Music Activates Central Hub of Brain’s Reward System

Posted on February 20, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Ben Gold

Ben Gold, a PhD candidate
Lab of Robert Zatorre
The Neuro (Montreal Neurological Institute and Hospital)
McGill University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Music is just sound in air, but it carries considerable power. It captivates our brain’s reward system, we devote an enormous amount of time and money to it, and we’re just beginning to tap its therapeutic potential. We wanted to explore how something so abstract could have such an impact, and since music is so well suited to establishing and manipulating patterns of sound as it unfolds, we focused on how it manipulates expectations.

Previous research has shown that surprises are often the most emotional and pleasurable moments in music listening, but whether and how this engaged the brain’s reward system was unclear. So we adapted an experimental protocol designed for studying learning and surprise about more concrete rewards like food or money, and applied it to a musical context during brain imaging. This protocol relies on participants making decisions from which we could infer their expectations, allowing us to estimate how surprised they were by each outcome whenever it occurred. In our case, we asked participants to make choices about colors and directions that were associated with different musical outcomes, but we didn’t tell them what those associations were so that they they started with no expectations and learned as they went.

We found that our participants could learn about music just like they would learn about how to find food or win money, and that the same neural process was involved. Specifically, we saw that the activity of the nucleus accumbens — a central hub of the reward system — reflected both how pleasant and how surprising each musical outcome was: a computation known as a reward prediction error. Across individuals, those who better represented these reward prediction errors in their nucleus accumbens also learned better about the music in the experiment, making more decisions over time to find the music they preferred. Continue reading →

Older Sperm May Produce Healthier Offspring

Posted on February 19, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Immler

Dr Simone Immler PhD
School of Biological Sciences
University of East Anglia

MedicalResearch.com: What is the background for this study?

Response: Sperm produced by one male vary substantially both in their genetic content as well as their swimming ability including speed and duration. In a previous study in the zebrafish, we showed that sperm swimming duration is at least partly determined by the underlying haploid genetic content carried by the different sperm within an ejaculate (alavioon et al. 2017 PNAS). If sperm with different swimming ability differ in their genetic content, we expect to see differences among the offspring sired by sperm that vary on their swimming ability.

In our new study, we tested how selection on sperm swimming duration affects offspring fitness. We performed in vitro fertilisation assays mimicking natural conditions in the externally fertilising zebrafish. We split the ejaculate of one male into two halves and in one half we added the sperm straight away to the eggs, allowing all motile sperm to have a go at fertilising an egg. In the second half, we activated the sperm but delayed the moment of fertilisation by 25 seconds and thus selected for the longer swimming sperm. In this treatment only sperm that were still swimming after this period of time (about 50%) were able to fertilise an egg.

We then reared the offspring to adulthood and measured number of offspring produced throughout life and measured lifespan. We found that sperm that were able to swim for longer sired offspring that not only produced more and healthier offspring but also lived for longer than their full siblings sired by sperm with reduced swimming ability. Our previous research (Alavioon et al. 2017 PNAS) suggests that these differences are caused at least partly by genetic differences among sperm. Continue reading →

Ultrasensitive DNA Screening for Down Syndrome Offers Potential for Early Detection

Posted on February 18, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Zhiyong Zhang PhD Key Laboratory for the Physics and Chemistry of Nanodevices and Department of Electronics Peking University Beijing China

Prof. Zhang

Zhiyong Zhang PhD
Key Laboratory for the Physics and Chemistry of Nanodevices
Department of Electronics
Peking University
Beijing China

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Down syndrome is caused by the presence of an extra 21st chromosome within the genome and is the most common birth defect (occurring in approximately 1 in 800 births). In the absence of a multiplexed quantitative diagnostic device, pregnant women have been examined with the ultrasound and the indirect biochemical markers (Alpha-fetoprotein, chorionic gonadotropin and free estriol) which are accompanied with a high misdiagnosis rate. And the diagnostic test (such as amniocentesis) following the wrong screening test results will bring harm to both the pregnant women and the fetuses.

Through PCR (polymerization chain reaction) amplification of the fetal DNA in the pregnant mother’s peripheral blood and fluorescence read-out, whole-genome sequencing (WGS)-based non-invasive prenatal testing (NIPT) sequences all the genomic DNA segments in parallel and quantitatively compares the percentage of different chromosomes, which increases the sensitivity for prenatal detection of Down syndrome. However, the complex instrumental setups and the resulted high processing cost present challenges for the large-scale application of WGS-based diagnosis at the point of care in the urban and rural areas of developing countries. Hence, beside the costly WGS method, there is an urgent need to develop a cost-effective NIPT biochip with simple instrumental setting, fast detection speed, high sensitivity, and programmable to multiple disease markers.

Taking advantages of we have developed a novel field effect transistor (FET) based biosensor that reveals a fast, ultra-sensitive, highly specific and cost-effective methods and someday can be used to detect fetal Down syndrome in NIPT. Continue reading →

Memories Can Be Stored During Some Unconscious Sleep States

Posted on February 11, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Züst

Marc Züst, PhD
University of Bern
Department of Psychology
Division of Experimental Psychology and Neuropsychology
Switzerland

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Slow wave sleep (deep sleep) is known to be very important for memory reorganization. The brain goes through the memory traces that were created during wakefulness and strengthens the important ones, while unimportant ones are weakened or deleted to make room for new learning the next day. This happens during the peaks of the eponymous slow waves, also called up-states, where the brain is highly active and interconnected. Up-states last for about 0.5 sec before transitioning into down-states, where the brain is relatively silent.

Based on these findings, we hypothesized that up-states constitute windows of opportunity to learn new information during slow wave sleep: The “channels are open”, and the brain is already performing memory functions.

The results of our study support this hypothesis. We found that, if we repeatedly managed to synchronize presentation of word pairs with up-states, memory for these pairs was best. Moreover, we find a dose-response function: The more often word pairs hit up-states, the better the memory. On top of that, fMRI during the retrieval test suggests that the same brain regions are involved in sleep learning as are involved in learning during wakefulness.

Continue reading →

Systematic Reviews May Not Address Adverse Side Effects

Posted on February 8, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Golder

Dr. Su Golder, PhD
Department of Health Sciences
University of York

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Patients and providers need to know about the relative benefits and harms of an intervention. It is not just those adverse events deemed to be serious that are important but also those categorized as minor.

Systematic reviews are summaries of the evidence, often used in to inform guidelines and decision-making. It is common for systematic reviews to focus on the potential benefits of an intervention without addressing the adverse effects. This leads to bias and an incomplete picture of the evidence.

To aid transparency in systematic reviews, authors should published a protocol, describing what they intend to do. We look at protocols with a completed systematic review published in 2017 or 2018. We found that only 38% said that they would record adverse effects.

Equally worrying of those authors that stated in their protocol that they intended to look at adverse effects – only 65% fully reported the adverse outcome exactly as they set out to do. Continue reading →

Skin Care Products Make Cotton Fabrics More Flammable

Posted on February 6, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Hall

Dr Sarah Hall PhD
Senior Lecturer in Forensic Science
Anglia Ruskin University

MedicalResearch.com: What is the background for this study?

Response: We initially started the study in collaboration with Essex Fire and Rescue Services, as we were already doing some research on the recovery of evidence from fire scenes. During a visit to their cold fire scene facility, they described a tragic fatality with extensive fire damage, which didn’t link with the main fuel in the room. Therefore they questioned if a skin cream, regularly used by the victim, could have contributed as a fuel or ignited to initiate the fire and asked if we would do some initial research. Now we are also working with West Yorkshire and Cambridgeshire Fire and Rescue Service, the London Fire Brigade, St Andrews Centre for Plastic Surgery and Burns and the National Fire Chiefs Council.

We initially started the study in collaboration with Essex Fire and Rescue Services, as we were already doing some research on the recovery of evidence from fire scenes. During a visit to their cold fire scene facility, they described a tragic fatality with extensive fire damage, which didn’t link with the main fuel in the room. Therefore they questioned if a skin cream, regularly used by the victim, could have contributed as a fuel or ignited to initiate the fire and asked if we would do some initial research. Now we are also working with West Yorkshire and Cambridgeshire Fire and Rescue Service, the London Fire Brigade, St Andrews Centre for Plastic Surgery and Burns and the National Fire Chiefs Council.

Continue reading →

Waist to Height Ratio Linked to Cardiovascular Disease Risk in Men

Posted on February 4, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Vitor Engrácia Valenti Professor São Paulo State University Marília

Dr. Valenti

Vitor Engrácia Valenti, PhD
Professor
São Paulo State University Marília

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Autonomic modulation and cardiorespiratory variables are influenced by numerous factors. Abdominal fat tissue is a relevant variables related to metabolic and cardiovascular disorders, including diabetes mellitus, dyslipidemia and hypertension, which are associated to increased risk of morbidity and mortality.

We evaluated cardiorespiratory variables and autonomic nervous system before and during recovery from exercise in healthy physically active men divided according to with waist-stature ratio (WSR): G1 – between 0.40 and 0.449 (N = 19), and G2 – between 0.45 and 0.49. This metholodigcal procedure is able to provide important information regarding the risk for developing cardiovascular disease in the future.

Our main findings indicated that healthy physically active men with waist-stature ratio values close to the risk limit (between 0.449 and 0.5) presented slower return of autonomic and cardiorespiratory variables to baseline values after moderate exercise. It suggests that this group present an elevated probability of developing cardiovascular disease in the future compared to the groups with lower values of waist-stature ratio.

Continue reading →

Antioxidants May Enhance Efficacy of Chemotherapy on Glioblastoma

Posted on January 30, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Litofsky

Dr. Scott Litofsky, MD
Division of Neurological Surgery
University of Missouri-Columbia School of Medicine
Columbia, MO 65212

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Many patients take over-the-counter medications to held their cancers. Some of these remedies may be helpful; others are potentially harmful. Anti-oxidant medications are frequently selected by patients as they are inexpensive and available.

We were approached by a high school student, Macy Williams (one of the authors) to do some research in our laboratory when she won a research scholarship (the 2016 Emperor Science Award) from Stand Up to Cancer. She worked with us several times per week doing experiments during her senior year of high school. When she graduated, we continued the work that she started.

We studied effects of Vitamin D₃, Melatonin, and alpha-Lipoic Acid on glioblastoma cells, a highly malignant brain tumor. We included experiments of these agents alone and in combination with Temozolomide, a chemotherapy agent used as standard of care in glioblastoma. The work was done in cultured cells, measuring growth and survival of cells. We used concentrations that could be achieved by oral intake of the drugs.

We found that antioxidant medications, particularly alpha Lipoic Acid, had synergistic effects with Temozolomide – that is Temozolomide impair glioblastoma cell growth and survival better when combined with an antioxidant. The mechanism of action may be through reactive oxygen species. Continue reading →

Not All Hospital Readmissions Are Preventable but READI Protocol Can Assist in Some Cases

Posted on January 29, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Weiss

Marianne Weiss DNSc RN
READI study Principal Investigator
Professor of Nursing and
Wheaton Franciscan Healthcare / Sister Rosalie Klein Professor of Women’s Health
Marquette University College of Nursing
Milwaukee Wi, 53201-1881

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our team of researchers has been studying the association of patient readiness for discharge and readmission for several years. We have previously documented that patients who had ‘low readiness’ on our Readiness for Hospital Discharge Scale were more likely to be readmitted. In this study we added structured protocols for discharge readiness assessment and nurse actions to usual discharge care practices to determine the optimal protocol configuration to achieve improved post-discharge utilization outcomes.

In our primary analysis that included patients from a broad range of patient diagnoses, we did not find a significant effect on readmission from adding any of the discharge readiness assessment protocols. The patient sample came from Magnet hospitals, known for high quality care, and the average all-cause readmission rates were low (11.3%).

In patients discharged from high-readmission units (>11.3%), one of the protocols was effective in reducing the likelihood of readmission. In this protocol, the nurse obtained the patients self-report of discharge readiness to inform the nurse’s discharge readiness assessment and actions in finalizing preparations for discharge. This patient-informed discharge readiness assessment protocol produced a nearly 2 percentage point reduction in readmissions. Not unexpectedly, in lower readmission settings, we did not see a reduction in readmission; not all readmissions are preventable.

In the last phase of study, we informed nurses of a cut-off score for ‘low readiness’ and added a prescription for nurse action only in cases of ‘low readiness’; this addition to the protocol added burden to the nurses’ daily work and eliminated the beneficial effects, perhaps because it limited the nurse’s attention to only a subset of patients.

Continue reading →

Hospital-Based Violence Prevention Programs Need to Engage More ER Patients

Posted on January 24, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Coupet

Edouard Coupet Jr, MD, MS
Assistant Professor
Department of Emergency Medicine
Yale School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: For many individuals with nonfatal firearm injuries, their only point of contact with the healthcare system may be the emergency department. Both hospital-based violence intervention programs and counseling and safe firearm storage have shown promise in reducing the burden of firearm injury.

In this study, one third of individuals with firearm injuries presented to non-trauma centers. Only 1 out of 5 firearm injuries were assault injuries that led to admission to trauma centers, the population most likely to receive interventions to reduce re-injury.

Continue reading →

Dramatic Rise in Benzodiazepine/ Z-Drugs and Opioid Co-Use

Posted on January 21, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Vozoris

Dr. Nicholas Vozoris, MHSc, MD, FRCPC
Division of Respirology, Department of Medicine
St. Michael’s Hospital, 30 Bond Street
Toronto, Ontario, Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: While there has been a lot of attention and research devoted to understanding trends in opioid use in North America, there has been relatively less attention paid to a more concerning drug use pattern, combination of benzodiazepines and opioids. Co-use of benzodiazepines and opioids is associated with a many more-fold risk of hospitalization and death than opioid use alone. Another concerning drug use pattern that has received little attention is combinations of benzodiazepines and Z-drugs. Z-drugs act similarly as benzodiazepine drugs, and when one is receiving both drug types, one is exposing oneself to excessive benzodiazepine receipt.

The purpose of my study was to characterize the trends in benzodiazepine and opioid co-use, and benzodiazepine and Z-drug co-use, in the United States over the past two decades, and to identify risk factors for receipt of these suboptimal drug use patterns.

The main findings were that there has been a dramatic rise in both benzodiazepine and opioid co-use, and benzodiazepine and Z-drug co-use, in the United States between 1999 and 2014. Benzodiazepine and opioid co-use increased by about 250% and benzodiazepine and Z-drug use increased by about 850%. Individuals with mental health disorders was one group at increased risk for getting a combination of benzodiazepines and opioids and morbidly obese individuals were at risk for being prescribed both a benzodiazepine and a Z-drug.

MedicalResearch.com: What should readers take away from your report?

Response: I hope readers of my study come away with a greater awareness of the potential concerns and problems that can arise with combining benzodiazepines and opioids, and benzodiazepines and Z-drugs. I hope prescribers become more reflective of their prescribing practices relating to such drugs as benzodiazepines, Z-drugs and opioids, and prescribe these agents with more judiciousness. In particular, I think there is a lot on confusion and lack of knowledge around the Z-drugs, that is, what drug group do they belong to and how do they act. Even though they go by the name Z-drugs, they act in the same way as benzodiazepines do, and so in effect, they can be considered as benzodiazepine-equivalents.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Although this can be challenging to get at, understanding the ‘why’ behind these rising concerning drug use patterns is important. Why are doctors prescribing, and why are patients receiving, in increasing numbers these concerning drug combinations? Having this knowledge would help us potentially reverse the trends of rising benzodiazepine and opioid co-use, and benzodiazepine and Z-drug co-use, and also potentially help prevent future ‘drug crises’. In September 2017, the US Food & Drug Administration issued that a safety warning be printed on all opioid and benzodiazepine drug labels, warning about the dangerous of combination use. In would be interesting to know if the frequency of combined benzodiazepines and opioids decreased as a result. Unfortunately, my study included only data up to 2014, so it was unable to ascertain an answer to this question.

No disclosures

Citation:

Nicholas T Vozoris; Benzodiazepineand Opioid Co-Usage in the United States Population, 1999–2014: An Exploratory Analysis, Sleep, , zsy264, https://doi.org/10.1093/sleep/zsy264

Jan 21, 2019 @ 3:42 am

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Hospitalist Workforce in the US is on a Growing Spree

Posted on January 17, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Lauren Williams
Marketing Manager and Research Analyst
MedicoReach
TwitterHandle: https://twitter.com/Lauren7321

MedicalResearch.com: What is the driving force behind the research and market study for estimating the hospitalist number in the US?

Response: The existing physician’s database available in the industry comprises details that don’t specify the number of hospitalists in particular. As a result, it is turning out challenging to track and count the hospitalists amidst other specialties. There are a lot of incorrect estimations that are circulating, giving no clear picture.

In a vast and growing industry like healthcare, there is no scope for wrong data as it can mislead others. Even the Physician Masterfile that the American Medical Association (AMA) offers do not cover the complete hospitalist population. This is because earlier the hospitalist specialty was not a part of the list of physicians.

Hospitalists work as primary care providers specializing in inpatient medicine. They play a significant role, coordinating with specialist physicians and other healthcare professionals. As a caregiver, they provide quality hospital care and boosts efficiency through effective hospital resource allocation. And so, how can we let their presence go overlooked? Our research aimed to bring out their actual numbers before the industry. That is why our research team came up with the research and market study to fetch real facts. Continue reading →

All Travelers to Pakistan At Risk of Getting Drug Resistant Typhoid Fever

Posted on January 11, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Chatham-Stephens

Kevin Chatham-Stephens, MD, MPH, FAAP
CDR U.S. Public Health Service

MedicalResearch.com: What is the background for this study?

Response: Typhoid fever is a life-threatening disease caused by Salmonella Typhi bacteria. It spreads when someone consumes food or water that has been contaminated with feces (poop) from someone carrying the bacteria. About 12–27 million cases of typhoid fever occur worldwide every year.

About 350 culture-confirmed cases of typhoid fever in the United States are reported to CDC each year. Most of these cases occur among international travelers.

Symptoms of typhoid fever often include high fever, weakness, stomach pain, cough, and loss of appetite. Some people have diarrhea or constipation. Typhoid fever can be prevented through vaccination and safe food and water practices. Typhoid fever is treated with antibiotics, although most infections diagnosed in the United States cannot be successfully treated with the class of antibiotics called fluoroquinolones.

Continue reading →

Smoking Highlights Health Disparities Among US Cities

Posted on January 11, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Leas

Eric Leas PhD, MPH
Stanford Prevention Research Center
University of California, San Diego

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Recent research has demonstrated the importance that neighborhood context has on life opportunity, health and well-being that can perpetuate across generations. A strongly defining factor that leads to differences in health outcomes across neighborhoods, such as differences in chronic disease, is the concurrent-uneven distribution of modifiable risk factors for chronic disease.

The main goal of our study was to characterize inequities in smoking, the leading risk factor for chronic disease, between neighborhoods in America’s 500 largest cities. To accomplish this aim we used first-of-its-kind data generated from the 500 Cities Project—a collaboration between Robert Wood Johnson Foundation and the US Centers for Disease Control and Prevention—representing the largest effort to provide small-area estimates of modifiable risk factors for chronic disease.

We found that inequities in smoking prevalence are greater within cities than between cities, are highest in the nation’s capital, and are linked to inequities in chronic disease outcomes. We also found that inequities in smoking were associated to inequities in neighborhood characteristics, including race, median household income and the number of tobacco retailers.

Continue reading →

Disaster-Related Media Exposure Can Heighten Post-Storm Stress

Posted on January 6, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Thompson

Rebecca R. Thompson, Ph.D.
Postdoctoral Scholar
Department of Psychological Science
University of California, Irvine

MedicalResearch.com: What is the background for this study?

Response: Our research team has been interested in how people respond to the repeated threat of disaster exposure for many years. We recently published a review of the literature on evacuation from natural disasters, and one of our main findings was that there have been no studies that include assessments of individuals’ intentions, perceptions, and psychological states assessed prior to an approaching storm’s landfall – all prior research has been retrospective, and recall is undoubtedly biased and unreliable. Our goal in undertaking this study was to fill this hole in the literature. We sought to assess individuals’ responses to Hurricane Irma in the days leading up to and immediately after its landfall in the State of Florida.

Continue reading →

Autistic Adults Also Display Non-Social Cognitive Deficits

Posted on January 4, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Velikonja

Tjasa Velikonja, PhD
Department of Psychiatry
The Seaver Autism Center for Research and Treatment
Icahn School of Medicine at Mount Sinai
New York, New York

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Autism is a lifelong condition, and challenges associated with autism persist from childhood into adulthood. Despite this, research and treatment have been largely dedicated to children. Because of that, we had very little understanding of what areas – what cognitive domains – are most severely impacted in adults with autism. Importantly, the lack of such information also limits treatment development in this area.

What is known already is that adults with autism display deficits in social cognition (which refers to the role that cognitive processes play in our social interactions). Although our meta-analysis supported these theories, it also highlighted several other challenges in cognitive processing, such as deficits in processing speed and verbal learning and memory. And these impairments were observed in adults with autism without an overall intellectual disability.

Continue reading →

Multiple Concussions Linked to Decrease in Executive Brain Functions

Posted on January 3, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Robert Ross, Ph.D.
Assistant Professor
McConnell Hall, Room 424
University of New Hampshire

MedicalResearch.com: What is the background for this study?

Response: In the United States, 1.5-2 million people suffer from mild traumatic brain injuries, more commonly referred to as concussions, per year.

There is a large body of work illustrating the cognitive impairments associated with concussions in the immediate aftermath of the concussive event. However, it is not clear whether concussions can change cognition more long-term and how concussions might change how the brain functions during specific types of cognition.

In our study, we examined executive function, which is a cognitive process that helps control or manage other cognitive functions, in a group of healthy young adults aged 18-24 that had suffered at least two concussions and compared their performance and their brain oscillations to a group that had not suffered any concussions. Brain oscillations help the brain coordinate the activity of the thousands of neurons necessary for any sort of cognitive process to occur. The participants in the study self-reported their concussions with all concussions occurring at least one month prior to participating in the experiment.

Continue reading →

Teenagers’ Health Impacted by Parental Stress from Work

Posted on January 2, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Spitzmueller

Christiane Spitzmueller, Ph.D.
Professor, Psychology
Industrial Organizational Psychology
University of Houston

MedicalResearch.com: What is the background for this study?

Response: We generally conduct research on how parents’ work experiences affect the health and well-being of family systems. Many families struggle to successfully reconcile work and family demands, and we were wondering what specific work experiences were most likely to relate to negative outcomes for children. We also wanted to know how the impact of parents’ stressful work experiences’ with the happiness and health of their children could be addressed. Hence the study!

Continue reading →

Soda, Sugary Drinks Linked to Increased Risk of Kidney Disease

Posted on January 2, 2019 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Rebholz

Casey M. Rebholz, PhD, MS, MNSP, MPH, FAHA
Assistant Professor, Department of Epidemiology
Johns Hopkins Bloomberg School of Public Health
Core Faculty, Welch Center for Prevention, Epidemiology, and Clinical Research
Baltimore, MD 21287

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Individual beverages have been previously shown to influence risk of a wide range of cardiometabolic diseases. Less is known about beverage consumption and kidney disease risk.

In this study population, we found that one such beverage pattern consisted of soda, sugar-sweetened beverages, and water, and that higher adherence to the sugar-sweetened beverage pattern was associated with greater odds of developing incident kidney disease, even after accounting for demographic characteristics and established risk factors. Continue reading →

Cardiology Articles Pertaining to Lifestyle and Nutrition Receive Most Media Attention

Posted on November 26, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Patel

Ravi B. Patel, MD
Division of Cardiology, Department of Medicine
Northwestern University Feinberg School of Medicine
Chicago, Illinois

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The digital attention of scientific articles can be readily quantified using the Altmetric score. The Altmetric score is a weighted measure, incorporating a variety of media platforms.

We aimed to characterize the Top 10% of articles by Altmetric score among 4 major cardiovascular journals (Circulation, European Heart Journal, Journal of the American College of Cardiology, and JAMA Cardiology) in 2017.

Our primary findings were:

1) nearly half of the most disseminated articles were not original research investigations,

2) the most common article topic was nutrition/lifestyle, and

3) there was a weak but significant correlation between Altmetric scores and citation number. Continue reading →

Asthma in Children Can Worsen From Allergy to Secondhand Marijuana

Posted on November 18, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Bryce Hoffman, MD
Allergy & Immunology Fellow
National Jewish Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Secondhand marijuana exposure is expected to increase as personal cannabis use becomes legalized in more states and countries. Cannabis allergy from firsthand use has been reported in adults but allergy in young children exposed to secondhand smoke has not been previously reported. We present a case of a young child with difficult-to-control asthma who was found to have cannabis allergy after being exposed to secondhand marijuana smoke in his household. This child’s asthma improved after cannabis was removed from the environment.

MedicalResearch.com: What should readers take away from your report?

Response: Children exposed to secondhand marijuana smoke can become allergic to cannabis, which in turn may significantly worsen their asthma or allergy symptoms. This is particularly concerning as the cannabis may not be suspected as a cause. Parents and physicians should consider the possibility of cannabis allergy in any child with uncontrolled asthma who is being exposed to secondhand marijuana smoke. This includes any use of marijuana in the household where the patient lives. These children should be referred to an allergist for further work-up.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Further studies are needed to replicate these results with more patients in the future, and to optimize methods of testing for cannabis allergy. We need to better understand how secondhand allergy develops – is it from particles in the smoke, or plant particles left over in the environment? We also need to better characterize cannabis allergy and in particular its cross-reactivity with other plant foods and pollens.

I have no disclosures.

Citation:Abstract MEETING American College of Allergy, Asthma and Immunology 2018 Annual Scientific Meeting

Abstract Title: Cannabis allergy in a young child with severe asthma exposed to secondhand marijuana smoke

Author: Bryce Hoffman, MD

Nov 18, 2018 @ 12:20 pm

Not All Pharmacies Have Naloxone for Opioid Overdose in Stock

Posted on November 14, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Puzantian

Talia Puzantian, PharmD, BCPP
Associate Professor of Clinical Sciences,
School of Pharmacy and Health Sciences
Keck Graduate Institute

MedicalResearch.com: What is the background for this study?

Response: Naloxone has been used in hospitals and emergency rooms since the early 1970s. Distribution to laypersons began in the mid-1990s with harm reduction programs such as clean needle exchange programs providing it, along with education, to mostly heroin users. In the years between 1996-2014, 152,000 naloxone kits were distributed in this way with more than 26,000 overdoses reversed (https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6423a2.htm).

We have data showing that counties in which there was greater naloxone distribution among laypeople, there were lower opioid death rates (Walley AY et al BMJ 2013). However, not all opioid users at risk for overdose will interface with harm reduction programs, particularly prescription opioid users, hence more recent efforts to increase access to laypersons through pharmacists. Naloxone access laws have been enacted in all 50 states but very little has been published about how they’ve been adopted by pharmacists thus far. One small study (264 pharmacies) from Indiana (Meyerson BE et al Drug Alcohol Depend 2018) showed that 58.1% of pharmacies stocked naloxone, only 23.6% provided it without prescription, and that large chain pharmacies were more likely to do so.

Continue reading →

Advanced Prostate Cancer: Androgen-Receptor Testing May Guide Selection of Treatment

Posted on November 14, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Diagram_showing_prostate_cancer_that_has_spread_to_the_bones_CRUK_183.svg.png

Prostate cancer that has metastasized to the bone: Wikipedia Image

Vincenza Conteduca, MD, PhD
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Srl – IRCCS
Meldola , Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In our previous publications, we showed that the study of plasma cell-free DNA holds promise for improving treatment choice in metastatic castration-resistant prostate cancer (mCRPC). Specifically, we demonstrated that the detection in plasma of aberrations (copy number alterations and/or point somatic mutations) of androgen receptor (AR), using an easy and robust multiplex droplet digital PCR method, predicted an adverse outcome in mCRPC patients treated with second-generation AR-directed therapies (abiraterone or enzalutamide) in both settings: chemotherapy-naïve and post-docetaxel.

This current multi-institution work builds on our previous discoveries. We investigated the association of androgen receptor status and survival in men treated with docetaxel. Moreover, we performed an exploratory analysis in patients treated with docetaxel or AR-directed therapies as first-line therapy.

Interestingly, we observed that plasma AR-gained patients do not have a worse outcome compared to AR-normal patients when treated with docetaxel as first-line therapy. This introduces the opportunity to use plasma to select for docetaxel in preference to androgen receptor-directed therapies in AR gained mCRPC patients.

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Pilates Enabled Patients with Musculo-Skeletal Symptoms to Function Better

Posted on November 13, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Ms Lynne Gaskell MSc
University of Salford
Manchester UK

MedicalResearch.com: What is the background for this study?

Response: Musculoskeletal Pain as a result of common problems affecting the back, neck, shoulder, knee and multi-site pain is an increasing cause of reduced function and quality of life, and ever increasing demands on healthcare, Prognosis is often poor with many people reporting persistent symptoms after consulting their primary care practitioner. The likelihood of persistent and recurrent clinical symptoms may accentuate the physical, psychological, and social impacts of musculoskeletal pain particularly with the middle aged and elderly populations. Pilates is an exercise approach that has become increasingly popular in recent years and includes over fifty different exercises to improve flexibility, balance, core strength, core stability. It can therefore can be individualised for people with different needs, preferences, musculoskeletal conditions, ages and abilities. Aligning exercise to patient’s functional needs has been linked to long-term exercise adherence. Many physiotherapists such as sydney physio solutions have started to specialise in this as a form of treatment, click here for more info on pilates and the many benefits they can have on your physical health.

This study investigated the personal experiences and perceptions of the impact of Pilates on the day-to-day lives of adults with a myriad of chronic MSK conditions following a 12 week Pilates Exercise Programme.The results were organised into five main themes: 1. Physical Improvements strength, core stability, flexibility and balance. 2. Pilates Promotes an Active Lifestyle and improved performance at work and / or hobbies. 3. Psychosocial benefits and improved confidence, 4. Increased Autonomy in Managing their own Musculoskeletal Condition and 5. Motivation to continue with exercise.

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Electronic Decision Support Facilitates Home Discharge of Some PE Patients From ER

Posted on November 13, 2018 by Marie Benz MD FAAD

Dr. Vinson

MedicalResearch.com Interview with:
David R. Vinson, MD
Department of Emergency Medicine
Kaiser Permanente Sacramento Medical Center Sacramento, CA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: At least one-third of emergency department (ED) patients with acute blood clots in the lung, or pulmonary embolism (PE), are eligible for expedited discharged to home, either directly from the ED or after a short (<24 hour) period of observation. Yet in in most hospitals in the U.S. and around the world nearly all ED patients with acute PE are hospitalized. These unnecessary hospitalizations are a poor use of health care resources, tie up inpatient beds, and expose patients to the cost, inconvenience, and risk of inpatient care. The better-performing medical centers have two characteristics in common: they help their physicians identify which PE patients are candidates for outpatient care and they facilitate timely post-discharge follow-up. At Kaiser Permanente Northern California (KPNC), we have had the follow-up system in place for some time, but didn’t have a way to help our physicians sort out which patients with acute PE would benefit from home management.

To correct this, we designed a secure, web-based clinical decision support system that was integrated with the electronic health record. When activated, it presented to the emergency physician the validated PE Severity Index, which uses patient demographics, vital signs, examination findings, and past medical history to classify patients into different risk strata, correlated with eligibility for home care. To make use of the PE Severity Index easier and more streamlined for the physician, the tool drew in information from the patient’s comprehensive medical records to accurately auto-populate the PE Severity Index. The tool then calculated for the physician the patient’s risk score and estimated 30-day mortality, and also offered a site-of-care recommendation, for example, “outpatient management is often possible.” The tool also reminded the physician of relative contraindications to outpatient management. At the time, only 10 EDs in KPNC had an on-site physician researcher, who for this study served as physician educator, study promotor, and enrollment auditor to provide physician-specific feedback. These 10 EDs functioned as the intervention sites, while the other 11 EDs within KPNC served as concurrent controls. Our primary outcome was the percentage of eligible ED patients with acute PE who had an expedited discharge to home, as defined above.

During the 16-month study period (8-month pre-intervention and 8-months post-intervention), we cared for 1,703 eligible ED patients with acute PE. Adjusted home discharge increased at intervention sites from 17% to 28%, a greater than 60% relative increase. There were no changes in home discharge observed at the control sites (about 15% throughout the 16-month study). The increase in home discharge was not associated with an increase in short-term return visits or major complications. Continue reading →

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Tag Archives: medical research

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Pilates Enabled Patients with Musculo-Skeletal Symptoms to Function Better

Electronic Decision Support Facilitates Home Discharge of Some PE Patients From ER