Author Interviews, Education, JAMA / 20.07.2023

MedicalResearch.com Interview with: Cassandra Kelleher, MD Surgical Director, Fetal Care Program Surgical Director, Neonatal Intensive Care Unit Physician Investigator (Cl) Surgery, Mass General Research Institute Associate Professor of Surgery Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Physicians practicing in academic hospitals have unique responsibilities. They are not only expected to treat patients, but also to conduct research to improve treatments for future patients, and to train future physicians. Diverse healthcare teams have better patient outcomes and lower healthcare costs. Women physicians, for example, are more likely to practice patient-centered care, and through their teaching and research work at academic medical centers, they help to disseminate and normalize novel approaches to practicing medicine. For these reasons, gender diversity in academic medicine is important for the quality of healthcare in the future. (more…)
Author Interviews, Biomarkers, Brigham & Women's - Harvard, Diabetes, Endocrinology / 26.06.2023

MedicalResearch.com Interview with: Dr. Bita Zahedi MD MA Endocrinologist Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Response: The purpose of this study was to develop and validate a measure of dietary advanced glycation end-products (AGEs) to investigate the role of dietary AGEs in diabetic disease processes.  AGEs are a group of highly reactive compounds involved in the pathophysiology of diabetic complications, such as microvascular disease, cardiomyopathy, and possibly bone health. AGEs form through a nonenzymatic reaction between reducing sugars and free amino groups of proteins, lipids, and nucleic acids, also known as a Maillard or browning reaction. Endogenous AGE formation and accumulation is a normal part of metabolism and aging, however the process of glycation can be enhanced by hyperglycemia, hyperlipidemia, and increased oxidative stress. Additionally, AGEs can be absorbed from exogenous sources via consumption of various food items. Prior studies demonstrate that skin AGEs are predictive of Dietary AGEs (dAGEs) which are naturally present in certain uncooked foods, mainly animal-derived products, furthermore the method of food preparation can result in significant AGE formation. Considering the ubiquitous intake of dAGEs, it is possible that the consumption of exogenous AGEs contribute to AGE-induced oxidative stress, inflammation, and its subsequent detrimental sequalae. (more…)
Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Gender Differences, JAMA, Menopause / 03.04.2023

MedicalResearch.com Interview with: Rachel Buckley, PhD ​Assistant Professor Department of Neurology Massachusetts General Hospital/Harvard Medical School MedicalResearch.com: What is the background for this study? Response: While a fair amount of studies have focused on the effects of menopause and hormone therapy on risk of dementia, far fewer studies have tested their association with the biology of Alzheimer’s disease, namely amyloid and tau. This is critical to know given that it still remains unclear what might be the driving mechanism of the menopause transition on risk for dementia. This is what our study set out to investigate. This study is one of the first to report a link between women’s age at menopause and tau in the brain, which we measured with positron emission tomography neuroimaging. We found that in multiple areas of the brain that tend to be most likely to show higher tau in women than men, women with earlier age at menopause and elevated levels of amyloid showed higher levels of tau than those who reported an average age at menopause (~50 years in the United States). Women who reported premature menopause (<40 years at menopause onset) exhibited a much higher risk of tau in the brain. This supports the notion that longer exposure to estrogen throughout life might be protective against Alzheimer’s disease. (more…)
Author Interviews, Brigham & Women's - Harvard, Fertility, Heart Disease, JACC / 19.04.2022

MedicalResearch.com Interview with: Emily Lau, MD, MPH Cardiologist Instructor in Medicine, Harvard Medical School Director, Menopause, Hormones & Cardiovascular Disease Clinic Massachusetts General Hospital MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Emerging data suggest that a woman’s reproductive history influences her future risk of heart disease. Infertility is a reproductive risk factor that affects ~14% of women but has not been rigorously studied with respect to its relationship with cardiovascular disease risk. We studied over 38,000 women enrolled in the Women’s Health Initiative and found that infertility was associated with greater risk of heart failure. In particular, we found that the association was driven by greater risk of heart failure with preserved ejection fraction, a form of heart failure that is far more common among women. (more…)
Author Interviews, Autism, Medical Imaging / 02.04.2022

MedicalResearch.com Interview with: Alpen ORTUĞ, PhD Postdoctoral Research Fellow​ Massachusetts General Hospital Department of Radiology Martinos Center for Biomedical Imaging Boston, MA   MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Finding the earliest diagnosis possible for autism spectrum disorder (ASD) is one of the main goals for researchers studying ASD. This study aimed to investigate the critical abnormalities in prenatal brain development in ASD using structural magnetic resonance imaging (MRI). We hypothesized that volumetric analyses of brain segmentations are useful to identify such abnormalities before birth. We have retrospectively analyzed fetal MRI based on the knowledge that the same individuals were later diagnosed with autism spectrum disorder. We have evaluated developmental abnormalities in brain structures of prospective ASD fetuses using volumetric segmentation. The current study is still preliminary, but the ‘insula’ of the brain showed statistically significant volumetric enlargement in prospective ASD patients, compared to the other three control groups.  (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Stroke / 30.09.2021

MedicalResearch.com Interview with: Daniel E. Singer, MD Professor of Medicine, Harvard Medical School Professor in the Department of Epidemiology Harvard T.H. Chan School of Public Health Division of General Internal Medicine Massachusetts General Hospital Boston, MA, 02114 MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) raises the risk of ischemic stroke 4-5-fold and this risk is largely reversible by oral anticoagulants (OAC). These facts are part of the core knowledge of internal medicine and the basis of multiple guidelines. They are based on studies of patients with persistent or predominantly “heavy burden” paroxysmal AF completed in the 1990s. More recent studies using cardiac implantable devices (CIEDs: implantable defibrillators, pacemakers, etc) which have the capacity to monitor heart rhythm continuously have found that many older patients have brief, often undiagnosed, episodes of AF. Several of these studies have found that strokes occur during periods of sinus rhythm temporally distant from a preceding episode of AF. This has led to a widespread suspicion that AF is not a direct causal risk factor but a risk “marker” indicating the presence of other truly causal features like a diseased left atrium (atrial myopathy). If the risk marker hypothesis is correct, then long-term anticoagulation is needed even for brief and rare episodes of AF (assuming the patient’ s CHA2DS2-VASc score is high enough). The key problem with prior prospective studies using CIEDs was that only a small number of strokes were observed leading to inadequate statistical power. Our study addressed this power problem by linking the very large Optum electronic health record database which could identify ischemic strokes with the Medtronic CareLink database of long-term, continuous heart rhythm records of patients with CIEDs. We ended up studying 891 individuals who had an ischemic stroke and had 120 days of continuous heart monitoring prior to the stroke. (more…)
Allergies, Author Interviews, COVID -19 Coronavirus, JAMA, Vaccine Studies, Vanderbilt / 27.07.2021

MedicalResearch.com Interview with: Kimberly G. Blumenthal, MD, MSc Massachusetts General Hospital The Mongan Institute Boston, MA 02114 Matthew S. Krantz, MD Division of Allergy, Pulmonary and Critical Care Medicine Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee   MedicalResearch.com: What is the background for this study? Response: During the initial COVID-19 vaccine campaign with healthcare workers in December 2020, there was an unexpected higher than anticipated rate of immediate allergic reactions after Pfizer and Moderna mRNA vaccines.  This prompted both patient and provider concerns, particularly in those with underlying allergic histories, on the associated risks for immediate allergic reactions with the mRNA vaccines. Because of the significantly improved effectiveness of two doses of an mRNA vaccine compared to one dose, it was important to determine if those who experienced immediate allergic reaction symptoms after their first dose could go on to tolerate a second dose safely.    (more…)
Alcohol, Author Interviews, Heart Disease, JACC / 09.05.2021

MedicalResearch.com Interview with: Kenechukwu Ndubisi Mezue, M.D Fellow in Nuclear Cardiology  Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Response: Observational studies have shown that moderate alcohol intake may have beneficial effects on cardiovascular disease. However, the mechanisms through which this benefit occurs is mostly unknown. Chronic stress is also known to associate with increased risk of cardiovascular disease and our group has shown in previous work that increased activity in the stress-associated regions of the brain (such as the amygdala) is significantly associated with increased bone marrow activity, arterial inflammation, and cardiovascular events. Our current study hypothesizes that moderate alcohol intake reduces cardiovascular events by reducing chronic stress-associated brain activity.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Colon Cancer, Radiation Therapy / 04.05.2021

MedicalResearch.com Interview with: James Donald Byrne, Ph.D., M.D. Department of Radiation Oncology Massachusetts General Hospital Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: Radiation therapy is used as a treatment for more than half of all cancer patients and can be highly effective at shrinking tumors and killing cancer cells. But radiation treatment can also damage healthy tissue, including tissue in the mouth and gastrointestinal tract. This tissue injury can lead to oral mucositis, esophagitis, and proctitis — painful and sometimes debilitating tissue damage. It’s estimated that these injuries occur in over 200,000 patients in the U.S. each year. Our goal was to develop personalized shields that blocked radiation from affecting healthy GI tissue. (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, NEJM / 22.04.2021

MedicalResearch.com Interview with: Aditya Bardia MD, MPH Director, Breast Cancer Research Program, Attending Physician, Massachusetts General Hospital Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: Triple negative breast cancer (TNBC) represents an aggressive subtype of breast cancer associated with guarded prognosis. For patients with pre-treated metastatic TNBC, standard chemotherapy is associated with low response rate (5-10%) and poor progression-free survival (2-3 months), highlighting need for better therapies. Sacituzumab govitecan is an antibody drug conjugate (ADC) which  combines SN-38, an active metabolite of irinotecan, with an antibody against Trop-2, an antigen overexpressed in majority of triple negative breast cancer. (more…)
Author Interviews, Gender Differences, Surgical Research / 14.10.2020

MedicalResearch.com Interview with: Cassandra M. Kelleher, MD, FACS Surgical Director, Fetal Care Program Surgical Director, NICU Quality and Safety Chair, Pediatric Surgery MGH eCare Clinical Informaticist Pediatric Surgery MassGeneral Hospital for Children Boston, MA MedicalResearch.com: What is the background for this study? Response: Only about one in five surgeons practicing in U.S. is female. Unemployment is virtually nonexistent among surgeons, but many female surgeons, as well as professional women in other fields, experience underemployment—the underuse of skills—according to the Federal Reserve Bank. Women in surgery talk among themselves about how they may be perceived as less confident or competent, and for those reasons they may have less opportunity to do exciting and challenging cases. We wondered if this was true, and if so, why? (more…)
Author Interviews, COVID -19 Coronavirus, Pediatrics / 22.08.2020

MedicalResearch.com Interview with: Lael Yonker, MD Pediatric Pulmonology Director, MGH Cystic Fibrosis Center Principal Investigator, Pediatric COVID biorepository Mucosal Immunology and Biology Research Center Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Children were initially felt to be spared from the COVID-19 pandemic. Here, we show that children can become sick from SARS-CoV-2 infection, and even if the initial illness is mild, some go on to develop a severe inflammatory illness after the initial illness. We also show that children can carry very high levels of virus early in the course of infection, suggesting they may play a larger role in spreading the virus than previously thought. (more…)
Author Interviews, COVID -19 Coronavirus, Infections, Pulmonary Disease / 08.05.2020

MedicalResearch.com Interview with: Jehan Alladina MD Massachusetts General Hospital Pulmonary and Critical Care Medicine Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: During the pandemic, clinicians around the world have shared anecdotal experiences to help inform care of patients with COVID-19. However, these anecdotes and observations, without careful analysis, can bias clinicians; many clinicians have even recommended experimental therapies based on this information alone. To that end, the goal of our study was to rigorously examine the respiratory failure experienced by critically ill patients with COVID-19 and understand their response to the standards of care for respiratory failure. (more…)
Author Interviews, Gender Differences / 16.08.2019

MedicalResearch.com Interview with: Jack Turban MD MHS Resident Physician in Psychiatry The Massachusetts General Hospital and McLean Hospital Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Gender identity conversion efforts are attempts by a professional (for example a therapist, counselor, or religious advisor) to make a transgender person cisgender. The practice has been labelled unethical and ineffective by major medical organizations, including the American Medical Association. Accordingly, many U.S. states have made this practice illegal. Other states, however, have deferred passing bans on gender identity conversion efforts. Some state legislators have argued that such bans are unnecessary because this practice doesn’t occur in their state. (more…)
Author Interviews, Diabetes, JAMA / 12.08.2019

MedicalResearch.com Interview with: Pooyan Kazemian, Ph.D. Instructor in Medicine Massachusetts General Hospital  MedicalResearch.com: What is the background for this study? Response: Advances in diabetes care can meaningfully improve outcomes only if they effectively reach the populations at risk. However, it is not known if recent innovations in diabetes treatment and care models have reached the United States population at risk. (more…)
Author Interviews, JAMA, Nutrition, Weight Research / 11.07.2019

MedicalResearch.com Interview with: Anne Thorndike, MD, MPH Massachusetts General Hospital General Internal Medicine Division Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: Nearly one-third of the 150 million US adults who are employed are obese. Employees frequently eat meals acquired at work, and workplace food is often high in calories. Effective strategies for reducing non-nutritive energy intake during the workday could help address the rising prevalence of obesity. Simplified labeling, such as traffic-light labels, provide understandable information about the relative healthfulness of food and can be placed on menu boards, shelf labels, and individual packages to help employees make healthier choices. Choice architecture (e.g., product placement) interventions make it easier and more convenient for employees to choose a healthy item. It is unknown if labeling interventions are associated with sustained reductions in calorie intake, or if there are only temporary effects after which most people revert to higher-calorie choices. A previous study demonstrated that a hospital cafeteria traffic-light labeling and choice architecture program resulted in a higher proportion of healthy green-labeled purchases and lower proportion of unhealthy red-labeled purchases over two years. The current study analyzed calories purchased by a longitudinal cohort of 5,695 hospital employees who used the cafeteria regularly. The study examined changes in calories purchased over time and hypothesized the effect of the change in calorie intake on employees’ weight. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Orthopedics, Osteoporosis, Surgical Research / 15.05.2019

MedicalResearch.com Interview with: Elaine W. Yu, MD, MMSc Assistant Professor,  Harvard Medical School Director, Bone Density Center Endocrine Unit, Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Roux-en-Y gastric bypass (RYGB) is a popular surgical weight loss procedure.  We have previously shown that gastric bypass leads to rapid high-turnover bone loss. Bariatric procedures are being increasingly performed in older adults, and the clinical consequences of gastric bypass-associated skeletal changes in this vulnerable population have been unclear to date.  Thus, we used Medicare claims data to investigate fracture risk among older adults after gastric bypass, and in comparison to adults who received another bariatric procedure called adjustable gastric banding (AGB), which is thought to have fewer negative bone effects. In our analysis, we found that patients undergoing Roux-en-Y gastric bypass were 73% more likely to fracture than those undergoing AGB. Importantly, we found that hip fracture risk increased nearly 180% after RYGB, and that fracture rates in patients aged 65 or older were similar to the overall group.  (more…)
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Chemotherapy, NEJM / 24.02.2019

MedicalResearch.com Interview with: Aditya Bardia, MBBS, MPH Director, Precision Medicine, Center for Breast Cancer, Attending Physician Massachusetts General Hospital Cancer Center Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: Metastatic triple negative breast cancer is associated with aggressive tumor biology, and tends to affect younger patients and African Amerians. The response rate with standard chemotherapy regimens in patients with pre-treated metastatic TNBC ranges from 10-15%, and median progression-free survival ranges from 3-4 months. The median survival of metastatic TNBC is around 12 months and has not changed in the past 20 years. Thus, treatment of metastatic triple negative breast cancer represents an unmet clinical need.   (more…)
Author Interviews, Genetic Research, JAMA, Race/Ethnic Diversity, Stroke / 11.02.2019

MedicalResearch.com Interview with: Sandro Marini, MD Research Fellow Jonathan Rosand Laboratory Massachusetts General Hospital Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The epsilon(ε) 4 allele of the Apolipoprotein E (APOE) gene increases risk for Alzheimer’s disease (AD) and intracerebral hemorrhage (ICH). In both diseases, it is believed to increase risk through the deposition of beta-amyloid within the brain and blood vessels, respectively. The effect of APOE ε4 on both AD and ICH risk changes across populations, for unclear reasons. In our study, we confirmed the role of APOE ε4 for ICH risk in whites and found that the risk-increasing effect of the 4 allele is demonstrable in Hispanics only when balancing out the effect of hypertension. (more…)
Author Interviews, JAMA, Opiods / 02.02.2019

MedicalResearch.com Interview with: "Opioids" by KSRE Photo is licensed under CC BY 2.0. To view a copy of this license, visit: https://creativecommons.org/licenses/by/2.0Dr. Qiushi Chen (first author) and Jagpreet Chhatwal PhD Assistant Professor, Harvard Medical School Senior Scientist, Institute for Technology Assessment Massachusetts General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Opioid overdose epidemic is a national public health emergency — in 2017, more than 49,000 people died from overdose. Our study shows that under current conditions, the number of deaths is projected to increase to 81,700 by 2025. Efforts to curb the epidemic by reducing the incidence of prescription opioid misuse — the primary focus of current interventions — will have a modest effect of 3-5% reduction in overdose deaths. (more…)