Medical Research Centers
29 Mar Gene Expression-based Breast Cancer Index Can Improve Decision Making For ER+ Patients
MedicalResearch.com Interview with: [caption id="attachment_33526" align="alignleft" width="133"]
Dr. Tara Sanft[/caption]
Tara Sanft, MD
Assistant Professor of Medicine (Medical Oncology)
Medical Director of Adult Survivorship
Yale Cancer Center Survivorship Clinic
MedicalResearch.com: What is the background for this study?
Response: Previous studies have demonstrated the benefit of extended endocrine therapy (EET) for hormone receptor-positive (HR+) breast cancer in preventing late relapse, however that benefit is limited to 3-5% of women where late recurrence was prevented or staved off. However, EET has become common practice and as a result we are exposing many patients to risks of side effects and toxicities associated with anti-estrogen therapies when they may not be benefitting, and, conversely may not be treating the patients that might actually benefit. There is a real need to better identify the patients who are both at most risk of late distant recurrence, and most likely to benefit from EET.
This prospective study included 141 patients with a mean age of 62. In the study, 83% of patients were postmenopausal, 73% were stage I.
Breast Cancer Index (BCI) is a gene expression-based test and is the only currently available validated biomarker that is both prognostic for late distant recurrence and predictive for likelihood of benefit from EET. The purpose of this prospective study was to assess the impact of BCI on: physician EET recommendations; physician confidence; patient satisfaction, anxiety, and decision-conflict; and the cost impact of BCI.
29 Mar Patients With Clostridium difficile Infections Should Have Need For Gastric Acid Suppression Reassessed
MedicalResearch.com Interview with: [caption id="attachment_33270" align="alignleft" width="166"]
Dr. Sahil Khanna[/caption]
Sahil Khanna, M.B.B.S. MS
Division of Gastroenterology and Hepatology
Mayo Clinic, Rochester, Minnesota
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Clostridium difficile infection (CDI) is the most common cause of hospital-acquired diarrhea and has recently shown increasing incidence especially in the community. Novel risk factors for CDI development include the use of gastric acid suppression medication, presence of systemic comorbid conditions, C difficile carriage in water and food sources, amongst others.
Gastric acid suppression medications such as proton-pump inhibitors (PPIs) and histamine-2 receptor blockers (H2Bs) are commonly prescribed and consumed over the counter for gastroesophageal reflux disease, peptic ulcer disease, or functional dyspepsia, but they are also sometimes prescribed for unnecessary indications, which leads to overuse of these medications. Recurrent CDI after a primary infection is a major problem, with the risk being as high as 50% to 60% after 3 or more Clostridium difficile infections. Data on the association between acid suppression and recurrent CDI are conflicting and therefore we performed a systematic review and meta-analysis to study the association between the use of gastric acid suppression medications and the risk of recurrent CDI.
28 Mar Adolescents Perinatally Infected with HIV Are At Increased Risk of Serious Physical and Mental Health Problems
MedicalResearch.com Interview with: [caption id="attachment_33465" align="alignleft" width="135"]
Dr. Neilan[/caption]
Anne M Neilan, MD,MPH
Assistant in Medicine and Pediatrics
Massachusetts General Hospital
Instructor at Harvard Medical School
Department: Medicine Service
Division: Infectious Disease
Department: Pediatric Service
Massachusetts General Hospital
Boston, MA 02114
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Adolescents infected with HIV – either at birth or later in life – experience poorer health outcomes compared to adults with HIV in nearly every respect. This study found that U.S. youth infected with HIV around the time of their birth are at higher risk throughout their adolescence and young adulthood for experiencing serious health problems, poor control of the HIV virus (having high levels of HIV virus in their bodies and fewer CD4 immune cells which protect the body from infection), or death. The study also found that among those with good HIV control, serious health problems are rare.
By combining data from two large, long-term U.S. studies – the Pediatric HIV/AIDS Cohort Study (PHACS, www.phacsstudy.org) and the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT, www.impaactnetwork.org) Network – we were able to study the health of more than 1,400 perinatally HIV-infected children, adolescents and young adults ages 7 to 30 years between 2007 and 2015. The study found that youth ages 13 to 30 were most likely to have poor HIV control AIDS-related illnesses, and death compared to younger participants. Among 18 – 30 year-olds, the study found that poor control of the HIV virus – meaning higher levels of HIV virus and lower levels of CD4 immune cells which protect the body from infection –35 percent of the time, increasing the risk that these youth would stop responding to certain HIV medications and could transmit HIV to others. These findings are consistent with other U.S. and European reports. Despite being engaged in health care, the number of deaths among youth born with HIV in the U.S. is 6 to12 times higher than for youth without HIV of the same age, sex and race.
Along with HIV-related health problems, the most commonly reported health conditions concerned mental health and brain and nervous system development. Many women in the study also had sexually transmitted infections, which was found to be associated with lower CD4 immune cell counts. This may suggest a biological mechanism or may reflect that patients who have difficulty with their medications are also engaging in more frequent risky sexual behaviors.
24 Mar BRCA Testing Shifts From Cancer Patients to Unaffected Women
MedicalResearch.com Interview with: [caption id="attachment_33272" align="alignleft" width="133"]
Dr. Fangjian Guo[/caption]
Fangjian Guo, MD, PhD
Department of Obstetrics and Gynecology
Center for Interdisciplinary Research in Women’s Health
University of Texas Medical Branch
Galveston TX
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: BRCA testing in patients diagnosed with early-onset breast or ovarian cancer can identify women with high-risk mutations, which can guide treatment. Women who learn they have a high-risk mutation may also want to inform family members that they may also carry a high-risk mutation.
Additionally, BRCA testing can be used to identify high-risk mutation carriers before they develop breast or ovarian cancer. Carriers can then manage their cancer risks with screening (MRI/mammogram), chemoprevention, or prophylactic surgery. Current guidelines recommend BRCA testing for individuals who are considered high-risk for breast or ovarian cancer based on personal or family history. However, this practice fails to identify most BRCA mutation carriers. It is estimated that more than 90% of mutation carriers have not been identified. One of the issues is that many women who do get tested are actually low-risk and do not have any personal or family history of breast or ovarian cancer.
This study assessed how BRCA testing was used in the US health care system during the past decade. We found that in 2004 most of the tests (75.7%) were performed in patients who had been diagnosed with breast or ovarian cancer. Only 24.3% of tests were performed in unaffected women. However, since 2006, the proportion of BRCA tests performed in unaffected women has increased sharply, with over 60% of the tests performed in unaffected women in 2014.
23 Mar Computerized Clinical Decision Support Systems Can Reduce Rate of Venous Thromboembolism
Posted at 23:34h
in Author Interviews, Clots - Coagulation, Electronic Records, JAMA, NYU/NYMC, Surgical Research
MedicalResearch.com Interview with:
Zachary Borabm, Research fellow
Hansjörg Wyss Department of Plastic Surgery
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Recent studies have shown that health care providers perform poorly in risk stratifying their patients for venous thromboembolism (VTE) which leads to inadequate VTE prophylaxis delivery, especially in surgical patients. Computerized Clinical Decision Support Systems (CCDSSs) are programs integrated into an electronic health record that have the power to aid health care providers. Using a meta-analysis study technique we were able to pool data from 11 studies, including 156,366 patients that either had CCDSSs intervention or routine care without CCDSSs.
Our main outcome measures were the rate of prophylaxis for VTE and the rate of actual VTE events. We found that CCDSSs increased the rate of VTE prophylaxis (odds ratio 2.35, p<0.001) and decreased the risk of VTE events (risk ratio 0.78, p<0.001).
22 Mar Autism Increases Risk of Death From Injury, Especially Drowning
MedicalResearch.com Interview with: Joseph Guan MPH Candidate in Epidemiology, Certificate in Chronic Diseases Epidemiology Columbia University Mailman School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: The prevalence of autism has been increasing especially in the past two decades. With an estimate of more than 3.5 million people living with autism in the US, approximately 500,000 of them are children under 15 years old. Current studies show that males are approximately four times as likely than females to be diagnosed with autism. There is also evidence that people with autism are at a heightened risk of injury. However, the research on the relationship between autism and injury is understudied. We found that 28% of deaths in individuals with autism were due to injury, compared to 7% of deaths in the general population. Injury deaths in individuals with autism occurred at a much younger age (29.1 years) on average compared to injury deaths in the general population (54.7 years). Our study show that drowning was the leading cause of injury death among individuals with autism, followed by suffocation and asphyxiation. Children under the age of 15 years were 160 times more likely to die from drowning.19 Mar iFR Can Assess Need For Coronary Revascularization Without Adenosine
Posted at 23:13h
in Author Interviews, Heart Disease, Imperial College, Medical Imaging, Surgical Research
MedicalResearch.com Interview with:
[caption id="attachment_33035" align="alignleft" width="149"]
Dr. Davies[/caption]
Dr. Justin Davies PhD
Senior Reserch Fellow and Hononary Consultant Cardiologist
National Heart and Lung Institute,
Imperial College London
MedicalResearch.com: What is the background for this study?
Response: We know from the FAME study that compared to angiography alone, FFR guided revascularization improves long-term clinical outcomes for our patients. Despite this, adoption of FFR into everyday clinical practice remains stubbornly low. One major factor for this is the need for adenosine (or other potent vasodilator medications) in order to perform an FFR measurement. Adenosine is expensive, unpleasant for the patient, time consuming and even potentially harmful.
iFR is a newer coronary physiology index that does not require adenosine for its measurement. In the prospective, multi center, blinded DEFINE FLAIR study, 2492 patients were randomly assigned to either FFR guided revascularisation or iFR guided revascularization and followed up for a period of 1 year.
19 Mar Cardiovascular Procedures That Push the Line: High-Risk or Futility of Care?
MedicalResearch.com Interview with: [caption id="attachment_33090" align="alignleft" width="200"]
Dr. Adam Skolnick[/caption]
Adam Skolnick, MD
Cardiologist
Associate professor of medicine
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: I am privileged to serve on the ACC Program Planning Committee and helped to design this important session that seeks to determine the line between when a cardiovascular procedure is high risk and when it is futile. I am co-chairing the session with the incoming chair of the section on Geriatric Cardiology for the ACC, Dr. Karen Alexander from Duke.
We are practicing medicine at one of the most extraordinary times when there are so many devices and procedures to prolong and improve quality of life. It is critical to assess a patient's goals of care for a given intervention. In some patients, particularly those who are multiple degenerative chronic conditions, are frail and/or have cognitive impairment it is difficult to know when a given procedure multiple medical conditions will achieve a patient's goals. When is a procedure high risk, and when is it simply futile? This is the fine line upon which many cardiologists often find themselves.
The speakers present case examples of high risk patients considering TAVI, high risk PCI or CABG and mechanical support devices and with interaction from the audience work through when each procedure is high risk and when it is unlikely to achieve a patient's goals of care. We also have a dedicated talk on high risk procedures in patients with cognitive impairment, such as advanced dementia.
19 Mar Effect of Moderate-Intensity Exercise Training on Peak Oxygen Consumption in Patients With Hypertrophic Cardiomyopathy
Posted at 00:33h
in Author Interviews, Exercise - Fitness, Genetic Research, Heart Disease, JAMA, University of Michigan
MedicalResearch.com Interview with:
[caption id="attachment_33068" align="alignleft" width="200"]
Dr. Sara Saberi[/caption]
Sara Saberi, MD
Assistant Professor
Inherited Cardiomyopathy Program
Frankel Cardiovascular Center
University of Michigan Hospital and Health Systems
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Patients with hypertrophic cardiomyopathy are often told not to exercise or to significantly curb their exercise due to concern over the potential risk of increased ventricular arrhythmias and sudden cardiac death. There is no data regarding risks/benefits of exercise in HCM though. There is, however, data that shows that patients with HCM are less active and more obese than the general population AND a majority feel that exercise restrictions negatively impact their emotional well-being.
So, we devised a randomized clinical trial of a 16-week moderate-intensity aerobic exercise program versus usual activity with the primary outcome being change in peak VO2 (oxygen consumption). This exercise intervention resulted in a 1.27 mL/kg/min improvement in peak VO2 over the usual activity group, a statistically significant finding. There were no major adverse events (no death, aborted sudden cardiac death, appropriate ICD therapies, or sustained ventricular tachycardia). There was also a 10% improvement in quality of life as measured by the Physical Functioning scale of the SF-36v2.
19 Mar Curcumin Gel May Speed Healing of Scalds and Burns
MedicalResearch.com Interview with: [caption id="attachment_33064" align="alignleft" width="167"]
Dr. Madalene Heng[/caption]
Madalene Heng MD, FRACP, FACD, FAAD
Professor of Medicine/Dermatology
UCLA School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Curcumin, the active ingredient in the spice, turmeric, is an excellent anti-inflammatory agent with unique healing properties.
However, this is only observed with our preparation of topical curcumin but not with oral curcumin. This is because curcumin is not absorbed and does not cross cell membranes - low bioavailability.
The biochemical basis for the efficacy of topical curcumin is based on the fact that it is a phosphorylase kinase inhibitor. Phosphorylase kinase is an enzyme released by injured tissue 5 mins following injury, and is responsible for activating the transcription activator (NF-kB), resulting in turning on over 200 genes responsible for inflammation, and scarring among others, resulting in redness, swelling, pain, and eventually scarring. By blocking phosphorylase kinase activity early in the injury pathway, topical curcumin (curcumin gel) results in rapid healing with minimal or no scarring following many types of healing, including burns and scalds. The unique healing properties are also due to the fact that curcumin induces cell death (apoptosis) to damaged cells, resulting in the "space" for replacement by new healthy cells, resulting in normal appearing skin following burns and scalds.
The salutary result depends on when the curcumin gel is applied - the earlier the better. We observed that when curcumin gel was applied within 4 days to second degree burns- hourly applications, tapering after the patient is improved - we observed rapid healing within 5 days, with the skin returning to normal within 6 weeks to 2 months without redness or visible scarring. Minor burns and scalds heal even more rapidly. Pain was improved within hours.
MedicalResearch.com: What should readers take away from your report?
Response: If the readers happen to have curcumin gel (Psoria-Gold) in their first aid kit, they should apply curcumin gel multiple times as soon as possible. Within the first hour, they should apply it every 5-10 mins, tapering off when the pain and swelling is improved. If they do this, it is possible that blistering may be aborted. The scarring is also minimal. The curcumin gel should be applied twice daily until the skin returns to normal (no redness, swelling, pigmentation etc) and no visible scarring is seen.
17 Mar Patients Who Quit Smoking Had Fewer Adverse Events After Knee Replacement
MedicalResearch.com Interview with: Amy Wasterlain, MD Fourth-year orthopaedic surgery resident NYU Langone Medical Center who led the study with Dr. Richard Iorio MedicalResearch.com: What is the background for this study? Response: We looked at smoking habits and outcomes for 539 smokers undergoing primary total hip or knee arthroplasty, 73 of whom participated in a pre-operative smoking cessation program. Patients who participated in program were 4.3 times more likely to quit than smokers who tried to quit on their own. Program participants also reduced their tobacco intake dramatically (10.6 fewer cigarettes/day) compared to smokers who didn’t participate (2.3 fewer cigarettes/day), even if they weren’t able to quit completely. Patients who completed the program before undergoing total knee arthroplasty had about 24% fewer adverse events (readmission, venous thromboembolism, stroke, urinary tract infection, pneumonia, and surgical site infection) than smokers who didn’t participate in the program.16 Mar Laypeople Perceive Facelift To Give More Youthful, Healthier Appearance
MedicalResearch.com Interview with: Lisa E. Ishii, MD, MHS Associate Professor of Otolaryngology - Head and Neck Surgery John Hopkins Medicine [caption id="attachment_32938" align="alignleft" width="80"]
Dr. Ishii[/caption]
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There was a gap in our knowledge about what the average lay person thought about the impact of a facelift. We had information about what experts in the field like Dr. Swail thought, and some about what patients themselves thought, but nothing about lay people.
Patients who choose to have a facelift are typically concerned about the opinions of:
1) Themselves when they look in the mirror, and
2) Laypeople they encounter socially in society.
Our study showed for the first time that laypeople find people who have had a facelift to appear more attractive, more youthful, healthier and more successful than they were before their facelift.
16 Mar How Does Spinal Deformity Impact Hip Stability?
MedicalResearch.com Interview with: [caption id="attachment_33024" align="alignleft" width="200"]
Dr. Aaron Buckland[/caption]
Dr Aaron J. Buckland
Spinal and scoliosis surgeon and
Assistant professor
Orthopedic surgery
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study?
Response: For decades, surgeons performing hip replacements have placed the acetabular component adjacent to the pelvis in a “safe zone” which has been shown to reduce dislocation risk. However, beginning in residency, I would notice that several of my patients with spinal deformities or lumbar fusions, would experience dislocations despite the safe zone placement of these implants. Our initial research demonstrated that there was an increased dislocation risk in patients with lumbar fusions, particularly if they underwent spinal realignment. We investigated this phenomenon further by retrospectively reviewing 107 patients who met the criteria for sagittal spinal deformity, including 139 hip replacements collectively.
16 Mar Should Teenagers Be Able To Get Oral Contraceptives Over The Counter?
MedicalResearch.com Interview with: [caption id="attachment_33016" align="alignleft" width="80"]
Dr. Upadhya[/caption]
Krishna K. Upadhya, M.D., M.P.H.
Division of General Pediatrics & Adolescent Medicine
Department of Pediatrics
Johns Hopkins University School of Medicine
Baltimore, MD 21287
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our study reviewed medical literature to examine the question of whether minor teens should be treated differently from older women with regard to a future over the counter oral contraceptive product. Our analysis found that oral contraceptive pills are safe and effective for teens and there is no scientific rationale to restrict access to a future oral contraceptive pill based on age.
16 Mar Racial Disparities in Genetic Testing of Women With Breast Cancer
Posted at 20:55h
in Author Interviews, Breast Cancer, Cancer Research, Genetic Research, Race/Ethnic Diversity, Yale
MedicalResearch.com Interview with:
[caption id="attachment_33012" align="alignleft" width="200"]
Dr. Cary Gross[/caption]
Cary P. Gross, MD
Section of General Internal Medicine
Yale University School of Medicine
New Haven, CT
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Prior work has demonstrated racial and socioeconomic disparities in breast cancer diagnosis, treatment, and outcomes. As the oncology field has progressed over the past decade, the use of genetic testing to guide treatment decisions is one of the most exciting new developments.
Our team was concerned that these new gene tests, which can offer important benefits, may have the potential to exacerbate disparities further. That is, if there is unequal access to gene testing among patients for whom it is recommended, then our progress against cancer will not be equitably shared among people of all races and ethnicities.
16 Mar Taking Testosterone Doesn’t Increase Prostate Cancer Risk
Posted at 20:41h
in ASCO, Author Interviews, Boehringer Ingelheim, Journal Clinical Oncology, NYU/NYMC, Prostate Cancer, Testosterone
MedicalResearch.com Interview with:
[caption id="attachment_15257" align="alignleft" width="199"]
Dr. Stacy Loeb[/caption]
Dr. Stacy Loeb MD Msc
Assistant Professor of Urology and Population Health
New York University Langone Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The association between exposure to testosterone replacement therapy and prostate cancer risk is controversial. The purpose of our study was to examine this issue using national registries from Sweden, with complete records on prescription medications and prostate cancer diagnoses. Overall, we found no association between testosterone use and overall prostate cancer risk. There was an early increase in favorable cancers which is likely due to a detection bias, but long-term users actually had a significantly reduced risk of aggressive disease.
16 Mar No Increased Health Consequences After Chinese Famine Except Schizophrenia
MedicalResearch.com Interview with: [caption id="attachment_32996" align="alignleft" width="165"]
Dr. Lumey[/caption]
L. H. Lumey, MD, PhD
Professor of Epidemiology
Mailman School of Public Health
Columbia University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The Chinese Great Leap Forward Famine in 1959-1961 is the largest famine in human history. Earlier studies have reported that overweight, type 2 diabetes, hyperglycemia, the metabolic syndrome and schizophrenia were more common among adults who were exposed to the famine. Our re-analysis of all previous studies shows no increases in diabetes, high blood pressure and other chronic conditions among famine births except for schizophrenia.
15 Mar Skin Testing Plus APP May Reduce Overdiagnosis of Penicillin Allergy
MedicalResearch.com Interview with: Kimberly Gold Blumenthal, M.D Assistant Professor of Medicine Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Response: Over-reported penicillin allergies negatively impact patient care, as alternative drugs that are often used can be less effective, more toxic, more broad-spectrum (killing all of the good bacteria and leaving patients increasingly vulnerable to C.diff colitis), and more expensive. Most hospitalized patients who have a recorded penicillin allergy are not actually allergic. This has drawn attention by national organizations such as the CDC, National Quality Forum, and both allergy and infectious diseases professional societies. The message is clear: Address reported penicillin allergies in some way to improve care.15 Mar Effect of SSRIs and Depression On Revisions After Hip or Knee Replacement
MedicalResearch.com Interview with: [caption id="attachment_32948" align="alignleft" width="180"]
Dr. Hilal Maradit Kremers[/caption]
Hilal Maradit Kremers, M.D. M.Sc.
Associate Professor of Epidemiology
Mayo Clinic College of Medicine
MedicalResearch.com: What is the background for this study?
Response: Depression and mood disorders are common comorbidities in patients undergoing total hip and total knee arthroplasty. Based on previous research, there is evidence to suggest presence of depression in arthroplasty patients is associated with worse functional and clinical outcomes, such as complications, readmissions and mortality. Although the mechanisms are poorly understood, it is important to identify strategies to effectively manage perioperative depression in an effort to improve arthroplasty outcomes. One potential strategy is effective medical treatment of underlying depression which can potentially improve depression symptoms, thereby surgical outcomes.
15 Mar Combination Opioids and Benzodiazepines Raises Risk of Overdose
MedicalResearch.com Interview with: [caption id="attachment_32934" align="alignleft" width="200"]
Dr. Eric Sun[/caption]
Eric C Sun MD PhD, assistant professor
Department of Anesthesiology
Perioperative and Pain Medicine
Stanford University School of Medicine
Stanford, CA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There have been large increases in opioid-related adverse events over the past decade. The goal of our study was to examine the extent to which these increases may have been driven by combined use of opioids and benzodiazepines, a combination that is known to be potentially risky. Overall, we found that the combined use of opioids and benzodiazepines nearly doubled (80% increase) between 2001 and 2013, and that opioid users who also used benzodiazepines were at a higher risk of an opioid-related adverse event. Indeed, our results suggest eliminating the combined use of opioids and benzodiazepines could have reduced the population risk of an opioid-related adverse event by 15%.
14 Mar Parents Live Longer Than Those Without Children
MedicalResearch.com Interview with: [caption id="attachment_32866" align="alignleft" width="150"]
Dr. Modig[/caption]
Dr. Karin Modig, PhD
Institute of Environmental Medicine,Epidemiology
Karolinska Institute
MedicalResearch.com: What is the background for this study?
Response: The background to the study was that even though it is established that parents live longer than non-parents the underlying mechanisms are not clear. And it was not known how the association changed with the age of the parents. We hypothesize that if social support is one mechanism – the association between having children and the death risk of parents-non-parents would increase with age of the parents, when health starts to deteriorate and the need of support increases.
13 Mar Increased Physician Spending On Hospital Care Does Not Improve Outcomes
MedicalResearch.com Interview with: Yusuke Tsugawa, research associate Department of Health Policy and Management Harvard T H Chan School of Public Division of General Internal Medicine and Primary Care Brigham and Women’s Hospital, Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that health spending varies substantially across geographical regions, and yet regions that spend more on health care dot not achieve better health outcomes. These findings has led to many to conclude that at least 20% of U.S. health care spending could be reduced without compromising quality of care. However, while physicians play a critical role in health care decision making, little is known as to how much health care spending varies between physicians, and its implications for patient outcomes. In this study, we found that the variation in spending across physicians is slightly larger than the variation across hospitals. More importantly, higher spending by physicians did not lead to lower patient mortality or readmission rates, within the same hospital.13 Mar Adiposity Related Cancer Risk May Vary On Fat Locations
MedicalResearch.com Interview with: Arjun Gupta, MD and Ian J. Neeland MD, Assistant Professor Dedman Family Scholar in Clinical Care Division of Cardiology UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adiposity is traditionally measured using the body mass index, which refers to a persons weight in kilograms divided by their height (in meters) squared. Persons with higher body mas index have been shown to have increased risk of certain cancers, however body mass index by itself is not a completely representative measure of body fat risk, because distinct fat depots such as visceral adipose tissue, abdominal subcutaneous adipose tissue, liver fat and lower body fat have differing metabolic impact. We aimed to study the relationship between specific fat depots and the risk of incident cancer among relatively young, multiethnic participants in the Dallas Heart Study. Individuals without prevalent cancer underwent quantification of adipose depots using MRI and DEXA scans from 2000-2002, and were followed for the development of cancer for up to 12 years. In multivariable models adjusted for age, sex, race, smoking, alcohol use, family history of malignancy and body mass index, visceral adipose tissue, subcutaneous adipose tissue or liver fat were not associated with risk of cancer but each 1-standard deviation increase in lower body fat was associated with a 31% reduced incidence of cancer.11 Mar Physicians, PAs and Nurse Practitioners Provide Similar Amount of Low Value Care
MedicalResearch.com Interview with: [caption id="attachment_32850" align="alignleft" width="200"]
Dr. John N. Mafi[/caption]
John N. Mafi, MD, MPH
Division of General Internal Medicine and Health Services Research
Department of Medicine, Ronald Reagan UCLA Medical Center
Los Angeles, CA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our country has a primary care physician shortage. Some have advocated that we expand the scope of practice for nurse practitioners and physician assistants to help alleviate this problem and improve access to primary care. But a 2013 study in the New England Journal of Medicine found that a large number of physicians believed that nurse practitioners provided lower value care when compared with physicians. We decided to put that belief to the test. We studied 29,000 U.S. patients who saw either a nurse practitioner, physician assistant, or physician in the primary care setting for common conditions, and we compared the rate of low-value or unnecessary services—for example, unnecessary antibiotics for the common cold, or MRI for low back pain, or a CT scan for headache. Things that don’t help patients and may harm.
We found no difference in the rates of low value services between nurse practitioners, physician assistants, and physicians. In other words, they did equivalent amounts of inappropriate or bad care.
08 Mar Diabetes Raises Risk of Death From Cancer in Asians
Posted at 12:57h
in Author Interviews, Cancer Research, Diabetologia, NYU/NYMC, Race/Ethnic Diversity
MedicalResearch.com Interview with: [caption id="attachment_32662" align="alignleft" width="150"] Dr. Yu Chen[/caption] Yu Chen PhD MPH Associate Professor, Department of Population Health Associate Professor, Department of Environmental Medicine Associate Professor, Department of Medicine NYU Langone School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response There is increasing evidence of an association between type...
07 Mar Gene “Decorations” Can Serve as Blood Biomarkers To Detect Cancer
MedicalResearch.com Interview with: [caption id="attachment_32737" align="alignleft" width="153"]
Dr. Kun Zhang[/caption]
Kun Zhang, PhD
Professor
UCSD Department of Bioengineering
La Jolla, CA 92093-0412
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We have been interested in a type of chemical modification on the DNA, called CpG methylation, for years. This is like a decoration of DNA molecules that is specific to the cell type or tissue type. We were particularly interested in studying how such decoration spread along the DNA molecules. In this study, we did a very comprehensive search of the entire human genome for various human cell types and tissue types, and found close to 150,000 regions (called MHB in this study) in which adjacent CpG share the same decoration. We then went on to find out how many of such regions are unique to each normal cell/tissue type, and how many are specific to cancers. Then we took some of these highly informative regions as “biomarkers”, and showed that we can detect the absence or presence of cancer, and, in the latter case, where the tumor grow, in a patient’s blood.
07 Mar Maternal Cancer During Pregnancy Linked To Stillbirths and Infant Mortality
Posted at 21:26h
in Author Interviews, Cancer Research, Journal Clinical Oncology, Karolinski Institute, OBGYNE
MedicalResearch.com Interview with: [caption id="attachment_32727" align="alignleft" width="150"] Dr. Donghao Lu[/caption] Donghao Lu PhD student Department of Medical Epidemiology and Biostatistics Karolinska Institute MedicalResearch.com: What is the background for this study? Response: Cancer during pregnancy is a rare event. Whether prenatal exposure to a maternal malignancy and its treatment during pregnancy impair fetal development and neonatal health...
07 Mar Genetic Variants Tied To Kidney Disease in African Americans
Posted at 01:55h
in Author Interviews, Blood Pressure - Hypertension, Genetic Research, Kidney Disease, Nature, Race/Ethnic Diversity, University of Pennsylvania
MedicalResearch.com Interview with:
[caption id="attachment_32695" align="alignleft" width="148"]
Dr. Susztak[/caption]
Katalin Susztak MD, PhD
Associate Professor of Medicine
Perelman School of Medicine
University of Pennsylvania
Philadelphia, PA 19104
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous studies showed an association between genetic variants in the APOL1 gene and kidney disease development, but it has not been confidently shown that this genetic variant is actually causal for kidney disease. For this reason we developed a mouse model that recapitulates the human phenotype.
06 Mar Membership In Medical Schools’ Honor Society Skews Toward White Students
MedicalResearch.com Interview with: [caption id="attachment_32681" align="alignleft" width="175"]
Dr. Dowin Boatright[/caption]
Dowin Boatright, MD, MBA
Department of Emergency Medicine
Yale School of Medicine
New Haven, Connecticut
Fellow, Robert Wood Johnson Clinical Scholars Program
Veterans Affairs Scholar
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Studies have demonstrated racial and ethnic inequities in medicine, including disparities in the receipt of awards, research funding, and promotions. Yet few studies have examined the link between race and ethnicity and opportunities for medical school students.
Our results show that black and Asian medical school students are less likely to be selected for membership in a prestigious medical honor society, Alpha Omega Alpha (AΩA), than white medical school students.