It is possible that some patients may suffer more harm than good, so doctors should be cautious when considering treatment...
Dr. John A. Staples, MD
Clinical Assistant Professor
University of British Columbia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: At this time last year, my co-author Candace Yip and I noticed an impressive number of advertisements for Halloween-themed parties at bars taped to lamp-posts. We wondered if the combination of dark costumes, dark evenings, alcohol and trick-or-treaters made the streets more dangerous for pedestrians.
To see if our hunch was correct, we examined 42 years of data on all fatal vehicle crashes in the United States between 1975 and 2016. We compared the number of pedestrian fatalities between 5 p.m. and midnight on Halloween with the number during the same hours on control days one week earlier and one week later. We found that 14 pedestrian deaths occurred on the average Halloween, while only 10 pedestrian deaths occurred on the average control evening. This corresponded to a 43% increase in the relative risk of pedestrian fatality on Halloween.
Among children aged 4 to 8 years of age, the risk of death was ten times higher on Halloween evening compared to control evenings. Risks were highest around 6pm, which is prime trick-or-treating time. Absolute risks were small and declined throughout the four decades of the study, but the relative risk increase on Halloween persisted throughout the entire study interval. 
Faiz Gani, PhD
Postdoctoral research fellow
Department of Surgery
Johns Hopkins University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Firearm related injuries are a leading cause of injury and death in the United States, yet, due to combination of factors, limited data exist that evaluate these injuries, particularly among younger patients (patients younger than 18 years).
The objective of this study was to describe emergency department utilization for firearm related injuries and to quantitate the financial burden associated with these injuries.
In our study of over 75,000 emergency department visits, we observed that each year, over 8,300 children and adolescents present to the emergency department for the treatment / management of a gunshot injury. Within this sub-population of patients, we observed that these injuries are most frequent among patients aged 15-17 years and while these injuries decreased over time initially, were observed to increase again towards the end of the time period studied.
In addition to describing the clinical burden of these injuries, we also sought to describe the financial burden associated with these injuries. For patients discharged from the emergency department, the average (median) charge associated with their care was $2,445, while for patients admitted as inpatients for further care, the average (median) charge was $44,966.
Collectively these injuries resulted in $2.5 billion in emergency department and hospital charges over the time period studied. This translates to an annual financial burden of approximately $270 million.
Dr Sharon Leitch | MBChB, DCH, PGDipGP, FRNZCGP
General Practitioner, Clinical Research Training Fellow
Department of General Practice and Rural Health
University of Otago
New Zealand
MedicalResearch.com: What is the background for this study?
Response: Loneliness is associated with poor health, reduced quality of life, and increased mortality. Loneliness typically worsens with age. We were curious to learn what the prevalence of loneliness was among older New Zealanders, if there were age-specific associations with loneliness, whether there were any associations between demographic and psychosocial variables and loneliness, and we also wanted to compare centenarians (100 years or older) with elderly people (aged 65-99 years). Centenarians are a particularly interesting group to study because they are a model of successful ageing.
The international Resident Assessment Instrument-Home Care (interRAI-HC) assessment has been mandatory in New Zealand for anyone undergoing assessment for publically funded support services or residential care since 2012, providing us with a comprehensive data set. We conducted a retrospective, observational, cross-sectional review of the interRAI-HC data from over 70,000 people living in the community who had their first assessment during the study period (January 2013-November 2017). We analysed eight items from the interRAI-HC data set to describe the population and evaluate the core psychosocial components of aging; age, gender, ethnicity, marital status, living arrangements, family support, depression and loneliness.
Prof. Cooper[/caption]
Jamie Cooper AO
BMBS MD FRACP FCICM FAHMS
Professor of Intensive Care Medicine
Monash University
Deputy Director & Head of Research,
Intensive Care & Hyperbaric Medicine
The Alfred, Melbourne
MedicalResearch.com: What is the background for this study?
Response: 50-60 million people each year suffer a traumatic brain injury (TBI) . When the injury is severe only one half are able to live independently afterwards.
Cooling the brain (hypothermia) is often used in intensive care units for decades to decrease inflammation and brain swelling and hopefully to improve outcomes, but clinical staff have had uncertainty whether benefits outweigh complications.
We conducted the largest randomised trial of hypothermia in TBI, in 500 patients, in 6 countries, called POLAR. We started cooling by ambulance staff, to give hypothermia the best chance to benefit patients. We continued for 3-7 days in hospital ind ICU. We measured functional outcomes at 6 months.
Maintaining a high functional aerobic class appears to be associated with low mortality in all age groups. ...
Dr. Winkelman[/caption]
Tyler Winkelman MD, MSc
Clinician-Investigator
Division of General Internal Medicine, Hennepin Healthcare
Center for Patient and Provider Experience, Hennepin Healthcare Research Institute
Assistant Professor
Departments of Medicine & Pediatrics
University of Minnesota
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Trends in amphetamine use are mixed across data sources. We sought to identify trends in serious, problematic amphetamine use by analyzing a national sample of hospitalizations.
Amphetamine-related hospitalizations increased over 270% between 2008 and 2015. By 2015, amphetamine-related hospitalizations were responsible for $2 billion in hospital costs. While opioid-related hospitalizations were more common, amphetamine-related hospitalizations increased to a much larger degree. After accounting for population growth, amphetamine hospitalizations grew 245% between 2008 and 2015, whereas opioid-related hospitalizations increased 46%. Amphetamine-related hospitalizations were more likely to be covered by Medicaid and be in the western United States compared with other hospitalizations. In-hospital mortality was 29% higher among amphetamine-related hospitalizations compared with other hospitalizations.
Prof. Pickering[/caption]
Dr John W Pickering, BSc(Hons), PhD, BA(Hons)
Associate Professor , Senior Research Fellow in Acute Care
Emergency Care Foundation, Canterbury Medical Research Foundation, Canterbury District Health Board | Christchurch Hospital
Research Associate Professor | Department of Medicine
University of Otago Christchurch
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The assessment of patients with suspected myocardial infarction is one of the most common tasks in the emergency department. Most patients assessed (80 to 98% depending on the health system) are ultimate not diagnosed with an MI. High-sensitivity troponin assays have been shown to have sufficient precision at low concentrations to allow very early rule-out of myocardial infarction. However, these are lab-based assays which typically result in a delay from blood sampling before the result is available and the physician is able to return to a patient to make a decision to release the patient or undertake further investigation. Point-of-care assays provide results much quicker, but have to-date not had the analytical characteristics that allow precise measurements at low concentrations.
In this pilot study we demonstrated that a single measurement with a new point-of-care assay (TnI-Nx; Abbott Point of Care) which can measure low troponin concentrations, could safely be used to rule-out myocardial infarction a large proportion of patients (57%). The performance was at least comparable to the high-sensitivity troponin I assay, if not a little better (44%).
Dr. Po-Hong Liu[/caption]
Stuart Po-Hong Liu, MD, MPH
Clinical and Translational Epidemiology Unit Massachusetts General Hospital and
Harvard Medical School
Boston
MedicalResearch.com: What is the background for this study?
Response: Although there were global decreases in overall colorectal cancer (CRC) incidence, CRC rates have increased dramatically in those aged 20 to 49 years in the United States, parts of Europe, and Asia. The etiology and early detection of young-onset becomes an emerging research and clinical priority. Another important fact that is that this emerging public health concern has resulted in updated guidelines from the American Cancer Society advising average-risk screening begin at age 45, rather than 50.
However, up to this point, the etiology of young onset CRC remains largely unknown. Elucidating the role of traditional CRC risk factors in the etiopathogenesis of young-onset CRC is one of the first research agenda.
Dr. Daniel J. Livorsi, MD
Assistant Professor
INFECTIOUS DISEASE SPECIALIST
University of Iowa
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: One of the Joint Commission’s standards is that hospitals audit and provide feedback on hand hygiene compliance among healthcare workers. Audit-and-feedback is therefore commonly practiced in US hospitals, but the effective design and delivery of this intervention is poorly defined, particularly in relation to hand hygiene improvement.
We studied how 8 hospitals had implemented audit-and-feedback for hand hygiene improvement. We found that hospitals were encountering several barriers in their implementation of audit-and-feedback. Audit data on hand hygiene compliance was challenging to collect and was frequently questioned. The feedback of audit results did not motivate positive change.
Elani Streja MPH PhD
Division of Nephrology and Hypertension
University of California, Irvine | UCI ·
Elvira O. Gosmanova, MD, FASN
Medicine/Nephrology
Albany Stratton VA Medical Center
Csaba P Kovesdy MD
Fred Hatch Professor of Medicine
Division of Nephrology, University of Tennessee Health Science Center
Nephrology Section Chief, Memphis VA Medical Center
Director, Clinical Outcomes and Clinical Trials Program
Memphis TN, 38163
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Cardiovascular disease (CVD) is one of the leading causes of mortality and morbidity in patients with chronic kidney disease (CKD).
Statins are lipid-lowering drugs that have a proven track record in reducing risk of CVD in patients with advanced CKD who did not yet reach its terminal stage or end-stage renal disease (ESRD). Paradoxically, new prescription of statins after ESRD onset failed to reduce CVD related outcomes in three large clinical trials. However, benefits of statin continuation at transition from advanced CKD to ESRD was never formally tested.
Therefore, we identified a cohort of 14,298 US Veterans who used statins for at least half of the year during 1 year before ESRD transition and evaluated mortality outcomes based on whether statins were continued or stopped after ESRD onset.
We found that ESRD patients who continue statins for at least 6 months after transition had 28% and 18% lower risk of death from any cause or cardiovascular causes, respectively, during 12-months of follow up, as compared with statin discontinuers.
The results demonstrate both the potential and the challenges of using AI systems to identify diabetic retinopathy in clinical practice....
The fact that men are also significantly affected emphasizes that this is not a women´s issue but a phenomenon that...
Dr. Howard[/caption]
Dr. George Howard DPH, for the research team
Professor and Chair of Biostatistics
University of Alabama at Birmingham
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Perhaps the most important distinction to draw for the readers is that this is not a paper about risk factors for hypertension, but rather a paper that looks for contributors to the black-white difference in the presence of hypertension. This racial difference in hypertension is the single biggest contributor to the immense disparities in cardiovascular diseases (stroke, MI, etc.) that underpin the approximate 4-year difference in black-white life expectancy. As such, this work is “going back upstream” to understand the causes that lead to blacks having a higher prevalence of hypertension than whites with hopes that changing this difference will lead to reductions in the black-white disparities in cardiovascular diseases and life expectancy. This difference in the prevalence of hypertension is immense … in our national study of people over age 45, about 50% of whites have hypertension compared to about 70% of blacks … that is HUGE. We think that changing this difference is (at least one of) the “holy grail” of disparities research.
This study demonstrates that there are several “targets” where changes could be made to reduce the black-white difference in hypertension, and thereby the black-white difference in cardiovascular diseases and life expectancy; however, the most “potent” of these appears to be diet changes. Even though we know what foods promote a heart healthy lifestyle, we still have major differences in terms of how that message is being adopted by various groups of Americans. We can’t know from our data what about the Southern diet is driving these racial differences in hypertension but we can begin to design community based interventions that could possibly help to reduce these racial disparities through diet. It is interested that diet more than being overweight was the biggest contributor to the racial disparities in hypertension. This would suggest we might want to consider interventions to increase health foods in the diet while minimizing fried foods and processed meats.
While this is not a clinical trial that “proves” that changes in diet will reduce the disparity in blood pressure, we consider the “message” of the paper to be good news, as the things that we found that contribute to this black-white difference are things that can be changed. While it is always hard for individual people to change their diet, it can be done. More importantly, over time we as a society have been changing what we eat … but we need to “double down” and try to change this faster. Also, policy changes of play a role to gently make changes in these diet, where for example Great Britain has been making policy changes to slowly remove salt from the diet. These changes are possible … and as such, we may see a day when the black-white differences in hypertension (and thereby CVD and death) may be reduced.
Dr. med. Martin Feller, MSc Epidemiology (LSHTM)
FMH Allgemeine Innere Medizin & Prävention und Gesundheitswesen
Scientific Research Coordinator
INSELSPITAL, Universitätsspital Bern
Universitätsklinik und Poliklinik für Allgemeine Innere Medizin (RodondiResearch)
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: SUBCLINICAL HYPOTHYROIDISM IS VERY COMMON, WITH AN ESTIMATED 13 MILLION AMERICANS AFFECTED. SUBCLINICAL HYPOTHYROIDISM IS OFTEN TREATED WITH LEVOTHYROXINE, PARTICULARLY WHEN IT CO-OCCURS WITH SYMPTOMS POTENTIALLY ATTRIBUTABLE TO HYPOTHYROIDISM SUCH AS TIREDNESS, CONSTIPATION, AND UNEXPLAINED WEIGHT GAIN. THIS PRACTICE MAY CONTRIBUTE TO LEVOTHYROXINE BEING THE MOST PRESCRIBED DRUG FROM 2014 ONWARDS IN THE US.
HOWEVER, IN OUR META-ANALYSIS OF 21 RANDOMIZED CLINICAL TRIALS, WE OBSERVED NO BENEFIT OF LEVOTHYROXINE THERAPY (COMPARED TO PLACEBO) REGARDING GENERAL QUALITY OF LIFE, THYROID-RELATED SYMPTOMS, DEPPRESSIVE SYMPTOMS, FATIGUE, COGNITIVE FUNCTION, BLOOD PRESSURE OR BODY-MASS INDEX. 
Professor Yair Lotan MD
Chief of Urologic Oncology
Holder of the Helen J. and Robert S. Strauss Professorship in Urology
UT Southwestern Medical Center at Dallas
Department of Urology
Dallas, Texas 75390-9110
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Urinary tract infections are extremely common in women and many women experience recurrent episodes which impact their quality of life. There are also many women who do not drink as much water as is recommended.
This study found that in healthy women with recurrent UTIs who drink less than 1.5 liters per day, the additional intake of 1.5 liters of water daily reduced the risk of recurrent infections by nearly 50%. 
MedicalResearch.com Interview with: [caption id="attachment_44776" align="alignleft" width="200"] Dr. McCoy[/caption] Thomas McCoy, M.D. Assistant Professor of Psychiatry Massachusetts General Hospital Psychiatry Massachusetts General Hospital MedicalResearch.com: What is the...
Raghav Tripathi[/caption]
Raghav Tripathi, MPH
Case Western Reserve University
MD Candidate, Class of 2021
MedicalResearch.com: Why did you decide to perform this study?
Response: Differences in the impact of dermatologic conditions on different groups have been of interest to our research group for a long time. Previously, our group had found differences in time to treatment for patients with different skin cancers. Beyond this, we had found differences in mortality and incidence of various skin conditions (controlling for other factors) in different racial groups/ethnicities, socioeconomic groups, demographic groups, and across the rural-urban continuum.
The goal of this study was to investigate socioeconomic and demographic differences in utilization of outpatient dermatologic care across the United States. As demographics throughout the country become more diverse, understanding differences in utilization of dermatologic care is integral to developing policy approaches to increasing access to care across the country. 
Thomas J Moore[/caption]
Thomas J Moore AB
Senior Scientist Institute for Safe Medication Practices
Lecturer, Department of Epidemiology and Biostatistics
The George Washington University
Milken Institute of Public Health
Alexandria, VA 22314
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Haarbauer-Krupa[/caption]
Juliet Haarbauer-Krupa, PhD
Senior Health Scientist
Division of Unintentional Injury Prevention
CDC
MedicalResearch.com: What is the background for this study?
Fudi Wang, M.D., Ph.D.
Qiushi Chair Professor
Nutrition Discovery Innovation Center
School of Public Health/School of Medicine
Zhejiang University
Hangzhou China
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Parkinson disease (PD) is the second most common neurodegenerative disease affecting approximately 10 million people around the world. To date, the cause of PD remains poorly understood. It is reported that 90% PD cases have no identifiable genetic cause. What’s worse, few therapeutic advances for the treatment of PD have been made in the past decades. Nevertheless, growing prospective longitudinal studies shed lights on the potential beneficial effect of lifestyle factors on reducing the risk of developing Parkinson disease. In this study, we performed a a dose-response meta-analysis of more than half a million participants.
We found that physical activity, particularly moderate to vigorous physical activity, could significantly reduce PD risk.
Dr. Cohen[/caption]
Eyal Cohen, MD, MSc, FRCP(C)
Associate Scientist and Program Head (interim), Child Health Evaluative Sciences
Research Institute, The Hospital for Sick Children
Staff Physician, Division of Paediatric Medicine, The Hospital for Sick Children
Professor, Paediatrics and Health Policy
Management & Evaluation
The University of Toronto
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Having a child with a major birth defect can be a life-changing and stressful event for the child's mother. This stress may be associated with higher risk of premature cardiovascular disease.
We found that mothers of infants born with a major birth defect had a 15% higher risk of premature cardiovascular disease that a comparison group of mothers. The risk was more pronounced, rising to 37% among mothers who gave birth to a more severely affected infant (and infant born with major birth defects affecting more than one organ system). The risk was apparent even within the first 10 years after the birth of the child.
Dr. Merrick[/caption]
Melissa T. Merrick, PhD
Behavioral Scientist,
Surveillance Branch, Division of Violence Prevention
CDC
MedicalResearch.com: What is the background for this study?
Response: Childhood experiences build the foundation for health throughout a person’s life. Adverse childhood experiences (ACEs) are potentially traumatic experiences, which occur in childhood. Exposure to ACEs, especially for young people without access to safe, stable, nurturing relationships and environments, can impact health in many ways, including increased risk of chronic disease, engagement in risky behaviors, limited life opportunities, and premature death.
Dr. Verbruggen[/caption]
Sascha Verbruggen, MD, PhD
Pediatric intensivist
Erasmus MC-Sophia Children's Hospital
MedicalResearch.com: What is the background for this study?
Response: In critically ill children treated in the pediatric intensive care unit (PICU) are often difficult to feed. The subsequent macronutrient deficit was found to be associated with impaired outcomes in the PICU. Furthermore, being undernourished in the PICU has also been associated with poor outcome of critical illness in children.
These associations formed the basis for guidelines recommending initiation of parenteral nutritional support early when enteral feeding is insufficient. However, the multicenter randomised controlled trial (RCT) 'Pediatric Early versus Late Parenteral Nutrition in Critical Illness' (PEPaNIC), including 1440 critically ill children, showed that withholding PN for one week (Late-PN) resulted in fewer new infections and reduced the duration of PICU stay as compared to initiating PN at day 1 (Early-PN). However, withholding PN for one week in critically ill children, who are already undernourished upon admission to the PICU, raised concerns among experts.
Therefore we set out to investigate the impact of withholding supplemental PN in a subgroup of critically ill children who were acutely undernourished upon admission to the PICU. 
Dr. Zakrison[/caption]
Tanya L. Zakrison, MHSc MD FRCSC FACS MPH
Associate Professor of Surgery
University of Miami Miller School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Over 2 million people in the United States are incarcerated, the highest rate in the entire world. To date no national statistics on surgical outcomes have been reported in this vulnerable patient population. We examined 301 medical examiner’s reports from prisoner deaths in Miami-Dade County. Excluding those with confounding medical conditions such as cirrhosis and cancer, we still found that one in five deaths were being attributed to trauma and reversible surgical diseases.
Crystal meth – illicit methamphetamine hydrochloride[/caption]
Ti-Fei Yuan, PhD
School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China
Guangdong-Hongkong-Macau Institute of CNS Regeneration, Ministry of Education CNS Regeneration Collaborative Joint Laboratory, Jinan University, Guangzhou, China
School of Psychology, Nanjing Normal University, Nanjing, China
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Addiction is causing serious challenge to public health. Few drugs can treat or even alleviate addiction.
In recent years, non-invasive brain stimulation has been used to modulate craving responses in different types of drug addicts (heroin, methamphetamine, cocaine), and to prevent smoking or alcohol abuse.
However it is unknown if brain stimulation can also help addicts get rid of the aversive symptoms in the early withdrawal period.
The present study is to our knowledge, the first trial to alleviate drug withdrawal symptoms and associated insomnia with non-invasive transcranial magentic stimulation. 
Dr. Harris[/caption]
Patrick Harris FRACP
Staff Specialist
Microbiology | Pathology Queensland | Health Support Queensland
Postdoctoral Research Fellow
University of Queensland, UQ Centre for Clinical Research (Paterson Group
MedicalResearch.com: What is the background for this study?
Response: Increasingly, common bacterial pathogens such as E. coli or Klebsiella have acquired genes known as extended-spectrum beta-lactamases (ESBLs), which mediate resistance to many of our most important antibiotics. Despite their clinical importance, we have limited information derived from randomised clinical trials on the best antibiotic treatments for life-threatening infections caused by these ESBL-producers.
We aimed to compare two readily available antibiotics, meropenem (a carbapenem drug, as the “standard of care”) and piperacillin-tazobactam (which may be an alternative to meropenem). Many ESBL-producing bacteria test susceptible to piperacillin-tazobactam in the laboratory, yet clinical efficacy has been uncertain. Some observational studies have suggested that piperacillin-tazobactam may be effective against ESBL-producers, but the data have been contradictory. The theory has been that piperacillin-tazobactam may be less likely to select for resistance to carbapenems - which, when it occurs, can result in infection with bacteria that are almost untreatable.
Dr. Hadland[/caption]
Scott E. Hadland, MD, MPH, MS
Assistant Professor of Pediatrics
Boston Medical Center / Boston University School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Amidst a worsening overdose epidemic in the United States, adolescents and young adults have not been spared. Although evidence-based medications like buprenorphine, naltrexone, and methadone are recommended for adolescents and young adults, the extent to which youth receive these medications — and whether these medications help retain youth in addiction treatment — isn’t yet known.
Dr. Simon[/caption]
Melissa A. Simon, M.D., M.P.H.
Member, U.S. Preventive Services Task Force
George H. Gardner professor of clinical gynecology, Vice chair of clinical research
Department of Obstetrics and Gynecology
Professor of preventive medicine and medical social sciences
Northwestern University Feinberg School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The number of babies born with syphilis is increasing, mirroring the recent increase of syphilis among women. Syphilis infection passed from a pregnant woman to her baby, also known as congenital syphilis, can lead to serious health complications for the baby including premature birth, low birthweight, birth defects, and even death. The Task Force recommends that all pregnant women be screened for syphilis as early in pregnancy as possible to prevent congenital syphilis.