Medical Research Journals

08 Jun

Posted at 19:24h in Abuse and Neglect, Author Interviews, Breast Cancer, JAMA, MD Anderson
MedicalResearch.com Interview with: Naoto Tada Ueno, M.D., Ph.D., F.A.C.P. Executive Director, Morgan Welch Inflammatory Breast Cancer Research Program and Clinic Section Chief, Section of Translational Breast Cancer Research, Department of Breast Medical Oncology Division of Cancer Medicine The University of Texas MD Anderson Cancer Center Houston, TXNaoto Tada Ueno, M.D., Ph.D., F.A.C.P. Executive Director, Morgan Welch Inflammatory Breast Cancer Research Program and Clinic Section Chief, Section of Translational Breast Cancer Research, Department of Breast Medical Oncology Division of Cancer Medicine The University of Texas MD Anderson Cancer Center Houston, TX   MedicalResearch.com: What is the background for this study? What are the main findings? Response: The best outcome of inflammatory breast cancer (IBC) is dependent on achieving a pathological completed response after neoadjuvant chemotherapy for primary inflammatory breast cancer, which is the most aggressive type of breast cancer. We have conducted extensive preclinical work, which showed that EGFR is a potential therapeutic targets of IBC. Based on this preclinical data, we have conducted a phase II study to determine the pathological complete response rate of panitumumab plus neoadjuvant chemotherapy for HER2 negative primary inflammatory breast cancer. 

08 Jun

Posted at 00:59h in Author Interviews, Autism, Blood Pressure - Hypertension, JAMA, OBGYNE, Pediatrics
MedicalResearch.com Interview with: “Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0Ali Khashan, PhD Senior Lecturer in Epidemiology School of Public Health & INFANT Centre University College Cork Cork, Ireland MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is some evidence to suggest an increased likelihood of neurodevelopmental disorders in relation to hypertensive disorders in pregnancy, however consensus is lacking. Considering hypertensive disorders in pregnancy are among the most common prenatal complication, we decided to synthesise the published literature on this topic by conducting a comprehensive systematic review and meta-analysis. Our main findings suggest that hypertensive disorders in pregnancy are associated with about 30% increase in the likelihood of autism spectrum disorders (ASD) and ADHD in the offspring, compared to offspring not exposed to hypertensive disorders in pregnancy.

07 Jun

Posted at 11:54h in Author Interviews, Dermatology, Hepatitis - Liver Disease, NEJM
MedicalResearch.com Interview with: [caption id="attachment_42257" align="alignleft" width="184"]Dr Christophe Corpechot Centre de Référence Maladie Rares: Maladies Inflammatoires des Voies Biliaires et Hépatites Auto-immunes (MIVB-H) Filière Maladies Rares: Maladies Rares du Foie de l’Adulte et de l’Enfant Hôpital Saint-Antoine (APHP) et Sorbonne Universités Paris Dr. Corpechot[/caption] Dr Christophe Corpechot Centre de Référence Maladie Rares: Maladies Inflammatoires des Voies Biliaires et Hépatites Auto-immunes (MIVB-H) Filière Maladies Rares: Maladies Rares du Foie de l’Adulte et de l’Enfant Hôpital Saint-Antoine (APHP) et Sorbonne Universités Paris MedicalResearch.com: What is the background for this study? Response: Primary biliary cholangitis (PBC, previously known as "primary biliary cirrhosis") is a rare, chronic, slowly progressive liver disease of unknown cause, mainly affecting women of middle age. It is characterized by serum marks of autoimmunity (specific auto-antibodies), chronic inflammation and destruction of small intra-hepatic bile ducts, and consequent bile secretion impairment (chronic cholestasis) leading to the progressive development of cirrhosis and liver failure. Ursodeoxycholic acid (UDCA) is the only first-line approved treatment for PBC. It improves the biochemical measures of cholestasis and prolongs survival without liver transplantation. However, 30% to 40% of UDCA-treated patients continue to have clinically significant abnormalities of their biochemical liver tests and those patients remain at high risk of developing end-stage liver disease complications. Recently (2016), obeticholic acid (OCA) in association with UDCA has been conditionally approved in patients with an inadequate response to UDCA. This approval (FDA, EMA) was based one the results of a 1-year randomized, double-blind, placebo-controlled trial of OCA in patients with an incomplete response or intolerance to UDCA (POISE trial). In this trial, OCA was shown to improve the biochemical features of cholestasis (alkaline phosphatase (ALP) level < 1.67 times the upper limit of the normal range and a reduction of at least 15% from baseline) but was associated with a significant increase of pruritus, a characteristic, potentially debilitating symptom of PBC. BEZURSO is the first ever placebo-controlled phase 3 trial of a fibrate (a class of drugs known to be agonists of the peroxisome proliferator-activated receptors alpha) in PBC. In this 2-year randomized double-blind trial, 100 patients with an incomplete response to UDCA were assigned to bezafibrate 400 mg/day (n=50) or placebo (n=50), all in association with continued UDCA therapy.

06 Jun

Posted at 12:40h in Addiction, Author Interviews, JAMA, Race/Ethnic Diversity
MedicalResearch.com Interview with: Randall C. Swaim, Ph.D. Senior Research Scientist and Director Linda R. Stanley, Ph.D. Senior Research Scientist Tri-Ethnic Center for Prevention Research Department of Psychology Colorado State University                           MedicalResearch.com: What is the background for this study? Response: American Indian adolescents consistently report the highest levels of substance use compared with other US racial/ethnic groups. The harm associated with these high rates of use include higher risk of developing a substance use disorder, more alcohol-related problems, including alcohol-attributable death, and other negative outcomes such as school failure. These findings point to the importance of continuing to monitor this group, particularly given changing trends in perceived harmfulness of illicit substances as new statutes alter access to medical and recreational use of cannabis.

05 Jun

Posted at 11:33h in Author Interviews, JNCI, Lung Cancer

MedicalResearch.com Interview with: Hilary Tindle, MD, MPH Associate Professor of Medicine and theWilliam Anderson Spickard, Jr., MD Chair in Medicine Founding Director of ViTAL, the Vanderbilt Center for Tobacco, Addiction and Lifestyle Division of Internal Medicine & Public Health and Vanderbilt Ingram Cancer Center (VICC) MedicalResearch.com: What is the background for this study? Response: Lung cancer is the most common...

05 Jun

Posted at 00:49h in Author Interviews, Breast Cancer, Chemotherapy, JAMA
MedicalResearch.com Interview with: [caption id="attachment_42177" align="alignleft" width="128"]Guy Jerusalem, MD, PhD CHU Sart Tilman Liege and Liege University Liege, Belgium Dr. Jerusalem[/caption] Dr. Guy Jerusalem, MD, PhD CHU Sart Tilman Liege and Liege University Liege, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Response: BOLERO-6 was conducted to fulfill postapproval regulatory commitments to the FDA and EMA to estimate treatment benefit with EVE + EXE vs EVE alone or CAP for ER+, HER2− ABC that had progressed on an NSAI. Everolimus plus exemestane has not previously been compared with everolimus alone or capecitabine in a randomized setting.Data describing everolimus alone are limited to a single phase 2 study of just 19 patients. Thus, the FDA deemed it important to ascertain the efficacy of everolimus alone for ER+ breast cancer, and to determine the contribution of exemestane to combination therapy with everolimus. Capecitabine is often the first chemotherapeutic agent given for ER+ breast cancer that has progressed on anti-estrogen therapy. It has a reported PFS of 4.1–7.9 months among patients with HER2-negative advanced breast cancer. However, it has a different safety profile to everolimus or exemestane, and a comparison of endocrine-based combination therapy with single-agent chemotherapy was yet to be conducted. The median PFS with EVE + EXE (8.4 months) was consistent with BOLERO-2 (7.8 months), and compared to EVE alone here (6.8 months) corresponded to an estimated 26% reduction of risk of disease progression or death (HR 0.74). A numerical median PFS difference was observed for CAP over EVE + EXE (9.6 vs 8.4 months), which may be attributed to various baseline characteristics favoring CAP and potential informative censoring. The median PFS with capacitabine was longer than expected based on previous trials. Interpretation of the results of BOLERO-6 must consider the limited sample size and open-label design. 

04 Jun

Posted at 18:53h in Author Interviews, Education, JAMA
MedicalResearch.com Interview with: Kathleen M. Finn MD, MPhil Christiana Iyasere MD, MBA Division of General Internal Medicine Department of Medicine Massachusetts General Hospital, Boston MedicalResearch.com: What is the background for this study? Response: While the relationship between resident work hours and patient safety has been extensively studied, little research evaluates the role of attending supervision on patient safety. Beginning with the Bell Commission there have been increased calls for enhanced resident supervision due to patient safety concerns. At the same time, with the growth of the hospitalist movement more faculty physicians join daily resident work rounds under the assumption that increased supervision is better for patient safety and resident education. However, we know that supervision is a complex balancing act, so we wanted to study whether these assumptions were true. On the one hand patient safety is important, but on the other adult learning theory argues residents need to be challenged to work beyond their comfort level. Importantly, being pushed beyond your comfort level often requires appropriate space between teacher and learner. To investigate the role of attending supervision on patient safety and resident learning we studied the impact of two levels of physician supervision on an inpatient general medical team. Twenty-two teaching faculty were randomized to either direct supervision of resident teams for patients previously known to the team vs usual care where they did not join rounds but rather discussed the patients later with the team. Faculty participated in both arms of the study, after completing the first arm they then crossed over to the other arm; each faculty member participated in the study for a total of 4 weeks.

04 Jun

Posted at 18:12h in Author Interviews, Cancer Research, JAMA, MD Anderson

MedicalResearch.com Interview with: [caption id="attachment_42120" align="alignleft" width="183"] Dr. Sood[/caption] Dr. Anil K. Sood M.D. Professor and Vice Chair for Translational Research in the Departments of Gynecologic Oncology and Cancer Biology and co-director of the Center for RNA Interference and Non-Coding RNA MD Anderson Cancer Center MedicalResearch.com: What is the background for this study? Response: Cancer survivorship...

02 Jun

Posted at 15:19h in Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_41912" align="alignleft" width="125"]Dr-Jiang He Dr. Jiang He[/caption] Jiang He, MD, PhD Joseph S. Copes Chair of Epidemiology, Professor School of Public Health and Tropical Medicine Tulane University MedicalResearch.com: What is the background for this study? What are the main findings?   Response: The 2017 American College of Cardiology and American Heart Association hypertension guideline recommended lower blood pressure cut points for initiating antihypertensive medication and treatment goals than the previous hypertension guideline. We estimated the prevalence of hypertension and the proportion of the US adult population recommended for antihypertensive treatment according to the 2017 hypertension guideline. More importantly, we estimated the risk reductions of cardiovascular disease and all-cause mortality, as well as increases in adverse events, assuming the entire US adult population achieved the 2017 guideline-recommended systolic blood pressure treatment goals of less than 130 mmHg. Our study indicated the prevalence of hypertension was 45.4%, representing 105 million US adults with hypertension, according to the 2017 hypertension guideline. In addition, the proportion of individuals recommended for antihypertensive treatment was 35.9% or 83 million US adults. Based on data from the National Health and Nutrition Examination Survey, antihypertensive clinical trials, and US population-based cohort studies, we estimated 610 thousand cardiovascular disease events and 334 thousand total deaths could be prevented annually in the US population if the 2017 hypertension guideline systolic blood pressure treatment goals were achieved in the entire US population. Compared to full implementation of the previous hypertension guideline, we estimated the 2017 hypertension guideline recommendations would reduce an additional 340 thousand cardiovascular disease events and 156 thousand deaths per year in the US. Implementing the 2017 hypertension guideline was estimated to increase 62 thousand hypotension, 32 thousand syncope, 31 thousand electrolyte abnormality, and 79 thousand acute kidney injury or kidney failure events. These analyses indicated implementing the 2017 hypertension guideline would significantly increase the proportion of US adults recommended for antihypertensive treatment and further reduce cardiovascular disease events and all-cause mortality, but might increase the number of adverse events in the US population.

01 Jun

Posted at 23:27h in Author Interviews, Cancer Research, Leukemia, Nature, University of Pennsylvania
MedicalResearch.com Interview with: [caption id="attachment_42093" align="alignleft" width="148"]Dr. J Joseph Melenhorst, PhD Director, Product Development & Correlative Sciences laboratories (PDCS) Adjunct Associate Professor Penn Medicine Center for Cellular Immunotherapies University of Pennsylvania Dr. Melenhorst[/caption] Dr. J Joseph Melenhorst, PhD Director, Product Development & Correlative Sciences laboratories (PDCS) Adjunct Associate Professor Penn Medicine Center for Cellular Immunotherapies University of Pennsylvania MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by CLL and CAR T cells?  Response: We started treating patients with a form of blood cancer called CLL (chronic lymphocytic leukemia) using a form of gene therapy wherein we engineer the patient’s own immune cells – T cells – with a tumor targeting molecule: The CAR, which stands for chimeric antigen receptor. When we engineer the patient’s immune cells we use a vehicle, in this case virus, that inserts the payload – the CAR – into the patient’s DNA. The virus disappears, and the CAR stays. Where this CAR inserts itself is unpredictable, but we always get stably engineered cells. 

01 Jun

Posted at 10:58h in Author Interviews, Duke, Education, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_42058" align="alignleft" width="156"]Pamela S. Douglas, MD, MACC, FASE, FAHA Ursula Geller Professor of Research in Cardiovascular Disease Duke University School of Medicine  Durham, NC 27715    Dr. Douglas[/caption] Pamela S. Douglas, MD, MACC, FASE, FAHA Ursula Geller Professor of Research in Cardiovascular Disease Duke University School of Medicine Durham, NC 27715     MedicalResearch.com: What is the background for this study? What are the main findings? Response: For any profession to succeed, it needs to attract top talent. We surveyed internal medicine residents to find out what they valued most in their professional development, how they perceived cardiology as field and how these two areas are associated with  their choosing a career in cardiology or another specialty. We found that trainees were seeking careers that had stable hours, were family friendly and female friendly, while they perceived cardiology to  have adverse work conditions, interfere with family life and to not be diverse. We were able to predict career choice with 89-97% accuracy from these responses; the predictors are mix of things that attract to cardiology and those that are deterrents. For men, the attractors outnumber the deterrents, for women its just the opposite.

01 Jun

Posted at 10:55h in Author Interviews, Diabetes, Heart Disease, Lancet, Metabolic Syndrome, Weight Research
MedicalResearch.com Interview with: Nathalie Eckel, MSc German Diabetes Center Düsseldorf, Germany  MedicalResearch.com: What is the background for this study?  Response: Obesity is associated with metabolic disorders such as diabetes, high blood pressure and hypercholesterolemia, and with a higher risk of cardiovacular disease compared to normal weight. However, there is also the phenomenon of the so-called "metabolically healthy obesity" and "metabolically unhealthy normal-weight". So far it has been unclear how metabolic risk factors change over time in metabolically healthy people depending on body weight and what cardiovascular disease risk results from this.

01 Jun

Posted at 10:54h in Author Interviews, Heart Disease, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_41967" align="alignleft" width="133"]Harindra C. Wijeysundera MD PhD FRCPC FCCS FAHA Director of Research, Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre Senior Scientist, Sunnybrook Research Institute (SRI) Associate Professor, Dept. of Medicine & Institute of Health Policy, Management and Evaluation, University of Toronto Adjunct Senior Scientist, Institute for Clinical Evaluative Sciences (ICES) Dr. Wijeysundera[/caption] Harindra C. Wijeysundera MD PhD FRCPC FCCS FAHA Director of Research, Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre Senior Scientist, Sunnybrook Research Institute (SRI) Associate Professor, Dept. of Medicine & Institute of Health Policy, Management and Evaluation, University of Toronto Adjunct Senior Scientist, Institute for Clinical Evaluative Sciences (ICES) Toronto, ON, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the most common complications post TAVR is the need for a permanent pacemaker.  It is unclear if the need for a pacemaker is associated with long term adverse outcomes. Using a population level registry of all TAVR procedures in ontario, canada, we found that pacemakers were required in ~15% of cases.  Requiring a pacemaker was associated with worse long term outcomes, including death, readmission to hospital and emergency room visits. 

31 May

Posted at 20:35h in Author Interviews, Heart Disease, JACC, Supplements
MedicalResearch.com Interview with: “Pills Vitamins Macro April 22, 2012 4” by Steven Depolo is licensed under CC BY 2.0David J.A. Jenkins, MD, PhD, DSc Professor and Canada Research Chair in Nutrition and Metabolism Department of Nutritional Sciences University of Toronto  MedicalResearch.com: What is the background for this study? Response: The study was requested by the editor of JACC (Dr. Valentin Fuster) due to the widespread use of vitamin and mineral supplementation by the public and the requirement to know if there were any benefits or harms for cardiovascular disease. Our study was a follow-up to the US Preventive Services Task Force 2013 recommendations.

31 May

Posted at 12:48h in AHA Journals, Author Interviews, Heart Disease, Red Meat
MedicalResearch.com Interview with: “mmmm Meat” by Glen MacLarty is licensed under CC BY 2.0 Jyrki Virtanen, PhD Adjunct professor of nutritional epidemiology Heli Virtanen, MSc University of Eastern Finland Institute of Public Health and Clinical Nutrition Kuopio, Finland  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have found that animal sources of protein may have an adverse impact on the risk of cardiovascular diseases, like myocardial infarct, whereas plant sources of protein have had an opposite impact. In this study we investigated that how protein intake from different dietary sources is associated with developing heart failure in men during the study’s follow-up. During the mean follow-up time of about 22 years, 334 men developed heart failure. The main finding of the study was that higher protein intake was associated with a moderately higher risk of heart failure and the findings were similar with protein from most dietary sources, although the association was stronger with protein from animal sources. Only protein from fish and eggs were not associated with the risk in our study.

31 May

Posted at 11:49h in Author Interviews, JAMA, Thromboembolism, University of Michigan
MedicalResearch.com Interview with: Paul Grant, MD [caption id="attachment_41858" align="alignleft" width="125"]Associate Professor of Medicine Associate Chief Medical Information Officer Director, Perioperative and Consultative Medicine Division of Hospital Medicine Department of Internal Medicine Michigan Medicine University of Michigan Dr. Grant[/caption] Associate Professor of Medicine Associate Chief Medical Information Officer Director, Perioperative and Consultative Medicine Division of Hospital Medicine Department of Internal Medicine Michigan Medicine University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is well known that hospitalized medical patients are at risk for venous thromboembolism VTE, but the severity of patient risk can vary significantly. National guidelines have consistently stated that low-risk patients should not receive VTE prophylaxis beyond early ambulation. In this retrospective cohort study, we analyzed data from 52 hospitals participating in the Michigan Hospital Medicine Safety consortium. Trained medical record abstractors at each hospital collected data from 44,775 medical patients including VTE risk factors, type of VTE prophylaxis administered, and contraindications to pharmacologic prophylaxis. Individual patient risk of VTE was determined using the Padua risk assessment model. Of the 32,549 low-risk patients, 77.9% received excess venous thromboembolism prophylaxis as either pharmacologic prophylaxis (30.6%), mechanical prophylaxis (20.8%), or both (26.5%). In the 12,226 high-risk patients, VTE prophylaxis was underused in 22% of patients. The rates of inappropriate prophylaxis varied considerably by hospital. 

31 May

Posted at 11:48h in Author Interviews, CDC, JAMA, Neurological Disorders, Zika
MedicalResearch.com Interview with: [caption id="attachment_41893" align="alignleft" width="125"]Dr. Emilio Dirlikov, PhD Office of Epidemiology and Research, Puerto Rico Department of Health Epidemic Intelligence Service Division of Scientific Education and Professional Development CDC Dr. Dirlikov[/caption] Dr. Emilio Dirlikov, PhD Office of Epidemiology and Research, Puerto Rico Department of Health Epidemic Intelligence Service Division of Scientific Education and Professional Development CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: After reporting local Zika transmission in December 2015, the Puerto Rico Department of Health (PRDH), US Centers for Disease Control and Prevention (CDC), and University of Puerto Rico began identifying cases of Guillain-Barré syndrome (GBS), testing specimens, and conducting follow-up telephone interviews after patients left the hospital. Through these efforts, we were able to characterize acute clinical features and long-term disability of GBS associated with Zika infection by analyzing data from GBS patients with and without evidence of Zika infection. This investigation increases scientific and medical understanding of Guillain-Barré syndrome following Zika infection, provides insight into the disease processes involved in GBS following Zika infection, and adds to growing evidence of a causal association between Zika and GBS. 

30 May

Posted at 19:29h in Author Interviews, JAMA, Obstructive Sleep Apnea, Sexual Health, Sleep Disorders

MedicalResearch.com Interview with: [caption id="attachment_38315" align="alignleft" width="200"] One CPAP modelImage by Bryan Alexander[/caption] Sebastian M. Jara, MD Resident Physician & Research Fellow Department of Otolaryngology - Head & Neck Surgery University of Washington Affiliated Hospitals  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Sleep apnea is a common disorder associated with...

30 May

Posted at 19:04h in Author Interviews, JAMA
MedicalResearch.com Interview with: “Stop smoking!” by Emil_95 is licensed under CC BY 2.0Shahrokh F. Shariat, M.D. Professor and Chairman Department of Urology, Comprehensive Cancer Center Medical University Vienna Adjunct Professor of Urology and Medical Oncology Weill Medical College of Cornell University, New York, NY, USA Adjunct Professor of Urology UT Southwestern, Dallas, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that tobacco smoking produces more than 70 carcinogens and is associated with worse prognosis in many solid cancers. Although the association between cigarette smoking and prostate cancer death has been demonstrated, such association regarding other end points is still unclear. We evaluated different disease endpoints, such as recurrence, occurrence of metastasis and cancer-specific mortality at an earlier stage of disease. We found that smokers who underwent primary treatment for localized prostate cancer - such as radical prostatectomy and radiotherapy - are at increased risk of recurrence, metastasis and cancer-specific mortality. 

30 May

Posted at 10:42h in Author Interviews, Cost of Health Care, Critical Care - Intensive Care - ICUs, End of Life Care, NEJM, University of Pittsburgh
MedicalResearch.com Interview with: [caption id="attachment_42024" align="alignleft" width="160"]Douglas B. White, M.D., M.A.S. Director of the Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center’s Program on Ethics and Decision Making in  Department of Critical Care Medicine University of Pittsburgh  Dr. White[/caption] Douglas B. White, M.D., M.A.S. Director of the Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center’s Program on Ethics and Decision Making in  Department of Critical Care Medicine University of Pittsburgh  MedicalResearch.com: What is the background for this study?  Response: We set out to test the effectiveness of PARTNER (PAiring Re-engineered ICU Teams with Nurse-driven Emotional Support and Relationship-building). PARTNER is delivered by the interprofessional team in the ICU, consisting of nurses, physicians, spiritual care providers, social workers and others who play a part in patient care. The program is overseen by nurse-leaders in each ICU who receive 12 hours of advanced communication skills training to support families. The nurses meet with the families daily and arrange interdisciplinary clinician-family meetings within 48 hours of a patient coming to the ICU. A quality improvement specialist helps to incorporate the family support intervention into the clinicians’ workflow. PARTNER was rolled out at five UPMC ICUs with different patient populations and staffing. It was implemented in a staggered fashion so that every participating ICU would eventually get PARTNER. Before receiving PARTNER, the ICUs continued their usual methods of supporting families of hospitalized patients. None of the ICUs had a set approach to family communication or required family meetings at regular intervals before receiving PARTNER. A total of 1,420 adult patients were enrolled in the trial, and 1,106 of these patients’ family members agreed to be a part of the study and its six-month follow-up surveys. The patients were very sick, with about 60 percent dying within six months of hospitalization and less than 1 percent living independently at home at that point.

30 May

Posted at 10:22h in Author Interviews, Gender Differences, JAMA
MedicalResearch.com Interview with: [caption id="attachment_41906" align="alignleft" width="125"]Julia Raifman, ScD SM Assistant Professor Health Law, Policy, and Management Boston University School of Public Health Boston, MA 02118 Dr. Raifman[/caption] Julia Raifman, ScD SM Assistant Professor Health Law, Policy, and Management Boston University School of Public Health Boston, MA 02118 MedicalResearch.com: What is the background for this study? What methods did you use? What are the main findings? Response: The study was motivated by evidence that lesbian, gay, and bisexual (LGB) people in the United States have elevated levels of depression, anxiety, suicide, and mental distress. LGB mental health disparities have been linked to experiences of stigma based on sexual orientation, but most of this evidence comes from studies of association. We were interested in investigating how state policies permitting the denial of services to same-sex couples affected the mental health of LGB individuals. We used data that are representative of all adults in each of the nine states included in the study, from the 2014 to 2016 waves of the Behavioral Risk Factor Surveillance System (BRFSS). The main outcome was mental distress, which can include stress, depression, and problems with emotions. We evaluated changes in mental distress among LGB adults in three states that passed policies permitting the denial of services to same-sex couples compared to changes in mental distress among heterosexual adults in the same states and among LGB adults in six control states. We controlled for all state characteristics that did not change over time, as well as individual age group, race, ethnicity,  sex, educational attainment, employment, income, and marital status. 

30 May

Posted at 10:20h in Author Interviews, BMJ, Depression, Weight Research
MedicalResearch.com Interview with: Dr Rafael Gafoor Research Associate Kings College London  MedicalResearch.com: What is the background for this study? Response: Obesity and weight gain are global public health problems, with approximately 60% of UK adults currently overweight or obese. Depression is common in people who are severely obese and the rate of antidepressant prescribing is increasing, which could have potential impact on public health. However, little research has been reported on the impact of widespread antidepressant treatment on weight gain. So a UK based research team, led by Rafael Gafoor at King’s College London, set out to investigate the association between the use of antidepressants and weight gain. The researchers analysed body weight and body mass measurement data from the UK Clinical Practice Research Datalink (CPRD) for over 300,000 adults with an average age of 51, whose body mass index (BMI) had been recorded three or more times during GP consultations from 2004-2014. Participants were grouped according to their BMI (from normal weight to severely obese) and whether or not they had been prescribed an antidepressant in a given year. Participants were then monitored for a total of 10 years.

30 May

Posted at 10:18h in Author Interviews, Dermatology, JAMA
MedicalResearch.com Interview with: [caption id="attachment_42016" align="alignleft" width="180"]Andrew Blauvelt, M.D., M.B.A. President Oregon Medical Research Center  Dr. Blauvelt[/caption] Andrew Blauvelt, M.D., M.B.A. President Oregon Medical Research Center  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This new paper focuses on treatment of psoriasis in classically difficult-to-treat areas of the body, which include the scalp, the palms/soles, and the fingernails. We show that guselkumab, which is a new biologic therapy that selectively targets IL-23 (a key pro-inflammatory cytokine in psoriasis pathogenesis), works well in these areas affected by psoriasis. More specifically, after 6 months of treatment with guselkumab, approximately 85%, 80%, and 60% of patients achieved complete or near complete clearance of psoriasis in their scalp, palms/soles, and fingernails, respectively. 

24 May

Posted at 20:14h in Author Interviews, Cancer Research, Gender Differences, Lung Cancer, NEJM, Smoking, Tobacco Research
MedicalResearch.com Interview with: “Woman smoking” by Pedro Ribeiro Simões is licensed under CC BY 2.0Ahmedin Jemal, DVM, PHD Scientific Vice President, Surveillance & Health Services Rsch American Cancer Society, Inc. Atlanta, GA 30303 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Historically, lung cancer rates have been higher in men than women at all ages because of the substantially higher cigarette smoking prevalence in men. However, cigarette smoking prevalences over the past few decades have become similar between young men and women. Consistent with this pattern, we previously reported the convergence of lung cancer rates between young men and young women. In this paper, we examined the lung cancer incidence rates in young women versus young men in the contemporary cohorts. We found that the historically higher lung cancer incidence rates in young men than in young women have reversed in whites and Hispanics born since the mid-1960s. However, this emerging incidence patterns were not fully explained by sex difference in smoking prevalence as cigarette smoking prevalences among whites and Hispanics were not higher in young women than young men.

24 May

Posted at 13:18h in Author Interviews, JAMA, Melanoma, UCLA
MedicalResearch.com Interview with: Joann G. Elmore, MD, MPH Professor of Medicine David Geffen School of Medicine at UCLA Director of the UCLA National Clinician Scholars Program Affiliate Professor of Medicine, University of Washington School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In a recent study published in 2017 in the British Medical Journal, our team found that pathologists disagreed on their diagnoses of some melanocytic skin biopsy lesions and early stage invasive melanoma more than 50% of the time. This concerning level of disagreement was particularly true for diagnoses in the middle of the disease spectrum, such as atypical lesions and melanoma in situ.  For example, Figure 1 from this paper shows the diagnoses of 36 pathologists who interpreted the same glass slide of a skin biopsy using their own microscopes; the diagnoses ranged from a benign lesion to invasive melanoma. Since that study, the American Joint Committee on Cancer has released new guidelines for melanoma staging. Given this change, we wanted to examine whether the updated guidelines improved the reliability of melanoma diagnosis. We found that using the new guidelines improved the accuracy of pathologists’ diagnoses for invasive melanoma (Elmore J, et al, JAMA Network Open 2018). 

23 May

Posted at 11:59h in Author Interviews, Cost of Health Care, End of Life Care, Geriatrics, JAMA, Medicare
MedicalResearch.com Interview with: [caption id="attachment_41835" align="alignleft" width="125"]William B Weeks, MD, PhD, MBA The Dartmouth Institute Dr. Weeks[/caption] William B Weeks, MD, PhD, MBA The Dartmouth Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for the study is that a common narrative is that end-of-life healthcare costs are driving overall healthcare cost growth.  Growth in end-of-life care has been shown, in research studies through the mid 2000’s, to be attributable to increasing intensity of care at the end-of-life (i.e., more hospitalizations and more use of ICUs). The main findings of our study are that indeed there have been substantial increases in per-capita end-of-life care costs within the Medicare fee-for-service population between 2004-2009, but those per-capita costs dropped pretty substantially between 2009-2014.  Further, the drop in per-capita costs attributable to Medicare patients who died (and were, therefore, at the end-of-life) accounts for much of the mitigation in cost growth that has been found since 2009 in the overall Medicare fee-for-service population.

23 May

Posted at 11:57h in Author Interviews, JAMA, NIH
MedicalResearch.com Interview with: [caption id="attachment_41923" align="alignleft" width="146"]Jennifer Villani, PhD, MPH Office of Disease Prevention National Institutes of Health Dr. Villani[/caption] Jennifer Villani, PhD, MPH Office of Disease Prevention National Institutes of Health MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The US Preventive Services Task Force (USPSTF) develops recommendations for the delivery of clinical preventive services based on the highest quality scientific evidence available. We performed a comprehensive assessment of the sources of funding for the research studies in this evidence base. The results showed that government agencies supported the most articles (56%), with the remaining support coming from nonprofits or universities (32%), and industry (17%). The National Institutes of Health was the single largest funder of research articles underlying the USPSTF recommendations. 

22 May

Posted at 21:20h in Asthma, Author Interviews, NEJM
MedicalResearch.com Interview with: [caption id="attachment_41963" align="alignleft" width="133"]Mario Castro, M.D., M.P.H. Alan A. and Edith L. Wolff Professor of Pulmonary and Critical Care Medicine, Professor of Medicine, Pediatrics, and Radiology Washington University School of Medicine  Drr. Castro[/caption] Mario Castro, M.D., M.P.H. Alan A. and Edith L. Wolff Professor of Pulmonary and Critical Care Medicine, Professor of Medicine, Pediatrics, and Radiology Washington University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This is a confirmatory phase 3 pivotal study that assessed the efficacy and safety of dupilumab in a population of uncontrolled moderate to severe asthmatics. This was the largest phase 3 placebo controlled trial conducted in this population evaluating a biologic. It enrolled patients without any minimum requirement for any type of biomarker such as blood eosinophils. It clearly confirmed the efficacy of dupilumab in reducing severe asthma exacerbations, improving lung function, asthma control and quality of life in the overall population. It also showed that patients with evidence of type 2 inflammation (increased blood eosinophils or exhaled NO) had a greater magnitude of effect.

22 May

Posted at 19:56h in Author Interviews, Brain Injury, Environmental Risks, Science, UCSF
MedicalResearch.com Interview with: “Space Shuttle Model” by terren in Virginia is licensed under CC BY 2.0Susanna Rosi, PhD Director of Neurocognitive Research Brain and Spinal Injury Center Professor in the departments of Physical Therapy and Rehabilitation Science and of Neurological Surgery UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: NASA and private space companies like SpaceX plan to send humans to the red planet within the next 15 years — but among the major challenges facing future crewed space missions is how to protect astronauts from the dangerous cosmic radiation of deep space. In this study we identified the first potential treatment for the brain damage caused by exposure to cosmic rays — a treatment can be given after exposure and that prevents memory impairment in mice exposed to simulated space radiation.

22 May

Posted at 17:31h in Author Interviews, Depression, Emory, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_41942" align="alignleft" width="150"]Viola Vaccarino, MD, PhD Department of Epidemiology and Division of Cardiology Professor, Department of Medicine Emory University School of Medicine Atlanta, Georgia Dr. Vaccarino[/caption] Viola Vaccarino, MD, PhD Department of Epidemiology and Division of Cardiology Professor, Department of Medicine Emory University School of Medicine Atlanta, Georgia  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown that people with depression tend to have lower heart rate variability (HRV), an index of autonomic nervous system dysregulation derived by monitoring the electrocardiogram over time, usually for 24 hours. Other literature, however, has pointed out that autonomic dysregulation (as indexed by reduced HRV) may also cause depression. Thus, the direction of the association between reduced HRV and depression still remains unclear. In addition, these two characteristics could share common pathophysiology, making shared familial background and genetic factors potential determinants of this association.