meta name="publication-media-verification"content="1ebe9089d92647b3b88294de308625d5
Author Interviews, Diabetes, Education, JAMA, Pediatrics / 06.02.2019

MedicalResearch.com Interview with: Niels Skipper PhD Associate Professor, Department of Economics and Business Economics Aarhus University MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is unclear if there is an association between type 1 diabetes and school performance in children. Some studies have found type 1 diabetes to be associated with worse performance, while others have found no differences. However, most of the existing literature are based on smaller, non-random samples of children with diabetes. In this study we used data on all public school children in the country of Denmark, involving more than 600,000 schoolchildren where approximately 2,000 had a confirmed diagnosis of type 1 diabetes. The children were tested in math and reading using a nationally standardized testing procedure, and we found no difference in the obtain test scores between children with diabetes compared to children without diabetes.  (more…)
Author Interviews, Cost of Health Care, Critical Care - Intensive Care - ICUs, Health Care Systems, Hospital Acquired, JAMA, Urinary Tract Infections / 06.02.2019

MedicalResearch.com Interview with: Heather Hsu, MD MPH Assistant Professor of Pediatrics Boston University School of Medicine Boston Medical Center Boston, MA 02118 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In October 2013, the Centers for Medicare and Medicaid Services (CMS) implemented value-based incentive programs to financially reward or penalize hospitals based on quality metrics. Two of these programs – Hospital Value Based Purchasing and the Hospital Acquired Condition Reduction Program – began targeting hospitals’ rates of certain healthcare-associated infections deemed to be preventable in October 2015. Previous studies demonstrated minimal impact of these value-based payment programs on other measures of hospital processes, patient experience, and mortality. However, their impact on healthcare-associated infections was unknown. Our goal was to study the association of value-based incentive program implementation with healthcare-associated infection rates, using catheter-associated urinary tract infection in intensive care units (one of the targeted outcomes) as an example. We found no evidence that federal value-based incentive programs had any measurable association with changes in catheter-associated urinary tract infection rates in the critical care units of US hospitals. (more…)
Author Interviews, JAMA, Ophthalmology, Pediatrics, STD, USPSTF / 05.02.2019

MedicalResearch.com Interview with: Michael Silverstein, M.D., M.P.H. Professor of Pediatrics Director of the Division of General Academic Pediatrics Vice chair of research for the Department of Pediatrics Boston University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gonococcal ophthalmia neonatorum, or GON, is a severe infection of the eye that can occur in babies born to women who have gonorrhea. If left untreated, GON can cause serious problems, including blindness, that can appear as soon as 24 hours after delivery. Fortunately, there are effective treatments available that can prevent GON in newborns. The U.S. Preventive Services Task Force reviewed the most current research on the benefits and harms of ocular prophylaxis—which is applying antibiotic ointment to the babies’ eyes at birth—to prevent GON. We found that, if applied within 24 hours after birth, the ointment is very effective at preventing gonococcal ophthalmia neonatorum and the problems it causes. Therefore, we are recommending that clinicians provide this preventive service for all newborns.  (more…)
Author Interviews, JAMA, Thyroid, Thyroid Disease / 04.02.2019

MedicalResearch.com Interview with: Joanna Klubo-Gwiezdzinska, M.D., Ph.D., M.H.Sc. Assistant Clinical Investigator/Assistant Professor Metabolic Disease Branch/NIDDK/NIH Bethesda, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: People with intermediate- and high-risk differentiated thyroid cancer (DTC) are treated with surgical removal of the thyroid gland and radioactive iodine therapy.  After surgery and initial treatment, the thyroid hormone levothyroxine is used for long-term management not only to replace appropriate physiologic thyroid hormones post-surgery, but also to suppress thyrotropin (TSH) release from the pituitary gland at supraphysiologic doses. The current recommended American Thyroid Association TSH suppression goal in patients with a high-risk differentiated thyroid cancer presenting with distant metastases is less than 0.1mIU/ml, and between 0.1-0.5 mIU/ml for patients with intermediate-risk DTC presenting with local metastases to the neck lymph nodes. This TSH goal is much lower than physiologic TSH level, which ranges between 0.4-4.1 mIU/ml, depending on the measurement method and person’s age. TSH suppression is used because some preclinical evidence suggests that TSH can stimulate growth of cancer cells.  However, several preclinical studies show that thyroid hormones may also stimulate cancer growth. In addition, too much levothyroxine, leading to TSH suppression, may cause side effects such as abnormal heart rhythms and decreased bone mass. In this study, based on a large multicenter database analysis, we found that continuous TSH suppression with levothyroxine was not associated with better progression-free survival and overall survival in patients with either intermediate- and high-risk differentiated thyroid cancer. The patients were followed for an average of 7 years after surgical thyroid cancer removal and radioactive iodine therapy.  (more…)
Antibiotic Resistance, Asthma, Author Interviews, JAMA / 04.02.2019

MedicalResearch.com Interview with: Mihaela S Stefan, MD, PhD FACP Research Scientist, Institute for Healthcare Delivery and Population Science Associate Professor, UMMS-Baystate Director of Perioperative Clinic and Medical Consultation Program Academic Hospitalist Director Quality Assessment, Division of Healthcare Quality Springfield MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: In a prior study we have found that roughly 41% of patients hospitalized with an asthma exacerbation receive antibiotics although the guidelines do not support this practice. We found that the evidence supporting the guidelines was however limited to 6 trials which included a total of only 681 adults and children and most trials’ outcomes were symptoms or lung function not length of stay, need for mechanical ventilation, readmissions or death. We performed the largest observational study to-date of approximately 20 000 patients hospitalized for asthma exacerbation and found that patients treated with antibiotics did not have better outcomes but instead they had longer hospital stay and an increased risk for antibiotic-related diarrhea. (more…)
Author Interviews, Education, JAMA, Pediatrics / 03.02.2019

MedicalResearch.com Interview with: Sheri Madigan, Ph.D, R.Psych Canada Research Chair in Determinants of Child Development Assistant Professor, Department of Psychology Alberta Children's Hospital Research Institute University of Calgary MedicalResearch.com: What is the background for this study? What are the main findings? Response: Parents are reporting that screen time is one of their major concerns, so we wanted to find out more about how large of a role screen time was playing on children’s developmental outcomes. We were especially interested in the long-term impact of screens, which is why we followed children over time, from ages 2 to 5 and repeatedly assessed both screen time use and children’s achievement of developmental milestones. There are three main findings:
  1. Our study revealed that on average children were viewing screens for 2.4, 3.6 and 1.6 hours per day at two, three and five years of age, respectively. This means that the majority of the participants in our sample are exceeding the American Academy of Pediatrics’ guideline.
  2. We found statistically significant, albeit small effects suggesting that greater amounts of screen time at two and three years predict poorer child outcomes at three and five years, respectively. Thus, screen time has a lasting influence on children’s development.
  3. The opposite pattern was not observed. That is, we did not find evidence that children showing poor performance in terms of achieving developmental milestones were more likely to be place in front of screens to help cope with their potentially challenging behaviors.
(more…)
Author Interviews, JAMA, Opiods / 02.02.2019

MedicalResearch.com Interview with: "Opioids" by KSRE Photo is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0Dr. Qiushi Chen (first author) and Jagpreet Chhatwal PhD Assistant Professor, Harvard Medical School Senior Scientist, Institute for Technology Assessment Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Opioid overdose epidemic is a national public health emergency — in 2017, more than 49,000 people died from overdose. Our study shows that under current conditions, the number of deaths is projected to increase to 81,700 by 2025. Efforts to curb the epidemic by reducing the incidence of prescription opioid misuse — the primary focus of current interventions — will have a modest effect of 3-5% reduction in overdose deaths. (more…)
Author Interviews, Diabetes, JAMA, Primary Care / 01.02.2019

MedicalResearch.com Interview with: Diane M. Gibson, Ph.D. Executive Director – New York Federal Statistical Research Data Center, Baruch RDC Associate Professor – Marxe School of Public and International Affairs, Baruch College - CUNY MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior studies have found that screening for diabetic retinopathy in primary care settings using telemedicine increased screening rates among individuals with diabetes and among subgroups of individuals with diabetes who are at high risk of missing recommended eye exams.  In a previous paper I looked at how often U.S. adults with diabetes visited primary care and eye care providers for recommended diabetes preventive care services using a sample from the 2007-2013 Medical Expenditure Panel Survey.  I found that while visits to eye care providers were often skipped, most adults with diabetes did visit primary care physicians.  I argued that these findings suggest that screening for diabetic retinopathy in primary care settings using telemedicine has the potential to fulfill unmet needs and reach most U.S. adults with diabetes. My brief report in JAMA Ophthalmology examines patterns of eye examination receipt and visits to primary care physicians among U.S. adults with diabetes using a sample from the 2016 National Health Interview Survey.  The report pays particular attention to individuals who are at high-risk of missing recommended eye exams. The study found that 87.7% of the sample of adults with diabetes visited a primary care physician in the past year and that, except for the uninsured subgroup, more than 78% of each high-risk subgroup visited a primary care provider in the past year.  (more…)
Author Interviews, Gender Differences, JAMA, Mental Health Research, UCSF / 31.01.2019

MedicalResearch.com Interview with: Christina Mangurian, MD MAS Professor Department of Psychiatry, Weill Institute for Neurosciences Center for Vulnerable Populations, University of California, San Francisco Veronica Yank, MD Assistant Professor Division of General Internal Medicine Department of Medicine University of California San Francisco MedicalResearch.com: What is the background for this study? Response: This article is about the behavioral health and burnout consequences among physician mothers who are caring for seriously ill loved ones. Our work was inspired, in part, by some of the authors’ own experiences caring for loved ones with serious illnesses while also being physician mothers themselves.  We sought to determine the proportion of physician mothers with such caregiving responsibilities beyond their patients and children and the how these additional responsibilities affected the women’s health and practice. (more…)
Author Interviews, Exercise - Fitness, Heart Disease, JAMA / 30.01.2019

MedicalResearch.com Interview with: Laura DeFina, MD President and Chief Executive Officer Chief Science Officer The Cooper Institute MedicalResearch.com: What is the background for this study? Response: Several studies suggest that endurance athletes may be at higher risk for asymptomatic hardening of the coronary arteries.  These studies, however, have been done on small numbers of endurance athletes (ie – marathon runners) and do not show whether this increase in hardening actually leads to increase in heart attacks or death of cardiovascular disease. In our population of 21,758 generally healthy individuals (average age 52 years) who presented for a preventive medicine examination, we were able to evaluate for the presence of hardening and cardiovascular events in individuals who exercised high volumes (≥3000 MET·minutes/week or comparable to running 6 miles/hour for an hour 5 days a week) versus those exercising less. (more…)
Author Interviews, Hospital Readmissions, JAMA, Nursing / 29.01.2019

MedicalResearch.com Interview with: Marianne Weiss DNSc RN READI study Principal Investigator Professor of Nursing and Wheaton Franciscan Healthcare / Sister Rosalie Klein Professor of Women’s Health Marquette University College of Nursing Milwaukee Wi, 53201-1881 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our team of researchers has been studying the association of patient readiness for discharge and readmission for several years. We have previously documented that patients who had ‘low readiness’ on our Readiness for Hospital Discharge Scale were more likely to be readmitted. In this study we added structured protocols for discharge readiness assessment and nurse actions to usual discharge care practices to determine the optimal protocol configuration to achieve improved post-discharge utilization outcomes. In our primary analysis that included patients from a broad range of patient diagnoses, we did not find a significant effect on readmission from adding any of the discharge readiness assessment protocols. The patient sample came from Magnet hospitals, known for high quality care, and the average all-cause readmission rates were low (11.3%). In patients discharged from high-readmission units (>11.3%), one of the protocols was effective in reducing the likelihood of readmission. In this protocol, the nurse obtained the patients self-report of discharge readiness to inform the nurse’s discharge readiness assessment and actions in finalizing preparations for discharge. This patient-informed discharge readiness assessment protocol produced a nearly 2 percentage point reduction in readmissions. Not unexpectedly, in lower readmission settings, we did not see a reduction in readmission; not all readmissions are preventable. In the last phase of study, we informed nurses of a cut-off score for ‘low readiness’ and added a prescription for nurse action only in cases of ‘low readiness’; this addition to the protocol added burden to the nurses’ daily work and eliminated the beneficial effects, perhaps because it limited the nurse’s attention to only a subset of patients.  (more…)
Author Interviews, Hospital Readmissions, JAMA, Primary Care / 28.01.2019

MedicalResearch.com Interview with: Dr. Dawn Wiest, 7-day pledge after hospital admissionDawn Wiest, PhD Director, Action Research & Evaluation Camden Coalition of Healthcare Providers MedicalResearch.com: What is the background for this study? Response: Understanding the role of care transitions after hospitalization in reducing avoidable readmissions, the Camden Coalition launched the 7-Day Pledge in 2014 in partnership with primary care practices in Camden, NJ to address patient and provider barriers to timely post-discharge primary care follow-up. To evaluate whether our program was associated with lower hospital readmissions, we used all-payer hospital claims data from five regional health systems. We compared readmissions for patients who had a primary care follow-up within seven days with similar patients who had a later or no follow-up using propensity score matching. (more…)
Author Interviews, Heart Disease, JAMA, Thyroid Disease, Vanderbilt / 27.01.2019

MedicalResearch.com Interview with: Joe-Elie Salem, MD, PhD Associate Professor - MCU-PH, Sorbonne Université - INSERM - CIC, Clinical Pharmacology, Cardio-oncology, APHP, La Pitié-Salpêtrière, Paris, France Adjunct Associate Professor, Vanderbilt University Medical Center, Cardio-oncology Clinical Pharmacology, Nashville, TN MedicalResearch.com: What is the background for this study? What are the main findings? Response: A study by researchers at Vanderbilt University Medical Center has strengthened the link between thyroid function and atrial fibrillation (AF), an irregular heart rhythm that increases the risk of stroke and other heart-related complications. They phenome-wide association study scanned the medical records of more than 37,000 people for an association between genetically determined variation in thyroid stimulating hormone levels (a measure of thyroid function) and AF risk. Previous observational studies have found that subclinical hyperthyroidism, an overactive thyroid which does not meet the clinical threshold for diagnosis or treatment, nevertheless can increase the risk of atrial fibrillation.  But whether to treat subclinical hypo- or hyperthyroidism to reduce AF risk remains a matter of debate in the medical community.  (more…)
Author Interviews, Cancer Research, Gender Differences, JAMA, UCLA / 25.01.2019

MedicalResearch.com Interview with: Dr. Ann Raldow MD MPH Assistant Professor Department of Radiation Oncology David Geffen School of Medicine UCLA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Similar to women in other historically male-dominated fields, female radiation oncologists face unique obstacles in achieving many metrics of career success, including equal salary, research funding, and academic promotion. Our study of industry payments found that female radiation oncologists were less likely than their male colleagues to receive payments from industry and that these payments tended to be of smaller monetary value. (more…)
Alzheimer's - Dementia, Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, JAMA / 25.01.2019

MedicalResearch.com Interview with: Jeff D. Williamson, MD Geriatric Medicine - Sticht Center Wake Forest Baptist Medical Center MedicalResearch.com: What is the background for this study? Response: A growing amount of epidemiologic research has suggested that higher blood pressure is associated with higher risk for dementia, including Alzheimer’s dementia. MedicalResearch.com: What are the main findings? Response: More than 9,300 ambulatory, community dwelling persons over age 50, 30% of whom were over the age of 75, were randomly assigned to a blood pressure goal of 120 vs 140.  Persons in the 120 group had a 19% lower risk for developing MCI an transitional stage between normal and dementia (P<.008).  There was a 17% lower risk for developing dementia but this only achieved a p value = 0.10.  The combined risk for both MCI and dementia was 15% lower in the 120 group (p<0.04).  The dementia outcome was the primary outcome but all the outcomes were pre-specified in the protocol at the beginning of the trial.  Unfortunately the blood pressure intervention was stopped after only 3.3 years due to CVD and mortality benefit and this may well have influenced the ability to reach the expected number of dementia cases.  (more…)
Accidents & Violence, Author Interviews, Emergency Care, JAMA, Yale / 24.01.2019

MedicalResearch.com Interview with: Edouard Coupet Jr, MD, MS Assistant Professor Department of Emergency Medicine Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: For many individuals with nonfatal firearm injuries, their only point of contact with the healthcare system may be the emergency department. Both hospital-based violence intervention programs and counseling and safe firearm storage have shown promise in reducing the burden of firearm injury. In this study, one third of individuals with firearm injuries presented to non-trauma centers. Only 1 out of 5 firearm injuries were assault injuries that led to admission to trauma centers, the population most likely to receive interventions to reduce re-injury.  (more…)
Author Interviews, Duke, JAMA, Mental Health Research, Pediatrics, Toxin Research / 23.01.2019

MedicalResearch.com Interview with: Aaron Reuben, MEM Department of Psychology and Neuroscience Duke University, Durham, North Carolina MedicalResearch.com: What is the background for this study? What are the main findings? (1)  Study members with greater lead exposure in childhood tended to endorse more psychiatric symptoms when assessed for psychiatric disorders in adulthood (between 18 and 38 years of age).
  1. These individuals tended to report more internalizing (e.g., depression, anxiety) and thought disorder (e.g., OCD, schizophrenia, mania) symptoms.
  2. Compared to other findings from this sample, the associations reported in this article are similar to those reported for lead and IQ, and are stronger than those reported for lead and criminal offending.
    1. Informants who knew Study members well reported higher levels of difficult adult personality traits among Study members with greater lead exposure in childhood.
    2. Specifically, Study members with greater blood lead levels at age 11 were rated as more neurotic, less agreeable, and less conscientious by 38 years of age.
    3. These personality traits have been previously linked to a number of poor life outcomes, including greater psychopathology, worse physical health, less job satisfaction, and troubled interpersonal relationships
  3. Psychiatric problems related to lead exposure could be detected as early as 11 years of age. In the 1980’s, parents and teachers of children with higher blood-lead levels had described them as displaying more antisocial behavior, hyperactivity, and negative emotions (e.g., sadness, anxiety).
(more…)
Author Interviews, Gastrointestinal Disease, JAMA, Nutrition, Sugar / 23.01.2019

MedicalResearch.com Interview with: Miriam Vos, MD, MSPH Associate Professor of Pediatrics and Director Pediatric Fatty Liver Program Emory and Children’s Healthcare of Atlanta MedicalResearch.com: What is the background for this study? What are the main findings? Response: Fatty liver disease has quickly become a common problem in children and adolescents, affecting an estimated 7 million children in the U.S.  This study resulted from our previous research demonstrating that fructose increases cardiometabolic risk factors in children with NAFLD in addition to other research that had demonstrated associations between NAFLD and sugar.    (more…)
Author Interviews, End of Life Care, JAMA, Kidney Disease / 22.01.2019

MedicalResearch.com Interview with: Susan P. Y. Wong, MD MS Assistant Professor Division of Nephrology University of Washington VA Puget Sound Health Care System  MedicalResearch.com: What is the background for this study? Response: Patients who reach the advanced stages of kidney disease  must often face the difficult decision of whether to undergo maintenance dialysis. While maintenance dialysis is a remarkable therapy that has extended the lives of many patients, its benefits do not necessarily accrue in older patients with significant comorbidity and functional impairment. It is also a very demanding form of therapy that comes with its own burdens and complications. Based on our prior research in the national VA health system, 1 in 7 patients with very advanced kidney disease (or their decision makers) do not pursue dialysis. We wanted to understand how these decisions to forgo initiation of maintenance dialysis unfold. (more…)
Author Interviews, Diabetes, Infections, JAMA, Pediatrics, Vaccine Studies / 22.01.2019

MedicalResearch.com Interview with: Dr Kirsten Perrett MBBS FRACP PhD Team Leader / Clinician-Scientist Fellow, Population Allergy, Murdoch Children's Research Institute Consultant Paediatrician, Department of Allergy and Immunology and General Medicine The Royal Children's Hospital Fellow, School of Population and Global Health The University of Melbourne Parkville, Victoria  Australia MedicalResearch.com: What is the background for this study? Response: Before rotavirus vaccines were available, rotavirus infection was the most common cause of severe gastroenteritis in infants and young children. Because it is so contagious, infection in childhood is thought to be universal in unvaccinated children. Previous studies indicated that rotavirus infection of infants might be an environmental promoter of type 1 diabetes. Therefore, we anticipated that the introduction of the rotavirus vaccine might alter the disease incidence in young children.  (more…)
Author Interviews, Breast Cancer, Cancer Research, JAMA, Leukemia / 21.01.2019

MedicalResearch.com Interview with: medicalresearch.comDr. Marie Joelle Jabagi, PharmD, MPH University of Paris Sud, Paris-Saclay University, Paris Health Product Epidemiology Department French National Agency for Medicines and Health Products Safety Saint-Denis, France MedicalResearch.com: What is the background for this study? Response: Secondary hematologic malignant neoplasms that develop months or years after the diagnosis of breast cancer may be a consequence of genetic predisposition, environmental factors, previous cancer treatments or a combination of all those factors. These secondary malignant neoplasms are increasingly becoming a concern given that the population of breast cancer survivors is growing substantially. However, their frequency in real life has been poorly investigated to date. The aims of our research were to estimate the frequency of various types of hematologic malignant neoplasm following a diagnosis of primary breast cancer among women aged 20 to 85 years in France during the past decade, and to compare it to the corresponding frequency in women of the French general population. (more…)
Author Interviews, Genetic Research, Hearing Loss, JAMA, Karolinski Institute / 21.01.2019

MedicalResearch.com Interview with: Christopher R. Cederroth | Ph.D. Docent Associate Professor Experimental Audiology | Department of Physiology and Pharmacology Karolinska Institutet Sweden MedicalResearch.com: What is the background for this study? Response: Tinnitus is experienced is experienced by a large proportion of the population and affects more than 15% of the population worldwide (estimated 70 million people in Europe). However, for near 3% of the population, tinnitus becomes a chronic bothersome and incapacitating symptom. Severe tinnitus interferes with sleep, mood, and concentration and thus impacts life quality, ultimately leading to sick leave and disability pension. A high cost to society has been reported, and since the prevalence of tinnitus has been predicted to double in Europe by 2050, there is an important need for an effective treatment. And today there are none, with the exception of cognitive behavioral therapy, which helps coping with it but does not remove the tinnitus. There has been a number of innovative treatment approaches, but they are overall not successful and it is now agreed that it is likely because tinnitus is a heterogeneous condition – meaning that we cannot consider tinnitus a single entity but an ensemble of different forms or subtypes, which need to be defined. Tinnitus has always been considered a condition influenced by environmental factors, but our initial studies suggested the opposite. Adoption studies are excellent in showing the influence of shared-environment effects and establish a genetic basis for a disease or a trait. It allows to test the transmission of a trait between the adoptee and their biological or their adoptive parent. Transmission via the biological parent is expected to be due to a heritable genetic effect, while transmission via the adoptive parent is associated with home-environment, the so-called shared-environmental effect. We used medical registry data to identify tinnitus patients and adoptees. (more…)
Author Interviews, Depression, Dermatology, JAMA, Mental Health Research / 21.01.2019

MedicalResearch.com Interview with: Isabelle Vallerand, PhD Epidemiologist, MD Student Department of Community Health Sciences Cumming School of Medicine University of Calgary MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that patients with alopecia areata, a form of autoimmune hair loss, are at a higher risk of suffering from depression than the general population. But in practice, we often hear patients tell us that they believe their hair loss developed as a result of stress or problems with mental health – certainly the phrase “so stressed your hair is falling out” is something most people have heard of. Despite this, there has actually been very little research investigating the role that mental health may have on development of alopecia areata. Interestingly, depression has recently been associated with increased systemic inflammatory markers, so there is biologic plausibility that depression could increase the risk of alopecia areata. Our group was interested in addressing this question, and used a large population-level health records database with up to 26 years of follow-up to study it. We ultimately found that not only does depression increase one’s risk of alopecia areata, but that it increases their risk by nearly 90% compared to people who have never had depression. We also found that using antidepressants can significantly decrease the risk of developing alopecia areata in patients with depression. So there appears to be an important link between mental health and development of hair loss from alopecia areata. (more…)
Author Interviews, Global Health, JAMA, Mental Health Research, Pediatrics, UCLA, Zika / 21.01.2019

MedicalResearch.com Interview with: Karin Nielsen-Saines, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? Response: Our study used a very simple evaluation called GMA (General Movement Assessment tool) which checks baby movements at approximately 3 to 5 months of age. We examined 111 babies exposed to maternal illness during the Zika epidemic in Brazil and 333 control babies without this exposure by GMA at 3 months  and then tested them through standard neurodevelopmental tests at the age of 12 months. We found that this simple evaluation, which consists of filming a baby lying down on their back for one minute and studying their movements worked extremely well in predicting which babies would or would not have future problems in their neurodevelopment. The study advances knowledge in the area because a simple one minute video of a baby can predict neurodevelopment, something that is extremely hard to determine in young babies.  This is true even in places where sophisticated brain scans are available. By identifying which babies are at risk of developmental problems early on, professionals can rapidly refer these babies to  stimulation programs when they are very young, which increases their chances of having better outcomes. Because the brains of young children respond much better  to stimulation, the timing of interventions to improve their development is very important, that is why they need to be identified early. (more…)
Author Interviews, Health Care Systems, JAMA / 21.01.2019

MedicalResearch.com Interview with: David Shulkin, MD Ninth Secretary, U.S. Department of Veterans Affairs Washington, District Of Columbia Shulkin Solutions LLC Gladwyne, Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings?  Response: I came to VA in 2015 as Under Secretary for Health, as a result of the 2014 wait time crisis.  At that time, it was determined that in some locations, veterans had been waiting for care for too long and there were allegations that this had resulted in harm to a number of veterans.  I was in the private sector at the time, but was asked by President Obama to come and help improve the situation. Upon my arrival we created systems to determine which veterans were waiting for urgent healthcare and which ones for routine care.  From here, we established same day services for all veterans waiting for urgent care through primary care and behavioral health access points.  This goal was achieved nationwide at the end of 2016.  When I became Secretary in 2017,  we began publishing our wait time data for all to see, so that veterans had accurate information on which to base their choices on and to provide transparency into where we were improving and where we needed to focus our efforts.  In addition, through programmatic and legislative efforts, we expanded our utilization of private sector options so that veterans with clinical needs would be able to get better access to care. This study was meant to determine whether our efforts from 2014 had resulted in improvements to access and in addition how access to care in the VA compared to access in the private sector.   Despite limitations in the data available from the private sector (since others do not publish their actual wait time data similar to VA) we used a data set that we felt had some applicability for these comparisons. We found that for the most part, VA wait times are often shorter than in the private sector,  and that VA wait times had improved since 2014 while the private sectors access had stayed the same.  (more…)
Allergies, Author Interviews, JAMA / 18.01.2019

MedicalResearch.com Interview with: ESS= Erica S. Shenoy, MD, PhD Harvard Medical School Division of Infectious Diseases, Department of Medicine Massachusetts General Hospital, Boston KGB= Kimberly G. Blumenthal MD, MSc Division of Rheumatology, Allergy and Immunology Department of Medicine, Massachusetts General Hospital,Boston   EMM= Eric M. Macy MD, MS Department of Allergy Southern California Permanente Medical Group San Diego Medical Center TR= Theresa Rowe, DO, MS General Internal Medicine and Geriatrics Feinberg School of Medicine Northwestern University, Chicago, Illinois MedicalResearch.com: What is the background for this review? ESS: A key component of reducing antimicrobial resistance is improving how antimicrobials are prescribed—both reducing inappropriate use (i.e., not prescribing when not needed) and favoring the use of narrow-spectrum agents that are less likely to contribute to the development of antimicrobial resistance. KGB: Because unverified penicillin allergy labels are so prevalent with greater than 32 million Americans affected, and these labels lead to the use of alternative antibiotics that are often more broad-spectrum, we now know that penicillin allergy evaluations are an emerging important component of antibiotic stewardship.  When patients with a reported penicillin allergy are tested, more than 95% of them are not allergic, and thus could (and should) receive penicillins, and often related drugs, when appropriate. (more…)
Author Interviews, Cost of Health Care, Heart Disease, Inflammation, JAMA, Stanford / 17.01.2019

MedicalResearch.com Interview with: Thomas S. G. Sehested MD Department of Cardiology Copenhagen University Hospital Gentofte   Jenny Bjerre, MD Department of Cardiology Copenhagen University Department of Health Research and Policy Stanford University School of Medicine Stanford, California   MedicalResearch.com: What is the background for this study? Response: n 2017, the results from the much-awaited Canakinumab Anti-inflammatory Thrombosis Outcome Study (CANTOS) trial were published, confirming the inflammatory hypothesis, i.e. that targeting inflammation can reduce cardiovascular disease. The trial tested the monoclonal antibody canakinumab in a population of post-myocardial infarction patients with elevated inflammation markers (hs-CRP). Canakinumab is currently used for rare diseases and carries an orphan drug price: the 150mg dose used in CANTOS costs approximately $73,000 per year. Due to the high prevalence of cardiovascular disease, millions of patients could potentially be eligible for treatment with this high-priced anti-inflammatory drug. Therefore, we wanted to investigate the cost-effectiveness for canakinumab for secondary prevention of cardiovascular disease, using the reported results from CANTOS. (more…)
Author Interviews, Gastrointestinal Disease, JAMA, Microbiome / 16.01.2019

MedicalResearch.com Interview with: Samuel P. Costello MBBS Inflammatory Bowel Disease Service, Department of Gastroenterology The Queen Elizabeth Hospital Australia MedicalResearch.com: What is the background for this study? Response: Ulcerative colitis (UC) is an inflammatory bowel disease that has high rates of persistent or relapsing symptoms despite available therapies. Many of these therapies also have the potential for unacceptable side effects including allergy, intolerance, serious infection and malignancy due to long-term immunosuppression. It is for these reasons that new therapies for Ulcerative colitis are required; particularly therapies that target novel pathways and are not immune suppressing. (more…)
Author Interviews, Dermatology, Diabetes, JAMA / 15.01.2019

MedicalResearch.com Interview with: Dong Hyun Kim M.D. Associate professor Department of Dermatology CHA Bundang Medical Center CHA University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a dermatologist, we see many patients with newly diagnosed with bullous pemphigoid (BP), many of whom have diabetes. The use of DPP-4 inhibitors is a common treatment for diabetes, we have noted previous case reports that DPP-4 inhibitors may be the cause of BP. For this reason, we started this study. The most important thing in my article is DPP-4 inhibitors, particularly vildagliptin, may be associated with the development of bullous pemphigoid in male patients with diabetes. We have confirmed these points based on the nationwide, population-based study. It is very meaningful because there have been few studies using large sample sizes so far. (more…)