Author Interviews, COVID -19 Coronavirus, JAMA / 10.08.2020

MedicalResearch.com Interview with: Karina W. Davidson, PhD, MA Senior Vice President of Research, Northwell Health Director, Center for Personalized Health, Feinstein Institutes for Medical Research Dean of Academic Affairs & Professor, Feinstein Institutes for Medical Research Donald and Barbara Zucker Professor in Health Outcomes, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell MedicalResearch.com: What is the background for this study? What are the main findings? Response: New York was epicenter for COVID-19 at the height of the pandemic, and Northwell Health, the largest health system in New York, did everything in its power to care for our sick community members but also care for and protect our frontline health care providers (HCPs) and 72,000 employees. We were fortunate enough to have not run out of PPE – from masks to gowns. Through our employee health team we were able to offer free antibody screenings and through the Northwell Health Research Consortium and the Feinstein Institutes for Medical Research we looked to use the data collected from our consented employees to determine the prevalence of antibodies. We designed the study to not only identify the presence of antibodies but also key factors like demographics, in what capacity our providers worked on the frontlines and if they suspected infection. Our data helped identify the best practices Northwell Health – from PPE to care procedures - and others nationwide would need to do to keep our frontline workers safe. Key takeaways from the research show that from April 20 to June 23, of the final consented sample of health care providers (40,329), 13 percent (5,523) tested positive for antibodies. The positive sample pool included 28.4 percent (11,468) nurses and 9.3 percent (3,746) physicians. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA / 07.08.2020

MedicalResearch.com Interview with: Ty J. Gluckman, M.D., FACC Providence St Joseph Health Portland, Oregon MedicalResearch.com: What is the background for this study? Response: In spite of significant decreases in the incidence of coronary artery disease, an estimated 800,000 Americans are expected to be diagnosed with an acute myocardial infarction (AMI) this year.  For large numbers of these patients, substantial benefit is afforded by early diagnosis and treatment.  Accordingly, multiple campaigns have been launched over time to increase public awareness about the symptoms and signs of AMI and the need to seek immediate medical attention. The COVID-19 pandemic has profoundly changed health care delivery worldwide.  While early attention was disproportionately focused on efforts to “flatten the curve”, recent reports have revealed a disturbing finding—a substantial decrease in the hospitalization rate for AMI.  Most worrisome among potential reasons for this has been reluctance of patients with an AMI to seek medical attention out of fear that they become infected with SARS-CoV-2. To better understand the impacts associated with this, we performed a retrospective, cross-sectional study of all AMI hospitalizations in a large multistate health care system (Providence St. Joseph Health).  We sought to define changes in AMI case rates, patient demographics, cardiovascular comorbidities, treatment approaches and in-hospital outcomes during the pandemic. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics / 05.08.2020

MedicalResearch.com Interview with: Taylor Heald-Sargent, M.D., Ph.D. Ann & Robert H. Lurie Children’s Hospital Chicago MedicalResearch.com: What is the background for this study? Response: Given the ongoing debate around the ability of children to transmit SARS-CoV-2, we noticed that our clinical data could address one of the prevalent assumptions.  Some people postulated that the reason children have less severe infections with SARS-CoV-2 is because they are not able to replicate virus as much as adults and therefore may not transmit as readily.  (more…)
Author Interviews, Cancer Research, COVID -19 Coronavirus, JAMA / 04.08.2020

MedicalResearch.com Interview with: Harvey W. Kaufman, MD, MBA, FCAP Senior Medical Director, Medical Informatics Quest Diagnostics Needham, MA  MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has disrupted routine healthcare and in particular cancer screenings.  We documented the impact on patients who were newly identified by cancer in the early months of the pandemic by analysis of Quest Diagnostics data. MedicalResearch.com: What are the main findings?  Response: We saw a 46% decline in newly identified patients with six common types of cancer.  In accordance to healthcare recommendations, many patients didn’t receive mammograms, colonoscopies, low-dose CT scans, and avoided physician visits for minor complaints.  When these patients return, some will present with more advanced stages of cancer than they would have without the disruption of the pandemic.  (more…)
Author Interviews, JAMA, Race/Ethnic Diversity, Social Issues / 03.08.2020

MedicalResearch.com Interview with: Nasim B. Ferdows, Ph.D. Assistant Professor, Department of Health Administration and Policy Hudson College of Public Health The University of Oklahoma Health Sciences Center Oklahoma City, OK MedicalResearch.com: What is the background for this study? Response: This half a century study of US senior men and women who died between 1968 and 2016 shows how disparities in the Black and White mortality of older US citizens have changed over time, as well as how the racial disparities differ in rural, suburban and urban areas. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, JAMA / 28.07.2020

MedicalResearch.com Interview with: Frank Wharam, MD, MPH Department of Population Medicine Harvard Medical School and Harvard Pilgrim Healthcare Institute Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response:  There is substantial concern that high-deductible health plans increase people’s risk of major adverse health events such as heart attack and stroke. No studies have examined this question. This study examines the effects of a transition to a high-deductible health plan on the risk of major adverse cardiovascular outcomes (myocardial infarction and stroke). The study group included individuals with risk factors for cardiovascular disease who were continuously enrolled in low-deductible (<$500) health plans during a baseline year followed by up to 4 years in high-deductible (≥$1000) plans after an employer-mandated switch. The matched control group included individuals with the same risk factors who were contemporaneously enrolled in low-deductible plans.  We examined time to first major adverse cardiovascular event, defined as myocardial infarction or stroke.  (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA, MRI / 28.07.2020

MedicalResearch.com Interview with: Assoc. Prof. Dr. Valentina Puntmann, MD, PhD, FRCP Deputy Head Goethe CVI Fellowship Programme Lead Consultant Physician, Cardiologist and Clinical Pharmacologist Institute for Experimental and Translational Cardiovascular Imaging DZHK Centre for Cardiovascular Imaging - Goethe CVI Department of Cardiology, Division of Internal Medicine University Hospital Frankfurt, Germany MedicalResearch.com: What is the background for this study? Response: Patients who recently recovered from COVID19 have been identified through the testing centre and invited to be screened for cardiac involvement with MRI. Importantly, they have not come to us because of having heart problems. In fact, none of them thought that they had had anything wrong with the heart.  They were mostly healthy, sporty and well prior to their illness. A considerable proportion had been infected while on skiing vacations. (more…)
Author Interviews, Health Care Systems, JAMA / 22.07.2020

MedicalResearch.com Interview with: Reshma Jagsi, M.D., D.Phil. Newman Family Professor and Deputy Chair Department of Radiation Oncology Director of the Center for Bioethics and Social Sciences in Medicine University of Michigan  MedicalResearch.com: What is the background for this study? Response: Hospitals and health care institutions often rely on philanthropy for support to be able to pursue their missions to serve the public health. Little is known about public perspectives, which are needed to inform ethical guidelines. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, JAMA, Lipids / 14.07.2020

MedicalResearch.com Interview with: Manja Koch, Ph.D., Research Associate Department of Nutrition Harvard T.H. Chan School of Public Health Majken K. Jensen, Ph.D. Adjunct Professor of Nutrition Harvard T.H. Chan School of Public Health & Professor in the Department of Public Health University of Copenhagen, Copenhagen, Denmark     MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease and other dementias are highly prevalent conditions. According to the Alzheimer’s Association, 50 million people are currently living with Alzheimer’s disease or other dementias worldwide. Lower apolipoprotein E in plasma is a risk factor for dementia, but the underlying biological mechanisms are not fully understood. Thus, we investigated the role of apolipoprotein E overall and in lipoproteins with distinct metabolic functions in relation to cognitive function and dementia risk.. (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 14.07.2020

MedicalResearch.com Interview with: Mario Fl Gaudino MD Professor of Cardiothoracic Surgery Department of Cardiothoracic Surgery Weill Cornell Medicine  MedicalResearch.com: What is the background for this study? Response: The radial artery is currently used in less than 10% of CABG procedures in the US.  MedicalResearch.com: What are the main findings? Response: The JAMA paper provides convincing evidence that the use of the radial artery rather than the saphenous vein to complement the internal thoracic artery for CABG is associated with improved long-term outcomes.  (more…)
Author Interviews, JAMA, Metabolic Syndrome, Nutrition, Sugar / 09.07.2020

MedicalResearch.com Interview with: Zhila Semnani-Azad, Ph.D. Candidate  Department of Nutritional Sciences Faculty of Medicine, University of Toronto Toronto, ON, Canada MedicalResearch.com: What is the background for this study? Response: Dietary fructose-containing sugars have been suggested to be an important contributing factor to increased metabolic syndrome risk. Several studies have consistently shown a strong association between sugar-sweetened beverages and increased incidence of metabolic syndrome. There is little information, however, on the role of other food sources of fructose-containing sugars in the development of metabolic syndrome. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA / 07.07.2020

MedicalResearch.com Interview with: Steven H. Woolf, MD, MPH Center on Society and Health Virginia Commonwealth University School of Medicine Richmond MedicalResearch.com: What is the background for this study? Response: Our concern since the pandemic began was that lives would be lost not only to the virus but also to the ripple effects of how society responds to the crisis, such as reduced access to health care, extreme economic hardships, and psychological stress.  (more…)
Author Interviews, JAMA, Sleep Disorders, Stanford / 07.07.2020

MedicalResearch.com Interview with: Eileen B. Leary, Ph.D. Student Epidemiology and Clinical Research Stanford University MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by REM sleep? Response: Sleep is a regulated, reversible, and recurring loss of consciousness that is a critical requirement for a happy, healthy life. REM sleep is an important component of sleep defined by rapid eye movements and commonly associated with dreaming. We learned from previous studies that sleep duration is associated with mortality, however little was known about how the different sleep stages relate to timing or cause of death. (more…)
Author Interviews, JAMA, Nutrition, Social Issues / 28.06.2020

MedicalResearch.com Interview with: Erin Brantley, PhD, MPH Senior Research Associate Department of Health Policy and Management Milken Institute School of Public Health Preferred pronouns: she/her/hers  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We looked at what happened when work requirements for the Supplemental Nutrition Assistance Program Participation, or SNAP, were turned on in many places after the Great Recession. We found large drops in participation in SNAP benefits due to work requirements, and that black recipients were more likely to lose benefits than white recipients. We think this is driven by the fact that black workers face higher unemployment rates than white workers, and work requirement policies do not take this into account. We also found that some people who report having disabilities lost benefits, even though the intent of work requirements is that they apply to people without disabilities.  (more…)
Author Interviews, COVID -19 Coronavirus, Dermatology, Environmental Risks, JAMA / 26.06.2020

MedicalResearch.com Interview with: Dr Herman Anne MD Service de Dermatologie Cliniques Universitaires Saint-Luc   MedicalResearch.com: What is the background for this study? Response: In the context of the COVID-19 pandemic, several cases of acro-located lesions (on foot or hands) suggestive of chilblains have been reported and were possibly related to COVID-19. We wanted to determine if chilblains, observed in many patients recently referred to our department, are indicative of COVID-19. MedicalResearch.com: Would you briefly explain what is meant by chilblains? Response: Chilblains are frequent cold induced inflammatory lesions. Chilblains are typically seen in winter and occur after repeated exposure to cold temperatures. Clinical presentation includes erythema and swelling on toes and/or digits followed by red-purple macules or patches. However, given the large number of patients affected, and the exceptionally high outdoor temperatures for the spring season over the past month and at the time of case-observation, cold-exposure seemed unlikely. These lesions were, therefore, suspected to be associated with COVID-19. However, to date, no study has proven a pathological link between these lesions and COVID-19. (more…)
Author Interviews, JAMA, Metabolic Syndrome, Race/Ethnic Diversity, Weight Research / 26.06.2020

MedicalResearch.com Interview with: Robert Wong, MD, MS Division of Gastroenterology and Hepatology Veterans Affairs Palo Alto Healthcare System Stanford University School of Medicine MedicalResearch.com: What is the background for this study? Response: Prior to this study, we already knew that obesity and metabolic syndrome were major public health issues in the U.S.  A previous analyses by our team which analyzed data through 2012 observed than one in three adults in the U.S. have metabolic syndrome.  The aim of our current study was to evaluate more recent trends in the prevalence of metabolic syndrome and to identify whether certain groups are at higher risk of having metabolic syndrome.  (more…)
Author Interviews, Cost of Health Care, JAMA, Race/Ethnic Diversity / 24.06.2020

MedicalResearch.com Interview with: Megan B. Cole Brahim, PhD, MPH Assistant Professor | Dept. of Health Law, Policy, & Management Boston University School of Public Health Boston, MA MedicalResearch.com: What is the background for this study? Response: Enrollment in high deductible health plans (HDHPs)—which require patients to pay on the upwards of thousands of dollars in out-of-pocket costs before they can use their health insurance coverage for most services—has skyrocketed over the last decade. For cancer survivors in particular, this is really concerning, as patients may avoid or delay necessary health care services or important medications because they can’t afford their deductible. We know from previous work that HDHPs are associated with less use of health care, including less cancer screening and treatment. However, there has been very little work to assess how HDHPs may contribute to racial/ethnic disparities in care, and our study is the first known study to assess how HDHPs may contribute to racial/ethnic disparities in cancer survivors. To fill this gap, we used nationally representative survey data from 2013-2018 to assess how enrollment in high deductible health plans was associated with cost-related barriers to care among cancer survivors with private insurance, and how this relationship varied across racial/ethnic groups. (more…)
Accidents & Violence, Author Interviews, Cannabis, JAMA, NYU / 23.06.2020

MedicalResearch.com Interview with: Julian Santaella Tenorio, MSc DrPH Epidemiology Center for Opioid Epidemiology and Policy Division of Epidemiology, Department of Population Health New York University Langone School of Medicine, New York, New York MedicalResearch.com: What are the main findings? car-accident-traffic-accidentResponse: This study found that recreational cannabis laws were associated with increases in traffic fatalities in Colorado (mean of 75 excess fatalities per year) but not in Washington State.  These findings suggest that unintended effects of recreational cannabis laws can be heterogeneous and may be specific to variations in how these laws are implemented
(eg, density of recreational cannabis stores).   (more…)
Accidents & Violence, Author Interviews, Cannabis, JAMA / 22.06.2020

MedicalResearch.com Interview with: Russell Kamer, MD Department of Medicine, New York Medical College, Valhalla 15 North Broadway, Suite E White Plains, NY 10601 New York MedicalResearch.com: What is the background for this study? "marijuana apocalypse - weed is a stimulant !" by Blind Nomad is licensed under CC BY 2.0Response: It is well known that marijuana usage impairs driving ability, yet the early studies of the effects of recreational marijuana legalization on traffic fatalities were inconclusive. MedicalResearch.com: What are the main findings? Response: By analyzing data over a longer time period, we found that the legalization of recreational marijuana increased traffic deaths in the first four states to legalize. Traffic fatalities increased about 20% in those states. If we apply these numbers to the nation as a whole, nationwide legalization would be associated with about 7,000 excess traffic fatalities each year. (more…)
Author Interviews, Heart Disease, JAMA, Opiods, Surgical Research, University of Pennsylvania / 20.06.2020

MedicalResearch.com Interview with: Chase Brown, MD Associate Fellow, Leonard Davis Institute of Health Economics Integrated Cardiac Surgery Resident Hospital of the University of Pennsylvania Nimesh D. Desai, MD, PhD Director, Thoracic Aortic Surgery Research Program Associate Professor of Surgery Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Dr. Chase Brown:  Opioid use in the United States is a public health emergency. We know that opioids prescribed after general surgery operations to patients who never received them within the year prior to their surgery are at increased risk for continuing to take opioids months later. However, this has not been studied in patients undergoing cardiac surgery, who often times have more severe post-operative pain. Our goal in this study was to determine how many patients after cardiac surgery and are opioid naive are continuing to take opioids within 90-180 days after their surgery.   (more…)
Addiction, Author Interviews, JAMA, Pediatrics, USPSTF / 20.06.2020

MedicalResearch.com Interview with: Dr. Karina Davidson, PhD Senior Vice President of Research Dean of Academic Affairs Professor of Behavioral Medicine Zucker School of Medicine Hofstra University/Northwell Health Vice Chairmam US Preventive Services Task Force  MedicalResearch.com: What is the background for this study? Response: Drug use is among the most common causes of preventable death, injury, and disability in the United States, with nearly 10 percent of adults reporting unhealthy drug use. This includes the use of illegal drugs, as well as using prescription drugs in ways that are not recommended by a doctor. (more…)
Author Interviews, Diabetes, JAMA / 17.06.2020

MedicalResearch.com Interview with: Richard E. Pratley, MD AdventHealth Samuel E. Crockett Chair in Diabetes Research Medical Director | AdventHealth Diabetes Institute Senior Investigator and Diabetes Program Lead AdventHealth Translational Research Institute  MedicalResearch.com: What is the background for this study? Response: Historically, older individuals with T1D have been underrepresented or excluded from clinical trials. Older individuals with T1D are at particularly high risk for hypoglycemia. Because of their long duration of diabetes, they often have impaired counterregulatory responses and hypoglycemia unawareness. Hypoglycemia in older individuals is particularly dangerous because it can lead to falls and fractures, cognitive impairment and cardiovascular events, including death. There has been the misperception that older individuals are less able to use technology to manage their diabetes.  This study dispelled that notion.   (more…)
Author Interviews, JAMA, Multiple Sclerosis, Neurology / 15.06.2020

MedicalResearch.com Interview with: Cris S Constantinescu,  MD, PhD, FRCP Professor, Division of Clinical Neuroscience Research Group in Clinical Neurology University of Nottingham Queen's Medical Centre Nottingham UK MedicalResearch.com: What is the background for this study? Response: The study is in some way a test of the hygiene or old friends hypothesis, whereby eradication, through improved hygiene, of some parasites that have existed in the human gut for thousands of years and have suppressed inflammatory reactions, leads to an increase in inflammatory conditions. This has been used to explain the increased autoimmune and inflammatory diseases in the developed world. Healthy volunteer studies at the University of Nottingham showed therapeutic hookworm infection to be safe and well tolerated up to about 50 larvae, and then safety studies in people with airway hyperreactivity and inflammatory bowel disease raised no concern. Following a study in Argentina showing that people with MS have milder disease when they have a natural co-existing asymptomatic infection with intestinal parasites, we (Professor Pritchard, immunoparasitologist and myself) decided to test hookworm in MS, and for the first time used 25 larvae in a patient study. (more…)
Author Interviews, COVID -19 Coronavirus, Environmental Risks, JAMA / 11.06.2020

MedicalResearch.com Interview with: Mohammad Sajadi, MD Associate Professor Institute of Human Virology Global Virus Network Center of Excellence University of Maryland School of Medicine Baltimore, MD 21201  MedicalResearch.com: What is the background for this study? Response: Because of geographical proximity and significant travel connections, epidemiological modeling of the epicenter predicted that regions in Southeast Asia, and specifically Bangkok would follow Wuhan, and China in the COVID-19 epidemic. When we saw this did not happen, we suspected that SARS-CoV-2 might be acting like a seasonal respiratory virus.  (more…)
Author Interviews, JAMA, Pain Research / 11.06.2020

MedicalResearch.com Interview with: Tobias Kurth, MD, ScD (Pronouns: he/him) Professor of Public Health and Epidemiology Director, Institute of Public Health Charité – Universitätsmedizin Berlin  MedicalResearch.com: What is the background for this study? Response: Migraine (with aura) has been associated with increased risk of cardiovascular disease but its absolute contribution in relation to other major vascular risk factors was not unclear. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 11.06.2020

MedicalResearch.com Interview with: Colm Travers, M.D., MSPH Assistant Professor Department of Pediatrics University of Alabama at Birmingham MedicalResearch.com: What is the background for this study? Response: It is known that black mothers are much more likely to deliver preterm and low birth weight infants. The purpose of this study was to determine whether racial/ethnic disparities in care practices and outcomes were decreasing or increasing among extremely preterm infants. These are infants born from 22 to 27 weeks of gestation who have a high risk of death and major illnesses.  (more…)
Author Interviews, Clots - Coagulation, JAMA, Kidney Disease / 09.06.2020

MedicalResearch.com Interview with: Manish M Sood MD FRCPC MSc Jindal Research Chair for the Prevention of Kidney Disease Associate Professor of Medicine, Dept. of Medicine and the School of Epidemiology and Public Health University of Ottawa Scientist, Ottawa Hospital Research Institute Nephrologist, The Ottawa Hospital Ottawa, Ontario, Canada  MedicalResearch.com: What is the background for this study? Response: Early work has suggested a very commonly used antibiotic, clarithromycin, may interfere with the metabolism of the most widely used type of blood thinning medication (called direct oral anticoagulants or DOACs) such that the blood level of the DOAC increases and may place the patient at a higher risk for bleeding.  In our study we looked at patients of advanced age (>66 years old) who were given clarithromycin while on a DOAC in Ontario, Canada. We compared patients on clairthromycin-DOAC to patients given a very similar antibiotic, azithromycin, that does not interfere with the metabolism of DOAC. (more…)
Allergies, Author Interviews, JAMA, OBGYNE / 05.06.2020

MedicalResearch.com Interview with: Niklas Andersson MS Department of Epidemiology Research Statens Serum Institut Copenhagen S, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Second-generation antihistamines are among the most commonly prescribed drug classes during pregnancy. Fexofenadine is a widely used antihistamine but given the limited fetal safety on the use of antihistamines during pregnancy in general, current clinical guidelines only recommend the use cetirizine and loratadine during pregnancy when needed due to a larger body of fetal safety data for these antihistamines. (more…)
Author Interviews, JAMA, OBGYNE / 05.06.2020

MedicalResearch.com Interview with: Anjali Kaimal, MD, MAS, Maternal-Fetal Medicine Specialist Associate Professor in the Departments of Obstetrics Massachusetts General Hospital Miriam Kuppermann, PhD, MPH Professor Vice Chair Clinical and Translational Research Director Program for Clinical Perinatal UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reducing the rate of cesarean delivery is an important public health goal.  Nearly one third (31.9%) of deliveries in the US are via cesarean, and dramatic increases in the cesarean rate since the 1990s have been associated with substantial increases in maternal morbidity.  One of the reasons for the increased rate of cesarean delivery is the decreasing rate at which women attempt to have a vaginal birth after cesarean (VBAC).  Although having a “trial of labor” (in the hopes of giving birth vaginally) after cesarean is safe, and many women say they would prefer a vaginal delivery, most women who have had a previous cesarean plan a scheduled repeat cesarean delivery.  While some hospitals do not offer trial of labor after cesarean, even at institutions where this is an option. VBAC rates remain low. We created a patient-facing “decision tool” that provides detailed information on both trial of labor and scheduled repeat cesarean, a personalized risk assessment of the likelihood that the a trial of labor would end in a VBAC, and a series of values clarification exercises, to help women think through their options and engaged in informed, shared decision making with their providers.  We then conducted a randomized study in three geographic areas (San Francisco, Boston, and Chicago) to determine whether use of the decision tool affected rates of trial of labor and vaginal birth after cesarean, as well as several aspects of decision quality (knowledge, shared decision making, decisional conflict, and decision satisfaction).   (more…)