Author Interviews, Ophthalmology, PLoS / 20.01.2022

MedicalResearch.com Interview with: Prof. Jugnoo S Rahi Professor of Ophthalmic Epidemiology and Honorary Consultant Ophthalmologist NIHR Senior Investigator Head, Vision and Eyes Group UCL HeadPopulation Policy and Practice Research and Teaching Department GOS ICH UCL Director, Ulverscroft Vision Research Group  GOS Institute of Child Health UCL / Great Ormond Street Hospital NHS Foundation Trust Institute of Ophthalmology UCL / NIHR Moorfields Biomedical Research Centre Chair, Academic Committee Chair, British Ophthalmological Surveillance Unit Executive Committee Royal College of Ophthalmologists  MedicalResearch.com:  What is the background for this study?    Response: We hypothesised that if changing environmental factors, in particular educational experience, are accounting for increasing frequency of myopia in the UK, a cohort effect would be discernible in changing associations with myopia, with different profiles for childhood and adult-onset forms. We investigated this using the UK Biobank Study, a unique large contemporary adult population sample whose members, born over a period of more than three decades, have undergone a detailed ophthalmic examination. This affords the opportunity to analyse ‘historical’ cohorts covering a period of important socio-demographic, economic, and educational change in the UK from which current and emerging trends may be identified and examined. Drawing on our previous proof-of-concept study, we investigated whether there were differences between childhood-onset versus adult-onset myopia in temporal trends in both frequency and severity and in associations with key environmental factors. (more…)
Author Interviews, Multiple Sclerosis / 19.01.2022

MedicalResearch.com Interview with: Marcus Koch MD PhD Associate Professor of Neurology Multiple Sclerosis Program University of Calgary MedicalResearch.com: What is the background for this study? Response: Primary progressive multiple sclerosis (PPMS) is the least common, but also the least treatable form of multiple sclerosis. PPMS does not react well to commonly used MS treatments. We believe that this is at least in part because PPMS is driven by other disease mechanisms. One disease mechanism that we believe is important in PPMS is microglial activation. Microglial cells are a type of cell in the brain and spinal cord that normally have beneficial functions, such as clearing debris or assisting repair after injury. In PPMS however, microglial cells are chronically active, and we believe that this chronic microglial activation contributes to tissue damage. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Pediatrics / 18.01.2022

MedicalResearch.com Interview with: Edward Bell, MD Professor of Pediatrics-Neonatology Vice Chair for Faculty Development, Stead Family Department of Pediatrics Roy J. and Lucille A. Carver College of Medicine University of Iowa MedicalResearch.com: What is the background for this study? Response: The National Institute of Child Health and Human Development, a branch of the National Institutes of Health (NIH), has supported the Neonatal Research Network (NRN) since 1986. The NRN, a group of US academic centers, is tasked with conducting research to improve the treatment and health outcomes of premature and critically-ill babies in US neonatal intensive care units (NICUs). Every few years, the NRN publishes reports on the survival rates and outcomes of surviving extremely premature babies, those born before 28 weeks of gestation. These reports help us to judge progress in the care and outcomes of these infants. This paper is the 9th in this series of reports but the first that includes not only survival and in-hospital outcomes but also outcomes at 2 years of age.  (more…)
Author Interviews, Duke, Gastrointestinal Disease, Nature, Sugar / 17.01.2022

MedicalResearch.com Interview with: Laura Rupprecht, PhD Postdoctoral Fellow Kelly L Buchanan The Laboratory of Gut Brain Neurobiology Duke Medicine – GI Diego V. Bohórquez PhD Associate Professor in Medicine Duke Institute for Brain Sciences Durham, NC MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: In 2018, my laboratory discovered that a cell type in the gut epithelium synapses with the vagus nerve, the nerve which connects the gut and the brain. These gut cells are called neuropod cells. Neuropod cells transduce sugar within milliseconds using the neurotransmitter glutamate. Since then, we have been interested in defining how this rapid communication between neuropod cells and the brain regulates behavior. – Diego Bohórquez Over a decade ago, it was shown that the gut is the key site for discerning sugar and non-caloric sweetener. But the specific cell in the gut that underlies this effect was unknown. – Kelly Buchanan   (more…)
Author Interviews, Kidney Disease, Race/Ethnic Diversity / 13.01.2022

MedicalResearch.com Interview with: Joshua D. Bundy, PhD, MPH Department of Epidemiology Tulane University School of Public Health and Tropical Medicine and Tulane University Translational Science Institute New Orleans Louisiana MedicalResearch.com: What is the background for this study? What is included in the KFRE score? Response: Kidney function is quantified using estimated glomerular filtration rate (eGFR), which is often calculated in clinical practice using filtration markers like serum creatinine and/or cystatin C, and patient characteristics like age, sex, and race. Recently, new eGFR equations were created that remove race adjustment because of concerns that using a patient’s race may perpetuate racial inequities in healthcare delivery. The Kidney Failure Risk Equation (KFRE) is the most commonly-used tool to predict end-stage kidney disease (ESKD) risk and includes age, sex, eGFR, and urinary albumin-creatinine ratio. We sought to evaluate the impact of removing race from eGFR on prediction of ESKD.  (more…)
Author Interviews, COVID -19 Coronavirus, Environmental Risks, Technology / 13.01.2022

MedicalResearch.com Interview with: Krystal Pollitt, PhD, P.Eng. Assistant Professor of Epidemiology (Environmental Health Sciences) Assistant Professor in Chemical and Environmental Engineering Affiliated Faculty, Yale Institute for Global Health Yale School of Public Health  MedicalResearch.com: What is the background for this study? Response: People infected with COVID-19 can release SARS-CoV-2 virus in aerosol and droplets when they exhale. This can be from coughing or sneezing but also when they speaker or just breathe. While the larger droplets can settle to the ground quickly (seconds to minutes), smaller aerosol can remain in the air in longer periods (minutes to hours). SARS-CoV-2 can be transmitted by inhaling aerosol or droplets containing infectious virus. The Fresh Air Clip enables detection of droplet and aerosol containing virus. (more…)
Author Interviews, Diabetes, Global Health, Lancet / 12.01.2022

MedicalResearch.com Interview with: Prof Dianna J Magliano PhD Baker Heart and Diabetes Institute Melbourne Australia  MedicalResearch.com: What is the background for this study? Response: Mortality among people with diabetes, and how it changes over time, is an important indicator of quality of and access to health care. However, population level trends in mortality among people with diabetes are inadequately described. The establishment of national diabetes registers, health insurance data and administrative data has allowed the examination of mortality among those with diabetes at a granular level which has been previously not possible. This has allowed us to examine whether global efforts in regards to diabetes care over the last couple of decades have been effective. (more…)
Author Interviews, Environmental Risks, Gastrointestinal Disease / 11.01.2022

MedicalResearch.com Interview with: Morgan Walker Ph.D. Candidate, UNC-Chapel Hill Chemistry Redinbo Laboratory MedicalResearch.com: What is the background for this study? Where is triclosan commonly found? Response: Triclosan is a commonly found antibacterial compound present in hand soaps, toothpastes, athletic clothes, and children’s toys. A previous study by the Zhang group (corresponding author on this publication) found that antimicrobial compounds including triclosan increased inflammation (similar to that of inflammatory bowel disease (IBD)) and tumor formation in the colon. These effects were observed only in mice with an intact gut microbiome, not in germ-free mice which lack a gut microbiome, suggesting that the gut microbiome is somehow responsible for the toxicity of triclosan to the gut. Our study investigates how gut bacteria promote triclosan toxicity in the gut  (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics / 11.01.2022

MedicalResearch.com Interview with: Stephen Freedman MDCM, MSc Professor of Pediatrics and Emergency Medicine Alberta Children’s Hospital Foundation Professor in Child Health and Wellness Alberta Children’s Hospital Research Institute, Cumming School of Medicine University of Calgary MedicalResearch.com: What is the background for this study? Response: During the early stages of the global 2019 coronavirus disease (COVID-19) pandemic, children represented fewer than 5% of reported cases.  However, children now represent a significant percent of all new COVID-19 cases.  Similarly, pediatric hospitalizations due to COVID-19, are now at an all-time high.  Although COVID-19 is generally mild in children, severe outcomes and death do occur.  The risk of severe outcomes among SARS-CoV-2 infected children is poorly understood with estimates varying considerably between study designs, settings, and regions.  Studies generally include large administrative databases (i.e. community based), hospitalized populations, and children admitted to the intensive care unit (ICU). Identified risk factors for severe COVID-19 in children have included young (i.e. 1-3 months) or old (15-18 years) pediatric age group, male sex, and pre-existing medical condition.  However, data from large prospective cohort studies which include children with early or mild stages of disease seeking emergency department (ED) care are lacking. To address this knowledge gap we sought to quantify the frequency of and risk factors for severe outcomes in SARS-CoV-2 infected children enrolled in a prospective ED-based cohort study.  (more…)
Author Interviews, Cannabis, JAMA, Pediatrics / 07.01.2022

MedicalResearch.com Interview with: Daniel Myran, MD, MPH, CCFP, FRCPC Family and Public Health and Preventive Medicine Physician CIHR Fellow, Ottawa Hospital Research Institute Department of Family Medicine Innovation Fellow University of Ottawa MedicalResearch.com: What is the background for this study? Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Canada took phased approach to legalization initially only allowing flower-based cannabis products and oils and after one year permitting the sale of commercial cannabis edibles (e.g. THC containing candies, baked goods, and drinks). In this study we took advantage of this phased roll out of legal cannabis to understand the impact of legalization on cannabis exposures or poisonings in children aged 0-9 years and the contribution of different types of cannabis products to these events. (more…)
Author Interviews, Cancer Research, Nutrition, Supplements / 06.01.2022

MedicalResearch.com Interview with: Dr Rana Conway PhD RNutr  Research Fellow Energy Balance & Cancer Group, and Obesity Research Group Research Department of Behavioural Science and Health University College London    MedicalResearch.com: What is the background for this study? Response: We’ve seen great advances in cancer diagnosis and treatment in recent years which means the number of people living with and beyond a cancer diagnosis is rapidly increasing. The WCRF and CRUK recommend improving diet and exercise to reduce the risks of cancer coming back but we know anecdotally that supplements are sometimes seen as an easier option, and people who’ve had cancer are often interested to know if they should be taking any supplements.    (more…)
Author Interviews, Columbia, COVID -19 Coronavirus, Pediatrics / 06.01.2022

MedicalResearch.com Interview with: Dani Dumitriu, MD, PhD Assistant Professor of Pediatrics (in Psychiatry) The Sackler Institute for Developmental Psychobiology Columbia University, New York MedicalResearch.com: What is the background for this study? What are the main findings?  Response: A lot of research has focused on the effects of COVID-19 in various vulnerable populations, such as elderly individuals, immunocompromised patients, and individuals with severe comorbidities. However, one vulnerable population that has remained relatively understudied are the infants exposed to maternal COVID-19 disease during pregnancy. While early on in the pandemic we and other groups showed reassuring data on low risk of vertical transmission, meaning the passing of the virus from mother-to-infant is rare, this does not necessarily mean that these infants wouldn't experience long-term consequences related to the maternal infection through other means. We know from other viral illness that maternal illness, most commonly through the activation of her immune system, can lead to a cascade of events that affect fetal development. This is why a large number of physicians and researchers at Columbia University spearheaded the COVID-19 Mother Baby Outcomes (COMBO) Initiative -- to look at potential long-term health effects on both infants and mothers. (more…)
Author Interviews, NEJM, OBGYNE / 05.01.2022

MedicalResearch.com Interview with: Laura Schummers, ScD (she/her/hers) Postdoctoral Fellow, Contraception and Abortion Research Team CIHR Patient-Oriented Research Leadership Fellow Post-doctoral Trainee, ICES McMaster UBC - Department of Family Practice | Women's Health Research Institute MedicalResearch.com: What is the background for this study? Response: Canada was the first country in the world to remove all supplemental restrictions on the dispensing and administration of mifepristone, making the drug available as a normal prescription. This meant that the abortion pill could be prescribed by any doctor or nurse practitioner, dispensed by any pharmacist, and taken by patients when, where and if they choose. (more…)
Author Interviews / 05.01.2022

MedicalResearch.com Interview with: Dr. Thomas Blank PD Dr. Institute of Neuropathology, Faculty of Medicine University of Freiburg Freiburg, Germany MedicalResearch.com: What is the background for this study? Response: There has been growing evidence of the benefits of fecal transplants in some medical conditions, like cancer, hypertension and obesity for several years. In fish, it’s been shown that their lifespan could be extended significantly after fecal transplant from young fish. When we found an impact on cognitive function in mice from a fecal transplant, we decided to research and isolate how that biological mechanism was implemented. (more…)
Author Interviews, JAMA, Prostate Cancer, Race/Ethnic Diversity, UCLA / 03.01.2022

MedicalResearch.com Interview with: Ting Martin Ma, MD, PhD Resident Physician Amar U. Kishan, MD Assistant Professor, Department of Radiation Oncology Vice-Chair of Clinical and Translational Research Department of Radiation Oncology at UCLA MedicalResearch.com: What is the background for this study? Response: We know from epidemiologic studies that  Black men are more likely to be diagnosed with and die of prostate cancer than White men. Recent studies hinted that Black men had better oncological outcome (such as prostate cancer specific mortality and overall survival) responding to systemic therapy for advanced prostate cancer (e.g. cancer that has spread or metastasized to other parts of the body). The question we were trying to answer in this study is: is there a difference in outcomes between Black and White men with localized prostate cancer (cancer that has not spread) receiving definitive radiotherapy enrolled in clinical trials?  (more…)
Author Interviews, Eating Disorders, Exercise - Fitness, JAMA, Pediatrics / 31.12.2021

MedicalResearch.com Interview with: Sean C. Rose, MD Child Neurology Nationwide Children’s Hospital The Ohio State University, Columbus MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is conflicting evidence regarding the association between repetitive head impacts during youth contact sports and worse neurocognitive outcomes.   Most research has been conducted in older adults, while the research in children is mostly limited to 1-2 sports seasons. (more…)
Author Interviews, CDC, Opiods / 28.12.2021

MedicalResearch.com Interview with: Julie O’Donnell, PhD MPH Division of Overdose Prevention National Center for Injury Prevention and Control CDC National Network of Public Health Institutes New Orleans, Louisiana MedicalResearch.com: What is the background for this study? Response: The estimated number of drug overdose deaths in the US surpassed 100,000 over a 12-month period for the first time during May 2020-April 2021, driven by the involvement of synthetic opioids other than methadone (mainly illicitly manufactured fentanyl (IMF)), according to data from the National Vital Statistics System. The State Unintentional Drug Overdose Reporting System (SUDORS) is a CDC-funded surveillance program that has collected detailed data on unintentional and undetermined intent drug overdose deaths since 2016 from death certificates, medical examiner and coroner reports, and full postmortem toxicology reports. SUDORS data allow for the analysis specifically of deaths involving fentanyl (rather than the larger category of synthetic opioids), and contain information about decedent demographics and other characteristics, as well as circumstances surrounding the overdose that might help inform prevention. (more…)
Author Interviews, Diabetes, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 20.12.2021

MedicalResearch.com Interview with: Lauren A. Eberly, MD, MPH Clinical Fellow, Cardiovascular Medicine Perelman School of Medicine Cardiovascular Division, Perelman School of Medicine Center for Cardiovascular Outcomes, Quality, and Evaluative Research, Cardiovascular Center for Health Equity and Social Justice, Leonard Davis Institute of Health Economics University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study? Response: Racial inequities are pervasive in our country, and cardiovascular therapeutics with proven benefit have been shown to be underutilized among Black and Latinx patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a recommended treatment option for glycemic control in patients with diabetes, have recently emerged as a cardioprotective therapy as multiple large randomized clinical trials have shown they prevent cardiovascular events among patients with Type 2 Diabetes (T2D), particularly patients with established atherosclerotic cardiovascular disease (ASCVD). Given this, they are now recommended therapy for patients with diabetes and established or high risk of ASCVD. Given the known inequitable utilization of other therapies, along with the known higher burden of diabetes and cardiovascular disease among Black patients, the aim of this study was to evaluate the uptake of GLP-1 RA as well as for inequities in utilization. (more…)
Author Interviews, Cancer Research, HPV / 17.12.2021

MedicalResearch.com Interview with: Ashish A. Deshmukh, PhD, MPH Associate Professor, Management, Policy & Community Health Associate Director, Center for Health Services Research Co-director, Clinical Analytics and Decision Science Lab UTHealth School of Public Health Houston, TX 77030 MedicalResearch.com: What is the background for this study? Response: Oropharyngeal cancer is the most common cancer caused by human papillomavirus (HPV) in the United States (US). We know from previous studies that oropharyngeal cancer to be one of the fastest rising cancers in the US. However, trends (i.e., extent of change) in incidence rates among men and women in all 50 US states and trends according to tumor diagnostic characteristics (i.e., stage, size) have not been comprehensively studied. In addition, no prior study evaluated contemporary trends in oropharyngeal cancer mortality (death) rates in the US. Our study provides a comprehensive picture of oropharyngeal cancer incidence and mortality (according to age, stage, tumor size, and state of residence) in all 50 states and DC. (more…)
Author Interviews, Environmental Risks, Race/Ethnic Diversity / 17.12.2021

MedicalResearch.com Interview with: Jiawen Liu, PhD student Department of Civil & Environmental Engineering University of Washington  MedicalResearch.com: What is the background for this study? Response: As previous literature has documented, racial/ethnic minority populations and lower-income populations in the US often experience higher-than-average burdens of air pollution and its associated health impacts. The disparities vary by pollutant, location, and time. In 2014, Clark et al. found higher average NO2 exposure for nonwhites than for whites and for below-poverty-level than for above-poverty-level. Clark et al. (2017) expanded research for NO2 exposure by race-ethnicity and socioeconomic status to 2000 and 2010 and found that absolute racial-ethnic disparities decreased over time while relative racial-ethnic disparities persisted.  (more…)
Author Interviews / 16.12.2021

MedicalResearch.com Interview with: Professor Ooi Eng Eong Programme in Emerging Infectious Diseases Duke-NUS Medical School Professor, Saw Swee Hock School of Public Health National University of Singapore Co-director, Viral Research And Experimental Medicine Centre MedicalResearch.com: What is the background for this study? Response: The emergence of Zika virus as a cause of fetal developmental disorder, or congenital Zika syndrome (CZS), mirrors the impact of congenital rubella syndrome on public health. Congenital rubella syndrome was controlled through the development of a live attenuated rubella virus vaccine that, when given to young children, elicited long-lasting immunity that protected against rubella well into adulthood. Indeed, live viral vaccines cause subclinical infection to elicit immunity that approaches those that develop following wild-type viral infection. However, the boundary between attenuated and virulent Zika virus has not been clearly defined, making development of any live attenuated Zika virus vaccine risky. (more…)
Annals Internal Medicine, Author Interviews, COVID -19 Coronavirus, Kidney Disease, Vaccine Studies / 16.12.2021

MedicalResearch.com Interview with: Shuchi Anand, MD MS (she/her) Assistant Professor in Medicine Director, Center for Tubulointerstitial Kidney Disease Stanford University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A majority of  people on dialysis who completed vaccination as of September 2021 have had a decline in antibody response to levels that would render them vulnerable to infection. Antibody response immediately after vaccination and circulating antibody response is strongly associated with risk for breakthrough after the initial vaccination series. (more…)
Author Interviews, Columbia, Genetic Research, Hematology, NEJM / 16.12.2021

MedicalResearch.com Interview with: Markus Y Mapara, MD Professor of Medicine Director of the Blood and Marrow Transplantation Columbia University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Sickle cell disease is caused by a point mutation in the beta-globin gene of hemoglobin  resulting in the production of abnormal hemoglobin which leads to formation of sickle-shaped RBC under conditions of low oxygen. Sickle cell disease affects about 100,000 patients in the US which are predominantly African  American. The only curative approach is to perform an allogeneic bone marrow transplant which is however fraught with significant treatment-related risks if a matched sibling donor is not available. The current study describes the successful application of a novel gene therapy  to treat patients with sickle cell disease. The strategy is based on a gene-addition approach to introduce the genetic information for a Hemoglobin F-like molecule termed HgAT87Q into hematopoietic stem cells. The expression of this novel  hemoglobin prevents polymerization of HgbS  and has now been demonstrated to prevent the occurrence of vaso-occlusive pain crises in sickle cell disease patients. (more…)
Author Interviews, Cannabis, Neurology, Pediatrics / 15.12.2021

MedicalResearch.com Interview with: Rayyan Raja Zafar BSc. MSc. MRSB. Medical Research Council Doctoral Training Partnership (MRC DTP) PhD Candidate Centre for Psychedelic research & Neuropsychopharmacology Division of Psychiatry Department of Brain Sciences, Faculty of Medicine Professor David Nutt DM, FRCP, FRCPsych, FSB, FMedSci Faculty of Medicine, Department of Brain Sciences The Edmond J Safra Chair in Neuropsychopharmacology Imperial College London MedicalResearch.com: What is the background for this study? Response: Since 2018 medical cannabis prescription has become legal in the UK for patients to access. In spite of this legal change less than 3 NHS prescriptions have been made available and access to whole-plant medical cannabis products has been restricted largely to private prescriptions with very few clinicians prescribing such products. There has been a lot of anecdotal and real world evidence of the value of whole-plant medical cannabis in children suffering with treatment resistant epilepsy. (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Social Issues, Transplantation / 14.12.2021

MedicalResearch.com Interview with: Rebecca Thorsness, PhD Research Associate Department of Health Services, Policy, and Practice Brown University School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2019, the President signed the Advancing American Kidney Health executive order, which included provisions to increase the use of home dialysis and kidney transplant for Americans living with kidney failure. To carry out this vision, the Centers for Medicare & Medicaid Services (CMS) developed the ESRD Treatment Choices (ETC) payment model, which uses financial incentives and penalties to incentivize dialysis facilities to pursue home dialysis or kidney transplant for their patients. Transplant and home dialysis are optimal care for people with kidney failure, but there are social and clinical reasons that patients with high social risk (such as those exposed to racism, poverty, or housing instability) may not be candidates for these treatments. This means that facilities which serve a large number of patients with high social risk might be disproportionately penalized by this new payment model. Using data immediately prior to the implementation of the ETC model, we found that dialysis facilities that serve high proportions of patients with high social risk have lower rates of home dialysis and kidney transplantation than facilities that care for lower proportions of such patients. (more…)
Author Interviews, JAMA, Opiods, University of Pennsylvania / 14.12.2021

MedicalResearch.com Interview with: Ashish Thakrar, MD Internal Medicine & Addiction Medicine National Clinician Scholars Program University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: About 1.8 million Americans are currently incarcerated, more than any other country in the world per capita. Of those 1.8 million, about 1 in 7 suffers from opioid addiction, putting them at high risk of overdose and death, particularly in the weeks following release. Opioid use disorder is a treatable condition, particularly with the medications buprenorphine or methadone, but historically, prisons and jails have not offered treatment. Over the past five years, a few states and municipalities have enacted policies to provide access for OUD treatment. We examined whether these policies were actually improving access to treatment.  (more…)
Aging, Alzheimer's - Dementia, Author Interviews, Blood Pressure - Hypertension, JAMA / 14.12.2021

MedicalResearch.com Interview with: Jan Willem van Dalen, PhD Department of Neurology Donders Institute for Brain, Behaviour and Cognition Radboud University Medical Centre Nijmegen Department of Neurology The Netherlands3Department of Public and Occupational Health Amsterdam UMC, University of Amsterdam, Amsterdam   MedicalResearch.com: What is the background for this study? Response: Although high systolic blood pressure in midlife has consistently been reported as a condition that increases the risk of developing dementia in old age, reports regarding this relationship in older people have been inconsistent. One potential reason for this, is that the relationship between systolic blood pressure and dementia in later life may be U-shaped, meaning that both individuals with low and with high systolic blood pressure are at increased incident dementia risk. This study combined data from several longitudinal cohort studies specifically designed to study incident dementia in older people, to investigate whether these U-shaped relationships exist, and in which age ranges they appear. We included more than 16,500 people aged 60 and older, with over 2,700 incident dementia cases. Also, we aimed to investigate whether these observational associations might be caused by confounding, differences in mortality, or result from opposite relationships between certain subgroups of individuals. (more…)
Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, JAMA / 13.12.2021

MedicalResearch.com Interview with: Liise-anne Pirofski, M.D. Mitrani Professor of Biomedical Research Chief, Division of Infectious Diseases Albert Einstein College of Medicine and Montefiore Medical Center Liise-anne Pirofski, MD on behalf of lead authors Mila Ortigoza MD, PhD, Assistant professor at NYU Langone Health and Hyunah Yoon MD, Assistant Professor, Albert Einstein Medical Center and the CONTAIN COVID-19 trial authors and team MedicalResearch.com: What is the background for this study? Response: The study was designed to determine the efficacy of COVID-19 convalescent plasma (CCP) in hospitalized patients with COVID-19. It was designed and launched in New York City in April 2020 during the height of the first COVID-19 pandemic wave and later extended to sites in Miami, Houston, and other regions affected by subsequent waves of the pandemic. At that time, there were no validated therapeutic options for COVID-19, and there was clinical equipoise for CCP use in hospitalized patients. COVID-19 convalescent plasma was considered worthy of investigation because of the historical success of convalescent plasma in prior pandemics and epidemics dating to the beginning of the 20th century, and importantly, biological plausibility because convalescent plasma contains antibodies to agents from which people have recovered, and case series and observational studies showing signals of CCP efficacy in patients with COVID-19. The trial was designed to focus on patients with moderate to severe COVID-19 who required supplemental oxygen, but not mechanical intubation. At the time the trial was designed, hospitals in New York City were overwhelmed with severely and critically ill patients with COVID-19, an entirely new disease about which more and more was learned over the 11 months the trial was conducted.  (more…)
Author Interviews, COVID -19 Coronavirus, NEJM, Vaccine Studies / 13.12.2021

MedicalResearch.com Interview with: Ronen Arbel, PhD Outcomes Research, Community Medical Services Division Clalit Health Service Tel Aviv, Israel Director, Maximizing Health Outcomes Research Lab Sapir College, Sderot, Israel.  MedicalResearch.com: What is the background for this study? Response: The emergence of the SARS-CoV-2 delta variant and reduced effectiveness over time of the BNT162b2 vaccine (Pfizer-BioNTech) led to a recent Coronavirus 2019 disease (Covid-19) resurgence in early vaccinated populations. The Israeli Ministry of Health was the first in the world to approve a third (booster) dose of BNT162b2 to cope with this resurgence. (more…)
Author Interviews, Cost of Health Care, JAMA, Medicare / 12.12.2021

MedicalResearch.com Interview with: Jeanne Madden, PhD Associate Professor Department of Pharmacy and Health Systems Sciences School of Pharmacy and Pharmaceutical Sciences Bouvé College of Health Science Northeastern University MedicalResearch.com: What is the background for this study? Response: Medicare is the US public insurance program mainly serving people 65 years and older, but also some younger adults who have long-term disabling conditions. As such, on average, the Medicare population bears a heavy burden of illness and has high health care needs, compared to the general US population. The under-65 group for the most part has quite low incomes, while the older group represents a wide spectrum, from poor to well-off. Medicare beneficiaries also differ a great deal in terms of whether they have access to supplemental insurance that can help with patient cost-sharing requirements. I’m referring to Medicaid assistance, or a self-purchased Medigap plan, or retiree health benefits, etc. The cost-sharing requirements in traditional Medicare are substantial — e.g., 20% for doctor visits — and there is no annual cap on patient out-of-pocket spending. That’s in contrast to commercial insurance and Medicare Advantage managed care plans — all of those have an annual cap on patient out-of-pocket costs. There’s a good amount of existing research on whether people in Medicare can afford their drugs, and on the affordability of medical care among younger groups such as working-aged uninsured people and those in ACA exchange plans. But there hasn’t been much research into medical care affordability among older Americans. (more…)