Medical Research Journals

23 Jul

Posted at 11:29h in Author Interviews, CMAJ, Heart Disease, Lifestyle & Health, Stroke
MedicalResearch.com Interview with: [caption id="attachment_43236" align="alignleft" width="159"]Dr. Doug Manuel MD, MSc, FRCPC Professor and Senior Scientist Ottawa Hospital Research Institute | L’Institut de Recherche de l’Hôpital d’Ottawa Department of Family Medicine, University of Ottawa Départment de Médicine Familiale Université d’Ottawa  Dr. Manuel[/caption] Dr. Doug Manuel MD, MSc, FRCPC Professor and Senior Scientist Ottawa Hospital Research Institute | L’Institut de Recherche de l’Hôpital d’Ottawa Department of Family Medicine, University of Ottawa Départment de Médicine Familiale Université d’Ottawa  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A lot of people are interested in healthy living, but often we don't have that discussion in the doctor's office," says Dr. Manuel, who is also a professor at the University of Ottawa. "Doctors will check your blood pressure and cholesterol levels, but they don't necessarily ask about lifestyle factors that could put you at risk of a heart attack and stroke. We hope this tool can help people — and their care team — with better information about healthy living and options for reducing their risk of heart attack and stroke." "What sets this cardiovascular risk calculator apart is that it looks at healthy living, and it is better calibrated to the Canadian population," says Dr. Doug Manuel, lead author, senior scientist at The Ottawa Hospital and a senior core scientist at the Institute for Clinical Evaluative Sciences (ICES).” 

22 Jul

Posted at 11:33h in Author Interviews, Education, Gender Differences, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_43304" align="alignleft" width="151"]Julie Silver, MD Associate Professor and Associate Chair Department of Physical Medicine and Rehabilitation at Harvard Medical School and staff physician at Massachusetts General Brigham and Women’s and Spaulding Rehabilitation Hospitals Dr. Silver[/caption] Julie Silver, MD Associate Professor and Associate Chair Department of Physical Medicine and Rehabilitation at Harvard Medical School and Staff physician at Massachusetts General Brigham and Women’s and Spaulding Rehabilitation Hospitals  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many documented disparities for women in medicine that include promotion and compensation. For physicians in academic medicine, both promotion and compensation may be directly or indirectly linked to publishing. Similarly, opportunities that stem from publishing such as speaking engagements, may be affected by a physician’s ability to publish. For more than twenty years, there have been reports of women being underrepresented on journal editorial boards and gaps in their publishing rates. For example, a report titled “Is There a Sex Bias in Choosing Editors?” by Dickersin et al was published in JAMA in 1998 and made a compelling case for bias. Moreover, the authors noted that “a selection process favoring men would have profound ramifications for the professional advancements and influence of women”. Despite a steady stream of reports over the years, gaps have not been sufficiently addressed, and in 2014 Roberts published an editorial in Academic Psychiatry titled “Where Are the Women Editors?”. The 2017 review by Hengel titled “Publishing While Female” highlights many of the gaps, disparities and barriers for women in medicine. Conventional reasons for disparities, such as there are not enough women in the pipeline or women do not want to conduct research or pursue leadership positions, are simply not valid. Therefore, it is important to look at other barriers, such as unconscious (implicit) bias that may affect the editorial process. In this study, we analyzed perspective type articles from four high impact pediatric journals. We selected pediatrics, because most pediatricians are women, and therefore there are plenty of highly accomplished women physicians. We found that women were underrepresented among physician first authors in all of the journals (140 of 336 [41.7%]). We also found that underrepresentation was more pronounced in article categories that were described as more scholarly (range, 15.4%-44.1%) versus narrative (52.9%-65.6%). 

20 Jul

Posted at 14:31h in Author Interviews, CDC, Infections, JAMA
MedicalResearch.com Interview with: [caption id="attachment_40787" align="alignleft" width="160"]Dr. Katherine Fleming-Dutra, MD, senior author Deputy Director Office of Antibiotic Stewardship CDC Dr. Fleming-Dutra[/caption] Dr. Katherine Fleming-Dutra MD Deputy Director Office of Antibiotic Stewardship CDC MedicalResearch.com: What is the background for this study? Response: Antibiotics are life-saving medications that treat bacterial infections. Any time antibiotics are used, they can lead to antibiotic resistance and could cause side effects such as rashes and adverse events, such as Clostridium difficile infection, which is a very serious and sometimes even fatal diarrheal disease. This is why it is so important to only use antibiotics when they are needed. When antibiotics aren’t needed, they won’t help you and the side effects could still hurt you. A previous study* reported at least 30% of antibiotic prescriptions written in doctor’s offices and emergency departments were unnecessary. However, the data from that study did not include urgent care centers or retail health clinics. We conducted the current analysis to examine antibiotic prescribing patterns in urgent care centers, retail health clinics, emergency departments, and medical offices. *Fleming-Dutra, K., et al. (2016). "Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011." JAMA: the Journal of the American Medical Association 315(17): 1864-1873. https://jamanetwork.com/journals/jama/fullarticle/2518263

20 Jul

Posted at 12:09h in Author Interviews, Education, JAMA, Ophthalmology, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_43313" align="alignleft" width="132"]Aparna Raghuram, OD, PhD Optometrist, Department of Ophthalmology Instructor, Harvard Medical School Dr. Raghuram[/caption] Aparna Raghuram, OD, PhD Optometrist, Department of Ophthalmology Instructor, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Developmental dyslexia is a specific learning disability of neurobiological origin whose core cognitive deficit is widely believed to involve language (phonological) processing. Although reading is also a visual task, the potential role of vision has been controversial, and experts have historically dismissed claims that visual processing might contribute meaningfully to the deficits seen in developmental dyslexia. Nevertheless, behavioral optometrists have for decades offered vision therapy on the premise that correcting peripheral visual deficits will facilitate reading. Yet there is a surprising dearth of controlled studies documenting that such deficits are more common in children with developmental dyslexia, much less whether treating them could improve reading. In the present study, we simply assessed the prevalence and nature of visual deficits in 29 school aged children with developmental dyslexia compared to 33 typically developing readers. We found that deficits in accommodation 6 times more frequent in the children with developmental dyslexia and deficits in ocular motor tracking were 4 times more frequent. In all, more than three-quarters of the children with developmental dyslexia had a deficit in one or more domain of visual function domain compared to only one third of the typically reading group.

19 Jul

Posted at 19:50h in AHA Journals, Author Interviews, Heart Disease, Lipids, Menopause, University of Pennsylvania, Women's Heart Health
MedicalResearch.com Interview with: [caption id="attachment_36295" align="alignleft" width="160"]Samar R. El Khoudary, PhD, MPH, BPharm, FAHA Associate Professor, Epidemiology PITT Public Health Epidemiology Data Center University of Pittsburgh Pittsburgh, PA 15260  Dr. El Khoudary[/caption] Samar R. El Khoudary, Ph.D., M.P.H. BPharm, FAHA Associate Professor Department of Epidemiology University of Pittsburgh Graduate School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is based on the current measurements used to determine cardiovascular disease risk in postmenopausal women. Higher levels of HDL “good cholesterol” as measured by the widely available clinical test, HDL-Cholesterol, may not always be indicative of a lower risk of cardiovascular disease in postmenopausal women. HDL is a family of particles found in the blood that vary in sizes, cholesterol contents and function. HDL particles can become dysfunctional under certain conditions such as chronic inflammation. HDL has traditionally been measured as the total cholesterol carried by the HDL particles, known as HDL cholesterol. HDL cholesterol, however, does not necessarily reflect the overall concentration, the uneven distribution, or the content and function of HDL particles. We looked at 1,138 women aged 45 through 84 enrolled across the U.S. in the Multi-Ethnic Study of Atherosclerosis (MESA), a medical research study sponsored by the National Heart, Lung and Blood Institute of the National Institutes of Health (NIH). MESA began in 1999 and is still following participants today. We assessed two specific measurements of HDL: the number and size of the HDL particles and total cholesterol carried by HDL particles. Our study also looked at how age when women transitioned into post menopause, and the amount of time since transitioning, may impact the expected cardio-protective associations of HDL measures. Our study points out that the traditional measure of the good cholesterol, HDL cholesterol, fails to portray an accurate depiction of heart disease risk for postmenopausal women. We reported a harmful association between higher HDL cholesterol and atherosclerosis risk that was most evident in women with older age at menopause and who were greater than, or equal to, 10 years into post menopause. In contrast to HDL cholesterol, a higher concentration of total HDL particles was associated with lower risk of atherosclerosis. Additionally, having a high number of small HDL particles was found beneficial for postmenopausal women. These findings persist irrespective of age and how long it has been since women became postmenopausal. On the other hand, large HDL particles are linked to an increased risk of cardiovascular disease close to menopause. Women are subject to a variety of physiological changes in their sex hormones, lipids, body fat deposition and vascular health as they transition through menopause. We are hypothesizing that the decrease of estrogen, a cardio-protective sex hormone, along with other metabolic changes, can trigger chronic inflammation over time, which may alter the quality of HDL particles. Future studies should test this hypothesis. The study findings indicate that measuring size and number of HDL particles can better reflect the well-known cardio-protective features of the good cholesterol in postmenopausal women.

19 Jul

Posted at 19:11h in Author Interviews, Cost of Health Care, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_43292" align="alignleft" width="142"]Julie L. Hudson, PhD Center for Financing, Access, and Cost Trends Agency for Healthcare Research and Quality Rockville, Maryland Dr. Hudson[/caption] Julie L. Hudson, PhD Center for Financing, Access, and Cost Trends Agency for Healthcare Research and Quality Rockville, Maryland MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Since 2013, public coverage has increased not only among low-income adults newly eligible for Medicaid but also among children and adults who were previously eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Recent research has shown that growth in public coverage varied by state-level policy choices. In this paper we study the growth in public coverage (Medicaid/CHIP) for three population samples living in Medicaid Expansion states between 2013 and 2015: previously eligible children, previously eligible parents, and newly eligible parents by state-level marketplace policies (Note: eligibility refers to eligible for Medicaid/CHIP, eligibility for marketplace subsidized coverage). All marketplaces are required to assess each applicants’ eligibility for both the marketplace and for Medicaid/CHIP. States running state-based marketplaces are required to enroll Medicaid-/CHIP-eligible applicants directly into public coverage (Medicaid or CHIP), but states using federally-facilitated marketplaces can opt to require their marketplace to forward these cases to state Medicaid/CHIP authorities for final eligibility determination and enrollment. We study the impact of marketplace policies on public coverage by observing changes in the probability Medicaid-/CHIP-eligible children and parents are enrolled in public coverage across three marketplace structures: state-based marketplaces that are required to enroll Medicaid-/CHIP-eligible applicants directly into public coverage, federally-facilitated marketplaces in states that enroll Medicaid-/CHIP-eligible applicants directly into public coverage, and federally-facilitated marketplaces with no authority to enroll Medicaid-/CHIP-eligible applicants into public coverage. Supporting the existing literature, we find that public coverage grew between 2013-2015 for all three of our samples of Medicaid-/CHIP-eligible children and parents living in Medicaid expansion states. However, we show that growth in public coverage was smallest in expansion states that adopted a federally-facilitated marketplace and gave no authority to the marketplace to enroll Medicaid-/CHIP-eligible applicants directly into public coverage. Additionally, once we account for enrollment authority, we found no differences in growth of public coverage for eligible children and parents living in expansion states that adopted a state-based marketplace versus those in states that adopted a federally-facilitated marketplaces with the authority to directly enroll Medicaid-/CHIP-eligible applicants

19 Jul

Posted at 16:42h in Author Interviews, Biomarkers, Infections, NEJM, University of Pittsburgh
MedicalResearch.com Interview with: [caption id="attachment_43206" align="alignleft" width="200"]David T. Huang, MD, MPH Associate Professor, Critical Care Medicine, Emergency Medicine, Clinical and Translational Science Director, MACRO (Multidisciplinary Acute Care Research Organization) Director, CRISMA Administrative Core (Clinical Research, Investigation, and Systems Modeling of Acute illness) University of Pittsburgh Dr. David Huang[/caption] David T. Huang, MD, MPH Associate Professor, Critical Care Medicine, Emergency Medicine, Clinical and Translational Science Director, MACRO (Multidisciplinary Acute Care Research Organization) Director, CRISMA Administrative Core (Clinical Research, Investigation, and Systems Modeling of Acute illness) University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: The overuse of antibiotics has become a serious threat to global public health, causing antibiotic resistance and increasing health care costs. Physicians have long known that antibiotics are usually unnecessary for acute bronchitis and for some other cases of lower respiratory tract infections, and that antibiotics treat only bacterial infections, not viral. But in daily practice, many physicians often prescribe them. Previous research had reported that using a biomarker blood test and following an antibiotic guideline tied to the test results could reduce antibiotic use in lower respiratory tract infections. In February 2017, the U.S. Food and Drug Administration approved the biomarker test that measures procalcitonin – a peptide that typically increases in bacterial infections, but not viral. We conducted the Procalcitonin Antibiotic Consensus Trial (ProACT) trial to evaluate whether a procalcitonin antibiotic prescribing guideline, implemented for the treatment of suspected lower respiratory tract infection with reproducible strategies, would result in less exposure to antibiotics than usual care, without a significantly higher rate of adverse events. The ProACT trial involved 14 predominately urban academic hospitals. We enrolled 1,656 adult patients who presented to the hospital emergency department and were initially diagnosed with a lower respiratory tract infection. All the patients were tested for their procalcitonin levels, but the results were shared only with the physicians of the patients randomly assigned to procalcitonin-guided antibiotic prescription.

19 Jul

Posted at 14:57h in Author Interviews, Heart Disease, JAMA, PAD, Stroke
MedicalResearch.com Interview with: [caption id="attachment_42708" align="alignleft" width="143"]Dr. Michael Barry MD Director of the Informed Medical Decisions Program Health Decision Sciences Center at Massachusetts General Hospital Physician at Massachusetts General Hospit Professor of Medicine,Harvard Medical School Dr. Barry[/caption] Dr. Michael Barry MD Director of the Informed Medical Decisions Program Health Decision Sciences Center at Massachusetts General Hospital Physician at Massachusetts General Hospit Professor of Medicine,Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Peripheral artery disease—which is known as PAD—is a disease that reduces blood flow to a person’s limbs, especially the legs. PAD can cause leg and foot pain when resting or walking, wounds to not heal properly, and loss of limbs. Additionally, people with PAD are more likely to experience a cardiovascular disease event, such as heart attack and stroke. The U.S. Preventive Services Task Force looked at the latest research to see if screening people without signs or symptoms of PAD using the ankle brachial index (ABI) can prevent heart attack, stroke, or other adverse health effects. We found that more research is needed to determine if screening with ABI can help to identify PAD and/or prevent heart attack or stroke in people without signs or symptoms. Additionally, in a separate recommendation statement, we looked into the effectiveness of what we call nontraditional risk factors for assessing a person’s risk of cardiovascular disease. Clinicians typically check someone’s risk for cardiovascular disease using traditional risk factors, such as age, race, and smoking status. The Task Force looked at the current evidence to see if three additional, nontraditional risk factors can help prevent heart disease or stroke. The nontraditional factors considered were ABI measurements, an elevated amount of high-sensitivity C-reactive protein (hsCRP) in the blood, and an elevated amount of calcium in the coronary arteries (CAC score). In this recommendation, we also found that there is insufficient evidence to recommend for or against using nontraditional risk factors in addition to those normally used to assess cardiovascular disease risk in people without signs or symptoms. 

19 Jul

Posted at 14:32h in Author Interviews, Dermatology, Environmental Risks, JAMA, Melanoma
MedicalResearch.com Interview with: “Sunscreen” by Tom Newby is licensed under CC BY 2.0Dr Caroline Watts  PhD Post-doctoral Researcher The University of Sydney. MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The study analysed data collected from nearly 1700 young Australians who participated in the Australian Melanoma Family Study, a population-based case-control-family study that focused on people who had a melanoma under 40 years of age and compared them with people the same age who did not have a melanoma. We examined sunscreen use during childhood and adulthood and its association with melanoma risk and found that compared to people who did not use sunscreen, regular sunscreen use during childhood reduced melanoma risk by 30-40 per cent. 

19 Jul

Posted at 14:24h in Author Interviews, BMJ, Boehringer Ingelheim, McGill, Pharmacology
MedicalResearch.com Interview with: [caption id="attachment_43242" align="alignleft" width="133"]Samy Suissa, PhD Director, Centre for Clinical Epidemiology, Lady Davis Institute Professor, Departments of Epidemiology and Biostatistics and of Medicine McGill University Dr. Suissa[/caption] Samy Suissa, PhD Director, Centre for Clinical Epidemiology, Lady Davis Institute Professor, Departments of Epidemiology and Biostatistics and of Medicine McGill University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sulfonylureas are widely used oral antidiabetic drugs that are recommended as second-line treatments after first-line metformin to treat patients with type 2 diabetes. While their safety has been studied extensively, studies in patients with poorly controlled diabetes in need of pharmacotherapy escalation have been sparse and limited. Our study evaluated whether adding or switching to sulfonylureas after initiating metformin treatment is associated with increased cardiovascular or hypoglycaemic risks, compared with remaining on metformin monotherapy. Using a large cohort of over 77,000 patients initiating treatment with metformin monotherapy, we found that adding or switching to sulfonylureas is associated with modest increases of 26% in the risk of myocardial infarction and 28% in the risk of death, as well as an over 7-fold major increase in the risk of severe hypoglycaemia leading to hospitalisation. In particular, we found that switching from metformin to sulfonylureas was associated with higher risks of myocardial infarction and death, compared with adding sulfonylureas to metformin. 

18 Jul

Posted at 18:47h in Author Interviews, Dermatology, Environmental Risks, Exercise - Fitness, JAMA
MedicalResearch.com Interview with: Sherry Pagoto, PhD Director, UConn Center for mHealth and Social Media President, Society of Behavioral Medicine UConn Institute for Collaboration in Health, Interventions, and Policy Professor, Department of Allied Health Sciences University of Connecticut Storrs, CT 06268 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent research has shown that while physical activity is associated with reduced risk for many cancers, it is associated with an increased risk for melanoma. We are not sure why this is the case, however, we have noticed that popular gym chains (e.g., Planet Fitness) often offer tanning beds, which are carcinogenic. We surveyed over 600 people who had used a tanning bed at least once in their life to see how many had used tanning beds in gyms. About one-quarter had used tanning beds in gyms and those folks actually tanned significantly more than people who had not tanned in gyms.  Gym tanners were also more likely to show signs of “tanning addiction.”  We also found an association between tanning and physical activity, such that the people who were the most physically active were the heaviest tanners. 

18 Jul

Posted at 18:26h in Annals Internal Medicine, Author Interviews, Hepatitis - Liver Disease, Kidney Disease, Transplantation
MedicalResearch.com Interview with: [caption id="attachment_43183" align="alignleft" width="140"]Mark H. Eckman, MD Posey Professor of Clinical Medicine Director, Division of General Internal Medicine Director, Center for Clinical Effectiveness University of Cincinnati Medical Center Cincinnati, OH Dr. Eckman[/caption] Mark H. Eckman, MD Posey Professor of Clinical Medicine Director, Division of General Internal Medicine Director, Center for Clinical Effectiveness University of Cincinnati Medical Center Cincinnati, OH  MedicalResearch.com: What is the background for this study? Response: People who are infected with hepatitis C virus and have kidney failure need a kidney transplant. Recent studies have found that it is possible to transplant kidneys from donors who are infected with hepatitis C virus into patients who need a transplant and are already infected with the virus. In addition, drugs are available to cure most patients of hepatitis C virus, including those who have kidney failure. Infected patients who need a kidney transplant have 2 options. One option is to receive an infected kidney and then use drugs after the transplant to cure themselves and the transplanted kidney of the virus. Another option is to use the drugs first to get rid of the virus and then to receive a kidney from a donor who does not have hepatitis C virus infection. For the more than 500,000 patients receiving dialysis for end-stage renal disease (ESRD), less than 4% receive kidney transplants. Because of the limited organ availability, hemodialysis is the final treatment for most patients with ESRD. Of the 10% or so of U.S. patients receiving dialysis who are infected with the hepatitis C virus (HCV), some are willing to accept HCV-infected kidneys, in part, because the wait times for such kidneys are shorter than those for HCV-uninfected kidneys. Because the yearly mortality rate for patients receiving hemodialysis is so high, between 4% and 16%, reducing the time to kidney transplant can have a dramatic effect on both survival and quality of life. Because it may not be possible to do this type of research with actual people, we created a model that allowed us to estimate possible outcomes without using actual people. The model was a computer program that combined the best available information to approximate what might happen to participants in a real-world clinical trial.

17 Jul

Posted at 14:27h in Author Interviews, ENT, JAMA, Neurology, Pain Research

MedicalResearch.com Interview with: Jen-Tsung Lai, MD Department of Otolaryngology Kuang-Tien General Hospital Shalu, Taichung, Taiwan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cochlear Migraine( CM ) is a new proposed diagnosis in 2018. CM could present as fluctuating hearing loss or sudden hearing loss that provoked the tinnitus. Furthermore , CM with...

17 Jul

Posted at 00:43h in Author Interviews, Heart Disease, Hospital Readmissions, JACC, Outcomes & Safety
MedicalResearch.com Interview with: [caption id="attachment_43117" align="alignleft" width="146"]Professor Mamas Mamas (BM BCh, MA, DPhil, MRCP) Professor of Cardiology at Keele University and an Honorary Professor of Cardiology at the University of Manchester Prof. Mamas[/caption] Professor Mamas Mamas (BM BCh, MA, DPhil, MRCP) Professor of Cardiology at Keele University and an Honorary Professor of Cardiology at the University of Manchester MedicalResearch.com: What is the background for this study? Response: Discharge against medical advice occurs in 1 to 2% of all medical admissions but little / no data around how frequently this occurs in the context of PCI or the outcomes associated with such a course of action. We undertook this study to understand both how commonly discharge against medical advice occurs, the types of patients it occurs in and outcomes in terms of both readmission rates and causes of readmisison.  

17 Jul

Posted at 00:34h in Author Interviews, Clots - Coagulation, JAMA
MedicalResearch.com Interview with: [caption id="attachment_43084" align="alignleft" width="145"]David L. Brown, MD, FACC Professor of Medicine Cardiovascular Division Washington University School of Medicine St. Louis, MO 63110 Dr. Brown[/caption] David L. Brown, MD, FACC Professor of Medicine Cardiovascular Division Washington University School of Medicine St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is very little high quality data for use of IVC filters in general and no high quality data for using them in the population of patients who have had a DVT or PE and have a contraindication to anticoagulation. However, this is the patient population for which filters are most commonly placed. Using administrative, observational data, we found that IVC filter placement in this all-comer population was associated with an increased risk of 30-day mortality after adjusting for baseline differences and immortal time bias.

16 Jul

Posted at 18:20h in Allergies, Author Interviews, PLoS
MedicalResearch.com Interview with: “TOMATOES” by RubyGoes is licensed under CC BY 2.0Prof. Dr. rer. nat. Wilfried Schwab Technical University of Munich Center of Life and Food Science Weihenstephan Biotechnology of Natural Products Freising, Germany MedicalResearch.com: What is the background for this study? Response: The prevalence of food allergy is an increasing health problem. Although tomatoes are one of the most consumed vegetables worldwide and have health beneficial effects lowering the risk of cancer and cardiovascular diseases, patients suffering from birch pollen allergy can develop cross-reactivity after consumption of fresh tomatoes. The aim of this study was to develop an analytical method for the quantification of the birch-pollen homologous allergen Sola l 4 in various tomatoes cultivars. Furthermore, the effect of conventional or organic cultivation as well as processing techniques on Sola l 4 content was investigated.

15 Jul

Posted at 13:00h in Author Interviews, Depression, JAMA, OBGYNE
MedicalResearch.com Interview with: [caption id="attachment_43130" align="alignleft" width="175"]Rebecca Pearson, PhD Lecturer in Psychiatric Epidemiology Centre for Academic Mental Health School of Social & Community Medicine University of Bristol Dr. Pearson[/caption] Rebecca Pearson, PhD Lecturer in Psychiatric Epidemiology Centre for Academic Mental Health School of Social & Community Medicine University of Bristol MedicalResearch.com: What is the background for this study? What are the main findings?  Response: We know depression and anxiety are common in young women and during pregnancy when there are also implications for the developing child. It is therefore important to investigate whether symptoms are rising given the pressures of modern life. We found that compared to their mothers generation in the 1990s young pregnancy women today are more likely to be depressed. This was driven largely by symptoms of anxiety and feeling overwhelmed rather than feeling down. 

15 Jul

Posted at 01:50h in Author Interviews, Circadian Rhythm, Microbiome, Occupational Health, PNAS
MedicalResearch.com Interview with: [caption id="attachment_43172" align="alignleft" width="125"]Dr. Hans Van Dongen, PhD Director of the Sleep and Performance Research Center. ELSON S. FLOYD COLLEGE OF MEDICIN Washington State University Spokane, WA Dr. VAN DONGEN[/caption] Dr. Hans Van Dongen, PhD Director of the Sleep and Performance Research Center. ELSON S. FLOYD COLLEGE OF MEDICIN Washington State University Spokane, WA MedicalResearch.com: What is the background for this study? Response: Night shift workers are at increased risk of metabolic disorders, including obesity and type 2 diabetes, as well as cardiovascular disease, chronic kidney disease, and cancer. Although it is believed that the biological clock – the master circadian clock in the brain – plays an important role in these adverse chronic health consequences of night shift work, the underlying mechanisms are not well understood.

13 Jul

Posted at 16:27h in Author Interviews, Infections, PLoS
MedicalResearch.com Interview with: Nine-banded armadillo image credit: Dr. Richard Truman, USPHS, Public Domain (2014)John S. Spencer, Ph.D. Colorado State University Fort Collins, Colorado MedicalResearch.com: What is the background for this study? Where can armadillos be found? What are the main findings?  Response: The ancient disease leprosy, a disease causing skin lesions, nerve damage, disfigurement and disability, is caused by the bacterium Mycobacterium leprae, and is mainly spread by aerosol infection (coughing and sneezing) from human to human. It is rare in the United States (less than 200 cases on average per year), while it is endemic in Brazil, where over 25,000 new cases were diagnosed last year. In addition, zoonotic transmission of leprosy by nine-banded armadillos (Dasypus novemcintus, pictured at left) has been shown to occur in the southern United States, mainly in Texas, Louisiana and Florida. Nine-banded armadillos originated from South America, and expanded their range from Mexico into Texas in the 1800’s, eventually spreading north and east throughout the gulf states. People in Brazil, particularly in rural areas, hunt and kill armadillos as a dietary source of protein. In the small town of Belterra in western Pará state in the Brazilian Amazon region, a survey of 146 residents showed that around 65% of people had some contact with armadillos, through hunting, preparing the meat for cooking, or by eating them. A group of individuals who ate armadillos most frequently (more than once per month and up to twice a week) had a significantly higher antibody titer towards the M. leprae-specific antigen PGL-I and an almost two-fold higher risk of being diagnosed with disease, a significant risk.  

12 Jul

Posted at 21:50h in Author Interviews, Environmental Risks, PLoS, UCSF
MedicalResearch.com Interview with: [caption id="attachment_43120" align="alignleft" width="196"]Lara Cushing PhD Assistant Professor of Health Education, College of Health and Social Sciences San Francisco State University 1600 Holloway Avenue San Francisco, CA 94132 Dr. Cushing[/caption] Lara Cushing PhD Assistant Professor of Health Education, College of Health and Social Sciences San Francisco State University San Francisco, CA 94132 MedicalResearch.com: What is the background for this study? Response: More and more countries are adopting cap-and-trade programs as a way to reduce emissions of greenhouse gases to address climate change. These efforts can lead to short-term health benefits because when you reduce greenhouse gas emissions, you usually also reduce emissions other harmful air pollutants that can cause cardiovascular disease, asthma and cancer. However, environmental equity concerns were raised early on about whether cap-and-trade would result in localized differences in emissions reductions that would also result in uneven reductions in harmful co-pollutants, such as particulate matter and air toxics. This is because companies can trade pollution permits under a cap-and-trade system and choose to buy more permits rather than reduce their emissions locally. Prior studies show that low income communities and communities of color are much more likely to live near polluting industries.

11 Jul

Posted at 20:56h in Asthma, Author Interviews, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_43088" align="alignleft" width="128"]Aivaras Cepelis, MSci Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology Trondheim, Norway Aivaras Cepelis[/caption] Aivaras Cepelis, MSci Department of Public Health and Nursing, Faculty of Medicine and Health Science NTNU, Norwegian University of Science and Technology Trondheim, Norway MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation is the most common sustained, irregular and often rapid heart rate with a lifetime risk of 26%. The number of adults with atrial fibrillation is projected to double by 2050. Atrial fibrillation is also linked to adverse cardiovascular outcomes such as doubled risk of stroke and cardiovascular mortality. Therefore, we believe that research into the novel risk factors of the disease is highly warranted. One of the potential condition that could play a role in the growing prevalence of atrial fibrillation is asthma. Asthma is a chronic inflammatory airway disease, affecting as many as 30 million children and adults in Europe. High levels of systemic inflammation biomarkers have been reported in both uncontrolled asthmatics and patients with atrial fibrillation. Furthermore, beta-agonists, the most common prescribed asthma control medication, has been shown to influence heart rate and increase the risk of irregular heartbeat. However, research looking at asthma and atrial fibrillation link are lacking and no previous studies have assessed the dose-response relationship between levels of asthma control and atrial fibrillation. We utilized over 54 000 adults from a large well-defined Norwegian population cohort The Nord-Trøndelag Health Study (HUNT) to explore this association.

11 Jul

Posted at 13:51h in Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Pediatrics, Social Issues
MedicalResearch.com Interview with: [caption id="attachment_43004" align="alignleft" width="145"]Dr. Tessie W. October. MD, MPH Critical Care Specialist Children’s National Health System Dr. October[/caption] Dr. Tessie W. October. MD, MPH Critical Care Specialist Children’s National Health System  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This is a qualitative study that examines the impact of empathetic statements made by doctors on the ensuing conversation with families of critically ill children. We know families are more satisfied when doctors show empathy, but until this study, we did not know how these empathetic statements are received by families. In this study we found that doctors frequently respond to a family’s emotions by responding with empathy, but how the doctor presented that empathetic statement mattered. When doctors made an empathetic statement, then paused to allow time for a family’s response, the family was 18 times more likely to share additional information about their fears, hopes or values. Conversely, when doctors buried the empathetic statement within medical talk or if a second doctor interrupted, the empathetic statement frequently went unheard by the family.

10 Jul

Posted at 21:28h in Annals Internal Medicine, Author Interviews, Emory, Endocrinology, Heart Disease, Sexual Health, Thromboembolism
MedicalResearch.com Interview with: [caption id="attachment_43071" align="alignleft" width="150"]Michael Goodman, MD, MPH Professor of Epidemiology Director, MD/MPH program Emory University School of Public Health Atlanta, GA  30322 Dr. Goodman[/caption] Michael Goodman, MD, MPH Professor of Epidemiology Director, MD/MPH program Emory University School of Public Health Atlanta, GA  30322 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is a concern that hormone therapy may be associated with higher risk of certain cardiovascular problems such as heart attacks, stroke and formation of blood clots (“venous thromboembolism”). To study this concern we examined data on 4,960 transgender and gender non-conforming people enrolled in Kaiser Permanente health systems in Georgia, Northern California, and Southern California. They were matched to 48,686 cisgender men and 48,775 cisgender women.  Below are the main findings
  • Rates of venous thromboembolism in all transwomen were approximately twice as high as the rates among cisgender men or cisgender women. The data for stroke and myocardial infarction demonstrated little difference between transwomen and cisgender men, but 80% to 90% higher rates among transwomen compared to cisgender women.
  • When the analyses focused specifically on transwomen who started therapy with female hormone estrogen at Kaiser Permanente, the incidence of both venous thromboembolism and stroke was more clearly elevated relative to either reference group.  There was evidence that incidence of both of these conditions among transwomen was particularly increased two to six years after estrogen initiation. By contrast, the association between estrogen therapy and myocardial infarction was less evident due to relatively few observed events.
  • Transmen did not appear to have significantly higher rates of venous thromboembolism, ischemic stroke, or myocardial infarction than their non-transgender counterparts, but this group was rather young and included a relatively small proportion of participants who initiated their hormone therapy during the study.

10 Jul

Posted at 11:12h in Author Interviews, Cancer Research, Lancet
MedicalResearch.com Interview with: [caption id="attachment_43029" align="alignleft" width="190"]Paul Lyon DPhil, MRCS Academic Clinical Fellow in Radiology Oxford University Hospitals NHS Foundation Trust Oxford, UK Dr. Lyon[/caption] Paul Lyon DPhil, MRCS Academic Clinical Fellow in Radiology Oxford University Hospitals NHS Foundation Trust Oxford, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Delivering therapeutic doses of systemic chemotherapy to solid tumours, whilst ensuring side effects remain tolerable, has a presented a long-standing and unsolved challenge in oncology. With the advent of smart nanomedicines for clinical use, such as Lyso-Thermosensitive Liposomal Doxorubicin (LTLD, ThermoDox®, Celsion, USA), which has been formulated to release its doxorubicin content at 2.5°C above body temperature, there is now opportunity for targeted tumour therapy in combination with therapeutic devices. Much like a magnifying glass can focus energy from the sun to burn a hole in paper, ultrasound can be focused deep within the body to induce therapeutic effects in tumours, including ablation, hyperthermia and other bioeffects. Since its inception in the 1940s, focused (or therapeutic) ultrasound has evolved and is now FDA-approved for a variety of indications including ablation of several tumour types, virtue of being safe, non-invasive and non-ionising. Building on decades of preclinical research efforts worldwide, the TARDOX study is the first clinical trial to attempt triggered drug delivery to a target tumour non-invasively using an external focused ultrasound device. This phase 1 study which ran between March 2015-March 2017 in Oxford, UK, treated 10 patients with inoperable primary or secondary liver tumours which were either stable or refractory to previous chemotherapies. In each patient, a single intervention under general anaesthetic was performed during which a selected liver tumour was targeted and gently heated with focused ultrasound following an intravenous infusion of LTLD. Biopsies were used to determine the quantity of intratumoral doxorubicin before and after the ultrasound exposure. 

09 Jul

Posted at 12:18h in Author Interviews, JAMA, Opiods
MedicalResearch.com Interview with: [caption id="attachment_42968" align="alignleft" width="133"]Tyler Winkelman MD, MSc   Clinician-Investigator Division of General Internal Medicine, Hennepin Healthcare Center for Patient and Provider Experience, Hennepin Healthcare Research Institute Assistant Professor Departments of Medicine & Pediatrics University of Minnesota Dr. Winkelman[/caption] Tyler Winkelman MD, MSc  Clinician-Investigator Division of General Internal Medicine, Hennepin Healthcare Center for Patient and Provider Experience, Hennepin Healthcare Research Institute Assistant Professor Departments of Medicine & Pediatrics University of Minnesota MedicalResearch.com: What is the background for this study? Response: Opioid overdose deaths continue to escalate, and there have been reports that jails and prisons are bearing the brunt of the opioid epidemic. However, it wasn’t known, nationally, how many people who use opioids were involved in the criminal justice system. We also didn’t have recent estimates of common physical and mental health conditions among people with different levels of opioid use. We used two years of national survey data to understand these associations, which are critical in developing a public health response to the opioid epidemic.

09 Jul

Posted at 09:44h in Author Interviews, Colon Cancer, JNCI, NIH, Vitamin D
MedicalResearch.com Interview with: [caption id="attachment_42971" align="alignleft" width="160"]Stephanie J. Weinstein, M.S., Ph.D.  Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH  Dr. Weinstein[/caption] Stephanie J. Weinstein, M.S., Ph.D.  Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute, NIH   MedicalResearch.com: What is the background for this study?   Response: Vitamin D, known for its role in maintaining bone health, is hypothesized to lower colorectal cancer risk via several pathways related to cell growth and regulation. Previous prospective studies have reported inconsistent results for whether higher concentrations of circulating 25-hydroxyvitamin D, the accepted measure of vitamin D status, are linked to lower risk of colorectal cancer. The few randomized clinical trials of vitamin D supplementation and colorectal cancer completed thus far have not shown an effect; but study size, relatively short supplementation duration, and only moderate compliance may have contributed to their null findings. To address inconsistencies in prior studies on vitamin D, and to investigate associations in population subgroups, we harmonized and analyzed participant-level data from over 5,700 colorectal cancer cases who had blood collected before colorectal cancer diagnosis, and 7,100 matched cancer-free controls. Study participants were drawn from 17 prospective cohorts from the United States, Europe, and Asia and were followed for an average of 5.5 years (range: 1 – 25 years). We used a single, widely accepted assay and laboratory for new vitamin D measurements and calibrated existing vitamin D measurements. In the past, substantial differences between assays made it difficult to integrate vitamin D data from different studies. Our novel calibration approach enabled us to explore risk systematically over the broad range of vitamin D levels seen internationally. 

08 Jul

Posted at 16:31h in Author Interviews, Beth Israel Deaconess, HIV, Lancet, Vaccine Studies
MedicalResearch.com Interview with: [caption id="attachment_42987" align="alignleft" width="200"]Dan Barouch, M.D., Ph.D. Professor of Medicine Harvard Medical School Ragon Institute of MGH, MIT, and Harvard Director, Center for Virology and Vaccine Research Beth Israel Deaconess Medical Center Boston, MA 02215 Dr. Barouch[/caption] Dan Barouch, M.D., Ph.D. Professor of Medicine Harvard Medical School Ragon Institute of MGH, MIT, and Harvard Director, Center for Virology and Vaccine Research Beth Israel Deaconess Medical Center Boston, MA 02215 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study demonstrates that the mosaic Ad26/Env HIV vaccine candidate induced robust and comparable immune responses in humans and monkeys. Moreover, the vaccine provided 67% protection against viral challenge in monkeys.   

07 Jul

Posted at 12:20h in Author Interviews, BMJ, Clots - Coagulation, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_42974" align="alignleft" width="120"]Yana Vinogradova, PhD, Research Fellow Division of Primary Care, School of Medicine University of Nottingham Nottingham Dr. Vinogradova[/caption] Yana Vinogradova, PhD, Research Fellow Division of Primary Care, School of Medicine University of Nottingham Nottingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: Anticoagulants are prescribed for treatment and prevention of thrombosis and stroke but may lead to major bleeding.  Unlike the older drug warfarin, newer direct oral anticoagulants do not require regular blood tests but their safety was shown only in selected patients and in trial conditions. The study found that Direct Oral AntiCoagulants (DOACs) are safer than warfarin in terms of bleeding risks with apixaban being the safest. 

07 Jul

Posted at 12:14h in Author Interviews, Brigham & Women's - Harvard, Electronic Records, JAMA
MedicalResearch.com Interview with: [caption id="attachment_42960" align="alignleft" width="124"]Li Zhou, MD, PhD, FACMI Associate Professor of Medicine Division of General Internal Medicine and Primary Care Brigham and Women’s Hospital, Harvard Medical School Somerville, MA 02145 Dr. Li Zhou[/caption] Li Zhou, MD, PhD, FACMI Associate Professor of Medicine Division of General Internal Medicine and Primary Care Brigham and Women’s Hospital, Harvard Medical School Somerville, MA 02145 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Documentation is one of the most time-consuming and costly aspects of electronic health record (EHR) use. Speech recognition (SR) technology, the automatic translation of voice to text, has been increasingly adopted to help clinicians complete their documentation in an efficient and cost-effective manner. One way in which SR can assist this process is commonly known as “back-end” SR, in which the clinician dictates into the telephone, the recorded audio is automatically transcribed to text by an speech recognition engine, and the text is edited by a professional medical transcriptionist and sent back to the EHR for the clinician to review and sign. In this study, we analyzed errors at different processing stages of clinical documents collected from 2 health care institutions using the same back-end SR vendor. We defined a comprehensive schema to systematically classify and analyze these errors, focusing particularly on clinically significant errors (errors that could plausibly affect a patient’s future care). We found an average of 7 errors per 100 words in raw  speech recognition transcriptions, and about 6% of those errors were clinically significant. 96.3% of the raw speech recognition transcriptions evaluated contained at least one error, and 63.6% had at least one clinically significant error. However, the rate of errors fell significantly after review by a medical transcriptionist, and it fell further still after the clinician reviewed the edited transcript.

06 Jul

Posted at 13:27h in Author Interviews, Breast Cancer, Cancer Research, Cost of Health Care, JAMA

MedicalResearch.com Interview with:

[caption id="attachment_42920" align="alignleft" width="150"]Dr Nora Pashayan PhD Clinical Reader in Applied Health Research University College London Dept of Applied Health Research London  Dr. Pashayan[/caption]

Dr Nora Pashayan PhD

Clinical Reader in Applied Health Research

University College London

Dept of Applied Health Research

London 

MedicalResearch.com:  What is the background for this study?

Response: Not all women have the same risk of developing breast cancer and not all women have the same potential to benefit from screening.

 

If the screening programme takes into account the individual variation in risk, then evidence from different studies indicate that this could improve the efficiency of the screening programme. However, questions remain on what is the best risk-stratified screening strategy, does risk-stratified screening add value for money, and what are benefit and harm trade-offs.