Author Interviews, Cancer Research, Cost of Health Care, JAMA / 19.05.2019

MedicalResearch.com Interview with: Nina Niu Sanford, M.D.  Assistant Professor UT Southwestern Department of Radiation Oncology Dallas TX 75390  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is that we know cancer survivors are at risk for uninsurance or underinsurance and the most commonly cited reason for this is cost of insurance.  However, there have been no prior studies assessing from the patient perspective the reasons for not having insurance. In addition, there has been further recent controversy over the Affordable Care Act, including threats from the current administration to dismantle it.  Thus assessing the impact of the ACA among at risk populations including cancer survivors is timely. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Orthopedics, Osteoporosis, Surgical Research / 15.05.2019

MedicalResearch.com Interview with: Elaine W. Yu, MD, MMSc Assistant Professor,  Harvard Medical School Director, Bone Density Center Endocrine Unit, Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Roux-en-Y gastric bypass (RYGB) is a popular surgical weight loss procedure.  We have previously shown that gastric bypass leads to rapid high-turnover bone loss. Bariatric procedures are being increasingly performed in older adults, and the clinical consequences of gastric bypass-associated skeletal changes in this vulnerable population have been unclear to date.  Thus, we used Medicare claims data to investigate fracture risk among older adults after gastric bypass, and in comparison to adults who received another bariatric procedure called adjustable gastric banding (AGB), which is thought to have fewer negative bone effects. In our analysis, we found that patients undergoing Roux-en-Y gastric bypass were 73% more likely to fracture than those undergoing AGB. Importantly, we found that hip fracture risk increased nearly 180% after RYGB, and that fracture rates in patients aged 65 or older were similar to the overall group.  (more…)
Author Interviews, Hip Fractures, JAMA, Supplements / 13.05.2019

MedicalResearch.com Interview with: Prof. Haakon E Meyer, PhD Department of Public Health and Global Health Norwegian Institute of Public Health Oslo, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of high dose vitamin supplementation is popular in parts of the population, often without any clear indication and in the absence of clear evidence of benefit. However, side effects can occur, and in a previous published secondary analysis of double blinded randomized controlled trials, we found to our surprise an increased risk of hip fracture in those supplemented with high doses of vitamin B6 in combination with vitamin B12. This finding was re-assessed in the current study employing data from the large observational Nurses' Health Study. As in the previous study, we found that a combined high intake of vitamin B6 and B12 was associated with increased risk of hip fracture. (more…)
Author Interviews, Biomarkers, Cancer Research, Colon Cancer, JAMA, Karolinski Institute / 13.05.2019

MedicalResearch.com Interview with: Louise Olsson MD PhD Senior researcher Department of Molecular Medicine and Surgery Colorectal Surgery Karolinski Institute Stockholm, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: I read a very interesting paper back in 2006 “Detection and quantification of mutation in the plasma of patients with colorectal cancer”. Only some 60 % of patients with early colorectal cancer were detectable in this way whereas patients with stage IV disease all had a high concentration of APC mutations in their plasma. So the prospects of using the method for example, screening of primary colorectal cancer seemed limited but I thought wow, this is the test to detect recurrences and generalized disease during follow-up after surgery for colorectal cancer. After some discussion we started to collect plasma samples from patients at the hospital where I worked and that´s how my research began. (more…)
Author Interviews, JAMA, Opiods, Primary Care, University of Michigan / 11.05.2019

MedicalResearch.com Interview with: Kao-Ping Chua, M.D., Ph.D. Department of Pediatrics Susan B. Meister Child Health Evaluation and Research Center University of Michigan, Ann Arbor MedicalResearch.com: What is the background for this study?   Response: Doctor and pharmacy shopping is a high-risk behavior in which patients obtain opioid prescriptions from multiple prescribers and fill them at multiple pharmacies. Because this behavior is associated with a high risk of overdose death, there have been many efforts to help clinicians detect doctor and pharmacy shopping among patients prescribed opioids. For example, 49 states have a prescription drug monitoring program that provides information on patients’ prior controlled substance prescriptions. In contrast, there has been little attention to the possibility that patients prescribed opioids may have family members who are engaged in opioid doctor and pharmacy shopping. Such family members may divert opioids prescribed to patients because of their access to these opioids. (more…)
Author Interviews, JAMA, OBGYNE, Weight Research / 09.05.2019

MedicalResearch.com Interview with: Dr-Romy GaillardRomy Gaillard MD PhD LifeCycle Project-Maternal Obesity and Childhood Outcomes Study Group Erasmus MC MedicalResearch.com: What is the background for this study?   Response: Obesity among women of reproductive age is a major problem for society. Scientists have long known that maternal weight before and during pregnancy are associated with pregnancy outcomes. Gestational weight gain is necessary to ensure healthy development of the fetus, but too much weight gain is associated with a higher risk of pregnancy complications. The magnitude of the associations of maternal weight before and during pregnancy with the risks of pregnancy complications, as well as the optimal amount of weight that especially obese women should gain during pregnancy were not well-known. (more…)
Author Interviews, Electronic Records, JAMA, Pediatrics, Primary Care / 07.05.2019

MedicalResearch.com Interview with: Cari McCarty, PhD Research Professor, UW Investigator, Seattle Children’s Research Institute  MedicalResearch.com: What is the background for this study? Response: Adolescence is a time when teens begin to take charge of their health, but it is also a time when they can be prone to health risk behaviors, such as insufficient physical activity, poor sleep, and substance use. We were interested in whether using an electronic health risk screening tool in primary care settings could improve healthcare and health for adolescents.  The tool was designed to provide screening as well as motivational feedback directly to adolescents, in addition to clinical decision support for the healthcare clinician.  We conducted a trial with 300 adolescent patients where one group received the screening tool prior to their health checkup, and the other group received usual care. (more…)
Author Interviews, Heart Disease, JAMA, Johns Hopkins, Pulmonary Disease / 07.05.2019

MedicalResearch.com Interview with: Robert A. Wise, M.D. Professor of Medicine Pulmonary and Critical Care Johns Hopkins University School of Medicine Baltimore, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a lingering controversy about the safety of long-acting anti-muscarinic agents (LAMA) as maintenance treatment for COPD in patients who have increased cardiovascular risk.  This study enrolled participants with COPD who also had increased cardiovascular risk or known cardiovascular disease.  Participants were randomly treated with either aclidinium bromide (Tudorza Pressair) or placebo. Over 3 years of follow up there was no increased risk of adverse cardiovascular events.  Moreover, the medication had a significant benefit in terms of reducing exacerbations and COPD hospitalizations. (more…)
Alcohol, Author Interviews, Hepatitis - Liver Disease, JAMA / 07.05.2019

MedicalResearch.com Interview with: Robert Wong, MD, MS, FACG Assistant Clinical Professor of Medicine Director, GI Education & Research Highland Hospital   I A member of Alameda Health System Oakland, CA 94602  MedicalResearch.com: What is the background for this study?   Response: Alcoholic liver disease is a major cause of chronic liver disease in the United States and has become the leading indication for liver transplantation in the U.S.  However, accurate estimates of the true burden among U.S. adults is not well studies due to challenges in accurately identifying alcoholic liver disease or lack of awareness is screening individuals for alcohol use disorder.  Given the gaps in knowledge regarding the epidemiology of alcoholic liver disease in the U.S., our current study attempts to further contribute to the understanding of alcoholic liver disease epidemiology in the U.S We utilized a U.S. national cross sectional database and focused on the specific subset of alcoholic fatty liver disease, which is the earlier stage of disease along the spectrum of alcoholic liver disease.  Focusing on alcoholic fatty liver disease allowed us to more accurately define and capture the prevalence of this disease.  Furthermore, given that alcoholic fatty liver disease is early on the overall spectrum of alcoholic liver disease, it is a disease state that early identification provides opportunities to implement therapy and counseling for alcohol abstinence that can prevent further liver damage and disease progression. (more…)
Author Interviews, Cancer Research, Colon Cancer, JAMA / 07.05.2019

MedicalResearch.com Interview with: Prof. Dr. med. Hermann Brenner Clinical Epidemiology and Aging Research Division Head German Cancer Research Center Foundation under Public Law Germany  MedicalResearch.com: What is the background for this study? Response: Colorectal cancer is the third most common cancer globally, accounting for almost 900.000 deaths every year. Most of these deaths could be prevented by screening colonoscopy with early detection and removal of precursors of the cancer. However, capacities and use of screening colonoscopy are limited in most parts of the world, and low-cost but reliable noninvasive screening tests are important alternative primary screening tests. The currently best established noninvasive tests are fecal immunochemical tests for hemoglobin (FITs) which are offered for colorectal cancer screening in an increasing number of countries. Although FITs detect the majority of colorectal cancers they detect approximately one out of four advanced adenomas only, the precursors of most colorectal cancers. We hypothesized that this proportion could be increased by taking a single pill of aspirin two days prior to collecting the stool sample for FIT, because the well-established antithrombotic effects of aspirin might favor detecting occult bleeding from colorectal cancer or its precursors. (more…)
Author Interviews, Dermatology, Environmental Risks, FDA, JAMA / 06.05.2019

MedicalResearch.com Interview with: David Strauss, MD, PhD Director, Division of Applied Regulatory Science U.S. Food and Drug Administration Center for Drug Evaluation and Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is unknown whether most active ingredients in sunscreens are absorbed. FDA has provided guidance that sunscreen active ingredients with systemic absorption greater than 0.5 ng/mL or with safety concerns should undergo nonclinical toxicology assessment including systemic carcinogenicity and additional developmental and reproductive studies. This randomized clinical trial demonstrated systemic exposure of 4 commonly used sunscreen active ingredients on application of sunscreen products under maximal use conditions consistent with current sunscreen labeling. All 4 sunscreen active ingredients tested resulted in exposures exceeding 0.5 ng/mL.  (more…)
Allergies, Author Interviews, Immunotherapy, JAMA / 06.05.2019

MedicalResearch.com Interview with: Marcus S. Shaker, MD Associate Professor of Pediatrics Associate Professor of Community and Family Medicine Dartmouth-Hitchcock Medical Center MedicalResearch.com: What is the background for this study? Response: There are two peanut allergy treatments that are being evaluated for potential FDA approval—an orally administered treatment and an epicutaneous (skin based) treatment.  Both have tremendous potential benefit.  The focus of our study was to explore the range of health and economic benefits in terms of establishing pathways for how each therapy could be cost effective. We want to be clear that our purpose was not to suggest one therapy is or is not cost effective at present.  That would be a ridiculous statement to make regarding two treatments that not only lack FDA approval, but do not have established pricing.  Rather, we used preliminary inputs that are presently available to create as robust a model as we could to better determine the individual paths that would make them more or less cost-effective. (more…)
Author Interviews, Brigham & Women's - Harvard, Education, JAMA / 06.05.2019

MedicalResearch.com Interview with: Arabella L. Simpkin,  MD, MMSc Associate Director, Center for Educational Innovation and Scholarship, MGH Associate Program Director, Education and Curriculum, Internal Medicine Residency, MGH Instructor in Medicine, Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: The academic health care environment has changed in unprecedented ways over several decades, with mounting evidence that faculty are becoming increasingly more unhappy, dissatisfied, and burnt out in their work. Concern for faculty wellbeing is high, with much speculation about causes of burnout. Comprehending what affects satisfaction at work in academic health care centers is critically important to stem this epidemic of discontent. For physicians, satisfaction has been reported to be associated with quality of care delivered, particularly as measured by patient satisfaction; faculty retention and job satisfaction are intricately linked, with dissatisfied physicians more likely to leave the profession and to discourage others from entering. Other industries that have suffered similar rises in employee discontent have found that demonstration of respect is the most important leadership behavior in improving employees satisfaction. To our knowledge this factor has not been looked at in healthcare professionals. To address this gap, we sought to determine key variables influencing satisfaction at work for faculty in a large academic medical center in the United States. (more…)
Author Interviews, JAMA, Pediatrics, Smoking / 06.05.2019

"E-Cigarette/Electronic Cigarette/E-Cigs/E-Liquid/Vaping/Cloud Chasing" by Vaping360 is licensed under CC BY 2.0 CC BY 2.0MedicalResearch.com Interview with:Jenny L. Carwile, ScD, MPH Department of Medicine Maine Medical Center Portland   MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Although e-cigarette aerosols are commonly perceived to be "harmless water vapors" they contain numerous potentially harmful chemicals including volatile organic compounds like formaldehyde, nicotine, heavy metals, and ultrafine particulates. Non-users can be exposed to these chemicals through secondhand exposure. We found that in the US 4.9% of adults who lived in a household with children were current e-cigarette users. (more…)
Author Interviews, Infections, JAMA / 01.05.2019

MedicalResearch.com Interview with: Nicholas B. DeFelice, PhD Department of Environmental Medicine & Public Health Icahn School of Medicine at Mount Sinai New York, New York MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Effective allocation of public health resources during an outbreak is complicated and often reactive. Thus, it is important that we develop quantitative tools that can accurately and rapidly forecast the progression of an outbreak and provide decision support. Recently, several advancements have been made in the realm of infectious disease forecasting: it is a field that is growing in exciting directions. However, for these forecasting tools to work in real time, we must understand how the forecasting apparatus and observational network work in real time to ensure they are sufficient to support accurate operational predictions. We previously showed that accurate and reliable forecasts of West Nile virus outbreaks can be made using surveillance data and a mathematical model representing the interactions between birds, mosquitoes and risk of human spillover. This model system was able to retrospectively forecast mosquito infection rates prior to the week of peak mosquito infection, and to forecast accurately the seasonal total number of human West Nile virus cases prior to when the majority of cases were reported. For this study, we were interested in the data flow process and the question of whether appropriate infrastructure is in place to support real time forecasting. If this forecast system were made operational in real time, public health officials would have an evidence-based decision-support tool to help 1) actively target control of infected mosquito populations (i.e., larviciding and adulticiding), 2) alert the public to future periods of elevated West Nile virus spillover transmission risk, and 3) identify when to intensify blood donor screening. (more…)
Alzheimer's - Dementia, Author Interviews, End of Life Care, JAMA, University of Pennsylvania / 30.04.2019

MedicalResearch.com Interview with: Emily Largent, PhD, JD, RN Assistant Professor, Medical Ethics and Health Policy Perelman School of Medicine Leonard Davis Institute of Health Economics University of Pennsylvania  MedicalResearch.com: What is the background for this study? What are the main findings?  Response:  Public support for aid in dying in the United States is rapidly growing.  As a result, we’re now seeing debates about whether to expand access to aid-in-dying to new populations – such as people with Alzheimer’s disease – who wouldn’t be eligible under current laws. With those debates in mind, we asked currently healthy people who recently learned about their risk for developing Alzheimer’s disease dementia (i.e., due to the presence of amyloid, an Alzheimer’s disease biomarker) whether they would be interested in aid-in-dying. Our findings suggest that about 20% of individuals with elevated amyloid may be interested in aid-in-dying if they become cognitively impaired.   (more…)
Author Interviews, Cancer Research, Genetic Research, JAMA, Technology / 30.04.2019

MedicalResearch.com Interview with: Steven J.M. Jones, Professor, FRSC, FCAHS Co-Director & Head, Bioinformatics Genome Sciences Centre British Columbia Cancer Research Centre Vancouver, British Columbia, Canada and Jasleen Grewal, BSc.Genome Sciences CentreBritish Columbia Cancer Research CentreVancouver, British Columbia, CanadaJasleen Grewal, BSc. Genome Sciences Centre British Columbia Cancer Research Centre Vancouver, British Columbia, Canada MedicalResearch.com: What is the background for this study? Response: Cancer diagnosis requires manual analysis of tissue appearance, histology, and protein expression. However, there are certain types of cancers, known as cancers of unknown primary, that are difficult to diagnose based purely on their appearance and a small set of proteins. In our precision medicine oncogenomics program, we needed an accurate approach to confirm diagnosis of biopsied samples and determine candidate tumour types for where the primary site of the cancer was uncertain.  We developed a machine learning approach, trained on the gene expression data of over 10,688 individual tumours and healthy tissues, that has been able to achieve this task with high accuracy. Genome sequencing offers a high-resolution view of the biological landscape of cancers. RNA-Seq in particular quantifies how much each gene is expressed in a given sample. In this study, we used the entire transcriptome, spanning 17,688 genes in the human genome, to train a machine learning method for cancer diagnosis. The resultant method, SCOPE, takes in the entire transcriptome and outputs an interpretable confidence score from across a set of 40 different cancer types and 26 healthy tissues.  (more…)
Author Interviews, Cancer Research, JAMA, MD Anderson, Radiation Therapy / 30.04.2019

MedicalResearch.com Interview with: Quynh-Nhu Nguyen, MD Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This is the first non-spine bone metastases trial comparing higher dose single fraction radiotherapy vs multifraction standard fractionated radiotherapy for patients with painful bone metastases. The results of this trial demonstrated more durable pain relief and superior local control for patients treated in the higher dose(12 Gy-16 Gy)  single fraction RT compared to standard 30 Gy/10 fractions multifractionated regimen.  This trial supports the previous multiple randomized trials which recommend single fraction should be standard palliative radiotherapy regimen for bone metastases.  This trial is unique in that it addressed previous criticism that single fraction does not provide durable palliation with lower 8 gy single fraction and result in higher re-irradiation rates.  This trial on the contrary with the utilization of modern radiotherapy techniques, demonstrated we can safely and more effectively deliver a higher single fraction radiotherapy regimen for improvement in the quality of life for patients.  This higher dose should be the new standard single fraction regimen for patients who are functional and have a longer life expectancy.  (more…)
Author Interviews, Global Health, JAMA / 29.04.2019

MedicalResearch.com Interview with: Dr Barbara Mintzes PhD Associate Professor The University of Sydney Charles Perkins Centre and School of Pharmacy Faculty of Medicine and Health The University of Sydney MedicalResearch.com: What is the background for this study?   Response: When medicines are approved for marketing, the information available on rare serious harmful effects, longer-term effects, and outcomes in vulnerable populations is often limited. New serious safety concerns often arise when a medicine is already on the market. In many cases these can be  managed for example through dose reductions or avoiding prescribing to at-risk patients. Drug regulatory agencies such as the US FDA often issue safety warnings to let health professionals and the public know  about new evidence of potential harm and often to provide advice on how to avoid this. We were interested to know how consistent these warnings are between different countries. This is a research project funded by Australia’s National Health and Medical Research Council and the Canadian Institutes of Health Research. We examined warnings for medicines in Australia, Canada the US and the UK over a 10-year period, from 2007 to 2016 inclusive. We were looking at how often regulators issue the same warning if the drug is approved for marketing at the time.  (more…)
Author Interviews, Environmental Risks, Heart Disease, JAMA, Toxin Research / 29.04.2019

MedicalResearch.com Interview with: Monica Lind, PhD, Professor, Environmental toxicologist Occupational and Environmental Medicine Uppsala University Hospital Visiting adress: Dag Hammarskjölds väg 60 Uppsala Sweden MedicalResearch.com: What is the background for this study? Response: Previous studies in workers exposed to very high levels of polychlorinated biphenyls (PCBs) have suggested hazardous health effects. However, circulating PCB levels are detected in almost all indivuduals in industrialized countries, but the health effects of moderately elevated levels as seen in the general population are not well established. We investigated levels of PCBs in around 1,000 individuals, all aged 70 years, randomly chosen from the City of Uppsala, Sweden. (more…)
Author Interviews, JAMA, Opiods / 28.04.2019

MedicalResearch.com Interview with: Leah LaRue, PharmD, PMP Associate Director, Clinical Affairs Millennium Health MedicalResearch.com: What is the background for this study? Response: Drug overdose deaths continue to increase, despite the leveling off of prescription opioid use and policy changes limiting opioid prescribing. While fentanyl has garnered most of the attention, overdose deaths involving cocaine and methamphetamine also have increased markedly over the past few years. It is possible that those increases are due not just to those drugs, but to concomitant use with fentanyl. To better understand what is causing this rapid increase in overdose deaths, it is important to characterize the emerging combination of other illicit drugs with fentanyl, which increases the risk of overdose. The purpose of this study was to determine whether rates of the combination of nonprescribed fentanyl with cocaine or methamphetamine have changed in urine drug test (UDT) results through time. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Pediatrics, Weight Research / 26.04.2019

MedicalResearch.com Interview with: Vincent W. V. Jaddoe, MD, PhD Adjunct Professor of Epidemiology Department of Epidemiology MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Childhood body fat may be affected by patterns of fetal and infant weight change. Children born small for gestational age (SGA) tend to have infant growth acceleration, whereas those born large for gestational age (LGA) tend to have infant growth deceleration. Little is known about fetal and infant growth patterns affecting visceral, liver, and pericardial fat, which are strongly associated with cardiometabolic disease in later life. We assessed in a large population cohort study whether fetal and infant weight change was associated with not only general, but also organ fat at school age. We observed that fetal and infant weight change patterns were both associated with childhood body fat, but weight change patterns in infancy tended to have larger effects. Fetal growth restriction followed by infant growth acceleration was associated with increased visceral and liver fat.  (more…)
Author Interviews, Infections, JAMA, Pediatrics / 26.04.2019

MedicalResearch.com Interview with: Dr. Matthieu Domenech de Cellès PhD Biostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases Unit, Institut Pasteur, Inserm U1181, University of Versailles St-Quentin-en-Yvelines, Versailles, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most high-income countries now use acellular pertussis vaccines (called DTaP, which are sub-unit vaccines based on purified antigens of the bacterium Bordetella pertussis) to protect children against pertussis. Although clinical trials demonstrated the short-term effectiveness of DTaP vaccines, there was a growing concern that the duration of protection they conferred was not very long. Those concerns were mostly based on the results of a number of epidemiological studies, which showed that the relative risk of contracting pertussis increased substantially over time, typically by 20–40% every year since last vaccination. Although such increases seem high, it was not immediately obvious how to interpret them—the more so because pertussis epidemiology is complex. In our study, we developed mathematical models of pertussis epidemiology to try to understand what the results of recent epidemiological studies really meant about the effectiveness and the duration of protection of DTaP vaccines. The most interesting—and perhaps counterintuitive—finding of our study was that those results are fully consistent with highly effective DTaP vaccines, which confer long-term protection. This is a consequence of the fact that pertussis is highly contagious and that the immunity conferred by DTaP, though very high, is not perfect.    (more…)
Author Interviews, Infections, JAMA, Mental Health Research, Pediatrics / 25.04.2019

MedicalResearch.com Interview with: Lauren Breithaupt, PhD Department of Psychology George Mason University Fairfax, Virginia  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Our study provides novel insight into the relationship between the immune system and eating disorders characterized by chronic restriction (e.g., anorexia nervosa) and binge eating and/or purging (e.g., binge eating disorder, bulimia nervosa). These findings also add to the growing body of literature linking the immune systems broadly and mental disorders. We found that infections in early childhood were associated with an increased risk of anorexia nervosa, bulimia nervosa, and other eating disorders such as binge eating disorder in adolescence. These relationships appear to be both time and dose-dependent, meaning that the onset of eating disorder diagnosis is greatest in the first three months following the infection, and the more infections, the greater the risk.    (more…)
Author Interviews, Genetic Research, Heart Disease, JAMA, Lipids / 25.04.2019

MedicalResearch.com Interview with: Florian Kronenberg, MD Division of Genetic Epidemiology Department of Medical Genetics, Molecular and Clinical Pharmacology Medical University of Innsbruck, Innsbruck, Austria MedicalResearch.com: What is the background for this study? Response: Lp(a) is one of the most prevalent lipoprotein risk factors for cardiovascular disease. Roughly 20% of the general Caucasian population have concentrations above 50 mg/dL and the 10% with the highest concentrations have a 2 to 3-fold increased risk for myocardial infarction. There is strong evidence from genetic studies that high Lp(a) concentrations are causally related to cardiovascular outcomes. Until recently there was no drug available which lowers Lp(a) without any effects on other lipoproteins. This has recently changed by the development of drugs that block the production of Lp(a) in an impressive way. These drugs have to be studied in randomized controlled trials whether they not only lower Lp(a) concentrations but also cardiovascular outcomes. For the planning of such studies it is crucial to estimate the amount of Lp(a) lowering required to show a clinical benefit. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics, Race/Ethnic Diversity / 24.04.2019

MedicalResearch.com Interview with: Clare Brown, PhD Health Systems and Services Research University of Arkansas for Medical Sciences J. Mick Tilford, PhD, Professor and Chair Department of Health Policy and Management Fay W. Boozman College of Public Health University of Arkansas for Medical Science   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Prematurity and low birthweight are associated with increased risk of infant mortality as well as increased risk of chronic conditions throughout infancy and into adulthood. Non-Hispanic black infants are twice as likely to be born low birthweight (13.9% vs 7.0%) and 1.5 times as likely to be born prematurely (13.9% vs 9.1%) compared to non-Hispanic white infants. Under the Affordable Care Act (ACA), states may expand Medicaid to adults with household income levels at or below 138% of the federal poverty level, thus extending coverage to childless adults and improving continuity. Insurance gain may ultimately improve maternal health, increased use and earlier initiation of prenatal care services, and improved access to pregnancy planning resources. Our study aimed to evaluate whether there were changes in rates of low birthweight and preterm birth outcomes among states that expanded Medicaid versus states that did not expand Medicaid. (more…)
Author Interviews, Environmental Risks, JAMA, Pediatrics, Primary Care, Toxin Research, USPSTF / 23.04.2019

MedicalResearch.com Interview with: Alex H. Krist, MD, MPH Vice-Chairperson, U.S. Preventive Services Task Force Professor of family medicine and population healt Virginia Commonwealth University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Exposure to lead can have serious lifelong effects on the health and wellbeing of children. There is no safe level of lead exposure, so finding and removing any source of lead exposure is essential. In its review of the evidence, the Task Force found that more research is needed to determine what primary care clinicians can do to help prevent and treat the health problems that can result from lead exposure in childhood and pregnancy. (more…)
Author Interviews, Environmental Risks, JAMA, Lymphoma, Occupational Health, Toxin Research / 23.04.2019

MedicalResearch.com interview with: Sylvain Lamure, MD, Hematologist, Principal Investigator Pascale Fabbro-Peray, MD, PhD , Epidemiologist, Senior Investigator University of Montpellier, France MedicalResearch.com: What is the background for this study? Response: Occupational exposure to pesticides is a well-documented associated factor for non-Hodgkin lymphoma. The main biological mechanisms of both pesticides and chemotherapy are genotoxicity and reactive oxygen species generation. Cellular adaptation among patients exposed to low doses of genotoxic and oxidative compounds might hinder chemotherapy efficiency in lymphoma patients. T hus, we have investigated the association of occupational exposure with response to immunochemotherapy and survival in the subgroup of diffuse large B cell lymphoma, whose treatment is standardized. (more…)
Author Interviews, JAMA, Pediatrics, Sugar / 23.04.2019

MedicalResearch.com Interview with: Asher Y Rosinger, PhD, MPH Assistant Professor of Biobehavioral Health and Anthropology Director of the Water, Health, and Nutrition Laboratory Pennsylvania State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sugar-sweetened beverage consumption has been linked to many negative health conditions, such as weight gain, dental caries, and type 2 diabetes. Previous research found that when you replace sugar-sweetened beverages (SSBs) with water intake then total energy intake goes down. We wanted to know how many calories from SSBs children consume when they drink water or not since sugar-sweetened beverages are often used as a replacement for water. SSB intake has been falling among children over the last 15 years, but there are still pockets and sub-populations that have high consumption levels. It is critical to identify which kids are particularly at risk for high SSB intake since this can lead to these negative health effects. Overall we found that kids that did not consume any plain water (from tap or bottled water) consumed almost twice as many calories and percent of total calories from sugar-sweetened beverages than kids that consumed water. And for the sample overall that translated to nearly 100 extra calories on a given day.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA, Radiation Therapy, Technology / 19.04.2019

MedicalResearch.com Interview with: Raymond H Mak, MD Radiation Oncology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? 
  • Lung cancer remains the most common cancer, and leading cause of cancer mortality, in the world and ~40-50% of lung cancer patients will need radiation therapy as part of their care
  • The accuracy and precision of lung tumor targeting by radiation oncologists can directly impact outcomes, since this key targeting task is critical for successful therapeutic radiation delivery.
  • An incorrectly delineated tumor may lead to inadequate dose at tumor margins during radiation therapy, which in turn decreases the likelihood of tumor control.
  • Multiple studies have shown significant inter-observer variation in tumor target design, even among expert radiation oncologists
  • Expertise in targeting lung tumors for radiation therapy may not be available to under-resourced health care settings
  • Some more information on the problem of lung cancer and the radiation therapy targeting task here:https://www.youtube.com/watch?v=An-YDBjFDV8&feature=youtu.be
(more…)