#bidmchealth

Dr. Wadhera Rishi Wadhera, MD, MPP, MPhil Instructor in Medicine at Harvard Medical School Cardiologist,Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: With more than a million confirmed cases of COVID-19 in the United States, there is growing concern that low-income communities and racial/ethnic minorities may be disproportionately shouldering the burden of the pandemic. New York City, which is comprised of 5 boroughs (Bronx, Brooklyn, Manhattan, Queens, and Staten Island) with unique demographic and socioeconomic characteristics, has emerged as the epicenter of the COVID-19 outbreak. MedicalResearch.com: What are the main findings? Response: This study found substantial differences in COVID-19-related hospitalizations and deaths across the boroughs of New York City. The Bronx — the borough with the highest proportion of racial and ethnic minorities, the most persons living in poverty, and lowest levels of educational attainment — had higher rates of hospitalization and death related to COVID-19 than the four other boroughs. In contrast, hospitalization and death rates were lowest in Manhattan, the most affluent borough, which is comprised of a predominately white population. The number of COVID-19 deaths per 100,000 persons was nearly two times greater in the Bronx than in Manhattan. MedicalResearch.com: What should readers take away from your report? Response: This study demonstrates that substantial inequities in COVID-19 hospitalization and death rates have emerged along racial and socioeconomic lines in New York City amid the pandemic. These disparities may be related to population-level differences in underlying comorbid illnesses, occupational exposures, socioeconomic determinants and race-based structural inequities across the boroughs. Public health and policy strategies should focus on mitigating the spread of COVID-19, and associated adverse outcomes, among vulnerable populations. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Further studies are needed to examine whether the disproportionate burden of COVID-19 is being borne by lower income and minority communities in other regions of the US.  Citation: Wadhera RK, Wadhera P, Gaba P, et al. Variation in COVID-19 Hospitalizations and Deaths Across New York City Boroughs. JAMA. Published online April 29, 2020. doi:10.1001/jama.2020.7197 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

MedicalResearch.com Interview with: Dr. Ballou Sarah Ballou, PhD Health Psychologist Division of Gastroenterology, Hepatology, and Nutrition Beth Israel Deaconess Medical Center Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obesity is known to be associated with an increased risk of gastrointestinal and liver diseases, but less is known about the relationship between obesity and constipation or diarrhea. We used a nationally representative sample of the US population to evaluate whether obesity was associated with abnormal bowel habits. We found that obese individuals were 60% more likely to have diarrhea, even after controlling for possible confounding factors such as dietary, lifestyle, psychological, and medical conditions. MedicalResearch.com: What should readers take away from your report?  Response: These findings confirmed our hypothesis that obesity would be associated with an increased risk for diarrhea. It is important to note that we found that this association was not due to dietary factors (for example, increased fat, caffeine, alcohol, sugar, or carbohydrate intake), physical activity, diabetes, laxative use, or demographic factors (age, sex, race, income, education level). The treatment of obesity and obesity-related medical conditions requires multidisciplinary management. Clinicians should be aware of the relationship between obesity and diarrhea, especially considering the potential negative impact of altered bowel habits on quality of life. MedicalResearch.com: What recommendations do you have for future research as a result of this work?  Response: Our findings raise the question of why obese individuals would be more likely than non-obese individuals to have diarrhea. Previous studies investigating the relationship between diarrhea and obesity have hypothesized that this was due to dietary factors, but our study suggests otherwise. Future research should seek to clarify this relationship and to identifying underlying factors that would explain the association between obesity and diarrhea.  Citation: Sarah Ballou, Prashant Singh, Vikram Rangan, Johanna Iturrino, Judy Nee, Anthony Lembo. Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors: a cross-sectional analysis of the 2009-2010 National Health and Nutrition Examination Survey. Alimentary Pharmacology & Therapeutics, 2019; DOI: 10.1111/apt.15500 Last Modified: The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article

Dr. Wee Christina C. Wee, MD, MPH Associate Professor of Medicine Harvard Medical School Director , Obesity Research Program Division of General Medicine Beth Israel Deaconess Medical Center (BIDMC) Associate Program Director, Internal Medicine Program, BIDMC Deputy Editor of the Annals of Internal Medicine MedicalResearch.com: What is the background for this study? Response: New research is showing that for many people without diagnosed heart disease, the risk of bleeding may outweigh the benefits of taking a daily aspirin particularly in adults over 70 years of age.  The American Heart Association and the American College of Cardiology recently updated their guidelines and now explicitly recommend against aspirin use among those over the age of 70 who do not have existing heart disease or stroke. Our study found that in 2017,  a quarter of adults aged 40 years or older without cardiovascular disease – approximately 29 million people – reported taking daily aspirin for prevention of heart disease. Of these, some 6.6. million people did so without a physician's recommendation. MedicalResearch.com: What are the main findings? Response: Concerningly, nearly half of adults 70 years and older (over 9 million adults) without a history of heart disease or stroke reported taking aspirin daily. Moreover, adults who had a history of peptic ulcer disease – another contraindication for the routine use of aspirin – were not significantly less likely to use aspirin as we would have expected. MedicalResearch.com: What should readers take away from your report? Response: Readers should be aware that our understanding of the benefits and risks of aspirin use for preventing new heart disease has changed  and that they should talk to their doctor about whether aspirin use in this context is appropriate for their particular health situation. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: This study looked at aspirin use in 2017 before the recent release of the new guidelines. It would be important to see whether aspirin use to prevent heart disease among patients without pre-existing heart disease or stroke changes in response to these new recommendations. MedicalResearch.com: Is there anything else you would like to add? Response: I want to emphasize that this study did not look at adults who had a history of heart disease or stroke. Every person’s health situation is unique, we recommend that people talk to their doctors before making any changes.  Citation: Colin W. O'Brien, Stephen P. Juraschek, Christina C. Wee. Prevalence of Aspirin Use for Primary Prevention of Cardiovascular Disease in the United States: Results From the 2017 National Health Interview Survey. Annals of Internal Medicine, 2019; DOI: 10.7326/M19-0953 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.   Read the full article