Aging, Author Interviews, Brigham & Women's - Harvard, Frailty, Geriatrics, JAMA / 22.09.2022

MedicalResearch.com Interview with: Ariela Orkaby, MD, MPH Geriatrics & Preventive Cardiology Associate Epidemiologist Division of Aging, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? Response: As the population is living longer, there is increased risk of frailty and vulnerability. Frailty is defined as reduced physiological reserve and decreased ability to cope with even an acute stress. Up to half of adults over the age of 85 are living with frailty and preventative measures are greatly needed. We tested the effect of vitamin D and marine omega-3 fatty acid supplementation on the risk of developing frailty in healthy older adults in the US enrolled in the VITamin D and OmegA-3 TriaL (VITAL) trial. (more…)
Aging, Author Interviews, Brigham & Women's - Harvard, Frailty, Geriatrics, JAMA, Medical Research Centers, Supplements / 15.09.2022

MedicalResearch.com Interview with: Ariela Orkaby, MD, MPH Geriatrics & Preventive Cardiology Associate Epidemiologist Division of Aging, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? Response: As the population is living longer, there is increased risk of frailty and vulnerability. Frailty is defined as reduced physiological reserve and decreased ability to cope with even an acute stress. Up to half of adults over the age of 85 are living with frailty and preventative measures are greatly needed. We tested the effect of vitamin D and marine omega-3 fatty acid supplementation on the risk of developing frailty in healthy older adults in the US enrolled in the VITamin D and OmegA-3 TriaL (VITAL) trial. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, JAMA, Lancet, Lung Cancer, Medical Imaging, Technology / 07.09.2022

MedicalResearch.com Interview with: Raymond H. Mak, MD Radiation Oncology Disease Center Leader for Thoracic Oncology Director of Patient Safety and QualityDirector of Clinical Innovation Associate Professor, Harvard Medical School Cancer - Radiation OncologyRadiation Oncology Department of Radiation Oncology Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? What is the algorithm detecting? Response: Lung cancer, the most common cancer worldwide is highly lethal, but can be treated and cured in some cases with radiation therapy.  Nearly half of lung cancer patients will eventually require some form of radiation therapy, but the planning for a course of radiation therapy currently entails manual, time-consuming, and resource-intensive work by highly trained physicians to segment (target) the cancerous tumors in the lungs and adjacent lymph nodes on three-dimensional images (CT scans). Prior studies have shown substantial variation in how expert clinicians delineate these targets, which can negatively impact outcomes and there is a projected shortage of skilled medical staff to perform these tasks worldwide as cancer rates increase. To address this critical gap, our team developed deep learning algorithms that can automatically target lung cancer in the lungs and adjacent lymph nodes from CT scans that are used for radiation therapy planning, and can be deployed in seconds. We trained these artificial intelligence (AI) algorithms using expert-segmented targets from over 700 cases and validated the performance in over 1300 patients in external datasets (including publicly available data from a national trial), benchmarked its performance against expert clinicians, and then further validated the clinical usefulness of the algorithm in human-AI collaboration experiments that measured accuracy, task speed, and end-user satisfaction. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA / 03.08.2022

MedicalResearch.com Interview with: Lisa A. Cosimi, MD Division of Infectious Diseases Brigham and Women’s Hospital Boston, Massachusetts  MedicalResearch.com:  What is the background for this study?  Response: Response: Current CDC COVID-19 isolation guidance allows for ending isolation after day 5 for non-immunocompromised individuals if they are afebrile and with improving symptoms, or if the individual is asymptomatic from the start. It has been proposed that rapid antigen tests (RATs) may assist in determining when individuals are no longer infectious. Specifically, a negative test would be potentially reassuring for an individual not being transmissible, while a positive test could be suggestive of continued infectiousness.  However, there is little data about use of RATs in this particular setting and how they may correlate with ongoing risk of transmission as they were developed to be used during the initial diagnosis of infection, not in the later phase. (more…)
Author Interviews, Brigham & Women's - Harvard, Endocrinology, Hip Fractures, NEJM, Osteoporosis, Vitamin D / 27.07.2022

MedicalResearch.com Interview with: Meryl S. LeBoff, MD Chief, Calcium and Bone SectionDirector of the Skeletal Health and Osteoporosis CenterDirector, Bone Density UnitDistinguished Chair in Skeletal Health and Osteoporosis Professor of Medicine, Harvard Medical School Endocrinology, Diabetes and HypertensionWomen's Health Brigham And Women's Hospital JoAnn E. Manson, MD, DrPH Professor, Epidemiology, Harvard T.H. Chan School Of Public Health Michael and Lee Bell Professor of Women's Health, Medicine, Harvard Medical School Chief, Preventive Medicine, Brigham And Women's Hospital Co-Director, Womens Health, Brigham And Women's Hospital   MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Osteoporosis is a major public health problem. Although supplemental vitamin D has been widely used to reduce the risk of fractures in the general population, studies of the effects of vitamin D on fractures, the most important bone health outcome, have been conflicting. Randomized controlled trials, the highest quality studies, from around the world have shown benefit, no effect, or even harm of supplemental vitamin D on risk of fractures. Some of the trials used bolus dosing, had small samples sizes or short study duration, and co-administered calcium. No large RCTS of this scale tested whether daily supplemental vitamin D (without co-administration with calcium) prevented fractures in the US population. To fill these knowledge gaps, we tested the hypothesis in this ancillary study to VITAL, whether daily supplemental vitamin D3 reduced the risk of incident total, non-spine and hip fractures in women and men in the US. (more…)
Annals Internal Medicine, Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease / 07.06.2022

MedicalResearch.com Interview with: HoJin Shin, BPharm, PhD Postdoctoral Research Fellow Division of Pharmacoepidemiology and Pharmacoeconomics Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston, Massachusetts MedicalResearch.com:  What is the background for this study?  Response: The public health burden of cardiovascular disease has been increasing in people with diabetes along with the burden of diabetes itself.
  •  Cardiovascular disease affects approximately one-third of the population with type 2 diabetes and accounts for     50%–80% of their mortality
  • 1 in 10 people in the US has diabetes
Since 2008, the US FDA has recommended post-approval cardiovascular outcome trials to ensure the safety of new glucose-lowering drugs responding to this growing burden of cardiovascular disease in type 2 diabetes and the potential increase in cardiovascular risk with certain existing glucose-lowering drugs (e.g., rosiglitazone). Notably, SGLT-2i have demonstrated superiority to placebo in reducing the risk of cardiovascular events, including hospitalization for heart failure. Consequently, beginning in 2018, clinical guidelines in the US have recommended SGLT-2i as a preferred second-line treatment for patients with type 2 diabetes and cardiovascular disease. As the paradigm of second-line pharmacological treatment for type 2 diabetes has shifted to include the management of cardiovascular risk in addition to glycemic control, this further raised the question of whether SGLT-2i should be advanced to first-line treatment. Since 2019, SGLT-2i have been recommended as a first-line agent for patients with type 2 diabetes and cardiovascular disease by the European guidelines (the European Society of Cardiology and the European Association for the Study of Diabetes). In the absence of head-to-head RCTs, non-randomized studies using real-world data could provide information on whether SGLT-2i may have greater cardiovascular benefits over metformin more timely than randomized clinical trials among both patients with and without existing CVD. Therefore, we evaluated the risk for cardiovascular events among adults with T2D who initiated treatment with first-line SGLT-2i versus metformin in clinical practice. (more…)
Author Interviews, Dermatology / 14.05.2022

MedicalResearch.com Interview with: Naeem Bhojani, MD, FRCSC Division of Urology, Centre Hospitalier de l’Université de Montréal (CHUM), University of Montréal, Montréal, Québec, Canada David-Dan Nguyen MPH Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MassachusettsFaculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada  MedicalResearch.com:  What is the background for this study?  Response: In a recent study by our group published in JAMA Dermatology (https://jamanetwork.com/journals/jamadermatology/fullarticle/2772818), finasteride use was found to be associated with increased reporting of suicidality and depression in young patients with androgenetic alopecia. This previous analysis suggested that the association between finasteride and depression might be mediated by sexual dysfunction. Building on this work, we conducted this second analysis to examine the association between finasteride use and reports of sexual dysfunction. (more…)
Aging, Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Genetic Research, Nature / 20.04.2022

MedicalResearch.com Interview with: Michael B. Miller, MD, PhD Instructor, Harvard Medical School Department of Pathology Brigham and Women's Hospital MedicalResearch.com:  What is the background for this study? Would you explain what is meant by somatic genetic changes and how they might occur?  Response: Changes, also called mutations, in the DNA sequence of genes can be passed from parents to their children, and explain why many diseases run in families. This kind of DNA change is called a germline mutation and is present in every cell in a person’s body. Gene mutations can also occur in a subset of cells of a person, in which case they are called somatic mutations. Somatic mutations are well known as a cause of cancer, and recent research has found that somatic mutations can also happen in non-cancerous cells that appear otherwise normal. Recent studies have even found that somatic mutations are present in neurons, cells in the brain that transmit electrical signals and play an important role in how the brain functions. Furthermore, in neurons, somatic mutations increase with age, so we set out to understand if somatic mutations might be playing a role in age-related brain diseases like Alzheimer’s. (more…)
Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Sleep Disorders / 18.03.2022

MedicalResearch.com Interview with: Peng Li, Ph.D. Assistant Professor of Medicine, Harvard Medical School Research Director, Medical Biodynamics Program (MBP) Division of Sleep and Circadian Disorders Associate Physiologist, Brigham and Women's Hospital MedicalResearch.com:  What is the background for this study?  Response: People commonly see increased sleep during daytime in older adults. In people with Alzheimer’s disease or dementia, daytime drowsiness or sleepiness are even more common. Prior studies have showed protective effects of short naps on cognitive performance and alertness acutely, while also there are studies that have demonstrated more daytime naps are associated with faster cognitive decline in the long-term. We sought to investigate whether daytime napping behavior predicts future development of Alzheimer’s dementia. And we noted that there had been no studies to date that have documented the longitudinal profile of daytime napping during late life objectively. (more…)