Author Interviews, Blood Pressure - Hypertension, JAMA, OBGYNE / 04.05.2022

MedicalResearch.com Interview with: Richard McManus MA PhD MBBS FRCGP FRCP Professor of Primary Care Dr. McManus chairs the Blood Pressure Monitoring Working Party of the British Hypertension Society Nuffield Department of Primary Care Health Sciences  MedicalResearch.com:  What is the background for this study?  Response: About one in ten people who are pregnant develop high blood pressure and almost half of these go onto to have pre-eclampsia. Many pregnant women and individuals are already measuring their own blood pressure – well over half of those with high blood pressure in a recent large survey in the UK but until recently there were no data to support this. (more…)
Alzheimer's - Dementia, Author Interviews, Race/Ethnic Diversity, UCSF / 20.04.2022

MedicalResearch.com Interview with: Erica Kornblith, PhD Assistant Professor, Psychiatry UCSF Weill Institute for Neurosciences MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: As the population of the United States grows more diverse and dementia is a serious public health concern, we hoped to understand whether differences in dementia risk exist based on race or ethnicity.  Older studies have shown that Black and Hispanic folks have higher risk of dementia, perhaps due to medical risk factors, diagnostic bias, lack of equal access to health care and education, or the health effects of racism, among other factors.  However, these older studies have been small or limited geographically or by only studying a few race and ethnicity groups. Our study used a nationwide sample of almost two million older Veterans who all had access to care through the Veterans Health Administration (VHA), and we examined 5 race or ethnicity groups: American Indians or Alaska Natives, Asians, Blacks, Hispanics, and Whites. Our results show that dementia risk is higher for Black and Hispanic Veterans compared to white Veterans, even when education and medical factors are considered. (more…)
Author Interviews, CDC, COVID -19 Coronavirus, Emory, Heart Disease, JAMA / 25.01.2022

MedicalResearch.com Interview with: Matthew Oster, MD, MPH CDC COVID-19 Response CDC Center on Birth Defects and Developmental Disabilities Pediatric Cardiologist, Sibley Heart Center, Children’s Healthcare of Atlanta Emory University School of Medicine Emory University Rollins School of Public Health MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: More than 192 million people ages 12 years and older in the U.S. received at least one dose of mRNA COVID-19 vaccines from December 2020 through August 2021. From this population, VAERS (the Vaccine Adverse Event Reporting System) received 1,991 reports of myocarditis,  1,626 of which met the case definition of myocarditis. Rates of myocarditis were highest following the second dose of an mRNA vaccine among males aged 12–15 years (70.7 per million doses of Pfizer), 16-17 years (105.9 per million doses of Pfizer), and 18–47 years (52.4 and 56.3 per million doses of Pfizer and Moderna, respectively). Of those with myocarditis, the median age was 21 years and the median time from vaccination to symptom onset was two days. Males accounted for 82% of patients for whom sex was known. Approximately 96% were hospitalized, 87% of whose symptoms had gone away by the time they were discharged from the hospital. Non-steroidal anti-inflammatory drugs (589/676, 87%) were the most common treatment. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Social Issues, Transplantation / 14.12.2021

MedicalResearch.com Interview with: Rebecca Thorsness, PhD Research Associate Department of Health Services, Policy, and Practice Brown University School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2019, the President signed the Advancing American Kidney Health executive order, which included provisions to increase the use of home dialysis and kidney transplant for Americans living with kidney failure. To carry out this vision, the Centers for Medicare & Medicaid Services (CMS) developed the ESRD Treatment Choices (ETC) payment model, which uses financial incentives and penalties to incentivize dialysis facilities to pursue home dialysis or kidney transplant for their patients. Transplant and home dialysis are optimal care for people with kidney failure, but there are social and clinical reasons that patients with high social risk (such as those exposed to racism, poverty, or housing instability) may not be candidates for these treatments. This means that facilities which serve a large number of patients with high social risk might be disproportionately penalized by this new payment model. Using data immediately prior to the implementation of the ETC model, we found that dialysis facilities that serve high proportions of patients with high social risk have lower rates of home dialysis and kidney transplantation than facilities that care for lower proportions of such patients. (more…)
Author Interviews, JAMA, Johns Hopkins, Weight Research / 25.11.2021

MedicalResearch.com Interview with: Alejandra Ellison-Barnes, MD MPH General Internal Medicine Johns Hopkins Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Emerging adulthood is a unique period of development that ultimately leads to the formation of adult identity, but how this stage contributes to obesity is relatively understudied. The prevalence of obesity has been increasing in the United States population as a whole, and we wanted to know how mean body mass index and the prevalence of obesity have changed over the past several decades specifically among emerging adults. We found that among emerging adults aged 18 through 25, mean BMI has increased from 23.1 kg/m2 in 1976-1980 to 27.7 kg/m2 in 2017-2018. In the same period, the prevalence of obesity increased from 6.2% to 32.7%. (more…)
Author Interviews, JAMA, Primary Care, Social Issues / 13.09.2021

MedicalResearch.com Interview with: Karina W. Davidson, Ph.D., M.A.Sc. Professor of Behavioral Medicine Zucker School of Medicine at Hofstra University/Northwell Health Chairperson, USPSTF MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The social and economic conditions in someone’s life, such as whether or not they have secure food, housing, or transportation, can affect their health in multiple ways. As part of our commitment to improving health equity, the U.S. Preventive Services Task Force took two key steps. We both thoroughly reviewed the existing research around screening and interventions for social risk factors, and audited our own portfolio of recommendation statements to determine how and how often social risks have been considered in the past. This information serves as a benchmark and foundation for our ongoing work to further advance health equity through our methods and recommendations. (more…)
Author Interviews, CDC, Clots - Coagulation, COVID -19 Coronavirus, JAMA / 05.05.2021

MedicalResearch.com Interview with: Isaac See, MD Centers for Disease Control and Prevention COVID-19 Response Team Atlanta, Georgia MedicalResearch.com: What is the background for this study? Response: On February 27, 2021 the U.S. Food and Drug Administration (FDA) granted emergency use authorization for the Janssen/Johnson & Johnson (J&J) COVID-19 Vaccine in people 18 years of age or older in the United States.  The Janssen/J&J COVID-19 Vaccine uses a replication-deficient (i.e., cannot cause infections) human adenovirus vector.  In mid-March, the European Medicines Agency announced that they had conducted a preliminary investigation of cases of blood clots and low counts of blood cells called platelets in patients who had recently received the Oxford/AstraZeneca COVID-19 Vaccine, which uses a replication-deficient chimpanzee adenovirus vector.  This syndrome of blood clots and low platelet counts has been called thrombosis with thrombocytopenia syndrome, or TTS.  The European investigation showed that over 70% of their cases specifically involved blood clots in particular veins inside the brain, a condition caused cerebral venous sinus thrombosis (CVST), in addition to low platelet counts (thrombocytopenia is the medical term for low platelet counts). CVST is already a rare condition, and CVST with thrombocytopenia is even rarer.  By April 12, 2021, approximately 7 million doses of the Janssen/J&J COVID-19 Vaccine had been given in the United States, and six cases of CVST and thrombocytopenia after receipt of the Janssen/J&J COVID-19 Vaccine had been reported to the U.S. Vaccine Adverse Event Reporting System (VAERS), which is the U.S. national vaccine safety monitoring system.  The next day (April 13, 2021) CDC and FDA recommended a pause in use of the vaccine recommended to allow for further investigation of these events.  On April 23, 2021 data about the first 12 cases reported after authorization of the Janssen/J&J COVID-19 Vaccine were presented at an emergency meeting of the Advisory Committee on Immunization Practices (ACIP) to decide what to recommend regarding the Janssen COVID-19 vaccine.  The ACIP concluded that the benefits of resuming Janssen COVID-19 vaccination among persons aged 18 years or older outweighed the risks and reaffirmed its interim recommendation under the FDA’s Emergency Use Authorization.  The FDA’s Emergency Use Authorization includes a new warning for rare clotting events among women aged 18 to 49 years. Our report provides clinical details about these first reported 12 U.S. cases of CVST and thrombocytopenia following receipt of the Janssen COVID-19 Vaccine. (more…)
Author Interviews, Emory, Health Care Systems, JAMA, Kidney Disease, Transplantation / 11.09.2019

 A retraction and replacement have been issued due to a major coding error that resulted in the reporting of incorrect data in this study surrounding the difference in transplant rates between for-profit and non-profit dialysis centers. Please see link below:

Bauchner H, Flanagin A, Fontanarosa PB. Correcting the Scientific Record—Retraction and Replacement of a Report on Dialysis Ownership and Access to Kidney Transplantation. JAMA. 2020;323(15):1455. doi:10.1001/jama.2020.4368

MedicalResearch.com Interview with: Rachel Patzer, PhD, MPH Associate Professor Director, Health Services Research Center Department of Medicine Department of Surgery Emory University School of Medicine   MedicalResearch.com: What is the background for this study? Response: We know that historically, for-profit dialysis facilities have been shown to have lower rates of kidney transplantation than patients who receive treatment in non-profit dialysis facilities. However, these studies are outdated, and did not examine access to living donor transplantation or include the entirety of the end-stage kidney disease population  (more…)
Author Interviews, Heart Disease, JAMA / 19.03.2019

MedicalResearch.com Interview with: Dr. Carina Blomström-Lundqvist, MD Professor of Cardiology Department of Cardioloy Institution of Medical Science Uppsala, Sweden MedicalResearch.com: What is the background for this study?   Response: While all previous trials comparing atrial fibrillation (AF) ablation and antiarrhythmic drugs to our best knowledge have evaluated the efficacy of these treatments in terms of atrial fibrillation (AF) recurrences (with an AF episode of 30 seconds duration as standard primary endpoint) we wanted to use quality of Life (QoL) - general health - as primary endpoint, since the indication for treatment is improving QoL. This was important since, despite the fact that the indication for treatment is to improve (QoL) and reduce symptom, all prior trials have used 30 seconds AF episodes as standard primary endpoint, which if occurred it would be defined as a failed treatment. We also wanted to assess effects on various clinical outcome events. We know from registries such as ORBIT AF registry that around 60 % of AF patients have symptoms resulting in repeated hospitalisation visits in at least 30-40% of patients annually, and that only around 5 % of the AF population are being referred for AF ablation. Previous trials have used intermittent 24 hours Holter recordings whioch does not give the true AF burden (% of time in AF). We therefore also wanted to assess and compare treatments effects on true AF burden by implanting an implantable cardiac monitor (ICM) which continuosly records the heart rhythm. We would then be able to prove that improvement in QoL was directly related to a reduction in AF burden and that treatment differences in QoL was related to a difference in reduction in AF burden. We also wanted to study an AF population in their early AF disease state so that we could offer atrial fibrillation ablation to a broader AF population before their atria have become remodelled and too damaged for a pulmonary vein isolation to be effective.  (more…)