Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, JAMA / 28.07.2020

MedicalResearch.com Interview with: Frank Wharam, MD, MPH Department of Population Medicine Harvard Medical School and Harvard Pilgrim Healthcare Institute Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response:  There is substantial concern that high-deductible health plans increase people’s risk of major adverse health events such as heart attack and stroke. No studies have examined this question. This study examines the effects of a transition to a high-deductible health plan on the risk of major adverse cardiovascular outcomes (myocardial infarction and stroke). The study group included individuals with risk factors for cardiovascular disease who were continuously enrolled in low-deductible (<$500) health plans during a baseline year followed by up to 4 years in high-deductible (≥$1000) plans after an employer-mandated switch. The matched control group included individuals with the same risk factors who were contemporaneously enrolled in low-deductible plans.  We examined time to first major adverse cardiovascular event, defined as myocardial infarction or stroke.  (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA, MRI / 28.07.2020

MedicalResearch.com Interview with: Assoc. Prof. Dr. Valentina Puntmann, MD, PhD, FRCP Deputy Head Goethe CVI Fellowship Programme Lead Consultant Physician, Cardiologist and Clinical Pharmacologist Institute for Experimental and Translational Cardiovascular Imaging DZHK Centre for Cardiovascular Imaging - Goethe CVI Department of Cardiology, Division of Internal Medicine University Hospital Frankfurt, Germany MedicalResearch.com: What is the background for this study? Response: Patients who recently recovered from COVID19 have been identified through the testing centre and invited to be screened for cardiac involvement with MRI. Importantly, they have not come to us because of having heart problems. In fact, none of them thought that they had had anything wrong with the heart.  They were mostly healthy, sporty and well prior to their illness. A considerable proportion had been infected while on skiing vacations. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, JAMA, Lipids / 14.07.2020

MedicalResearch.com Interview with: Manja Koch, Ph.D., Research Associate Department of Nutrition Harvard T.H. Chan School of Public Health Majken K. Jensen, Ph.D. Adjunct Professor of Nutrition Harvard T.H. Chan School of Public Health & Professor in the Department of Public Health University of Copenhagen, Copenhagen, Denmark     MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease and other dementias are highly prevalent conditions. According to the Alzheimer’s Association, 50 million people are currently living with Alzheimer’s disease or other dementias worldwide. Lower apolipoprotein E in plasma is a risk factor for dementia, but the underlying biological mechanisms are not fully understood. Thus, we investigated the role of apolipoprotein E overall and in lipoproteins with distinct metabolic functions in relation to cognitive function and dementia risk.. (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 14.07.2020

MedicalResearch.com Interview with: Mario Fl Gaudino MD Professor of Cardiothoracic Surgery Department of Cardiothoracic Surgery Weill Cornell Medicine  MedicalResearch.com: What is the background for this study? Response: The radial artery is currently used in less than 10% of CABG procedures in the US.  MedicalResearch.com: What are the main findings? Response: The JAMA paper provides convincing evidence that the use of the radial artery rather than the saphenous vein to complement the internal thoracic artery for CABG is associated with improved long-term outcomes.  (more…)
Author Interviews, Brigham & Women's - Harvard, Geriatrics, Lipids / 08.07.2020

MedicalResearch.com Interview with: Ariela Orkaby, MD, MPH Geriatrics & Preventive Cardiology Associate Epidemiologist Division of Aging, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Statins are cholesterol lowering medications that have been proven to prevent heart attacks, strokes and death in middle-aged adults. Current guidelines for cholesterol lowering therapy are uncertain as to treatment for older adults due to a lack of available data, even though older adults are at the highest risk of heart disease and death. (more…)
Author Interviews, JAMA, Sleep Disorders, Stanford / 07.07.2020

MedicalResearch.com Interview with: Eileen B. Leary, Ph.D. Student Epidemiology and Clinical Research Stanford University MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by REM sleep? Response: Sleep is a regulated, reversible, and recurring loss of consciousness that is a critical requirement for a happy, healthy life. REM sleep is an important component of sleep defined by rapid eye movements and commonly associated with dreaming. We learned from previous studies that sleep duration is associated with mortality, however little was known about how the different sleep stages relate to timing or cause of death. (more…)
Author Interviews, JAMA, Nutrition, Social Issues / 28.06.2020

MedicalResearch.com Interview with: Erin Brantley, PhD, MPH Senior Research Associate Department of Health Policy and Management Milken Institute School of Public Health Preferred pronouns: she/her/hers  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We looked at what happened when work requirements for the Supplemental Nutrition Assistance Program Participation, or SNAP, were turned on in many places after the Great Recession. We found large drops in participation in SNAP benefits due to work requirements, and that black recipients were more likely to lose benefits than white recipients. We think this is driven by the fact that black workers face higher unemployment rates than white workers, and work requirement policies do not take this into account. We also found that some people who report having disabilities lost benefits, even though the intent of work requirements is that they apply to people without disabilities.  (more…)
Author Interviews, COVID -19 Coronavirus, Dermatology, Environmental Risks, JAMA / 26.06.2020

MedicalResearch.com Interview with: Dr Herman Anne MD Service de Dermatologie Cliniques Universitaires Saint-Luc   MedicalResearch.com: What is the background for this study? Response: In the context of the COVID-19 pandemic, several cases of acro-located lesions (on foot or hands) suggestive of chilblains have been reported and were possibly related to COVID-19. We wanted to determine if chilblains, observed in many patients recently referred to our department, are indicative of COVID-19. MedicalResearch.com: Would you briefly explain what is meant by chilblains? Response: Chilblains are frequent cold induced inflammatory lesions. Chilblains are typically seen in winter and occur after repeated exposure to cold temperatures. Clinical presentation includes erythema and swelling on toes and/or digits followed by red-purple macules or patches. However, given the large number of patients affected, and the exceptionally high outdoor temperatures for the spring season over the past month and at the time of case-observation, cold-exposure seemed unlikely. These lesions were, therefore, suspected to be associated with COVID-19. However, to date, no study has proven a pathological link between these lesions and COVID-19. (more…)
Author Interviews, Cost of Health Care, JAMA, Race/Ethnic Diversity / 24.06.2020

MedicalResearch.com Interview with: Megan B. Cole Brahim, PhD, MPH Assistant Professor | Dept. of Health Law, Policy, & Management Boston University School of Public Health Boston, MA MedicalResearch.com: What is the background for this study? Response: Enrollment in high deductible health plans (HDHPs)—which require patients to pay on the upwards of thousands of dollars in out-of-pocket costs before they can use their health insurance coverage for most services—has skyrocketed over the last decade. For cancer survivors in particular, this is really concerning, as patients may avoid or delay necessary health care services or important medications because they can’t afford their deductible. We know from previous work that HDHPs are associated with less use of health care, including less cancer screening and treatment. However, there has been very little work to assess how HDHPs may contribute to racial/ethnic disparities in care, and our study is the first known study to assess how HDHPs may contribute to racial/ethnic disparities in cancer survivors. To fill this gap, we used nationally representative survey data from 2013-2018 to assess how enrollment in high deductible health plans was associated with cost-related barriers to care among cancer survivors with private insurance, and how this relationship varied across racial/ethnic groups. (more…)
Accidents & Violence, Author Interviews, Cannabis, JAMA, NYU / 23.06.2020

MedicalResearch.com Interview with: Julian Santaella Tenorio, MSc DrPH Epidemiology Center for Opioid Epidemiology and Policy Division of Epidemiology, Department of Population Health New York University Langone School of Medicine, New York, New York MedicalResearch.com: What are the main findings? car-accident-traffic-accidentResponse: This study found that recreational cannabis laws were associated with increases in traffic fatalities in Colorado (mean of 75 excess fatalities per year) but not in Washington State.  These findings suggest that unintended effects of recreational cannabis laws can be heterogeneous and may be specific to variations in how these laws are implemented
(eg, density of recreational cannabis stores).   (more…)
Accidents & Violence, Author Interviews, Cannabis, JAMA / 22.06.2020

MedicalResearch.com Interview with: Russell Kamer, MD Department of Medicine, New York Medical College, Valhalla 15 North Broadway, Suite E White Plains, NY 10601 New York MedicalResearch.com: What is the background for this study? "marijuana apocalypse - weed is a stimulant !" by Blind Nomad is licensed under CC BY 2.0Response: It is well known that marijuana usage impairs driving ability, yet the early studies of the effects of recreational marijuana legalization on traffic fatalities were inconclusive. MedicalResearch.com: What are the main findings? Response: By analyzing data over a longer time period, we found that the legalization of recreational marijuana increased traffic deaths in the first four states to legalize. Traffic fatalities increased about 20% in those states. If we apply these numbers to the nation as a whole, nationwide legalization would be associated with about 7,000 excess traffic fatalities each year. (more…)
Addiction, Author Interviews, JAMA, Pediatrics, USPSTF / 20.06.2020

MedicalResearch.com Interview with: Dr. Karina Davidson, PhD Senior Vice President of Research Dean of Academic Affairs Professor of Behavioral Medicine Zucker School of Medicine Hofstra University/Northwell Health Vice Chairmam US Preventive Services Task Force  MedicalResearch.com: What is the background for this study? Response: Drug use is among the most common causes of preventable death, injury, and disability in the United States, with nearly 10 percent of adults reporting unhealthy drug use. This includes the use of illegal drugs, as well as using prescription drugs in ways that are not recommended by a doctor. (more…)
Author Interviews, Diabetes, JAMA / 17.06.2020

MedicalResearch.com Interview with: Richard E. Pratley, MD AdventHealth Samuel E. Crockett Chair in Diabetes Research Medical Director | AdventHealth Diabetes Institute Senior Investigator and Diabetes Program Lead AdventHealth Translational Research Institute  MedicalResearch.com: What is the background for this study? Response: Historically, older individuals with T1D have been underrepresented or excluded from clinical trials. Older individuals with T1D are at particularly high risk for hypoglycemia. Because of their long duration of diabetes, they often have impaired counterregulatory responses and hypoglycemia unawareness. Hypoglycemia in older individuals is particularly dangerous because it can lead to falls and fractures, cognitive impairment and cardiovascular events, including death. There has been the misperception that older individuals are less able to use technology to manage their diabetes.  This study dispelled that notion.   (more…)
Author Interviews, JAMA, Multiple Sclerosis, Neurology / 15.06.2020

MedicalResearch.com Interview with: Cris S Constantinescu,  MD, PhD, FRCP Professor, Division of Clinical Neuroscience Research Group in Clinical Neurology University of Nottingham Queen's Medical Centre Nottingham UK MedicalResearch.com: What is the background for this study? Response: The study is in some way a test of the hygiene or old friends hypothesis, whereby eradication, through improved hygiene, of some parasites that have existed in the human gut for thousands of years and have suppressed inflammatory reactions, leads to an increase in inflammatory conditions. This has been used to explain the increased autoimmune and inflammatory diseases in the developed world. Healthy volunteer studies at the University of Nottingham showed therapeutic hookworm infection to be safe and well tolerated up to about 50 larvae, and then safety studies in people with airway hyperreactivity and inflammatory bowel disease raised no concern. Following a study in Argentina showing that people with MS have milder disease when they have a natural co-existing asymptomatic infection with intestinal parasites, we (Professor Pritchard, immunoparasitologist and myself) decided to test hookworm in MS, and for the first time used 25 larvae in a patient study. (more…)
Author Interviews, COVID -19 Coronavirus, Environmental Risks, JAMA / 11.06.2020

MedicalResearch.com Interview with: Mohammad Sajadi, MD Associate Professor Institute of Human Virology Global Virus Network Center of Excellence University of Maryland School of Medicine Baltimore, MD 21201  MedicalResearch.com: What is the background for this study? Response: Because of geographical proximity and significant travel connections, epidemiological modeling of the epicenter predicted that regions in Southeast Asia, and specifically Bangkok would follow Wuhan, and China in the COVID-19 epidemic. When we saw this did not happen, we suspected that SARS-CoV-2 might be acting like a seasonal respiratory virus.  (more…)
Author Interviews, Clots - Coagulation, JAMA, Kidney Disease / 09.06.2020

MedicalResearch.com Interview with: Manish M Sood MD FRCPC MSc Jindal Research Chair for the Prevention of Kidney Disease Associate Professor of Medicine, Dept. of Medicine and the School of Epidemiology and Public Health University of Ottawa Scientist, Ottawa Hospital Research Institute Nephrologist, The Ottawa Hospital Ottawa, Ontario, Canada  MedicalResearch.com: What is the background for this study? Response: Early work has suggested a very commonly used antibiotic, clarithromycin, may interfere with the metabolism of the most widely used type of blood thinning medication (called direct oral anticoagulants or DOACs) such that the blood level of the DOAC increases and may place the patient at a higher risk for bleeding.  In our study we looked at patients of advanced age (>66 years old) who were given clarithromycin while on a DOAC in Ontario, Canada. We compared patients on clairthromycin-DOAC to patients given a very similar antibiotic, azithromycin, that does not interfere with the metabolism of DOAC. (more…)
Allergies, Author Interviews, JAMA, OBGYNE / 05.06.2020

MedicalResearch.com Interview with: Niklas Andersson MS Department of Epidemiology Research Statens Serum Institut Copenhagen S, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Second-generation antihistamines are among the most commonly prescribed drug classes during pregnancy. Fexofenadine is a widely used antihistamine but given the limited fetal safety on the use of antihistamines during pregnancy in general, current clinical guidelines only recommend the use cetirizine and loratadine during pregnancy when needed due to a larger body of fetal safety data for these antihistamines. (more…)
Author Interviews, Blood Clots, Clots - Coagulation, COVID -19 Coronavirus, JAMA / 29.05.2020

MedicalResearch.com Interview with: Dr Tristan Morichau-Beauchant, MD. Intensive Care Unit Centre Cardiologique du Nord Saint-Denis, France MedicalResearch.com: What is the background for this study? Response: During the spread of the COVID-19 epidemic in France, early reports on severe patients stated a highly increased inflammatory response associated with procoagulant changes in coagulation pathways and high D-Dimer levels. Preliminary reports from the intensive care community signaled frequent events of deep vein thrombosis (DVT) among this population. We decided to perform prospectively a venous ultrasonogram of the inferior limbs for all patients with severe COVID-19 pneumonia at admission in our ICU.  All patients had acute respiratory distress syndrome according to the Berlin definition an required mechanical ventilation. Considering the high prevalence of venous thrombosis at admission we repeated a venous ultrasonography after 48 hours if the first exam was normal. All patients received standard anticoagulant prophylaxis since hospital admission. (more…)
Author Interviews, Cancer Research, JAMA, Yale / 28.05.2020

MedicalResearch.com Interview with: Daniel J. Boffa, MD Associate Professor of Thoracic Surgery Yale School of Medicine MedicalResearch.com: What is the background for this study? Response: The study examined networks that formed around hospitals that had been previously ranked in the top-50 by US News and World Report.  These top-ranked hospitals have shared their brand with hospitals in their network, which leads some people to believe that the care is the same at top-ranked hospitals and their affiliate hospitals.  We wanted to determine if outcomes after complex surgical procedures were truly the same at affiliate hospitals and top-ranked hospitals.  (more…)
Author Interviews, Gender Differences, JAMA, Surgical Research, University of Pittsburgh / 21.05.2020

MedicalResearch.com Interview with: Sara P. Myers, M.D., Ph.D. University of Pittsburgh School of Medicine  MedicalResearch.com: What is the background for this study? Response: Compared to other fields, medicine, and especially academic surgery and its subspecialties, trail with respect to gender diversity. Considering that these fields were traditionally male-dominated, two issues that may present ongoing challenges to the retention and promotion of women are pro-male bias and negative stereotypes about women. Training specific to pursuing a surgical career begins in residency, so it is important to understand how these issues affect motivation and achievement during this formative period. In our study we first evaluated the association between pro-male bias and research-related career engagement using a survey methodology, and then looked at whether evoking negative stereotypes about women was associated with reduced performance on a simulated technical skill assessment called the Fundamentals of Laparoscopic Surgery (FLS) assessment.  (more…)
Author Interviews, JAMA, Orthopedics, Race/Ethnic Diversity, Surgical Research / 19.05.2020

MedicalResearch.com Interview with: Alyson Cavanaugh, PT, PhD Joint Doctoral Program in Epidemiology University of California, San Diego/ San Diego State University MedicalResearch.com: What is the background for this study? Response: More than 700,000 total knee replacements are performed annually in the United States, but there is a racial disparity in outcomes after the surgery. If the knee replacement procedure is considered a highly effective treatment, why don't black women present with the same outcomes as whites? Physical function when going into surgery has a large impact on the potential functional outcomes after surgery. Our hypothesis was that black women were presenting to surgery with poorer physical function, which was contributing to poorer functional outcomes after surgery. (more…)
Author Interviews, Cost of Health Care, JAMA / 19.05.2020

MedicalResearch.com Interview with: James D. Chambers, PhD, MPharm, MSc Associate Professor of Medicine Tufts Medical Center Institute for Clinical Research and Health Policy Studies MedicalResearch.com: What is the background for this study? Response: We know that biosimilars have not had the same uptake in the US as they have had elsewhere. We know that this is in part due to reference product manufacturer tactics to delay biosimilar market entry and patent disputes. In this study we examined whether lack of preferred coverage by commercial health insurers may also play a role. (more…)
Author Interviews, Cost of Health Care, JAMA, Primary Care / 19.05.2020

MedicalResearch.com Interview with: Sara Martin, MD, MSc Santa Rosa Family Medicine Residency Program Santa Rosa, California MedicalResearch.com: What is the background for this study? Response: To improve access to comprehensive primary care, we need to understand how much is being spent on primary care. Until recently, the United States lacked any data-based estimate of primary care expenditure.  This study utilizes Medical Expenditure Panel Survey (MEPS)data from 2002 – 2016 to estimate the percentage of healthcare expenditures that was spent on primary care. Most discussions around health care expenditure in the U.S. focus on the fact that we spend more than any other country and do not have the corresponding outcomes to match that investment.  This paper focuses the conversation around the distribution of the expenditure. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, Race/Ethnic Diversity, Statins / 14.05.2020

MedicalResearch.com Interview with: Dr. Ankur Pandya, PhD Assistant Professor of Health Decision Science Department of Health Policy and Management Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: The 2013 ACC-AHA cholesterol treatment guidelines greatly expanded statin medication eligibility for individuals between the ages of 40-75 years without known cardiovascular disease, and there was some concern that African Americans at "intermediate risk" per those guidelines could be (arguably) overtreated with statins. The 2018 ACC-AHA guidelines included coronary artery calcium assessment for individuals at intermediate cardiovascular disease risk; those with a "zero" calcium score and no other risk factors would now change the eligibility (from indicated statin to not indicated). (more…)
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, JAMA / 08.05.2020

MedicalResearch.com Interview with: Anurag K. Singh MD Professor of Oncology Director of Radiation Research Leader, Cell Stress and Biophysical Therapy Program Associate Dean Graduate Medical Education, Research Roswell Park Comprehensive Cancer Center Buffalo NY MedicalResearch.com: What is the background for this study? Response: More than 40% of women with hormone receptor-positive, HER2-negative early stage breast cancer with high recurrence scores (RS) have RS of 26-30. Optimal adjuvant systemic therapy in this subgroup remains unclear, and national guideline currently recommends either chemoendocrine therapy or endocrine therapy alone. In addition, the difference in overall survival of a patient with a RS 26-30 versus RS >30 is unclear.   (more…)
Author Interviews, JAMA, Pediatrics, Tobacco Research, USPSTF / 05.05.2020

MedicalResearch.com Interview with: Dr. Michael Silverstein M.D., M.P.H Professor of Pediatrics Director of the Division of General Academic Pediatrics Vice Chair of Research, Department of Pediatrics Boston University School of Medicine MedicalResearch.com: What is the background for this study? Response: The number of children and teens who use tobacco products continues to be a major issue in the U.S., driven largely by an increase in e-cigarette use, which makes preventing tobacco use among young people critical to the health of our nation. To help prevent kids and teens from starting to use tobacco, the Task Force recommends clinicians provide behavioral interventions, such as education or brief counseling.   (more…)
Addiction, Author Interviews, JAMA, Opiods / 24.04.2020

MedicalResearch.com Interview with: Tami L. Mark, PhD Senior Director, Behavioral Health Financing and Quality Measurement RTI International  MedicalResearch.com: What is the background for this study? Response: There are effective medications to treat opioid use disorder. Federal and state policymakers have tried to improve access to these medications. However, medications to treat opioid use disorders are still often subject to prior authorization. Studies of other medications finds that prior authorization can reduce access. This study looked at whether removing prior authorization in Medicare Part D plans was associated with increases in the use of medications to treat opioid use disorder.  (more…)
Author Interviews, Diabetes, JAMA, Surgical Research / 14.04.2020

MedicalResearch.com Interview with: Katherine Moll Reitz, MD General Surgery Resident University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: Surgical interventions both save lives and improve the quality of those lives each day. However, these same interventions and the recovery thereafter are a major physiologic stressor. Younger, more resilient patients tend to recover faster, with fewer postoperative complications when compared to older, frailer patients undergoing the same surgical treatments. Therefore, investigators at University of Pittsburgh and UPMC have begun focusing on prehabilitation in order to optimize at risk patients preoperatively. Just as an athlete would train for an upcoming event, prehabilitation (including smoking cessation, healthy eating, and physical activity increases) prepares or trains patients for their surgical intervention and can improve their postoperative outcomes. Currently, there is no medication available to aid in this training process, improving patients’ response to the physiologic stress of surgery. Therefore, we are interested in exploring potential safe, well tolerated medical therapies which can optimize patients as pharmacologic prehabilitation. (more…)
Author Interviews, JAMA, Pediatrics / 10.04.2020

MedicalResearch.com Interview with: Dr Alfredo Tagarro MD PhD Pediatrician - Hospital Universitario Infanta Sofía Clinical Research - Fundación Investigación Hospital Assistant Professor - Universidad Europea de Madrid Madrid MedicalResearch.com: What is the background for this study? Response: Madrid is being hit hard by the disease. Almost all doctors, including pediatricians, are dedicated to attending COVID-19 patients, essencially adults. However, there are some moderate and severe cases among children. In Madrid, clinical pediatricians from 30 hospitals joined their efforts to report and analyze pediatric patients with COVID-19.   (more…)