Sleep Deprivation: Specific Molecular Changes Lead To Memory Impairment

MedicalResearch.com Interview with:
Jennifer Choi Tudor, Ph.D. Postdoctoral Fellow
Ted Abel Lab Department of Biology 10-17
Smilow Center for Translational Research
Philadelphia, PA 19104

Medical Research: What is the background for this study? What are the main findings?

Dr. Tudor: We (Dr. Tudor, Dr. Abel, and colleagues) are interested in better understanding the molecular changes that occur with sleep deprivation.  Previously, we found that the expression of over 500 genes changes with sleep deprivation and that many of the genes were involved with protein synthesis.  Upon further investigation, we found that 5 hours of sleep deprivation impairs protein synthesis in the hippocampus, a brain region critical for memory.  This impairment is due to changes in mammalian target of rapamycin (mTOR) signaling and eukaryotic initiation factor 4E binding protein 2 (4EBP2) is critical to this process.  When we boosted levels of 4EBP2 in the hippocampus, mice that were sleep deprived were resistant to the detrimental effects of sleep deprivation on memory.
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Musical Training Enhances Long Term Memory

MedicalResearch.com Interview Invitation with:
Dr. Heekyeong Park
Assistant Professor of Psychology
University of Texas at Arlington

Medical Research: What is the background for this study? What are the main findings?

Dr. Park: This study shows that music experts with extensive musical training may have altered neural processing related to improved memory.

There has been much interest in the beneficial effects of musical training on cognition. Notably, musical training has been reported to boost processing of verbal material. Previous studies have indicated that musical training was related to superior verbal working memory and that these differences in musical training were associated with differences in neural activity in brain regions important for verbal processing. However, it was not clear whether musical training impacts memory in general, beyond working memory for verbal items. By recruiting professional musicians with vast instrumental training, we investigated if extensive musical training has a broad impact on memory with corresponding changes in the brain.

For this study, we compared highly trained musicians (10+ years of experience) and individuals with little or no formal musical training on working memory and long-term memory tasks. Each memory task included both verbal and pictorial items. We measured memory accuracy on tasks and scalp-recorded changes in the brain’s electrical activity (ERPs) while participants studied and remembered items. Musicians showed enhanced performance on the working memory task for both words and pictures. For the long-term memory task, musicians also remembered studied pictures better than non-musicians. These behavioral findings demonstrate the relationship between extensive musical training and improved memory broadly. ERP waveforms were also different between musicians and non-musicians while they performed long-term memory tasks.

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Flu Season Linked To Increase in Acute Aortic Dissection

MedicalResearch.com Interview with:
Harleen Sandhu, MD MPH
Senior Researcher
University of Texas Health Science Center at Houston

Medical Research: What is the background for this study? What are the main findings?

Dr. Sandhu: Previous studies have shown a correlation between seasonal variations and occurrence of acute aortic dissection, however, reasons for such associations are unknown. Seasonal flu activity has been associated with the occurrence of cardiovascular diseases such as acute myocardial infarction in the past. This led us to verify this seasonal correlation in our experience with acute aortic dissection patients and to further investigate if its incidence was associated with flu activity. Our results confirmed the seasonal variation in acute aortic dissection as well as demonstrated a positive correlation with seasonal flu activity.

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Benefits of Medication Therapy Management Remain Unclear

MedicalResearch.com Interview with:
Meera Viswanathan, PhD
RTI International, Research Triangle Park
North Carolina

Medical Research: What is the background for this study? What are the main findings?

Dr. Viswanathan: Medications, when used appropriately, can alleviate symptoms. Often, however, they result in side effects, interact with one another, are prescribed incorrectly, or are taken incorrectly. These problems are particularly pronounced for the elderly who may have multiple chronic conditions and may be on numerous medications. We evaluated a variety of research studies and program evaluations regarding a distinct type of health care service known as Medication Therapy Management or “MTM.” The goals of MTM services are to help patients and their clinicians to optimize prescription and nonprescription drug regimens, thereby achieving better health outcomes from drug therapy, and. at the same time to minimize the potential for harms, such as incorrect dosing and duplicate medications. Some have proposed that optimizing drug regimens and preventing adverse drug events may reduce health-care-related costs.

Medication Therapy Management services are most often provided directly to patients by pharmacists. Sometimes the same pharmacists who dispense medications to patients offer Medication Therapy Management services as well; in other models, pharmacists working in a nondispensing role within a health care system, health insurance plan administering a prescription drug benefit program, or a centralized pharmacy call center may offer such services Although Medication Therapy Management can vary quite substantially in specifics, Medication Therapy Management programs in general share common elements; these include medication therapy review of all prescription drugs, over-the-counter products, and herbal or dietary supplements; patient education and counseling to solve issues with the drug regimen that a patient may be experiencing, such as side effects or difficulty remembering to take medications; and coordination and communication with the prescribing provider. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 allowed Medicare to expand access to Medication Therapy Management services for selected patients through Medicare Part D prescription drug benefits.

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Fat Around the Heart Increases Risk of Atrial Fibrillation

Mark Rabbat, MD Assistant Professor of Medicine and Radiology Division of Cardiology at Loyola University Medical CenterMedicalresearch.com Interview with:
Mark Rabbat, MD
Assistant Professor of Medicine and Radiology
Division of Cardiology at Loyola University Medical Center

MedicalResearch.com: What are the main findings of this study?

Dr. Rabbat : Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice and is responsible for significant morbidity and mortality. Epidemiologic data suggest that obesity as measured by one’s BMI is a risk factor for Atrial fibrillation. But there is more to the story. What may be even more important than overall BMI is how much fat you have around the heart. There are many individuals who, as measured by their BMI, are not considered obese, but they have high volumes of fat around their heart, which may have been a major cause for their atrial fibrillation. Therefore, simple measures such as BMI may fail to completely inform us of a patient’s true CV risk.

In a previous study we found that epicardial adipose tissue (EAT), or the fat around the heart, has been associated with the presence and severity of AF independent of known risk factors and body mass index (BMI). The inflammatory mediators released from the fat are metabolically active, and may promote fibrosis in adjacent heart muscle. Fibrosis of the left atrium appears to be a hallmark feature of atrial fibrillation and higher amounts of fibrosis are linked to recurrence of atrial fibrillation. New innovations in cardiac magnetic resonance imaging (CMR) allow LA fibrosis and EAT to be precisely quantified. Our current study is the first of its kind to demonstrate the association of EAT volume and extent of LA fibrosis in human AF independent of LA size, BMI, and other AF risk factors.

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Maternal Touch Activates Genes That Alleviate Pain in Infants

MedicalResearch.com Interview with:
Regina Marie Sullivan PhD

Professor Child and Adolescent Psychiatry
Nathan Kline Institute
The Child Study Center at NYU Langone Medical Center
Department of Child and Adolescent Psychiatry
One Park Ave 8th Floor, New York, NY 10016

Medical Research: What is the background for this study? 

Dr. Sullivan: Managing pain during medical procedures in a critically important issue in medicine today. Our study was designed to better understand one method of reducing pain in young infants – having the caregiver be in contact with the baby during the painful procedure, which reduces the infant’s behavioral response to the medical procedure. This study explored the neural basis of the ability of the caregiver to reduce the pain response.

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New Cholesterol Management Guidelines Not Fully Implemented in Medical Practice

Thomas M. Maddox MD MSc Cardiology, VA Eastern Colorado Health Care System Associate Director, VA CART ProgramMedicalResearch.com Interview with:
Thomas M. Maddox MD MSc
Cardiology, VA Eastern Colorado Health Care System
Associate Director, VA CART Program
Associate Professor, Department of Medicine
University of Colorado School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Maddox: With the release of the updated cholesterol guidelines last year and their significant changes in recommendations, we wanted to see what the potential impact would be on U.S. cardiovascular practices.  Specifically, we were interested in present cholesterol treatment and testing patterns, and how they would potentially need to change under the new guidelines.

We used the PINNACLE registry to conduct our investigation.  Under the sponsorship of the American College of Cardiology, the registry collects EMR data from 111 cardiovascular practices around the U.S.  We analyzed cholesterol treatment and testing patterns in approximately 1.2 million patients.  We found that most patients qualified for cholesterol treatment with statins, but 32.4% weren’t currently prescribed them.  We also found that 22.6% of patients were being treated with non-statin lipid-lowering therapies which, under the new guidelines, aren’t currently recommended for cholesterol treatment.  Finally, we found that 20.8% of patients underwent repeated LDL-C testing, which may not be necessary under the new guidelines.
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Smoking Cessation Key To Improving Quality of Life in Asthmatic Adolescents

MedicalResearch.com Interview with:
Dr. Wanjun Cui, MS PhD
Department of Health and Human Services,
Centers for Disease Control and Prevention (CDC)

Medical Research: What is the background for this study? What are the main findings?

Authors’ response: Asthma is a leading chronic disease among adolescents that adversely affects their health. However, it is unclear how asthma influences their perceived health or health-related quality of life (HRQOL). Because their perceptions of their health may differ from those of their caregivers (such as parents or health professionals), knowing how adolescents with asthma would rate their own health is very important. Our study compares the responses of adolescents with and without asthma about different aspects of HRQOL including their overall health, their recent physical health, their recent mental health, and their recent activity limitations due to health. Unlike previous U.S. studies based on small clinical samples, our study used a nationally representative sample of U.S. adolescents that can be generalized to the whole U.S. adolescent population.

We found that asthma is adversely associated with almost all these aspects of HRQOL but only among those with asthma and current symptoms such as wheezing and dry cough. Adolescents with asthma without current symptoms did not report significantly worse HRQOL than those without asthma. For example, compared with those who never had asthma, adolescents with asthma and symptoms of dry cough or wheezing reported significantly more fair or poor self-rated health (14% vs. 8%), 34% more recent physically unhealthy days , and 26% more recent mentally unhealthy days. More importantly, adolescents with asthma who currently smoked cigarettes or reported limited physical functioning reported even worse physical and mental HRQOL.
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Telephone CPR May Improve Out-of-Hospital Cardiac Arrest Survival

Bentley Bobrow, MD, Medical Director Bureau of Emergency Medicine Services and Trauma System Arizona Department of Health Services, Phoenix Professor, University of ArizoneaMedicalResearch.com Interview with:
Bentley Bobrow, MD,
Medical Director
Bureau of Emergency Medicine Services and Trauma System
Arizona Department of Health Services, Phoenix
Professor, University of Arizona

Medical Research: What is the background for this study? What are the main findings?

Dr. Bobrow: Out-of-Hospital Cardiac Arrest is a leading cause of death worldwide. There are nearly half a million EMS-assessed Out-of-Hospital Cardiac Arrest s in the United States annually. Bystander CPR (B-CPR) before arrival of EMS can double or even triple survival from OHCA. Yet it occurs in only 1/3 of cases. Telephone CPR – the provision of B-CPR with a 9-1-1 telecommunicator’s instructions – is independently associated with increased rates of Bystander CPR and patient survival and requires almost no capital investment. For this reason, we believe Telephone CPR may be THE most effective and efficient way to move the needle on OHCA survival. In order to achieve this potential, however, EMS systems must adopt the latest guideline recommendations for T-CPR and continuously measure system performance. Very few systems do this. The aim of our project was to do just this at multiple 9-1-1 centers in Arizona. We implemented the guidelines and measured the impact on process metrics and patient outcomes. Our findings confirmed what we expected: a significant increase in the proportion of cases where T-CPR was performed, a significant reduction in time from call-receipt to first bystander chest compression, and, most importantly, significant increases in patient survival and survival with positive neurologic outcome. Continue reading

Low Dose Chest CT of High Risk Patients Results In Fewer Lung Cancer Deaths

MedicalResearch.com Interview with
Dr. Peter Mazzone MD, FCCP
Regarding
CHEST lung cancer experts recent policy statement to CMS Committee on Coverage for Lung Cancer Screening
Medical Research: What is the background for this study? What are the main findings?

Dr. Mazzone: The National Lung Screening Trial showed that lung cancer screening of a well-defined group, at high risk of developing lung cancer, with a low dose chest CT scan results in fewer lung cancer deaths. The results from this large and well supported trial are being translated into clinical practice. Our report describes a framework for developing and monitoring lung cancer screening programs that will help ensure the benefits of screening outweigh the harms.

Medical Research: What should clinicians and patients take away from your report?

Dr. Mazzone: Our report describes 9 key components of high quality lung cancer screening (who to screen, how often and how long, how to perform the scan, defining a positive scan, how to report the scan, how to manage lung nodules, the inclusion of smoking cessation, patient and provider education, and data collection/reporting). It is our hope that clinicians developing lung cancer screening programs will use this framework to provide high quality lung cancer screening.

Medical Research: What recommendations do you have for future research as a result of this report?

Dr. Mazzone: Each component of our report has a section on future research. Lung cancer screening will be optimized through developments within each component (e.g. incorporating lung cancer risk prediction, studying lung nodule management algorithms).

Citation:
Components for High Quality Lung Cancer Screening: American College of Chest Physicians and American Thoracic Society Policy Statement

 

Running Does Not Lead To Knee Osteoarthritis

Dr. Grace Hsiao-Wei Lo Baylor College of Medicine Assistant Professor, Section of Immunology, Allergy and Rheumatology, Department of Medicine, Baylor College of Medicine Faculty, Immunology, Allergy, and Rheumatology Section, Michael E. DeBakey VA Medical CenterMedicalResearch.com Interview with:
Dr. Grace Hsiao-Wei Lo
Baylor College of Medicine
Assistant Professor, Section of Immunology, Allergy and Rheumatology,  Department of Medicine, Baylor College of Medicine
Faculty, Immunology, Allergy, and Rheumatology Section,
Michael E. DeBakey VA Medical Center

Medical Research:What is the background for this study? What are the main findings?

Dr. Hsiao-Wei Lo: Controversy exists regarding whether running is harmful versus beneficial to the knee.  There is concern that chronic repetitive loading of the knee could physically damage structures within the knee.  Alternatively, runners have a lower body mass index, which we know is protective of knee osteoarthritis.  Limitations of prior studies evaluating the relationship between running and osteoarthritis include that they have been small studies and they have focused on those participating in a high level or an elite level of running which may not be very generalizable.  Addressing the question of whether running is associated with osteoarthritis is of particular relevance given that recent CDC guidelines recommend that all adults participate in regular physical activity, as there is definitive evidence that increased physical activity is associated with reduced cardiovascular events and mortality.

To address this question, we used data from a multicenter observational study, the Osteoarthritis Initiative (OAI). Of 2,683 participants, 56 percent were female, the mean age was 64.5 and the mean BMI was 28.6.  Twenty-nine percent of the participants reported that they ran at some time in their lives.

Patients had knee X-rays, were given symptom assessments, and were asked to complete the Lifetime Physical Activity Questionnaire (LPAQ), identifying the top three most frequently performed physical activities (≥ 10 times in life) they performed at different age ranges throughout their life. Age ranges included 12-18, 19-34, 35-49, and 50 years or older.

Knee X-rays were taken and then scored for evidence of radiographic OA using the Kellgren-Lawrence (KL) grade scale. Participants with KL grades of two or higher were considered as having radiographic OA (ROA). The researchers also measured if participants had frequent knee pain. Researchers considered a participant to have symptomatic OA (SOA) if they had at least one knee with both ROA and frequent knee pain. Anyone with a total knee replacement was classified as having frequent knee pain, ROA and SOA.

After collecting all the data, the researchers reported that runners, regardless of the age when they ran, had a lower prevalence of knee pain, ROA and SOA than non-runners. For people who had run at any time in their lives, 22.8 percent had SOA compared to 29.8 percent of non-runners. People with the lowest BMI scores were the most likely to report being habitual runners. Regular running, even at a non-elite level, not only does not increase the risk of developing knee osteoarthritis but may protect against it, the researchers concluded.  Continue reading

More Women Choosing Mastectomy For Early Breast Cancer Management

MedicalResearch.com Interview with:
Dr. Kristy Lynn Kummerow MD

Division of Surgical Oncology and Endocrine Surgery
Vanderbilt University Medical Center
Tennessee Valley Healthcare System, Veterans Affairs Medical Center
Geriatric Research, Education, and Clinical Center
Nashville, Tenn

Medical Research: What is the background for this study? What are the main findings?

Dr. Kummerow: This study looked at how we are currently treating early stage breast cancer in the US – early stage breast cancer includes small cancers with limited or no lymph node involvement and no spread to other body site – it was prompted by something we observed an our own cancer center, which is that more and more women seem to be undergoing more extensive operations than are necessary to treat their cancer.  It is helpful to understand the historical context of how we treat early breast cancer.  Prior to the 1980s, the standard of care for any breast cancer was a very extensive procedure, which involved removal of the entire breast, as well as underlying and overlying tissues and multiple levels of lymph nodes drained by that area.  Informative clinical trials were completed in the 1980s demonstrated that these extensive procedures were unnecessary, and that equivalent survival could be achieved with a much more minimal operation, by removing only the tumor, with a margin of normal breast tissue around it, and performing radiation therapy to the area; this technique is now known as breast conservation surgery, also known as lumpectomy with radiation.  In the 1990s, breast conservation was established by the national institutes of health and was embraced as a standard of care for early stage breast cancer; performance of breast conservation surgery also became a quality metric – accredited breast centers in the US are expected to perform breast conservation surgery in the majority of women who they treat for breast cancer.  However, what our research team observed at our institution didn’t fit – over time it appears more aggressive surgical approaches are being used for more women.  This has been found in other institutions as well, and is supported by smaller national studies.  We wanted to understand how surgical management of early breast cancer is changing over time at a national level using the largest data set of cancer patients in the United States.

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Childhood Skin Prick Allergies Remain Predictive of Future Allergies

MedicalResearch.com Interview with:
Maria Pesonen MD, PhD
Specialist in Dermatology
Assistant Chief Medical Officer
Finnish Institute of Occupational Health
Occupational Medicine Helsinki, Finland

Medical Research: What is the background for this study? What are the main findings?

Dr. Pesonen: Skin prick test is a widely used, established methods in assessing immediate (i.e. immunoglobulin E-mediated) sensitization. However, the knowledge on long-term reproducibility and predictive value of skin prick testing in children has been limited. We assessed the predictive value of skin prick testing in the setting of a follow-up study on healthy, unselected newborns, who were followed up to age 20 years with skin prick testing with 11 common allergens, structured interview and clinical examination at ages 5, 11 and 20 years. The reproducibility of skin prick test positivity at age 5 years was 100% at ages 11 and 20 years, i.e. none of the skin prick positive subjects turned negative during the follow-up. Gaining of new sensitizations to aeroallergens was common. Skin prick test positivity at age 5 years predicted allergic symptoms at ages 11 (sensitivity 28%, specificity 94%) and 20 years (sensitivity 23%, specificity 91%), but not atopic dermatitis.
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Moderate Alcohol Ingestion May Not Benefit Everyone

MedicalResearch.com Interview with:
Kirsten Mehli
Department of Public Health and Community Medicine,
Sahlgrenska Academy, University of Gothenburg,
Gothenburg, Sweden

Medical Research: What is the background for this study?

Dr. Mehlig: Many studies found that the ‘good’ HDL-cholesterol is associated with lower risk for atherosclerosis, and cardiovascular risk. This finding has not been translated into clinical practice because medical trials with HDL-cholesterol rising medication did rise the HDL-cholesterol but did not prevent CVD. One possible explanation could be that a high level of HDL-cholesterol is but a marker for other factors that truly contribute to reduced cardiovascular risk. One such factor is alcohol consumption, and ethanol intake in grams / day is associated with higher HDL-C in our study, too. Another factor is a certain genotype that has been found to modulate HDL-cholesterol levels. The fact that co-called ‘moderate’ alcohol consumption is beneficial wrt. CVD has been observed and discussed often, and is confirmed in our study. Here, we asked whether the beneficial effect of alcohol was further strengthened by having a favorable CETP genotype wrt. HDL-cholesterol.

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Exercise Improves Outcomes in Dialysis Patients

Prof. Francesca Mallamaci Professor of Nephrology Head of the Hypertension Unit at the Department of Nephro-Urology, CNR-IBIM Research on Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria, ItalyMedicalResearch.com Interview with:
Prof. Francesca Mallamaci
Professor of Nephrology
Head of the Hypertension Unit at the Department of Nephro-Urology, CNR-IBIM Research on Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria, Italy

Medical Research: What is the background for this study? What are the main findings?

Dr. Mallamaci: It is well known that physical activity is beneficial both in normal individuals and in patients with heart failure which represent a high risk category of patients. We have scanty information about physical activity in dialysis patients. So the aim of our study was to test the effectiveness of a low-intensity, easy to implement, home exercise program on physical performance in about 300 dialysis patients in a multicenter, randomized, controlled clinical trial (EXCITE, ClinicalTrials.gov NCT01255969). What we found in our study was that dialysis patients who performed exercise improved their physical performance and this was documented by 2 well known and validated performance tests such as the Six Minute Walking Test and the Sit-to-stand-to sit test. We found also that after 2 year follow-up dialysis patients who were in the active exercise arm had a lower rate of hospitalization and a trend to a better survival, compared to dialysis patients in the control arm of the study. Continue reading

DNA Test May Distinguish Primary From Metastatic Lung Cancer

Marie-Christine Aubry, M.D. Professor of Laboratory Medicine and Pathology Consultant, Department of Laboratory Medicine and Pathology, Mayo Clinic in Rochester, Minn.MedicalResearch.com Interview with:
Marie-Christine Aubry, M.D.

Professor of Laboratory Medicine and Pathology
Consultant, Department of Laboratory Medicine and Pathology,
Mayo Clinic in Rochester, Minn.

 

Medical Research: What is the background for this study? What are the main findings?

Dr. Aubry: Up to 20% of patients will present with multifocal lung cancer or will develop a second lung cancer.  The main clinical issue is distinguishing between independent primaries from true intrapulmonary metastases since this distinction will drive the therapy of the patient.  Currently no ancillary studies allows for this distinction and the distinction is provider specific based on a combination of clinical, radiologic and pathologic assumptions. Based on our prior research using a method called mate pair sequencing , we observed that the probability of detecting identical chromosomal breakpoints in two unrelated tumors, from 2 different patients was basically zero. Similarly, when assessing different components within a single tumor, we always found identical chromosomal breakpoints between these components.  We thus hypothesized that if two tumors within a patient were related, i.e. true metastasis, we should always find a number of identical chromosomal breakpoints between the tumors. And in contrast, if 2 tumors were truly independent primaries, we should not observe any chromosomal breakpoints in common.

We first studied a control group of patients that had
1- a primary lung cancer with a known distant metastasis (usually brain metastasis),
2- two lung cancers of different histologic subtype, adenocarcinoma and squamous cell carcinoma which are accepted as true independent primaries and
3- 1 tumor with different portions of the tumor being analyzed individually and compared as true relatedness.

There were thus a total of 11 pairs of tumors with predetermined status of independent primaries versus relatedness (ie metastasis or same tumor).  The mate pair generated data showed a perfect concordance with this status.  We then studied 11 pairs of lung tumors of similar histology (2 adenocarcinomas or 2 squamous cell carcinomas).  The current gold standard for the distinction between independent primaries and intrapulmonary metastasis relies on a pathologist’s comparative morphologic assessment. In order to strengthen this gold standard, 2 pulmonary pathologists independently made this assessment. Interestingly, the pathologists agreed on the status of independent primaries and intrapulmonary metastasis in 9 (of 11) cases demonstrating the shortcomings of this gold standard.  Furthermore, there were discordance between the pathologists’ prediction and the clinicians’ assessment in 3 of the 11 patients and the clinician could not come to a final assessment in 1 patient.  The MP data was concordant with the pathology assessment in 8 of these 9 cases, and supported the pathologists’ prediction in 2 (of the 3) discordance with the clinical assumptions.

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Obesity, Sedentary Lifestyle May Increase Risk of Breast Cancer

MedicalResearch.com: Interview Invitation
Dr. Wenji Guo
University of Oxford

Medical Research: What is the background for this study?

Response: Previous studies report increased risk for breast cancer in postmenopausal women who have a higher Body Mass Index (BMI) – a measure of body fat based on height and weight. However, BMI is unable to distinguish between excess weight due to fat rather than muscle. More direct measures of fatness, such as body fat percentage, may be better indicators of disease risk. And although probable evidence for the relationship between physical activity and breast cancer now exists, questions still remain over the role of vigorous compared to lower intensity physical activity.

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Cardiovascular Disease Risk Varies By Demographics and Geography

MedicalResearch.com Interview with:
Dr. Quanhe Yang PhD
CDC’s Division for Heart Disease and Stroke Prevention

What is the background for this study? What are the main findings?

Dr. Yang: Our study reveals that an individual’s predicted risk of developing cardiovascular disease (CVD), coronary heart disease (CHD) and stroke over the next decade varies significantly from state-to-state, as well as by demographic factors including age, gender, race-ethnicity and household income.

Among the key findings: the 10-year risk is higher in the Southeast and lower in northwestern states – and higher among men than women. For men, the 10-year risk of developing CVD was 14.6 percent for the nation as a whole, ranging from a low of 13.2 percent in Utah to a high of 16.2 percent in Louisiana. CHD risk among men ranged from 9.5 percent in Utah to 11.7 percent in Louisiana, while stroke risk was 2.1 percent in Utah and 2.6 percent in Louisiana. Among women, CVD risk was 7.5 percent, ranging from 6.3 percent in Minnesota to as high as 8.7 percent in Mississippi. CHD risk for women ranged from 3.8 percent in Minnesota to 5.3 percent in Mississippi, while stroke risk was as low as 1.5 percent in Minnesota and as high as 2.1 percent in Mississippi. Nationally, we found the risk increased significantly with age and was highest among non-Hispanic blacks, those with less than a high school education and those with household incomes below $35,000 .

As part of this study, CDC researchers analyzed data from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2010, as well as the 2009 Behavioral Risk Factor Surveillance System, the world’s largest ongoing telephone health surveillance system. The state-based, random-digit-dialed phone survey included information from almost 300,000 U.S. residents between the ages of 30 and 74.

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Genetically Low Vitamin D Levels Linked To Increased Mortality

MedicalResearch.com Interview with:
Børge G Nordestgaard, MD, DMSc

Professor, University of Copenhagen
Chief Physician, Herlev Hospital, Copenhagen University Hospital
Dept. Clinical Biochemistry Herlev Ringvej Herlev, Denmark

Medical Research: What is the background for this study? What are the main findings?

Prof. Nordestgaard: Many people take vitamin D supplements with the hope of reducing morbidity and mortality. However, it is unclear whether low vitamin D per se is a direct cause of increased mortality or whether it is simply a marker of poor lifestyle in general and/or underlying hidden disease. Our study involved 95,766 white participants of Danish descent from three cohorts in Copenhagen, who had genetic variants known to affect vitamin D levels. We found that genetically low vitamin D levels were associated with increased all-cause mortality, cancer mortality, and other mortality, but not with cardiovascular mortality. This is important as such genetics studies cannot be explained by poor lifestyle or hidden disease, as neither can change your genes.

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Risk of Sudden Cardiac Death Elevated in Law Enforcement Officers

MedicalResearch.com Interview with:
Vasileia Varvarigou MD
, Visiting Scientist at Harvard School of Public Health and Senior Medical Resident, St Elizabeth’s Medical Center, Tufts Medical School and
Stefanos N Kales MD, MPH, Associate Professor, Harvard School of Public Health, Division Chief of Occupational Medicine, Cambridge Health Alliance/ Harvard Medical School

Medical Research: What is the background for this study?

Response: Previous epidemiologic studies of firefighters have documented markedly increased risks of acute death from heart disease during strenuous activities such as fire suppression as compared to non-emergency duties. We hypothesized that certain law enforcement tasks could serve as an occupational trigger in susceptible police officers, leading to an increased frequency of sudden cardiac death during stressful duties.

Our main objective therefore, was to assess the association between risk of sudden cardiac death and stressful law enforcement duties compared with routine/non-emergency duties.
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