AHA Journals, Author Interviews, Brigham & Women's - Harvard, Exercise - Fitness, Lifestyle & Health / 08.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38085" align="alignleft" width="142"]I-Min Lee, MD, ScD Professor of Medicine, Harvard Medical School Professor of Epidemiology, Harvard T.H. Chan School of Public Health Brigham and Women's Hospital Boston, MA 02215 Dr. Lee[/caption] I-Min Lee, MD, ScD Professor of Medicine, Harvard Medical School Professor of Epidemiology, Harvard T.H. Chan School of Public Health Brigham and Women's Hospital Boston, MA 02215 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The fact that physical activity lowers the risk of premature mortality is not a new fact – we have many studies showing this.  However, previous studies have primarily relied on self-reported physical activity, and self-reports tend to be imprecise.  Based on these self-report studies, we know that physical activity is associated with a 20-30% reduction in mortality rates.  And, these self-report studies also have focused on moderate-to-vigorous intensity physical activity, since they are more reliably reported than lighter intensity activity.  We have little information on whether light-intensity activities (e.g., light household chores, very slow walking such as when strolling and window shopping) are associated with lower mortality rates. We now have “wearables” – devices that can more precisely measure physical activity at low (as well as higher) intensities, and sedentary behavior.  The present study, conducted between 2011 and 2015, investigated a large cohort of older women (n=16,741; mean age, 72 years)  who were asked to wear these devices for a week – thus, providing detailed physical activity and sedentary behavior measures.  During an average follow-up of about two-and-a-half years, 207 women died.  The study confirmed that physical activity is related to lower mortality rates. What is new and important is how strong this association is when we have more precise measures of physical activity – the most active women had a 60-70% reduction in mortality rates, compared with the least active, during the study.  For context, non-smokers have about a 50% risk reduction, compared to smokers, which is why patients (and doctors) should pay attention to being physically active.
Author Interviews, Brigham & Women's - Harvard, Cannabis, Pediatrics, Pediatrics / 07.11.2017

MedicalResearch.com Interview with: [caption id="attachment_38051" align="alignleft" width="180"]Dr. Wong Dr. Wong[/caption] Shane Shucheng Wong, MD Massachusetts General Hospital Boston, Massachusetts  MedicalResearch.com: What is the background for this study? Response: Medical cannabis is now legal in 29 states and the District of Columbia, and in those areas with active programs, children and adolescents can legally access medical cannabis with certification from their doctor and consent from a parent. This means that doctors and families need to understand what we know and what we don’t yet know about medical cannabis in order to make the best decision for the health of the individual child. Two synthetic cannabinoids – compounds that act on specific receptors in the brain – have been approved for medical use in the U.S., both of which mimic a form of THC (tetrahydrocannabinol), the compound responsible for the “high” of recreational cannabis use. Dronabinol (Marinol) is approved to treat chemotherapy-induced nausea and vomiting in both children and adults, while the pediatric use of nabilone (Cesamet) carries a caution. A third cannabinoid, cannabidiol, is currently in phase 3 trials for treatment of seizures.
Author Interviews, Kidney Disease, Mayo Clinic, NEJM / 06.11.2017

MedicalResearch.com Interview with: Dr. TorresVicente E. Torres, M.D., Ph.D. Director of the Mayo Clinic Translational Polycystic Kidney Disease (PKD) Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Experimental work pioneered by Dr. Jared Grantham showed that cyclic AMP, an intracellular signaling molecule, promotes the development and growth of cysts. Vasopressin, a hormone produced by the pituitary gland, stimulates the production of cyclic AMP in the collecting ducts, from which most cysts derive in autosomal dominant polycystic kidney disease (ADPKD). While this effect of vasopressin is necessary for the kidneys to concentrate and reduce the volume of urine, it promotes the development and growth of cysts in patients with ADPKD. Dr. Vincent Gattone realized that inhibiting the action of vasopressin could be protective in polycystic kidney disease. Work in our and other laboratories confirmed that suppression of vasopressin production, release or action reduces cyst burden, protects kidney function, and prolongs survival in rodent models of the disease. This experimental work provided a strong rationale for clinical trials of tolvaptan, a vasopressin V2 receptor antagonist. Tolvaptan reduced the rate of kidney growth in the TEMPO 3:4 trial, in patients with early ADPKD. It also reduced the rate of decline in kidney function, measured by the estimated glomerular filtration rate (eGFR), from 10.1 to 6.8 mL/min/1.73 m2 over three years. The eGFR benefit was maintained during two additional years when all the patients were treated with tolvaptan in an open label extension of the TEMPO 3:4 trial (TEMPO 4:4). Safety laboratory tests performed every four months showed elevations of liver transaminases in blood in 4.4% of tolvaptan and 1% of placebo-treated patients. Three of 1,271 tolvaptan-treated patients during TEMPO 3:4 and TEMPO 4:4 had evidence of potentially serious drug-induced liver injury. These abnormalities occurred all within the first 18 months of exposure to tolvaptan. Based on the TEMPO 3:4 results, tolvaptan was approved for the treatment of rapidly progressive ADPKD in Japan, Canada, European Union, Switzerland and South Korea. In the United States, the Food and Drug Administration requested additional data to further evaluate the efficacy and safety of this drug. The REPRISE trial was performed to determine the efficacy and safety of tolvaptan in patients with later stage ADPKD.
Author Interviews, Heart Disease, NEJM, UCLA / 05.11.2017

MedicalResearch.com Interview with: [caption id="attachment_37907" align="alignleft" width="100"]Bruno Péault PhD Professor and Chair, Vascular Regeneration Center For Cardiovascular Science MRC Centre for Regenerative Medicine Scientific Director, BHF Laboratories The University of Edinburgh and Professor, David Geffen School of Medicine at UCLA Orthopaedic Hospital Research Center University of California at Los Angeles Los Angeles, CA 90095-7358 Dr. Péault[/caption] Bruno Péault PhD Professor and Chair, Vascular Regeneration Center For Cardiovascular Science MRC Centre for Regenerative Medicine Scientific Director, BHF Laboratories The University of Edinburgh and Professor, David Geffen School of Medicine at UCLA Orthopaedic Hospital Research Center University of California at Los Angeles Los Angeles, CA 90095-7358 MedicalResearch.com: What is the background for this study? Response: Kidney, lung, liver, muscle, heart are among the many organs which can be severely affected by fibrosis, a natural scarring process whereby healthy tissues are replaced by a fibrous non-functional substitute. For instance, the billions of cardiac muscle cells that die after a heart infarct, consequently to blood supply interruption, are replaced by a fibrotic scar that cannot contract, reducing the capacity of the heart to pump blood, and leading often to heart failure. There is currently no efficient treatment of fibrotic scars, the basic cellular component of which is the myofibroblast, a cell of unremarkable appearance and unclear origin. The transforming growth factor β (TGFβ) molecule triggers fibrosis development after being activated, via the extra-cellular matrix, by αv integrins, which are adhesion molecules present at the surface of the target cells. To gain further insight into the cells that drive fibrosis in the heart and skeletal muscle, and explore ways to control this deleterious process, mice were used in which cells expressing the β receptor for PDGF (platelet derived growth factor) have been genetically tagged with a green fluorescent protein, a system previously used by Prof. Neil Henderson to trace fibrosis in the diseased liver (cells naturally expressing PDGFRβ are, in their vast majority, perivascular cells surrounding small blood vessels, as well as some interstitial fibroblasts). Skeletal muscle was injured by a small incision or with a targeted injection of cardiotoxin, a snake venom compound that locally kills myofibers, while the heart was damaged by prolonged infusion of angiotensin II. In both settings, progression of fibrosis was followed over time and contribution of green fluorescent cells – i.e. those expressing PDGFRβ – was assessed.
Alzheimer's - Dementia, Author Interviews, Johns Hopkins, Memory, Mental Health Research / 04.11.2017

MedicalResearch.com Interview with: Keenan A. Walker, PhD Johns Hopkins University School of Medicine Baltimore, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is quite a bit of evidence linking immune function with dementia. For example, several of the risk genes for Alzheimer’s disease are known to play a key role in immune functioning and the regulation of inflammation. We conducted the current study to determine whether systemic inflammation earlier in life might be a risk factor for neurodegeneration decades later. This long temporal window allows us to get closer to understanding causality. That is, which comes first – systemic inflammation or brain volume loss. Using a large community sample, we found that individuals with higher levels of blood inflammatory markers during midlife tended to have smaller brain volumes in select regions and reduced memory ability as older adults. We found the strongest associations between systemic inflammation and brain volume loss in brain regions most vulnerable Alzheimer’s disease.
Author Interviews, Brigham & Women's - Harvard, Chocolate, Pediatrics, Weight Research / 01.11.2017

MedicalResearch.com Interview with: [caption id="attachment_13134" align="alignleft" width="125"]Jorge E. Chavarro, M.D., Sc.D. Assistant Professor of Nutrition and Epidemiology Harvard T.H. Chan School of Public Health Assistant Professor of Medicine Harvard Medical School Boston, MA 02113 Dr. Chavarro[/caption] Jorge E. Chavarro, MD, ScD Associate Professor Departments of Nutrition and Epidemiology Harvard T.H. Chan School of Public Health Channing Division of Network Medicine Department of Medicine Brigham and Women’s Hospital and Harvard Medical School Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that sugared sweetened beverages (SSBs) promote excessive weight gain and obesity in children. The excess sugars in chocolate milk and other flavored milks puts them in a category that may be closer to sugared sweetened beverages than to plain milk. However, data on whether flavored milks promote weight gain is scarce. We followed a cohort of 5,321 children and adolescents over a four year period to evaluate whether intake of chocolate milks was related to weight gain. We found that children who increased their intake of flavored milk gained more weight than children whose intake of flavored milk remained stable over this period. Moreover, among those children who did not drink any chocolate milk at baseline, those who started drinking chocolate milk over the course of the study gained substantially more weight than children who remained non-consumers of chocolate milk.
Author Interviews, Brigham & Women's - Harvard, Environmental Risks, JAMA, OBGYNE / 01.11.2017

MedicalResearch.com Interview with: [caption id="attachment_37794" align="alignleft" width="300"]“Pesticide spraying” by jetsandzeppelins is licensed under CC BY 2.0 “Pesticide spraying” by jetsandzeppelins[/caption] Yu-Han Chiu, M.D., M.P.H., Sc.D Department of Nutrition Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Animal experiments suggest that ingestion of pesticide mixtures at environmentally relevant concentrations decreases the number of live-born pups. However, it is unclear whether intake of pesticide residues has any adverse effects in humans, especially for susceptible populations such as pregnant women and their fetuses. Therefore, in this study we examined the association of preconception intake of pesticide residues in fruits and vegetables with pregnancy outcomes among 325 women undergoing assisted reproduction. A pesticide is far cheaper than pest control services, like termite control los angeles, so it makes sense why most farmers choose to use pesticide for their farmhouse and crops. However, this isn't necessarily the best procedure for human health, or consumption! We found that intake of high pesticide residue fruits and vegetables were associated with higher risks of pregnancy loss, while low pesticide residue fruit and vegetable intake was associated with lower risks of early pregnancy loss. These data suggest dietary pesticide exposure within the range of typical human exposure may be associated with adverse reproductive consequences
Author Interviews, JAMA, Menopause, Ophthalmology, UCLA / 31.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37775" align="alignleft" width="150"]Anne L. Coleman, MD, PhD Center for Community Outreach and Policy, Stein Eye Institute David Geffen School of Medicine Director, UCLA Mobile Eye Clinic Department of Epidemiology, Fielding School of Public Health UCLA Dr. Coleman[/caption] Anne L. Coleman, MD, PhD Center for Community Outreach and Policy, Stein Eye Institute David Geffen School of Medicine Director, UCLA Mobile Eye Clinic Department of Epidemiology, Fielding School of Public Health UCLA MedicalResearch.com: What is the background for this study? Response: Cataracts are a leading cause of vision loss worldwide, and cataract surgery is an intervention that is known to be extremely effective to address the vision loss related to cataract. However, it is unclear if there are benefits of cataract surgery beyond vision improvement in people with cataracts. Previous studies have suggested that in addition to improving vision, cataract surgery may decrease the risk of fractures and accidents, improve mental health, and improve overall quality of life. The purpose of the present study was to further investigate the potential benefits of cataract surgery and to determine if cataract surgery was associated with increased survival in people with cataracts.
ASCO, Author Interviews, Cancer Research, Electronic Records, University Texas / 29.10.2017

MedicalResearch.com Interview with: Dr. Ali Haider, MBBS MD Assistant Professor, Department of Palliative Care and Rehabilitation Medicine Division of Cancer Medicine The University of Texas MD Anderson Cancer Center Houston, TX  MedicalResearch.com: What is the background for this study? Response: Patients with chronic and serious illnesses such as cancer often experience high physical and psychosocial symptoms. Recent studies have reported association of physicians' examination room computer use with less face to face interactions and eye contact. It's important for the clinicians to look for certain physical cues to better understand the well being of their patients. Therefore we conducted this randomized clinical trial to understand patients perception of physicians compassion, communication skills and professionalism with and without the use of examination room computer.
Author Interviews, Heart Disease, JAMA, Pulmonary Disease, Vanderbilt / 27.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37714" align="alignleft" width="112"]Dr. Evan L. Brittain, MD Assistant Professor of Medicine Vanderbilt University School of Medicine Dr. Brittain[/caption] Dr. Evan L. Brittain, MD Assistant Professor of Medicine Vanderbilt University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The purpose of this study was to determine whether pulmonary pressure values below the diagnostic threshold for pulmonary hypertension (25mmHg) are associated with an increased risk of mortality. We studied over 4,000 consecutive individuals referred for right heart catheterization, the “gold-standard” procedure for measuring pulmonary pressure. We found that borderline levels of mean pulmonary pressure (19-24mmHg) were common, representing 18% of all patients referred for this procedure. Borderline mean pulmonary pressure values were also associated with 31% increase in mortality after accounting for many other clinical factors. Finally, we found that most of the patients with borderline pulmonary hypertension who underwent repeat catheterization often progressed to overt pulmonary hypertension. This study suggests that patients with borderline pulmonary hypertension should be considered an at-risk group.
AHA Journals, Author Interviews, Heart Disease, Thyroid, UCSF / 26.10.2017

MedicalResearch.com Interview with: Christine Baumgartner MD Inselspital Universitätsspital Bern Bern, Switzerland Research Fellow, Division of Hospital Medicine UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: Overt and subclinical hyperthyroidism increase the risk of atrial fibrillation, but it is unclear whether subclinical hypothyroidism, which is known to increase cardiovascular events, or thyroid function in the normal range are also associated with incident atrial fibrillation. Given the high prevalence of atrial fibrillation and its associated morbidity and mortality, identifying potentially modifiable risk factors is important. Therefore, we aimed to assess the risk of atrial fibrillation in individuals with subclinical hypothyroidism or variations of thyroid function within the normal range. Our main findings are that higher free thyroxine levels are associated with an increased risk of atrial fibrillation in euthyroid individuals, but thyroid-stimulating hormone levels within the euthyroid or subclinical hypothyroid range was not related to atrial fibrillation risk.
Author Interviews, Biomarkers, Heart Disease, JACC, Karolinski Institute / 25.10.2017

MedicalResearch.com Interview with: Martin Holzmann PhD Department of Medicine Functional Area of Emergency Medicine, Karolinska University Hospital, Huddinge Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a few studies in the general population that indicate that subjects with detectable and elevated high-sensitivity troponin T (hs-cTnT) levels have an increased risk of death and cardiovascular disease. However, in clinical practice troponins are not used for anything else than to rule in or rule out myocardial infarction in the emergency department. In addition, in a previous publication we have shown that patients with persistently elevated troponin levels are rarely investigated or followed-up to exclude heart disease. Therefore, we wanted to investigate how the association between different levels of hs-cTnT are associated with outcomes in patients with chest pain but no MI or other acute reasons for having an acutely elevated troponin level.
AACR, Alzheimer's - Dementia, Author Interviews, Cancer Research, Cognitive Issues, Colon Cancer, UCSF / 24.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37702" align="alignleft" width="112"]Yingjia Chen, M.Sc, MPH, Ph.D. Postdoctoral Fellow University of California, San Francisco Dr. Chen[/caption] Yingjia Chen, M.Sc, MPH, Ph.D. Postdoctoral Fellow University of California, San Francisco  MedicalResearch.com: What is the background for this study? Response: Both colon cancer and dementia are prevalent among the elderly and have a high risk of co-occurrence. Previous studies found that patients with dementia were treated less aggressively. In this study, we hypothesized that presence of pre-existing dementia was associated with worse survival for stage III colon cancer patients, and that post-operative chemotherapy was on the causal pathway.
Author Interviews, Salt-Sodium, University of Michigan / 23.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37686" align="alignleft" width="101"]Julia Wolfson, PhD MPP Assistant Professor Department of Health Management and Policy Department of Nutritional Sciences University of Michigan School of Public Health Ann Arbor, MI 48109 Dr. Wolfson[/caption] Julia Wolfson, PhD MPP Assistant Professor Department of Health Management and Policy Department of Nutritional Sciences University of Michigan School of Public Health Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over the past several years, Large chain restaurants in the United States have made some progress in introducing new lower calorie items on their menus. Since 2012, calories of items consistently on restaurant menus in all years have not significantly change. In this study, we examined the sodium content of restaurant menu items among 66 of the 100 largest restaurants in the US. We examined sodium content among items on the menu in all years (2012-2016) and among newly introduced items in 2013, 2014, 2015 and 2016 compared to items on the menu in 2012 only. We found that sodium content of menu items on the menu in all years did not change, but that restaurants were introducing new, lower sodium menu items. However, sodium content of restaurant menu items remains high. This is important because diets high in sodium are associated with serious adverse health outcomes including hypertension, stroke and cardiovascular disease.
Author Interviews, Gastrointestinal Disease, Pharmaceutical Companies, University of Michigan / 23.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37675" align="alignleft" width="106"]William D. Chey Dr. Chey[/caption] William D. Chey, M.D., F.A.C.G. Timothy T. Nostrant Professor of Gastroenterology & Nutrition Director, Digestive Disorders Nutrition & Lifestyle Program Michigan Medicine Ann Arbor, Michigan  MedicalResearch.com: What is the background for this study? Response: Functional Dyspepsia (FD) has been characterized as recurring indigestion with no known organic cause and is an area of high unmet medical need. This medical condition, which is non-life threatening, can have a significant impact on an individual’s quality of life. It remains poorly recognized and presents a significant management challenge for providers and patients. Gastrointestinal symptoms can include epigastric pain or discomfort, inability to finish a normal-sized meal, heaviness, pressure, nausea, bloating and belching. Currently, there are no FDA-approved drugs for FD. Off-label medications are used to treat the condition and patient dissatisfaction remains high.[1] In a real-world, observational study, called FDACT™ (Functional Dyspepsia Adherence and Compliance Trial), we analyzed information on the frequency of FD symptoms, daily consumption of capsules, onset of action, improvement in FD symptoms, quality of life and patient satisfaction among 600 patients who took FDgard®, a nonprescription medical food specially formulated for the dietary management of FD.
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Mammograms, Technology / 20.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37640" align="alignleft" width="135"]Manisha Bahl, MD, MPH Director, Breast Imaging Fellowship Program, Massachusetts General Hospital Assistant Professor of Radiology, Harvard Medical School Dr. Bahl[/caption] Manisha Bahl, MD, MPH Director, Breast Imaging Fellowship Program, Massachusetts General Hospital Assistant Professor of Radiology, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Image-guided biopsies that we perform based on suspicious findings on mammography can yield one of three pathology results: cancer, high-risk, or benign. Most high-risk breast lesions are noncancerous, but surgical excision is typically recommended because some high-risk lesions can be upgraded to cancer at surgery. Currently, there are no imaging or other features that reliably allow us to distinguish between high-risk lesions that warrant surgery from those that can be safely followed, which has led to unnecessary surgery of high-risk lesions that are not associated with cancer. We decided to apply machine learning algorithms to help us with this challenging clinical scenario: to distinguish between high-risk lesions that warrant surgery from those that can be safely followed. Machine learning allows us to incorporate the full spectrum of diverse and complex data that we have available, such as patient risk factors and imaging features, in order to predict which high-risk lesions are likely to be upgraded to cancer and, ultimately, to help our patients make more informed decisions about surgery versus surveillance. We developed the machine learning model with almost 700 high-risk lesions, then tested it with more than 300 high-risk lesions. Instead of surgical excision of all high-risk lesions, if those categorized with the model to be at low risk for upgrade were surveilled and the remainder were excised, then 97.4% malignancies would have been diagnosed at surgery, and 30.6% of surgeries of benign lesions could have been avoided.
Author Interviews, Exercise - Fitness, Pain Research, UCSD / 19.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37597" align="alignleft" width="130"]Erik Groessl PhD Associate Adjunct Professor Family Medicine and Public Health University of California, San Diego Dr. Groessl[/caption] Erik Groessl PhD Associate Adjunct Professor Family Medicine and Public Health University of California, San Diego MedicalResearch.com: What is the background for this study? What are the main findings? Response: Chronic low back pain (cLBP) is prevalent among military veterans, but cLBP treatment options have limited benefits and side effects. This has resulted in efforts to reduce opioid use and embrace nonpharmacological pain treatments. Yoga has been shown to improve health outcomes and have few side effects in non-veteran community samples. Our objective was to study the effectiveness and safety of yoga for military veterans with chronic low back pain. In a study of 150 veterans with cLBP, we found that yoga participants had greater reductions in disability and pain than those receiving usual. Opioid medication use declined among all participants, and no serious side effects occurred.
Author Interviews, Psychological Science, UC Davis / 19.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37587" align="alignleft" width="350"]Monogamous Titi monkeys Monogamous Titi monkeys[/caption] Karen L. Bales PhD Professor of Psychology University of California Davis, CA 95616 MedicalResearch.com: What is the background for this study? Response:  Titi monkeys are a socially monogamous species in which adults form pair bonds.  In my laboratory we are studying the neurobiology of pair bonding, and understanding jealousy is important because it's one mechanism by which the pair bond is maintained.  In this study, male titi monkeys viewed their pair mate next to a stranger male, and we examined the neural, behavioral, and hormonal consequences. 
Author Interviews, Dermatology, Melanoma, Transplantation, University of Pennsylvania / 17.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37504" align="alignleft" width="148"]Thuzar M.Shin MD, PhD Assistant Professor of Dermatology Hospital of the University of Pennsylvania Dr. Shin[/caption] Thuzar M.Shin MD, PhD Assistant Professor of Dermatology Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Organ Procurement Transplant Network (OPTN) collects data on cancers that develop after organ transplantation. Previous studies have shown incomplete reporting to the OPTN for many cancers (including melanoma). Skin cancer is the most common malignancy in solid organ transplant recipients and the most common post-transplant skin cancer, cutaneous squamous cell carcinoma (cSCC), is not captured in standard cancer registries. We hypothesized that cSCC and melanoma are underreported to the OPTN. When compared to detailed medical record review obtained from the Transplant Skin Cancer Network database (JAMA Dermatol. 2017 Mar 1;153(3):296-303), we found that the sensitivity of reporting to the OPTN was only 41% for cSCC and 22% for melanoma. The specificity (99% for cSCC and 100% for melanoma) and negative predictive values (93% for cSCC and 99% for melanoma) were high. As a result, the OPTN database is unable to robustly and reliably distinguish between organ transplant recipients with and without these two skin malignancies.
Author Interviews, ENT, JAMA, Stanford, Surgical Research / 12.10.2017

MedicalResearch.com Interview with: David Schoppy, MD PhD Resident, Division of Head and Neck Surgery Department of Otolaryngology Stanford University School of Medicine Stanford, Palo Alto, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a growing focus in healthcare on quality, and one component of this focus is the development of robust measures of quality. Currently, there are relatively few validated metrics of performance in oncologic surgery, and several of these indicators are relatively static metrics (such as hospital case volume and institution type). This study examined the relationship between overall survival (one surrogate of quality cancer surgery) and two modifiable variables in Head and Neck surgery - achieving negative surgical margins around a primary tumor and 18 or more lymph nodes from a concurrent neck dissection. After controlling for multiple other patient variables, data collected from the National Cancer Database (NCDB) showed that treatment at hospitals where a high percentage of patients had a surgery with negative margins and 18 or more lymph nodes removed from their neck was associated with improved survival. Importantly, this survival benefit was independent of the individual, patient-level survival benefit conferred by having either of these surgical process measures reached. This study therefore highlights two modifiable measures of institutional performance in Head and Neck surgery that may serve as targets for quality improvement programs.
Accidents & Violence, Author Interviews, Cost of Health Care, Johns Hopkins / 04.10.2017

MedicalResearch.com Interview with: Faiz Gani MD Postdoctoral research fellow Department of Surgery Johns Hopkins University School of Medicine Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: The current study sought to evaluate epidemiological trend in emergency department (ED) visits for firearm-related injuries in the US. In our study, we observed that 25.3 patients per 100,000 presented to the ED for a firearm-related injury. This translated to over 78,000 ED visits per year. Over time, while firearm injuries decreased from 2006-2013, an increase in the incidence of firearm-related injuries was observed in 2014. Additionally, over time injuries among older patients and those injured in an unintentional firearm injury increased. Injuries due to an assault decreased over time. The average ED and inpatient charges were $5,254 and $95,887, respectively, resulting in an overall financial burden of approximately $25 billion over the study or an annual $2.8 billion in ED and inpatients charges.
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, OBGYNE / 03.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37260" align="alignleft" width="125"]Andrew L. Beam, PhD Instructor in Biomedical Informatics Department of Biomedical Informatics Harvard Medical School Dr. Beam[/caption] Andrew L. Beam, PhD Instructor in Biomedical Informatics Department of Biomedical Informatics Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is one piece of a larger story regarding the use of 17-alpha-hydroxyprogesterone caproate (17P) to treat recurrent preterm birth. This drug was originally only available in a compounded form, but since receiving an orphan drug designation in 2011, a branded and manufactured form was marketed under the name "Makena". This branded form was then sold for a much higher price than the compounded version, but a study that provided concrete data on pricing and outcomes had not been done.
Author Interviews, Diabetes, Gastrointestinal Disease, Lancet, Mayo Clinic, Weight Research / 29.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37242" align="alignleft" width="125"]Prof Michael Camilleri, MD Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Mayo Clinic, Rochester, MN Prof. Camilleri[/caption] Prof Michael Camilleri, MD Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Mayo Clinic, Rochester, MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Liraglutide is approved for treatment of obesity; the precise mechanisms for the beneficial weight loss are unclear. We are interested to learn whether it is possible to identify people who are more likely to benefit from this treatment.
Author Interviews, Columbia, Genetic Research / 29.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37237" align="alignleft" width="133"]Carlos Eduardo G. Amorim PhD Columbia University Department of Systems Biology Irving Cancer Research Center Dr. Amorim[/caption] Carlos Eduardo G. Amorim PhD Columbia University Department of Systems Biology Irving Cancer Research Center  MedicalResearch.com: What is the background for this study? Response: More generally, we were interested in understanding the determinants of the frequencies of mutations that cause disease in humans. More specially, we wanted to test if a long-standing theory in population genetics (namely mutation-selection balance) was a good explanation for the observed frequencies of disease mutations in humans.
Author Interviews, Columbia, Heart Disease, Orthopedics / 28.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37221" align="alignleft" width="125"]Dr. Mathew Maurer, Medical Director The Hypertrophic Cardiomyopathy Center NewYork-Presbyterian/Columbia University Medical Center. Dr. Maurer[/caption] Dr. Mathew Maurer, Medical Director The Hypertrophic Cardiomyopathy Center NewYork-Presbyterian/Columbia University Medical Center. MedicalResearch.com: What is the background for this study? Response: Transthryretin cardiac amyloidosis (TTR-CA) is an underdiagnosed type of cardiomyopathy in which TTR (transthyretin, also known as prealbumin), a protein that forms amyloid fibrils, deposits in the heart. The deposits cause thickening of the ventricular wall and diastolic as well as systolic dysfunction. It is usually discovered around age 75 and presents more commonly in men than in women. With advances in non-invasive diagnostic modalities and growing awareness, TTR-CA is being diagnosed increasingly more frequently. Additionally, there are several emerging treatments that are under active investigation. Most of these therapies prevent disease progression and don’t address the amyloid already deposited in the heart. Accordingly, it is imperative that we diagnose TTR-CA before patients develop significant amyloid heart disease. However, this presents a great challenge since there are few known clinical predictors that might alert even the most astute physician that a patient is at such risk. With identification of predictors that may appropriately raise the index of clinical suspicion, clinicians may begin to pick up more subtle (and perhaps not yet clinically significant) forms of TTR-CA and initiate treatment before significant damage occurs. The few known clinical predictors of TTR-CA include bilateral carpal tunnel syndrome and lumbar spinal stenosis, and numerous studies found TTR on biopsies and autopsies of other musculoskeletal sites, particularly in hip and knee joints. (Just last week, and also discussed here on MedicalResearch.com, biceps tendon rupture was also shown to occur more frequently in TTR-CA!) We suspected that patients who ultimately develop TTR-CA may first develop clinically significant hip and knee disease, enough to even warrant a hip (THA) or knee (TKA) replacement.
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Nutrition / 27.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37208" align="alignleft" width="125"]Seth A. Berkowitz, MD, MPH Division of General Internal Medicine Diabetes Population Health Unit Harvard Medical School Massachusetts General Hospital, Boston Dr. Berkowitz[/caption] Seth A. Berkowitz, MD, MPH Division of General Internal Medicine Diabetes Population Health Unit Harvard Medical School Massachusetts General Hospital, Boston MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is ever growing pressure to contain healthcare costs in the US. Increasingly, attention is turning to programs that address social determinants of health--that is, those factors which affect health but lie outside the realm of clinical medicine. Prior research has highlighted food insecurity as having a clear association with poor health and higher healthcare costs. SNAP is the nation's largest program to combat food insecurity. However, we did not know whether SNAP participation would be associated with any difference in healthcare costs, compared with eligible non-participants. This study found that participating in SNAP was associated with approximately $1400 lower healthcare expenditures per year in low-income adults.
Author Interviews, Mayo Clinic, Weight Research / 27.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37204" align="alignleft" width="125"]Dr. W. Stephen Brimijoin PhD Department of Molecular Pharmacology and Experimental Therapeutics Mayo Clinic, Rochester, MN 55905 Dr. Brimijoin[/caption] Dr. W. Stephen Brimijoin PhD Department of Molecular Pharmacology and Experimental Therapeutics Mayo Clinic, Rochester, MN 55905 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study was: 1) Ordinary C57 black mice readily become obese when given unrestricted access to high-fat mouse chow. 2) If the obese mice are put on a forced calorie restricted diet they will regain their previous normal healthy weight.  However, if they are given unrestricted access to their previous “normal” low-fat mouse chow, they will rebound into obesity.  This effect can be seen as a model of human obesity and the difficulties that formerly obese men and women face in maintaining healthy body mass gained after dieting. 3) The literature on obesity provided reason to believe that this self-defeating behavioral cycle involves ghrelin, the so-called “hunger hormone.” 4) We had recently shown that the plasma enzyme called “butyrylcholinesterase” was a key regulator of active ghrelin. Therefore, it seemed plausible that raising enzyme levels would reduce ghrelin and, in turn, would blunt food craving.
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Orthopedics / 22.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37118" align="alignleft" width="125"]Avinainder Singh, M.B.B.S. Research Fellow Cardiovascular Medicine Brigham & Women's Hospital Harvard Medical School Boston, MA Dr. Singh[/caption] Avinainder Singh, M.B.B.S. Research Fellow Cardiovascular Medicine Brigham & Women's Hospital Harvard Medical School Boston, MA MedicalResearch.com: What is the background for this study? Response: Amyloidosis due to aberrant folding of proteins. These misfolded proteins can deposit in various parts of the body and lead to organ dysfunction. The two most common types of amyloidosis affecting the heart include transthyretin and light chain amyloidosis. Transthyretin is a protein produced by the liver which supports the transport of thyroxine and retinol. Wild-type transthyretin amyloidosis (ATTRwt, previously known as senile amyloidosis) occurs due to deposition of misfolded fibrils derived from transthyretin and primarily affects elderly men. Once considered a rare disease, it is now reported to be responsible for nearly 13% of heart failure with preserved ejected fraction and increased wall thickness. Rupture of the biceps tendon is a rare occurrence in the general population (<1 per 1000). We noticed a ruptured biceps tendon in several patients with wild-type transthyretin amyloidosis and performed this study to further evaluate this finding in a group of patients with wild-type transthyretin amyloidosis and in a control group of age-matched patients with non-amyloid heart failure.
Author Interviews, Education, Karolinski Institute, Pediatrics, Psychological Science / 22.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37074" align="alignleft" width="125"]Malin Bergström PhD Center for Health Equity Studies Karolinska Institutet   Dr. Bergstrom[/caption] Malin Bergström PhD Center for Health Equity Studies Karolinska Institutet   MedicalResearch.com: What is the background for this study? Response: The increase in children who move between their parent's homes after a divorce is one of the major changes in children's life circumstances during the last decade. Spending equal amounts of time in both parents' homes means that these children move fifty times a year. Child experts have claimed this to be stressful and potentially harmful to children's attachment relations to their mothers. Especially for children this young the practice of joint physical custody has been questioned.
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Technology / 20.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37046" align="alignleft" width="120"]MedicalResearch.com Interview with: Muthiah Vaduganathan, MD, MPH Brigham and Women’s Hospital Heart & Vascular Center and Harvard Medical School Boston, Massachusetts Dr. Vaduganathan[/caption] Muthiah Vaduganathan, MD, MPH Brigham and Women’s Hospital Heart & Vascular Center and Harvard Medical School Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: The CardioMEMS™ HF System (Abbott, Sylmar, CA) is a commercially-available, wireless hemodynamic monitor that can be permanently implanted in the pulmonary artery (PA) to permit real-time, remote monitoring of PA pressures to enhance clinical decision-making in patients with heart failure (HF). Based on a favorable safety profile and the results of the CHAMPION trial, the US Food and Drug Administration (FDA) approved the device in May 2014. Since FDA approval, the device is being implanted in older patients with greater comorbidities compared with those enrolled in CHAMPION. Limited safety data are available after market introduction in this higher-risk pool.