Medical Research Journals

22 May Lack of Dialysis Access for Undocumented Immigrants Stresses Patients and Providers

Posted at 10:42h in Annals Internal Medicine, Author Interviews, Cost of Health Care, Kidney Disease

MedicalResearch.com Interview with: [caption id="attachment_41937" align="alignleft" width="133"]

Lilia Cervantes, M.D. Internal Medicine, Hospitalist Denver Health and Hospital Authority Assistant Professor, Division of General Internal Medicine Founder, Healthcare Interest Program and Health Equity Lecture Series at Denver Health University of Colorado Health Sciences Center

Dr. Cervantes[/caption] Lilia Cervantes, M.D. Internal Medicine, Hospitalist Denver Health and Hospital Authority Assistant Professor, Division of General Internal Medicine Founder, Healthcare Interest Program and Health Equity Lecture Series at Denver Health University of Colorado Health Sciences Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: For most undocumented immigrants with kidney failure in the U.S., access to hemodialysis is limited and they can only receive it when they are critically ill and near-death. This type of “emergency-only” hemodialysis is already known to be nearly 4-fold more costly, has 14-fold higher mortality rate, and leads to debilitating physical and psychosocial distress for these patients compared to those receiving regular hemodialysis. This study shows that clinicians who are forced to provide this substandard care are also harmed. They experience moral distress, emotional exhaustion, and several other drives of professional burnout due to witnessing needless suffering and high mortality.

22 May Amyloid Biomarker Predictive of Mortality in Non-STEMI Heart Attack

Posted at 10:01h in Annals Internal Medicine, Author Interviews, Biomarkers, Heart Disease

MedicalResearch.com Interview with: [caption id="attachment_41928" align="alignleft" width="200"]

Prof. Dr. med. Konstantinos Stellos,MD, FAHA, FESC Cardiovascular Research Centre, Institute of Genetic Medicine Newcastle upon Tyne United Kingdom

Prof. Stellos[/caption] Prof. Dr. med. Konstantinos Stellos,MD, FAHA, FESC Cardiovascular Research Centre, Institute of Genetic Medicine Newcastle upon Tyne United Kingdom MedicalResearch.com: What is the background for this study? Response: Risk stratification of patients with a non-ST-segment elevation acute coronary syndrome (NSTE-ACS) remains a major challenge in clinical cardiology. Risk stratification is important to identify patients at high risk, to whom an early coronary intervention with optimal adjunctive medical therapy shall be applied to reduce that risk. Conversely, it is equally important to identify patients at low risk, to whom a potentially hazardous invasive therapy or a multi-drug administration shall be avoided. Current ACC/AHA and ESC guidelines agree in a standardized approach that uses Global Registry of Acute Coronary Events (GRACE) score, a well validated scoring system, to calculate a patient’s risk and guide triage and management decisions. Amyloid-β (Aβ) 1-40 and 1-42 peptides (Aβ40 and Aβ42), are proteolytic fragments of a larger protein, the amyloid precursor protein (APP) cleaved by β- and γ-secretases, found in typical brain amyloid deposits in Alzheimer’s disease. Many lines of evidence support a role of Aβ40 in cardiovascular disease as a peptide with pro-inflammatory and pro-thrombotic properties. Most cardiovascular risk factors seem to affect APP metabolism and thus, Aβ production and its soluble circulating APP770 isoform are elevated in patients with ACS_ENREF_15, suggesting a role for Aβ40 in the triggering and outcome of ACS in stable CAD patients. Although vascular inflammation is considered as a hallmark in the pathophysiologic pathways of coronary artery disease (CAD) and novel mechanisms are continuously recognized in its pathogenesis, no inflammatory marker is currently recommended for risk stratification of patients with NSTE-ACS individually or as a component of the GRACE score. This may partly explain the moderate discriminative ability of GRACE score in some studies, especially in older patients and those after early percutaneous coronary intervention (PCI). In this retrospective study, we used data from two independent prospective cohorts, the Heidelberg study (n=1,145) and the validation multicenter international APACE (Advantageous Predictors of Acute Coronary Syndrome Evaluation, n=734) study and determined the clinical prognostic and reclassification value of baseline circulating Aβ40 levels in the prediction of mortality over the GRACE risk score in patients with NSTE-ACS across a median follow-up of 21.9 ( Heidelberg cohort) and 24.9 months (APACE cohort), respectively.

21 May Multiple Myeloma Cases and Deaths Increase Worldwide

Posted at 21:55h in Author Interviews, Global Health, JAMA, Leukemia

MedicalResearch.com Interview with: [caption id="attachment_41916" align="alignleft" width="125"]

Dr. Cowan[/caption] Andrew J. Cowan, MD Seattle Cancer Care Alliance Division of Medical Oncology University of Washington, Seattle MedicalResearch.com: What is the background for this study? What are the main findings? Response: Multiple myeloma (MM) is a plasma cell neoplasm with substantial morbidity and mortality. A comprehensive description of the global burden of multiple myeloma is needed to help direct health policy, resource allocation, research, and patient care. Myeloma cases and deaths increased from 1990 to 2016, with middle-income countries contributing the most to this increase. Treatment availability is very limited in countries with low socioeconomic development.

21 May ADHD More Common in Grandchildren of Women Who Used DES During Pregnancy

Posted at 16:03h in ADHD, Author Interviews, Columbia, JAMA, Toxin Research

MedicalResearch.com Interview with:

Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University MedicalResearch.com: What is the background for this study? Response: The prevalence of neurodevelopmental disorders, like attention deficit/hyperactivity disorder (ADHD) has been increasing. One of the hypothesized risk factors for increased risk for neurodevelopmental disorders is a class of chemicals known as endocrine disrupting chemicals (EDCs). These chemicals are known to interfere with the endocrine system, i.e. the system that uses hormones to control and coordinate metabolism, reproduction and development. Several high production volume chemicals, ubiquitously present in commercial products, are known or suspected endocrine disruptors. Because of their widespread use in consumer products, the population-wide exposure to known and suspected EDCs is very high. Recently, there has been increased attention in the potential effects of EDCs on neurodevelopment that span multiple generations. Animal studies have provided evidence that exposure to EDCs, such as phthalates and bisphenol A (BPA), alter the behavior and social interactions in mice in three to five generations after exposure. However, evidence of such multi-generational impacts of EDC exposure on neurodevelopment in humans is unavailable, likely because of the lack of detailed information on exposures and outcomes across generations. For this study we leveraged information from a nationwide cohort, the Nurses’ Health Study II (NHSII), to investigate the potential link between exposure to diethylstilbestrol (DES) and third generation ADHD, i.e. ADHD among the grandchildren of the women who used DES while pregnant. DES is a very potent endocrine disruptor that was prescribed between 1938 and 1971 to pregnant women thought to prevent pregnancy complications. In the United States, between 5 and 10 million women are estimated to have used DES, although the exact number is not known. DES was banned in 1971, when was linked to vaginal adenocarcinomas (a rare cancer of the reproductive system) in the daughters of the women who had used it during pregnancy. Since then, DES has been also linked to multiple other reproductive outcomes in DES daughters, as well as with some reproductive outcomes in the grandchildren of the women who used it, such as hypospadias and delated menstrual regularization. However, to our knowledge, no study to date has evaluated the association between DES, or any other EDC, and multigenerational neurodevelopment.

21 May Early Study Demonstrates Airways Can Be Transplanted from Aortic Templates

Posted at 14:49h in Author Interviews, JAMA, Pulmonary Disease, Stem Cells, Transplantation

MedicalResearch.com Interview with: Emmanuel Martinod MD PhD Assistance Publique–Hôpitaux de Paris, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Paris 13, Sorbonne Paris Cité, UFR Santé, Médecine et Biologie Humaine, Bobigny, Université Paris Descartes, Fondation Alain Carpentier, Laboratoire de Recherche Bio-chirurgicale, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou Paris, France MedicalResearch.com: What is the background for this exciting new technology and study? What are the main findings? Response: What is the background for this exciting new technology and study? What are the main findings? Response: The background is 10 years of research at laboratory followed by 10 years of academic clinical research. We demonstrated the feasability of airway bioengeenring using stented aortic matrices for complex tracheal or bronchial reconstruction.

21 May Does Chiropractic Care Benefit Low Back Pain?

Posted at 10:47h in Author Interviews, JAMA, Orthopedics, Pain Research

MedicalResearch.com Interview with: Christine Goertz DC, PhD Vice Chancellor for Research and Health Policy Palmer College of Chiropractic MedicalResearch.com: What is the background for this study? Response: Low back pain in the leading cause of physical disability worldwide, with up to 80% of US adults seeking care for this debilitating condition at some point in their lives. Low-back pain is also one of the most common causes of disability in U.S. military personnel. Although a number of studies have previously evaluated chiropractic care for low back pain, the vast majority had small sample sizes and did not study chiropractic as part of a multi-disciplinary approach to care in real world settings, including the military.

19 May Oral Anticoagulants Still Underused in AFib Patients

Posted at 11:16h in Author Interviews, Heart Disease, JAMA, Stroke

MedicalResearch.com Interview with: Anna Gundlund, MD, PhD Herlev-Gentofte Hospital, Department of Cardiology Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atrial fibrillation increases a person’s risk of ischemic strokes up to 5-fold. Oral anticoagulation therapy lowers this risk effectively (>60%) and is therefore recommended for patients with atrial fibrillation and at least 1-2 other risk factors for stroke. Our study show, that oral anticoagulation therapy is still underused in patients with atrial fibrillation – even after a stroke event. In stroke survivors with atrial fibrillation, oral anticoagulation therapy were associated with better outcomes than no oral anticoagulation therapy.

18 May LPA Gene Variants Linked To Cardiac Events Despite Statins

Posted at 12:20h in AHA Journals, Author Interviews, Genetic Research, Heart Disease, Lipids, Vanderbilt

MedicalResearch.com Interview with: [caption id="attachment_41816" align="alignleft" width="161"]

Dr. Wei-Qi Wei[/caption] Wei-Qi Wei, MD, PhD Assistant Professor Department of Biomedical Informatics Vanderbilt University Nashville, TN 37203 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study was motived by the clinical observation that some patients develop coronary heart disease events despite taking statins, one of our most effective drugs to reduce cardiovascular risk. We collected data within the eMERGE network of people taking statins and monitored them for development of coronary heart disease events over time. We conducted a genome-wide association study of those with events compared to those without events. Our results showed that single nucleotide polymorphisms (SNPs) on the LPA gene were associated with a significantly increased risk of coronary heart disease events. Individuals with the variant were 50% more likely to have an event. More importantly, even among patients who achieved ideal on-treatment LDL cholesterol levels (<70 mg/dL), the association remained statistically significant. We then did a phenome-wide association study to see if other diseases or conditions were associated with these LPAvariants. The major associated conditions were all cardiovascular. This sort of study can highlight potential other indications for a drug targeting this pathway and suggest potential adverse events that might be experienced from targeting this pathway. Clearly, more and larger studies will be needed to truly understand the potential risks and benefits of a future drug targeting this pathway.

17 May Automated Bone Scan Index Correlates with Survival in Metastatic Prostate Cancer

Posted at 21:00h in Author Interviews, JAMA, Medical Imaging, Prostate Cancer, Technology

MedicalResearch.com Interview with: [caption id="attachment_41807" align="alignleft" width="156"]

Andrew J. Armstrong, MD ScM FACP Associate Professor of Medicine, Surgery, Pharmacology and Cancer Biology Associate Director for Clinical Research in Genitourinary Oncology Duke Cancer Institute Divisions of Medical Oncology and Urology Duke University

Dr. Armstrong[/caption] Andrew J. Armstrong, MD ScM FACP Associate Professor of Medicine, Surgery, Pharmacology and Cancer Biology Associate Director for Clinical Research in Genitourinary Oncology Duke Cancer Institute Divisions of Medical Oncology and Urology Duke University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Men with prostate cancer commonly develop bone metastases and undergo nuclear medicine bone scans. However, these scans are non-quantitative, and disease burden has been challenging to assess over time and to relate to clinical outcomes. We developed a software program and measurement called the automated bone scan index that essentially reads a standard of care nuclear bone scan, provides a quantitative metric, and demonstrate in a phase 3 trial that this aBSI is highly associated with clinical outcomes including survival, time to symptomatic progression, and prostate cancer specific survival. We accomplished this within a prospective phase 3 international trial of men with metastatic hormone resistant prostate cancer who were followed over a long period of time. All bone scans were read and measured using the aBSI at baseline, and we found that the aBSI was highly prognostic. This work validates prior smaller phase 2 BSI studies, and demonstrates both the feasibility and clinical utility for incorporating the aBSI into clinical practice to provide this important prognostic information to patients and providers.

17 May SKINDER App Teaches Intuitive Visual Diagnosis of Melanoma

Posted at 16:16h in Author Interviews, Dermatology, Education, JAMA, Melanoma

MedicalResearch.com Interview with: [caption id="attachment_41796" align="alignleft" width="200"]

Image from SKINDER APP[/caption] Michael S. Kolodney, MD, PhD Section of Dermatology, Department of Medicine West Virginia University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Melanoma is easily curable if recognized early. Dermatologists are good at spotting melanomas because they develop an innate sense of how melanomas appear after examining thousands of malignant and benign lesions. In contrast, most medical students are relatively disadvantaged by their limited dermatology exposure. We felt that too little experience, rather than lack of knowledge of the rules, is the primary barrier to development of pattern-recognition and intuition as a reliable tool for melanoma diagnosis in non-experts. To remedy this problem, we developed a novel web-based application to mimic the training of a dermatologist by teaching medical students intuitive melanoma diagnosis in a highly condensed period of time. Our application, which we call Skinder, teaches intuitive visual diagnosis of melanoma by quickly presenting the learner with thousands of benign and malignant skin lesions. The user makes rapid binary decisions, by swiping right for benign or left for malignant, and receives instant feedback on accuracy. With this application, the learner can amass a mental repository of diagnostic experience in a short amount of time. To determine if intuitive visual diagnosis training is superior to a traditional rule-based approach, we compared our web-based application to a rules based approach, the publicly available INFORMED Skin Education Series. Medical students were tested on the ability top differentiate melanomas from benign pigmented lesions before and after training with either Skinder of the Informed Skin Education Series. The pre-test mean for the Skinder group was 75% correct, compared to 74.7% correct for the INFORMED group. The post-test mean for the skinder application group was 86.3% correct, compared to 77.5% correct for the INFORMED group which was highly signifcant.

17 May Ibuprofen Can Not Replace Antibiotics in Uncomplicated UTI

Posted at 15:07h in Author Interviews, Infections, Pain Research, PLoS, Urinary Tract Infections

MedicalResearch.com Interview with: [caption id="attachment_41792" align="alignleft" width="150"]

Ingvild Vik MD Doctoral Research Fellow Department of General Practice Institute of Health and Society - UiO University of Oslo, Norway.

Dr. Vik[/caption] Ingvild Vik MD Doctoral Research Fellow Department of General Practice Institute of Health and Society - UiO University of Oslo, Norway MedicalResearch.com: What is the background for this study? Response: Uncomplicated urinary tract infection (UTI) is the most common bacterial infection in women. It is painful and troublesome, and even though it is often self-limiting most women who see a doctor will be prescribed an antibiotic, as antibiotics provide quick symptom relief. Antibiotic resistance is a growing, serious public health problem. Antibiotic use is the main contributor to antibiotic resistance, and to stop the rapid development it is crucial that we reduce unnecessary use of antibiotics. Antibiotics can cause unpleasant and potentially severe side effects, so avoiding unnecessary use is also beneficial for the individual patient. A small German trial published in 2010 by Bleidorn et al. suggested that ibuprofen was non-inferior to the antibiotic ciprofloxacin in achieving symptomatic cure in uncomplicated UTI. This inspired us to conduct a larger trial to compare the anti-inflammatory drug ibuprofen to antibiotics in the treatment of uncomplicated UTI.

17 May Functional Brain ‘Fingerprint’ Identified in Schizophrenia

Posted at 11:47h in Author Interviews, Genetic Research, JAMA, Schizophrenia

MedicalResearch.com Interview with: [caption id="attachment_41730" align="alignleft" width="162"]

Tobias Kaufmann UiO Institute of Clinical Medicine

Dr. Kaufmann[/caption] Tobias Kaufmann PhD Norwegian Centre for Mental Disorders Research (NORMENT), KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine University of Oslo, Oslo, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: Over the past years, a lot of work has pointed toward impaired brain networks in schizophrenia. With this work we assessed brain network stability across different loads of a cognitive task using functional magnetic resonance imaging of the brain. Based on our earlier work on adolescents with pre-clinical signs of mental illness who showed decreased stability of networks across different tasks and conditions, we hypothesized that brain networks in adults with schizophrenia show similar properties of decreased stability. Our results confirmed this hypothesis. Stability was reduced in several large-scale brain networks across the sampled age range from early adulthood to the sixties. Further, network stability was associated with polygenic risk for schizophrenia as well as cognitive task performance.

17 May Does Exercise Slow Dementia?

Posted at 11:42h in Author Interviews, BMJ, Depression, Exercise - Fitness

MedicalResearch.com Interview with: [caption id="attachment_41782" align="alignleft" width="200"]

Prof. Sarah E Lamb, MSc, MA, MCSP, Grad Dip Statistics, DPhil Centre for Rehabilitation Research and Centre for Statistics in Medicine Nuffield Department of Orthopaedics Rheumatology & Musculoskeletal Sciences Botnar Research Centre, University of Oxford, Oxford

Prof. Lamb[/caption] Prof. Sarah E Lamb, MSc, MA, MCSP, Grad Dip Statistics, DPhil Centre for Rehabilitation Research and Centre for Statistics in Medicine Nuffield Department of Orthopaedics Rheumatology & Musculoskeletal Sciences Botnar Research Centre, University of Oxford, Oxford MedicalResearch.com: What is the background for this study? What are the main findings? Response: Scientists and clinicians have considered the possibility that higher intensity aerobic and muscle strength training might have a beneficial effect in preventing dementia or slowing the progression of cognitive impairment in those who have dementia. The hypothesis has come mostly from animal research. The main findings of our research which used a large sample and high quality methods was that higher intensity exercise, whilst possible, did not slow cognitive impairment. Neither did it have an impact on the functional and behavioural outcomes for people with dementia. It was a substantial commitment for people to participate in the programmes, although many enjoyed the experience and their physical fitness improved.

16 May Disturbed Circadian Rhythm Associated With Poor Mental Health

Posted at 20:18h in Author Interviews, Circadian Rhythm, Lancet, Mental Health Research

MedicalResearch.com Interview with: [caption id="attachment_41693" align="alignleft" width="128"]

Dr. Lyall[/caption] Laura Lyall MA; MSc; PhD Research Associate Institute of Health and Wellbeing University of Glasgow MedicalResearch.com: What is the background for this study? Response: Previous studies have suggested a link between disturbed circadian rhythms and depression and bipolar disorder. These studies have however usually used small samples, subjective measures of circadian disruption, or have not accounted for potential confounding factors like sociodemographic and lifestyle characteristics. The UK Biobank cohort has accelerometry (activity monitor) data as well as mental health, lifestyle, BMI and sociodemographic data for over 91,000 individuals, and means we can address this question using objective measures of circadian rhythmicity on a large scale. We derived a measure of relative amplitude from the UK Biobank’s accelerometry data, which was recorded for 7 days between 2013-2014 from around 100,000 participants. Relative amplitude reflects the distinction, in terms of activity levels, between an individual’s most active 10 hours and least active 5 hours, in an average day. If an individual is inactive during the day, or has disturbed sleep at night, the will show low relative amplitude, consistent with disturbed circadian rest-activity patterns.

16 May Benefits of Clopidogrel and Aspirin In Minor Stroke and High-Risk TIA

Posted at 16:55h in Author Interviews, NEJM, Stroke, University Texas

MedicalResearch.com Interview with: [caption id="attachment_41746" align="alignleft" width="151"]

Dr. S. Claiborne "Clay" Johnston MD, PhD Dean Vice President for Medical Affairs Frank and Charmaine Denius Distinguished Dean’s Chair Dell Medical School The University of Texas at Austin

Dr. Johnston[/caption] Dr. S. Claiborne "Clay" Johnston MD, PhD Dean Vice President for Medical Affairs Frank and Charmaine Denius Distinguished Dean’s Chair Dell Medical School The University of Texas at Austin MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior studies have shown that the risk of a stroke or other ischemic events is high in the days to weeks after a TIA or minor stroke. We sought to test whether blocking platelet aggregation more effectively with clopidogrel plus aspirin could reduce this risk compared to aspirin alone. We found that the combination did reduce risk of major ischemic events. It also showed a small increase in risk of major hemorrhage, but for most people the benefits would outweigh the potential risk.

16 May Does Acupuncture Increase Live Births For Women Undergoing IVF?

Posted at 11:06h in Author Interviews, Fertility, JAMA, OBGYNE

MedicalResearch.com Interview with: Caroline Smith, PhD Professor Clinical Research Western Sydney University Research Theme Champion Health and Wellbeing MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite technological improvements to IVF the success of IVF treatment remains low. Consequently, new drugs, laboratory techniques and other treatments need to be developed and rigorously tested to explore their effects on producing healthy babies for women undergoing IVF. In 2002, the first randomised controlled trial of acupuncture administered a specific form of IVF acupuncture at the time of embryo transfer. The results indicated the chance of achieving a pregnancy from acupuncture was twice that to women undergoing IVF treatment alone. From mid 2000s many women have started to use adjunctive treatments such as acupuncture whilst undergoing IVF. We conducted and reported on a pilot study in 2006 which produced results suggesting a benefit. It is important that these findings were rigorously examined in a larger trial. Findings are presented from our trial presented in JAMA. Our study of over 800 Australian and New Zealand women undergoing acupuncture treatment during their IVF (in vitro fertilization) cycle has failed to confirm significant difference in live birth rates.

16 May Consumers Trying But Not Continuing E-Cigarettes

Posted at 10:41h in Author Interviews, JAMA, Smoking, Tobacco Research

MedicalResearch.com Interview with: Wei Bao, MD, PhD Assistant Professor Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although the health effects of e-cigarettes remains unclear, e-cigarettes have been marketed as an approach for smoking cessation. Previous studies have reported an increase in e-cigarette use in US people since 2010. The current study showed that from 2014 to 2016, there was an increase in ever use of e-cigarettes but decline in current use of e-cigarettes.

16 May Changes in Gestational Age and Perinatal Mortality in US

Posted at 10:35h in Author Interviews, JAMA, OBGYNE

MedicalResearch.com Interview with: [caption id="attachment_41636" align="alignleft" width="165"]

Dr. Cande V. Ananth, PhD, MPH Professor of Epidemiology and Vigil G. Damon Professor of Obstetrics and Gynecology Columbia University Medical Center

Dr. Ananth[/caption] Dr. Cande V. Ananth, PhD, MPH Adjunct professor Department of Health Policy and Management Mailman School of Public Health Columbia University, NY MedicalResearch.com: What is the background for this study? Response: Preterm delivery rates have declined between 2005 and 2014 in the US and in several European countries. Since reductions in preterm and early term deliveries, and perinatal mortality remain a global health priority, determining the relationship between gestational age distribution and perinatal mortality, remains a challenge. Efforts expended to a more complete understanding of the impact of new interventions, policies, and practices on reducing the burden of early deliveries, and in turn improvements in perinatal survival will be of tremendous benefit for clinical management and care of women during their pregnancy and the newborn.

15 May Fewer US Children Taking Prescription Medications

Posted at 17:33h in Author Interviews, CDC, JAMA, Pediatrics

MedicalResearch.com Interview with: [caption id="attachment_41724" align="alignleft" width="200"]

Craig M. Hales, MD, MPH, MS CDR, U.S. Public Health Service Division of Health and Nutrition Examination Surveys National Center for Health Statistics Centers for Disease Control and Prevention

Dr. Hales[/caption] Craig M. Hales, MD, MPH, MS CDR, U.S. Public Health Service Division of Health and Nutrition Examination Surveys National Center for Health Statistics Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? Response: Monitoring trends in prescription medication use among children and adolescents is an important part of understanding the health of youth in the U.S. and the healthcare they receive. For this study we used data from the National Health and Nutrition Examination Survey or NHANES, which is a nationally representative survey of the US population and as part of this face-to-face survey in the home, we ask participants about their prescription medication use in the last 30 days and collect information about the prescription directly from the medication package.

15 May Checkpoint Inhibitors Rapidly Being Incorporated Into Routine Cancer Care

Posted at 12:40h in Author Interviews, Cancer Research, JAMA, Yale

MedicalResearch.com Interview with: [caption id="attachment_41716" align="alignleft" width="171"]

Jeremy O'Connor, MD Section of General Internal Medicine Department of Internal Medicine Postdoctoral Fellow, National Clinician Scholars Program Yale University

Dr. O'Connor[/caption] Jeremy O'Connor, MD Section of General Internal Medicine Department of Internal Medicine Postdoctoral Fellow, National Clinician Scholars Program Yale University MedicalResearch.com: What is the background for this study? Response: There has been a lot of enthusiasm for the use of novel therapies in cancer care, and in particular for novel anticancer agents known as immune checkpoint inhibitors. But very little is known about how quickly providers have adopted immune checkpoint inhibitors into clinical practice. Existing studies suggest, in fact, that the process of clinical adoption is slow, with conventional wisdom holding that it takes an average of 17 years for new evidence to change practice. Our study evaluated whether the adoption of novel therapies might be much faster in certain contexts with the early use of immune checkpoint inhibitors as a notable example.

15 May Solar Powered Oxygen Could Fill Critical Gap in Underserved Areas

Posted at 10:47h in Author Interviews, Global Health, JAMA, Pulmonary Disease, Technology

MedicalResearch.com Interview with: [caption id="attachment_41623" align="alignleft" width="200"]

Michael Hawkes MD PhD Adjunct Professor Assistant Professor Pediatrics, Faculty of Medicine School of Public Health University of Alberta

Dr. Hawkes[/caption] Michael Hawkes MD PhD Adjunct Professor Assistant Professor Pediatrics, Faculty of Medicine School of Public Health University of Alberta MedicalResearch.com: What is the background for this study? What are the main findings?

Pneumonia is the leading cause of mortality in children globally.
Oxygen is an essential therapy for children with hypoxemic pneumonia, but is not available in many resource-limited and rural areas.
Our innovation, solar powered oxygen delivery, harnesses freely available sun and air to delivery oxygen to patients independent of grid electricity.
We performed a randomized controlled trial of solar powered oxygen delivery, compared to standard oxygen delivery using compressed oxygen cylinders in children with hypoxemia hospitalized at two centres in Uganda.
Solar powered oxygen was non-inferior to cylinder oxygen with respect to clinical outcomes, and offers advantages in terms of reliability, simplicity, and cost.

14 May More Opioids Prescribed By Doctors Who Received Free Pharmaceutical Lunches

Posted at 20:10h in Addiction, Author Interviews, JAMA, Opiods, Pharmaceutical Companies

MedicalResearch.com Interview with: Scott E. Hadland, MD, MPH, MS Assistant Professor of Pediatrics | Boston University School of Medicine Boston Medical Center Director of Urban Health & Advocacy Track | Boston Combined Residency Program Boston, MA 02118 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous pharmaceutical companies have received media attention for their role in promoting opioid prescribing through speaker programs and other marketing plans in which large-value payments are given to a small number of doctors to promote opioids. In our study, we sought to tell the other side of the story. We wanted to identify whether low-value marketing, including industry-sponsored meals, which are commonplace in the US, were associated with increased opioid prescribing. We found that 1 in 14 doctors received opioid marketing from pharmaceutical companies in 2014, and those that received marketing prescribed 9% more opioids the following year. With each additional meal a doctor received, he or she prescribed more and more opioids the following year. Our sample included 43% of the active physician workforce in the US, suggesting how widespread and far-reaching this effect might be.

14 May Parents More Willing To Lets Kids Watch ‘Justified’ Violence on TV

Posted at 19:48h in Accidents & Violence, Author Interviews, Pediatrics, Pediatrics

MedicalResearch.com Interview with: Daniel Romer, PhD Research Director Annenberg Public Policy Center and Director of its Adolescent Communication Institute (ACI) University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have been studying the steady increase in gun violence that has been occurring in popular PG-13 movies since the new rating was adopted in 1984. It has recently even surpassed the amount of gun violence in R-rated movies. Since these movies are open to the public at any age, we are concerned that they promote the use of guns and potentially socialize youth to believe that using guns to defend oneself is an appropriate way to handle threats and other conflicts. We knew that the rating requires the omission of graphic consequences, such as blood and suffering, that can make the violence more acceptable. But we also wondered whether the motivation for the violence might make a difference as well. Many of the characters in PG-13 movies are seen as heroic (e.g., Bruce Willis and Liam Neeson). Could that also be a factor that makes such films more acceptable to parents despite their concerns about their children seeing so much violence in the movies. So, we conducted this experiment to see if parents are less upset by justified violence in PG-13 style movies.

14 May Thyroid Inflammation Linked to Depression and Anxiety

Posted at 14:16h in Author Interviews, Depression, Endocrinology, JAMA, Mental Health Research, Thyroid Disease

MedicalResearch.com Interview with: Teja Grömer PD Dr. med. Habil Facharzt für Psychiatrie und Psychotherapie Lehrbefugter der Universität Erlangen-Nürnberg im Fach Psychiatrie Bamberg MedicalResearch.com: What is the background for this study? 1) I had seen hundreds of clinical cases with combined depression and anxiety and noted end of 2015 that most (far more than 50%) from the subjective clinical impression were associated with autoimmune thyroiditis (AIT) 2) Autoimmune thyroiditis on the mental side leads to specific symptoms, exhaustion, tachycardia, restlessness. 3) I thus decided to do a systematic review and meta-analysis.

14 May Men Receive Triple Amount of Cancer Research Funding

Posted at 00:07h in Author Interviews, BMJ, Cancer Research, Gender Differences

MedicalResearch.com Interview with: Dr. Mahiben Maruthappu Public Health Registrar MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gender disparities in the fields of science and technology have been documented, and it becomes increasingly apparent at higher levels of seniority. In this analysis, we found a quantifiable difference in cancer research funding awarded to female principle investigators compared to male principle investigators (PIs). Across all cancer research funding grants that we identified, male PIs received 3.6 times the total investment value, and 1.6 times the average award value compared with their female counterparts.

12 May Benefits and Complexities of More Breast Cancer Genes to Screen For

Posted at 13:04h in Author Interviews, Genetic Research, JAMA, UCSF

[caption id="attachment_41598" align="alignleft" width="200"]

Dr. Kurian[/caption] MedicalResearch.com Interview with: Allison W. Kurian, M.D., M.Sc. Associate Professor of Medicine (Oncology) and of Health Research and Policy Director, Women’s Clinical Cancer Genetics Program Stanford University School of Medicine Stanford, CA 94305-5405 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Changes in genetic sequencing technology and regulation have allowed much cheaper testing of many more genes in recent years. We investigated how these changes have affected hereditary cancer risk evaluation in women newly diagnosed with breast cancer. The main findings are that more comprehensive multiple-gene sequencing tests have rapidly replaced more limited tests of two genes (BRCA1 and BRCA2) only. This has helped patients by doubling the chance of finding an important gene mutation that can change their treatment options. However, there are important gaps in how this new, more comprehensive sequencing is used: more testing delays and more uncertain results, particularly among racial/ethnic minority women.

11 May Does Drinking More Water Preserve Kidney Function?

Posted at 10:28h in Author Interviews, JAMA, Kidney Disease

MedicalResearch.com Interview with: Dr. William Clark Lawson Health Research Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is about the use of increased water intake in people with chronic kidney disease (CKD). Although there are a large number of benefits claimed most are not substantiated by evidence. However there is a growing body of evidence (animal and human observational studies) that increased hydration with the suppression of antidiuretic hormone preserves kidney function in CKD. This led to our current randomised clinical trial of 631 patients with stage 3 CKD and proteinuria to determine if drinking an extra 4-6 glasses of water per day for 1 year would slow their progressive loss of kidney function as measured by eGFR. The main findings were that those coached to increase their water intake versus those coached to sustain their normal fluid intake suffered no ill effects from the intervention and on average were able to sustain an average increase of approximately 3 glasses of water per day. At the end of 1 year the increased hydration group had suppressed their antidiuretic hormone levels (copeptin) significantly but did not demonstrate a greater preservation in their eGFR.

11 May USPSTF: Men 70 and Older Should Not Be Screened for Prostate Cancer

Posted at 10:22h in Author Interviews, JAMA, Prostate Cancer

MedicalResearch.com Interview with: [caption id="attachment_41344" align="alignleft" width="143"]

Alex Krist, M.D., M.P.H Professor of family medicine and population health Virginia Commonwealth University and Active clinician and teacher at the Fairfax Family Practice residency

Dr. Krist[/caption] Alex Krist, M.D., M.P.H Professor of family medicine and population health Virginia Commonwealth University and Active clinician and teacher at the Fairfax Family Practice residency MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prostate cancer is one of the most common cancers to affect men. However, the decision about whether to be screened is complex and personal. The U.S. Preventive Services Task Force reviewed the latest research on the benefits and harms of screening for prostate cancer using PSA-based testing, as well as evidence on treatment. We found that men who are 55 to 69 years old should discuss the benefits and harms of screening with their doctor, so they can make the best choice for themselves based on their values and individual circumstances. Men age 70 and older should not be screened, as the benefits of screening diminish as men age and the harms are greater.

10 May How Many Diseases Should Newborns Be Screened For?

Posted at 09:29h in Author Interviews, BMJ, Genetic Research, Pediatrics

MedicalResearch.com Interview with: Dr Sian Taylor-Phillips MPhys, PhD Associate Professor Screening and Test Evaluation / NIHR Career Development Fellow Division of Health Sciences Warwick Medical School University of Warwick Coventry MedicalResearch.com: What is the background for this study? What are the main findings? Response: In newborn blood spot screening a small amount of blood is taken from newborn babies heels, and this is tested for a range of rare diseases. The idea is to detect each disease earlier when it is more treatable. However, it would be better not to test for some diseases, for example if the test is inaccurate so worries parents that their baby may have a serious illness when they do not. Some countries test for as few as 5 diseases and others as many as 50. In this study we investigated how different countries choose which diseases to test for. We found that many national recommendations on whether to screen newborn babies for rare diseases do not assess the evidence on the key benefits and harms of screening. Evidence about the accuracy of the test was not considered in 42% of recommendations, evidence about whether early detection at screening has health benefits was not consulted in 30% of recommendations, and evidence around the potential harm of overdiagnosis where babies have variants of the disease that would never have caused any symptoms or ill effects was not considered in 76% of recommendations. We also found through meta-analysis that when a systematic review was used to bring together the evidence then countries were less likely to recommend screening for the disease.