Author Interviews, Cancer Research, Health Care Systems, JAMA, Outcomes & Safety, Surgical Research, Yale / 12.04.2019

MedicalResearch.com Interview with: Daniel J. Boffa, MD Associate Professor of Thoracic Surgery Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prominent cancer hospitals have been sharing their brands with smaller hospitals in the community.  We conducted a series of nationally representative surveys and found that a significant proportion of the U.S. public assumes that the safety of care is the same at all hospitals that share the same respected brand.  In an effort to determine if safety was in fact the same, we examined complex surgical procedures in the Medicare database. We compared the chance of dying within 90 days of surgery between top-ranked hospitals, and the affiliate hospitals that share their brands.  When taking into account differences in patient age, health, and type of procedure, Medicare patients were 1.4 times more likely to die after surgery at the affiliate hospitals, compared to those having surgery at the top-ranked cancer hospitals. (more…)
Author Interviews, Epilepsy, Genetic Research, JAMA, Pediatrics / 12.04.2019

MedicalResearch.com Interview with: Dr. Ahmad Abou Tayoun, PhD Clinical Molecular Geneticist Director of the Genetics Laboratory Al Jalila Children’s United Arab Emirates MedicalResearch.com: What is the background for this study?   Response: In this study, we provide data in favor of using an exome-based testing approach, where parental samples can be readily accessible, for early onset epilepsy patients. The exome test includes all coding genes in the human genome. Although we perform exome sequencing on those patients, we demonstrate that a first tier analysis should include targeted interpretation of ~100 genes strongly associated with the disease. This analysis provides diagnoses in ~11% of the patients. Follow up parental testing on a limited number of patients (n=15) that had inconclusive results, revealed de novo (new mutations) variant status, leading to upgrade to positive reports in 7 patients and adding ~5% to the overall diagnostic yield. (more…)
Author Interviews, Cancer Research, JAMA, UT Southwestern / 11.04.2019

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: There has been increasing interest in use of complementary and alternative medicine in the oncology population – both in terms of its potential efficacy and harms. The main finding of this study is that approximately 1/3 of cancer patients and survivors self-reported using complementary or alternative medicine over the past year, the most common being herbal supplements. Of these patients, approximately 1/3 did not disclose to their physicians that they were doing so. (more…)
Author Interviews, Depression, Exercise - Fitness, JAMA, Parkinson's / 10.04.2019

MedicalResearch.com Interview with: Dr. Jojo Kwok  R.N., BN(Hons), MPH, Ph.D. School of Nursing, Li Ka Shing Faculty of Medicine The University of Hong Kong MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Before the study, we knew that mind-body exercises such as yoga and stretching improves the physical health of patients with Parkinson’s disease (PD), however the benefits to their mental health was not known. This study concludes that mindfulness yoga alleviates psychological distress, improves spiritual well-being and quality of life, not to mention motor symptoms and mobility. When it comes to managing the stress and symptoms of Parkinson Disease, what is exciting, is that yoga has now been proven to be a better strategy than just stretching. Yoga draws together body, mind and spirit through mindful practice of 1) yoga posture, 2) breathing and 3) meditation. These form the three core components of our Mindfulness Yoga Program. Mindfulness is non-judgemental awareness of the present moment - of one’s physical sensations and thoughts, be they positive or negative. By adopting a mind-body approach, patients are much better positioned to reframe their illness journey than through physical training alone. By learning to relate non-judgmentally to their physical symptoms and emotions, they develop new coping skills that cultivate openness, acceptance and resilience to these symptoms. They feel better.  (more…)
Author Interviews, Cancer Research, JAMA, Vitamin D / 09.04.2019

MedicalResearch.com Interview with: Mitsuyoshi Urashima MD, PhD, MPH Professor of Molecular Epidemiology Jikei University School of Medicine Tokyo, JAPAN MedicalResearch.com: What is the background for this study?   Response: Serum levels of vitamin D, increase in response to exposure to sunlight, a vitamin D-rich diet, or vitamin D supplementation. In 1989, the risk of colon cancer was estimated to be 70% lower in people with serum vitamin D levels ≥ 20 ng/mL, compared with those < 20 ng/mL. In a cohort study, higher vitamin D levels were associated with lower total cancer incidence and lower total cancer mortality, particularly digestive system cancer mortality. However, because of the studies’ observational nature, whether lower levels of vitamin D is merely a precursor to relapse and death or causally related to shorter survival cannot be determined. To clarify this, a randomized, double-blind, placebo-controlled trial using vitamin D supplement was performed in patients with digestive tract cancer from esophagus to rectum; this is the first trial designed to evaluate the effect of vitamin D on survival of these patients.  (more…)
Author Interviews, JAMA, Race/Ethnic Diversity, Surgical Research, Transplantation, Yale / 09.04.2019

MedicalResearch.com Interview with: Sanjay Kulkarni, MD MHCM FACS Associate Professor of Surgery & Medicine Surgical Director – Kidney Transplant Program Medical Director – Center for Living Organ Donors Scientific Director – Yale Transplant Research New Haven, CT 06410 MedicalResearch.com: What is the background for this study? Response: The kidney allocation system changed in December of 2014. The aim of the new system was to increase transplant in patients who were highly sensitized (difficult matches based on reactive antibodies) and to improve access to underserved populations. (more…)
Author Interviews, End of Life Care, Health Care Systems, JAMA / 08.04.2019

MedicalResearch.com Interview with: Cindy L. Cain, PhD Assistant Professor Department of Sociology University of Alabama at Birmingham Birmingham, AL 35233   MedicalResearch.com: What is the background for this study? What are the main findings? Response: The End of Life Option Act permits terminally ill Californians to request a prescription for medications that would hasten death, providing they meet all requirements of the law and follow the steps outlined by their health care provider. However, the law also allows health care providers and organizations to opt out of participating. Until now, we did not know how common it was for entire health care organizations to opt out. In this study, we found that 61% of the surveyed hospitals prohibited physician participation in the End of Life Option Act. Thirty-nine percent of hospitals did allow participation in the law; these participating hospitals were less likely to be religiously affiliated and more likely to be nonprofit. (more…)
ADHD, Author Interviews, JAMA, OBGYNE, Pediatrics, Pharmacology / 08.04.2019

MedicalResearch.com Interview with: Dr. Angela Lupattelli, PhD School of Pharmacy University of Oslo MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Between 1-4% of pregnant women take at least once a benzodiazepine and/or a z-hypnotic medication during the course of gestation. These medications are generally used intermittently in pregnancy, mainly for treatment of anxiety disorders and sleeping problems, which are not uncommon conditions among pregnant women. However, data regarding the safety of benzodiazepine and/or a z-hypnotic in pregnancy on child longer-term development are sparse. For instance, studies on child motor skills are only available up to toddler age, and little is known in relation to other child developmental domains. So, there is an urgent need to better understand whether prenatal use of benzodiazepine and/or a z-hypnotic medication may pose detrimental longer-term child risks. (more…)
Author Interviews, JAMA, Kidney Disease / 08.04.2019

MedicalResearch.com Interview with: Matthew T James MD, PhD Assistant Professor University of Calgary  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Acute Kidney Disease and Disorders (AKD) criteria from the KDIGO Acute Kidney Injury guidelines identified many patients who do not meet existing criteria for Chronic Kidney Disease or Acute Kidney Injury (AKI), and the majority of AKD events occured in the community rather than hospital setting. This study characterized the frequency and outcome for patients with AKD (without  AKI) as well as AKD with CKD from among over 1.1 million adults  residing in Alberta Canada who received  kidney function testing and were followed for up to 8 years. (more…)
Author Interviews, ENT, JAMA, Pain Research, Pediatrics, Surgical Research / 05.04.2019

MedicalResearch.com Interview with: Gillian R. Diercks, MD, MPH Instructor in Otolaryngology, Harvard Medical School Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston, Massachusetts  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pediatric tonsillectomy is a commonly performed procedure, representing the second most common ambulatory surgery performed on children in the United States, with over half a million children undergoing the surgery annually.  A major concern for surgeons, patients, and their families is the issue of postoperative pain control as pain can last up to 10-14 days after surgery, be quite severe, and result in readmission to the hospital or ED visits for medications and dehydration. In young children and children with sleep apnea we cannot safely administer narcotic pain medications at home.  This leaves limited options for pain control, including acetaminophen and ibuprofen.  However, there are concerns that ibuprofen could potentially increase bleeding risk after surgery because of its effects on platelet function in the blood.  At baseline, the risk of postoperative hemorrhage within the first two weeks after tonsillectomy is around 4.5%, with about 1-1.5% of children requiring a return to the operating room to control severe bleeding.  Our study set out to show that the risk of severe postoperative bleeding when ibuprofen is given for 9 days after tonsillectomy was not increased compared with the bleeding risk when acetaminophen was administered instead. Our study could not conclude that the risk of bleeding is no different when ibuprofen is used, and was suggestive that the bleeding risk may actually be higher. (more…)
Author Interviews, Diabetes, Genetic Research, JAMA, Mental Health Research, Schizophrenia / 03.04.2019

MedicalResearch.com Interview with: Prof Sabine Bahn MD PhD MRCPsych FRSB Cambridge Centre for Neuropsychiatric Research Jakub Tomasik, PhD Department of Chemical Engineering and Biotechnology University of Cambridge   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Schizophrenia patients are at increased risk of impaired glucose metabolism, yet the comorbidity between the two conditions cannot be fully explained by known risk factors such as obesity, smoking, stress or antipsychotic medication. Previous family and genome-wide studies have suggested that the co-occurrence between schizophrenia and impaired glucose metabolism might be due to shared genetic factors, as exemplified by increased risk of diabetes in first-degree relatives of schizophrenia patients, but the biological mechanisms underlying this association remain unknown. We examined the association between insulin resistance, schizophrenia polygenic risk and response to treatment in 58 drug-naive schizophrenia patients and 58 matched healthy individuals while controlling for a range of demographic (age, gender, body mass index), lifestyle (smoking, alcohol and cannabis use) and clinical (psychopathology scores, treatment drug) factors. We found that insulin resistance, a key feature contributing to the development of type 2 diabetes, significantly correlated with schizophrenia polygenic risk score in patients, with higher genetic risk of schizophrenia associated with increased insulin resistance. Furthermore, we found that patients with higher insulin resistance were more likely to switch medication during the first year of treatment, which implies lower clinical response.  (more…)
Allergies, Author Interviews, Dermatology, Heart Disease, JAMA / 03.04.2019

MedicalResearch.com Interview with: Amber Reck Atwater, M.D. Dermatology Residency Program Director Associate Professor of Dermatology Director, Contact Dermatitis Clinic Duke Dermatology  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We completed an evaluation of our Duke Dermatology patients who underwent patch testing for possible allergy to their cardiac devices - pacemakers and defibrillators. From March 1, 2012 to September 15, 2017 we saw 11 patients with suspected allergy to their devices.  Concern for allergy, skin eruption, skin symptoms, and concern for infection were common. 73% of patients had erythema at their implant scars; pruritus and pain were also noted.  Six of our patients had relevant reactions, and the most common allergies were metals, silicone and rubber accelerators.  (more…)
Author Interviews, Cost of Health Care, General Medicine, Hospital Readmissions, JAMA, Race/Ethnic Diversity / 02.04.2019

MedicalResearch.com Interview with: Teryl K. Nuckols, MD Vice Chair, Clinical Research Director, Division of General Internal Medicine Cedars-Sinai Medical Center  MedicalResearch.com: What is the background for this study?   Response: Healthcare policymakers have long worried that value-based payment programs unfairly penalize hospitals treating many African-American patients, which could worsen health outcomes for this group. For example, policy experts have suspected that the Medicare Hospital Readmission Reduction Program unevenly punishes institutions caring for more vulnerable populations, including racial minorities. They've also feared that hospitals might be incentivized to not give patients the care they need to avoid readmissions. The study Investigators wanted to determine whether death rates following discharges increased among African-American and white patients 65 years and older after the Medicare Hospital Readmission Reduction Program started. (more…)
Author Interviews, Heart Disease, JAMA, Lipids / 02.04.2019

MedicalResearch.com Interview with: Victor Wenze Zhong, Ph.D. Postdoctoral fellow Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago, IL 60611  MedicalResearch.com: What is the background for this study? Response: Dietary cholesterol is a common nutrient in human diet. Eggs, specially egg yolks, are the single richest source of dietary cholesterol among all commonly consumed foods. The associations between dietary cholesterol consumption and cardiovascular disease and mortality remain controversial despite decades of research. Eating less than 300 mg of dietary cholesterol per day was the guideline recommendation before 2015. However, the most recent 2015-2020 Dietary Guidelines for Americans no longer include a daily consumption limit for dietary cholesterol and recommend weekly egg consumption as part of the healthy US-style eating pattern. Whether these recommendations are appropriate have been intensely debated. (more…)
Author Interviews, JAMA, Social Issues / 01.04.2019

MedicalResearch.com Interview with: Rajan Sonik, PhD JD MPH Research Scientist Tucker-Seeley Research Lab Leonard Davis School of Gerontology Postdoctoral Research Fellow Leonard D. Schaeffer Center for Health Policy and Economics Leonard Davis School of Gerontology University of Southern California Los Angeles, CA 90089-3333 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Not everyone who is eligible for public benefits like Supplemental Security Income (SSI) tries to receive them. One distinguishing factor is that those who apply for benefits disproportionately experience shocks (e.g., divorce, job loss, health problems) and sharp increases in material hardships (e.g., food insecurity, housing insecurity) shortly before applying. Typically, these increases in hardships are then partially—but not fully—alleviated by receipt of the public benefits. Given strong associations between these hardships and poor health outcomes, we wanted to examine whether health status might fluctuate before and after the receipt of public benefits as well. We examined SSI in particular given its focus on individuals with disabilities, keeping in mind the particular health vulnerabilities experienced by this population. In line with patterns previously observed for material hardships, we found in a nationally representative sample that the health status of eventual SSI recipients worsened significantly in the period prior to program entry. After enrollment began, the decline in health status stopped but was not fully reversed. In the paper, we discuss why these findings were more likely to be driven by changes in material hardship levels rather than changes in disability status. (more…)
Author Interviews, Cancer Research, FDA, JAMA / 01.04.2019

MedicalResearch.com Interview with: Emerson Chen, MD Chief Fellow, Hematology-Oncology, PGY-6 Oregon Health & Science University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many cancer drugs are approved annually giving the appearance of innovation; however, some drugs may have been approved because of a lower bar. Use of lesser endpoints like response rate (how tumor shrinks) and progression-free survival (how tumor has delayed growth) have been proposed to speed trials when compared against traditional endpoints like overall survival (how long patients might live). Using published trials that led to cancer drug approval from 2006 to 2017, we estimated how long it would take to get each of these three endpoints across all cancer drugs and indications to see how much time we could save by using these weaker but faster endpoints. We see that many trials using overall survival used less time than anticipated, and many trials using response rate or progression-free survival actually took quite a bit of time.  In part that is due to researchers needing to document the duration of the response. But, whatever the reason, the time to get each of the three endpoints is actually more similar than different, and we estimate that our current use of  these faster endpoints are saving us only 11 months compared to using only overall survival. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 31.03.2019

MedicalResearch.com Interview with: Abhay K Lodha MD, DM, MSc Department of Pediatrics Alberta Health Services   MedicalResearch.com: What is the background for this study? Response: There is no physiological rationale for clamping the umbilical cord immediately after birth. In moderate (32+0 weeks-33+6 weeks) and late preterm infants (34+0 to 36+6), delayed cord clamping reduces the need for blood transfusions, leads to circulatory stability and improves blood pressure. However, the information on the association of delayed cord clamping with outcomes for extremely low gestational age neonates (22-28 weeks of gestation) is limited. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 31.03.2019

MedicalResearch.com Interview with: Valerie Seror, PhD French Institute of Health and Medical Research Inserm MedicalResearch.com: What is the background for this study? Response: In the highly sensitive context of prenatal diagnosis where autonomous and informed decision-making is of crucial issue, the present study is a companion study to a prospective clinical trial [ClinicalTrials.gov Identifier: NCT02127515] aiming at comparing clinical benefits involved by invasive vs. non-invasive testing in women at high risk of Down syndrome following routine combined screening. Our study (involving 2,436 consecutive high-risk pregnant women following combined screening for Down syndrome) confirmed that attitudes towards invasive testing are notably guided by risk aversion to invasive testing-related fetal loss whereas it showed that attitudes towards non-invasive testing are notably guided by aversion to the ambiguity generated by results restricted to the only targeted abnormalities. (more…)
Author Interviews, Breast Cancer, Exercise - Fitness, Heart Disease, JAMA, UCLA / 29.03.2019

MedicalResearch.com Interview with: Christina M. Dieli-Conwright, PhD, MPH, FACSM, CSCS Assistant Professor of Research Director, Integrative Center for Oncology Research in Exercise Division of Biokinesiology & Physical Therapy, Ostrow School of Dentistry Department of Medicine, Keck School of Medicine University of Southern California Los Angeles, CA 90033  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study was designed to assess the effects of an aerobic and resistance exercise on metabolic dysregulation in sedentary, obese breast cancer survivors, however we further examined the effects on cardiovascular disease risk measured by the Framingham Risk Score, reported here. Our findings indicated that exercise, indeed, reduces the risk of cardiovascular disease in this population.  (more…)
Author Interviews, JAMA, Smoking, Tobacco Research / 29.03.2019

MedicalResearch.com Interview with: Jidong Huang, PhD Associate Professor Department of Health Policy & Behavioral Sciences School of Public Health, Georgia State University Atlanta, GA 30303 MedicalResearch.com: What is the background for this study?   Response: The US tobacco market has been transformed in the past decade by a rapid increase in awareness and use of e-cigarettes among youth and adults. This transformation has been accelerated in recent years by the emergence of new generations of e-cigarettes, such as JUUL e-cigarettes. The exponential growth in e-cigarettes has prompted a renewed interest in the tobacco harm reduction approach, which aims to rapidly curbing the smoking epidemic by encouraging smokers to switch to low risk tobacco products, such as e-cigarettes. There is an ongoing debate about whether the scientific evidence on the health risks of e-cigarettes in comparison with combustible cigarettes has been accurately communicated to the public. Large representative surveys are needed to examine how the public perceives the health risk of e-cigarettes and how their perception change over time. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA / 28.03.2019

MedicalResearch.com Interview with: Isaac Chua MD Instructor of Medicine at Harvard Medical School Boston, Massachusetts  MedicalResearch.com: What is the background for this study?   Response: Opioids are routinely prescribed for cancer-related pain, but little is known about the prevalence of opioid-related hospitalizations for patients with cancer. Although opioid addiction among patients with cancer is estimated to be as high as 7.7%, our understanding of opioid misuse is based on small, preliminary studies. In light of the wider opioid epidemic, oncologists and palliative care clinicians frequently balance providing patients with legitimate access to opioids while protecting them and the general public from the risks of prescribing these medications. (more…)
Accidents & Violence, Alzheimer's - Dementia, Author Interviews, JAMA, Mental Health Research / 28.03.2019

MedicalResearch.com Interview with: Madeleine Liljegren, MD Division of Oncology and Pathology Department of Clinical Sciences Lund University Lund, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know from former studies including patients with a clinical diagnosis of dementia, that criminal and socially inappropriate behaviors can be signs of dementia, sometimes even the first signs of a neurodegenerative disorder. We wanted to study this relatively large (n=220) cohort of neuropathologically verified Alzheimer disease (AD) and frontotemporal dementia (FTD) patients, who had been followed clinically by specialists in cognitive medicine or geriatric psychiatry during their disease period, to see if we could confirm results from previous studies. In this paper, we further wanted to study potential differences regarding protein pathology and criminal behavior in frontotemporal dementia patients. This has, to our knowledge, never been done before. (more…)
Author Interviews, Environmental Risks, JAMA, Mental Health Research, Pediatrics / 28.03.2019

MedicalResearch.com Interview with: “air pollution, beijing” by 大杨 is licensed under CC BY 2.0Joanne B. Newbury, PhD ESRC Postdoctoral Fellow King’s College London Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology & Neuroscience London, United Kingdom MedicalResearch.com: What is the background for this study? Response: Urban living is one of the most well-established risk factors for adult psychotic disorders such as schizophrenia. However, less is known about the role of the urban environment in subclinical psychotic experiences in childhood and adolescence, such as hearing voices and extreme paranoia. These early psychotic experiences are a developmental risk factor for adult psychotic disorders and a range of other serious mental health problems such as depression and anxiety. It is therefore important that we understand what factors might contribute to the development of early psychotic experiences so that we might be able to intervene and prevent their onset and progression. In a cohort of over 2000 UK-born children (The Environmental Risk Longitudinal Twin Study), we have previously shown that subclinical psychotic experiences are also around twice as common among children and teenagers raised in urban versus rural settings. We have also shown that this appears to be partly explained by social features in urban neighbourhoods such as higher crime levels and lower levels of social cohesion. However, no studies have examined the potential link between air pollution and psychotic experiences. This is despite air pollution being a major health problem worldwide (particularly in cities), and despite emerging evidence linking air pollution to the brain.  (more…)
Author Interviews, Cannabis, JAMA, Mental Health Research, OBGYNE / 28.03.2019

MedicalResearch.com Interview with: Jeremy Fine B.A. in Philosophy, Neuroscience, and Psychology Washington University in St. Louis, Class of 201 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Alongside increasingly permissive marijuana use attitudes and laws, the prevalence of marijuana use among pregnant mothers has increased substantially (by 75% between 2002 and 2016), with some evidence that pregnant women may be using cannabis to combat pregnancy-related nausea. Our data came from the Adolescent Brain Cognitive Development (ABCD) Study, which included over 4,000 subjects with data on maternal marijuana use during pregnancy. Our main finding was that the children of mothers who used marijuana after learning they were pregnant had a small but significant increase in risk for psychosis in their future. (more…)
Author Interviews, Brigham & Women's - Harvard, Dermatology, Heart Disease, JAMA / 27.03.2019

MedicalResearch.com Interview with: Seoyoung C. Kim, MD, ScD, MSCE Director, Program in Rheumatologic, Immunologic, and Musculoskeletal PharmacoEpidemiology Associate Professor of Medicine Division of Pharmacoepidemiology & Pharmacoeconomics Division of Rheumatology, Immunology and Allergy Brigham and Women's Hospital Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Given a high cardiovascular (CV) risk among patients with psoriasis and psoriatic arthritis, it is important to have more information with regard to potential effect of different treatment agents on CV risk. As the number of treatment options for psoriasis and psoriatic arthritis has been rising over the few decades, it is even more crucial to have high-quality evidence on comparative safety of different treatment options so physicians and patients can choose an agent based on the benefit-risk profile of each drug they are considering. (more…)
Author Interviews, Brigham & Women's - Harvard, Flu - Influenza, Heart Disease, JAMA / 27.03.2019

MedicalResearch.com Interview with: Sonja Kytomaa MA Research Associate Brigham and Women’s Hospital Scott D. Solomon, MD The Edward D. Frohlich Distinguished Chair Professor of Medicine Harvard Medical School Senior Physician Brigham and Women’s Hospital International Associate Editor, European Heart Journal   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Influenza is associated with an increased risk of cardiovascular events, yet few studies have explored the temporal association between influenza activity and hospitalizations, especially due to heart failure (HF). Our aim with this study was to explore the temporal association between influenza activity and hospitalizations for HF and myocardial infarction (MI) in the general population. We related the number of MI and HF hospitalizations by month, which were sampled from 4 US communities and adjudicated in the surveillance component of the Atherosclerosis Risk in Communities (ARIC) study, to monthly influenza-like illness activity, as reported by the Centers for Disease Control and Prevention. We found that a 5% increase in influenza activity was associated with a 24% increase in HF hospitalizations rates, while overall influenza was not significantly associated with MI hospitalizations. Influenza activity in the months before hospitalization was not associated with either outcome. (more…)
Author Interviews, JAMA, Karolinski Institute, Pediatrics / 26.03.2019

MedicalResearch.com Interview with: Mikael Norman, MD, PhD, Professor Karolinska Institutet & Karolinska University Hospital Stockholm, Sweden  MedicalResearch.com: What is the background for this study? Response: So far, preterm birth has been difficult to predict and prevent. In particular, extremely preterm birth has continued to be an issue in terms of optimal care before and after birth, costs and long term health outcomes. Therefore, studies on how the management and outcome varies over time in these patients are important. (more…)
Author Interviews, Heart Disease, JAMA, Stem Cells / 26.03.2019

MedicalResearch.com Interview with: Annetine C. Gelijns, PhD Professor and System Chair Population Health Science and Policy Icahn School of Medicine at Mount Sinai Alan J Moskowitz, MD Professor of Population Health Science and Policy Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Where do these mesenchymal cells come from?  Response: Implantable LVADs significantly improve the survival and quality of life of advanced heart failure patients. However, these devices are associated with substantial adverse events, including infection and thromboembolic events. Moreover, whereas these devices improve myocardial function, few patients recover sufficient function to be explanted from their LVAD. These observations have focused attention on stem cells as a possible adjunctive therapy to further augment cardiac recovery. Mesenchymal precursor cells (MPCs), which are obtained from healthy donors and culture-expanded, have been shown in animal and early human studies to improve cardiac function. Using temporary weaning as a signal of cardiac recovery, we conducted an exploratory trial in the Cardiothoracic Surgical Trials Network (CTSN), which found that MPCs increased the probability of temporary weaning from full LVAD support compared to sham-control patients. Therefore, this signal of efficacy led the CTSN to design our current follow-up trial evaluating the efficacy and safety of a higher dose of MPCs in LVAD patients. (more…)
Author Interviews, JAMA, Pediatrics, Stanford, Technology / 26.03.2019

MedicalResearch.com Interview with: Dennis P. Wall, PhD Associate Professor Departments of Pediatrics, Psychiatry (by courtesy) and Biomedical Data Science Stanford University  MedicalResearch.com: What did we already know about the potential for apps and wearables to help kids with autism improve their social skills, and how do the current study findings add to our understanding? What’s new/surprising here and why does it matter for children and families?  Response: We have clinically tested apps/AI for diagnosis (e.g.  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002705) in a number of studies. This RCT is a third phase of a phased approach to establish feasibility and engagement through in-lab and at-home codesign with families with children with autism. This stepwise process is quite important to bring a wearable form of therapy running AI into the homes in a way that is clinically effective. What’s new here, aside from being a first in the field, is the rigorous statistical approach we take with an intent-to-treat style of analysis. This approach ensures that the effect of the changes are adjusted to ensure that any significance observed is due to the treatment.  Thus, with this, it is surprising and encouraging to see an effect on the VABS socialization sub-scale. This supports the hypothesis that the intervention has a true treatment effect and increases the social acuity of the child. With it being a home format for intervention that can operate with or without a clinical practitioner, it increases options and can help bridge gaps in access to care, such as when on waiting lists or if the care process is inconsistent.   (more…)
Author Interviews, JAMA, Pediatrics / 26.03.2019

MedicalResearch.com Interview with: Edward Bell, MD Vice Chair for Faculty Development Department of Pediatrics Professor of Pediatrics - Neonatology Carver College of Medicine University of Iowa Health Care  MedicalResearch.com: What is the background for this study? Response: The study is an analysis of what happened to the 205 babies with birth weigh below 400 grams and gestational age of 22 through 26 weeks who were born between 2008 and 2016 at 21 academic medical centers that are members of the National Institute of Child Health and Human Development Neonatal Research Network. The Network exists to collaborate in finding ways to improve the survival and health of premature and other critically-ill newborn infants. 400 grams is very small. By comparison, 1 pound is 454 grams. (more…)