Author Interviews, COVID -19 Coronavirus, Infections, JAMA, NYU/NYMC, Race/Ethnic Diversity / 04.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56129" align="alignleft" width="133"]Gbenga Ogedegbe, MD, MPH Dr. Adolph & Margaret Berger Professor of Population Health Director, Division of Health & Behavior Director Center for Healthful Behavior Change Department of Population Health NYU Langone Health NYU School of Medicine Dr. Ogedegbe[/caption] Gbenga Ogedegbe, MD, MPH Dr. Adolph & Margaret Berger Professor of Population Health Director, Division of Health & Behavior Director Center for Healthful Behavior Change Department of Population Health NYU Langone Health NYU School of Medicine MedicalResearch.com: What is the background for this study? Response: The background for the study is the disproportionately higher rates of COVID-19 hospitalizations and deaths in Blacks and Hispanics compared to Whites in major cities across the country. We asked two questions: 1) are there racial/ethnic differences in COVID-19 outcomes (likelihood of testing positive, hospitalizations, severe illness, and deaths) among patients who receive care at NYU Langone Health? If there are differences, are they explained by comorbidity and neighborhood characteristics (poverty, educational status, employment, housing, proportion of Blacks and Hispanics in communities)?
Author Interviews, JAMA, Social Issues / 04.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56079" align="alignleft" width="196"]Amal Trivedi, MD, MPH Professor of Health Services, Policy & Practice Director of Graduate Studies, Health Services Research Brown University School of Public Health Dr. Trivedi[/caption] Amal Trivedi, MD, MPH Professor of Health Services, Policy & Practice Director of Graduate Studies, Health Services Research Brown University School of Public Health MedicalResearch.com: What is the background for this study? Response: Nearly all hospitals in the United States, including all Veterans Affairs Medical Centers (VAMCs), report mortality rates for patients hospitalized for common medical and surgical conditions. But these mortality rates do not adjust for socioeconomic factors that are associated with worse outcomes following hospitalization.
Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics, Smoking, Stanford, Tobacco, Tobacco Research / 03.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56099" align="alignleft" width="187"]Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her) Professor of Pediatrics Taube Endowed Research Faculty Scholar Professor (by courtesy), Epidemiology and Population Health Professor (by courtesy), Psychiatry and Behavioral Sciences Director of Fellows’ Scholarship, Department of Pediatrics Dr. Halpern-Felsher[/caption] Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her) Professor of Pediatrics Taube Endowed Research Faculty Scholar Professor (by courtesy), Epidemiology and Population Health Professor (by courtesy), Psychiatry and Behavioral Sciences Director of Fellows’ Scholarship, Department of Pediatrics Director of Research, Division of Adolescent Medicine Co-leader, Scholarly Concentrations, Pediatrics Residency Program MedicalResearch.com: What is the background for this study? What are the main findings? Response: To examine adolescent and young adult e-cigarette use during the COVID-19 pandemic. There were 4 main findings:
  • About 2/3 of adolescent and young adult ever-e-cigarette users reported either quitting or cutting back on e-cigarette use since COVID-19 began.
  • Users least likely to quit or cut back e-cigarette use were those showing higher levels of nicotine dependence and those who had used e- cigarettes a large number of times.
  • Adolescent and young adult e-cigarette users found it harder to access e-cigarettes, but unlike studies before COVID-19, the dominant source of purchasing e-cigs was online instead of brick-and-mortar during COVID-19 pandemic.
  • Youth below 21 years were able to purchase e-cigarettes without any age verification, and those whose age was verified were asked to physically show ID or provided an email, which are less effective means to prevent underage youth use.
Author Interviews, Heart Disease, JAMA, Lifestyle & Health, USPSTF / 03.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56105" align="alignleft" width="133"]Dr. John Epling, M.D., M.S.Ed Professor of family and community medicine Virginia Tech Carilion School of Medicine in Roanoke, VA. Medical director of research for family and community medicine Medical director of employee health and wellness for the Carilion Clinic Dr. Epling[/caption] Dr. John Epling, M.D., M.S.Ed Professor of family and community medicine Virginia Tech Carilion School of Medicine in Roanoke, VA. Medical director of research for family and community medicine Medical director of employee health and wellness for the Carilion Clinic Dr. Epling joined the U.S. Preventive Services Task Force in January 2016. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cardiovascular disease, which includes heart disease and stroke, is one of the leading causes of death in the United States. Nearly half of all adults have at least one risk factor for cardiovascular disease. Evidence shows that counseling aimed at helping people improve their diet and increase their physical activity can help prevent cardiovascular disease. This typically involves a trained counselor who provides education, helps people set goals, shares strategies, and stays in regular contact.  The Task Force recommends behavioral counseling interventions that promote a healthy diet and physical activity to help people at risk for cardiovascular disease stay healthy.
Author Interviews, COVID -19 Coronavirus, Inflammation, JAMA, Pediatrics, Race/Ethnic Diversity / 30.11.2020

MedicalResearch.com Interview with: Ellen H. Lee, MD Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene Long Island City, New York  MedicalResearch.com: What is the background for this study? Response: Published reports of the COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) have described higher proportions of cases among Black and Hispanic children. However, case series are limited by the lack of population-level data, which could help provide context for the racial/ethnic distribution of cases described in these reports. The New York City (NYC) Department of Health and Mental Hygiene required reporting of all possible cases of MIS-C among NYC residents, and for cases meeting MIS-C criteria, applied population denominators to calculate MIS-C incidence rates stratified by race/ethnicity. To help characterize the burden of severe COVID-19 disease in NYC, we also calculated COVID-19 hospitalization rates stratified by race/ethnicity.
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, JAMA, Yale / 26.11.2020

MedicalResearch.com Interview with: [caption id="attachment_56014" align="alignleft" width="191"]Lajos Pusztai, M.D, D.Phil. Professor of Medicine Director, Breast Cancer Translational Research Co-Director, Yale Cancer Center Genetics and Genomics Program Yale Cancer Center Yale School of Medicine Dr. Pusztai[/caption] Lajos Pusztai, M.D, D.Phil. Professor of Medicine Director, Breast Cancer Translational Research Co-Director, Yale Cancer Center Genetics and Genomics Program Yale Cancer Center Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In HER2-positive early stage (stage I-II) breast cancer, several different preoperative (also called neoadjuvant) chemotherapy options exist, each of these is associated with a different rate of complete eradication of cancer from the breast and lymph nodes (called pathologic complete response or pCR). Patients who experience pCR have excellent long term survival. The complete response rates range from 20% to 80%, the rates are higher with regimens that include several different chemotherapy drugs and dual HER2 blockade. Unfortunately, these highly effective multi-drug treatment regimens are also more toxic and more expensive.  We also learned that patients who do not achieve pCR after preoperative therapy, have high rates of recurrence, but the recurrence rate can be improved by administering postoperative adjuvant therapy. These two observations together, (1) different regimens with different toxicities and costs resulting in different pCR rates, and (2) existence of effective postoperative therapies for patients with residual cancer after preoperative therapy, sets the stage for combining various pre- and post-operative treatment strategies. Starting with a shorter, less toxic and less expensive neoadjuvant regimen would allow a substantial minority (20-45%) of patients who archive pCR to be spared of longer and more toxic regimens, whereas those with residual disease could receive the remaining part of the currently most effective regimens post-operatively as adjuvant therapy. In this study we examined the cost effectiveness of different neoadjuvant followed by adjuvant treatment strategies from a healthcare payer perspective.
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Genetic Research, Melanoma, Prostate Cancer / 23.11.2020

MedicalResearch.com Interview with: [caption id="attachment_56034" align="alignleft" width="97"]Saud H AlDubayan, M.D. Instructor in Medicine, Harvard Medical School Attending Physician, Division of Genetics, Brigham and Women's Hospital
 Computational Biologist, Department of Medical Oncology,  Dana-Farber Cancer Institute Associate Scientist, The Broad Institute of MIT and Harvard Dr. AlDubayan[/caption] Saud H AlDubayan, M.D. Instructor in Medicine, Harvard Medical School Attending Physician, Division of Genetics, Brigham and Women's Hospital Computational Biologist, Department of Medical Oncology, Dana-Farber Cancer Institute Associate Scientist, The Broad Institute of MIT and Harvard  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The overall goal of this study was to assess the performance of the standard method currently used to detect germline (inhered) genetic variants in cancer patients and whether we could use recent advances in machine learning techniques to further improve the detection rate of clinically relevant genetic alterations. To investigate this possibility, we performed a head to head comparison between the current gold-standard method for germline analysis that has been universally used in clinical and research laboratories and a new deep learning analysis approach using germline genetic data of thousands of patients with prostate cancer or melanoma. This analysis showed that across all different gene sets that were tested, the deep learning-based framework was able to identify additional cancer patients with clinically relevant germline variants that went undetected by the standard method. For example, several patients in our study also had germline variants that are associated with an increased risk of ovarian cancer, for which the surgical removal of the ovaries (at a certain age) is highly recommended. However, these genetic alterations were only identified by the proposed deep learning framework.    
Author Interviews, Brigham & Women's - Harvard, JAMA, Prostate Cancer, Social Issues / 18.11.2020

MedicalResearch.com Interview with: David-Dan Nguyen, MPH Research Fellow | Center for Surgery and Public Health Brigham and Women's Hospital Medical Student | McGill University  MedicalResearch.com: What is the background for this study? Response: In 2017, the US Preventive Services Task Force updated its recommendation for PSA screening for prostate cancer from a grade D to a grade C for men aged 55 to 69 years. This updated recommendation endorsed shared decision making and harmonizes with the guidelines of the American Urological Association and the American Cancer Society which also recommend shared decision making for PSA screening. Shared decision making is a meaningful dialogue between the physician and the patient that namely includes a review of risks and expected outcomes of screening as well as the patient’s preferences and values. Understandably, the patient’s ability to critically assess the medical information provided (i.e. their health literacy) likely influences this process. We sought to characterize the effect of health literacy on shared decision making for PSA screening. We used data from 2016 when PSA screening for prostate cancer was not recommended by the US Preventive Services Task Force — in other words, we also sought to understand how health literacy impacted screening rates in the context of countervailing guidelines on PSA screening.
Author Interviews, Brain Injury, Exercise - Fitness, JAMA / 17.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55977" align="alignleft" width="142"]Tara L Sharma DO Clinical Assistant Professor of Neurology at UWMC Seattle, WA 98133 Dr. Sharma[/caption] Tara L Sharma DO Clinical Assistant Professor of Neurology at UWMC Seattle, WA 98133 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Flying can lead to reduced oxygen partial pressures and cerebral blood flow causing worsening clinical outcome in cases of moderate to severe TBI; however, not much is known regarding the clinical consequences of flying in individuals with concussion or mild TBI. Because many athletes suffer concussions during games, it is necessary to know if flying afterward may potentially hinder their ability to return to play. Overall, we found no associated between air travel and increased symptom severity in both our entire cohort and the subset of football players.
Author Interviews, COVID -19 Coronavirus, JAMA / 12.11.2020

MedicalResearch.com Interview with: Brunella Posteranno PhD Associate Professor of Microbiology Department of Medical and Surgical Sciences Rome, Italy MedicalResearch.com: What are the main findings? Response: This study arises from an attempt to clarify some recent evidences of positive real-time PCR (RT-PCR) test results among patients who recovered from COVID-19 with prior negative results. Retesting positive for SARS-CoV-2 RNA, in the absence of any symptoms suggestive of new infection, poses questions regarding not only the SARS-CoV-2 infection course but also, most importantly, the infectivity status of recovered COVID-19 patients. In other words, it is unknown whether such patients are infectious and whether they should be quarantined. Detecting genetic sequences (i.e., RNA) of SARS-CoV-2 in respiratory samples (e.g., nasal/oropharyngeal swab samples) by RT-PCR assays enable us to identify persons suffering from COVID-19 along with those who have been exposed and able to transmit virus to others even if they are asymptomatic. It is not hyperbole to say that without RT-PCR testing an effective fight against the virus would be impossible. However, RT-PCR assays are not a viral culture and do not allow to determine whether the virus is viable and, consequently, transmissible. In this study, we investigated RT-PCR retested positive nasal/oropharyngeal swab (NOS) samples from recovered COVID-19 patients for the presence of replicative SARS-CoV-2 RNA to assess active virus replication. 
Author Interviews, Columbia, JAMA, OBGYNE, Weight Research / 05.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55855" align="alignleft" width="139"]Dr-Marissa-N-Spann Dr. Spann[/caption] Marisa N. Spann, PhD, MPH Columbia University Irving Medical Center New York, New York MedicalResearch.com: What is the background for this study? Response: Prior research has demonstrated that higher maternal pre-pregnancy body mass index is associated with adverse long-term outcomes for offspring including obesity, poorer cognitive and social abilities, and increased risk of psychiatric disorders.  MedicalResearch.com: What are the main findings? Response: In this study, we investigated the association of maternal pre-pregnancy body mass index with fetal growth and neonatal functional connectivity and found that maternal pre-pregnancy BMI has a significant positive correlation with fetal weight and with greater thalamic connectivity of the brain. 
Author Interviews, Cancer Research, Dermatology, JAMA / 30.10.2020

MedicalResearch.com Interview with: Selin Tokez, PhD Student Department of Dermatology Erasmus MC, Rotterdam MedicalResearch.com: What is the background for this study? [caption id="attachment_55804" align="alignleft" width="200"]MedicalResearch.com Interview with: Selin Tokez, PhD Student Department of Dermatology Erasmus MC, Rotterdam MedicalResearch.com: What is the background for this study? Response: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer worldwide with still increasing incidence rates. Given these high incidence rates together with the associated health costs and possibility of fatal progression, it is extremely important to have accurate and complete data on the epidemiology of this disease. Nevertheless, national cancer registries in many countries do not routinely record cSCC cases and therefore currently known numbers are mainly based on incomplete data sources. Additionally, if cSCC cases are registered, this usually only concerns the first cSCC per patient while we know that, contrary to many other malignant neoplasms, patients may develop numerous cSCCs over time. MedicalResearch.com: What are the main findings? Response: In the present study, we analyzed Dutch nationwide data comprising about 145,000 patients with a first invasive cSCC diagnosis between the years 1989 and 2017. We found that the incidence rates of a first cSCC per patient almost tripled in male patients and increased about fivefold in female patients in this 30-year time period. Also, we had data on all cSCCs per patient for the year 2017 and could therefore compare this with the data on only the first cSCC per patient: incidence rates increased by 58% for men and 35% for women when multiple cSCCs were considered. In absolute numbers, this resulted in an increase of 45% in cSCC diagnoses in 2017. Lastly, we extended our analyses by predicting future cSCC incidence rates up to 2027. Given that no substantially effective measures are undertaken in the near future, current cSCC incidence rates will increase with 23% in males and 29% in females in the next decade. MedicalResearch.com: What should readers take away from your report? Response: We could summarize our main message in two points: while people generally know that cSCC is a very common disease with increasing incidence rates, it is not taken into account that these numbers are often based on incomplete data registries and that the real numbers are even higher. In this paper, we provided these numbers for a period of 30 years based on highly accurate data from the Netherlands Cancer Registry. On top of that, as a second main finding, we showed that the real burden caused by cSCC is approximately 50% higher (taken males and females together) when all cSCC diagnoses in 1 year are registered instead of only the first tumor per patient. Together with our prediction analyses that showed an on average 26% further increase for the coming decade, this will have enormous implications for the dermato-oncological health care planning and cost management. Our results urgently call for revision of skin cancer health policies to be able to cope with this rising burden of cSCC management. Ultimately, primary prevention will remain the key strategy to halt the increasing trend in cSCC incidence and the occurrence of multiple cSCCs per patient, which we hope to further stimulate with our paper as well. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: As we had data on multiple cSCCs for only one year, we would suggest to perform trend analyses for multiple cSCCs per patient as well when a longer follow-up duration has been reached. Furthermore, it would be very relevant to identify high-risk cSCCs or patients at risk for multiple cSCCs in order to be able to establish efficient follow-up regimens and take these high risk groups into account when revising skin cancer health policies. MedicalResearch.com: Is there anything else you would like to add? Response: The authors of this study have no conflicts of interest that are relevant to this article. Citation: Tokez S, Hollestein L, Louwman M, Nijsten T, Wakkee M. Incidence of Multiple vs First Cutaneous Squamous Cell Carcinoma on a Nationwide Scale and Estimation of Future Incidences of Cutaneous Squamous Cell Carcinoma. JAMA Dermatol. Published online October 28, 2020. doi:10.1001/jamadermatol.2020.3677 [subscribe] Last Modified: [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. Example of one type of squamous cell skin cancer: DermNetNZ image[/caption]Response: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer worldwide with still increasing incidence rates. Given these high incidence rates together with the associated health costs and possibility of fatal progression, it is extremely important to have accurate and complete data on the epidemiology of this disease. Nevertheless, national cancer registries in many countries do not routinely record cSCC cases and therefore currently known numbers are mainly based on incomplete data sources. Additionally, if cSCC cases are registered, this usually only concerns the first cSCC per patient while we know that, contrary to many other malignant neoplasms, patients may develop numerous cSCCs over time. MedicalResearch.com: What are the main findings? Response:  In the present study, we analyzed Dutch nationwide data comprising about 145,000 patients with a first invasive cSCC diagnosis between the years 1989 and 2017. We found that the incidence rates of a first cSCC per patient almost tripled in male patients and increased about fivefold in female patients in this 30-year time period. Also, we had data on all cSCCs per patient for the year 2017 and could therefore compare this with the data on only the first cSCC per patient: incidence rates increased by 58% for men and 35% for women when multiple cSCCs were considered. In absolute numbers, this resulted in an increase of 45% in cSCC diagnoses in 2017. Lastly, we extended our analyses by predicting future cSCC incidence rates up to 2027. Given that no substantially effective measures are undertaken in the near future, current cSCC incidence rates will increase with 23% in males and 29% in females in the next decade.
Author Interviews, Infections, JAMA / 21.10.2020

MedicalResearch.com Interview with: Liliana Sanchez-Gonzalez MD, MPH Medical Epidemiologist Dengue Branch – Division of Vector Borne Diseases Centers for Disease Control and Prevention San Juan, PR MedicalResearch.com: What is the background for this study? Would you briefly explain the significance of prion disease? Response: Prion diseases are neurodegenerative diseases that occur in animals and humans. These diseases are caused by an infectious agent known as a prion. While the accuracy of diagnostic tests using cerebrospinal fluid or brain imaging from living patients has improved greatly in recent years, analysis of brain tissue is still necessary to confirm the diagnosis of these diseases. [caption id="attachment_55692" align="alignleft" width="300"]This tissue slide shows sponge-like lesions in the brain tissue of a classic CJD patient. This tissue slide shows sponge-like lesions in the brain tissue of a classic CJD patient.[/caption] Human prion disease cases are rare, but always fatal. There have been around 500 reported cases annually in the US in recent years. A very small percentage of human prion disease cases are acquired, meaning they are caused by an exposure to the infectious agent from an external source. The most well-known acquired human prion disease is variant Creutzfeldt-Jakob disease (vCJD), which was first described in the United Kingdom in 1996 and linked to consumption of contaminated beef from cattle with the animal prion disease bovine spongiform encephalopathy (BSE, or “mad cow” disease). The only US state where classic BSE has been reported is Washington, where an infected dairy cow was imported from Canada in 2003. Beef from the slaughtered cow was processed for human consumption, and beef from cattle slaughtered the same day at the involved slaughter plant was recalled. After this incident, the Washington State Department of Health, in collaboration with the US Centers for Disease Control and Prevention and the National Prion Disease Pathology Surveillance Center (NPDPSC), implemented enhanced human prion disease surveillance. All patients with positive results from tests conducted at the NPDPSC are investigated. We present the results of 12 years of human prion disease surveillance, from 2006 to 2017, plus results of surveillance for vCJD through July 2020.
Author Interviews, JAMA, Social Issues / 20.10.2020

MedicalResearch.com Interview with: [caption id="attachment_55663" align="alignleft" width="130"]Aaron Baum, PhD Assistant Professor, Department of Health System Design & Global Health Economist, Arnhold Institute for Global Health Icahn School of Medicine at Mount Sinai Health System Dr. Baum[/caption] Aaron Baum, PhD Assistant Professor, Department of Health System Design & Global Health Economist, Arnhold Institute for Global Health Icahn School of Medicine at Mount Sinai Health System MedicalResearch.com: What is the background for this study? Response: To what degree are geographic health disparities in the leading risk factors for morbidity and mortality in the United States – including elevated blood pressure and blood sugar, obesity, and poor mental health – driven by the place where people live versus by characteristics of the people who live in different places? For example, male adults in Mississippi are 33% more likely to have uncontrolled blood pressure and 54% more likely to be obese than male adults in Colorado. One explanation is that male adults who live in Mississippi are different is many other ways from male adults in Colorado, some of which can't be directly measured and adjusted for, and that those unobserved differences cause the health disparity. Another possibility is that the place where a person lives actually contributes to the health disparity. Using national electronic health records from the Veterans Health Administration, we conducted a retrospective cohort study of 5 million adults, including 1 million who moved zip codes exactly once between 2008-2018. Our goal was to isolate how a movers' likelihood of uncontrolled blood pressure, uncontrolled diabetes, obesity and depression changed in response to changes in the prevalence of each outcome in his or her environment.
Author Interviews, Cannabis, JAMA, Tobacco Research / 07.10.2020

MedicalResearch.com Interview with: [caption id="attachment_55574" align="alignleft" width="180"]Isabella Lanza, PhD   Associate Professor of Human Development   California State University, Long Beach  Dr. Lanza[/caption] Isabella Lanza, PhD Associate Professor of Human Development California State University, Long Beach   MedicalResearch.com: What is the background for this study? What are the main findings? Response: This is the first study to examine both nicotine vaping and cannabis vaping trajectories across adolescence and young adulthood, which allowed us to assess whether poly-substance vaping is common among adolescents and young adults. Poly-substance vaping (nicotine and cannabis vaping) was reported among a significant proportion of participants in the study (25% were identified as poly-substance vapers). For those that either escalated to frequent nicotine vaping use in adolescence or initiated frequent nicotine vaping use in young adulthood, the probability of engaging in cannabis vaping was very high (85%+).   
Author Interviews, COVID -19 Coronavirus, JAMA, Social Issues / 01.10.2020

MedicalResearch.com Interview with: [caption id="attachment_55544" align="alignleft" width="150"]Dr. Madhur Garg, MD MBA Clinical director, Radiation Oncology Montefiore Health System and Professor Departments of Otorhinolaryngology - Head & Neck Surgery - and Urology Albert Einstein College of Medicine Dr. Garg[/caption] Dr. Madhur Garg, MD MBA Clinical director, Radiation Oncology Montefiore Health System and Professor Departments of Otorhinolaryngology - Head & Neck Surgery - and Urology Albert Einstein College of Medicine  MedicalResearch.com: What is the background for this study? Response: ​The Bronx was hit particularly hard with Covid-19 - making up one of the highest per capita cases and deaths in the country. Montefiore Health System and Albert Einstein College of Medicine, care for a large population of ethnic minorities (non-Hispanic Black and Hispanic individuals make up 65% of our patient population).
Author Interviews, COVID -19 Coronavirus, Kidney Stones, Lancet, Stanford / 26.09.2020

MedicalResearch.com Interview with: [caption id="attachment_55479" align="alignleft" width="150"]Shuchi Anand M.D. M.S. Director of the Center for Tubulointerstitial Kidney Disease Stanford University Dr. Anand[/caption] Shuchi Anand M.D. M.S. Director of the Center for Tubulointerstitial Kidney Disease Stanford University MedicalResearch.com: What is the background for this study? Response: Seroprevalence (or presence of antibodies in response to SARS CoV-2) is considered by many experts to be the most complete to track the spread of COVID19 in communities. However seroprevalence studies are hard to conduct, because they require going into communities and underdoing random blood draws. Many people—especially racial and ethnic minorities, or people with underlying health conditions, or people with language barriers—may be hard to reach for these types of surveys. Plus outreach into communities is very difficult in light of the COVID19 pandemic. To mitigate this problem we worked with a random sample of 28,503 patients on hemodialysis, the vast majority of whom are covered by Medicare. They get their blood drawn monthly, as part of their routine care. Furthermore even though we used a random sample, we know that patients on dialysis are more likely to be racial and ethnic minorities, and more likely to come from disadvantaged backgrounds. 
Author Interviews, Cannabis, JAMA, OBGYNE, Pediatrics / 25.09.2020

MedicalResearch.com Interview with: Sarah E. Paul, BA , Graduate Student and Ryan Bogdan, PhD, Associate Professor BRAIN Lab Washington University in St. Louis St. Louis, MO 63130 MedicalResearch.com: What is the background for this study? Sarah Paul: This study was motivated by several trends in cannabis use, its legal landscape, and people's perception of risk. As more states legalize recreational cannabis use, cannabis has become more accessible as well as more potent. Over the past couple of decades, the percentage of adolescents and adults who think that cannabis use is risky or harmful has fallen substantially. Cannabis dispensaries have been reported to actually recommend cannabis to pregnant women for the treatment of pregnancy-related nausea. And finally, between 2002/2003 and 2016/2017, the percentage of women reporting cannabis use during their pregnancies rose 106%. Given these trends and the mixed literature regarding the potential consequences associated with prenatal cannabis exposure, we aimed to comprehensively examine a range of outcomes in a large, representative sample while accounting for a host of important potentially confounding covariates.
Author Interviews, Brain Injury, Brigham & Women's - Harvard, JAMA / 25.09.2020

MedicalResearch.com Interview with: [caption id="attachment_55471" align="alignleft" width="150"]Dr-Maria Gabriela Figueiro Longo Dr. Figueiro LongoTBI[/caption] Maria Gabriela Figueiro Longo, MD, MSc Department of Radiology, Massachusetts General Hospital Harvard Medical School, Boston MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transcranial low-level light therapy (3LT) has been shown to be effective in animal models of traumatic brain injury. Our goal was to assess the 3LT in humans with acute TBI. We tested (1) safety, and (2) any effect in the brain in a measurable way. We found positive results for both - there was no event adverse during the trial related to the 3LT; and we found some differences in the brain MRI diffusivity parameters in the patients who received light therapy compared to the sham group. The study was not powered for clinical evaluation, although there was a trend towards lower symptom burden in the treated group.
Author Interviews, Infections, JAMA / 08.09.2020

MedicalResearch.com Interview with: Yaa-Hui Dong PhD Faculty of Pharmacy National Yang-Ming University Taipei, Taiwan MedicalResearch.com: What is the background for this study? Response: Previous observational studies found that fluoroquinolones may be associated with more than 2-fold increased risk of aortic aneurysm or aortic dissection (AA/AD). However, these studies might not well address the influence of concurrent infection, which is also a suggested risk factor for AA. Moreover, most of these studies compared fluoroquinolone use versus no fluoroquinolone use, which might overestimate the risk with fluoroquinolones as patients on fluoroquinolones may have more severe infection versus those not on fluoroquinolones.
Author Interviews, COVID -19 Coronavirus, Education, Pediatrics / 04.09.2020

MedicalResearch.com Interview with: [caption id="attachment_55326" align="alignleft" width="133"]Katherine A. S. Auger, MD, MSc Division of Hospital Medicine James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center Department of Pediatrics, University of Cincinnati College of Medicine Pediatric Research in Inpatient Settings Network Cincinnati, Ohio Dr. Auger[/caption] Katherine A. S. Auger, MD, MSc Division of Hospital Medicine James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center Department of Pediatrics, University of Cincinnati College of Medicine Pediatric Research in Inpatient Settings Network Cincinnati, Ohio MedicalResearch.com: What is the background for this study? What are the main findings? Response: All states closed schools in the spring of 2020 to try to mitigate the spread of COVID-19. Our study demonstrated a large, significant association between school closure and fewer COVID-19 cases and deaths even when accounting for other state policies.
Author Interviews, Autism, Environmental Risks, JAMA, Pediatrics / 31.08.2020

MedicalResearch.com Interview with: [caption id="attachment_55258" align="alignleft" width="150"]Jessica Shoaff, MPH, PhD Postdoctoral Research Fellow Dr. Shoaff[/caption] Jessica Shoaff, MPH, PhD Postdoctoral Research Fellow and [caption id="attachment_55259" align="alignleft" width="150"]Susan A. Korrick, MD Pulmonary and Critical Care Assistant Professor in the Department of Environmental Health Dr. Korrick[/caption] Susan A. Korrick, MD Pulmonary and Critical Care Assistant Professor in the Department of Environmental Health Harvard Medical School · Harvard T. H. Chan School of Public Health Brigham and Women's Hospital Channing Laboratory Boston, MA 02115   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study posed the question:  Do teenagers’ exposures to chemicals that are often found in consumer products increase behaviors that are common among individuals diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD)? Our results suggest that teenagers exposed to chemicals often found in consumer products (particularly phthalates) may have increased behaviors that are common among individuals diagnosed with ADHD.  However, we did not study the diagnosis of ADHD (most of our study teens did not have ADHD).  This means our results cannot answer the question of whether these chemical exposures increase the likelihood of being diagnosed with ADHD. Also, in our study design, chemical exposures and ADHD-related behaviors were measured at the same time, so it is not possible to know with certainty whether the chemical exposures altered behavior or behavior altered chemical exposures. 
Author Interviews, Geriatrics, Hearing Loss, JAMA / 28.08.2020

MedicalResearch.com Interview with: [caption id="attachment_55235" align="alignleft" width="145"]Cameron C. Wick, MD Assistant Professor, Otology/Neurotology Washington University School of Medicine St. Louis, MO Dr. Wick[/caption] Cameron C. Wick, MD Assistant Professor, Otology/Neurotology Washington University School of Medicine St. Louis, MO MedicalResearch.com: What do you see as the primary message of your findings for the general public? Response:  Older adults not satisfied with their hearing aids achieved clinically meaningful improvement in both hearing and quality of life with a cochlear implant compared to an optimized bilateral hearing aid condition. MedicalResearch.com: Do you see your findings as changing the way older adults with hearing loss are managed? Response:   Yes and partially because this study is unique in its design and the outcomes that were measured. Specifically  the study is a prospective, multicenter clinical trial conducted at 13 locations across the United States. All patients were setup with a 30-day optimized hearing aid experience before cochlear implantation (context: sometimes hearing aids are not appropriately optimized so baseline testing may not reflect the "best" that hearing aids can do). This study assesses both hearing data as well as quality of life data before and 6-months after cochlear implantation. After implantation patients were tested in both the unilateral (cochlear implant alone) and bimodal (cochlear implant plus hearing aid in the opposite ear) conditions.  My paper is a subanalysis of adults 65 years and older (range 65 - 91 years) enrolled in the clinical trial. The principal investigator of the clinical trial is Dr. Craig Buchman. Dr. Buchman and myself are at Washington University in St. Louis which was the lead center for the clinical trial. The findings of the study are meaningful because they demonstrate clear superiority of cochlear implants over hearing aids in many key areas, such as understanding speech, hearing in background noise, and ability to communicate. Hearing loss, which becomes more prevalent as we age, can negatively impact communication leading to social isolation, depression, frustration, and possibly cognitive decline. This study highlights that if patients are not satisfied with their hearing aid performance then they should be referred to a center that can evaluate for cochlear implantation. Cochlear implant indications have evolved considerably since they were first FDA approved in 1984. This study emphasizes that patients do not have to be profoundly deaf to experience significant hearing and social benefits from cochlear implants. Also, it demonstrates that cochlear implant surgery is well tolerated even as adults age and acquire other health ailments. 
Author Interviews, Environmental Risks, JAMA, Pediatrics / 24.08.2020

MedicalResearch.com Interview with: Kaleab Baye PhD Center for Food Science and Nutrition Addis Ababa University MedicalResearch.com: What is the background for this study? Response: Reducing child stunting is one of the most important objectives of the Sustainable development goals (SDGs) and the World Health Assembly (WHA). Progress is routinely measured using anthropometric indices such as height-for-age z score that compare child height to the World Health Organization (WHO) growth standards. Such comparisons rely on the assumption that children living in ideal home environment that promotes adequate growth have the same growth potential, irrespective of their genetic make-up. This assumption was confirmed by the Multicenter Growth Reference Study (MGRS), which was the origin of the development of the growth standards. However, the MGRS excluded sites above 1500 m above sea level (asl); hence, it remains unclear whether the widely adopted WHO growth standards are applicable to populations above the 1500 m asl threshold. This study investigated the association between altitude and linear growth faltering and evaluated whether the prescriptive WHO growth standards can apply to children residing at higher altitudes.
Author Interviews, Heart Disease, JAMA, Lipids / 21.08.2020

MedicalResearch.com Interview with: First Author Dhruv Mahtta, DO, MBA Cardiovascular Disease Fellow Baylor College of Medicine Houston, TX Senior & Corresponding Author [caption id="attachment_55170" align="alignleft" width="150"]Dr-Salim S. Virani Dr. Virani[/caption] Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development Michael E. DeBakey VA Medical Center, Houston, TX MedicalResearch.com: What is the background for this study? Response: The incidence of atherosclerotic cardiovascular disease among young patients has been on the rise. These patients with premature and extremely premature atherosclerotic cardiovascular disease experience similar rates of mortality compared to older adults. Additionally, these young patients have a greater accrued rate of life-time morbidity. Therefore, secondary prevention measures such as use of guideline concordant statin therapy and aspirin therapy are paramount in this population. 
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, JAMA, Social Issues / 21.08.2020

MedicalResearch.com Interview with: [caption id="attachment_55163" align="alignleft" width="133"]Dr-Monik Jimenez Dr. Jimenez[/caption] Monik Carmen Jimenez, Sc.D Assistant Professor of Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: We wanted to get a comprehensive picture of the epidemiology of COVID-19 in carceral facilities that included jails and was not restricted solely to prisons. We utilized publicly available data collected in Massachusetts, pursuant to a court order. These data included prison and jail systems and were used to calculate rates of confirmed cases of COVID-19 and testing rates among incarcerated individuals. We were also able to compare those to changes in the population size within each system.
Author Interviews, Clots - Coagulation, COVID -19 Coronavirus, JAMA / 12.08.2020

MedicalResearch.com Interview with: [caption id="attachment_55105" align="alignleft" width="150"]Dr-Morayma Reyes Gil Dr. Reyes Gil[/caption] Morayma Reyes Gil M.D., Ph.D. Director of hematology and Coagulation Labs Associate Professor, Pathology Montefiore Medical Center and Albert Einstein School of Medicine Bronx, NY 10467 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Antiphospholipid Syndrome is an entity caused by autoantibodies that cause arterial and venous thrombosis as well as miscarriages. During the COVID-19 pandemic, we tested 187 patients for Lupus anticoagulant (LA); 68 turned out to be COVID positive. 30 of the 68 COVID-positive patients were found to be positive for LA by the DRVVT test, and 17 of them were also determined to be positive by the hexagonal phospholipid neutralization STACLOT-LA test. Importantly, of the 30 patients who were LA positive, 19 had documented thrombosis (arterial and venous), an event rate of 63%, as compared with a rate of 34% (p = .03) for LA-negative patients. We also checked CRP, an inflammatory marker known to affect the hexagonal phospholipid neutralization STACLOT-LA test. Although the mean CRP level was higher in patients testing positive for LA by DRVVT (14.4 vs 7.5 mg/dL; P < .01), patients with thrombosis did not have significantly higher CRP levels than those with no thrombosis. Hence, we adjusted for CRP, and LA was found to be independently associated with thrombosis (odds ratio, 4.39; 95% CI, 1.45-14.57; p= .01). No statistically significant difference was found by anticoagulation at the time of thrombosis, gender, race, ethnicity, ventilation, and mortality between patients who tested LA positive vs. negative. 
Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA / 07.08.2020

MedicalResearch.com Interview with: [caption id="attachment_55053" align="alignleft" width="160"]Ty J. Gluckman, M.D., FACC Providence St Joseph Health Portland, Oregon Dr. Gluckman[/caption] Ty J. Gluckman, M.D., FACC Providence St Joseph Health Portland, Oregon MedicalResearch.com: What is the background for this study? Response: In spite of significant decreases in the incidence of coronary artery disease, an estimated 800,000 Americans are expected to be diagnosed with an acute myocardial infarction (AMI) this year.  For large numbers of these patients, substantial benefit is afforded by early diagnosis and treatment.  Accordingly, multiple campaigns have been launched over time to increase public awareness about the symptoms and signs of AMI and the need to seek immediate medical attention. The COVID-19 pandemic has profoundly changed health care delivery worldwide.  While early attention was disproportionately focused on efforts to “flatten the curve”, recent reports have revealed a disturbing finding—a substantial decrease in the hospitalization rate for AMI.  Most worrisome among potential reasons for this has been reluctance of patients with an AMI to seek medical attention out of fear that they become infected with SARS-CoV-2. To better understand the impacts associated with this, we performed a retrospective, cross-sectional study of all AMI hospitalizations in a large multistate health care system (Providence St. Joseph Health).  We sought to define changes in AMI case rates, patient demographics, cardiovascular comorbidities, treatment approaches and in-hospital outcomes during the pandemic.
Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics / 05.08.2020

MedicalResearch.com Interview with: [caption id="attachment_54986" align="alignleft" width="200"]Taylor Heald-Sargent, M.D., Ph.D. Ann & Robert H. Lurie Children’s Hospital Chicago Dr. Heald-Sargent[/caption] Taylor Heald-Sargent, M.D., Ph.D. Ann & Robert H. Lurie Children’s Hospital Chicago MedicalResearch.com: What is the background for this study? Response: Given the ongoing debate around the ability of children to transmit SARS-CoV-2, we noticed that our clinical data could address one of the prevalent assumptions.  Some people postulated that the reason children have less severe infections with SARS-CoV-2 is because they are not able to replicate virus as much as adults and therefore may not transmit as readily. 
Author Interviews, JAMA, Race/Ethnic Diversity, Social Issues / 03.08.2020

MedicalResearch.com Interview with: [caption id="attachment_55005" align="alignleft" width="200"]Nasim B. Ferdows, Ph.D. Assistant Professor, Department of Health Administration and Policy Hudson College of Public Health The University of Oklahoma Health Sciences Center Oklahoma City, OK  Dr. Ferdows[/caption] Nasim B. Ferdows, Ph.D. Assistant Professor, Department of Health Administration and Policy Hudson College of Public Health The University of Oklahoma Health Sciences Center Oklahoma City, OK MedicalResearch.com: What is the background for this study? Response: This half a century study of US senior men and women who died between 1968 and 2016 shows how disparities in the Black and White mortality of older US citizens have changed over time, as well as how the racial disparities differ in rural, suburban and urban areas.