HHRI Media Coverage
Hennepin Healthcare Research Institute investigator Dr. Fred Apple, PhD, DABCC, discusses his article "Myocardial Infarction Risk Stratification With a Single Measurement of High-Sensitivity Troponin I" recently published in the Journal of the American College of Cardiology.
Read the interview on MedicalResearch.com
A new program is underway in Hennepin County to help inmates struggling with addiction. They are now screened for opioid use disorder when they arrive at the Adult Detention Center. It started in January to connect inmates with medication assisted treatment. “The folks that we’re seeing have been struggling with their substance use disorder for at least a year, but often 10, 15 or 20 years,” said Dr. Tyler Winkelman.
At Hennepin Healthcare, doctors read plenty of studies, but one that claims taking certain pills may increase your risk of dementia by as much as 50%, certainly stands out. Dr. Anne Murray works in geriatrics and conducts research of her own. She says the medical community has long suspected anticholinergic drugs, which are used to treat things like depression, Parkinson’s, incontinence, allergies and other conditions, may cause dementia later in life.
Mark Linzer, MD, Principal Investigator of the Healthy Work Place study, was interviewed on JNO Live about the study that shows trust is an important attribute to clinician satisfaction; identifies characteristics associated with gender, organizational climate. The live JAMA Network Open broadcast aired on Twitter, YouTube and Facebook.
The World Health Organization this week recognized burnout as an official medical diagnosis. "I think it's a really important thing that they've done this. I think that provides a foothold to begin the conversation about the workplace. What we can do to help," said Dr. Mark Linzer at Hennepin Healthcare. "Raises an important question. Now that we have a diagnosis, what can we do?"
Drug seizures for Minnesota's Violent Crime Enforcement Teams increased in several major drug categories in 2018. The increase in drug seizures corresponds with studies that have found a rise in drug use among Minnesotans and nationally. Dr. Tyler Winkelman of Hennepin Healthcare says research has shown that hospitalizations related to methamphetamine increased 270 percent nationally between 2008 and 2015.
Seizures of methamphetamine in Minnesota surged at an alarming level last year, as have confiscations of other illicit drugs, state public safety officials said, and a major bust already this year suggests the influx is not letting up. Dr. Tyler Winkelman, a physician and researcher at Hennepin Healthcare, said the “unintended consequences of getting rid of local meth labs with the crackdown on Sudafed” — the over-the-counter product that provides a key ingredient for making meth — is “that opened up the meth cartels from Mexico.”
What is the background for this study? What are the main findings?
Response: Kidney transplantation confers profound survival, quality of life, and cost benefits over dialysis for the treatment of end-stage kidney disease. Kidney transplant recipients under 65 years of age qualify for Medicare coverage following transplantation, but coverage ends after three years for patients who are not disabled.
Drug seizures for Minnesota’s Violent Crime Enforcement Teams (VCET) increased in several major drug categories in 2018, according to the Minnesota Department of Public Safety. The increase in drug seizures corresponds with studies that have found a rise in drug use among Minnesotans and nationally. According to research conducted by Dr. Tyler Winkelman of Hennepin Healthcare, hospitalizations related to methamphetamine increased nationally by 270 percent from 2008-2015, faster that any other form of substance abuse. The number of women using methamphetamine during pregnancy has increased significantly since 2008, particularly in rural areas.
Researchers from the University of Minnesota and Hennepin County hope to use a recent study regarding opioid-related deaths after incarceration to address the opioid epidemic. About one-third of opioid-related deaths in Hennepin County occurred within one year of inmates leaving jail, according to a report released by the county last month. Now, public health care officials and University researchers hope to offer care to incarcerated individuals with opioid use disorder based on the report’s recommendations. "Our workgroup made recommendations to begin treating people with opioid use disorders in county correctional facilities," said Tyler Winkelman, an author of the report, clinician-investigator with Hennepin Healthcare and assistant professor of medicine at the University. The treatment would include providing medications to incarcerated individuals with opioid use disorder and connecting them to community providers upon release.
New research by a local team of doctors is proving to be life-changing for people paralyzed by spinal cord injuries. It’s giving hope to thousands who previously thought they would never walk again. It took the University of Minnesota and Hennepin Healthcare two years to get through all of the paperwork, including grant approvals. It’s especially unique because doctors are studying patients who have been paralyzed for multiple years.
There are more than 290,000 people estimated to be living in the United States with a spinal cord injury. Previously, it has been shown that it is possible to restore some function to young and healthy patients within a few years of injury. Now, researchers show spinal cord stimulation can immediately restore some voluntary movement and autonomic functions such as cardiovascular, bowel, and bladder years after a paralyzing injury without any significant rehabilitation. "This was an opportunity to use epidural stimulation, combine my background in mathematics, collaborate with people from multiple disciplines including biomedical engineering and set up a truly innovative trial," said Dr. David Darrow, a neurosurgery resident at the University of Minnesota Medical School and a lead investigator for the E-STAND Clinical trial. He is also a senior neurosurgery resident at Hennepin Healthcare and University of Minnesota Medical Center.
There are more than 290,000 people estimated to be living in the United States with a spinal cord injury. Previously, it has been shown that it is possible to restore some function to young and healthy patients within a few years of injury. Now, researchers show spinal cord stimulation can immediately restore some voluntary movement and autonomic functions such as cardiovascular, bowel, and bladder years after a paralyzing injury without any significant rehabilitation. "This was an opportunity to use epidural stimulation, combine my background in mathematics, collaborate with people from multiple disciplines including biomedical engineering and set up a truly innovative trial," said Dr. David Darrow, a neurosurgery resident at the University of Minnesota Medical School and a lead investigator for the E-STAND Clinical trial. He is also a senior neurosurgery resident at Hennepin Healthcare and University of Minnesota Medical Center. "We wanted to push the envelope for patients. Once we determined it worked, we moved on to knocking down other barriers to translation to patient care."
Seasonal flu and other respiratory infections may be especially dangerous for kidney failure patients, researchers say. A new study found that influenza-like illnesses likely contribute to more than 1,000 deaths among kidney failure patients in the United States each year. These illnesses include potentially serious respiratory tract infections caused by flu and other viruses. For the study, David Gilbertson, co-director of the Chronic Disease Research Group at Hennepin Healthcare Research Institute in Minneapolis, and his colleagues reviewed 14 years of federal data.
Community activity for influenza-like illness (ILI) is associated with seasonal variation in all-cause mortality among patients with end-stage renal disease (ESRD), according to a study published online January 24 in the Journal of the American Society of Nephrology. David T. Gilbertson, PhD, from the Hennepin Healthcare Research Institute in Minneapolis, and colleagues calculated quarterly relative mortality compared with average third-quarter (summer) death counts after addressing overall increasing trends in death due to the growing prevalent ESRD population. Linear regression models were used to assess the correlation between ILI data and mortality.
In patients with kidney failure, influenza-like illness (ILI) likely contributes to more than 1,000 deaths per year. The finding, which comes from a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN), points to the importance of protection against, surveillance of, and, where possible, treatment of such infections in patients with kidney dysfunction.
The extent to which ILI contributes to mortality in patients with ESRD is unclear. To investigate, David Gilbertson, Ph.D. (Hennepin Healthcare Research Institute and the University of Minnesota) and his colleagues analyzed data from the Centers for Disease Control and Prevention Outpatient ILI Surveillance Network and the Centers for Medicare & Medicaid Services ESRD database from 2000-2013.
Flu-like illness contributed substantially to mortality for people with end-stage renal disease (ESRD), an analysis spanning 14 years of U.S. data indicated. During influenza season -- the 6 months from October to March -- excess deaths averaged more than 1,000 annually among the at-risk ESRD population, according to David Gilbertson, PhD, of the Hennepin Healthcare Research Institute and the University of Minnesota, and colleagues, pointing to influenza-like illness (ILI) as the likely reason.
Kristen Philman had already been using heroin and prescription painkillers for several years when, one day in 2014, a relative offered her some methamphetamine, a chemical cousin to the stimulant amphetamine. "I didn't have any heroin at the time," says Philman, a resident of Littleton, Colo. "I thought, 'Oh this might make me feel better.' "It did, she says. Soon, she was using both heroin and methamphetamine on a regular basis.
Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing, issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand the challenges physicians face.
Mark Linzer, MD, director of the division of general internal medicine at Hennepin County Medical Center in Minneapolis, has long studied physician burnout.
“Burnout doesn’t have to be highly expensive to fix,” said Dr. Linzer, director of the HCMC Center for Patient and Provider Experience. “Preventing burnout can actually save money in the long run on recruiting and training new practice staff.”
The number of people hospitalized because of amphetamine use is skyrocketing in the United States, but the resurgence of the drug has largely been overshadowed by the nation’s intense focus on opioids.
Amphetamine-related hospitalizations jumped by about 245 percent from 2008 to 2015, according to a study published last month in the Journal of the American Medical Association. That dwarfs the rise in hospitalizations from other drugs, such as opioids, which were up by about 46 percent. The most significant increases were in Western states.
The JAMA study, based on hospital discharge data, found that the cost of amphetamine-related hospitalizations had jumped from $436 million in 2003 to nearly $2.2 billion by 2015. Medicaid was the primary payer.
For those with a substance use disorder, the risk of death from an overdose in the two weeks after leaving prison is 10 times higher than in the general population, said Dr. Tyler Winkelman of the Minneapolis-based Hennepin Healthcare, who researches health
issues in the criminal justice system.
Because there has been so much attention on opioids, “we have not been properly keeping tabs on other substance use trends as robustly as we should,” said study author Dr. Tyler Winkelman, a physician at Hennepin Healthcare in Minneapolis.
The number of people hospitalized because of amphetamine use is skyrocketing in the United States, but the resurgence of the drug largely has been overshadowed by the nation’s intense focus on opioids.
The number of people hospitalized because of amphetamine use is skyrocketing in the United States, but the resurgence of the drug largely has been overshadowed by the nation’s intense focus on opioids. Amphetamine-related hospitalizations jumped by about 245% from 2008 to 2015, according to a recent study in the Journal of the American Medical Association.
11 a.m. – MPR News at 11
An estimated 30,000 people died from opioid overdoses in the U.S. in 2017. With so many people being affected what is being done to treat addiction?
Dr. Diana Cutts, a pediatrician from Hennepin Healthcare, part of the FoodRx program, said the dilemmas poor families face are real and wrenching.
“One of the problems with addiction treatment is that it’s generally been put on the patient to take care of on their own. We wouldn’t tell someone with cancer or heart disease to go make an appointment and hope they get better,” said Dr. James Miner, chief of emergency medicine at HCMC. “The goal now is to get people started on treatment and on the road to recovery right away.”
Aspirin has been a top topic all week — in clinics, living rooms and offices — because
three studies challenged the guidance for certain older adults taking it daily.
The latest study, known as ASPREE, followed 15,000 healthy adults ages 70 and older
over five years. It found that those taking aspirin had no greater protection from
disabilities or heart attacks but did have higher drug-related risks of internal bleeding.
Margolis and Bloomington-based HealthPartners enrolled 250 adults. Minneapolis-based
Hennepin Healthcare led the U.S. arm of the study, which was based in Australia.
Dr. Anne Murray, the Hennepin geriatrician who led the research, has been flooded with
questions about her results: “It’s been a combination of patients and colleagues, some of
whom are taking aspirin themselves.”
Many older people who’ve survived a heart attack or stroke take low-dose aspirin every day to help prevent further cardiovascular problems . There is compelling evidence that this works. But should perfectly healthy older folks follow suit?
Most of us would have guessed “yes”—but the answer appears to be “no” when you consider the latest scientific evidence. Recently, a large, international study of older people without a history of cardiovascular disease found that those who took a low-dose aspirin daily over more than 4 years weren’t any healthier than those who didn’t. What’s more, there were some unexpected indications that low-dose aspirin might even boost the risk of death.
The long-awaited results of the Aspirin in Reducing Events in the Elderly (ASPREE) trial, partly funded by NIH, were presented in three papers just published in the New England Journal of Medicine [2,3,4]. It’s the largest primary prevention study ever undertaken in healthy older people.
To take a closer look, a research team led by John McNeil, Monash University, Melbourne, Australia, and Anne Murray, Hennepin Healthcare Research Institute, Minneapolis, launched the ASPREE trial in 2010.
A major international study led in part by a Minnesota physician has found that healthy
people over age 70 got no preventive benefit from aspirin and were at greater risk for
harm such as stomach bleeding. It's the third major study this year to reach a similar
"We hope this shifts the paradigm for people 70 and older who are considering taking
aspirin," said Dr. Anne Murray, a geriatrician at Hennepin Healthcare in Minneapolis
who led the research along with Dr. John McNeil in Australia.
Many heart-healthy older people take a daily baby aspirin out of a belief that it will help prevent a
heart attack or stroke. A major new study, published online Sunday in three articles in the New England Journal of Medicine (NEJM), now calls that common practice into serious question. It found that for older people with no history of heart attack, stroke or congestive heart failure taking a daily aspirin might do more harm than good.
”We found there was no discernible benefit of aspirin on prolonging independent, healthy life for the elderly,” Dr. Anne Murray, one of the authors of the study and an epidemiologist and geriatrician at Hennepin Healthcare in Minneapolis, told National Public Radio (NPR) reporter Rob Stein.
Read the MinnPost story
In healthy elderly people who never had a heart attack, the widespread practice of taking a baby aspirin every day may do more harm than good, according to a U.S.-Australian study of more than 19,000 volunteers.
The results - which show that risks of major bleeding in low-dose aspirin users overwhelm any heart benefits - were reported online in the New England Journal of Medicine and presented Sunday at the European Respiratory Society International Congress in Paris.
Read the Reuters story on FOX NEWS
It's one of the most well-known tenets of modern medicine: An aspirin a day keeps the doctor away. But according to a trio of studies published Sunday in the New England Journal of Medicine, a daily low-dose aspirin regimen provides no significant health benefits for healthy older adults. Instead, it may cause them serious harm.
Should older people in good health start taking aspirin to prevent heart attacks, strokes,
dementia and cancer?
No, according to a study of more than 19,000 people, including whites 70 and older, and
blacks and Hispanics 65 and older. They took low-dose aspirin — 100 milligrams — or a
placebo every day for a median of 4.7 years. Aspirin did not help them — and may have
Read the story in The New York Times
The possible utility of aspirin for primary prevention has taken another blow with new results showing no benefit of treatment in extending disability-free survival, a novel endpoint that combines all-cause death, dementia, or physical disability, among healthy elderly persons.
A second report showed no significant reduction in cardiovascular disease but a significantly higher risk for major hemorrhage, and a third analysis showed higher all-cause mortality with aspirin therapy, mostly attributed to increased cancer risk, although the researchers urge caution in interpreting this latter finding.
The results, from the Aspirin in Reducing Events in the Elderly (ASPREE) trial, were published online September 16 in three separate papers in the New England Journal of Medicine (NEJM).
Many healthy Americans take a baby aspirin every day to reduce their risk of having a heart attack, getting cancer and even possibly dementia. But is it really a good idea?
Results released Sunday from a major study of low-dose aspirin contain a disappointing answer for older, otherwise healthy people.
"We found there was no discernible benefit of aspirin on prolonging independent, healthy life for the elderly," says Anne Murray, a geriatrician and epidemiologist at Hennepin Healthcare in Minneapolis, who helped lead the study.
A regimen of low-dose aspirin “offers healthy, older people no benefit in staving off cardiovascular disease, dementia or disability and increases their risk of bleeding in the digestive tract and brain, according to a large study released Sunday.” The article says that research indicates “a regimen of low-dose aspirin offers healthy, older people no benefit in staving off cardiovascular disease, dementia or disability and increases their risk of bleeding in the digestive tract and brain.” The findings were published in three articles in the New England Journal of Medicine. In a news release, Richard J. Hodes, Director of the National Institute on Aging, said, “Clinical guidelines note the benefits of aspirin for preventing heart attacks and strokes in persons with vascular conditions such as coronary artery disease.” Hodes added, “The concern has been uncertainty about whether aspirin is beneficial for otherwise healthy older people without those conditions.” To view the NEJM articles, click here, here, and here.
Researchers determined that after nearly five years in treatment, participants’ “rate of heart disease was not significantly lower,” although the “rate of major bleeding with daily aspirin use was 3.8 percent, versus 2.8 percent with placebo.” Lead author Dr. John J. McNeil of Monash University commented, “Essentially, we could not identify any subgroup in whom aspirin was beneficial in preserving good health.”
For decades, a daily dose of aspirin has been widely considered a way to protect healthy people from cardiovascular disease and even cancer. But a large international study finds that even at low doses, long-term use of aspirin may be harmful — without providing any benefit — for older people who have not already had a heart attack or stroke.
The new research reinforces the results of a study published in late August, which found that daily low-dose aspirin was too risky to be prescribed to patients at moderate risk of heart disease. In the August study and the new one, researchers found a significant risk of internal gastric bleeding caused by the medication, which thins the blood. Older patients experienced no health benefits from taking aspirin, according to the new report, published Sunday in the New England Journal of Medicine.
“We knew there would an increased risk of bleeding with aspirin, because there has always been," said study coauthor Dr. Anne Murray, a geriatrician and epidemiologist at the Hennepin Healthcare Research Institute and the University of Minnesota, Minneapolis. "But not only did it not decrease risk of disability or death, it did not decrease the risk of heart attack and stroke, and there was an increase in the rate of death."
Another clinical trial has added more evidence against the fairly common practice of prescribing aspirin to healthy older adults in order to prevent the onset of cardiovascular disease.
The clinical trial, which ran from 2010 to 2014 and included 19,114 individuals 70 years and older from the U.S. and Australia, found that a low daily dose of aspirin only marginally decreased a patient's risk of cardiovascular disease while significantly increasing the patient's risk of hemorrhage. Additionally, higher death rates were reported among those taking aspirin daily although the researchers are skeptical about how much weight to put on the finding since it's an unexpected outcome compared to similar studies.
"For a healthy person 70 and older who doesn't have an indication to be on aspirin, there really is no benefit to be on aspirin, in fact, the risks appear to outweigh the benefits in terms of increase bleeding risk and the potential for increased mortality risk," said Dr. Anne Murphy, co-principal investigator of the trial and director of the Berman Center for Outcomes and Clinical Research.
Millions of healthy people who take aspirin to ward off illness in old age are unlikely to
benefit from the drug, a trial has found.
While a daily dose of the blood-thinning medicine can protect older people who have
previously experienced heart attacks, strokes and angina, researchers found the drug did
not extend the lifespan of healthy people over the age of 70.
Doctors in Australia and the US enrolled more than 19,000 healthy people, mostly aged
over 70, for the trial. Half the participants were asked to take 100mg of aspirin each day,
while the rest took a placebo pill.
People addicted to prescription opioids or heroin are far more likely to have run-ins with the
law than those who don't use opioids, according to a new study published Friday in JAMA
"There have been reports that jails and prisons are bearing the brunt of the opioid epidemic,
but we didn't know nationally how many people who use opioids are involved in the criminal
justice system," says Tyler Winkelman, a clinician-investigator at Hennepin Healthcare in Minneapolis, and lead author of the study.
Providing integrated medical care and social support services led to increased use of
primary care among vulnerable adults who were enrolled in a Medicaid accountable
care organization (ACO), according to two studies published in Medical Care Research
One study used Medicaid claims data for about 90,000 enrollees to compare the use of
medical services by Hennepin Health (Hennepin County, MN) ACO enrollees to non-ACO
Medicaid enrollees in the same geographic area.
The second study used interview data from 35 Hennepin Health members enrolled for two or more years during the study period.
People take a vaccine for the flu every year to avoid getting sick, but researchers across the country are working on a vaccine to help opioid addicts avoid overdosing.
"Ultimately, I think it can save lives. A vaccine like this could offer sort of long lasting protection," said senior investigator at the Minneapolis Medical Research Foundation (MMRF) Dr. Marco Pravetoni. Pravetoni and his team at MMRF have been working on a vaccine for the last 10 years, with their primary focus on the prescription painkiller oxycontin.
Read the CircaNews story