MedicalResearch.com Interview with:
Andrew Blauvelt, M.D., M.B.A.
President
Oregon Medical Research CenterMedicalResearch.com: What is the background for this study? What are the main findings?Response: This new paper focuses on treatment of psoriasis in classically difficult-to-treat areas of the body, which include the scalp, the palms/soles, and the fingernails.
We show that guselkumab, which is a new biologic therapy that selectively targets IL-23 (a key pro-inflammatory cytokine in psoriasis pathogenesis), works well in these areas affected by psoriasis.
More specifically, after 6 months of treatment with guselkumab, approximately 85%, 80%, and 60% of patients achieved complete or near complete clearance of psoriasis in their scalp, palms/soles, and fingernails, respectively.(more…)
MedicalResearch.com Interview with:
Joann G. Elmore, MD, MPH
Professor of Medicine
David Geffen School of Medicine at UCLA
Director of the UCLA National Clinician Scholars Program
Affiliate Professor of Medicine, University of Washington School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?Response: In a recent study published in 2017 in the British Medical Journal, our team found that pathologists disagreed on their diagnoses of some melanocytic skin biopsy lesions and early stage invasive melanoma more than 50% of the time. This concerning level of disagreement was particularly true for diagnoses in the middle of the disease spectrum, such as atypical lesions and melanoma in situ. For example, Figure 1 from this paper shows the diagnoses of 36 pathologists who interpreted the same glass slide of a skin biopsy using their own microscopes; the diagnoses ranged from a benign lesion to invasive melanoma.
Since that study, the American Joint Committee on Cancer has released new guidelines for melanoma staging. Given this change, we wanted to examine whether the updated guidelines improved the reliability of melanoma diagnosis.
We found that using the new guidelines improved the accuracy of pathologists’ diagnoses for invasive melanoma (Elmore J, et al, JAMA Network Open 2018).(more…)
MedicalResearch.com Interview with:
William B Weeks, MD, PhD, MBA
The Dartmouth Institute
MedicalResearch.com: What is the background for this study? What are the main findings?Response: The background for the study is that a common narrative is that end-of-life healthcare costs are driving overall healthcare cost growth. Growth in end-of-life care has been shown, in research studies through the mid 2000’s, to be attributable to increasing intensity of care at the end-of-life (i.e., more hospitalizations and more use of ICUs).
The main findings of our study are that indeed there have been substantial increases in per-capita end-of-life care costs within the Medicare fee-for-service population between 2004-2009, but those per-capita costs dropped pretty substantially between 2009-2014. Further, the drop in per-capita costs attributable to Medicare patients who died (and were, therefore, at the end-of-life) accounts for much of the mitigation in cost growth that has been found since 2009 in the overall Medicare fee-for-service population.
(more…)
MedicalResearch.com Interview with:
Jennifer Villani, PhD, MPH
Office of Disease Prevention
National Institutes of Health
MedicalResearch.com: What is the background for this study? What are the main findings?Response: The US Preventive Services Task Force (USPSTF) develops recommendations for the delivery of clinical preventive services based on the highest quality scientific evidence available. We performed a comprehensive assessment of the sources of funding for the research studies in this evidence base.
The results showed that government agencies supported the most articles (56%), with the remaining support coming from nonprofits or universities (32%), and industry (17%). The National Institutes of Health was the single largest funder of research articles underlying the USPSTF recommendations.(more…)
MedicalResearch.com Interview with:
Viola Vaccarino, MD, PhD
Department of Epidemiology and Division of Cardiology
Professor, Department of Medicine
Emory University School of Medicine
Atlanta, GeorgiaMedicalResearch.com: What is the background for this study? What are the main findings?Response: Previous studies have shown that people with depression tend to have lower heart rate variability (HRV), an index of autonomic nervous system dysregulation derived by monitoring the electrocardiogram over time, usually for 24 hours. Other literature, however, has pointed out that autonomic dysregulation (as indexed by reduced HRV) may also cause depression. Thus, the direction of the association between reduced HRV and depression still remains unclear. In addition, these two characteristics could share common pathophysiology, making shared familial background and genetic factors potential determinants of this association.
(more…)
MedicalResearch.com Interview with:
Andrew J. Cowan, MD
Seattle Cancer Care Alliance
Division of Medical Oncology
University of Washington, Seattle
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Multiple myeloma (MM) is a plasma cell neoplasm with substantial morbidity and mortality. A comprehensive description of the global burden of multiple myeloma is needed to help direct health policy, resource allocation, research, and patient care.
Myeloma cases and deaths increased from 1990 to 2016, with middle-income countries contributing the most to this increase. Treatment availability is very limited in countries with low socioeconomic development.
(more…)
MedicalResearch.com Interview with:
Marianthi-Anna Kioumourtzoglou ScD
Assistant Professor
Environmental Health Sciences
Mailman School of Public Health
Columbia UniversityMedicalResearch.com: What is the background for this study? Response: The prevalence of neurodevelopmental disorders, like attention deficit/hyperactivity disorder (ADHD) has been increasing. One of the hypothesized risk factors for increased risk for neurodevelopmental disorders is a class of chemicals known as endocrine disrupting chemicals (EDCs). These chemicals are known to interfere with the endocrine system, i.e. the system that uses hormones to control and coordinate metabolism, reproduction and development. Several high production volume chemicals, ubiquitously present in commercial products, are known or suspected endocrine disruptors. Because of their widespread use in consumer products, the population-wide exposure to known and suspected EDCs is very high.
Recently, there has been increased attention in the potential effects of EDCs on neurodevelopment that span multiple generations. Animal studies have provided evidence that exposure to EDCs, such as phthalates and bisphenol A (BPA), alter the behavior and social interactions in mice in three to five generations after exposure. However, evidence of such multi-generational impacts of EDC exposure on neurodevelopment in humans is unavailable, likely because of the lack of detailed information on exposures and outcomes across generations.
For this study we leveraged information from a nationwide cohort, the Nurses’ Health Study II (NHSII), to investigate the potential link between exposure to diethylstilbestrol (DES) and third generation ADHD, i.e. ADHD among the grandchildren of the women who used DES while pregnant. DES is a very potent endocrine disruptor that was prescribed between 1938 and 1971 to pregnant women thought to prevent pregnancy complications. In the United States, between 5 and 10 million women are estimated to have used DES, although the exact number is not known. DES was banned in 1971, when was linked to vaginal adenocarcinomas (a rare cancer of the reproductive system) in the daughters of the women who had used it during pregnancy. Since then, DES has been also linked to multiple other reproductive outcomes in DES daughters, as well as with some reproductive outcomes in the grandchildren of the women who used it, such as hypospadias and delated menstrual regularization. However, to our knowledge, no study to date has evaluated the association between DES, or any other EDC, and multigenerational neurodevelopment. (more…)
MedicalResearch.com Interview with:
Emmanuel Martinod MD PhD
Assistance Publique–Hôpitaux de Paris, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Paris 13, Sorbonne Paris Cité, UFR Santé, Médecine et Biologie Humaine, Bobigny,
Université Paris Descartes, Fondation Alain Carpentier, Laboratoire de Recherche Bio-chirurgicale, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou
Paris, FranceMedicalResearch.com: What is the background for this exciting new technology and study? What are the main findings? Response:What is the background for this exciting new technology and study? What are the main findings?Response: The background is 10 years of research at laboratory followed by 10 years of academic clinical research.
We demonstrated the feasability of airway bioengeenring using stented aortic matrices for complex tracheal or bronchial reconstruction.(more…)
MedicalResearch.com Interview with:
Christine Goertz DC, PhD
Vice Chancellor for Research and Health Policy
Palmer College of Chiropractic
MedicalResearch.com: What is the background for this study? Response: Low back pain in the leading cause of physical disability worldwide, with up to 80% of US adults seeking care for this debilitating condition at some point in their lives. Low-back pain is also one of the most common causes of disability in U.S. military personnel.
Although a number of studies have previously evaluated chiropractic care for low back pain, the vast majority had small sample sizes and did not study chiropractic as part of a multi-disciplinary approach to care in real world settings, including the military.
(more…)
MedicalResearch.com Interview with:
Anna Gundlund, MD, PhD
Herlev-Gentofte Hospital, Department of Cardiology
DenmarkMedicalResearch.com: What is the background for this study? What are the main findings?Response: Atrial fibrillation increases a person’s risk of ischemic strokes up to 5-fold. Oral anticoagulation therapy lowers this risk effectively (>60%) and is therefore recommended for patients with atrial fibrillation and at least 1-2 other risk factors for stroke.
Our study show, that oral anticoagulation therapy is still underused in patients with atrial fibrillation – even after a stroke event. In stroke survivors with atrial fibrillation, oral anticoagulation therapy were associated with better outcomes than no oral anticoagulation therapy.(more…)
MedicalResearch.com Interview with:
Dr Dorina Cadar
Research Associate in Dementia
Psychobiology Group
Department of Behavioural Science and Health
University College London
London
MedicalResearch.com: What is the background for this study?Response: Dementia is one of the most feared medical conditions, which represents a significant global challenge to health and social care.
Education may serve different roles in the development of dementia: it is a proxy for early life experiences and (parental) socioeconomic status, it is related to future employment prospects, income and wealth, determines occupational exposures and characteristics of adult life (e.g., job complexity, work stress, environmental exposures) and it provides lifelong skills for optimal mental abilities and mastery. However, given that education is typically completed many decades before dementia onset, other individual and area-based components of socioeconomic status, such as wealth, income and area deprivation may provide a more accurate indication of current socioeconomic resources. Also, at older ages, accumulated wealth represents a more robust measure of socioeconomic resources than income or occupation alone.
(more…)
MedicalResearch.com Interview with:
Andrew J. Armstrong, MD ScM FACP
Associate Professor of Medicine, Surgery, Pharmacology and Cancer Biology
Associate Director for Clinical Research in Genitourinary Oncology
Duke Cancer Institute
Divisions of Medical Oncology and Urology
Duke University
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Men with prostate cancer commonly develop bone metastases and undergo nuclear medicine bone scans. However, these scans are non-quantitative, and disease burden has been challenging to assess over time and to relate to clinical outcomes.
We developed a software program and measurement called the automated bone scan index that essentially reads a standard of care nuclear bone scan, provides a quantitative metric, and demonstrate in a phase 3 trial that this aBSI is highly associated with clinical outcomes including survival, time to symptomatic progression, and prostate cancer specific survival.
We accomplished this within a prospective phase 3 international trial of men with metastatic hormone resistant prostate cancer who were followed over a long period of time. All bone scans were read and measured using the aBSI at baseline, and we found that the aBSI was highly prognostic. This work validates prior smaller phase 2 BSI studies, and demonstrates both the feasibility and clinical utility for incorporating the aBSI into clinical practice to provide this important prognostic information to patients and providers.
(more…)
MedicalResearch.com Interview with:
Michael S. Kolodney, MD, PhD
Section of Dermatology, Department of Medicine
West Virginia University
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Melanoma is easily curable if recognized early. Dermatologists are good at spotting melanomas because they develop an innate sense of how melanomas appear after examining thousands of malignant and benign lesions. In contrast, most medical students are relatively disadvantaged by their limited dermatology exposure. We felt that too little experience, rather than lack of knowledge of the rules, is the primary barrier to development of pattern-recognition and intuition as a reliable tool for melanoma diagnosis in non-experts. To remedy this problem, we developed a novel web-based application to mimic the training of a dermatologist by teaching medical students intuitive melanoma diagnosis in a highly condensed period of time.
Our application, which we call Skinder, teaches intuitive visual diagnosis of melanoma by quickly presenting the learner with thousands of benign and malignant skin lesions. The user makes rapid binary decisions, by swiping right for benign or left for malignant, and receives instant feedback on accuracy. With this application, the learner can amass a mental repository of diagnostic experience in a short amount of time. To determine if intuitive visual diagnosis training is superior to a traditional rule-based approach, we compared our web-based application to a rules based approach, the publicly available INFORMED Skin Education Series.
Medical students were tested on the ability top differentiate melanomas from benign pigmented lesions before and after training with either Skinder of the Informed Skin Education Series. The pre-test mean for the Skinder group was 75% correct, compared to 74.7% correct for the INFORMED group. The post-test mean for the skinder application group was 86.3% correct, compared to 77.5% correct for the INFORMED group which was highly signifcant.
(more…)
MedicalResearch.com Interview with:
Tobias Kaufmann PhD
Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine
University of Oslo, Oslo, Norway
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Over the past years, a lot of work has pointed toward impaired brain networks in schizophrenia. With this work we assessed brain network stability across different loads of a cognitive task using functional magnetic resonance imaging of the brain.
Based on our earlier work on adolescents with pre-clinical signs of mental illness who showed decreased stability of networks across different tasks and conditions, we hypothesized that brain networks in adults with schizophrenia show similar properties of decreased stability. Our results confirmed this hypothesis. Stability was reduced in several large-scale brain networks across the sampled age range from early adulthood to the sixties. Further, network stability was associated with polygenic risk for schizophrenia as well as cognitive task performance.
(more…)
MedicalResearch.com Interview with:
Caroline Smith, PhD
Professor Clinical Research
Western Sydney University Research Theme Champion Health and Wellbeing
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Despite technological improvements to IVF the success of IVF treatment remains low. Consequently, new drugs, laboratory techniques and other treatments need to be developed and rigorously tested to explore their effects on producing healthy babies for women undergoing IVF. In 2002, the first randomised controlled trial of acupuncture administered a specific form of IVF acupuncture at the time of embryo transfer.
The results indicated the chance of achieving a pregnancy from acupuncture was twice that to women undergoing IVF treatment alone. From mid 2000s many women have started to use adjunctive treatments such as acupuncture whilst undergoing IVF. We conducted and reported on a pilot study in 2006 which produced results suggesting a benefit. It is important that these findings were rigorously examined in a larger trial.
Findings are presented from our trial presented in JAMA. Our study of over 800 Australian and New Zealand women undergoing acupuncture treatment during their IVF (in vitro fertilization) cycle has failed to confirm significant difference in live birth rates.
(more…)
MedicalResearch.com Interview with:
Wei Bao, MD, PhD
Assistant Professor
Department of Epidemiology,
College of Public Health,
University of Iowa,
Iowa City, IA 52242MedicalResearch.com: What is the background for this study? What are the main findings?Response: Although the health effects of e-cigarettes remains unclear, e-cigarettes have been marketed as an approach for smoking cessation. Previous studies have reported an increase in e-cigarette use in US people since 2010. The current study showed that from 2014 to 2016, there was an increase in ever use of e-cigarettes but decline in current use of e-cigarettes.(more…)
MedicalResearch.com Interview with:
Dr. Cande V. Ananth, PhD, MPH
Adjunct professor
Department of Health Policy and Management
Mailman School of Public Health
Columbia University, NY
MedicalResearch.com: What is the background for this study?Response: Preterm delivery rates have declined between 2005 and 2014 in the US and in several European countries. Since reductions in preterm and early term deliveries, and perinatal mortality remain a global health priority, determining the relationship between gestational age distribution and perinatal mortality, remains a challenge. Efforts expended to a more complete understanding of the impact of new interventions, policies, and practices on reducing the burden of early deliveries, and in turn improvements in perinatal survival will be of tremendous benefit for clinical management and care of women during their pregnancy and the newborn.
(more…)
MedicalResearch.com Interview with:
Craig M. Hales, MD, MPH, MS
CDR, U.S. Public Health Service
Division of Health and Nutrition Examination Surveys
National Center for Health Statistics
Centers for Disease Control and Prevention
MedicalResearch.com: What is the background for this study? Response: Monitoring trends in prescription medication use among children and adolescents is an important part of understanding the health of youth in the U.S. and the healthcare they receive.
For this study we used data from the National Health and Nutrition Examination Survey or NHANES, which is a nationally representative survey of the US population and as part of this face-to-face survey in the home, we ask participants about their prescription medication use in the last 30 days and collect information about the prescription directly from the medication package.
(more…)
MedicalResearch.com Interview with:
Jeremy O'Connor, MD
Section of General Internal Medicine
Department of Internal MedicinePostdoctoral Fellow, National Clinician Scholars Program
Yale University
MedicalResearch.com: What is the background for this study? Response: There has been a lot of enthusiasm for the use of novel therapies in cancer care, and in particular for novel anticancer agents known as immune checkpoint inhibitors. But very little is known about how quickly providers have adopted immune checkpoint inhibitors into clinical practice. Existing studies suggest, in fact, that the process of clinical adoption is slow, with conventional wisdom holding that it takes an average of 17 years for new evidence to change practice.
Our study evaluated whether the adoption of novel therapies might be much faster in certain contexts with the early use of immune checkpoint inhibitors as a notable example.
(more…)
MedicalResearch.com Interview with:
Michael Hawkes MD PhD
Adjunct ProfessorAssistant Professor
Pediatrics, Faculty of Medicine
School of Public Health
University of Alberta
MedicalResearch.com: What is the background for this study? What are the main findings?
Pneumonia is the leading cause of mortality in children globally.
Oxygen is an essential therapy for children with hypoxemic pneumonia, but is not available in many resource-limited and rural areas.
Our innovation, solar powered oxygen delivery, harnesses freely available sun and air to delivery oxygen to patients independent of grid electricity.
We performed a randomized controlled trial of solar powered oxygen delivery, compared to standard oxygen delivery using compressed oxygen cylinders in children with hypoxemia hospitalized at two centres in Uganda.
Solar powered oxygen was non-inferior to cylinder oxygen with respect to clinical outcomes, and offers advantages in terms of reliability, simplicity, and cost.
MedicalResearch.com Interview with:
Scott E. Hadland, MD, MPH, MS
Assistant Professor of Pediatrics | Boston University School of Medicine
Boston Medical Center
Director of Urban Health & Advocacy Track | Boston Combined Residency Program
Boston, MA 02118
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Numerous pharmaceutical companies have received media attention for their role in promoting opioid prescribing through speaker programs and other marketing plans in which large-value payments are given to a small number of doctors to promote opioids.
In our study, we sought to tell the other side of the story. We wanted to identify whether low-value marketing, including industry-sponsored meals, which are commonplace in the US, were associated with increased opioid prescribing.
We found that 1 in 14 doctors received opioid marketing from pharmaceutical companies in 2014, and those that received marketing prescribed 9% more opioids the following year. With each additional meal a doctor received, he or she prescribed more and more opioids the following year. Our sample included 43% of the active physician workforce in the US, suggesting how widespread and far-reaching this effect might be.
(more…)
MedicalResearch.com Interview with:
Teja Grömer PD Dr. med. Habil
Facharzt für Psychiatrie und Psychotherapie
Lehrbefugter der Universität Erlangen-Nürnberg im Fach Psychiatrie
BambergMedicalResearch.com: What is the background for this study?
1) I had seen hundreds of clinical cases with combined depression and anxiety and noted end of 2015 that most (far more than 50%) from the subjective clinical impression were associated with autoimmune thyroiditis (AIT)
2) Autoimmune thyroiditis on the mental side leads to specific symptoms, exhaustion, tachycardia, restlessness.
3) I thus decided to do a systematic review and meta-analysis.(more…)
MedicalResearch.com Interview with:
Allison W. Kurian, M.D., M.Sc.
Associate Professor of Medicine (Oncology) and of Health Research and Policy
Director, Women’s Clinical Cancer Genetics Program
Stanford University School of Medicine
Stanford, CA 94305-5405MedicalResearch.com: What is the background for this study? What are the main findings?Response: Changes in genetic sequencing technology and regulation have allowed much cheaper testing of many more genes in recent years. We investigated how these changes have affected hereditary cancer risk evaluation in women newly diagnosed with breast cancer.
The main findings are that more comprehensive multiple-gene sequencing tests have rapidly replaced more limited tests of two genes (BRCA1 and BRCA2) only. This has helped patients by doubling the chance of finding an important gene mutation that can change their treatment options.
However, there are important gaps in how this new, more comprehensive sequencing is used: more testing delays and more uncertain results, particularly among racial/ethnic minority women.(more…)
MedicalResearch.com Interview with:
Dr. William Clark
Lawson Health Research InstituteMedicalResearch.com: What is the background for this study? What are the main findings?Response: This study is about the use of increased water intake in people with chronic kidney disease (CKD).
Although there are a large number of benefits claimed most are not substantiated by evidence. However there is a growing body of evidence (animal and human observational studies) that increased hydration with the suppression of antidiuretic hormone preserves kidney function in CKD. This led to our current randomised clinical trial of 631 patients with stage 3 CKD and proteinuria to determine if drinking an extra 4-6 glasses of water per day for 1 year would slow their progressive loss of kidney function as measured by eGFR.
The main findings were that those coached to increase their water intake versus those coached to sustain their normal fluid intake suffered no ill effects from the intervention and on average were able to sustain an average increase of approximately 3 glasses of water per day. At the end of 1 year the increased hydration group had suppressed their antidiuretic hormone levels (copeptin) significantly but did not demonstrate a greater preservation in their eGFR.
(more…)
MedicalResearch.com Interview with:
Alex Krist, M.D., M.P.H
Professor of family medicine and population health
Virginia Commonwealth University and
Active clinician and teacher at the Fairfax Family Practice residency
MedicalResearch.com: What is the background for this study? What are the main findings?Response: Prostate cancer is one of the most common cancers to affect men. However, the decision about whether to be screened is complex and personal. The U.S. Preventive Services Task Force reviewed the latest research on the benefits and harms of screening for prostate cancer using PSA-based testing, as well as evidence on treatment.
We found that men who are 55 to 69 years old should discuss the benefits and harms of screening with their doctor, so they can make the best choice for themselves based on their values and individual circumstances. Men age 70 and older should not be screened, as the benefits of screening diminish as men age and the harms are greater.
(more…)
MedicalResearch.com Interview with:
Christoph U. Correll, MD
Professor of Psychiatry and Molecular Medicine
The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Hempstead, NY
Investigator, Center for Psychiatric Neuroscience
Feinstein Institute for Medical Research
Medical Director, Recognition and Prevention (RAP) Program
The Zucker Hillside Hospital, Department of Psychiatry
MedicalResearch.com: What is the background for this study? Response: Schizophrenia and other psychotic disorders are still all to often chronic and recurring mental health conditions that not uncommonly take a course during which individuals have varying degrees of significantly impaired personal, social and educational/vocational functioning.
Prior individual studies examining early specialty intervention services, which integrate multiple different and complementary treatment components, had shown that this treatment approach can yield superior outcomes for people with early-phase schizophrenia and other psychotic disorders compared to usual care given to all people with psychotic disorders. However, we were lacking a broad overview of the type and results of treatment programs that had been conducted across different countries, continents and mental health service delivery systems. Moreover, we did not yet have a synthesis across all important outcomes that had been examined across these individual studies. This first comprehensive meta-analysis on this topic provides previously missing information on the different early intervention programs and their components as well as on all relevant outcomes for people who did or did not receiving early integrated care, also recently called ‘coordinated specialty care.’
(more…)
MedicalResearch.com Interview with:
Deborah E. Barnes, PhD, MPH
Professor, UCSF Weill Institute for Neurosciences
Departments of Psychiatry and Epidemiology & Biostatistics
University of California, San Francisco: http://profiles.ucsf.edu/deborah.barnes
Research Health Sciences Specialist
San Francisco VA Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Previous studies have found a link between moderate to severe head injuries and increased dementia risk.
The association between mild head injuries and dementia – especially mild head injury that doesn’t result in loss of consciousness – is less well established
We examined the association between mild head injuries with and without loss of consciousness and dementia diagnoses in nearly 360,000 Veterans receiving care in the VA health care system.
We found that Veterans with a head injury diagnoses were two to four times more likely to be diagnosed with dementia than those without head injury diagnoses.
The risk of dementia diagnosis was doubled in Veterans who experienced head injury without loss of consciousness compared to those with no head injury.
MedicalResearch.com Interview with:
Dr. M. Carrington Reid, MD PhD
Associate Professor of Medicine
Irving Sherwood Wright Associate Professor in Geriatrics
Joachim Silbermann Family Clinical Scholar
Geriatric Palliative Care
Joan and Sanford I. Weill Department of Medicine
Weill Cornell Medical College
MedicalResearch.com: What is the background for this study? Response: Major guidelines (American College of Physicians, Centers for Disease Control, Veterans Administration) on the management of chronic pain strongly encourage clinicians to use nonpharmacologic approaches to include psychological therapies when managing pain.
While many studies have evaluated psychological therapies such as cognitive behavioral theraphy (CBT) in nonelderly populations with chronic pain, far fewer have evaluated these treatments in studies of older adults. We identified 22 randomized controlled trials that evaluated a psychological therapy for chronic pain in older adults and examined the impact of these treatments on salient outcomes to include ability to reduce pain and pain-related disability, improve patients' self efficacy to manage pain, and improve their physical health and function and their psychological health (by reducing rates of anxiety and depression).
(more…)
MedicalResearch.com Interview with:
Dr. Karl T. Kelsey, MD, MOHProfessor of Epidemiology and Pathology and Laboratory Medicine
Fellow, Collegium Ramazzini
Providence, R.I. 02912
MedicalResearch.com: What is the background for this study? What are the main findings?Response: There is a large literature suggesting that the ratio of neutrophils to lymphocytes (the neutrophil to lymphocyte ratio or NLR) in the peripheral blood at the time of diagnosis is robustly predictive of outcome in acute cardiovascular disease.
We were curious to know if the peripheral blood profile and this ratio was a feature of the disease process, since, to our knowledge, this had not been investigated in a prospective study. Hence, we used the resources of 2 prospective studies to assess this question, the Jackson Heart Study and the Normative Aging Study. In both cases, the NLR predicted all cause mortality and, in the Jackson Heart Study, where we had well adjudicated outcomes, the NLR predicted various specific cardiovascular outcomes as well. Interestingly, the outcome was also modified by a well known genetic polymorphism of African origin that results in a relative neutropenia.
(more…)
MedicalResearch.com Interview with:
Chelain Goodman, MD PhD
PGY-3, Radiation Oncology
Northwestern University
Chicago, IL 60611
MedicalResearch.com: What is the background for this study? Response: Circulating tumor cells are cancer cells that are shed from the primary tumor into the peripheral blood stream and are hypothesized to be one of the first steps in the initiation of metastatic progression. Prospective studies have demonstrated that approximately 15-25% of patients with early-stage breast cancer can be found to have at least one circulating tumor cell in a small sample of their blood. Currently, all patients with early-stage invasive breast cancer who undergo breast conserving surgery receive adjuvant radiation therapy. In these analyses, we wanted to determine whether presence of circulating tumor cells may be predictive of benefit of radiation therapy following surgery.
(more…)
This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish.AcceptRejectRead More
Privacy & Cookies Policy
Privacy Overview
This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
