Medical Research Journals

17 Aug

Posted at 22:42h in Author Interviews, Genetic Research, JAMA, OBGYNE
MedicalResearch.com Interview with: [caption id="attachment_27104" align="alignleft" width="200"]Gabriel Lazarin MS Vice President,Counsyl Medical Science Liaisons Gabriel Lazarin[/caption] 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.

17 Aug

Posted at 20:13h in Aging, Author Interviews, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_27134" align="alignleft" width="200"]Dr Janice Atkins Research Fellow Epidemiology and Public Health University of Exeter Medical School RD&E Hospital Wonford Barrack Road, Exeter Dr. Janice Atkins[/caption] Dr Janice Atkins Research Fellow Epidemiology and Public Health University of Exeter Medical School RD&E Hospital Wonford Barrack Road, Exeter MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have previously shown that having longer-lived parents increases your likelihood of living longer, and family history of heart attacks is already used by physicians to identify patients at increased risk of disease. However, it has been unclear how the health advantages of having longer lived parents is transferred to their middle-aged offspring. Our study of nearly 200,000 UK volunteers aged 55-73 at baseline, and followed for 8 years using health records data, found that having longer-lived parents reduced the risk of morbidity and mortality in the participants. We found that for each parent that lived beyond 70 years of age the participants had 20% less chance of dying from heart disease. To illustrate this, in a group of 1,000 people whose father’s died at 70 and followed for 10 years, on average 50 would die from heart disease. When compared to a group whose father’s died at 80, on average only 40 would die from heart disease over the same 10-year period. Similar trends were seen in the mother’s. The relationship between parental age at death and survival and health in their offspring is complex, with many factors playing a role. Shared environment and lifestyle choices play a large role, including smoking habits, high alcohol consumption, low physical activity and obesity; but even accounting for these factors parents lifespan was still predictive in their offspring. The biggest genetics effects on lifespan in our studies affected the participant’s blood pressure, their cholesterol levels, their Body Mass Index, and their likelihood to be addicted to tobacco. These are all factors that affect risk of heart disease, so is consistent with the lower rates of heart disease in the offspring.

16 Aug

Posted at 18:25h in Annals Internal Medicine, Author Interviews, Flu - Influenza, Pediatrics, Vaccine Studies
MedicalResearch.com Interview with: [caption id="attachment_26888" align="alignleft" width="150"]Dr. Mark Loeb BSc (McGill), MD (McGill), MSc (McMaster), FRCPC Professor, Department of Pathology and Molecular Medicine Joint Member, Dept of Clinical Epidemiology & Biostatistics Division Director, Infectious Diseases, McMaster University Dr. Mark Loeb[/caption] Dr. Mark Loeb BSc (McGill), MD (McGill), MSc (McMaster), FRCPC Professor, Department of Pathology and Molecular Medicine Joint Member, Dept of Clinical Epidemiology & Biostatistics Division Director, Infectious Diseases, McMaster University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is that in the U.S, the Advisory Committee on Immunization Practices (ACIP), the committee that advises the CDC on vaccination policy, decided this June not to recommend LAIV (nasal live vaccine) for children. This is because of non-randomized studies conducted in the U.S suggesting that the vaccine was ineffective. This was an unprecedented decision in influenza vaccine policy making for children. Our study, a randomized, blinded, controlled trial, which is the most rigorous type of study design, conducted over 3 years (2012-13, 2013-2014, 2014-2015 influenza seasons), showed in fact very similar protection for children and their communities for the live and inactivated vaccines. We conducted the study in the Hutterite community of Western Canada which allowed us to compare the effect of the vaccines in entire communities. That is, we were able to study the direct effect and the indirect effect of these vaccines.

16 Aug

Posted at 18:21h in Author Interviews, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_26934" align="alignleft" width="160"]Timothy C. Y. Chan, PhD Canada Research Chair in Novel Optimization and Analytics in Health Associate Professor, Mechanical and Industrial Engineering Director, Centre for Healthcare Engineering Department of Mechanical & Industrial Engineering Faculty of Applied Science & Engineering | University of Toronto Toronto Ontario Dr. Timothy Chan[/caption] Timothy C. Y. Chan, PhD Canada Research Chair in Novel Optimization and Analytics in Health Associate Professor, Mechanical and Industrial Engineering Director, Centre for Healthcare Engineering Department of Mechanical & Industrial Engineering Faculty of Applied Science & Engineering | University of Toronto Toronto Ontario MedicalResearch.com: What is the background for this study? What are the main findings? Response: The immediate access to and use of an automated external defibrillator (AED) can increase the likelihood of survival from out-of-hospital cardiac arrest (OHCA). Currently, guidelines for AED deployment focus only on spatial factors, such as where to place AEDs with respect to cardiac arrest risk, and assume that the buildings housing the AEDs are open and accessible 24 hours a day. However, this is not the case in reality. AED accessibility by time of day has largely been overlooked despite the fact that cardiac arrest incidence and survival vary by time of day and day of week. In this study we performed two main analyses, using data from Toronto, Canada. First, we determined the impact of accessibility on cardiac arrest coverage. That is, we determined what fraction of OHCAs occurred near a registered AED, but when that AED was unavailable based on the hours of operation of the building. Second, we developed a novel optimization model that identifies locations to place AEDs that maximize the number of out-of-hospital cardiac arrestswith an accessible AED nearby. We compared this approach to one where AEDs were placed guided by only spatial information. We found that of the OHCAs occurring within 100 m of an AED, approximately 21% occur when the AED is inaccessible. Nearby AEDs were inaccessible for 8.6% of OHCAs during the day (8 a.m. – 3:59 p.m.), 28.6% in the evening (4 – 11:59 p.m.) and 48.4% at night (midnight –7:59 a.m.). When applying our optimization model to determine new AED locations, we achieved a 25.3% relative increase in the number of out-of-hospital cardiac arrests that occur near an accessible AED over the spatial-only approach. The relative increase was 10.9% during the day, 38.0% in the evening, and 122.5% at night.

16 Aug

Posted at 18:14h in Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Education, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_26997" align="alignleft" width="225"]Rory Brett Weiner, MD Assistant Professor of Medicine Harvard Medical School Dr. Rory Brett Weiner[/caption] 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.

16 Aug

Posted at 18:11h in Author Interviews, JAMA, Pediatrics, Pharmacology
MedicalResearch.com Interview with: [caption id="attachment_26957" align="alignleft" width="200"]Dr Evie Stergiakouli Lecturer in Genetic Epidemiology and Statistical Genetics MRC Integrative Epidemiology Unit at the University of Bristol University of Bristol Bristol UK Dr. Evie Stergiakouli[/caption] 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.

16 Aug

Posted at 01:45h in Author Interviews, JAMA, Lipids
MedicalResearch.com Interview with: [caption id="attachment_27017" align="alignleft" width="142"]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 Dr. David Grossman[/caption] 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.

16 Aug

Posted at 00:15h in Author Interviews, Bone Density, Calcium, Mineral Metabolism, Nature
MedicalResearch.com Interview with: Dr. Constance Hilliard Department of History University of North Texas Denton, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: As an evolutionary historian, I have devoted the last several years to researching the health implications of genetic diversity. I was particularly concerned with the tendency of medical researchers to unwittingly use the biology of people with Northern European ancestry as a universal standard for everyone. For instance, lactose intolerance may be a disorder in that community, which suffers high rates of osteoporosis. But since 65% of the world’s population are lactose intolerant and have low rates of osteoporosis, a one-size-fits-all approach to bone health can prove dangerous for those whose ethnic-specific biological needs are overlooked. This study shows that osteoporosis is not a global problem. It has a strong and devastating impact in dairy-farming societies and is virtually non-existent in the tsetse zone of West Africa, where cattle rearing and dairying are not possible. Previous studies have tried to correlate the degenerative bone disease with socio-economic income. However, this study compares two regions of Africa with similar socio-economic conditions. In dairy-farming East Africa, the incidence of osteoporosis is 245 per 100,000. However in the tsetse belt of West Africa, where people do not consume dairy products, it is 3 per 100,000. When regression analyses are performed on 40 countries around the world, the association between dairy consumption and osteoporosis is high (0.851). It only correlates with national Gross National Product at a regression rate of 0.447.

14 Aug

Posted at 11:59h in Author Interviews, Cleveland Clinic, Genetic Research, Heart Disease, PLoS
MedicalResearch.com Interview with: [caption id="attachment_26978" align="alignleft" width="120"]MedicalResearch.com Interview with: Qing Kenneth Wang PhD, MBA Huazhong University of Science and Technology Wuhan, P. R. China and Department of Molecular Cardiology The Cleveland Clinic Cleveland, Ohio Dr. Qing Kenneth Wang[/caption] Qing Kenneth Wang PhD, MBA Huazhong University of Science and Technology Wuhan, P. R. China and Department of Molecular Cardiology The Cleveland Clinic Cleveland, Ohio MedicalResearch.com: What is the background for this study? What are the main findings? Response: Coronary Artery Disease (CAD) and its complication myocardial infarction (MI or so called heart attacks) are the most common causes of deaths in the US and other parts of the world. Based on the American Heart Association statistics, 620,000 Americans have a new MI each year in the United States alone, 295 000 have a recurrent MI, and nearly 400,000 of them will die from it suddenly. Moreover, an estimated 150,000 silent first MI occur each year. CAD and MI are caused by an occlusion or blockage of a coronary artery, which disrupts blood flow to the heart region, leading to damage or death of cardiac cells, impairment of cardiac function and sudden death. Current treatment of CAD and MI relies on reperfusion therapy with reopening of the occluded coronary artery with percutaneous coronary intervention (PCA) and coronary artery bypass surgery (CABG). However, 12% of patients are not candidates for PCA or CABG due to an unfavorable occlusive pattern, diffuse coronary atherosclerosis, small distant vessels and co-morbidities. An alternative revascularization strategy has to be developed to benefit these patients.

13 Aug

Posted at 12:54h in Author Interviews, JAMA, Smoking, Tobacco
MedicalResearch.com Interview with: [caption id="attachment_26969" align="alignleft" width="200"]Anna Pulakka PhD, Postdoctoral Researcher Department of Public Health University of Turku, Finland Dr. Anna Pulakka[/caption] 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.

12 Aug

Posted at 03:21h in Author Interviews, NEJM, Neurological Disorders, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_26807" align="alignleft" width="133"]Photograph: Douglas Levere Dr. Gil Wolfe[/caption] Gil I. Wolfe, MD, FAAN Irvin and Rosemary Smith Professor and Chair Dept. of Neurology/Jacobs Neurological Institute Univ. at Buffalo Jacobs School of Medicine and Biomedical Sciences/SUNY Buffalo General Medical Center Buffalo, NY 14203-1126 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Thymectomy has been used in myasthenia gravis (MG), in particular those patients who do not have a tumor of the thymus gland, known as a thymoma, for over 75 years without randomized data to support its use. A practice parameter in 2000 on behalf of the American Academy of Neurology stated that the benefits of thymectomy in this population of non-thymomatou smyasthenia gravis patients remained uncertain, classified thymectomy as a treatment option in this group, and called for rigorous, randomized studies. What we found is that compared to an identical prednisone protocol alone, that extended transsternal thymectomy confers significant benefits to non-thymomatous MG patients over a period of three years after the procedure. The benefits include better disease status, reduced prednisone requirements, fewer hospitalizations to manage  myasthenia gravis worsenings, and a lower symptom profile related to side effects from medications used to control the disease state.

12 Aug

Posted at 03:12h in Author Interviews, Brain Cancer - Brain Tumors, Cancer, Cost of Health Care
MedicalResearch.com Interview with: [caption id="attachment_26739" align="alignleft" width="180"]Wuyang Yang, M.D., M.S. Research Fellow Department of Neurosurgery Johns Hopkins Hospital Baltimore, MD 21287 Dr. Wuyang Yang[/caption] Wuyang Yang, M.D., M.S. Research Fellow Department of Neurosurgery Johns Hopkins Hospital Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The treatment for glioblastoma (GBM) patients involves a combined approach of surgery, radiation therapy and chemotherapy. Despite advancement in the therapeutic approaches for GBM, differing socioeconomic status result in disparities in health-care access, and may superimpose a significant impact on survival of glioblastoma patients. Insurance status is an indirect indicator of overall socioeconomic status of a patient, and has been shown to correlate with survival of patients with malignant tumor in other parts of the body. We conducted the first study to determine a relationship between different types of insurance and survival of GBM patients. In our study of 13,665 cases of GBM patients, we found that non-Medicaid insured patients have a significant survival benefit over uninsured and even Medicaid insured patients. This is the first time a study describes this relationship in glioblastoma patients, and also the first to compare and quantify the likelihood of poor prognosis between different insurance categories. A difference in insurance coverage was also uncovered, and patients with insurance were more likely to be older, female, white, and married. In addition, we found that younger, female, married patients with smaller tumor size survive longer than other patients, which confirmed findings in existing literature.

12 Aug

Posted at 03:02h in Author Interviews, Clots - Coagulation, Diabetes, Heart Disease, JACC
MedicalResearch.com Interview with: Raffaele Piccolo, MD Department of Cardiology Bern University Hospital University of Bern Bern, Switzerland MedicalResearch.com: What is the background for this study? Response: Over the past two decades, the prevalence of diabetes mellitus has doubled in Western countries and future projections are even worse by showing a 55% increase by 2035 when approximately 592 million of people are expected to live with diabetes all over the world. Acute myocardial infarction still represents the most common diabetes-related complication and its occurrence is associated with a higher risk of mortality. Timely recanalization of the occluded coronary vessel with primary percutaneous coronary intervention (PCI) represents the therapy of choice for acute ST-segment elevation myocardial infarction (STEMI). Our study investigated whether the direct application of an intracoronary bolus of abciximab, which is an antiplatelet drug blocking the glycoprotein IIb/III a receptor, at the time of primary PCI improves the outcomes at 1-year follow-up compared with the standard intravenous route. The study was in individual patient-level pooled analysis of 3 randomized trials including 2,470 patients, of whom 473 (19%) had diabetes.

12 Aug

Posted at 02:45h in Author Interviews, Heart Disease, JACC, Stroke, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_21314" align="alignleft" width="120"]Josep Rodés-Cabau, MD Director, Catheterization and Interventional Laboratories Quebec Heart and Lung Institute Professor, Faculty of Medicine, Laval University Quebec City, Quebec, Canada Dr. Josep Rodés-Cabau[/caption] Josep Rodés-Cabau, MD Director, Catheterization and Interventional Laboratories Quebec Heart and Lung Institute Professor, Faculty of Medicine, Laval University Quebec City, Quebec, Canada MedicalResearch.com: What is the background for this study? Response: Transcatheter aortic valve replacement (TAVR) is increasingly used in patients with severe aortic stenosis deemed at prohibitive or high surgical risk. Recently, a randomized trial demonstrated the non-inferiority of TAVR compared to surgical aortic valve replacement in intermediate risk patients for the outcome of death and disabling stroke at 2 years. Therefore, TAVR indications are likely to expand to younger and lower risk patients in the near future. While the short-term (30-day) cerebrovascular event (CVE) rate post-TAVR has decreased over time, it remains the most dreadful complication of TAVR, and still occurs in 2% to 3% of patients. A few dedicated studies identified numerous predictors of CVE which mainly differ from one study to another. However, identifying the risk factors of CVE is of paramount relevance in clinical practice to implement preventive strategies, either instrumental (embolic protection devices) or pharmacological in high-risk patients. Thus, we performed a systematic review and meta-analysis using random-effect models to provide pooled estimates of sixteen (8 patient-related and 8 procedural-related) clinically-relevant predictors of CVE within 30 days post TAVR.

11 Aug

Posted at 22:06h in Author Interviews, JAMA, Obstructive Sleep Apnea, Pulmonary Disease, Sleep Disorders
MedicalResearch.com Interview with: [caption id="attachment_26802" align="alignleft" width="150"]Ken Kunisaki, MD, MS Associate Professor of Medicine Minneapolis Veterans Affairs Health Care System and University of Minnesota Dr. Kunisaki[/caption] Ken Kunisaki, MD, MS Associate Professor of Medicine Minneapolis Veterans Affairs Health Care System and University of Minnesota and [caption id="attachment_26803" align="alignleft" width="98"]Roxanne Prichard, PhD Associate Professor of Psychology and Neuroscience University of St. Thomas Dr. Prichard[/caption] 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.

11 Aug

Posted at 22:01h in Author Interviews, Critical Care - Intensive Care - ICUs, Infections, JAMA, Mental Health Research
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.

11 Aug

Posted at 20:22h in Author Interviews, Genetic Research, JAMA, Melanoma
MedicalResearch.com Interview with: [caption id="attachment_26912" align="alignleft" width="150"]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 Dr. Ulrich Pfeffer[/caption] 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.

10 Aug

Posted at 10:25h in Aging, Author Interviews, BMJ, Geriatrics, Mental Health Research
MedicalResearch.com Interview with: [caption id="attachment_26773" align="alignleft" width="180"]Dr. Faiza Tabassum, PhD University of Southampton, Southampton Dr. Faiza Tabassum[/caption] Dr. Faiza Tabassum, PhD Southampton Statistical Sciences Research Institute  University of Southampton Southampton, UK MedicalResearch.com: What is the background for this study? Response: Previous research has shown that volunteering in older age is associated with better mental and physical health, but it’s unclear whether this extends to other age groups. We aimed to examine the association of volunteering with mental health or well-being among the British population across all ages. The British Household Panel Survey (BHPS) was used which has collected information from 1991 to 2008 from over 5000 households. The published study has analysed over 66,000 responses representing the whole of the UK. The BHPS included a wide range of questions on leisure time activities, which covered the frequency of formal volunteering—from at least once a week through to once a year or less, or never. The BHPS also included a validated proxy for mental health/emotional wellbeing known as the GHQ-12.

10 Aug

Posted at 02:13h in Author Interviews, JAMA, Lipids, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_26893" align="alignleft" width="142"]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 Dr. Paula Lozano[/caption] 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.

10 Aug

Posted at 02:06h in Author Interviews, Diabetes, JAMA, Kidney Disease
MedicalResearch.com Interview with: [caption id="attachment_26816" align="alignleft" width="133"]Ian de Boer, MD, MS Associate Professor of Medicine Adjunct Associate Professor of Epidemiology Division of Nephrology and Kidney Research Institute University of Washington, Seattle, WA Dr. Ian de Boer[/caption] Ian de Boer, MD, MS Associate Professor of Medicine Adjunct Associate Professor of Epidemiology Division of Nephrology and Kidney Research Institute University of Washington, Seattle, WA MedicalResearch.com: What is the background for this study? What are the main findings? Response: From the perspective of patients with diabetes, kidney disease can be a devastating complication, leading to end stage renal disease requiring dialysis or kidney transplantation and markedly increasing the risks heart disease, stroke, peripheral vascular disease, and amputation. From a public health perspective, diabetes is the most common cause of end stage renal disease in the US, so understanding, preventing, and treating diabetic kidney disease is critical to reduce the numbers of people needing dialysis and kidney transplants. There have been major changes in the treatment of patients with diabetes over the last 30 years, so we were interested in evaluating how diabetic kidney disease was changing in this context. We observed that the clinical manifestations of kidney disease have indeed changed among US adults with diabetes over the last 30 years. Albuminuria, or elevated levels of albumin in the urine, has traditionally been thought of as the first evidence of kidney damage for people with diabetes. Reduced GFR, or a reduced ability of the kidneys to filter out waster products, has typically been thought of as a late stage of diabetic kidney disease. But from 1988 to 2014, we saw a significant decrease in the prevalence of albuminuria accompanied by a significant increase in reduced GFR.

10 Aug

Posted at 01:02h in Author Interviews, JAMA, Opiods, Toxin Research
MedicalResearch.com Interview with: Ann M. Arens, MD California Poison Control Center San Francisco, CA 94110 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prescription opioid abuse is a significant public health threat that has garnered the attention of health care providers throughout medicine. With efforts to curb the number of prescriptions for opioid pain medications, users may begin to purchase prescription medications from illegal sources. Our study reports a series of patients in the San Francisco Bay Area who were exposed to counterfeit alprazolam (Xanax®) tablets found to contain large amounts of fentanyl, an opioid 100 times more potent than morphine, and in some cases etizolam, a benzodiazepine. The California Poison Control System – San Francisco division identified eight patients with unexpected serious health effects after exposure to the tablets including respiratory depression requiring mechanical ventilation, pulmonary edema, cardiac arrest, and one fatality. Patients reportedly purchased the tablets from drug dealers, and were unaware of their true contents. In one case, a 7 month-old infant accidentally ingested a counterfeit tablet dropped on the floor by a family member.

10 Aug

Posted at 00:25h in Author Interviews, BMJ, Psychological Science, Sexual Health
MedicalResearch.com Interview with: [caption id="attachment_26876" align="alignleft" width="205"]Steven Arnocky, PhD Associate Professor Department of Psychology Nipissing University North Bay, ON CAN Dr. Steven Arnocky[/caption] Steven Arnocky, PhD Associate Professor Department of Psychology Nipissing University North Bay, ON CAN  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our work was based on previous findings from hunter-gatherer populations showing that men who hunt and share meat often enjoy greater reproductive access to women.  Research in North America has shown that individuals prefer altruistic partners, especially for long-term mating, and that there may be a sex difference in these preferences such that women exhibit this preference more strongly than men. In line with this, some research has shown that men will sometimes compete with other men in order to make charitable donations to attractive female fundraisers (termed 'competitive altruism'). Taken together, these findings led us to hypothesise that individuals (and perhaps particularly men) who behave altruistically might experience greater mating success. In Study 1, undergraduate men and women completed a self-report altruism questionnaire (items such as “I have donated blood”), a personality measure, and a sexual history survey. We found that participants who scored higher on a self-report altruism measure reported they were more desirable to the opposite sex, as well as reported having more sex partners, more casual sex partners, and having sex more often within relationships. Moreover, altruism mattered more for men’s number of lifetime and casual sex partners relative to women’s. Given the possibility that in any survey research, there is a chance individual’s may report their altruism of sexual history in what they view to be a more positive light (who doesn’t want to think of themselves as altruistic!), in Study 2, we used a behavioral measure of altruism (each participant was entered onto a draw for $100, and at the end of the survey was given the choice to keep their winnings or to donate to a charity). Participants again reported on their sexual histories, as well as completed a personality measure, a scale to capture socially-desirable responding, and a measure of narcissism. Results showed that even when controlling for these potentially confounding variables, that altruists reported having more lifetime sex partners, more casual sex partners, and more sex partners over the past year. Men who were willing to donate also reported having more lifetime dating partners.

10 Aug

Posted at 00:18h in Author Interviews, Microbiome, Nature, Pediatrics, Pulmonary Disease

[caption id="attachment_26871" align="alignleft" width="139"] Dr. Lal[/caption] MedicalResearch.com Interview with: Charitharth ‘Vivek' Lal, MD Assistant Professor, Division of Neonatal-Perinatal Medicine, Departments of Pediatrics University of Alabama at Birmingham Birmingham, AL 35249-7335 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Airway microbiome of neonates, at birth, has not been studied. Also, association of airway...

08 Aug

Posted at 18:57h in Author Interviews, Endocrinology, JCEM, NIH, Vitamin D
MedicalResearch.com Interview with: [caption id="attachment_26830" align="alignleft" width="100"]Quaker Harmon M.D., Ph.D. Epidemiology Branch National Institute of Environmental Health Sciences Research Triangle Park, NC 27709 Dr. Quaker Harmon[/caption] Quaker Harmon M.D., Ph.D. Epidemiology Branch National Institute of Environmental Health Sciences Research Triangle Park, NC 27709 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vitamin D is important for bone health. In the United States many women are vitamin D deficient. Vitamin D does not naturally occur in many foods, however some foods are fortified with vitamin D. Supplements and sunshine are the most reliable sources of vitamin D. Previous studies suggested that women using birth control pills containing estrogen had higher levels of vitamin D. These studies were generally small and were not always able to examine important factors such as time spent outside. We were interested in examining the association between hormonal contraception and vitamin D levels in a larger group of women. We found that women who use estrogen-containing contraception had a 20% increase in their vitamin D levels. This increase was not due to time spent outside or behaviors related to choice of contraception. The magnitude of increase for hormonal contraception was smaller than for regular use of a supplement containing vitamin D.

08 Aug

Posted at 18:45h in Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA
MedicalResearch.com Interview with: [caption id="attachment_24380" align="alignleft" width="123"]Benjamin D. Sommers, MD, PhD Assistant Professor of Health Policy & Economics Harvard T. H. Chan School of Public Health / Brigham & Women's Hospital Boston, MA 02115 Dr. Benjamin D. Sommers[/caption] Benjamin D. Sommers, M.D., Ph.D Assistant Professor of Health Policy & Economics Department of Health Policy & Management Harvard T.H. Chan School of Public Health Assistant Professor of Medicine Division of General Medicine & Primary Care Brigham & Women’s Hospital / Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: More than half of states have expanded Medicaid under the Affordable Care Act, and several states have taken alternative approaches, such as using federal Medicaid funds to purchase private insurance for low-income adults. Our study looks at the effects of these two different approaches - vs. not expanding at all - in three southern states (Kentucky Arkansas, and Texas). What we find is that expanding coverage, whether by Medicaid (Kentucky) or private insurance (Arkansas), leads to significant improvements in access to care, preventive care, quality of care, and self-reported health for low-income adults compared to not expanding (Texas). The benefits of the coverage expansion also took a while to become evident - the first year of expansion (2014) showed some of these changes, but they become much more apparent in the second year (2015).

08 Aug

Posted at 17:47h in Author Interviews, Cost of Health Care, Critical Care - Intensive Care - ICUs, JAMA
MedicalResearch.com Interview with: Dong W. Chang, MD, MS Dong W. Chang, MD, is a lead researcher at LA BioMed, one of the nation’s leading independent nonprofit research institutes. His research interests include improving the delivery of care to patients with a focus on identifying new healthcare models for reducing hospital re-admission. He also is the director of Medical-Respiratory ICU at Harbor-UCLA Medical Center in Torrance MedicalResearch.com: What is the background for this study? What are the main findings? Response: With the use of intensive care units (ICUs) on the rise in many hospitals, researchers at LA BioMed and UCLA examined ICU usage. They found patients who were admitted to these units underwent more costly and invasive procedures but didn’t have better mortality rates than hospitalized patients with the same medical conditions who weren’t admitted to the ICU. The study, published in JAMA Internal Medicine, examined records from 156,842 hospitalizations at 94 acute care hospitals for four medical conditions where ICU care is frequently provided but may not be medically necessary:diabetic ketoacidosis, pulmonary embolism, upper gastrointestinal hemorrhage and congestive heart failure. The study found the hospitals that utilize ICUs more frequently were more likely to perform invasive procedures and incur higher costs. But the study found these hospitals had no improvement in mortality among patients in the ICU when compared with other hospitalized patients with these four conditions. Smaller hospitals and teaching hospitals used ICUs at higher rates for patients with the four conditions studied that did larger hospitals. The difference in the average costs ranged from $647 more for upper gastrointestinal hemorrhage care in the ICU to $3,412 more to care for a patient with congestive heart failure in the ICU when compared with hospital care for the same conditions outside the ICU.

08 Aug

Posted at 12:07h in Author Interviews, Exercise - Fitness, Hematology, NEJM, Stanford
MedicalResearch.com Interview with: D. Alan Nelson, MPAS, PhD Postdoctoral research fellow Stanford Medicine MedicalResearch.com: What is the background for this study? Response: The study was inspired by the uncertainty surrounding sickle cell trait (SCT) and its association with serious exertional collapse events and mortality in active populations. I conducted initial, exploratory analyses on these topics in 2014-15 while examining a range of military readiness predictors and outcomes. The early work indicated that the risk of mortality, rhabdomyolysis and other exertional events arising from SCT might be substantially lower than that suggested by prior work in the research literature. Dr. Lianne Kurina and I decided to conduct further, focused study at the Stanford University School of Medicine to confirm or refute these findings. In considering best approaches, we noted that there was an absence of prior research in which the  sickle cell trait status of an entire, large, physically-active study population was known. This limitation could introduce bias to inflate the apparent impact of a theorized predictive factor. Aside from the challenges in studying the impact of SCT on exertional outcomes, with respect to prevention, a further concern is that  sickle cell trait is a non-modifiable trait. If it were a serious risk factor for rhabdomyolysis and/or mortality, despite careful exertional injury precautions such as those employed by the Army, this might present great challenges for prevention efforts. To maximize the potential for new research to provide actionable prevention information, our interests included examining a range of modifiable risk factors for rhabdomyolysis. Dr. Kurina and I have employed large, longitudinal military datasets for about five years to examine critical military health outcomes, making this study a natural progression of our joint work. The research proceeded with the support of the Uniformed Services University of the Health Sciences, and in cooperation with a distinguished group of experts who co-authored the paper and advised the project. The study was conducted using de-identified records of all SCT-tested African American US Army soldiers on active duty during 2011 - 2014 (N = 47,944).

08 Aug

Posted at 11:39h in Author Interviews, Heart Disease, JACC
MedicalResearch.com Interview with: Ruben Casado-Arroyo, MD, PhD Heart Rhythm Management Center Cardiovascular Division, UZ Brussel–Vrije Universiteit Brussel, Cardiology Department, Arrhythmia Section Erasmus Hospital, Université Libre de Bruxelles Brussels, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of this study is to evaluate the evolution of the presentation of Brugada Syndrome (BrS) during the last 30 years. Only the first diagnosed patient of each family was included. The database was divided in two periods (early and latter group) in relation to the consensus conference of 2002. Aborted sudden death as the first manifestation of the disease occurred most frequently in the earlier period 12.1% versus 4.6% of the latter group. Inducibility (induction of ventricular fibrillation) during programmed electrical stimulation was achieved in 34.4% (earlier) and 19.2% (latter) of patients, respectively. A spontaneous type 1 electrocardiogram pattern that is a coved type ST elevation with at least 2 mm (0.2 mV) J-point elevation a gradually descending ST segment followed by a negative T-wave was presented at diagnosis 50.3% (earlier) versus 26.2% (latter patients). Early group patients had a higher probability of a recurrent arrhythmia (sudden cardiac death or ventricular arrhythmias) during follow-up (19%) than those of the latter group (5%). All these difference were significative. Overall, the predictors of recurrent arrhythmias were previous sudden cardiac death and inducibility. In the latter period, only previous sudden cardiac death was a predictor of arrhythmic events.

06 Aug

Posted at 13:18h in Author Interviews, Emory, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_26683" align="alignleft" width="133"]Dr. Amit J. Shah MD MSCR Research Assistant Professor Assistant Professor of Epidemiology Rollins School of Public Health Emory University Adjunct appointment in Medicine (Cardiology) Atlanta VA Medical Center Dr. Amit Shah[/caption] Dr. Amit J. Shah MD MSCR Research Assistant Professor Assistant Professor of Epidemiology Rollins School of Public Health Emory University Adjunct appointment in Medicine (Cardiology) Atlanta VA Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nearly ½ of sudden cardiac deaths occur in individuals who were not aware that they had heart disease; this increases the need for primary prevention. We studied whether the electrocardiogram could be a useful tool in helping to measure risk of cardiovascular disease in approximately 10,000 community-based adults aged 40-74 with a simple risk equation that is based on age, sex, and 3 numbers from the ECG: heart rate, T-axis, and QT interval. We found that such an equation estimates risk as well as the Framingham risk equation, which is the standard of care (based on traditional risk factors like smoking and diabetes). When combining both the Framingham and ECG risk assessments together, the accuracy improved significantly, with a net 25% improvement in the risk classification of cardiovascular death compared to using the Framingham equation alone.

06 Aug

Posted at 01:48h in Anemia, Author Interviews, Hematology, Lancet, Surgical Research
MedicalResearch.com Interview with: Clinical Professor Alhossain A.Khalafallah Menzies Institute for Medical Research, University of Tasmania, Australia Consultant Haematologist Senior Staff Specialist Launceston General Hospital, Australia MedicalResearch.com: What is the background for this study? Response: 1. Iron deficiency is one of the most common nutritional deficiencies worldwide, affecting up to one third of the population worldwide. 2. Prevalence of anaemia in orthopaedic surgery ranges between 10-20% with the main cause of anaemia identified as nutritional deficiency. 3. New intravenous iron preparations have been developed at a higher purchase price than oral iron. Iron carboxymaltose, as one example, remains underutilised in the treatment of perioperative anaemia. 4. To our knowledge, this study is the first to compare the efficacy, safety and long term effect on iron stores and length of hospital stay in the postoperative anaemia setting.