Annals Internal Medicine, Author Interviews, Kidney Disease, UCSF / 21.07.2023

MedicalResearch.com Interview with:   Chi-yuan Hsu, MD, MSc (he/him/his) Professor and Division Chief Robert W. Schrier Distinguished Professor Division of Nephrology University of California, San Francisco     MedicalResearch.com: What is the background for this study? Response: Acute kidney injury (AKI) had previously been considered a reversible short-term medical problem among hospitalized patients without long-term sequalae in that there is recovery of kidney function back to baseline should the patient survive the hospitalization. Then about 15 years ago, the concept began to shift as research by us and others showed that for patients with severe AKI (e.g. AKI severe enough to require acute dialysis in the hospital), there was more rapid subsequent loss of renal function.  Now based largely on additional observational studies in humans (and animal models), many nephrologists and opinion leaders think that even mild to moderate cases of AKI have long-term sequelae.  We are concerned that the paradigm has swung too much in the opposite direction and we questioned the results of many published studies which did not fully account for differences in background kidney function among those who did and did not experience AKI. (more…)
Author Interviews, Breast Cancer, JAMA, Mammograms, Medical Imaging, UCSF / 15.06.2022

MedicalResearch.com Interview with: Karla Kerlikowske, MD. Professor, Departments of Medicine and Epidemiology/Biostatistics, Cancer Center Program Membership. Breast Oncology UCSF MedicalResearch.com:  What is the background for this study?  Response: Digital breast tomosynthesis (DBT) was developed with the expectation it would improve detection of breast cancer in women with dense breasts and decrease false-positive results. DBT is now available at most breast screening centers. (more…)
Alzheimer's - Dementia, Author Interviews, Race/Ethnic Diversity, UCSF / 20.04.2022

MedicalResearch.com Interview with: Erica Kornblith, PhD Assistant Professor, Psychiatry UCSF Weill Institute for Neurosciences MedicalResearch.com:  What is the background for this study?  What are the main findings?  Response: As the population of the United States grows more diverse and dementia is a serious public health concern, we hoped to understand whether differences in dementia risk exist based on race or ethnicity.  Older studies have shown that Black and Hispanic folks have higher risk of dementia, perhaps due to medical risk factors, diagnostic bias, lack of equal access to health care and education, or the health effects of racism, among other factors.  However, these older studies have been small or limited geographically or by only studying a few race and ethnicity groups. Our study used a nationwide sample of almost two million older Veterans who all had access to care through the Veterans Health Administration (VHA), and we examined 5 race or ethnicity groups: American Indians or Alaska Natives, Asians, Blacks, Hispanics, and Whites. Our results show that dementia risk is higher for Black and Hispanic Veterans compared to white Veterans, even when education and medical factors are considered. (more…)
Author Interviews, Genetic Research, Sleep Disorders, UCSF / 20.03.2022

MedicalResearch.com Interview with: Ying-Hui Fu, PhD Professor, Neurology Weill Institute for Neurosciences UCSF MedicalResearch.com:  What is the background for this study?  Response: Most people are aware that a lack of sleep is associated with all sorts of health issues. However, familial natural short sleeper (FNSS) individuals sleep 4-6.5 hours a night most of their live and stay healthy. We set out to determine whether natural short sleep mutations can offer protection from various diseases. We chose Alzheimer as an example to start. (more…)
Aging, Author Interviews, Cognitive Issues / 03.12.2020

MedicalResearch.com Interview with: Susanna Rosi, Ph.D.  Lewis and Ruth Cozen Chair II Professor, Brain and Spinal Injury Center Weill Institute for Neuroscience Kavli Institute of Fundamental Neuroscience Departments of Physical Therapy Rehabilitation Science, Neurological Surgery University of California San Francisco MedicalResearch.com: What is the background for this study? Response: Everybody has experienced a “senior moment” forgetting where the car keys are, or where you put your glasses. These forgetful moments are not always indicative of a disease, but rather can be a consequence of normal aging. Normal aging is associated with decline of cognitive abilities, such as memory, spatial orientation, problem solving and executive functioning. Investigating what changes happen in the brain with age, can help us to understand why these ‘senior moments’ occur. When we understand what causes these moments, we can design therapeutics with the hopes of preventing or reversing them.  With increased life expectancy age-associatedmemory decline becomes a growing concern. We wanted to investigate (i) What causes memory decline with age? (ii) Are there ways to reverse it?  (more…)
Author Interviews, COVID -19 Coronavirus, Nutrition, Pediatrics, UCSF / 11.11.2020

MedicalResearch.com Interview with: Jason M Nagata M.D., M.Sc Assistant Professor of Pediatrics Division of Adolescent and Young Adult Medicine Department of Pediatrics, University of California San Francisco, San Francisco, CA MedicalResearch.com: What is the background for this study? Response: During the COVID-19 pandemic, food insecurity is expected to rise given economic uncertainty and job losses. Vulnerable and marginalized populations are disproportionately affected by both COVID-19 and food insecurity.   (more…)
Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity, Rheumatology, UCSF / 07.11.2020

MedicalResearch.com Interview with: Milena Gianfrancesco, PhD, MPH Assistant Professor. Education Division of Rheumatology, Department of Medicine University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: This study utilized data from the COVID-19 Global Rheumatology Alliance Provider Survey, which launched on March 25th. To date, it has collected information on over 6,000 patients with rheumatic disease diagnosed with COVID-19 from over 40 countries worldwide. As COVID-19 spread across the world in the spring, and especially within the United States, it became clear that the disease was impacting certain groups more than others. Growing attention and research began to illustrate the disproportionate burden of COVID-19 among racial/ethnic minorities in the United States. We know that racial and ethnic minorities experience a higher burden of rheumatic disease risk and severity; therefore, our group was interested in examining whether the disproportionate burden of COVID-19 also affected this susceptible population. (more…)
Author Interviews, COVID -19 Coronavirus, Nutrition, Social Issues / 07.10.2020

MedicalResearch.com Interview with: Jason Nagata, MD, MSc Assistant Professor of Pediatrics University of California, San Francisco San Francisco, California, USA MedicalResearch.com: What is the background for this study? Response: During the COVID-19 pandemic, food insecurity is expected to rise given economic uncertainty and job losses. Vulnerable and marginalized populations are disproportionately affected by both COVID-19 and food insecurity. MedicalResearch.com: What are the main findings? Response: In this perspective, we argue that food insecurity and COVID-19 can exacerbate one another via bidirectional links. Experiencing food insecurity can lead to nutritional deficiencies and weakened host defenses, increasing susceptibility to COVID-19 infection. Food insecurity is also associated with chronic medical conditions which may lead to a higher risk of severe COVID-19 illness. Conversely, people with COVID-19 may not be able to work, generate income, or procure food while quarantined, which may worsen food insecurity. (more…)
Author Interviews / 24.07.2020

MedicalResearch.com Interview with: Brian Shoichet, Professor UCSF http://www.bkslab.org/contact.php  MedicalResearch.com: What is the background for this study? Response: Excipients are ubiquitous in drug formulations.  What most people consider "drugs" are formulations of active and "inactive" ingredients--the excipients.  These "inactive" ingredients, which you can find on the label of all of the drugs you use, play crucial roles in drug stability, as antioxidants, as colorants to help patients distinguish among them, as anti-microbials to keep them from getting infected with bacteria, helping to make the soluble  in the patient, among other functions. They are considered "inactive" because they do not have observable toxicity in animal and sometimes histological studies, but few of them have been evaluated in a modern way.  This would involve testing the excipients for activity on individual receptors and enzymes that are involved in biological responses, which is what happens for drugs.  Doing this was the focus of this study (more…)
Author Interviews, CT Scanning, JAMA, Lung Cancer, UCSF / 23.09.2019

MedicalResearch.com Interview with: Joshua Demb, PhD, MPH Postdoctoral Scholar, Moores Cancer Center University of California, San Diego Health Science Research Specialist Veterans Affairs San Diego Healthcare System MedicalResearch.com: What is the background for this study? Response: Our study leveraged radiation dose data from 72 facilities performing CT scans around the United States to learn more about the radiation dose used for lung cancer screening scans, as well as possible institutional predictors that might be associated with higher dose.  Currently, the American College of Radiology has recommendations for how these low-dose lung cancer screening scans should be performed. However, it is unclear how much adherence there currently is to these guidelines. Our findings indicated that there is wide variation in the distribution of radiation doses for low-dose lung cancer screening scans both within- and between facilities in our sample—in some cases this variation led to doses higher than the ACR recommendations.   (more…)
Author Interviews, Biomarkers, Genetic Research, Infections, NEJM, UCSF / 13.06.2019

MedicalResearch.com Interview with: Dr. Charles Chiu, M.D./Ph.D. Professor, Laboratory Medicine and Medicine / Infectious Diseases Director, UCSF-Abbott Viral Diagnostics and Discovery Center Associate Director, UCSF Clinical Microbiology Laboratory UCSF School of Medicine MedicalResearch.com: What is the background for this study? Would you describe what is meant by metagenomic sequencing? Response: Metagenomic next-generation sequencing (mNGS) is the use of technology to generate millions of sequence reads to diagnose infection sin patients by characterizing the full range of potential pathogens (bacteria, viruses, fungi, and parasites) in a single sample. Although shown to be a promising diagnostic tool for  infectious diseases in case reports and limited case series (Chiu and Miller Nature Reviews Genetics 20, 341-355 (2019)), to date the “real-life” utility of this approach for patient care has hitherto not been demonstrated.  This study is the first prospective, multi-center study of clinical mNGS testing for the diagnosis of neurological infections in acutely ill hospitalized patients presenting with meningitis and/or encephalitis. (more…)
Author Interviews, Dermatology, JAMA, Pediatrics, Sleep Disorders, UCSF / 26.03.2019

MedicalResearch.com Interview with: Dr. Katrina Abuabara, MD, MA, MSCE Department of Dermatology Program for Clinical Research, University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: The wellbeing and development of children is strongly influenced by parents’ physical and psychosocial health. Parents of children with chronic illness, in particular, are susceptible to poor sleep, and previous studies have found major sleep impairments among parents of children with ventilator dependency and cystic fibrosis, but few studies have examined sleep patterns among parents of children with more common chronic illnesses like atopic dermatitis (also known as eczema). (more…)
Author Interviews, Diabetes, Technology, UCSF / 12.03.2019

MedicalResearch.com Interview with: Robert Avram MD MSc Division of Cardiology University of California, San Francisco MedicalResearch.com: What is the background for this study? Would you briefly describe what is meant by Photoplethysmography? While analyzing the heart rate data as collected using smartphones apps in the Health-eHeart study, we noticed that diabetic patients had, on average, a higher ‘free-living’ heart rate than non-diabetic patients when adjusted from multiple factors. This pushed us to analyze the signal to see if there were other features that would help differentiate diabetes patients from non-diabetes patients. By identifying these features, we saw a huge opportunity to develop a screening tool for diabetes using deep learning and a smartphone camera and flash, in order to classify patients as having prevalent diabetes/no-diabetes. Photoplethysmography is the technique of measuring the difference in light absorption by the skin in order to detect blood volume changes in the microvasculature. Most modern mobile devices, including smartphones and many fitness trackers (Apple Wathc, FitBit), have the ability to acquire PPG waveforms, providing a unique opportunity to detect diabetes-related vascular changes at population-scale.  (more…)
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, UCSF / 27.12.2018

MedicalResearch.com Interview with: Oanh Kieu Nguyen, MD, MA Assistant Professor Division of Hospital Medicine Zuckerberg San Francisco General Hospital UCSF MedicalResearch.com: What is the background for this study? Response: In U.S. citizens and permanent residents with kidney failure or end-stage renal disease (ESRD), having health insurance, Medicare, or Medicaid guarantees access to regularly scheduled hemodialysis 2-3 times per week, the evidence-based standard of care for ESRD. This treatment helps people live relatively normal lives. In 40 of 50 U.S. states, undocumented immigrants with ESRD have limited access to hemodialysis because they are not eligible for any form of federal assistance including Medicare or Medicaid, and must wait until they are life-threateningly ill to receive dialysis through a hospital emergency department, a situation called “emergency-only hemodialysis.” There are an estimated 6,500 undocumented individuals in the U.S. suffering from ESRD. A unique opportunity made it feasible for uninsured undocumented immigrants with ESRD receiving emergency-only dialysis in Dallas, Texas, to enroll in private, commercial health insurance plans in 2015 and made it possible for researchers to compare scheduled vs. emergency-only dialysis among undocumented immigrants with ESRD. This natural experiment included 181 undocumented immigrants, 105 of whom received insurance coverage and enrolled in scheduled dialysis and 76 of whom remained uninsured.  (more…)