Author Interviews, COVID -19 Coronavirus, JAMA / 28.01.2022

MedicalResearch.com Interview with: Eva Petkova, PhD Professor, NYU School of Medicine Department of Population Health Division of Biostatistics Department of Child and Adolescent Psychiatry, New York, NY 10016 Senior Scientist, Nathan Kline Institute of Psychiatric Research, Orangeburg, NY 10962 MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: The COMPILE study is based on real-time collection of individual patient data from 8 international completed, terminated early and ongoing randomized clinical trials testing the efficacy of convalescent plasma for the treatment of hospitalized patients with COVID-19. Recruitment covered the period from March 2020 to March 2021 in Asia, Europe, North and South America. Total of 2369 patients were enrolled and data from 2341 patients were used in the analysis. COMPILE, the largest study of convalescent plasma for hospitalized COVID-19 patients to date, provided robust information on a diverse patient population, which allowed rigorous evaluation of questions related to convalescent plasma efficacy. The main findings are that convalescent plasma might have only a moderate efficacy on average, but that there is a huge heterogeneity in the benefits for individual patients. (more…)
Author Interviews, Dermatology, Emory, JAMA, Race/Ethnic Diversity / 27.01.2022

MedicalResearch.com Interview with: Howa Yeung, MD MSc | He/him/his Assistant Professor of Dermatology Emory University School of Medicine Atlanta, GA 30322 MedicalResearch.com:  What is the background for this study?  Response: Asian Americans are the fastest growing racial group in the United States but are underrepresented in health research. Existing research often categorize Asian Americans into a single racial category, which may mask differences in health behaviors and outcomes subgroups. We sought to examine potential differences in skin cancer-related risk factors and screening among Asian Americans in a large, nationally representative study. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity / 26.01.2022

MedicalResearch.com Interview with: Tasleem J. Padamsee, PhD Co-Leader  C3-REACH -- Committed to Communities Collaborative: Research and Engagement to Advance beyond COVID to Health EquityPrincipal Investigator The Daughter Sister Mother Project: Empowering Women and their Healthcare Providers to Fight Familial Cancer Lead Qualitative Investigator WOW Project: Washington & Ohio Workers Study Assistant Professor Division of Health Services Management & Policy, College of Public Health Faculty Affiliate, James Comprehensive Cancer Center The Ohio State University MedicalResearch.com:  What is the background for this study?  Response: This is a study about COVID-19 vaccine hesitancy in the United States. Although there has been a lot of discussion about vaccine hesitancy as a barrier to achieving high rates of COVID-19 vaccination, there have been few studies of changes in hesitancy - or how it might vary across groups. As COVID-19 vaccines were becoming available in the US there was a lot of discussion about worrisome rates of vaccine hesitancy, particularly among communities of color. Our team suspected, however, that these high rates might be short-lived, and that Black Americans in particular might become willing to use COVID-19 vaccines after a short period of time - as they became reassured that they would be safe, effective, and protect communities. (more…)
Author Interviews, CDC, COVID -19 Coronavirus, Emory, Heart Disease, JAMA / 25.01.2022

MedicalResearch.com Interview with: Matthew Oster, MD, MPH CDC COVID-19 Response CDC Center on Birth Defects and Developmental Disabilities Pediatric Cardiologist, Sibley Heart Center, Children’s Healthcare of Atlanta Emory University School of Medicine Emory University Rollins School of Public Health MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: More than 192 million people ages 12 years and older in the U.S. received at least one dose of mRNA COVID-19 vaccines from December 2020 through August 2021. From this population, VAERS (the Vaccine Adverse Event Reporting System) received 1,991 reports of myocarditis,  1,626 of which met the case definition of myocarditis. Rates of myocarditis were highest following the second dose of an mRNA vaccine among males aged 12–15 years (70.7 per million doses of Pfizer), 16-17 years (105.9 per million doses of Pfizer), and 18–47 years (52.4 and 56.3 per million doses of Pfizer and Moderna, respectively). Of those with myocarditis, the median age was 21 years and the median time from vaccination to symptom onset was two days. Males accounted for 82% of patients for whom sex was known. Approximately 96% were hospitalized, 87% of whose symptoms had gone away by the time they were discharged from the hospital. Non-steroidal anti-inflammatory drugs (589/676, 87%) were the most common treatment. (more…)
Author Interviews, BMJ, Orthopedics / 20.01.2022

MedicalResearch.com Interview with: Prof. Matthew Costa Professor of Orthopaedic Trauma University of Oxford Honorary Consultant Trauma Surgeon, John Radcliffe Hospital, Oxford  MedicalResearch.com: What is the background for this study? Response: Fixation with metal implants provides reliable functional outcomes for patients after a manipulation of a displaced fracture of the distal radius, but such surgery carries risk for the patient and is expensive. A moulded plaster cast is a safer and cheaper intervention but may not provide the same functional outcome. It is not known which of these treatments is superior. (more…)
Author Interviews, Diabetes, NEJM, Pediatrics, Technology / 20.01.2022

MedicalResearch.com Interview with: Dr Julia Ware (née Fuchs) Clinical Research Associate Wellcome-MRC Institute of Metabolic Science-Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, University of Cambridge Addenbrooke’s Hospital, Cambridge MedicalResearch.com: What is the background for this study? Response: Management of type 1 diabetes is challenging in very young children, due to their high variability of insulin requirements and unpredictable eating and activity patterns. As a result, many young children do not meet the recommended glycemic targets, or only maintain recommended glycemic control with extensive caregiver input. This in turn leads to high management burden and reduced quality of life for the whole family. While the increasing use of continuous glucose-monitoring devices and insulin-pump therapy has led to reductions in the incidence of severe hypoglycaemia and diabetic ketoacidosis, and has been accompanied by modest improvements in glycemic control, the burden of management has remained high. Hybrid closed-loop systems (also called an artificial pancreas), in which an algorithm automatically adjusts insulin delivery on the basis of real-time sensor glucose levels, may address ongoing challenges in this age group. However, to date hybrid closed-loop studies involving very young children have been small and of short duration and the efficacy and safety of longer term use of a closed-loop system, as compared with standard therapy, was unclear.   To address this knowledge gap, we compared 16-week use of the Cambridge closed-loop algorithm with sensor-augmented pump therapy in children aged 1 to 7 years with type 1 diabetes in a multi-national randomised crossover study. (more…)
Author Interviews, Ophthalmology, PLoS / 20.01.2022

MedicalResearch.com Interview with: Prof. Jugnoo S Rahi Professor of Ophthalmic Epidemiology and Honorary Consultant Ophthalmologist NIHR Senior Investigator Head, Vision and Eyes Group UCL HeadPopulation Policy and Practice Research and Teaching Department GOS ICH UCL Director, Ulverscroft Vision Research Group  GOS Institute of Child Health UCL / Great Ormond Street Hospital NHS Foundation Trust Institute of Ophthalmology UCL / NIHR Moorfields Biomedical Research Centre Chair, Academic Committee Chair, British Ophthalmological Surveillance Unit Executive Committee Royal College of Ophthalmologists  MedicalResearch.com:  What is the background for this study?    Response: We hypothesised that if changing environmental factors, in particular educational experience, are accounting for increasing frequency of myopia in the UK, a cohort effect would be discernible in changing associations with myopia, with different profiles for childhood and adult-onset forms. We investigated this using the UK Biobank Study, a unique large contemporary adult population sample whose members, born over a period of more than three decades, have undergone a detailed ophthalmic examination. This affords the opportunity to analyse ‘historical’ cohorts covering a period of important socio-demographic, economic, and educational change in the UK from which current and emerging trends may be identified and examined. Drawing on our previous proof-of-concept study, we investigated whether there were differences between childhood-onset versus adult-onset myopia in temporal trends in both frequency and severity and in associations with key environmental factors. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Pediatrics / 18.01.2022

MedicalResearch.com Interview with: Edward Bell, MD Professor of Pediatrics-Neonatology Vice Chair for Faculty Development, Stead Family Department of Pediatrics Roy J. and Lucille A. Carver College of Medicine University of Iowa MedicalResearch.com: What is the background for this study? Response: The National Institute of Child Health and Human Development, a branch of the National Institutes of Health (NIH), has supported the Neonatal Research Network (NRN) since 1986. The NRN, a group of US academic centers, is tasked with conducting research to improve the treatment and health outcomes of premature and critically-ill babies in US neonatal intensive care units (NICUs). Every few years, the NRN publishes reports on the survival rates and outcomes of surviving extremely premature babies, those born before 28 weeks of gestation. These reports help us to judge progress in the care and outcomes of these infants. This paper is the 9th in this series of reports but the first that includes not only survival and in-hospital outcomes but also outcomes at 2 years of age.  (more…)
Author Interviews, Duke, Gastrointestinal Disease, Nature, Sugar / 17.01.2022

MedicalResearch.com Interview with: Laura Rupprecht, PhD Postdoctoral Fellow Kelly L Buchanan The Laboratory of Gut Brain Neurobiology Duke Medicine – GI Diego V. Bohórquez PhD Associate Professor in Medicine Duke Institute for Brain Sciences Durham, NC MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: In 2018, my laboratory discovered that a cell type in the gut epithelium synapses with the vagus nerve, the nerve which connects the gut and the brain. These gut cells are called neuropod cells. Neuropod cells transduce sugar within milliseconds using the neurotransmitter glutamate. Since then, we have been interested in defining how this rapid communication between neuropod cells and the brain regulates behavior. – Diego Bohórquez Over a decade ago, it was shown that the gut is the key site for discerning sugar and non-caloric sweetener. But the specific cell in the gut that underlies this effect was unknown. – Kelly Buchanan   (more…)
Author Interviews, Brigham & Women's - Harvard, Infections, Multiple Sclerosis, Science / 15.01.2022

MedicalResearch.com Interview with: Kassandra L. Munger Sc.D. Senior Research Scientist Alberto Ascherio MD Dr.P.H. Professor of Epidemiology and Nutrition Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: An infectious cause of MS has been hypothesized for decades. Research over the past 20 years conducted by our group and others has strongly suggested a role for EBV infection including that EBV-negative individuals have a near zero risk of developing MS, having a history of infectious mononucleosis (caused by EBV infection) increases the risk of MS 2-fold, and healthy individuals have higher risks of MS with higher antibody levels against EBV antigens.  Ideally, to prove causality a randomized clinical controlled trial would be conducted; however, this not a feasible approach in this case. Given that nearly 95% of the adult population is infected with EBV and MS is a rare disease, we utilized the Department of Defense Serum Repository which stores over 60 million serum samples from over 10 million US Military active duty personnel. From this large resource, we were able to identify a cohort who were EBV negative when they joined the military and we followed them for whether they had a primary infection with EBV and then for who developed MS. (more…)
Author Interviews, Diabetes, Global Health, Lancet / 12.01.2022

MedicalResearch.com Interview with: Prof Dianna J Magliano PhD Baker Heart and Diabetes Institute Melbourne Australia  MedicalResearch.com: What is the background for this study? Response: Mortality among people with diabetes, and how it changes over time, is an important indicator of quality of and access to health care. However, population level trends in mortality among people with diabetes are inadequately described. The establishment of national diabetes registers, health insurance data and administrative data has allowed the examination of mortality among those with diabetes at a granular level which has been previously not possible. This has allowed us to examine whether global efforts in regards to diabetes care over the last couple of decades have been effective. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics / 11.01.2022

MedicalResearch.com Interview with: Stephen Freedman MDCM, MSc Professor of Pediatrics and Emergency Medicine Alberta Children’s Hospital Foundation Professor in Child Health and Wellness Alberta Children’s Hospital Research Institute, Cumming School of Medicine University of Calgary MedicalResearch.com: What is the background for this study? Response: During the early stages of the global 2019 coronavirus disease (COVID-19) pandemic, children represented fewer than 5% of reported cases.  However, children now represent a significant percent of all new COVID-19 cases.  Similarly, pediatric hospitalizations due to COVID-19, are now at an all-time high.  Although COVID-19 is generally mild in children, severe outcomes and death do occur.  The risk of severe outcomes among SARS-CoV-2 infected children is poorly understood with estimates varying considerably between study designs, settings, and regions.  Studies generally include large administrative databases (i.e. community based), hospitalized populations, and children admitted to the intensive care unit (ICU). Identified risk factors for severe COVID-19 in children have included young (i.e. 1-3 months) or old (15-18 years) pediatric age group, male sex, and pre-existing medical condition.  However, data from large prospective cohort studies which include children with early or mild stages of disease seeking emergency department (ED) care are lacking. To address this knowledge gap we sought to quantify the frequency of and risk factors for severe outcomes in SARS-CoV-2 infected children enrolled in a prospective ED-based cohort study.  (more…)
Author Interviews, Cannabis, JAMA, Pediatrics / 07.01.2022

MedicalResearch.com Interview with: Daniel Myran, MD, MPH, CCFP, FRCPC Family and Public Health and Preventive Medicine Physician CIHR Fellow, Ottawa Hospital Research Institute Department of Family Medicine Innovation Fellow University of Ottawa MedicalResearch.com: What is the background for this study? Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Canada took phased approach to legalization initially only allowing flower-based cannabis products and oils and after one year permitting the sale of commercial cannabis edibles (e.g. THC containing candies, baked goods, and drinks). In this study we took advantage of this phased roll out of legal cannabis to understand the impact of legalization on cannabis exposures or poisonings in children aged 0-9 years and the contribution of different types of cannabis products to these events. (more…)
Author Interviews, NEJM, OBGYNE / 05.01.2022

MedicalResearch.com Interview with: Laura Schummers, ScD (she/her/hers) Postdoctoral Fellow, Contraception and Abortion Research Team CIHR Patient-Oriented Research Leadership Fellow Post-doctoral Trainee, ICES McMaster UBC - Department of Family Practice | Women's Health Research Institute MedicalResearch.com: What is the background for this study? Response: Canada was the first country in the world to remove all supplemental restrictions on the dispensing and administration of mifepristone, making the drug available as a normal prescription. This meant that the abortion pill could be prescribed by any doctor or nurse practitioner, dispensed by any pharmacist, and taken by patients when, where and if they choose. (more…)
Author Interviews, JAMA, Prostate Cancer, Race/Ethnic Diversity, UCLA / 03.01.2022

MedicalResearch.com Interview with: Ting Martin Ma, MD, PhD Resident Physician Amar U. Kishan, MD Assistant Professor, Department of Radiation Oncology Vice-Chair of Clinical and Translational Research Department of Radiation Oncology at UCLA MedicalResearch.com: What is the background for this study? Response: We know from epidemiologic studies that  Black men are more likely to be diagnosed with and die of prostate cancer than White men. Recent studies hinted that Black men had better oncological outcome (such as prostate cancer specific mortality and overall survival) responding to systemic therapy for advanced prostate cancer (e.g. cancer that has spread or metastasized to other parts of the body). The question we were trying to answer in this study is: is there a difference in outcomes between Black and White men with localized prostate cancer (cancer that has not spread) receiving definitive radiotherapy enrolled in clinical trials?  (more…)
Author Interviews, Eating Disorders, Exercise - Fitness, JAMA, Pediatrics / 31.12.2021

MedicalResearch.com Interview with: Sean C. Rose, MD Child Neurology Nationwide Children’s Hospital The Ohio State University, Columbus MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is conflicting evidence regarding the association between repetitive head impacts during youth contact sports and worse neurocognitive outcomes.   Most research has been conducted in older adults, while the research in children is mostly limited to 1-2 sports seasons. (more…)
Author Interviews, Diabetes, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 20.12.2021

MedicalResearch.com Interview with: Lauren A. Eberly, MD, MPH Clinical Fellow, Cardiovascular Medicine Perelman School of Medicine Cardiovascular Division, Perelman School of Medicine Center for Cardiovascular Outcomes, Quality, and Evaluative Research, Cardiovascular Center for Health Equity and Social Justice, Leonard Davis Institute of Health Economics University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study? Response: Racial inequities are pervasive in our country, and cardiovascular therapeutics with proven benefit have been shown to be underutilized among Black and Latinx patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a recommended treatment option for glycemic control in patients with diabetes, have recently emerged as a cardioprotective therapy as multiple large randomized clinical trials have shown they prevent cardiovascular events among patients with Type 2 Diabetes (T2D), particularly patients with established atherosclerotic cardiovascular disease (ASCVD). Given this, they are now recommended therapy for patients with diabetes and established or high risk of ASCVD. Given the known inequitable utilization of other therapies, along with the known higher burden of diabetes and cardiovascular disease among Black patients, the aim of this study was to evaluate the uptake of GLP-1 RA as well as for inequities in utilization. (more…)
Annals Internal Medicine, Author Interviews, COVID -19 Coronavirus, Kidney Disease, Vaccine Studies / 16.12.2021

MedicalResearch.com Interview with: Shuchi Anand, MD MS (she/her) Assistant Professor in Medicine Director, Center for Tubulointerstitial Kidney Disease Stanford University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A majority of  people on dialysis who completed vaccination as of September 2021 have had a decline in antibody response to levels that would render them vulnerable to infection. Antibody response immediately after vaccination and circulating antibody response is strongly associated with risk for breakthrough after the initial vaccination series. (more…)
Author Interviews, Columbia, Genetic Research, Hematology, NEJM / 16.12.2021

MedicalResearch.com Interview with: Markus Y Mapara, MD Professor of Medicine Director of the Blood and Marrow Transplantation Columbia University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Sickle cell disease is caused by a point mutation in the beta-globin gene of hemoglobin  resulting in the production of abnormal hemoglobin which leads to formation of sickle-shaped RBC under conditions of low oxygen. Sickle cell disease affects about 100,000 patients in the US which are predominantly African  American. The only curative approach is to perform an allogeneic bone marrow transplant which is however fraught with significant treatment-related risks if a matched sibling donor is not available. The current study describes the successful application of a novel gene therapy  to treat patients with sickle cell disease. The strategy is based on a gene-addition approach to introduce the genetic information for a Hemoglobin F-like molecule termed HgAT87Q into hematopoietic stem cells. The expression of this novel  hemoglobin prevents polymerization of HgbS  and has now been demonstrated to prevent the occurrence of vaso-occlusive pain crises in sickle cell disease patients. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Social Issues, Transplantation / 14.12.2021

MedicalResearch.com Interview with: Rebecca Thorsness, PhD Research Associate Department of Health Services, Policy, and Practice Brown University School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2019, the President signed the Advancing American Kidney Health executive order, which included provisions to increase the use of home dialysis and kidney transplant for Americans living with kidney failure. To carry out this vision, the Centers for Medicare & Medicaid Services (CMS) developed the ESRD Treatment Choices (ETC) payment model, which uses financial incentives and penalties to incentivize dialysis facilities to pursue home dialysis or kidney transplant for their patients. Transplant and home dialysis are optimal care for people with kidney failure, but there are social and clinical reasons that patients with high social risk (such as those exposed to racism, poverty, or housing instability) may not be candidates for these treatments. This means that facilities which serve a large number of patients with high social risk might be disproportionately penalized by this new payment model. Using data immediately prior to the implementation of the ETC model, we found that dialysis facilities that serve high proportions of patients with high social risk have lower rates of home dialysis and kidney transplantation than facilities that care for lower proportions of such patients. (more…)
Author Interviews, JAMA, Opiods, University of Pennsylvania / 14.12.2021

MedicalResearch.com Interview with: Ashish Thakrar, MD Internal Medicine & Addiction Medicine National Clinician Scholars Program University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: About 1.8 million Americans are currently incarcerated, more than any other country in the world per capita. Of those 1.8 million, about 1 in 7 suffers from opioid addiction, putting them at high risk of overdose and death, particularly in the weeks following release. Opioid use disorder is a treatable condition, particularly with the medications buprenorphine or methadone, but historically, prisons and jails have not offered treatment. Over the past five years, a few states and municipalities have enacted policies to provide access for OUD treatment. We examined whether these policies were actually improving access to treatment.  (more…)
Aging, Alzheimer's - Dementia, Author Interviews, Blood Pressure - Hypertension, JAMA / 14.12.2021

MedicalResearch.com Interview with: Jan Willem van Dalen, PhD Department of Neurology Donders Institute for Brain, Behaviour and Cognition Radboud University Medical Centre Nijmegen Department of Neurology The Netherlands3Department of Public and Occupational Health Amsterdam UMC, University of Amsterdam, Amsterdam   MedicalResearch.com: What is the background for this study? Response: Although high systolic blood pressure in midlife has consistently been reported as a condition that increases the risk of developing dementia in old age, reports regarding this relationship in older people have been inconsistent. One potential reason for this, is that the relationship between systolic blood pressure and dementia in later life may be U-shaped, meaning that both individuals with low and with high systolic blood pressure are at increased incident dementia risk. This study combined data from several longitudinal cohort studies specifically designed to study incident dementia in older people, to investigate whether these U-shaped relationships exist, and in which age ranges they appear. We included more than 16,500 people aged 60 and older, with over 2,700 incident dementia cases. Also, we aimed to investigate whether these observational associations might be caused by confounding, differences in mortality, or result from opposite relationships between certain subgroups of individuals. (more…)
Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, JAMA / 13.12.2021

MedicalResearch.com Interview with: Liise-anne Pirofski, M.D. Mitrani Professor of Biomedical Research Chief, Division of Infectious Diseases Albert Einstein College of Medicine and Montefiore Medical Center Liise-anne Pirofski, MD on behalf of lead authors Mila Ortigoza MD, PhD, Assistant professor at NYU Langone Health and Hyunah Yoon MD, Assistant Professor, Albert Einstein Medical Center and the CONTAIN COVID-19 trial authors and team MedicalResearch.com: What is the background for this study? Response: The study was designed to determine the efficacy of COVID-19 convalescent plasma (CCP) in hospitalized patients with COVID-19. It was designed and launched in New York City in April 2020 during the height of the first COVID-19 pandemic wave and later extended to sites in Miami, Houston, and other regions affected by subsequent waves of the pandemic. At that time, there were no validated therapeutic options for COVID-19, and there was clinical equipoise for CCP use in hospitalized patients. COVID-19 convalescent plasma was considered worthy of investigation because of the historical success of convalescent plasma in prior pandemics and epidemics dating to the beginning of the 20th century, and importantly, biological plausibility because convalescent plasma contains antibodies to agents from which people have recovered, and case series and observational studies showing signals of CCP efficacy in patients with COVID-19. The trial was designed to focus on patients with moderate to severe COVID-19 who required supplemental oxygen, but not mechanical intubation. At the time the trial was designed, hospitals in New York City were overwhelmed with severely and critically ill patients with COVID-19, an entirely new disease about which more and more was learned over the 11 months the trial was conducted.  (more…)
Author Interviews, COVID -19 Coronavirus, NEJM, Vaccine Studies / 13.12.2021

MedicalResearch.com Interview with: Ronen Arbel, PhD Outcomes Research, Community Medical Services Division Clalit Health Service Tel Aviv, Israel Director, Maximizing Health Outcomes Research Lab Sapir College, Sderot, Israel.  MedicalResearch.com: What is the background for this study? Response: The emergence of the SARS-CoV-2 delta variant and reduced effectiveness over time of the BNT162b2 vaccine (Pfizer-BioNTech) led to a recent Coronavirus 2019 disease (Covid-19) resurgence in early vaccinated populations. The Israeli Ministry of Health was the first in the world to approve a third (booster) dose of BNT162b2 to cope with this resurgence. (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare / 12.12.2021

MedicalResearch.com Interview with: Jeanne Madden, PhD Associate Professor Department of Pharmacy and Health Systems Sciences School of Pharmacy and Pharmaceutical Sciences Bouvé College of Health Science Northeastern University MedicalResearch.com: What is the background for this study? Response: Medicare is the US public insurance program mainly serving people 65 years and older, but also some younger adults who have long-term disabling conditions. As such, on average, the Medicare population bears a heavy burden of illness and has high health care needs, compared to the general US population. The under-65 group for the most part has quite low incomes, while the older group represents a wide spectrum, from poor to well-off. Medicare beneficiaries also differ a great deal in terms of whether they have access to supplemental insurance that can help with patient cost-sharing requirements. I’m referring to Medicaid assistance, or a self-purchased Medigap plan, or retiree health benefits, etc. The cost-sharing requirements in traditional Medicare are substantial — e.g., 20% for doctor visits — and there is no annual cap on patient out-of-pocket spending. That’s in contrast to commercial insurance and Medicare Advantage managed care plans — all of those have an annual cap on patient out-of-pocket costs. There’s a good amount of existing research on whether people in Medicare can afford their drugs, and on the affordability of medical care among younger groups such as working-aged uninsured people and those in ACA exchange plans. But there hasn’t been much research into medical care affordability among older Americans. (more…)
Author Interviews, Dental Research, JAMA, Pediatrics, USPSTF / 10.12.2021

MedicalResearch.com Interview with: Michael Cabana, M.D., M.A., M.P.H Professor of Pediatrics Albert Einstein College of Medicine. Physician-in-chief , Children's Hospital at Montefiore Chair of the Department of Pediatrics Albert Einstein College of Medicine Member, U.S. Preventive Services Task Force  MedicalResearch.com: What is the background for this study and recommendation statement?  Response: Dental caries, also known as cavities or tooth decay, is the most common chronic disease in children in the United States and can develop in any child whose teeth have come in. Many young children under five years old do not visit a dentist, so the Task Force reviewed the latest evidence on how primary care clinicians can help prevent tooth decay in young children. The Task Force’s research led to two important findings: all young children whose teeth have come in should have fluoride varnish applied by their clinician, and all children six months and older whose water supply doesn’t contain enough fluoride should receive fluoride supplements. Both approaches can help prevent cavities in kids. The Task Force also determined that there is not enough evidence to recommend for or against screening for tooth decay in the primary care setting for children under five. This is consistent with the Task Force’s 2014 recommendation on dental caries. (more…)
Author Interviews, Gender Differences, JAMA / 09.12.2021

MedicalResearch.com Interview with: Christopher J. D. Wallis, MD, PhD Assistant Professor, Division of Urology University of Toronto Urologic Oncologist, Division of Urology Mount Sinai Hospital and University Health Network MedicalResearch.com: What is the background for this study? Response: Previous research has shown that female and male physicians communicate differently with patients. Further, there is evidence that female physicians, including surgeons, spend more time with patients. This, coupled with evidence that female patients may experience disparities in the management of their pain, led us to consider that communication differences may underpin differences in surgical outcomes previously noted (eg. Wallis et al, BMJ 2017) between male and female physicians. We postulated that there may be a differential association between surgeon sex and patient sex in behaviours that would translate into clinically important outcomes. (more…)
Asthma, Author Interviews, NEJM, Pediatrics, Pulmonary Disease, Vanderbilt / 08.12.2021

MedicalResearch.com Interview with: Leonard B. Bacharier, MD Janie Robinson and John Moore Lee Chair in Pediatrics Professor of Pediatrics Director - Center for Pediatric Asthma Research Scientific Director - Center for Clinical and Translational Research Section Chief - Pediatric Allergy and Immunology Division of Allergy, Immunology and Pulmonary Medicine Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center  MedicalResearch.com: What is the background for this study?  Is Dupilumab used for other atopic conditions, ie eczema/atopic dermatitis?   Response: Many children with moderate-severe asthma continue to experience asthma exacerbations and poor asthma control despite use of controller therapies.  Dupilumab has been shown to reduce asthma exacerbations in adolescents and adults, as well as to improve atopic dermatitis in children and adults. (more…)
Author Interviews, Brigham & Women's - Harvard, Circadian Rhythm, Diabetes, Occupational Health, Science, Weight Research / 06.12.2021

MedicalResearch.com Interview with: Sarah L. Chellappa, MD PhD Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA Department of Nuclear Medicine Faculty of Medicine and University Hospital Cologne University of Cologne, Cologne, Germany. Frank A.J.L. Scheer, M.Sc., Ph.D. Professor of Medicine. Medical Chronobiology Program Division of Sleep and Circadian Disorders Departments of Medicine and Neurology Brigham and Women’s Hospital Division of Sleep Medicine, Harvard Medical School Boston, MA MedicalResearch.com: What is the background for this study? Would you explain the difference between the central circadian ‘clock’ and endogenous circadian glucose rhythms?  Response: Night work increases diabetes risk. This increased risk is not fully explained by differences in lifestyle, family history, and/or socioeconomic status, thus other mechanisms are likely involved. Laboratory studies in humans have shown glucose intolerance in both non-shift workers and shift workers exposed to simulated night work. Animal experimental data suggests that this may be in part due to a misalignment between central and peripheral rhythms. Central circadian rhythms (e.g., body temperature) are primarily modulated by the central circadian “clock”, which is located in the brain’s suprachiasmatic nucleus and is responsible for synchronizing our physiology and behavior with the 24-hour cycle. Peripheral rhythms, including endogenous circadian glucose rhythms, are likely modulated by peripheral “clocks” across the body that play an integral role in modulating the circadian expression of physiology, including metabolic functions. These central and peripheral clocks share a common molecular mechanism underlying their circadian rhythm generating capacity, including transcription-translation feedback loops of circadian “clock” genes.  (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Ophthalmology / 06.12.2021

MedicalResearch.com Interview with: Cecilia S. Lee, MD, MS Associate Professor,Director, Clinical Research Department of Ophthalmology Harborview Medical Center University of Washington Seattle, WA MedicalResearch.com: What is the background for this study? Response: Cataract is a natural aging process of the eye and affects the majority of older adults who are at risk for dementia. Sensory loss, including vision and hearing, is of interest to the research community as a possible risk factor for dementia, and also as a potential point of intervention. Because cataract surgery improves visual function, we hypothesized that older people who undergo cataract surgery may have a decreased risk of developing Alzheimer disease and dementia. We used the longitudinal data from an ongoing, prospective, community based cohort, Adult Changes in Thought (ACT) study. The ACT study includes over 5000 participants to date who are dementia free at recruitment and followed until they develop Alzheimer disease or dementia. We had access to their extensive medical history including comprehensive ophthalmology visit data. We investigated whether cataract surgery was associated with a decreased risk of developing Alzheimer disease and dementia.  (more…)