salem[/caption] Joe-Elie Salem, MD, PhD Associate Professor - MCU-PH, Sorbonne Université - INSERM - CIC, Clinical Pharmacology, Cardio-oncology, APHP, La Pitié-Salpêtrière, Paris, France Adjunct Associate Professor, Vanderbilt University Medical Center, Cardio-oncology Clinical Pharmacology, Nashville, TN MedicalResearch.com: What is the background for this study? What are the main findings? Response: A study by researchers at Vanderbilt University Medical Center has strengthened the link between thyroid function and atrial fibrillation (AF), an irregular heart rhythm that increases the risk of stroke and other heart-related complications. They phenome-wide association study scanned the medical records of more than 37,000 people for an association between genetically determined variation in thyroid stimulating hormone levels (a measure of thyroid function) and AF risk. Previous observational studies have found that subclinical hyperthyroidism, an overactive thyroid which does not meet the clinical threshold for diagnosis or treatment, nevertheless can increase the risk of atrial fibrillation.  But whether to treat subclinical hypo- or hyperthyroidism to reduce AF risk remains a matter of debate in the medical community. 

25 Jan

Posted at 22:58h in Author Interviews, Cancer Research, Gender Differences, JAMA, UCLA
MedicalResearch.com Interview with: [caption id="attachment_47094" align="alignleft" width="200"]Dr. Ann Raldow MD MPH Assistant Professor Department of Radiation Oncology David Geffen School of Medicine UCLA Dr. Raldow[/caption] Dr. Ann Raldow MD MPH Assistant Professor Department of Radiation Oncology David Geffen School of Medicine UCLA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Similar to women in other historically male-dominated fields, female radiation oncologists face unique obstacles in achieving many metrics of career success, including equal salary, research funding, and academic promotion. Our study of industry payments found that female radiation oncologists were less likely than their male colleagues to receive payments from industry and that these payments tended to be of smaller monetary value.

25 Jan

Posted at 13:55h in Author Interviews, Flu - Influenza, Infections, PLoS, University of Michigan
MedicalResearch.com Interview with: [caption id="attachment_47142" align="alignleft" width="135"]Betsy Foxman PhD Hunein F. and Hilda Maassab Endowed Professor of Epidemiology Director, Center for Molecular and Clinical Epidemiology of Infectious Diseases Ann Arbor, Michigan 48109-2029 Dr. Foxman[/caption] Betsy Foxman PhD Hunein F. and Hilda Maassab Endowed Professor of Epidemiology Director, Center for Molecular and Clinical Epidemiology of Infectious Diseases Ann Arbor, Michigan 48109-2029 MedicalResearch.com: What is the background for this study? Response: Influenza is a major cause of human illness and death worldwide. Vaccines are the best available means of prevention. However, vaccine effectiveness has been low to moderate in recent years and coverage remains low in many countries. There is increasing evidence suggesting the microbiome plays an important role in shaping host immunity and may be a potential target for reducing disease. In our study, we used a household transmission study to explore whether the respiratory microbiome was associated with influenza susceptibility. 

24 Jan

Posted at 18:17h in Accidents & Violence, Author Interviews, Emergency Care, JAMA, Yale
MedicalResearch.com Interview with: [caption id="attachment_47133" align="alignleft" width="142"]Edouard Coupet Jr, MD, MS Assistant Professor Department of Emergency Medicine Yale School of Medicine Dr. Coupet[/caption] Edouard Coupet Jr, MD, MS Assistant Professor Department of Emergency Medicine Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: For many individuals with nonfatal firearm injuries, their only point of contact with the healthcare system may be the emergency department. Both hospital-based violence intervention programs and counseling and safe firearm storage have shown promise in reducing the burden of firearm injury. In this study, one third of individuals with firearm injuries presented to non-trauma centers. Only 1 out of 5 firearm injuries were assault injuries that led to admission to trauma centers, the population most likely to receive interventions to reduce re-injury.