Author Interviews, Health Care Systems, Kidney Disease, NEJM, NIH, UT Southwestern / 04.04.2024

MedicalResearch.com Interview with: Miguel A. Vazquez, MD Professor of Internal Medicine University of Texas Southwestern Medical Center MedicalResearch.com: What is the background for this study? Response: The main reason to conduct our trial was to improve the care of patients with coexistent chronic kidney disease CKD),  type 2 diabetes and hypertension.   Patients with this triad are at high risk for multiple complications, end stage kidney disease and premature death.   There are effective interventions for these conditions.  Unfortunately, detection and awareness of CKD is low and many patients do not receive interventions that could be beneficial In our study in patients with the coexistent triad of chronic kidney disease, type 2 diabetes, and hypertension the use of an electronic algorithm to identify patients from the electronic health record and practice facilitators embedded in four large health systems to assist primary practitioners deliver evidence-based care did not lower hospitalizations when compared to usual care. (more…)
Author Interviews, JAMA, Nutrition, Sugar / 12.01.2024

MedicalResearch.com Interview with: Scott Kaplan PhD Assistant Professor of Economics United States Naval Academy Annapolis, MD 21402 Scott Kaplan PhD Assistant Professor of Economics United States Naval Academy Annapolis, MD 21402   MedicalResearch.com: What is the background for this study? Response: Sugar-sweetened beverages (colloquially known as SSBs), which include sodas, fruit drinks, sports drinks, energy drinks, and sweetened coffee drinks, are the leading source of added sugars in the American diet, according to the CDC. They are associated with serious negative health outcomes, including type 2 diabetes, obesity, heart disease, kidney disease, non-alcoholic liver disease, gum disease, tooth decay, and other conditions. As a result, several cities across the US have implemented sugar-sweetened beverage excise (per ounce) taxes, generally ranging from 1-2 cents per ounce. Most existing studies evaluating the impact of SSB taxes on SSB volume purchased and prices focus on a single city; this study is among the first to provide a composite estimate of the impact of local SSB taxes on purchases and prices of SSBs using retail scanner data from five cities across the US that implemented SSB taxes between January 1, 2017 and January 1, 2018. The five taxed cities we examine are Philadelphia, San Francisco, Oakland, Boulder, and Seattle.  (more…)
Author Interviews, Diabetes, NIH, Pediatrics / 18.06.2019

MedicalResearch.com Interview with: Dr. Ellen Leschek MD Program Director: Division of Diabetes, Endocrinology, and Metabolic Diseases The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Type 2 diabetes (T2D) is thought to be characterized by a progressive loss of pancreatic beta cell (insulin producing/releasing cell) function. For this reason, T2D medications eventually stop working and individuals with T2D require treatment with insulin. The Restoring Insulin Secretion (RISE) Consortium was established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to evaluate the effects of treatment and treatment withdrawal on the loss of pancreatic beta cell function. In the RISE Study, progression of disease was assessed by the measurement of pancreatic beta cell function in youth and adults who had either impaired glucose tolerance (IGT; prediabetes) or recently diagnosed Type 2 diabetes before, during and after treatment with study medications. Importantly, the RISE Pediatric Medication Study and the RISE Adult Medication Study were designed in tandem to allow direct comparison of the effects of two pharmacologic treatment regimens (the only two FDA-approved medications for Type 2 diabetes in youth) on disease progression in youth and adults. For more information about the RISE Study, please visit https://rise.bsc.gwu.edu/web/rise. (more…)
Author Interviews, JAMA, Thyroid, Thyroid Disease / 04.02.2019

MedicalResearch.com Interview with: Joanna Klubo-Gwiezdzinska, M.D., Ph.D., M.H.Sc. Assistant Clinical Investigator/Assistant Professor Metabolic Disease Branch/NIDDK/NIH Bethesda, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: People with intermediate- and high-risk differentiated thyroid cancer (DTC) are treated with surgical removal of the thyroid gland and radioactive iodine therapy.  After surgery and initial treatment, the thyroid hormone levothyroxine is used for long-term management not only to replace appropriate physiologic thyroid hormones post-surgery, but also to suppress thyrotropin (TSH) release from the pituitary gland at supraphysiologic doses. The current recommended American Thyroid Association TSH suppression goal in patients with a high-risk differentiated thyroid cancer presenting with distant metastases is less than 0.1mIU/ml, and between 0.1-0.5 mIU/ml for patients with intermediate-risk DTC presenting with local metastases to the neck lymph nodes. This TSH goal is much lower than physiologic TSH level, which ranges between 0.4-4.1 mIU/ml, depending on the measurement method and person’s age. TSH suppression is used because some preclinical evidence suggests that TSH can stimulate growth of cancer cells.  However, several preclinical studies show that thyroid hormones may also stimulate cancer growth. In addition, too much levothyroxine, leading to TSH suppression, may cause side effects such as abnormal heart rhythms and decreased bone mass. In this study, based on a large multicenter database analysis, we found that continuous TSH suppression with levothyroxine was not associated with better progression-free survival and overall survival in patients with either intermediate- and high-risk differentiated thyroid cancer. The patients were followed for an average of 7 years after surgical thyroid cancer removal and radioactive iodine therapy.  (more…)