Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA / 13.03.2017

MedicalResearch.com Interview with: Yusuke Tsugawa, research associate Department of Health Policy and Management Harvard T H Chan School of Public Division of General Internal Medicine and Primary Care Brigham and Women’s Hospital, Boston, MA      MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that health spending varies substantially across geographical regions, and yet regions that spend more on health care dot not achieve better health outcomes. These findings has led to many to conclude that at least 20% of U.S. health care spending could be reduced without compromising quality of care. However, while physicians play a critical role in health care decision making, little is known as to how much health care spending varies between physicians, and its implications for patient outcomes. In this study, we found that the variation in spending across physicians is slightly larger than the variation across hospitals. More importantly, higher spending by physicians did not lead to lower patient mortality or readmission rates, within the same hospital.
Author Interviews, Dermatology, JAMA, Race/Ethnic Diversity, Transplantation / 10.03.2017

MedicalResearch.com Interview with: Christina Lee Chung, MD, FAAD Associate Professor of Dermatology Director, Center for Transplant Patients Drexel University College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: It’s long been recognized immunosuppressed organ transplant recipients are at significantly increased risk for skin cancer and other types of skin disease. But despite advances to improve skin cancer prevention for these patients, little is known about how skin conditions affect African-American, Asian and Hispanic transplant recipients. This is problematic given that, according to the U.S. Department of Health and Human Services, more than half of the 120,000 Americans on the waiting list for organs identify as nonwhite. We compared medical records of 412 organ transplant recipients — including 154 white patients and 258 nonwhite (black, Asian or Hispanic) — who were referred to the Drexel Dermatology Center for Transplant Patients between 2011 and 2016. As one of the only models of its kind in the country, the center provides post-transplant dermatological care to every patient who is transplanted by and/or followed by the Drexel University and Hahnemann University Hospital Transplant Programs. That means that every patient, regardless of race, is screened annually for skin cancer, which provided a unique dataset for us to analyze. Two hundred eighty-nine transplant recipients exhibited malignant, infectious or inflammatory conditions during their evaluation, but their primary acute diagnoses differed greatly by race. In 82 white patients, skin cancer was the most common acute problem requiring attention at first visit. Black and Hispanic patients, by contrast, were most often diagnosed with inflammatory or infectious processes, such as fungal infections, warts, eczema, psoriasis, and rashes that required immediate medical attention. Overall, squamous cell carcinoma in situ was the most common type of skin cancer diagnosed in each racial or ethnic group. But the location of the cancerous lesions again depended on the race of the patient. Most lesions in white and Asian patients occurred in sun-exposed areas of the body, like the scalp, neck, chest and back. For black patients, the lesions were primarily found in the groin.  Moreover, six of the nine lesions found on black patients tested positive for high-risk HPV strains, suggesting an association between the virus and skin cancer for African Americans. We also provided questionnaires to 66 organ transplant recipients to find out more about the patients’ awareness of skin cancer prevention. Seventy-seven percent of white patients were aware their skin cancer risk was increased, compared to 68 percent of nonwhites. Only 11 percent of nonwhite patients reported having regular dermatologic examinations, compared to 36 percent of whites. Finally, 45 percent of white patients but only 25 percent of nonwhite reported knowing the signs of skin cancer.
Author Interviews, JAMA, Surgical Research / 09.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32802" align="alignleft" width="132"]Daniel Dante Yeh, MD FACC Assistant Professor of Surgery Harvard Medical School Course Director General/GI Surgery sub-internship Associate Course Director, Surgery Core Clerkship Associate Director, Surgical Intensive Care Unit Co-Director, Nutrition Support Unit Department of Surgery Division of Trauma, Massachusetts General Hospital Emergency Surgery, and Surgical Critical Care Boston, MA 02114 Dr. Yeh[/caption] Daniel Dante Yeh, MD FACC Assistant Professor of Surgery Harvard Medical School Course Director General/GI Surgery sub-internship Associate Course Director, Surgery Core Clerkship Associate Director, Surgical Intensive Care Unit Co-Director, Nutrition Support Unit Department of Surgery Division of Trauma, Massachusetts General Hospital Emergency Surgery, and Surgical Critical Care Boston, MA 02114 MedicalResearch.com: What is the background for this study?  Response: High Fresh Frozen Plasma to Red Blood Cells FFP:RBC transfusion ratio is a strategy which has emerged in the trauma literature as the preferred method of resuscitation for massively bleeding injured patients.  However, this strategy has now spread to other patient populations which have never been formally studied.   These populations include elective operations and even non-surgical patients.  Giving excess FFP when it is not needed is not only wasteful, but may be harmful, as other studies have reported that FFP can cause problems with lung function, heart function, and immune function.
Allergies, Asthma, Author Interviews, JAMA, Pediatrics / 09.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32613" align="alignleft" width="80"]Elizabeth C. Matsui, MD MHS Professor of Pediatrics, Epidemiology, and Environmental Health Sciences Johns Hopkins University Baltimore, MD 21287 Dr. Matsui[/caption] Elizabeth C. Matsui, MD MHS Professor of Pediatrics, Epidemiology, and Environmental Health Sciences Johns Hopkins University Baltimore, MD 21287  MedicalResearch.com: What is the background for this study? Response: We designed this study after our previous work indicated that mouse allergy was common among low-income children living in some urban neighborhoods in the US, that these children also had high levels of mouse allergen exposure in their homes, and that children who are both allergic to mice and exposed to high levels of mouse allergen are at greater risk of asthma symptoms, emergency room visits and hospitalization.   Given this background, we designed a randomized clinical trial to determine if an intensive professionally delivered mouse intervention was better than education about mouse control in reducing asthma symptoms and lowering home mouse allergen levels.
Author Interviews, JAMA, Sugar / 08.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32657" align="alignleft" width="200"]Marlene B. Schwartz PhD Director, Rudd Center for Obesity & Food Policy (Principal Investigator) Professor, Department of Human Development and Family Studies University of Connecticut Hartford, CT 06103 Dr. Schwartz[/caption] Marlene B. Schwartz PhD Director, Rudd Center for Obesity & Food Policy (Principal Investigator) Professor, Department of Human Development and Family Studies University of Connecticut Hartford, CT 06103 MedicalResearch.com: What is the background for this study?  Response: The aim of this study was to evaluate the impact of a community-wide campaign to reduce consumption of sugary beverages in Howard County, Maryland. We measured the retail sales of sugary drinks in supermarkets in the target community and a set of matched control supermarkets in another state. The campaign included multiple components over three years, including television advertising, digital marketing, direct mail, outdoor advertising, social media and earned media, creating 17 million impressions. The community partners successfully advocated for public policies to encourage healthy beverage consumption in schools, child care, health care and government settings.
Author Interviews, JAMA, Pain Research, Stroke / 08.03.2017

MedicalResearch.com Interview with: Alessandro Pezzini, MD, FESO Professore Associato di Neurologia Dipartimento di Scienze Cliniche e Sperimentali Clinica Neurologica Università degli Studi di Brescia Italia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Scarce reports have suggested that a relation might exist between migraine and cervical artery dissection (CEAD), the most frequent cause of ischemic stroke in young adults in Western countries. However, data available so far were obtained from few studies conducted on small cohorts of patients, which limits the generalizability of their findings. In our study we analysed the data from the Italian Project on Stroke in Young Adults (IPSYS) project, one of the largest registries of young ischemic stroke patients, and observed that migraine, especially the subtype without aura was strongly and independently associated to CEAD. This seems particularly true for men and for people younger than 39 years.
Author Interviews, CDC, Dermatology, Environmental Risks, JAMA, Melanoma / 07.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32722" align="alignleft" width="200"]Gery P. Guy Jr., PhD, MPH Senior Health Economist Division of Unintentional Injury CDC Dr. Gery Guy[/caption] Gery P. Guy Jr., PhD, MPH Senior Health Economist Division of Unintentional Injury CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: The incidence of skin cancer is increasing in the United States, and individuals who indoor tan are at an increased risk of skin cancer. Treating skin cancer costs $8.1 billion annually. The number of high school students who indoor tan dropped by half from 2009 to 2015. In 2015, 1.2 million high school students indoor tanned, down from 2.5 million in 2009. This is a much bigger decrease than we have seen in the past and is an encouraging finding. We also found that 82% of indoor tanners reported sunburn in the past year compared with 54% of those who did not engage in indoor tanning.
Author Interviews, Dermatology, Global Health, JAMA / 07.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32732" align="alignleft" width="136"]Chante Karimkhani, MD University Hospitals Case Western Medical Center, Cleveland, Ohio now with Department of Dermatology University of Colorado, Denver Dr. Karimkhani[/caption] Chante Karimkhani, MD University Hospitals Case Western Medical Center, Cleveland, Ohio now with Department of Dermatology University of Colorado, Denver MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ranging from benign inflammatory to infectious, autoimmune, and malignant conditions, skin diseases cause significant disfigurement, pain, and psychological morbidity. The Global Burden of Disease (GBD) Study 2013 is a large-scale epidemiological assessment of burden from 306 diseases in 195 countries, both sexes, and 14 age groups. Disease burden is measured by combining morbidity and mortality into a single metric of disability-adjusted life years (DALYs), where one DALY is equivalent to one year of healthy life lost. Skin diseases contributed 1.79% of the total global burden from all diseases. The skin diseases arranged in order of decreasing global DALYs are: dermatitis (atopic, contact, seborrheic), acne vulgaris, urticaria, psoriasis, viral skin diseases, fungal skin diseases, fungal skin diseases, scabies, melanoma, pyoderma, cellulitis, keratinocyte carcinoma (basal and squamous cell carcinomas), decubitus ulcer, and alopecia areata. Younger populations had the greatest burden from infectious skin conditions, while acne caused the greatest burden in the second and third decades of life. Elderly populations had the greatest DALY rates from melanoma and keratinocyte carcinoma. Skin conditions also exhibit distinct geographical patterns of disease burden.
Author Interviews, Education, JAMA, Race/Ethnic Diversity, Yale / 06.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32681" align="alignleft" width="175"]Dowin Boatright, MD, MBA</strong> Department of Emergency Medicine Yale School of Medicine New Haven, Connecticut Fellow, Robert Wood Johnson Clinical Scholars Program Veterans Affairs Scholar Dr. Dowin Boatright[/caption] Dowin Boatright, MD, MBA Department of Emergency Medicine Yale School of Medicine New Haven, Connecticut Fellow, Robert Wood Johnson Clinical Scholars Program Veterans Affairs Scholar MedicalResearch.com: What is the background for this study? What are the main findings? Response: Studies have demonstrated racial and ethnic inequities in medicine, including disparities in the receipt of awards, research funding, and promotions. Yet few studies have examined the link between race and ethnicity and opportunities for medical school students. Our results show that black and Asian medical school students are less likely to be selected for membership in a prestigious medical honor society, Alpha Omega Alpha (AΩA), than white medical school students.
Author Interviews, Education, Gender Differences, JAMA, UCLA / 06.03.2017

MedicalResearch.com Interview with: Julie R. Boiko, MD, MS Resident Physician, PGY1 Department of Pediatrics University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Grand rounds is an over 100-year-old tradition in US medical school clinical departments of recurring, expert-delivered lectures to update physicians and physicians-in-training on recent advances in relevant medicine. We wanted to determine whether gender representation of speakers at grand rounds aligns with the gender distribution of people typically represented in grand rounds audiences -- faculty, residents, and medical students -- by clinical specialty according to national academic medical trainee and workforce statistics. We chose to focus on grand rounds speakers as visible representations of women in academic medicine. This is important because, despite women and men entering medicine at comparable rates, women are much more likely to depart academic medical careers. As current and recent medical students, we considered that consistent exposure to successful female role models in grand rounds speaking venues may positively reinforce women trainees’ desires to continue in academic medical careers. We found that the people at the podiums do not resemble the people in the audience. Only 26% of grand rounds speakers are women. Even accounting that some clinical specialties contain few women faculty and residents, grand rounds speakers in most specialties we studied were statistically less likely to be women as compared to faculty and residents. Across the specialties, grand rounds speakers are 44% less likely than medical students, 39% less likely than residents, and 21% less likely than faculty to be women.
Aging, Author Interviews, Hearing Loss, JAMA, Johns Hopkins / 06.03.2017

MedicalResearch.com Interview with: Dr. Adele Gorman PhD Johns Hopkins Center on Aging & Health The Johns Hopkins University Baltimore, Maryland MedicalResearch.com: What is the background for this study? Response: Hearing loss affects many people, especially older adults. We have previously estimated how common hearing loss is across different age groups and how many adults have hearing loss today. However, we did not know the number of people that are expected to have hearing loss in the coming decades. This is important to know in order to appropriately plan for future hearing health care needs. Recently the National Academies of Sciences, Engineering and Medicine highlighted the crucial need to address hearing loss and made recommendations to improve hearing health care services. However, these recommendations should be considered by policy makers in the context of the number of adults with hearing loss in the coming years.
Author Interviews, JAMA, Obstructive Sleep Apnea, Sleep Disorders / 04.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32672" align="alignleft" width="150"]Dr. Simone Baiardi MD Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna Dr. Simone Baiardi[/caption] Dr. Simone Baiardi MD Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna MedicalResearch.com: What is the background for this study? Response: Drug-induced sleep endoscopy (DISE) is an useful tool for studying the upper airway dynamic in patients with obstructive sleep apnea syndrome (OSAS), and it’s crucial for the therapeutic choice (especially for non ventilatory treatment, such as surgery). The main limits of DISE are the lack of standardization of procedure and the low inter-observer reliability among non-experienced ENT surgeons.
Author Interviews, Heart Disease, JAMA, Lipids / 02.03.2017

MedicalResearch.com Interview with: Dr. Yashashwi Pokharel MD, MSCR Department of Cardiovascular Research Saint Luke’s Mid-America Heart Institute Kansas City, Missouri and Salim S. Virani, MD PhD, FACC, FAHA Associate Professor, Section of Cardiovascular Research Associate Director for Research, Cardiology Fellowship Training Program Baylor College of Medicine Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Houston, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unlike the previous cholesterol management guideline that recommended use of either statin and non-statin therapy to achieve low density lipoprotein cholesterol (LDL-C) target, the 2013 American College of Cardiology/American Heart Association cholesterol management guideline made a major paradigm shift by recommending statin focused treatment in 4 specific patient groups and replaced LDL-C target with fixed statin intensity treatment (moderate to high intensity statin therapy). With this change, it was speculated that a large number of patients would be eligible for statin treatment (in one study, up to 11.1% additional patients were expected to be eligible for statin therapy). Our study provided the real world trends in the use of statin and non-statin lipid lowering therapy (LLT) from a national sample of cardiology practices in 1.1 million patients 14 months before and 14 months after the release of the 2013 guideline. We found a modest, but significant increasing trend in the use of statin therapy in only 1 of the 4 patient groups eligible for statin therapy (i.e., 4.3% increase in the use of moderate to high intensity statin therapy in patients with established atherosclerotic cardiovascular disease). We did not find any significant change in non-statin LLT use. Importantly, about a third to half of patients in statin eligible groups were not receiving moderate to high intensity statin therapy even after the publication of the 2013 guideline.
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Sleep Disorders, UT Southwestern / 02.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32582" align="alignleft" width="132"]Ron B. Mitchell, MD Professor and Vice Chairman, Department of Otolaryngology, Head and Neck Surgery William Beckner Distinguished Chair in Otolaryngology Chief of Pediatric Otolaryngology UT Southwestern and Children's Medical Center Dallas Dallas, TX 75207 Dr. Ron Mitchell[/caption] Ron B. Mitchell, MD Professor and Vice Chairman, Department of Otolaryngology, Head and Neck Surgery William Beckner Distinguished Chair in Otolaryngology Chief of Pediatric Otolaryngology UT Southwestern and Children's Medical Center Dallas Dallas, TX 75207 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obstructive Sleep Apnea (OSA) has not been widely studies in adolescents. This is one of a few studies that was targeted at 12-17 year olds who were referred for a sleep study for possible OSA. The study included 224 adolescents (53% male). aged 12 to 17 years. The mean BMI was 33.4 and most were either Hispanic or African American (85.3%). A total of 148 (66.1%) were obese. Most adolescents referred for a sleep study (68%), had  Obstructive Sleep Apnea. Normal-weight adolescents were least likely to have OSA at 48%, while obese children were most likely at 77%. Severe OSA was most likely in obese males with tonsillar hypertrophy.
Author Interviews, Heart Disease, JAMA / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32483" align="alignleft" width="200"]Thomas Engstrøm Senior Consultant dr. sci., MD, PhD The Heart Center | Rigshospitalet | University of Copenhagen | Denmark Professor in cardiology | University of Lund | Sweden Adjunct professor in cardiology | University of Aalborg | Denmark Dr. Engstrøm[/caption] Thomas Engstrøm  MD, PhD The Heart Center | Rigshospitalet | University of Copenhagen | Denmark Professor in cardiology | University of Lund | Sweden Adjunct professor in cardiology | University of Aalborg | Denmark  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Timely reperfusion by primary angioplasty (primary PCI) in patients with ST-elevation myocardial infarction is mandatory. However reperfusion it self can harm the myocardium - so called reperfusion injury. During a number of years ischemic postconditioning (iPOST) by repetitive interruptions of blood flow after reperfusion has been a promising technique to address reperfusion damage. The trial investigated the effect of iPOST in 1200 patients treated with primary PCI and in addition either iPOST or conventional angioplasty.
Author Interviews, Brigham & Women's - Harvard, JAMA, Outcomes & Safety / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32411" align="alignleft" width="95"]Alisa Khan, MD, MPH Staff Physician Instructor in Pediatrics Boston Children's Hospital Dr. Khan[/caption] Alisa Khan, MD, MPH Staff Physician Instructor in Pediatrics Boston Children's Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​Medical errors are known to be a leading cause of death in the United States. However, the true rate at which errors and adverse events occur in medicine is believed to be even higher than what has been found through the most rigorous patient safety studies. Families are typically excluded from safety surveillance efforts, both in research and operationally in hospitals. We found that including families in safety reporting at four pediatric hospitals led to significantly higher error/adverse event detection rates, compared to the safety surveillance methodology typically considered most rigorous and highest yield in safety research. In addition, families reported errors/adverse events at similar rates as providers and at several-fold higher rates than the hospital incident reports which typically form the basis of operational hospital safety surveillance.
Author Interviews, Cancer Research, JAMA, Pediatrics, Radiation Therapy / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32379" align="alignleft" width="132"]Lucie Turcotte, MD, MPH University of Minnesota Masonic Children's Hospital Division of Pediatric Hematology-Oncology Assistant Professor Minneapolis, MN 55455 Dr. Lucie Turcotte[/caption] Lucie Turcotte, MD, MPH University of Minnesota Masonic Children's Hospital Division of Pediatric Hematology-Oncology Assistant Professor Minneapolis, MN 55455 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have observed dramatic improvements in the number of survivors of childhood cancer over the last 60 years. As more children are surviving, we have identified many important late health consequences of cancer therapy. One of the most devastating of these late health consequences is the diagnosis of a second cancer. As we have identified late effects, such as second cancers, we have modified therapy in an effort to prevent long-term sequelae of therapy, while still maintaining superior survival rates. For this study, we utilized data from the Childhood Cancer Survivor Study (CCSS), which is a cohort of more than 23,000 survivors of childhood cancer from multiple centers in North America, who were initially diagnosed between 1970 and 1999. Our analysis focused on elucidating whether survivors diagnosed more recently were experiencing fewer second cancers, and determining whether a reduction in second cancers could be associated with treatment modifications. The most important finding from this study is that the reductions in therapeutic radiation exposure that occurred between 1970-1999 resulted in a significant reduction in the second cancers experienced by survivors of childhood cancer.
Author Interviews, Diabetes, JAMA, Pediatrics / 28.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32404" align="alignleft" width="140"]Dana Dabelea, MD, PhD Conrad M. Riley Professor of Epidemiology and Pediatrics Director, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center University of Colorado Anschutz Medical Campus Aurora, CO 80045 Dr. Dana Dabelea[/caption] Dana Dabelea, MD, PhD Conrad M. Riley Professor of Epidemiology and Pediatrics Director, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center University of Colorado Anschutz Medical Campus Aurora, CO 80045 MedicalResearch.com: What is the background for this study? Response: These recent increasing trends in type 1 and 2 diabetes diagnosed in young individuals raise the question of whether the pattern of complications differs by diabetes type at similar ages and diabetes duration. The SEARCH for Diabetes in Youth Stud, looked at five health complications and co-morbidities of diabetes, including: retinopathy, diabetic kidney disease, peripheral, arterial stiffness and high blood pressure. The researchers studied 1,746 adolescents and young adults with type 1 diabetes and 272 with type 2 diabetes diagnosed when < 20 years, with a similar average duration of 7.9 years and at a similar age of 21 years.
Author Interviews, Heart Disease, JAMA / 25.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32393" align="alignleft" width="200"]David Gaist, MD, PhD</strong> Department of Neurology Odense University Hospital University of Southern Denmark Odense, Denmark Dr. David Gaist[/caption] MedicalResearch.com: What is the background for this study? What are the main findings? Response: The incidence of subdural hematoma (SDH; a bleed located within the skull, but outside the brain) has been reported to be on the increase. Previous studies have shown an association between use of antithrombotic drugs and SDH. However, studies with updated estimates of this risk and with focus on current more complex and aggressive regimens of antithrombotic treatment are scarce. We therefore performed this study, where we identified 10,010 patients aged 20-89 years that were admitted with SDH in Denmark in 2000 through 2015. Preadmission use of antithrombotic drugs (low-dose aspirin, clopidogrel, vitamin K antagonist, e.g. warfarin, and direct oral anticoagulants) of these cases was compared to that of 400,380 individuals from the general population with no history of SDH (controls). We found that use of antithrombotic drugs was associated with an increased risk of subdural hematoma . The magnitude of this risk varied by type of antithrombotic, and was, e.g., low for use of low-dose aspirin, and highest for warfarin. Further, with a single exception (low-dose aspirin and dipyridamole), concurrent use of more than one antithrombotic drug was associated with higher risk of SDH, particularly if warfarin was taken along with an antiplatelet drug, e.g., low-dose aspirin or clopidogrel. Increasing use of antithrombotic drugs was observed in the study period. The incidence of subdural hematomas in the Danish population also increased markedly in the years 2000-2015, particularly among those aged 75+ years. Our study indicates that this increased incidence, can, at least partly, be explained by increased use of antithrombotic drugs.
Author Interviews, Heart Disease, JAMA, Stroke / 25.02.2017

MedicalResearch.com Interview with: Peter Brønnum Nielsen MD PhD Aalborg Thrombosis Research Unit Department of Clinical Medicine Faculty of Health Department of Cardiology, Atrial Fibrillation Study Group Aalborg University Hospital Aalborg, Denmark   MedicalResearch.com: What is the background for this study? What are the main findings? Response:   Patients who sustain an intracranial hemorrhage (ICH) event are often excluded from randomized trials investigating stroke prevention in atrial fibrillation (AF) by use of oral anticoagulant treatment.
Author Interviews, Cancer Research, Heart Disease, JAMA / 24.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32371" align="alignleft" width="134"]Philip C. Haycock, PhD MRC Integrative Epidemiology Unit University of Bristol Bristol, England Dr. Philip Haycock[/caption] Philip C. Haycock, PhD MRC Integrative Epidemiology Unit University of Bristol Bristol, England MedicalResearch.com: What is the background for this study? What are the main findings? Response: The direction and causal nature of the association of telomere length with risk of cancer and other diseases is uncertain. In a Mendelian randomization study of 83 non-communicable diseases, including 420,081 cases and 1,093,105 controls, we found that longer telomeres were associated with increased risk for several cancers but reduced risk for some other diseases, including cardiovascular diseases.
Author Interviews, JAMA, Orthopedics, Osteoporosis, Testosterone / 23.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32296" align="alignleft" width="152"]Tony M. Keaveny, Ph.D. Professor, Departments of Mechanical Engineering and Bioengineering; Co-Director, Berkeley BioMechanics Laboratory University of California Berkeley, CA 94720-1740 Dr. Tony Keaveny[/caption] Tony M. Keaveny, Ph.D. Professor, Departments of Mechanical Engineering and Bioengineering; Co-Director, Berkeley BioMechanics Laboratory University of California Berkeley, CA 94720-1740 MedicalResearch.com: What is the background for this study? Response: As men age, they experience decreased serum testosterone concentrations, decreased bone mineral density (BMD) and increased risk of fracture. While prior studies have been performed to determine the effect of testosterone treatment on bone in older men, for various reasons those studies have been inconclusive. The goal of this study was to overcome past limitations in study design and determine if testosterone treatment — versus a placebo — in older men with low testosterone would improve the bone. Specifically, we used 3D quantitative CT scanning to measure changes in BMD and engineering “finite element analysis” to measure changes in the estimated bone strength, both at the spine and hip. The study was performed on over 200 older men (> age 65) who had confirmed low levels of serum testosterone.
Author Interviews, Depression, JAMA, Pharmacology, Yale / 23.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32285" align="alignleft" width="160"]Adam Chekroud PhD Candidate Human Neuroscience Lab Adam Chekroud[/caption] Adam Chekroud PhD Candidate Human Neuroscience Lab Department of Psychology Yale University MedicalResearch.com: What is the background for this study? Response: We know that depression includes a wide range of symptoms, from low mood and feeling worthless, to problems sleeping, slowed thinking, and suicidal ideation. We wanted to know whether antidepressants work well in treating all of these symptoms, or whether they are primarily effective on certain kinds of symptoms.
Author Interviews, Heart Disease, JAMA, Testosterone, UCLA / 23.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32281" align="alignleft" width="140"]Ronald S. Swerdloff, MD Chief of the Division of Endocrinology, Department of Medicine and Director of a World Health Organization Collaborative Center in Reproduction a Mellon Foundation Center for Contraceptive Development and a NIH Contraceptive Clinical Trial Center Director of the Harbor-UCLA Reproductive Program LA BioMed Lead Researcher David Geffen School of Medicine UCLA Health Dr. Ronald Swerdloff[/caption] Ronald S. Swerdloff, MD Chief of the Division of Endocrinology, Department of Medicine and Director of a World Health Organization Collaborative Center in Reproduction a Mellon Foundation Center for Contraceptive Development and a NIH Contraceptive Clinical Trial Center Director of the Harbor-UCLA Reproductive Program LA BioMed Lead Researcher David Geffen School of Medicine UCLA Health MedicalResearch.com: What is the background for this study? Response: While we have long known that testosterone levels decrease as men age, very little was known about the effects of testosterone treatment in older men with low testosterone until last year. Our team of researchers from LA BioMed and 12 other medical centers in the U.S., in partnership with the National Institute on Aging, conducted a coordinated group of seven trials known as The Testosterone Trials (TTrials). We studied the effects of testosterone treatment for one year as compared to placebo for men 65 and older with low testosterone. The TTrials are now the largest trials to examine the efficacy of testosterone treatment in men 65 and older whose testosterone levels are low due seemingly to age alone. The first published research from the TTrials last year reported on some of the benefits to testosterone treatment. We have now published four additional studies in the Journal of the American Medical Association (JAMA) and JAMA Internal Medicine that found additional benefits and one potential drawback.
Author Interviews, Depression, JAMA, Telemedicine / 23.02.2017

MedicalResearch.com Interview with: Eirini Karyotaki, MSc Department of Clinical Psychology and EMGO Institute for Health and Care Research Vrije Universiteit Amsterdam Amsterdam, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Depression is broadly acknowledged as a major health issue associated with a great risk of mortality and morbidity. Nevertheless, help-seeking rates are low among individuals with depression. Some of the barriers that impede help seeking are the limited availability of trained clinicians, the fear of stigmatisation and the cost of treatment. Self-guided Internet based Cognitive behavioural therapy (iCBT) has the potential to overcome many of these treatment barriers. However, recent randomised controlled trials (RCTs) have produced mixed evidence regarding the effects of self-guided iCBT in treating adults with depressive symptoms. To gain more insight in the effectiveness of self-guided iCBT, an Individual Participant Data meta-analysis was performed. 3876 individual participant data across 13 RCTs were collected and analysed.
Author Interviews, Heart Disease, JAMA, Testosterone / 21.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32221" align="alignleft" width="142"]Dr-Cheetham-Craig.jpg Dr. Craig Cheetham[/caption] T. Craig Cheetham, PharmD, MS Southern California Permanente Medical Group Department of Research & Evaluation Pasadena, CA 91101 MedicalResearch.com: What is the background for this study? Response: Concerns have been raised about the cardiovascular safety of testosterone replacement therapy. Patient selection criteria may have been a factor in the findings from studies reporting an increased cardiovascular risk with testosterone replacement therapy. Many men who were receiving testosterone replacement therapy don’t fall into the categories of ‘frail elderly’ or ‘high cardiovascular risk’. We therefore studied testosterone replacement therapy in a population of androgen deficient men within Kaiser Permanente Northern and Southern California.
Author Interviews, Gender Differences, JAMA, Johns Hopkins, Mental Health Research, Pediatrics / 21.02.2017

MedicalResearch.com Interview with: Julia R.G. Raifman, ScD Post-doctoral fellow Johns Hopkins Bloomberg School of Public Health  MedicalResearch.com: What is the background for this study? Response: Suicide is the second leading cause of death among adolescents between the ages of 15 and 24 years old in the United States. Gay, lesbian, and bisexual adolescents have elevated rates of suicide attempts. In our study, we found that 29% of gay, lesbian, and bisexual adolescents reported attempting suicide in the past year relative to 6% of heterosexual adolescents.
Author Interviews, JAMA, Prostate Cancer / 20.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32209" align="alignleft" width="142"]Neeraj Agarwal, MD Associate Professor, Division of Oncology, Department of Medicine University of Utah School of Medicine Dr. Neeraj Agarwal[/caption] Neeraj Agarwal, MD Associate Professor, Division of Oncology, Department of Medicine University of Utah School of Medicine MedicalResearch.com: What is the background for this study? Response: Biomarkers predicting response to cancer therapy help guide physicians personalize medicine. Significant advances have been made in the development of therapeutic biomarkers in various malignancies, but not in prostate cancer. Dr. Nima Sharifi’s group at the Cleveland Clinic recently discovered that a germline inherited polymorphic variant (1245A→C) in the HSD3B1 gene correlates with shorter duration of response to androgen deprivation therapy (ADT) in hormone sensitive prostate cancer (HSPC). HSD3B1 gene encodes the enzyme 3β-hydroxysteroid dehydrogenase-1 (3βHSD1), which catalyzes adrenal androgen precursors into dihydrotestosterone, the most potent androgen. The authors found that the variant allele of HSD3B1 led to decreased progression-free survival in a dose-dependent manner in post-prostatectomy biochemical recurrence and metastatic HSPC (mHSPC). These results needed external validation before application in the clinic. In our study, we sought to provide the first independent validation of these results in patients with mHSPC.
Author Interviews, JAMA, Multiple Sclerosis, Neurology / 18.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32165" align="alignleft" width="180"]Linard Filli, PhD Gait Research Lab Department of Neurology University Hospital Zurich Zürich Dr. Linard Filli[/caption] Linard Filli, PhD Gait Research Lab Department of Neurology University Hospital Zurich Zürich MedicalResearch.com: What is the background for this study? Response: Gait dysfunction is common in patients with multiple sclerosis (MS) and is perceived as the most restricting of symptoms. Fampridine (4-aminopyridine, dalfampridine), a blocker of voltage-gated potassium channels, is currently the only approved medication for the symptomatic treatment of walking disorders in patients in both the early and late phases of  multiple sclerosis.