Author Interviews, OBGYNE, Pediatrics, Vaccine Studies / 27.10.2018

MedicalResearch.com Interview with: Anna Beavis, MD, MPH Assistant Professor The Kelly Gynecologic Oncology Service Department of Gynecology and Obstetrics Johns Hopkins Medicine Baltimore, MD 21287-128 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to look at reasons parents don’t vaccinate their children against HPV, including how those reasons have changed over time from 2010-2016 and how those reasons are different between boys and girls in the most recent data from 2016. We used a nationwide dataset which is publically available from the CDC (Centers for Disease Control) – the National Immunization Survey-Teen, or NIS-Teen - which surveys parents of teens ages 13-17 years old every year to determine rates of all recommended vaccinations. In parents who report that they don’t intend to vaccinate their child against HPV , the survey asks parents why. We found that from 2010 to 2016, the percentage of parents reporting concerns about their child not being sexually active yet went down significantly for both boys and girls. Also, in boys specifically, parents reported male gender as a less common reason for not vaccinating. For both boys and girls, we found that concerns about safety and side effects, necessity, and lack of knowledge about the vaccine were common reasons for not planning to vaccinate.  Also, 10% of parents of girls vs. 20% of parents of boys reporting never having a provider recommendation for the vaccine as their primary reason for not vaccinating. These results may reflect the growing public understanding of the HPV vaccine as a vaccine which is best given before exposure, so before initiation of sexual activity between the ages of 11 and 12, and that it is recommended for both boys and girls. Also, over 80% of people will have an HPV infection in their lifetime, so everyone should get vaccinated regardless of anticipated sexual activity. Additionally, providers should focus their counseling and recommendation on improving knowledge about the HPV vaccine, including its decade-long track record of safety and necessity.    (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Pediatrics / 26.10.2018

MedicalResearch.com Interview with: Sean C. Rose, MD Pediatric sports neurologist and co-director Complex Concussion Clinic Nationwide Children’s Hospital Assistant professor of Pediatrics The Ohio State UniversitySean C. Rose, MD Pediatric sports neurologist and co-director Complex Concussion Clinic Nationwide Children’s Hospital Assistant professor of Pediatrics The Ohio State University MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The link between sub-concussive head impacts and declines in neurocognitive function has been reported by some studies, yet refuted by others.  There is very little evidence that has been collected in children as they are sustaining these head impacts. We initiated a multi-year study of youth football players to provide a more in-depth look at the question.  We measured head impacts using helmet sensors during the 2016 football season.  112 players age 9-18 completed a battery of neurocognitive tests before and after the football season. We found that neither the total burden of head impacts nor the intensity of individual impacts were associated with changes in testing performance from pre to post-season. (more…)
Author Interviews, JAMA, Opiods, Pediatrics / 26.10.2018

MedicalResearch.com Interview with: Joshua Barocas, MD Assistant Professor of Medicine Section of Infectious Diseases Boston Medical Center / Boston University School of Medicine Joshua Barocas, MD Assistant Professor of Medicine Section of Infectious Diseases Boston Medical Center / Boston University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Massachusetts has been particularly hard hit by the opioid epidemic despite lower opioid prescribing rates, near universal health insurance, and availability of opioid treatment. That said, it is difficult to estimate the population with or at-risk for opioid use disorder. It is generally a highly stigmatized disease and typical methods to estimate of opioid use disorder relay on contact with the healthcare system and/or patient reporting. We used a unique and powerful methodology coupled with a first-in-the-nation linked database in Massachusetts to obtain both an accurate count of people with opioid use disorder who are known to the healthcare system and estimate the number who are out there but not yet known to the system. We found that more than 275,000 people – or 4.6 percent of people over the age of 11 in Massachusetts– have opioid use disorder, a figure nearly four times higher than previous estimates based on national data. In 2011 and 2012, the prevalence of opioid use disorder in Massachusetts for those over the age of 11 was 2.72 percent and 2.87 percent, respectively. That increased to 3.87 percent in 2013, and even more, to 4.6 percent in 2015. Those between the ages of 11 and 25 experienced the greatest increase in prevalence of all age groups. The number of “known” persons increased throughout the study period – from 63,989 in 2011 to 75,431 in 2012, and 93,878 in 2013 to 119,160 in 2015.  (more…)
Author Interviews, Endocrinology, OBGYNE, Smoking / 24.10.2018

MedicalResearch.com Interview with: Nis Brix M.D., PhD Student Department of Public Health Department of Epidemiology Aarhus University Hospital Nis Brix M.D., PhD Student Department of Public Health Department of Epidemiology Aarhus University Hospital  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Several studies have indicated a secular trend towards earlier puberty. This is a potential concern as early puberty has been linked to an increased risk of a number of diseases, such as obesity, diabetes, cardiovascular diseases and certain types of cancer. For this reason, our research team are interested in identifying potential modifiable causes of early puberty. Smoking during pregnancy may be such a modifiable cause of early puberty in the children. Former studies have already linked smoking during pregnancy to earlier age at the daughters’ first menstrual period, a relatively late marker of pubertal development, but other markers of puberty are less studied, especially in the sons. We studied 15,819 sons and daughters. The mothers gave detailed information on smoking during their pregnancies, and the children gave information on a number of pubertal milestones half-yearly from the age of 11 years. The milestones for the sons were age at voice break, first ejaculation of semen, pubic hair and testicular growth, armpit hair growth and onset of acne. For the daughters the milestones were age at their first menstrual period, pubic hair growth, breast development, armpit hair growth and onset of acne. Our results suggested that the more cigarettes the mother smoked during her pregnancy the earlier her children, both sons and daughters, went through puberty. If the mother smoked more than ten cigarettes a day during pregnancy, the children appeared to go through puberty, on average, three to six months earlier than the children of non-smoking mothers. (more…)
Author Interviews, Cancer Research, JAMA, Nutrition / 23.10.2018

MedicalResearch.com Interview with: "Sunday market in Paris: all organic food" by Richard Smith is licensed under CC BY 2.0Julia Baudry & Emmanuelle Kesse-Guyot PhD Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité, Institut National de la Santé et de la Recherche Médicale (INSERM) U1153, Institut National de la Recherche MedicalResearch.com: What is the background for this study? What are the main findings? Response: Among the environmental risk factors for cancer, there are concerns about exposure to different classes of pesticides, notably through occupational exposure. Organic foods are less likely to contain pesticide residues than conventional foods, and studies have showed that an organic diet reduces exposure to certain pesticides (Baudry et al 2018, Oates et al 2014, Curl et al 2015). In the general population, the primary route of exposure is diet, especially intake of conventionally grown fruits and vegetables. However, few studies have examined the association of organic food consumption with cancer risk. In a population of 68 946 French adults from the NutriNet-Santé study, we found a reduction of 25% of cancer risk among consumers with a high frequency of organic foods compared to consumers with a low frequency, after accounting for many factors (such as lifestyle, diet and sociodemographic factors). Specifically a 34% and 76% decrease in risk was observed for post-menopausal breast cancer and all lymphomas, respectively, among frequent organic food consumers compared to consumers with a low organic food consumption frequency. (more…)
Addiction, Author Interviews, Mental Health Research, NEJM / 23.10.2018

MedicalResearch.com Interview with: Marc Lewis, Ph.D. Klingelbeekseweg Arnhem The Netherlands MedicalResearch.com: What is the background for this study? Response: According to the brain disease model, addiction is a chronic disease brought about by changes in brain systems that mediate the experience and anticipation of reward and higher-order systems underlying judgment and cognitive control. Its proponents propose that these changes are driven by exposure to drugs of abuse or alcohol. The brain disease model is the most prevalent model of addiction in the Western world. The disease model's narrow focus on the neurobiological substrates of addiction has diverted attention (and funding) from alternative models. Alternatives to the brain disease model highlight the social-environmental factors that contribute to addiction and the learning processes that translate these factors into negative outcomes. Learning models propose that addiction, though obviously disadvantageous, is a natural, context-sensitive response to challenging environmental contingencies, not a disease. In this review I examine addiction within a learning framework that incorporates the brain changes seen in addiction without reference to pathology or disease.  (more…)
Author Interviews, Cognitive Issues, Genetic Research, Heart Disease / 23.10.2018

MedicalResearch.com Interview with: "Pregnancy 1" by operalynn is licensed under CC BY 2.0Heather Boyd, Ph.D. Senior researcher Department of Epidemiology Research Copenhagen Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have known for a while that women who have had preeclampsia report different types of cognitive impairment (difficulties with short-term memory, attention deficits) in the years and decades after their pregnancies, and there are a few imaging studies suggesting that these women may have more white matter lesions in the brain and more signs of brain atrophy than women with uncomplicated pregnancies. We also know that women who have had preeclampsia are at increased risk of cardiovascular disease in the years and decades after delivery. Taken together, it was not a great leap to hypothesize that women with a history of preeclampsia might also be at increased risk of dementia later in life. However, the existing epidemiological data were unconvincing, possibly because it takes a great deal of power (a very large study population) to study links between two conditions that often occur decades apart. (more…)
Author Interviews, Pediatrics, Stanford, Surgical Research, Weight Research / 22.10.2018

MedicalResearch.com Interview with: Dr. Janey Pratt, MD Clinical Associate Professor, Surgery Stanford UniversityDr. Janey Pratt, MD Clinical Associate Professor, Surgery Stanford University MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2013 obesity became recognized as a disease.  The rate of pediatric obesity continues to rise.  Severe pediatric obesity is rising at a even faster rate than obesity in pediatrics.  Despite this Metabolic and Bariatric Surgery (MBS) remains underutilized in the treatment of severe pediatric obesity.  There is a significant amount of adult data and now pediatric data about effective treatments for severe obesity.  These support the use of MBS as a primary treatment for severe obesity in children. (BMI > 120% of 95th percentile with a comorbidity or BMI > 140% of 95th percentile). (more…)
Addiction, Author Interviews, Cost of Health Care, JAMA / 20.10.2018

MedicalResearch.com Interview with: Tyler Winkelman MD, MSc   Clinician-Investigator Division of General Internal Medicine, Hennepin Healthcare Center for Patient and Provider Experience, Hennepin Healthcare Research Institute Assistant Professor Departments of Medicine & Pediatrics University of Minnesota  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Trends in amphetamine use are mixed across data sources. We sought to identify trends in serious, problematic amphetamine use by analyzing a national sample of hospitalizations. Amphetamine-related hospitalizations increased over 270% between 2008 and 2015. By 2015, amphetamine-related hospitalizations were responsible for $2 billion in hospital costs. While opioid-related hospitalizations were more common, amphetamine-related hospitalizations increased to a much larger degree. After accounting for population growth, amphetamine hospitalizations grew 245% between 2008 and 2015, whereas opioid-related hospitalizations increased 46%. Amphetamine-related hospitalizations were more likely to be covered by Medicaid and be in the western United States compared with other hospitalizations. In-hospital mortality was 29% higher among amphetamine-related hospitalizations compared with other hospitalizations.  (more…)
Abbott, Author Interviews, Biomarkers, Heart Disease, JAMA / 20.10.2018

MedicalResearch.com Interview with: Dr John W Pickering, BSc(Hons), PhD, BA(Hons) Associate Professor , Senior Research Fellow in Acute Care Emergency Care Foundation, Canterbury Medical Research Foundation, Canterbury District Health Board |  Christchurch Hospital Research Associate Professor | Department of Medicine University of Otago Christchurch MedicalResearch.com: What is the background for this study? What are the main findings? Response: The assessment of patients with suspected myocardial infarction is one of the most common tasks in the emergency department. Most patients assessed (80 to 98% depending on the health system) are ultimate not diagnosed with an MI.   High-sensitivity troponin assays have been shown to have sufficient precision at low concentrations to allow very early rule-out of myocardial infarction. However, these are lab-based assays which typically result in a delay from blood sampling before the result is available and the physician is able to return to a patient to make a decision to release the patient or undertake further investigation. Point-of-care assays provide results much quicker, but have to-date not had the analytical characteristics that allow precise measurements at low concentrations. In this pilot study we demonstrated that a single measurement with a new point-of-care assay (TnI-Nx; Abbott Point of Care) which can measure low troponin concentrations, could safely be used to rule-out myocardial infarction a large proportion of patients (57%). The performance was at least comparable to the high-sensitivity troponin I assay, if not a little better (44%). (more…)
Author Interviews, CDC, Pediatrics, Vaccine Studies, Vanderbilt / 18.10.2018

MedicalResearch.com Interview with: "Vacuna influenza / Flu vaccine" by El Alvi is licensed under CC BY 2.0Kathryn M. Edwards, M.D. Sarah H. Sell and Cornelius Vanderbilt Chair in Pediatrics Professor of Pediatrics Vanderbilt University School of Medicine Dr. Edwards discusses the statement from the Infectious Diseases Society of America (IDSA) regarding the Centers for Disease Control and Prevention’s new data on child vaccine rates across the United States. MedicalResearch.com: What is the background for this study? What are the main findings? Response: To monitor the uptake of vaccines the CDC conducts a National Immunization Survey each year.  This survey is conducted by random-digit dialing (cell phones or landlines) of parents and guardians of children 19-35 months of age.  The interviewers ask the families who provides the vaccines for their children and if these providers can be contacted to inquire about the immunizations received.  The overall response rate to the telephone survey was 26% and immunization records were provided on 54% of the children where permission was granted.  Overall 15, 333 children had their immunization records reviewed. When comparing immunization rates for 2017 and 2016, the last two years of the study, several new findings were discovered. First the overall coverage rate for 3 doses of polio vaccine, one dose of MMR, 3 doses of Hepatitis b, and 1 dose of chickenpox vaccine was 90%, a high rate of coverage.  Children were less likely to be up to date on the hepatitis A vaccine (70%) and rotavirus vaccine (73%). Coverage was lower for children living in rural areas when compared with urban areas and children living in rural areas had higher percentages of no vaccine receipt at all (1.9%) compared with those living in urban areas (1%). There were more uninsured children in 2017 at 2.8% and these children had lower immunization rates.  In fact 7.1% of the children with no insurance were totally unimmunized when compared with 0.8% unimmunized in those with private insurance. Vaccine coverage varies by state and by vaccine. (more…)
Author Interviews, Cognitive Issues, Geriatrics, JAMA, Surgical Research / 17.10.2018

MedicalResearch.com Interview with Mark Oldham, M.D. Assistant Professor of Psychiatry Medical Director, PRIME Medicine Proactive Integration of Mental Health Care in Medicine University of Rochester Medical Center MedicalResearch.com: What is the background for this study? Response: Patients who have undergone coronary artery bypass graft (CABG) surgery and, specifically, those who have been placed on cardiopulmonary bypass (CPB) have received attention for the potential effects of such procedures on brain health. Heart valve surgery patients have received far less attention, which often leaves clinicians to extrapolate the data from CABG cohorts to their patients preparing to undergo valve surgery. However, there are many reasons why this is far less than ideal, especially as the CABG literature increasingly points to person- and procedure-specific factors as the determinants of postoperative cognitive outcomes. (more…)
Author Interviews / 17.10.2018

MedicalResearch.com Interview with: "Herpes" by LEONARDO DASILVA is licensed under CC BY 2.0Prof Ruth Itzhaki PhD Emeritus Professor Division of Neuroscience & Experimental Psychology The University of Manchester MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Over 30 million people worldwide suffer from Alzheimer’s disease and unfortunately, this figure will rise as longevity increases, so the need for effective treatments is extremely urgent. Current treatments, at best, alleviate symptoms but do not prevent further deterioration. Our research has strongly implicated a common virus in the development of the disease, indicating a direct route to treatment: very effective and safe antiviral agents are available to combat the virus and thus to treat AD patients. They indicate also the future possibility of preventing the disease by vaccination against the virus in infancy. The virus implicated in Alzheimer's disease, herpes simplex virus type 1 (HSV1), is the one that causes cold sores. It infects most humans in infancy and thereafter remains lifelong in the body in latent (i.e., dormant) form within the peripheral nervous system (PNS - the part other than the brain and the spinal cord). Occasionally, if the person is stressed, the virus becomes activated and in some people it then causes cold sores.  (more…)
Abuse and Neglect / 17.10.2018

MedicalResearch.com Interview with: Patrick Weber  Doctorate Student / Research Assistant University of Regensburg Regensburg, GermanyPatrick Weber Doctorate Student / Research Assistant University of Regensburg Regensburg, Germany MedicalResearch.com: What is the background for this study? What are the main findings? 
  • More than 20 years ago, Gigerenzer and Hoffrage (1995) were able to show the advantages of so-called natural frequencies (e.g., 8 out 10 women) compared to probabilities expressed with percentages (e.g. 80% of the women) when it comes to solving Bayesian reasoning problems. Only last year, a meta-analysis (McDowell & Jacobs, 2017) revealed that while only 4% of all people are able to solve such a task in probability format, tasks that are presented in natural frequencies have solution rates of 24%. Even though this improvement is remarkable, still more than three quarters of participants fail with the intuitive natural frequencies. We wanted to know what exactly these people did wrong.In a first step, we checked the questionnaires from previous studies (e.g. Binder, Krauss, & Bruckmaier, 2015) and found out that many participants had translated given frequencies into probabilities. In a second step, we wanted to examine this systematically.
  • With our study, we were able to show that many people actually do not actively make use of the intuitive natural frequencies when presented with a task in frequency format. Instead, they rely on the more complex probabilities, with which they are more familiar from their mathematics education. As a consequence, the majority of these people who translate the intuitive frequencies into more complex probabilities cannot solve the task any more.
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Author Interviews, Geriatrics, JAMA, Pharmacology / 17.10.2018

MedicalResearch.com Interview with: Dr. Emily Reeve BPharm(Hons) PhD NHMRC-ARC Dementia Research Fellow Northern Clinical School University of Sydney MedicalResearch.com: What is the background for this study? What are the main findings? Response: Older adults commonly take multiple medications. All medications carry the potential for both benefit and harm. When a medication is started a decision has been made between the healthcare professional and the patient that the likely benefits outweigh the potential risks. But over time the potential benefits and harms can change. So, part of good clinical care is discontinuation of medications when the benefit no longer outweighs the risks – for example when it is no longer needed or high risk. This is called “deprescribing”. Previously we knew that older adults could have mixed feelings about their medications, that is, they believe that all their medications are necessary but also feel that they are a burden to them. Qualitative research has explored this further, finding that there are a number of barriers and enablers to deprescribing from the patient perspective. For example, someone might have fear of deprescribing because they are worried that their symptoms may come back. But if they know that deprescribing is a trial and they will be monitored and supported by their physician or other healthcare professional they might be more open to deprescribing. From the physician perspective, there were concerns that older adults and their families were resistant to deprescribing and so there was fear that discussing possible medication discontinuation could damage the doctor-patient relationship. In this study of almost 2000 older adults in the United States, we found that over 90% were willing to stop one of more of their medications if their doctor said it was possible. Additionally, one third of participants wanted to reduce the number of medications that they were taking.  (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Emergency Care / 17.10.2018

MedicalResearch.com Interview with: Dr Anne Kristine Servais Iversen, Anne Kristine Servais Iversen Department of Obstetrics and Gynecology Rigshospitalet Copenhagen, Denmark  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Systematic triage has been implemented worldwide with different triage scales in use all over the world. Prior to the introduction of formalised triage, patients were prioritised based on clinical assumption. After the introduction of formalised triage only a few studies have assessed agreement between formal and informal triage. Additionally, the majority of formalised triage scales are supported by limited and often insufficient evidence. This is troublesome since formalised triage forces clinicians to follow an algorithm rather than use their experience and clinical judgement. During my own residency at a Danish Emergency ward I was often contacted by the nurse performing formalised triage telling me that a patient she was assessing scored to be very acute (high triage level), but that she didn’t believe that to be the case. In order for her to prioritise the patient to a lower (less acute) triage level the patient had to be assessed by a doctor. Very often my colleagues and I would agree with the nurse in that the scoring was to high, and we therefore had to overrule the formalised triage decision. In cases like these you ask yourself whether or not we are using the most effective and best form of triage for initial patient sorting. Our study found that agreement between formalised triage and a quick clinical assessment in the form of Eyeball triage is poor. It also suggest that eyeball triage better predicts those at highest risk of death within 48-hours and 30 days after assessment. (more…)
Author Interviews, BMJ, Genetic Research, Pain Research, Pediatrics / 17.10.2018

MedicalResearch.com Interview with: "DNA model" by Caroline Davis2010 is licensed under CC BY 2.0Hakon Hakonarson, MD, PhD Corresponding Author Xiao Chang, PhD Lead Author The Center for Applied Genomics Children’s Hospital Philadelphia Philadelphia, Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Migraine is a genetic disorder characterized by recurrent and intense headaches often accompanied by visual disturbances. Genome-wide association studies (GWASs) are a powerful hypothesis-free tool for investigating the genetic architecture of human disease. Currently, multiple GWASs have been conducted on European adults with migraine that have successfully identified several migraine susceptibility genes involved in neuronal and vascular functions. Considering the prevalence of migraines varies across ethnicities, the genetic risk factors may be different in patients of African ancestries and European ancestries. In addition, if migraine presents at an early age (childhood), it may reflect elevated biological predisposition from genetic factors or increased susceptibility to environmental risk factors. We performed the first GWAS to investigate the susceptibility genes associated with migraine in African-American children. The main out come was that common variants at the 5q33.1 locus in the human genome are associated with migraine risk in African-American children. The genetic underpinnings at this locus responsible for this finding are less relevant in patients of European ancestry.  (more…)
Author Interviews, Cannabis, Genetic Research, JAMA, Mental Health Research / 17.10.2018

MedicalResearch.com Interview with: Dr. Nicole Karcher, PhD Post-doctoral scholar with the NIMH Training in Clinical Sciences fellowship Department of Psychiatry Washington University School of Medicine   MedicalResearch.com: What is the background for this study? What are the main findings? Response: For over fifteen years, researchers have debated the role that cannabis use plays in the development of both psychotic disorders as well as subthreshold psychotic symptoms, such as psychotic-like experiences (PLEs). There is still a lack of consensus regarding the nature of the association between cannabis use and psychosis risk, with some research finding evidence for genetic overlap, while other research finds evidence for potentially causal pathways. The current study examined data from twins and siblings from two different samples, the U.S.-based Human Connectome Project and the Australian Twin Registry, with a total of 4,674 participants. Overall, psychotic-like experiences were associated with three separate cannabis use variables [frequent (≥100 times) use, a Cannabis Use Disorder diagnosis, and current cannabis use]. Furthermore, the current research found evidence for both shared genetic and individual-specific contributions to the association between PLEs and these three cannabis use variables. More specifically, while the association between cannabis use and psychotic-like experiences was largely attributable to shared genetic factors, cannabis users were more likely to endorse PLEs in comparison to the relative who used cannabis less.  (more…)
Author Interviews, Genetic Research, PLoS, Smoking, Tobacco Research / 17.10.2018

MedicalResearch.com Interview with: "Photo booth: The Smoking Man" by simpleinsomnia is licensed under CC BY 2.0Pradeep G. Bhide, Ph.D. Professor | Jim and Betty Ann Rodgers Eminent Scholar Chair of Developmental Neuroscience Director, Center for Brain Repair Department of Biomedical Sciences Florida State University College of Medicine Tallahassee, FL MedicalResearch.com: What is the background for this study? What are the main findings? Response: Until now, much attention had been focused on the adverse effects of cigarette smoking by pregnant women on their children’s cognitive development. Some reports suggested that cigarette smoking during pregnancy can produce harmful effects in multiple generations of descendants (transgenerational effects). Not much had been known about the effects of paternal smoking, although more men smoke cigarettes than women. Our study shows that paternal nicotine exposure can be deleterious to the offspring in multiple generations. That is, cognitive function may be compromised in children and grandchildren of a nicotine-exposed male. Of course, our study was done in mice and not men.  However, since studies done in mice on maternal nicotine exposure produced results consistent with studies done in women and children, we believe that he findings from our present study likely can be extrapolated to humans.  (more…)
Author Interviews, Brain Injury, CT Scanning, Emergency Care, Lancet, Technology / 16.10.2018

MedicalResearch.com Interview with: Qure-ai.jpgSasank Chilamkurthy AI Scientist, Qure.ai MedicalResearch.com: What is the background for this study? Response: Head CT scan is one of the most commonly used imaging protocols besides chest x-ray. They are used for patients with symptoms suggesting stroke, rise in intracranial pressure or head trauma. These manifest in findings like intracranial haemorrhage, midline shift or fracture. Scans with these critical findings need to be read immediately. But radiologists evaluate the scans on first-come-first-serve basis or based on stat/routine markers set by clinicians. If the scans with critical findings are somehow pushed to the top of radiologists’ work list, it could substantially decrease time to diagnosis and therefore decrease mortality and morbidity associated with stroke/head trauma. (more…)
Author Interviews, Hand Washing, Infections, Pulmonary Disease, Respiratory / 16.10.2018

MedicalResearch.com Interview with: "still picking her nose" by quinn norton is licensed under CC BY 2.0Dr Victoria Connor  Clinical Research Fellow Liverpool School of Tropical Medicine and Royal Liverpool Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pneumococcus is a bacteria which is very common and causes lots of different infections (pneumococcal disease). Infections can be non-invasive or invasive. Non-invasive diseases include middle ear infections, sinusitis and bronchitis. Invasive infections including chest infection (pneumonia), infections of brain and spinal cord (meningitis) and blood infections (sepsis). Invasive pneumococcal infections is a major cause of death around the world and in the UK, is estimated that is responsible for 1.3 million deaths in children under 5 annually. Pneumococcal disease causes more deaths in low and middle income countries where approximately 90% of pneumonia deaths occur. Pneumococcus also is commonly carried (colonises) the nose/throat of children and adults. This colonisation is important to understand as it is the main source of the bacterial transmission and is also the first step in pneumococcal infections. The understanding of transmission of pneumococcus is currently poor. It is generally thought that transmission occurs through breathing in the respiratory sections of someone carrying pneumococcus in their nose which are infected with pneumococcus. However more recently studies especially in mice have shown that there may be a role of hands or other objects as vehicles for the transmission of pneumococcus. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Colon Cancer, JAMA, Weight Research / 15.10.2018

MedicalResearch.com Interview with: Stuart Po-Hong Liu, MD, MPH Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston MedicalResearch.com: What is the background for this study? Response: Although there were global decreases in overall colorectal cancer (CRC) incidence, CRC rates have increased dramatically in those aged 20 to 49 years in the United States, parts of Europe, and Asia. The etiology and early detection of young-onset becomes an emerging research and clinical priority. Another important fact that is that this emerging public health concern has resulted in updated guidelines from the American Cancer Society advising average-risk screening begin at age 45, rather than 50. However, up to this point, the etiology of young onset CRC remains largely unknown. Elucidating the role of traditional CRC risk factors in the etiopathogenesis of young-onset CRC is one of the first research agenda. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Melanoma / 14.10.2018

MedicalResearch.com Interview with: Caroline C. Kim, M.D. Associate Professor, Department of Dermatology Harvard Medical School Director, Pigmented Lesion Clinic Associate Director, Cutaneous Oncology Program Beth Israel Deaconess Medical Center Boston, MA 02215 MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Atypical/dysplastic nevi have been identified as risk factors for melanoma, however the majority of melanomas arise as new lesions on the skin. Unlike other models of dysplasia having a clear trajectory towards cancer as seen in cervical dysplasia, dysplastic nevi are not proven to be obligate precursors for melanoma.  However, there is little evidence to guide the management of biopsied dysplastic nevi with positive margins, with much clinical variation in the management of moderately dysplastic nevi in particular. In this multi-center national study of 9 U.S. academic centers, we examined outcomes of 467 moderately dysplastic nevi excisionally biopsied without residual clinical pigmentation but with positive histologic margins with at least 3 years of clinical follow-up.  We found that no cases developed into a same-site melanoma with a mean follow-up time of 6.9 years. However, 22.8% of our patients went on to develop a future separate site melanoma. (more…)
Author Interviews, Colon Cancer, Gastrointestinal Disease, Technology / 14.10.2018

MedicalResearch.com Interview with: Nadim Mahmud, MD, MS, MPH Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colonoscopy is an effective screening technique for colorectal cancer (CRC) prevention, but many patients either do not show up or have poor bowel preparation for the procedure. There are many contributors to this issue, including challenges with colonoscopy bowel preparations and communication barriers between healthcare systems and their patients. To address this, we performed a pilot of 21 patients using automated text messages sent over the course of one week prior to scheduled colonoscopy. These messages included instructional, educational, and reminder messages regarding aspects of the colonoscopy preparation process. We found significantly improved colonoscopy adherence among patients who received the text message program as compared to routine care controls (90% versus 62%). Furthermore, patient satisfaction and likelihood to recommend the text messaging program was high. Similar texting programs are simple to create and manage, and should be considered to improve outpatient colonoscopy adherence.  (more…)
Author Interviews, BMJ, Exercise - Fitness, Lifestyle & Health / 13.10.2018

MedicalResearch.com Interview with: Dr Fehmidah Munir CPsychol, AFBPsS Reader in Health Psychology Athena SWAN School Champion School of Sport, Exercise & Health Sciences National Centre for Sports and Exercise Medicine Loughborough University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Given the evidence of the harmful effects of high levels of sitting time on health and the high proportion of time the majority of adults spend in this behaviour, particularly in the workplace, methods to reduce overall and prolonged sitting were needed. Our SMArT Work (Stand More AT Work) programme was delivered to NHS office workers and involved brief education about the impact of sitting on health and benefits of reducing sitting, feedback on sitting behaviour, providing staff with a height-adjustable desk to enable them to work either standing up or sitting down, motivational posters and brief chats with a researcher to see how they were getting on. They received this programme over 12 months. We found that office workers in our study spent nearly 10 hours/day sitting down, which can be bad for health, but we’ve shown that those office workers who received our SMArT Work programme had lower sitting time by around 80mins per day after 12 months compared to those who didn’t receive our programme. Those who received SMArT Work also reported an increase in work engagement, job performance and quality of life and less musculoskeletal issues such as back and neck pain, they felt less tired after a day at work, had less feelings of anxiety and lower sickness presenteeism (working whilst sick). We didn’t find any differences in the number of days absent at work though. Whether you work remotely from home or in an office environment, it may also be good to invest in new Office Furniture. This could also help combat the issue of back and neck pains that you may be experiencing. (more…)
Author Interviews, Hand Washing, Hospital Acquired, Infections, JAMA / 13.10.2018

MedicalResearch.com Interview with: "Hand Washing" by Anthony Albright is licensed under CC BY-SA 2.0Dr. Daniel J. Livorsi, MD Assistant Professor INFECTIOUS DISEASE SPECIALIST University of Iowa MedicalResearch.com: What is the background for this study? What are the main findings? Response: One of the Joint Commission’s standards is that hospitals audit and provide feedback on hand hygiene compliance among healthcare workers. Audit-and-feedback is therefore commonly practiced in US hospitals, but the effective design and delivery of this intervention is poorly defined, particularly in relation to hand hygiene improvement. We studied how 8 hospitals had implemented audit-and-feedback for hand hygiene improvement. We found that hospitals were encountering several barriers in their implementation of audit-and-feedback. Audit data on hand hygiene compliance was challenging to collect and was frequently questioned. The feedback of audit results did not motivate positive change.  (more…)
Author Interviews, Infections, MRSA, NIH, Probiotics / 12.10.2018

MedicalResearch.com Interview with: "staph aureus on blood agar" by Iqbal Osman is licensed under CC BY 2.0Pipat Piewngam Postdoctorol fellow Pathogen Molecular Genetics Section, Laboratory of Bacteriology, NIAID/NIH Bethesda, MD, USA 20892  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Our team at National Institutes of health, Mahidol University and Rajamangala University of Technology in Thailand has reported that the consumption of probiotic Bacillus bacteria comprehensively abolishes colonization with the dangerous pathogen, Staphylococcus aureus. We hypothesized that the composition of the human gut microbiota affects intestinal colonization with S. aureus. We collected fecal samples from 200 healthy individuals from rural populations in Thailand and analyzed the composition of the gut microbiome by 16S rRNA sequencing. Surprisingly, we did not detect significant differences in the composition of the microbiome between S. aureus carriers and non-carriers. We then sampled the same 200 people for S. aureus in the gut (25 positive) and nose (26 positive). Strikingly, we found no S. aureus in any of the samples where Bacillus were present. In mouse studies, we discovered S. aureus Agr quorum-sensing signaling system that must function for the bacteria to grow in the gut. Intriguingly, all of the more than 100 Bacillus isolates we had recovered from the human feces efficiently inhibited that system. Then, we discovered that the fengycin class of Bacillus lipopeptides achieves colonization resistance by inhibiting that system. To further validate their findings, we colonized the gut of mice with S. aureus and fed them B. subtilis spores to mimic probiotic intake. Probiotic Bacillus given every two days eliminated S. aureus in the guts of the mice. The same test using Bacillus where fengycin production had been removed had no effect, and S. aureus grew as expected. This is one of the first study that provide human evidence supporting the biological significance of probiotic bacterial interference and show that such interference can be achieved by blocking a pathogen’s signaling system. (more…)