2016 U.S. Presidential Election Associated With Increase in Preterm Births among U.S. Latina Women

MedicalResearch.com Interview with:

Alison Gemmill, PhD Assistant Professor Johns Hopkins Bloomberg School of Public Health

Dr. Gemmill

Alison Gemmill, PhD
Assistant Professor
Johns Hopkins Bloomberg School of Public Health 

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

Response: A growing body of evidence suggests that the circumstances surrounding the 2016 presidential election may have had a uniquely negative impact on the health of U.S. Latino population. Few studies, however, have evaluated the population health implications of the election for Latina mothers and their children.

We used national data and methods that control for temporal patterning to test the hypothesis that preterm birth rose above otherwise expected levels among Latina women in the U.S. following the election of Donald Trump. We find that the number of preterm births among Latina women increased above expected levels following the election. Specifically, we find 3.5 percent more preterm births among Latinas than projected for nine months following election.

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Older Patients May Benefit from Combination of Simvastatin-Ezetimibe After Acute Coronary Syndrome

MedicalResearch.com Interview with:

Richard G. Bach, MD FACC Professor of Medicine Washington University School of Medicine Director, Cardiac Intensive Care Unit Director, Hypertrophic Cardiomyopathy Center Barnes-Jewish Hospital St. Louis, MO 63110

Dr. Bach

Richard G. Bach, MD FACC
Professor of Medicine
Washington University School of Medicine
Director, Cardiac Intensive Care Unit
Director, Hypertrophic Cardiomyopathy Center
Barnes-Jewish Hospital
St. Louis, MO 63110

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

Response: Elderly patients represent the largest group of those hospitalized for an acute coronary syndrome, and age is an important marker of increased risk. The risk of death and recurrent cardiovascular events is greatest among the elderly. High intensity lipid lowering by statins has been shown to reduce the incidence of recurrent cardiovascular events after an acute coronary syndrome in general, but there remains limited data on efficacy and safety of that treatment in the elderly, and guidelines do not routinely advocate higher intensity treatment for patients older than 75 years. In practice, older age has been associated with a lower likelihood of being prescribed intensive lipid lowering therapy. IMPROVE-IT evaluated the effect of higher-intensity lipid lowering with ezetimibe combined with simvastatin compared with simvastatin-placebo among patients after ACS, and observed that ezetimibe added to statin therapy incrementally lowered LDL-cholesterol level and improved CV outcomes. IMPROVE-IT enrolled patients with no upper age limit, which gave us the opportunity to examine the effect of age on outcome on the benefit of more intensive lipid lowering with ezetimibe combined with simvastatin vs. simvastatin monotherapy.

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Voice Changes Common After Thyroid Cancer Surgery

MedicalResearch.com Interview with:

Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine

Dr. Haymart

Megan Rist Haymart MD
Associate Professor
Metabolism, Endocrinology and Diabetes Clinic
Michigan Medicine

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

Response: Thyroid cancer is a common malignancy with surgery considered one of the primary treatments. Complications from thyroid surgery can lead to long-term voice problems. However, few studies have used validated scales to quantify the impact of thyroid surgery on patient voice. Prior work has largely focused on single institution studies with high volume surgeons or claims data with reports of specific nerve injury.

We surveyed a diverse cohort of patients affiliated with SEER sites Georgia and Los Angeles to identify the prevalence, severity and correlates of poor voice outcomes following surgery for differentiated thyroid cancer.

We found that out of 2,325 patients 25.8% reported voice changes lasting greater than 3 months after surgery, 12.7% had abnormal voice per a validated voice scale (Voice Handicap Index- 10), and 4.7% reported a diagnosis of vocal fold motion impairment. We also identified patient factors associated with abnormal voice 2-4 years post op.

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Do New Medical Marijuana Laws Reduce Opioid Prescriptions?

MedicalResearch.com Interview with:

Silvia S. Martins, MD, PHD Associate Professor of Epidemiology Department of Epidemiology Mailman School Of Public Health Columbia University New York, NY 10032

Dr. Silvia Martins

Silvia S. Martins, MD, PHD
Associate Professor of Epidemiology
Department of Epidemiology
Mailman School Of Public Health
Columbia University 

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

Response: Prior studies have suggested t6hat medical marijuana legalization might play a role in decreasing opioid use.

We aimed to test this hypothesis using individual level data on nonmedical use of prescription opioids and opioid use disorder  from the US National Survey on Drug Use and Health.  Continue reading

Teens: Nonmedical Prescription Opioid Use Associated With Subsequent Heroin Use

MedicalResearch.com Interview with:

Lorraine Kelley-Quon, MD, MSHS, FAAP Assistant Professor | Division of Pediatric Surgery Children's Hospital Los Angeles Department of Surgery & Preventive Medicine Keck School of Medicine of USC

Dr. Kelley-Quon

Lorraine Kelley-Quon, MD, MSHS, FAAP
Assistant Professor | Division of Pediatric Surgery
Children’s Hospital Los Angeles
Department of Surgery & Preventive Medicine
Keck School of Medicine of USC 

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

Response: Prescription opioids are pharmacologically similar to heroin, and previous research has shown an association between nonmedical opioid use and heroin use.

This is the first study to follow a group of teenagers through all 4 years of high school and identify an association between nonmedical prescription opioid use and later heroin use.

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Preterm Babies Less Likely To Have Romantic Relationships as Adults

MedicalResearch.com Interview with:

Dr. Marina Mendonca PhD RECAP project (Research on European Children and Adults Born Preterm) Department of Psychology University of Warwick, UK

Dr. Mendonca

Dr. Marina Mendonca PhD
RECAP project (Research on European Children and Adults Born Preterm)
Department of Psychology
University of Warwick, UK

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

Response: Previous research on the social lives of adults born preterm (under 37 weeks gestation) was inconsistent. This meta-analysis brought together data from up to 4.4m adult participants and has shown that those who were born preterm are less likely to form romantic relationships, to have had sexual relations or experience parenthood than full terms. For example, those born preterm were 28% less likely to form romantic relationships and 22% less likely to become parents, when compared to those born full term. When looking at sexual relations, preterm born adults were 2.3 times (or 57%) less likely to ever have a sexual partner.

These associations were found for both men and women, and were stronger the lower gestational age. This means that the chances of finding a romantic partner or having children were lower for those born very (<28 weeks gestation) or extremely preterm (<28 weeks gestation), with the extremely pre-term born adults being for example 3.2 times (78%) less likely to ever having had sexual relations when compared to their full term peers.

Despite having fewer relationships, we found that when adults who were born preterm had friends or a partner, the quality of these relationships was at least as good as those born full term. 

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Surgical Safety Variations With Affiliation to a Top-Ranked Cancer Hospital

MedicalResearch.com Interview with:

Daniel Boffa, MD Professor of Surgery Yale School of Medicine

Dr. Boffa

Daniel Boffa, MD
Professor of Surgery
Yale School of Medicine 

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

Response: We have previously demonstrated that top-ranked hospitals are significantly safer than their affiliates for complex cancer surgery (patients 1.4 times more likely to die after cancer surgery at affiliate hospitals).  A logical extension of this work was to compare affiliate hospitals to hospitals that were not affiliated with a top ranked hospital.
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Genetic Variants Linked to Life-threatening Cardiac Arrhythmias in Patients With Dilated Cardiomyopathy and Implanted Defibrillators

MedicalResearch.com Interview with:

Ben Cordon, PhD NIHR Post-doctoral Academic Clinical Fellow Specialist Registrar training in cardiology

Dr. Cordon

Ben Cordon, PhD
NIHR Post-doctoral Academic Clinical Fellow
Specialist Registrar training in cardiology 

James S. Ware, PhD, MRCP  Reader in Genomic Medicine Group head within the Cardiovascular Genetics & Genomics Unit Imperial College London

Dr. Ware

James SWarePhD, MRCP
 Reader in Genomic Medicine
Group head within the Cardiovascular Genetics & Genomics Unit
Imperial College London

 

 

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

Response: Non-ischaemic dilated cardiomyopathy is a common cause of heart failure and carries the risk of life-threatening ventricular arrhythmia. An implantable cardioverter defibrillator (ICD) can be life-saving in this condition. However, the decision to implant an ICD is not one that can be taken lightly – ICD insertion carries its own risks, such as infection or inappropriate shocks, and our ability to predict who will benefit from a device is currently far from perfect. Genetic sequencing is affordable and widely available and for DCM, like many diseases, it is hoped that genetic stratification may one day help deliver personalised management. In DCM, variants in the Lamin A/C gene for example are known to cause a phenotype with early and severe arrhythmias and, as a result, international guidelines advocate a lower threshold for ICD insertion in these patients. However, Lamin A/C is an infrequent cause of DCM. The commonest known genetic cause of DCM are protein-truncating variants in the gene encoding Titin (TTNtv), accounting for ~15% of DCM cases. We wanted to know if this group had a higher risk of arrhythmia than the general DCM population.

Earlier work from our group on this topic found that patients with TTNtv-associated DCM were more likely to have a clinical history of arrhythmia (composite of atrial and ventricular arrhythmia, including NSVT), at the time of their initial DCM diagnosis. But it was unclear if this was driven by ventricular arrhythmia, atrial arrhythmia, or both or if it would translate into a long-term risk of potentially dangerous ventricular arrhythmia of the sort for which an ICD can be life-saving. In another study we analysed a larger cohort of ambulant DCM patients but did not find an increased risk of ventricular arrhythmia – but this was a relatively low-risk group, with comparatively mild symptoms (NHYA I/II heart failure) and moderately impaired LV function. As a result, the overall arrhythmic event rate was low, meaning that the power to detect differences between the TTNtv and non-TTNtv groups was reduced.

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Elevated Systolic Blood Pressure Linked to Increase in Valvular Heart Disease

MedicalResearch.com Interview with:

Prof-Kazem Rahimi

Prof. Rahimi

Dr Kazem Rahimi
Deputy Director of the George Centre for Healthcare Innovation
James Martin Senior Fellow in Essential Healthcare
Honorary Consultant Cardiologist at the John Radcliffe Hospital
Deputy Director of the George Institute for Global Health

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

Response: In the last century, we have witnessed a dramatic change in the spectrum of valvular heart disease and the prevalence of this condition has been rapidly increasing, due to population ageing, with poor patient outcomes and high healthcare costs associated with the only effective treatment available, which is valve repair or replacement. However, modifiable risk factors for valvular heart disease remain largely unknown, which limits prevention and treatment. We used a state-of-the-art, gene-based method called Mendelian randomization to determine the causality of the association between systolic blood pressure and risk of valvular heart diseases.  Continue reading

Heart Failure: Low Iron Storage vs Defective Iron Utilization

MedicalResearch.com Interview with:

Dr. Niels Grote Beverborg, MD PhD Post-doctoral research fellow Department of experimental cardiology University Medical Center Groningen, Groningen, The Netherlands Integrated CardioMetabolic Center Karolinska Institutet, Stockholm Sweden

Dr. Grote Beverborg

Dr. Niels Grote Beverborg, MD PhD
Post-doctoral research fellow
Department of experimental cardiology
University Medical Center Groningen,
Groningen, The Netherlands
Integrated CardioMetabolic Center
Karolinska Institutet, Stockholm
Sweden 

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

Response: Iron deficiency is very prevalent worldwide and a significant cause of morbidity and mortality, especially in vulnerable populations such as patients with heart failure. It is well known that iron deficiency can be a consequence of an insufficient iron uptake or increased iron loss (termed low iron storage), or of a chronic low inflammatory state (defective iron utilization). However, so far, we had no tools to distinguish these causes from each other in patients and have not been able to assess their potential consequences.

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Food Placement and Traffic Light Labeling To Reduce Caloric Intake in Employee Cafeteria

MedicalResearch.com Interview with:

Anne Thorndike, MD, MPH Massachusetts General Hospital General Internal Medicine Division Boston, MA 02114

Dr. Thorndike

Anne Thorndike, MD, MPH
Massachusetts General Hospital
General Internal Medicine Division
Boston, MA 02114

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

Response: Nearly one-third of the 150 million US adults who are employed are obese. Employees frequently eat meals acquired at work, and workplace food is often high in calories. Effective strategies for reducing non-nutritive energy intake during the workday could help address the rising prevalence of obesity.

Simplified labeling, such as traffic-light labels, provide understandable information about the relative healthfulness of food and can be placed on menu boards, shelf labels, and individual packages to help employees make healthier choices. Choice architecture (e.g., product placement) interventions make it easier and more convenient for employees to choose a healthy item. It is unknown if labeling interventions are associated with sustained reductions in calorie intake, or if there are only temporary effects after which most people revert to higher-calorie choices.

A previous study demonstrated that a hospital cafeteria traffic-light labeling and choice architecture program resulted in a higher proportion of healthy green-labeled purchases and lower proportion of unhealthy red-labeled purchases over two years. The current study analyzed calories purchased by a longitudinal cohort of 5,695 hospital employees who used the cafeteria regularly. The study examined changes in calories purchased over time and hypothesized the effect of the change in calorie intake on employees’ weight.

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Latinos, But Not African Americans, Report Less Discrimination in California Health Care

MedicalResearch.com Interview with:

Lucy Schulson, MD MPH Section of General Internal Medicine Boston University School of Medicine Boston, Massachusetts

Dr. Schulson

Lucy Schulson, MD MPH
Section of General Internal Medicine
Boston University School of Medicine
Boston, Massachusetts

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

Response: Research in the early 2000s in California demonstrated that racial and ethnic minorities, immigrants, and those with limited English proficiency (LEP) experienced high rates of discrimination in healthcare. Since those studies were published, California has made concerted efforts at the state and local level to address health equity; these efforts may have impacted perceptions of discrimination in health care. However, it is not known how perceptions of discrimination in healthcare have changed over the last ten years overall and for specific groups. This study sought to compare perceptions of discrimination in health care in 2003-2005 compared to 2015-2017 overall, for racial and ethnic minorities, among immigrants, and among those with Limited English Proficiency (LEP).  Continue reading

Trends in Health Equity by Race/Ethnicity, Sex, and Income

MedicalResearch.com Interview with:

Frederick J. Zimmerman PhD Professor Department of Health Policy and Management & Center for Health Advancement UCLA Fielding School of Public Health

Dr. Zimmerman

Frederick J. Zimmerman PhD
Professor
Department of Health Policy and Management &
Center for Health Advancement
UCLA Fielding School of Public Health 

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

Response: We’ve known that health equity is a priority, and we’ve known that we’re probably not doing well.  This new study quantifies the decline.

MedicalResearch.com: What should readers take away from your report? 

Response:  Looking at self-reported health status measures (general health and healthy days) from the Behavioral Risk Factor Surveillance System over 25 years, we found that while there have been small improvements in the disparities between White and African-American respondents over this period, several other measures of health equity show that we’re going backward.  In particular, while Black-White disparities slightly declined (0.5 standard deviations), income disparities increased markedly (1.5 SD) and a concept of Health Justice declines by 2 standard deviations over the 25 years.  An overall measure of health equity that integrates all of these perspectives was stagnant (self-reported general health) or declined by 1.0 standard deviations (healthy days).

While Black-White disparities have improved modestly since 1993, these gains have been more than wiped out by increasing income disparities in health. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: If we want serious progress on health equity, we need serious research on its causes.  That means tracking a single measure of health equity over time and across places to see what works and what doesn’t to improve performance in health equity.  

  • I’d like to acknowledge the generous support of the Robert Wood Johnson Foundations uclafsphfor partial funding for this research. 

Citation:

Zimmerman FJ, Anderson NW. Trends in Health Equity in the United States by Race/Ethnicity, Sex, and Income, 1993-2017. JAMA Netw Open. Published online June 28, 20192(6):e196386. doi:10.1001/jamanetworkopen.2019.6386

 

[last-modified] 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Sexting Linked to Increased Sexual Activity and Substance Abuse Among Teenagers

MedicalResearch.com Interview with:
texting, sextingCamille Mori, B.A. (hons)
M.Sc. candidate
Clinical Psychology Program
Determinants of Child Development Lab
University of Calgary 

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

Response: Sexting, which is the sharing of sexual messages, images, or videos over technological devices, has recently become a cause for concern among parents, teachers, and policy makers. However, the research on sexting among youth is still in early stages, and evidence of the risks associated with sexting is inconsistent. One way to resolve discrepancies in the field is to conduct a meta-analysis, which statistically summarizes existing research. We conducted a meta-analysis in order to examine the association between sexting and sexual activity (having sex, multiple sexual partners, and lack of contraception use). The associations between sexting and mental health related variables, including delinquent behaviour, substance use, and depression/anxiety were also examined.

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Statins May Double Risk of Diabetes

MedicalResearch.com Interview with:

Victoria A. Zigmont, PhD MPH Southern Connecticut State University/ Department of Public Health Assistant Professor New Haven, CT

Dr. Zigmont

Victoria A. Zigmont, PhD MPH
Southern Connecticut State University
Department of Public Health
Assistant Professor
New Haven, CT

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

  • We were interested in conducting this study to better understand the diabetogenic risks (dysglycemia (measured using elevated HbA1c) and new diagnoses of diabetes) associated with statin use for everyday people in the general population.
  • We conducted a retrospective cohort study and compared new users of statins to equivalent nonusers of statins. All of the study participants had indications for statin use in their electronic medical records for the primary (patients without a history of cardiovascular disease (CVD)) or secondary prevention (patients who have had CVD) of CVD. This study used pharmacy and medical claims, and biometric data as well as data from a health survey.

MedicalResearch.com: What are the main findings?

Response: After adjusting for confounding factors (age, gender, education level, ethnicity, cholesterol and triglyceride readings, body mass index, waist circumference and the number of visits to the doctor) statin users had at least double the risk for developing type 2 diabetes mellitus compared to statin nonusers. Individuals who used statins for the longest period of time (more than 2 years) had an even greater risk (3 times greater) for developing type 2 diabetes mellitus, after adjusting for confounding factors.

MedicalResearch.com: What should readers take away from your report?

  • These study findings indicate that statin users should receive special guidance on diet and physical activity for diabetes prevention from their medical care team. These individuals should also receive close monitoring to detect changes in glucose metabolism.
  • Statins are a well-established way to prevent heart attacks and strokes. It could be harmful if patients stopped taking their statins, and they should talk to their physicians if they have concerns about side effects associated with their medications.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Further research is needed to understand which statins and doses lead to a greater risk of diabetes, and well as the impact of statins on human metabolism. Clinical studies testing new medications should report on the risks and benefits in addition to the desired clinical outcomes.

This study was conducted as part of my doctoral dissertation at the Ohio State University. I am now an assistant professor at Southern Connecticut State University (New Haven). The study co-authors were Drs. Susan Olivo-Marston (dissertation advisor), Abigail Shoben, Bo Lu, Steven Clinton, Randall Harris and Gail Kaye. 

Citation:

Victoria A. Zigmont, Abigail B. Shoben, Bo Lu, Gail L. Kaye, Steven K. Clinton, Randall E. Harris, Susan E. Olivo‐Marston. Statin users have an elevated risk of dysglycemia and new‐onset‐diabetes. Diabetes/Metabolism Research and Reviews, 2019; e3189 DOI: 1002/dmrr.3189

 

[last-modified]

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Children with Birth and Chromosomal Defects More Likely to Develop Cancer

MedicalResearch.com Interview with:

Philip J. Lupo, PhD, MPH Co-Director, Childhood Cancer Epidemiology and Prevention Program, Texas Children's Cancer Center Associate Professor, Department of Pediatrics Section of Hematology-Oncology, Member, Dan L. Duncan Comprehensive Cancer Center Baylor College of Medicine Adjunct Associate Professor, Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences University of Texas School of Public Health

Dr. Lupo

Philip J. Lupo, PhD, MPH
Co-Director, Childhood Cancer Epidemiology and Prevention Program, Texas Children’s Cancer Center
Associate Professor, Department of Pediatrics
Section of Hematology-Oncology,
Member, Dan L. Duncan Comprehensive Cancer Center
Baylor College of Medicine
Adjunct Associate Professor, Human Genetics Center, Division of Epidemiology, Human Genetics and Environmental Sciences
University of Texas School of Public Health
 

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

Response: While cancer risk in children with certain chromosomal defects like Down syndrome is well established, much less is known for children with birth defects where there is no known genetic cause, sometimes called non-chromosomal defects. Non-chromosomal defects, as a group, affect more children, but one of the primary challenges of understanding risk among these children is that limited sample sizes make studying specific defects, like spina bifida, more difficult.

Because of that, we gathered data from birth, birth defect, and cancer registries across Texas, Arkansas, Michigan, and North Carolina to generate a birth cohort of more than 10 million children born between 1992 and 2013. We looked at diagnoses of cancer until 18 years of age to determine differences in cancer risk between those with and without birth defects.

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Lowered Price of Repatha® (evolocumab) Translates to Cost Effectiveness for Range of Heart Conditions in Some High Risk Patients

MedicalResearch.com Interview with:

Gregg C. Fonarow, MD, FACC, FAHA Eliot Corday Professor of Cardiovascular Medicine and Science Director, Ahmanson-UCLA Cardiomyopathy Center Co-Chief of Clinical Cardiology, UCLA Division of Cardiology Co-Director, UCLA Preventative Cardiology Program David Geffen School of Medicine at UCLA Los Angeles, CA, 90095-1679

Dr. Gregg Fonarow

Gregg C. Fonarow, MD, FACC, FAHA
Eliot Corday Professor of Cardiovascular Medicine and Science
Director, Ahmanson-UCLA Cardiomyopathy Center
Co-Chief of Clinical Cardiology, UCLA Division of Cardiology
Co-Director, UCLA Preventative Cardiology Program
David Geffen School of Medicine at UCLA
Los Angeles, CA 

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

Response: Last year, Amgen made the PCSK-9 inhibitor evolocumab available at a reduced list price of $5,850 per year This 60% reduction was aimed at improving patient access by lowering patient copays, especially for Medicare beneficiaries.

Additionally, the treatment landscape for PCSK9 inhibitors was further defined in 2018 when the American College of Cardiology/American Heart Association Multisociety Clinical Guideline on the Management of Blood Cholesterol recommended PCSK9 inhibitors for, among other patient populations, patients with very high-risk (VHR) ASCVD whose low-density lipoprotein cholesterol levels remain at 70 mg/dL or more  despite a heart-healthy lifestyle and treatment with standard background therapy.

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Decrease in Obesity Among Young US Children Enrolled in Special Supplemental Nutrition Program 2010-2016

MedicalResearch.com Interview with:

Liping Pan, MD, MPH Epidemiologist Division of Nutrition, Physical Activity, and Obesity National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention

Dr. Pan

Liping Pan, MD, MPH
Epidemiologist
Division of Nutrition, Physical Activity, and Obesity
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention

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

Response: Children with severe obesity face significant health and social challenges. Children with obesity are at higher risk for having other chronic health conditions and diseases, such as asthma, sleep apnea, bone and joint problems, and type 2 diabetes. They also have more risk factors for heart disease such as high blood pressure, impaired glucose tolerance, and high cholesterol than their healthyweight peers. Children with obesity can be bullied and teased more than their healthyweight peers. They are also more likely to suffer from social isolation, depression, and lower self-esteem. Children with obesity are also more likely to have obesity as adults. This can lead to lifelong physical and mental health problems. Adult obesity is associated with a higher risk of type 2 diabetes, heart disease, and many types of cancers. 

Childhood obesity is more common among children from lower-income families, as many lack access to healthy, affordable foods and beverages and opportunities for low-cost physical activity.

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Chronic Pain in Cancer Patients Varies by Income and Insurance Status

MedicalResearch.com Interview with:

Changchuan (Charles) Jiang MD, MPH MSSLW Internal Medicine Residency Program, Class of 2020 Ichan School of Medicine at Mount Sinai

Dr. Jiang

Changchuan (Charles) Jiang MD, MPH
MSSLW Internal Medicine Residency Program
Class of 2020
Ichan School of Medicine at Mount Sinai

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

Response: Chronic pain is one of the common side effects of cancer treatments and it has been linked to low life quality, lower adherence to treatment, higher medical cost. As the population of cancer survivors grows rapidly, chronic pain will be a major public health issue in this population. We know from previous studies that chronic pain is common in certain cancers such as breast cancer. However, little was known about the epidemiology of chronic pain in the cancer survivors until our study.

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Cinematic Rendering of CT Scans Can Assist Surgeons in Preparation for Surgery

MedicalResearch.com Interview with:

Christian Krautz, MD Department of Surgery, Universitätsklinikum Erlangen Friedrich-Alexander-Universität Erlangen Nürnberg Erlangen, Germany

Dr. Krautz

Christian Krautz, MD
Department of Surgery, Universitätsklinikum Erlangen
Friedrich-Alexander-Universität Erlangen Nürnberg
Erlangen, Germany 

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

Response: In this preclinical study that included 720 case evaluations, visualization with Cinematic Rendering allowed a more correct and faster comprehension of the surgical anatomy compared to conventional CT imaging independent from the level of surgical experience. Therefore,Cinematic Rendering is a tool that may assist HPB surgeons with preoperative preparation and intraoperative guidance through an improved interpretation of computed tomography imaging data.

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USPSTF Statement on PReP: Preexposure Prophylaxis for the Prevention of HIV Infection

MedicalResearch.com Interview with:

John W. Epling, Jr., M.D., M.S.Ed Professor of Family and Community Medicine Virginia Tech Carilion School of Medicine Roanoke, VA USPSTF Task Force Member

Dr. Epling

John W. Epling, Jr., M.D., M.S.Ed
Professor of Family and Community Medicine
Virginia Tech Carilion School of Medicine
Roanoke, VA
USPSTF Task Force Member
Medical Director of Employee Health and Wellness
Carilion Clinic
Dr. Epling maintains an active clinical primary care practice 

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

Response: HIV continues to be a significant public health issue, with about 40,000 people diagnosed each year. The U.S. Preventive Services Task Force reviewed the most recent evidence on how primary care clinicians can best help prevent HIV and its devastating health consequences. We looked at the research on two different topics: screening for HIV, and pre-exposure prophylaxis—a medication that prevents HIV, commonly known as PrEP. 

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Use of AV Grafts Drops in Dialysis Patients, But Still Room For Improvement

MedicalResearch.com Interview with:

Caitlin W. Hicks, M.D., M.S. Assistant Professor of Surgery Recipient of the Department of Surgery Rothman Early Career Development Award for Surgical Research Johns Hopkins Medicine

Dr. Hicks

Caitlin W. Hicks, M.D., M.S.
Assistant Professor of Surgery
Recipient of the Department of Surgery
Rothman Early Career Development Award for Surgical Research
Johns Hopkins Medicine

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

Response: Arteriovenous fistula are associated with better long-term patency, lower rates of infection, and lower long-term costs compared to arteriovenous graft. As a result, the Fistula First Catheter Last Guidelines recommend placement of an arteriovenous fistula over an AVG whenever possible.

We looked at individual physician utilization of AVF vs AVG for first-time AV access in Medicare beneficiaries. We found that the median physician utilization rate for AVG was only 18%, but that 21% of physicians use AVG in more than 34% of cases, which is above currently recommended  practice guidelines. 

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PTSD: Comparative Effectiveness of Medications, Psychotherapeutic and Combination Treatments

MedicalResearch.com Interview with:

Dr. Heike Gerger | Senior Postdoc University of Basel | Faculty of Psychology | Clinical Psychology and Psychotherapy Basel | Switzerland

Dr. Gerger

Dr. Heike Gerger | Senior Postdoc
University of Basel | Faculty of Psychology | Clinical Psychology and Psychotherapy
Basel | Switzerland

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

Response: Posttraumatic stress disorder (PTSD) is one of the most prevalent mental disorders, with a high risk of chronicity, comorbidity, and functional impairment. PTSD is complicated to treat, and the debate on the most efficacious treatment approach is ongoing. Treatment guidelines for the treatment of PTSD typically recommend different types of trauma-focused psychotherapeutic treatments as first-line PTSD treatment. However, concerning pharmacological therapies recommendations are inconsistent.

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Medicaid Expansion Linked to Reduced Deaths from Heart Disease

MedicalResearch.com Interview with:

Sameed Khatana, MD, MPH Fellow, Cardiovascular Medicine, Perleman School of Medicine Associate Fellow, Leonard Davis Institute of Health Economics University of Pennsylvania

Dr. Khatana

Sameed Khatana, MD, MPH
Fellow, Cardiovascular Medicine, Perleman School of Medicine
Associate Fellow,
Leonard Davis Institute of Health Economics
University of Pennsylvania 

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

Response: The Affordable Care Act (ACA) led to the largest increase in Medicaid coverage since the beginning of the program. However, a number of states decided not to expand eligibility. Studies of prior smaller expansions in Medicaid, such as in individual states, have suggested evidence of improved outcomes associated with Medicaid expansion. Additionally, studies of Medicaid expansion under the ACA of certain health measures such as access to preventive care and medication adherence have suggested some improvements as well. However, there have been no large, population-level studies to examine whether Medicaid expansion under the ACA led to changes in mortality rates. Given, a high burden of cardiovascular risk factors in the uninsured, we examined whether states that had expanded Medicaid had a change in cardiovascular mortality rates after expansion, compared to states that have not expanded Medicaid.

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Eggs Should Be Eaten In Moderation – Higher Intake Linked to Increased Mortality

MedicalResearch.com Interview with:

Prof. Katherine Tucker PhD Director of the Center for Population Health Zuckerberg College of Health Sciences Lowell’s Biomedical and Nutritional Sciences UMass

Dr. Tucker

Prof. Katherine Tucker PhD
Director of the Center for Population Health
Zuckerberg College of Health Sciences
Lowell’s Biomedical and Nutritional Sciences
UMass

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

Response: Cholesterol was excluded from the recent dietary guidelines, but research remains unclear about eggs and cholesterol on health.

MedicalResearch.com: What are the main findings? Why is the advice about the benefits/harms regarding egg intake often so conflicting?

Response: Higher egg intake and cholesterol intake were related to increased risk of mortality. Individual observational studies can be confusing as the overall results depend on the baseline intake of the population and adjustment for confounders.  

MedicalResearch.com: What should readers take away from your report?

Response: Balance and moderation is the key. Complete avoidance of eggs and egg yolks is not recommended because they have healthy nutrients as well. Extremely high intake of any single food may lead to imbalances. 3-4 eggs a week appears healthy but intakes of multiple eggs/day are probably not a good idea.  

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We need to clarify what exactly it is about too many eggs that is causing the risk. Healthy metabolism depends on a complex interaction of nutrients.

No disclosures 

Citation:

Zhong VW, Van Horn L, Cornelis MC, et al. Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality. JAMA. 2019;321(11):1081–1095. doi:10.1001/jama.2019.1572

https://jamanetwork.com/journals/jama/article-abstract/2728487 

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Traumatic Injuries Cost Medicare More Than Heart Failure, Pneumonia, Stroke or Heart Attacks

MedicalResearch.com Interview with:

Dr. Mark R. Hemmila MD Associate Professor of Surgery Division of Acute Care Surgery University of Michigan

Dr. Hemmila

Dr. Mark R. Hemmila MD
Associate Professor of Surgery
Division of Acute Care Surgery
University of Michigan 

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

Response: Traumatic injury has a tendency to be thought of as a disease that preferentially impacts younger people.  We wanted to explore the prevalence and impact of traumatic injury within the population of patients for whom Medicare is the third party payer.  Continue reading

Mortality: Number of Steps Matter, Up To a Point

MedicalResearch.com Interview with:

I-Min Lee, MD, ScDProfessor of Medicine, Harvard Medical SchoolProfessor of EpidemiologyHarvard T.H. Chan School of Public Health

Prof. I-Min Lee

I-Min Lee, MD, ScD
Professor of Medicine, Harvard Medical School
Professor of Epidemiology
Harvard T.H. Chan School of Public Health 

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

Response: While we have many studies showing that physical activity is beneficial for health, there are few data on steps and health, particularly long-term health outcomes.  An expert committee – the 2018 Physical Activity Guidelines Advisory Committee, which reviewed the scientific evidence to support the recently released Physical Activity Guidelines for Americans, 2nd edition – noted this (i.e., the relation between steps and health outcomes) to be a critical gap in knowledge, since many individuals are using wearables and monitoring their step counts.

We often hear the number 10,000 steps cited as a daily goal, but the basis for this number is unclear. It likely originated as a marketing tool: in 1965, the Yamasa Clock and Instrument Company, Japan sold a pedometer called “Manpo-kei” – “ten thousand steps meter” in Japanese.

For many older people, 10,000 steps/day can be a very daunting goal; thus, we wanted to investigate whether this was necessary for lower mortality rates in older women.  Additionally, steps taken can be fast or slow, and there are no published studies on step intensity and long-term health outcomes.  Note that walking pace and step intensity are not the same concept: walking pace gauges intensity when walking purposefully (e.g., for exercise or transportation), while step intensity assesses an overall best natural effort in our daily life. Continue reading

Does Genetic Information Encourage Doctors to Switch Anticoagulation Medications?

MedicalResearch.com Interview with:

Thomas J. Povsic, MD, PhDInterventional CardiologistDuke Clinical Research InstituteDuke University School of MedicineDurham, North Carolina 

Dr. Povsic

Thomas J. Povsic, MD, PhD
Interventional Cardiologist
Duke Clinical Research Institute
Duke University School of Medicine
Durham, North Carolina 

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

Response: The background for this study is that it is unknown how mandatory reporting of CYP2C19 metabolizer status affects how doctors treat patients or to what degree provision of this information would affect choice of a P2Y12 inhibitor within a clinical trial.

As part of the GEMINI-ACS trial, all patients underwent CYP2C19 metabolizer testing.  This trial enrolled patients with a recent acute coronary syndrome and randomized them to aspirin or a low dose of rivaroxaban.  All patients were also to be treated with ticagrelor or clopidogrel, which was at the discretion of the investigator.  Investigators were given information regarding the CYP2C19 metabolizer status about a week after randomization.  Importantly prior to randomization, all investigators were asked how they expected to use this information, and then we followed what they actually did.

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Only 1 in 5 Cancer Drugs Receiving FDA Accelerated Approval Have Proven Benefits in Confirmatory Trials

MedicalResearch.com Interview with:

Bishal Gyawali  MD PhD Med Onc. Asst. Professor 

Dr. Gyawali

Bishal Gyawali  MD PhD

  • Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
  • Department of Oncology, Department of Public Health Sciences, and Division of Cancer Care and Epidemiology, Queen’s University, Kingston, Ontario, Canada

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

Response: Accelerated approval pathway from the FDA allows cancer drugs to come to market sooner by showing improvement in surrogate measures such as change in tumor size. Surrogate measures do not reflect clinical benefit in terms of living longer or feeling better. So, when a drug receives accelerated approval, the drug is required to undergo a confirmatory trial to confirm that true clinical benefit from the drug actually exists.

Last year, a paper from the FDA argued that accelerated approval pathway is working effectively because 55% of such drugs confirmed clinical benefit. However, we saw that most of those drugs were actually improving only a surrogate measure even in confirmatory trials. So the confirmatory trials were not confirming clinical benefit but actually confirming benefit in a surrogate endpoint. We investigate that issue in our study using updated results from the confirmatory trials that were ongoing at the time of FDA review.

Our main finding is that only one-fifth of cancer drugs that received accelerated approval actually improved overall survival later in confirmatory trials. For, 20% of other drugs, the confirmatory trials tested the same surrogate endpoint as did the preapproval trial. For another 21%, the confirmatory trial showed benefit in a surrogate endpoint different from the one used in preapproval trial. Furthermore, when drugs fail to confirm clinical benefits in confirmatory trials, they still continue to remain on market.  Continue reading

Study Finds You Don’t Have To Fast Before Getting Your Lipids Measured

MedicalResearch.com Interview with:

Samia Mora, MD, MHSAssociate Physician, Brigham and Women's HospitalAssociate Professor of Medicine, Harvard Medical SchoolBrigham and Women's HospitalDepartment of MedicinePreventive MedicineBoston, MA 02115 

Dr. Mora

Samia Mora, MD, MHS
Associate Physician, Brigham and Women’s Hospital
Associate Professor of Medicine, Harvard Medical School
Brigham and Women’s Hospital
Department of Medicine
Preventive Medicine
Boston, MA 02115 

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

Response: Lipid testing plays a major role in cardiovascular disease (CVD) risk screening, prediction, and treatment. In the past decade, several pivotal studies (including the Women’s Health Study, the Copenhagen City Heart Study, and the Copenhagen General Population Study) compared populations of individuals who had fasting lipid testing with populations of individuals who had nonfasting lipid testing, and found that non-fasting lipids were at least as good as fasting lipids in cardiovascular risk screening and predicting CVD risk.

To date, however, no study has examined the cardiovascular predictive value of lipids measured on the same individuals who had both fasting and nonfasting lipid testing. This is important because individual-level variability in fasting versus nonfasting lipids may not be captured when looking at population-level risk associations, and evidence from randomized studies is lacking. Furthermore, it is unclear whether substituting nonfasting lipids would misclassify cardiovascular risk for individuals who may be eligible for statin therapy.

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