Author Interviews, Beth Israel Deaconess, Electronic Records, HIV / 31.10.2016

MedicalResearch.com Interview with: Douglas Krakower, MD Infectious Disease Division Beth Israel Deaconess Medical Center Boston, MA, MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are 45,000 new HIV infections in the US annually, so effective HIV prevention strategies are needed. HIV pre-exposure prophylaxis (PrEP), whereby a person who is HIV-uninfected uses an HIV treatment medication on a daily basis to protect themselves from becoming infected with HIV, is over 90% effective when taken with high adherence. The Centers for Disease Control and Prevention estimates that there are 1.2 million Americans who are likely to benefit from using PrEP. However, only 80,000 persons have been prescribed PrEP. One of the barriers to implementing PrEP is that clinicians face challenges with identifying persons who are most likely to benefit from PrEP, given infrequent sexual health history assessments during routine clinical care. We thus sought to develop an automated algorithm that uses structured data from electronic health records (EHRs) to identify patients who are most likely to benefit from using PrEP. Our methods included extracting potentially relevant EHR data for patients with incident HIV and without HIV from nearly a decade of EHR data from a large ambulatory practice in Massachusetts. We then used machine learning algorithms to predict HIV infection in those with incident HIV and those without HIV. We found that some algorithms could offer clinically useful predictive power to identify persons who were more likely to become infected with HIV as compared to controls. When we applied these algorithms to the general population and identified a subset of about 1% of the population with risk scores above an inflection point in the total distribution of risk scores; these persons may be appropriate for HIV testing and/or discussions about PrEP. (more…)
Author Interviews, Biomarkers, Cancer, Cancer Research, University of Pennsylvania / 28.10.2016

MedicalResearch.com Interview with: Eric Ojerholm, MD Resident, Radiation Oncology Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: Multiple studies reported that a blood test —the neutrophil-to-lymphocyte ratio (NLR)—might be a helpful biomarker for bladder cancer patients. If this were true, NLR would be very appealing because it is inexpensive and readily available. However, previous studies had several methodological limitations. MedicalResearch.com: What did you do in this study Response: We therefore put NLR to the test by performing a rigorous “category B” biomarker study—this is a study that uses prospectively collected biomarker data from a clinical trial. We used data from SWOG 8710, which was a phase III randomized trial that assessed surgery with or without chemotherapy for patients with muscle-invasive bladder cancer. We tested two questions. First, could NLR tell us how long a bladder cancer patient would live after curative treatment? Second, could NLR predict which patients would benefit from chemotherapy before surgery? (more…)
Author Interviews, Cost of Health Care, Emory / 27.10.2016

MedicalResearch.com Interview with: Elizabeth Walker, PhD, MPH, MAT Research Assistant Professor Assistant Director of Evidence-based Learning Department of Behavioral Sciences and Health Education Rollins School of Public Health Emory University MedicalResearch.com: What is the background for this study? Response: Previous research has shown that many adults in the United States have one or more chronic health condition; however, not much was known about multimorbidities – having multiple chronic conditions – among people with mental disorders. We used nationally representative data from the National Survey on Drug Use and Health to determine the patterns of co-occurrence of mental illness, substance abuse and/or dependence, and chronic medical conditions. We also examined the association between the cumulative burden of these conditions, as well as living in poverty, and self-rated health. (more…)
Author Interviews, JAMA, Nutrition, Urinary Tract Infections, Yale / 27.10.2016

MedicalResearch.com Interview with: Manisha Juthani-Mehta, MD, FACP, FIDSA, FSHEA Associate Professor, Section of Infectious Diseases Infectious Diseases Fellowship Program Director Yale University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the first studies that showed that cranberry juice was effective in older women living in nursing homes and assisted living facilities was published in 1994. Since that time, there have been multiple conflicting studies as to the effect of cranberry juice or capsules. We started our study in 2012. Shortly thereafter, a Cochrane review suggested that the vast body of evidence did not suggest that cranberry products work for UTI prevention, but questions still existed as to whether the appropriate dose of cranberry was being tested. Since cranberry juice is hard for older women to drink (taste, sugar load, volume), capsules at a high dose of the active ingredient (72mg type A proanthocyanidin [PAC}) was worthwhile to test. This study was a clinical trial of two cranberry capsules with a total of 72mg of proanthocyanidin (pac) vs two placebo capsules to prevent bacteria in the urine of older women who live in nursing homes. Unfortunately, it didn't work. It also didn't reduce the number of hospitalizations, deaths, antibiotics used, or antibiotic resistant bugs in the urine. (more…)
Allergies, Author Interviews, NIH / 26.10.2016

MedicalResearch.com Interview with: Geoffrey Mueller, Ph.D. Staff Scientist Genome Integrity and Structural Biology Laboratory National Institute of Environmental Health Sciences National Institutes of Health Research Triangle Park, NC 27709 MedicalResearch.com: What is the background for this study? What are the main findings? Response: While allergic disease is a wide spread problem, it is actually a select few proteins, called allergens, that initiate allergy symptoms. This study was focused on looking for fundamental biochemical differences between allergens and non-allergens derived from the house dust mite. We found that the mite allergens, as a group, are distinctly different from the non-allergens in that they are more highly produced, and more stable. Previous anecdotal evidence suggested that these properties would lead to more allergens surviving the journey from the source (either mites or pollens) to a person. In addition, the greater stability of allergens may influence the decision making of the immune system to target these proteins as dangerous instead of harmless. (more…)
Author Interviews, OBGYNE, Pediatrics, Primary Care, Yale / 26.10.2016

MedicalResearch.com Interview with: Ann Kurth, Ph.D., C.N.M., R.N. USPSTF Task Force member Dean of the Yale School of Nursing MedicalResearch.com: What is the background for this study? What are the main findings? Response: Breastfeeding is beneficial for both mothers and their babies, with the evidence showing that babies who are breastfed are less likely to get infections such as ear infections, or to develop chronic conditions such as asthma, obesity, and diabetes. For mothers, breastfeeding is associated with a lower risk for breast and ovarian cancer and type 2 diabetes. While breastfeeding rates have been rising in recent decades—with 80 percent of women starting to breastfeed and just over half still doing so at six months—they are still lower than the Healthy People 2020 targets and the Task Force wanted to review the latest evidence around how clinicians can best support breastfeeding.” After balancing the potential benefits and harms, the Task Force found sufficient evidence to continue to recommend interventions during pregnancy and after birth to support breastfeeding. This recommendation includes the same types of interventions the Task Force recommended in 2008, such as education about the benefits of breastfeeding, guidance and encouragement, and practical help for how to breastfeed. (more…)
ALS, Antioxidants, Author Interviews, Columbia, Inflammation, JAMA, Nutrition / 26.10.2016

MedicalResearch.com Interview with: Dr. Jeri Nieves PhD Director of bone density testing New York's Helen Hayes Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Amyotrophic lateral sclerosis (ALS) is a devastating severe neurodegenerative disorder that causes progressive muscle atrophy, paralyses, and eventual respiratory failure. Our objective was to evaluate the associations between nutrition and severity of ALS around the time of diagnosis. This was a cross-sectional analysis of data from a multicenter cohort of 302 patients with ALS. We assessed nutrient intake using a modified Block Food Frequency Questionnaire. The outcomes were respiratory function (measured using percentage forced vital capacity; FVC%) and functional performance measured by ALS Functional Rating Scale–Revised (ALSFRS-R), both considered important indicators of the severity of ALS. Results of the regression analysis were that higher intakes of antioxidants and carotenes from vegetable intake were associated with higher ALSFRS-R scores or better %FVC. We used a novel analysis to evaluate the diet as a whole and found that higher intakes of antioxidants, fiber from grains, vegetables, fruit, eggs, fish, and poultry were all associated with higher function in patients with ALS. However, milk and lunch meats were associated with lower measures of function. These consistent results from two different statistical analyses indicate that diet may help minimize the severity of ALS. Perhaps these findings point to the role of oxidative stress in ALS severity. In summary, increased consumption of antioxidant nutrients, foods high in carotenoids and fiber, vegetables and fruits, poultry and fish are associated with better function around the time of ALS diagnosis. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA / 24.10.2016

MedicalResearch.com Interview with: Anna D. Sinaiko, PhD, MPP Research Scientist Department of Health Policy & Management Harvard T.H. Chan School of Public Health Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: One strategy for reducing health care spending in the U.S. is to increase transparency in health care pricing for patients. The idea is that patients can learn about and anticipate the prices they would pay for health care before they receive care, and incorporate that information into their choices about whether and where to receive care. When patients incorporate price information into their decisions, it gives providers an incentive to compete on price and quality. There has been a dramatic increase in the availability of health care price information over the last few years for patients who have commercial health insurance, primarily through web-based tools. In this study, we examined the impact of this information on patient choice of health care facility. We find that a small number of enrollees with commercial health insurance through Aetna, 3% overall, accessed price information through their transparency tool. Among users of the tool, patients who viewed price information for imaging services and for sleep studies before they had the service chose facilities with lower prices, and incurred lower spending (of 12%) for imaging services. We found no effect on patient choices for patients who viewed price information for 6 other health care services (carpal tunnel release, cataract/lens procedures, colonoscopy, echocardiogram, mammograms, and upper gastrointestinal endoscopy). (more…)
Author Interviews, Columbia, JAMA, OBGYNE, Stroke / 24.10.2016

MedicalResearch.com Interview with: Eliza Miller, M.D. Vascular Neurology Fellow New York-Presbyterian Hospital/Columbia University Medical Center We collaborated with researchers at the Massachusetts General Hospital and with the New York State Department of Health. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior research has found that older women of childbearing age are at higher risk of stroke during pregnancy and postpartum than younger women. We hypothesized that their increased stroke risk might not be due to pregnancy-related factors, but just due to the fact that stroke risk increases with age for all people. We used billing data from New York State hospitals to calculate incidence risk ratios for four age groups: 12-24, 25-34, 35-44 and 45-55. In each age group, we compared the incidence of stroke in women who were pregnant or postpartum to the incidence of stroke in women of the same age who were not pregnant. As in prior studies, we found that the incidence of pregnancy-associated stroke was higher in older women compared to younger women (about 47/100,000 deliveries in the oldest group, versus 14/100,000 deliveries in the youngest group). However, the incidence ratios showed that pregnancy increased stroke risk significantly in women under 35, but did not appear to increase stroke risk in women over 35. In the youngest group (age 12-24), pregnancy more than doubled the risk of stroke, and in the 25-34 age group, pregnancy increased stroke risk by 60%. In women aged 35 and older, pregnancy did not increase stroke risk. Women who had pregnancy-related strokes tended to have fewer traditional vascular risk factors like hypertension and diabetes, compared to same-aged women with non-pregnancy related strokes. (more…)
AHA Journals, Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Clots - Coagulation, Heart Disease / 18.10.2016

MedicalResearch.com Interview with: Eric A. Secemsky, MD MSc Interventional Cardiology Fellow Massachusetts General Hospital Harvard Medical School Fellow, Smith Center for Outcomes Research in Cardiology Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: Use of oral anticoagulant (OAC) therapy prior to coronary stenting is a significant predictor of post-procedural bleeding events. Previous studies have estimated that the frequency of chronic OAC use among patients undergoing percutaneous coronary intervention (PCI) is between 3% to 7%. Yet many of these analyses examined select patient populations, such as those admitted with acute myocardial infarction or atrial fibrillation, and preceded the market approval of non-vitamin K antagonist oral anticoagulants (NOACs). As such, the contemporary prevalence of OAC use among all-comers undergoing PCI, as well as associated risks of adverse events, are currently unknown. Therefore, we used PCI data from a large, integrated healthcare system to determine current use of  oral anticoagulant use among all-comers undergoing coronary stenting and the related short- and long-term risks of therapy. (more…)
Author Interviews, FASEB, Heart Disease, Imperial College, Pain Research, Pharmacology / 17.10.2016

MedicalResearch.com Interview with: Dr Nicholas Kirkby BHF Intermediate Fellow | Vascular Biology National Heart & Lung Institute | Imperial College London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know drugs like ibuprofen, called ‘non-steroidal anti-inflammatory drugs’ cause an increase in the risk of heart attacks. These side effects cause very real concerns for the many millions of people who rely on them. They are also the reason why there are no new drugs in this class and why they have been withdrawn (2011) for use as a preventative treatment for colon cancer. Previous research from our group suggests that L-arginine supplements may prevent the cardiovascular side effects caused by these drugs. Our findings here suggest that a particular formulations of ibuprofen, called ibuprofen arginate, which is already available in many parts of the world, can act like an L-arginine supplement and that this could potentially protect the cardiovascular system. (more…)
Author Interviews, Cancer Research, ESMO, Immunotherapy, NYU / 16.10.2016

MedicalResearch.com Interview with: Arjun Balar, M.D. Assistant Professor of Medicine Director - Genitourinary Medical Oncology Program NYU Perlmutter Cancer Center New York, NY 10016 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Standard treatment for advanced urothelial cancer includes cisplatin-based chemotherapy which has been shown to improve survival. But more than half of patients are not expected tolerate it well and alternative treatment is inferior to cisplatin. The average survival for these patients is in the range of 9-10 months with carboplatin-based treatment, which is the most commonly used alternative to cisplatin. Pembrolizumab is a PD-1 blocking antibody that reactivates the body’s cancer-fighting T-cells (part of the immune system) to fight urothelial cancer. The trial overall enrolled 374 patients who had not yet received any treatment for advanced urothelial cancer, but were considered ineligible for cisplatin chemotherapy. (more…)
Alzheimer's - Dementia, Author Interviews, Hormone Therapy, JAMA, Prostate Cancer, University of Pennsylvania / 15.10.2016

MedicalResearch.com Interview with: Kevin T. Nead, MD, MPhil Resident, Radiation Oncology Perelman School of Medicine Hospital of the University of Pennsylvania. MedicalResearch.com: What is the background for this study? Response: Androgen deprivation therapy is a primary treatment for prostate cancer and works by lowering testosterone levels. There is a strong body of research suggesting that low testosterone can negatively impact neurovascular health and function. We were therefore interested in whether androgen deprivation therapy is associated with dementia through an adverse impact on underlying neurovascular function. (more…)
Author Interviews, Columbia, JAMA, Mental Health Research, OBGYNE, Pediatrics / 13.10.2016

MedicalResearch.com Interview with: Alan S. Brown, M.D., M.P.H. Professor of Psychiatry and Epidemiology Columbia University Medical Center Director, Program in Birth Cohort Studies, Division of Epidemiology New York State Psychiatric Institute  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Maternal use of antidepressants during pregnancy has been increasing.  A previous study from a team that I led in a national birth cohort in Finland showed that mother’s use of a serotonin reuptake inhibitor antidepressant is related to an increased risk of depression in offspring.  We sought to evaluate whether these medications also increased risk of speech/language, scholastic, and motor outcomes in offspring.  We found an increased risk (37% higher risk) of speech/language disorders in offspring of mothers exposed to SSRIs in pregnancy compared to mothers who were depressed during pregnancy but did not take an SSRI during pregnancy. (more…)
Alcohol, Author Interviews, NIH, Pharmacology / 12.10.2016

MedicalResearch.com Interview with: Megan Ryan M.B.A. Clinical Program Director, DMD Technology Development Coordinator National Institute on Alcohol Abuse and Alcoholism National Institutes of Health Bethesda, MD MedicalResearch.com: What is the background for this study? Response: Alcohol use disorder (AUD) has been linked to the dysregulation of the brain stress systems (e.g. corticotropin-releasing factor, glucocorticoids, and vasopressin) creating a negative emotional state leading to chronic relapsing behavior. Several pre-clinical studies have shown that by blocking the V1b receptor with a V1b receptor antagonist, dependence induced compulsive-like alcohol intake is also blocked. This is the first multi-site trial to assess the efficacy of the V1b receptor antagonist novel compound (ABT-436) for the treatment of alcohol dependence. (more…)
Author Interviews, Cost of Health Care, Dermatology, JAMA, NYU / 12.10.2016

MedicalResearch.com Interview with: Hao Feng, M.D., M.H.S. Resident, Department of Dermatology NYU Langone Medical Center MedicalResearch.com: What is the background for this study? Response: Recently, there has been an increased scrutiny on industry-physician interactions and emphasis on disclosures of interactions. While we know about the types of interaction between dermatologists and industry, we wanted to understand that relationship more in depth by probing the Open Payment database. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Technology / 12.10.2016

MedicalResearch.com Interview with: Ateev Mehrotra, M.D. Associate Professor Department of Health Care Policy Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior research has highlighted that physicians make diagnostic errors roughly 10 to 15 percent of the time. Over the last two decades, computer-based checklists and other “fail-safe” digital apps have been increasingly used to reduce medication errors or streamline infection-prevention protocols. Lately, experts have wondered whether computers might also help reduce diagnostic errors. In the study, 234 internal medicine physicians were asked to evaluate 45 clinical cases, involving both common and uncommon conditions with varying degrees of severity. For each case, physicians had to identify the most likely diagnosis along with two additional possible diagnoses. Each clinical vignette was solved by at least 20 physicians. The same cases were also evaluated using 19 symptom checkers, websites or apps that use computers that help patients determine potential diagnoses for what is wrong based on their symptoms. The physicians vastly outperformed the symptom-checker apps, listing the correct diagnosis 72 percent of the time, compared with 34 percent of the time for the digital platforms. Eighty-four percent of clinicians listed the correct diagnosis in the top three possibilities, compared with 51 percent for the digital symptom-checkers. (more…)
Author Interviews, C. difficile, Columbia, Hospital Acquired, JAMA / 12.10.2016

MedicalResearch.com Interview with: Dr. Daniel E. Freedberg MD MS Division of Digestive and Liver Diseases Columbia University Medical Center New York, New York MedicalResearch.com: What is the background for this study? Response: We conducted this study because previous studies indicate that the gastrointestinal microbiome is easily shared between people who co-occupy a given space (such as a hospital room).  We wondered if antibiotics might exert an effect on the local microbial environment. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Outcomes & Safety / 10.10.2016

MedicalResearch.com Interview with: Jared Conley, MD, PhD, MPH Department of Emergency Medicine Massachusetts General Hospital Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: As the U.S. healthcare system seeks to improve the health of populations and individual patients, there is increasing interest to better align healthcare needs of patients with the most appropriate setting of care—particularly as it relates to hospital-based care (accounting for 1/3 of total U.S. healthcare costs). Avoiding hospitalization—as long as safety and quality are not compromised—is often preferred by patients and the added benefit of potentially making care more affordable further promotes such care redesign efforts. There is a growing body of research studying alternative management strategies to hospitalization; we sought to comprehensively review and analyze this work. Alternative management strategies reviewed include outpatient management, quick diagnostic units, observation units, and hospital-at-home. (more…)
Author Interviews, Ophthalmology, UCLA / 10.10.2016

MedicalResearch.com Interview with: Pravin U. Dugel, MD Retina Consultants of Arizona Phoenix, Arizona; USC Roski Eye Institute Keck School of Medicine University of Southern California Los Angeles, California  MedicalResearch.com: What is the background for this study? Response: OASIS is an acronym for “OcriplASmIn for Treatment for Symptomatic Vitreomacular Adhesion including Macular Hole”.  It was a Phase IIIB, randomized, prospective, sham-controlled, double-masked, multicenter clinical study. The goal of the study was to further evaluate the long-term (24 months) efficacy and safety of a single injection of 0.125mg of ocriplasmin in patients with symptomatic vitreomacular adhesion (VMA) and vitreomacular traction (VMT), including macular hole (MH). OASIS evaluated 220 patients with symptomatic VMA/VMT.  One hundred forty-six patients received ocriplasmin while 74 served as a sham control group. In the latter group, no intravitreal injection was administered.  (more…)
Author Interviews, Biomarkers, Cancer, Prostate Cancer, UT Southwestern / 08.10.2016

MedicalResearch.com Interview with: Dr Ryan Hutchinson MD and Yair Lotan MD Department of Urology University of Texas Southwestern Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: The United States Preventative Services Task Force recommendation against PSA screening generated significant controversy. Research since then has relied heavily on survey data to examine the impact of the recommendation on PSA screening practices. In a hotly charged issue such as this, such data can carry significant bias. We examined a large, whole-institution data in the years before and after the USPSTF recommendations reflecting actual practice and found that the changes in PSA use at our institution, if any, were small. This is more consistent with behavior seen after the vast majority of practice recommendations. (more…)
Addiction, Author Interviews, NYU, Pediatrics, Tobacco, Tobacco Research / 08.10.2016

MedicalResearch.com Interview with: Professor Michael Weitzman MD New York University's College of Global Public Health and The Departments of Pediatrics and Population Health New York University School of Medicine NYU Langone Medical Center MedicalResearch.com: What is the background for this study? Response: There is a marked and rapidly increasing epidemic of hookah (waterpipe) use in the US. Hookah use appears to be as, or even more, dangerous than cigarette use. There are data suggesting that one hookah session is comparable to smoking 5 packs of cigarettes in terms of exposure to toxins. The CDC and WHO both have issued warnings that hookah pipe use may eradicate much or all of the progress of the past 50 years of tobacco control efforts. (more…)
Author Interviews, Electronic Records, JAMA, NYU, Technology / 07.10.2016

MedicalResearch.com Interview with: Saul Blecker, MD, MHS Department of Population Health New York University Langone School of Medicine, New York, NY 10016 [email protected] MedicalResearch.com: What is the background for this study? What are the main findings? Response: The identification of conditions or diseases in the electronic health record (EHR) is critical in clinical practice, for quality improvement, and for clinical interventions. Today, a disease such as heart failure is typically identified in real-time using a “problem list”, i.e., a list of conditions for each patient that is maintained by his or her providers, or using simple rules drawn from structured data. In this study, we examined the comparative benefit of using more sophisticated approaches for identifying hospitalized patients with heart failure. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Surgical Research / 06.10.2016

MedicalResearch.com Interview with: Diego Lopez Harvard medical student and Dr. Andrew Loehrer MD former surgical resident at MGH senior author: David C. Chang, PhD, MPH, MBA Associate Professor of Surgery Director of Healthcare Research and Policy Development Department of Surgery Massachusetts General Hospital Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Income inequality in the United States has been increasing in recent decades, and has become an important in this election cycle. Although income inequality is often framed in terms of its effects on politics and the economy, little attention has been paid to its effect on the healthcare system. In our study, we set out to evaluate the way in which counties with differing levels of income inequality made use of the healthcare system while controlling for the overall income (as well as other demographic variables). We found that areas with higher income inequality were associated with higher Medicare expenditures.  And these effects are independent of – meaning they are in addition to – the known effect of poverty on healthcare utilization. (more…)
Author Interviews, Duke, Exercise - Fitness, Lancet / 06.10.2016

MedicalResearch.com Interview with: Aarti Sahasranaman, PhD Duke-NUS Gradaute Medical School Singapore MedicalResearch.com: What is the background for this study? Response: More than half of adults in developed countries do not achieve recommended levels of physical activity. Despite the popularity of activity trackers as a tool for motivating and monitoring activity levels, little research exists on whether they can help people lead healthier lives, or if financial incentives could encourage people to wear them for longer and achieve higher fitness levels. One in ten US adults owns an activity tracker but research suggests that about a third of people abandon them within 6 months of purchase. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Heart Disease, JACC, Salt-Sodium / 06.10.2016

MedicalResearch.com Interview with: Nancy Cook ScD Professor of Medicine, Harvard Medical School Professor in the Department of Epidemiology Harvard T.H. Chan School Public Health Brigham & Women’s Hospital Division of Preventive Medicine Boston, MA 02215 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association of sodium intake with later mortality has been controversial. While there is a well-accepted effect on blood pressure, the effects of sodium on later cardiovascular disease, and particularly mortality, have been subject to dispute. While the adverse effects of high sodium are now widely accepted, effects at lower levels of sodium intake are less clear. Some recent studies have found a J-shaped relationship, with increased disease rates among those consuming lower levels of sodium, contrary to the effects on blood pressure. In contrast, we found a direct linear relationship of usual intake of sodium with later mortality over 20 years of follow-up. Those with the lowest sodium intake experienced the lowest mortality. Our measure of intake was based on the average over 1-3 years of several measures of 24hr urine sodium excretion, the gold standard of sodium measurement. This is much more precise than measurements based on a single 24hr sodium excretion or especially on a spot urine sample, which is used in many publications that found the J-shaped curve. Our data were assessed in a healthy cohort of men and women without hypertension or cardiovascular disease, so had less potential bias due to these factors. We thus believe that our results showing the lowest mortality among those consuming the lowest levels of sodium are more accurate. (more…)
Author Interviews, Imperial College, Stroke, Technology / 06.10.2016

MedicalResearch.com Interview with: Dr Paul Bentley MA MRCP PhD Clinical Senior Lecturer in Clinical Neuroscience Honorary Consultant Neurologist Neurology Dept Imperial College NHS Healthcare Trust Charing Cross Hospital London MedicalResearch.com: What is the background for this study? What are the main findings? Response: gripAble was designed to help people with arm disability practise physiotherapy when a physiotherapist is not available, or in between physiotherapy sessions. We know that the amount of physiotherapy provision in the UK, after stroke or arm injury, is typically below that which is recommended by professional bodies. Furthermore, increasing research suggests that higher-intensity training can boost functional outcomes. The innovation was designed to help people with a range of disabilities including severe paralysis engage with computer games with their weak arm. At the same time its designed to be portable for use at home or in bed, and low-cost. gripAble also enables remote measurement and monitoring of arm function, by setting users a series of calibrated tasks played out on the tablet screen. This way doctors and physiotherapists can assess the needs of a patient, and gain an idea of how well a patient is responding to home physiotherapy. (more…)
Author Interviews, Dermatology, Technology, UCLA / 05.10.2016

MedicalResearch.com Interview with: Dr. Andrea M Armani PhD Fluor Early Career Chair and Associate Professor Mork Family Department of Chemical Engineering and Materials Science University of Southern California, Los Angeles, California MedicalResearch.com: What is the background for this study? Response: The “Internet of Things” (IoT) has seen an explosion in online sensor technologies, including UV sensors and monitors; for example, those from Apple and Samsung. However, they require connectivity and power, and they are integrated into delicate electronic systems that are not compatible with outdoor, athletic activities such as swimming, which is precisely when you should monitor UV exposure. Therefore, somewhat ironically, the technologies developed to meet the demands of the IoT are not ideal for cumulative UV exposure detection. Our goal was to develop a single use patch – like a smart “band-aid” – for the beach to alert users when they had been in the sun for an hour and needed to re-apply sunscreen or get out of the sun altogether. This application required a rugged system that was waterproof, bendable, and compatible with sunscreen. Additionally, the sensor readout needed to be easy to interpret. These requirements influenced our design and material selection. (more…)
Author Interviews, JAMA, Karolinski Institute, Mental Health Research / 05.10.2016

MedicalResearch.com Interview with: Gustaf Brander Department of Clinical Neuroscience Karolinska Institutet MedicalResearch.com: What is the background for this study? Response: Obsessive-compulsive disorder (OCD) is believed to be caused by a complex interaction between genetic and environmental factors. Whereas genetic studies are well underway, the research on environmental factors has been lagging behind. As they explain a significant portion of the variance, are potentially malleable, and are essential for understanding how the genetic component works, this area of research is of great importance. (more…)
Author Interviews, Karolinski Institute, Stem Cells, Tobacco / 05.10.2016

MedicalResearch.com Interview with: Lukasz Antoniewicz MD, PhD candidate Karolinska Institutet Department of Clinical Sciences Danderyd University Hospital Stockholm, Sweden MedicalResearch.com: What is the background for this study? Response: Electronic cigarette sales increase exponentially on a global scale without knowledge about possible negative effects on human health. We performed an exposure study in young healthy volunteers and analyzed blood samples for endothelial progenitor cells and microvesicles. Increase in those markers may reflect vascular injury, inflammation and platelet activation. (more…)