University of Kansas

TUESDAY, Dec. 3, 2024 -- Preferential promotion of White men within academic medicine is persisting, with racially and ethnically diverse women experiencing greater underpromotion, according to a study published online Nov. 27 in JAMA Network Open . Lauren Clark, from the University of Kansas School of Medicine in Kansas City, and colleagues examined whether race and ethnicity and gender are associated with appointment to or promotion within academic medicine in a cohort study. The analytic sample included 673,573 graduates from U.S. M.D.-granting medical schools. The researchers found that compared with White men, Asian men, Asian women, Black women, and White women were more likely to be appointed to entry-level positions. Compared with physicians of nearly every other combination of gender and race and ethnicity, White men were more likely to be promoted to upper ranks among physicians graduating before and after 2000. Compared with White men, Black women were less likely to be promoted to associate professor and full professor among physicians graduating prior to 2000 (hazard ratios, 0.45 and 0.59, respectively). Conversely, compared with White men, Black men were more likely to be appointed department chair (hazard ratio, 1.29). "To achieve a workforce that reflects the diversity of the U.S. population, academic medicine must transform its culture and the practices that surround faculty appointments and promotions," the authors write. Abstract/Full Text Editorial Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

TUESDAY, Sept. 17, 2024 -- Positive airway pressure (PAP) utilization is associated with lower all-cause mortality and major adverse cardiovascular event (MACE) incidence in older adults with obstructive sleep apnea (OSA), according to a study published online Sept. 11 in JAMA Network Open . Diego R. Mazzotti, Ph.D., from the University of Kansas Medical Center in Kansas City, and colleagues sought to determine whether PAP initiation and utilization are associated with lower mortality and incidence of MACE among older U.S. adults with OSA. The analysis included 888,835 Medicare beneficiaries with two or more distinct OSA claims identified from multistate, statewide, multiyear Medicare fee-for-service claims data (2011 to 2020) with follow-up until death or censoring through 2020. The researchers found that during a median follow-up of 3.1 years, those with evidence of PAP initiation (32.6 percent) had significantly lower all-cause mortality (hazard ratio, 0.53) and MACE incidence risk (hazard ratio, 0.90). There was a progressive association between higher quartiles of annual PAP claims and lower mortality and MACE incidence risk. "These results might inform future trials assessing the importance of obstructive sleep apnea therapies toward minimizing cardiovascular risk and mortality in older adults," the authors write. One author disclosed being a cofounder of Hypnoscure. Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

MONDAY, July 29, 2024 -- A new test gauging levels of key proteins in the blood was far more accurate than doctor assessments in spotting Alzheimer's disease in people with early-stage illness. The test, called APS2 (the amyloid probability score 2), was 91% accurate in diagnosing Alzheimer's in people with mild cognitive decline or early dementia, compared to the 61% success rate of primary care doctors who examined the same patients. The test isn't yet approved for routine use. But Dr Teresa D'Amato , director of geriatric emergency medicine at Northwell Health in Forest Hills, NY, called the new data "very exciting." "This blood test would be great as a first round of diagnostic testing because it it looks like it's pretty accurate," said D'Amato, who wasn't involved in the new study. The findings were published July 28 in the Journal of the American Medical Association . They were published simultaneously at the Alzheimer’s Association International Conference in Philapdelphia. An accurate, easily administered blood test for Alzheimer's could be a game-changer, according to a team of dementia experts who wrote an editorial accompanying the research. "Diagnosing Alzheimer's is challenging, especially in primary care. Having a reliable blood test is essential to help primary care physicians make an early and accurate diagnosis," the editorialists said. They included Dr. Stephen Salloway , of Brown University, Dr. Christopher Rowe , of the University of Melbourne, Australia, and Dr. Jeffrey Burns , of the University of Kansas Medical Center. The new test was developed by a team led by Dr. Sebastian Palmquist . of Skane University Hospital and Lund University in Malmo, Sweden. The recent advent of drugs that slow Alzheimer's in its earliest stages have made the search for an easier, more accurate diagnostic test more urgent. "It becomes really important to diagnose Alzheimer’s very early on to make these folks eligible for possible treatment," D'Amato said. The new test relies on relative blood levels of two types of proteins whose buildup in the brain has long been a hallmark of Alzheimer's: Tau "tangles" and amyloid "plaques." In the study, 1,213 patients who were experiencing "cognitive symptoms" were evaluated by either a standard primary care physician exam or by the use of the APS2 test. The patients averaged about 74 years of age. Overall, 23% had "subjective cognitive decline," 44% had "mild cognitive impairment" and 33% had already been diagnosed with dementia. Patients were assessed by primary care physicians who relied on standard, internationally recognized criteria as well as CT scans and cognitive tests. Patients also got the APS2 blood test. Results from each of those screening methods were compared to "gold standard" tests for Alzheimer's (cerebrospinal fluid tests and PET scans looking for amyloid and tau in the brain). According to Palmquist's group, the ASPS2 ended up being 91% accurate in spotting Alzheimer's disease in patients, compared to the 61% accuracy of the primary care doctors. The blood test even beat dementia specialists: They were 73% correct in their diagnoses compared to the 91% accuracy of the blood screen. Of the two proteins being measured by the test, tau seemed by far to be the most important. In fact , looking at tau protein measurements alone produced an equally high accuracy (90%) in diagnosing Alzheimer's disease, the team found. The three editorial authors stressed that questions remained, however. Would the test be economical enough for use in doctors' offices? Will it gain FDA approval for use? And will the ASPS2 test be outshone by other Alzheimer's blood screens also in development? Still, "this study makes the case convincingly that highly sensitive blood measures of Alzheimer disease can be integrated into the clinical decision-making process, including in the primary care setting," they wrote. "The way that I think we envision it being used is that someone would come in [to their doctor] with cognitive decline," D'Amato explained. "A physician would do all the blood work that you would normally do to rule out all the other reasons for cognitive decline and, in addition, send these new blood tests looking for the amyloid and the tau and the blood. And that could be a screening exam. " "I think if it's used correctly it could be an exciting adjunct to diagnosing Alzheimer's sooner than later," she said. However, Palmquist's team stressed that a blood test will never be the only means of diagnosing Alzheimer's early in its development. That's because Alzheimer's can take years to develop in the brain and symptoms that resemble early Alzheimer's can also be caused by other conditions. "Incorrect interpretation of a positive Alzheimer disease biomarker [test] could thus lead to under-diagnosis of relatively common non-Alzheimer disease conditions," the study authors explained. Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.