Author Interviews, Gastrointestinal Disease, Gluten, JAMA / 06.09.2016

MedicalResearch.com Interview with: Brandon Hyunseok Kim, M.D., MPH Internal Medicine Resident Rutgers New Jersey Medical School MedicalResearch.com: What is the background for this study? Response: The background of this study was to investigate the time trends in the prevalence of celiac disease and gluten-free diet in the United States using most recent 6-year National Health And Nutrition Examination Survey. Previous studies using narrow populations or old study period mainly before mid 2000s suggested increasing prevalence of celiac disease. At the same time, there is a current popular trend of people following gluten-free diets beyond what would be expected if it were solely due to the increasing prevalence of celiac disease. (more…)
Author Interviews, Duke, JAMA, Surgical Research, Weight Research / 02.09.2016

MedicalResearch.com Interview with: Matthew Leonard Maciejewski, PhD Professor in the Division of General Internal Medicine Department of Medicine Duke University School of Medicine Research Career Scientist and Director of the Health Economics and Policy Unit in the Center for Health Services Research in Primary Care Durham VA Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: No study based on a US cohort undergoing current procedures has examined weight change comparing surgical patients and nonsurgical patients for as long as we have. This is the first study to report 10-year outcomes on gastric bypass patients and compare them to matched patients who did not get surgery. At 1 year, gastric bypass patients lost 31% of their baseline weight compared controls who only lost 1.1% of their baseline weight. At 10 years, gastric bypass had lost 28% of their baseline weight. We also compared weight loss at 4 years for Veterans who received the 3 most common procedures (gastric bypass, sleeve gastrectomy, and adjustable gastric banding). At 4 years, patients undergoing gastric bypass lost more weight than patients undergoing sleeve gastrectomy or gastric banding. Given that few high quality studies have examined sleeve gastrectomy to 4 years, the 4-year sleeve outcomes contribute to filling this important evidence gap as the sleeve gastrectomy is now the most commonly performed bariatric procedure worldwide. (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 02.09.2016

MedicalResearch.com Interview with: Dr Marlous Hall PhD Senior Epidemiologist Leeds Institute of Cardiovascular and Metabolic Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that death rates following heart attacks have fallen considerably over recent decades. Many studies have looked at the effect of medications and invasive strategies, and their association with better clinical outcomes is clear. However, a big question remains: why have heart attack deaths fallen? Is it due to increased use of medications and treatment, is the risk of patients simply lower over time due to things like earlier diagnosis or are patients generally healthier with fewer comorbidities such as diabetes? Answering this is not straightforward - as “gold standard” studies like clinical trials on historic data cannot be done. An alternative approach is to look for patterns in data observed from routine care to look at all these factors together. This study used a large and rich dataset covering heart attack care in the UK (Myocardial Ischaemia National Audit Project (MINAP)). This dataset was linked to outcome data from the Office for National Statistics to allow us to look at all the different factors that could influence the change in mortality over time. (more…)
Author Interviews, Cost of Health Care, JAMA / 31.08.2016

MedicalResearch.com Interview with: Dr. Rachel O. Reid MD MS Associate Physician Policy Researcher RAND Corporation MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Waste in the US health care system is both common and expensive, estimated to be in the range of $750 billion annually. Contributing to this waste is over-treatment and use of low value services that offer little or no clinical benefit to patients. We studied 1.46 million adults from across the US with commercial insurance and found that spending on 28 low value services totaled $32.8 million in 2013, accounting for 0.5% of their medical spending or $22 per person annually. The most commonly received low-value services included hormone tests for thyroid problems, imaging for low-back pain and imaging for uncomplicated headache. The greatest proportion of spending was for spinal injection for lower-back pain at $12.1 million, imaging for uncomplicated headache at $3.6 million and imaging for nonspecific low-back pain at $3.1 million. Low-value spending was lower among patients who were older, male, black or Asian, lower-income or enrolled on consumer-directed health plans, which have high member cost-sharing. (more…)
Anesthesiology, Author Interviews, Emergency Care, JAMA, Pediatrics / 31.08.2016

MedicalResearch.com Interview with: Marc Auerbach, MD, FAAP, MSc Associate Professor of Pediatrics (Emergency Medicine) and of Emergency Medicine Co-chair INSPIRE (International Network for Simulation Based Pediatric Innovation Research and Education) Director, Pediatric Simulation Yale Center for Medical Simulation; MedicalResearch.com: What is the background for this study? What are the main findings? Response: Severely ill infants and children present to any of over 5000 United States Emergency Departments every day. A direct comparison of the quality of resuscitative care across EDs is challenging due to the low frequency of these high stakes events in individual EDs. This study utilized in-situ simulation-based measurement to compare the quality of resuscitative care delivered to two infants and one child by 58 distinct interprofessional teams across 30 EDs. Composite quality scores correlated with annual pediatric patient volume, with higher volume departments demonstrating higher scores. The pediatric readiness score measures compliance with guidelines created by the American Academy of Pediatrics, the American College of Emergency Physicians and the Emergency Nurses Association. The pediatric readiness score correlated with composite quality scores measured by simulation. (more…)
Author Interviews, Education, JAMA / 30.08.2016

MedicalResearch.com Interview with: Daniel J. Morgan M.D., M.S Associate Professor Epidemiology & Public Health University of Maryland School of Medicine MedicalResearch.com: What is the background for this study? Response: Physicians are generally taught if a treatment is indicated, not how well the treatment works. Although this has been part of evidence based medical training, doctors still perform poorly with ability to understand risk and how treatment limits risk (Bayesian reasoning). Many publications focus on relative risk reduction which inflates the perception of an effect over the more accurate absolute risk reduction. (more…)
Author Interviews, Breast Cancer, Chemotherapy, Genetic Research, JAMA, NEJM / 26.08.2016

MedicalResearch.com Interview with: Prof. Laura van ’t Veer, PhD Leader, Breast Oncology Program, and Director, Applied Genomics, UCSF Helen Diller Family Comprehensive Cancer Center Angela and Shu Kai Chan Endowed Chair in Cancer Research UCSF Helen Diller Family Comprehensive Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: MINDACT was designed to involve only patients with node negative and 1 to 3 positive lymph node breast cancer. Node negative breast cancer is a cancer that has not spread to the surrounding lymph nodes and therefore has a lower risk of recurrence. Scientists have also demonstrated that breast cancer which has spread to 1 to 3 lymph nodes may behave like node negative breast cancer. Patients with either node negative cancer or with a cancer that involves 1-3 lymph nodes are often prescribed chemotherapy, although physicians believe that approximately 15% of them do not require such treatment. MINDACT provides the highest level of evidence to show that using MammaPrint® can substantially reduce the use of chemotherapy in patients with node-negative and 1-to-3 node positive breast cancer – in other words, it can identify patients with these types of breast cancer who can safely be spared a treatment that may cause significant side effects, and will offer no to very little benefit. (more…)
Author Interviews, Cancer Research, Chemotherapy, JAMA / 25.08.2016

MedicalResearch.com Interview with: Leni van Doorn, MSc Department of Medical Oncology Erasmus MC Cancer Institute Rotterdam, the Netherlands MedicalResearch.com: What is the background for this study? Response: The common cancer treatment capecitabine, a regular treatment for patients mostly diagnosed with breast-, colon- or gastic cancer, induces hand foot syndrome (HFS). HFS is a cutaneous condition that may lead to red palms and blisters in approximately 50% to 60% of the patients and is believed to result in the loss of fingerprints. This fingerprint loss has been described sporadically in the literature. The main aim of our prospective study was to have a closer look of the association between  hand foot syndrome and the loss of fingerprints. (more…)
Author Interviews, Columbia, Heart Disease, JAMA, Medical Imaging / 25.08.2016

MedicalResearch.com Interview with: Adam Castano, M.D., M.S. Division of Cardiology Columbia University Medical Center New York Presbyterian Hospital MedicalResearch.com: What is the background for this study? Response: Transthyretin cardiac amyloidosis (ATTR-CA) is an increasingly recognized cause of heart failure with preserved ejection fraction (HFpEF). Traditionally, the gold standard for diagnosis has required an endomyocardial biopsy coupled with either immunohistochemistry or mass spectroscopy. These specialized tests are only performed at centers with experienced satff, do not yield prognostically useful information, may be inadvisable for frail older adults, and often present logistical challenges that lead to delayed care. Fortunately, single center studies have demonstrated excellent diagnostic accuracy using technetium 99m pyrophosphate (Tc99mPYP) cardiac imaging for noninvasively detecting ATTR-CA and differentiating it from another major type of cardiac amyloidosis called light chain (AL). But the diagnostic accuracy of this technique in a multicenter study and the association of Tc99mPYP myocardial uptake with survival were not known prior to this study. Therefore, we assessed in a multicenter study Tc99mPYP cardiac imaging as a diagnostic tool and its association with survival. We conducted a retrospective cohort study of 229 patients evaluated at 3 academic specialty centers for cardiac amyloidosis and also underwent Tc99mPYP cardiac imaging. We measured retention of Tc99mPYP in the heart using a semiquantitative visual score (range 0-3) and a more quantitative heart-to-contralateral (H/CL) ratio calculated as total counts in a region of interest over the heart divided by background counts in an identical size region of interest over the contralateral chest. The outcome measured was time to death after Tc99mPYP imaging. (more…)
Author Interviews, Cancer Research, JAMA / 25.08.2016

MedicalResearch.com Interview with: Dr. Aaron Mitchell MD Hematology/Oncology Fellow University North Carolina MedicalResearch.com: What is the background for this study? Response: It is well known that many physicians work with the pharmaceutical industry. In some cases, this can create conflicts of interest with physicians' other responsibilities. The Open Payments law, passed as part of the Affordable Care Act, recently made these relationships public, which now allows us to study them more systematically. (more…)
Author Interviews, Dermatology, JAMA / 25.08.2016

MedicalResearch.com Interview with: Lisa Earnest Ishii, M.D. Associate Professor, Department of Otolaryngology-Head and Neck Surgery Division of Facial Plastic and Reconstructive SurgeryJohns Hopkins School of Medicine Baltimore Maryland 21287 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hair transplantation for men suffering from male pattern hair loss is a common procedure to improve their appearance. However, to the best of our knowledge the impact of the procedure for men with hair loss had never been clearly demonstrated. We showed, for the first time, that men who undergo the procedure can have real improvements in attractiveness, age, and the appearance of successfulness as perceived by the casual observer in society. (more…)
Author Interviews, Dermatology, Diabetes, Heart Disease, JAMA, Medical Imaging, NIH / 24.08.2016

MedicalResearch.com Interview with: Nehal N. Mehta, .MD., M.S.C.E. F.A.H.A. Lasker Clinical Research Scholar Section of Inflammation and Cardiometabolic Diseases NIH MedicalResearch.com: What is the background for this study? What are the main findings? Response: Psoriasis is associated with accelerated cardiovascular (CV) disease; however, screening for CV risk factors in psoriasis remains low. Coronary artery calcium (CAC) score estimates the total burden of atherosclerosis. Psoriasis has been associated with increase CAC score, but how this compares to patients with diabetes, who are aggressively screened for CV risk factors, is unknown. (more…)
Author Interviews, JAMA, Kidney Disease / 23.08.2016

MedicalResearch.com Interview with: Fan Fan Hou Chief, Division of Nephrology, Nanfang Hospital Professor of Medicine, Southern Medical UniversityFan Fan Hou MD Chief, Division of Nephrology, Nanfang Hospital Professor of Medicine, Southern Medical University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous trials (HOST and DIVINe) of folic acid therapy in CKD patients were conducted in patients with advanced CKD and treated with super-high dose of vitamin B or with cyanocobalamin that has been shown to be renal toxic. The current study sought to evaluated the efficacy of folic acid therapy without cyanocobalamin on renal outcomes in patients without folic acid fortification and across a spectrum of renal function at baseline from normal to moderate CKD. We found that treatment with enalapril-folic acid, as compared with enalapril alone, reduced the risk of progression of CKD by 21% and the rate of eGFR decline by 10% in hypertensive patients. More importantly, the presence of CKD at baseline was a significant modifier of the treatment effect (p for interaction = 0.01). Patients with CKD benefited most from the folic acid therapy, with a 56% and 44% reduction in the risk for progression of CKD and the rate of eGFR decline, respectively. In contrast, the renal protective effect in those without CKD was nominal. (more…)
Author Interviews, Frailty, Hip Fractures, JAMA, Pharmacology / 22.08.2016

MedicalResearch.com Interview with: Jeffrey Munson, MD, MSCE Assistant Professor The Dartmouth Institute for Health Policy & Clinical Practice Assistant Professor, Department of Medicine Geisel School of Medicine at Dartmouth MedicalResearch.com: What is the background for this study?  Response: Fragility fractures due to osteoporosis are a common and costly event among older Americans. Patients who experience one fragility fracture are at increased risk to have a second fracture. Our group is interested in exploring ways in which the risk of a second fracture could be reduced. In this paper, we studied prescription drug use both before and after fracture. We know many prescription drugs have been shown to increase the risk of fracture, but we don’t know whether doctors try to reduce the use of these drugs after a fracture has occurred. Our study was designed to answer this question. (more…)
Author Interviews, Cost of Health Care, Emergency Care, JAMA, Kidney Disease / 22.08.2016

MedicalResearch.com Interview with: Rachel Patzer, PhD, MPH Director of Health Services Research, Emory Transplant Center Assistant Professor Emory University School of Medicine Department of Surgery Division of Transplantation MedicalResearch.com: What is the background for this study? Response: Patients with End Stage Renal Disease (ESRD) make up less than 1% of all Medicare patients, but account for more than 7% of all Medicare expenses. Patients with ESRD have the highest risk of hospitalization of any patient with a chronic disease, and while hospital admissions have decreased over the last several years, emergency department utilization for this patient population has increased by 3% in the last 3 years. The purpose of the study we conducted was to describe the clinical and demographic characteristics associated with emergency department utilization. (more…)
Author Interviews, Dermatology, JAMA, Melanoma, Stanford / 22.08.2016

MedicalResearch.com Interview with: Susan M. Swetter, MD Professor of Dermatology Director, Pigmented Lesion & Melanoma Program Physician Leader, Cancer Care Program in Cutaneous Oncology Stanford University Medical Center and Cancer Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dysplastic nevi (DN) are frequently re-excised following initial biopsy due to concerns for malignant transformation; however, the long-term risk of melanoma developing in mildly or moderately dysplastic nevi with positive histologic margins is unknown. In this cohort study of 590 histologic DN that were followed over 20 years, 6 cases of melanoma (5 in situ) arose in the 304 DN with positive margins that were clinically observed, only 1 of which developed from an excisionally-biopsied dysplastic nevus. One melanoma in situ arose in the 170 cases that underwent complete excision at the outset. The risk of new primary melanoma at other sites of the body was over 9% in both groups. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Mental Health Research, OBGYNE / 19.08.2016

MedicalResearch.com Interview with: Krista F. Huybrechts, M.S., Ph.D. Assistant Professor of Medicine Harvard Medical School Epidemiologist Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital Boston, MA 02120 MedicalResearch.com: What is the background for this study? Response: The use of antipsychotic medications during pregnancy has doubled in the last decade. Yet, information on the safety of antipsychotic medication use during pregnancy for the developing fetus is very limited: existing studies tend to be small (the largest study available to date includes 570 exposed women) and findings have been inconsistent. Concerns have been raised about a potential association with congenital malformations. The objective of our study was to examine the risk of congenital malformations overall, as well as cardiac malformations given findings from earlier studies, in a large cohort of pregnant women. We used a nationwide sample of 1.3 mln pregnant women insured through Medicaid between 2000-2010, of which 9,258 used an atypical antipsychotic and 733 used a typical antipsychotic during the first trimester, the etiologically relevant period for organogenesis. We also examined the risks associated with the most commonly used individual medications. (more…)
Author Interviews, JAMA, Prostate Cancer / 18.08.2016

MedicalResearch.com Interview with: Dr. Ahmedin Jemal, DVM, PhD Vice President, Surveillance and Health Services Research American Cancer Society MedicalResearch.com: What is the background for this study? What are the main findings? Response: We previously showed large decrease in early stage prostate cancer incidence rates from 2011 to 2012 in men 50 years and older following the US Preventive services Task Force recommendation against routine prostate-specific antigen testing in 2011. In this paper, we examined whether the decrease in early stage incidence persisted through 2013. We found that early stage prostate cancer incidence rates in men age 50 and older decreased from 2012 to 2013, although the decrease (6%) was lower compared to the decrease from 2011-2012 (19%). In contrast, rates for distant stage disease between 2012 and 2013 remained unchanged. (more…)
Author Interviews, Heart Disease, JAMA, Lipids, Nutrition, Omega-3 Fatty Acids / 18.08.2016

MedicalResearch.com Interview with: David Iggman, MD, PhD Unit for Clinical Nutrition and Metabolism Department of Public Health and Caring Sciences Uppsala University, Uppsala Center for Clinical Research Dalarna Falun, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is some controversy regarding which dietary fats are preferable and in what amounts, not least regarding the polyunsaturated fats. It is also challenging to adequately assess peoples intakes of dietary fats. The main findings of this study was that among fatty acids in the body (reflecting the intake during the last year or so), linoleic acid (omega-6) was associated with lower mortality in 71-year-old men with 15 years follow-up. (more…)
Accidents & Violence, Author Interviews, Gender Differences, JAMA, Mental Health Research / 17.08.2016

MedicalResearch.com Interview with: Edith Chen, Ph.D. Professor Faculty Fellow, Institute for Policy Research Northwestern University Department of Psychology Evanston, IL 60208-2710 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has documented psychiatric consequences of childhood abuse, but less is known about possible physical health consequences. The main finding is that women who self-reported childhood abuse (in adulthood) were at greater risk for all-cause mortality compared to those who did not report abuse. (more…)
Author Interviews, Genetic Research, JAMA, OBGYNE / 17.08.2016

MedicalResearch.com Interview with: Gabriel Lazarin MS Vice President,Counsyl Medical Science Liaisons MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study finds there is a significant opportunity to identify more pregnancies affected by serious conditions, across all ethnicities, through the clinical use of expanded carrier screening (ECS). We found that compared to current prenatal genetic testing guidelines, expanded carrier screening for 94 genetically inherited conditions better addresses the risk of having a pregnancy affected with a serious condition. Certain physicians have been offering ECS since 2010. However, in order for it to come into routine use, a group of major medical organizations last year stated a need for further data regarding the frequency of previously unscreened genetic variants. This study uses real test results from approximately 350,000 people to provide that data. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Education, Heart Disease, JAMA / 16.08.2016

MedicalResearch.com Interview with: Rory Brett Weiner, MD Assistant Professor of Medicine Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: The increased use of noninvasive cardiac imaging and Medicare spending in the late 1990s and early 2000s has led to several measures to help optimize the use of cardiac imaging. One such effort has been the Appropriate Use Criteria (AUC) put forth by the American College of Cardiology Foundation. The AUC for echocardiography have been useful to characterize practice patterns and more recently been used as a tool to try to improve ordering of echocardiograms. Our research group previously conducted a randomized study of physicians-in-training (cardiovascular medicine fellows) and showed that an AUC based educational and feedback intervention reduced the rate of rarely appropriate transthoracic echocardiograms (TTEs). The current study represents the first randomized controlled trial of an AUC education and feedback intervention attending level cardiologists. In this study, the intervention group (which in addition to education received monthly feedback emails regarding their individual TTE ordering) ordered fewer rarely appropriate TTEs than the control group. The most common reasons for rarely appropriate TTEs in this study were ‘surveillance’ echocardiograms, referring to those in patients with known cardiac disease but no change in their clinical status. (more…)
Author Interviews, JAMA, Pediatrics, Pharmacology / 16.08.2016

MedicalResearch.com Interview with: Dr Evie Stergiakouli Lecturer in Genetic Epidemiology and Statistical Genetics MRC Integrative Epidemiology Unit University of Bristol Bristol UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Acetaminophen is considered safe to use during pregnancy. However, research suggests that acetaminophen use in pregnancy is associated with abnormal neurodevelopment. It is possible that this association might be confounded by unmeasured behavioural factors linked to acetaminophen use. We compared acetaminophen use during pregnancy to postnatal acetaminophen use and partner's acetaminophen use. Only acetaminophen use during pregnancy has the potential to cause behavioural problems in the offspring. Any associations with postnatal acetaminophen use and partner's acetaminophen use would be due to confounding. Behavioural problems in the offspring were only associated with acetaminophen use during pregnancy. (more…)
Author Interviews, JAMA, Lipids / 16.08.2016

MedicalResearch.com Interview with: Dr. David Grossman M.D., M.P.H. Vice chair of the U.S. Preventive Services Task Force and Professor at the University of Washington Schools of Public Health and Medicine MedicalResearch.com: What is the background for this recommendation? Response: The Task Force recognizes the importance of cardiovascular health for young people. Children and adolescents with high cholesterol are more likely to become adults with high cholesterol, and high cholesterol in adulthood can lead to serious health outcomes such as heart attacks and strokes. However, when the Task Force reviewed evidence for cholesterol screening in children and adolescents without any signs or symptoms, we found that there is not enough evidence to recommend for or against screening. In the face of unclear evidence, the Task Force is calling on the research community to prioritize studies on screening and treatment of lipid disorders in children and teens to help us all learn more about the impact that screening at an early age may have on the cardiovascular health of adults. (more…)
Author Interviews, JAMA, Smoking, Tobacco / 13.08.2016

MedicalResearch.com Interview with: Anna Pulakka PhD, Postdoctoral Researcher Department of Public Health University of Turku, Finland MedicalResearch.com: What is the background for this study? Response: Smoking is the one of the leading health risks globally. Finland, among some other countries, has set a target for a tobacco-free society by 2040. However, with the current rate of decline in smoking prevalence, the target will not be met. It is therefore important to explore new avenues for helping people to quit smoking. Recently, researchers have become more interested in availability of tobacco as one determinant for smoking habit. We have learned from cross-sectional studies that people who live in neighborhoods with many stores that sell tobacco, smoke more than those who have less tobacco stores in their neighborhood. What has been lacking is more robust evidence from longitudinal studies on the association between availability of tobacco in neighborhoods and smoking behaviours. We sought to determine whether change in the location of tobacco stores nearby people’s place of residence was associated with the odds of quitting smoking or smoking relapse in a longitudinal setting. (more…)
Author Interviews, JAMA, Obstructive Sleep Apnea, Pulmonary Disease, Sleep Disorders / 11.08.2016

MedicalResearch.com Interview with: Ken Kunisaki, MD, MS Associate Professor of Medicine Minneapolis Veterans Affairs Health Care System and University of Minnesota and Roxanne Prichard, PhD Associate Professor of Psychology and Neuroscience University of St. Thomas MedicalResearch.com: What is the background for this study? What are the main findings? Response: CPAP devices, or continuous positive airway pressure devices, are used to treat obstructive sleep apnea, a common condition that causes people to intermittently stop breathing during their sleep. This leads to poor sleep quality and often results in symptoms like excessive sleepiness in the daytime. In the United States, CPAP devices are classified by the Food and Drug Administration as Class II medical devices with possible risks; their sale requires a medical prescription. We were aware of online advertisements for secondhand, used CPAP machines, but we have not seen publications that have analyzed this practice. Once a week, our research team monitored online advertisements for secondhand CPAP devices on Craigslist.org in 18 U.S. cities and areas over a one-month period. During that time, we found 270 advertisements, most of which did not describe who previously had used the device or why it was being sold. Only 5 of the advertisements mentioned anything about the legal requirements of a prescription and 61 percent of the devices included a used mask without information about its age or how it was cleaned. CPAP devices create air pressure and attach to a nose or face mask that delivers that pressure to a patient’s airway, thereby keeping him or her breathing during sleep. The amount of air pressure delivered by the devices is adjusted for each patient and usually is determined by a medical exam that includes an overnight stay in a laboratory. Our study found that most of the Craigslist advertisements failed to mention the devices’ pressure settings—settings that were prescribed for the original owners. The average price for a CPAP device listed on Craigslist was $291, much less than the $600 to $2,000 cost of a new device. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA, Mental Health Research / 11.08.2016

MedicalResearch.com Interview with: Helene Lund-Sørensen BM Department of Biomedical Sciences Section of Cellular and Metabolic Research University of Copenhagen MedicalResearch.com: What is the background for this study? What are the main findings? Response: Accumulating research has shown that inflammation and infections are associated with psychiatric diagnoses and interactions between infectious agents, known to affect the brain, and suicidal behavior have been reported. We find an increased risk of death by suicide among individuals hospitalized with infections. The risk of suicide increased in a dose-response relationship with the number of hospitalizations with infections and with the number of days hospitalized with infections. We also examined the risk of suicide association with the time since the last hospitalization with infection and found that infection was linked to an elevated risk with the strongest effect after 1 and 2 years compared with those without infections. (more…)
Author Interviews, Genetic Research, JAMA, Melanoma / 11.08.2016

MedicalResearch.com Interview with: Ulrich Pfeffer, PhD Laboratory of Molecular Pathology Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliera Universitaria San Martino–IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: The melanoma of the eye or uveal melanoma is well controlled by radiotherapy or surgery but very aggressively growing metastases often develop and therapy has only marginally improved in decades. On the other hand, uveal melanoma is probably the best studied cancer in absolute: we know its development in great detail and we can make very precise prognosis. An important piece of information that is lacking is the effect of a chromosomal alteration, amplification of a part of chromosome 6, that is often encountered in a subset of uveal melanomas that show features of bad prognosis but actually perform better. Many have guessed that the immune system or more generally, inflammation might protect uveal melanomas with this alteration from progression to metastasis. Therefore we have set out to analyze a candidate gene, the putative immunomodulatory BTNL2, that is located on chromosome 6. We found highly variable expression of this gene in uveal melanoma samples where it is expressed by tumor cells and by infiltrating immune cells. The type of infiltrate is strongly associated with the risk to develop metastases. We also analyzed genetic variants of BTNL2 in 209 patients but we could not find a significant association with uveal melanoma risk. (more…)
Author Interviews, JAMA, Lipids, Pediatrics / 10.08.2016

MedicalResearch.com Interview with: Paula Lozano, MD MPH Associate Medical Director, Research and Translation Group Health Physicians Senior Investigator Group Health Research Institute Metropolitan Park East Seattle, WA 98101 MedicalResearch.com: What is the background for this study? Response: This wasn’t a study, but rather a study of studies, to support the US Preventive Services Task Force in updating its previous recommendation of I: insufficient to assess the balance of benefits and harms. We conducted two systematic evidence reviews of screening children and adolescents: 1. for familial hypercholesterolemia (FH, a genetic disorder that interferes with the body’s ability to metabolize cholesterol and can result in early coronary heart disease); and 2. for multifactorial dyslipidemia—which we defined as elevated LDL cholesterol or total cholesterol, not caused by familial hypercholesterolemia. LDL and total cholesterol were of interest because they are considered atherogenic. One of the challenges of lipid screening in youth is that blood levels of these atherogenic lipids are known to fluctuate during the course of childhood and adolescence. It’s sort of a W-shaped curve, with a peak at age 9-11 years. So for a given child, the definition of what’s an elevated LDL or total cholesterol level will change with age. Also, two-thirds of kids identified as having high cholesterol through universal screening would not go on to have high cholesterol as adults. (more…)