Long Term Exposure to Air Pollutants Linked To Metabolic Alterations Especially in Diabetics

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MedicalResearch.com Interview with:

Maayan Yitshak Sade MPH Chief Scientific Officer, Clinical Research Center, Soroka University Medical Center, Israel

Maayan Yitshak Sade

Maayan Yitshak Sade MPH
Chief Scientific Officer
Clinical Research Center,
Soroka University Medical Center, Israel and

 

Dr-Victor-Novack

Dr. Victor Novack

Victor Novack, MD, PhD
Soroka University Medical Center and Ben-Gurion University in Beer Sheva, Israel

 

MedicalResearch.com: What is the background for this study?

Response: Numerous studies found association between exposure the air pollution and increased risk of cardiovascular and respiratory diseases. In recent years links were found between air pollution and diabetes as well. The scientific evidence supports a causal association between air pollution and oxidative stress, possibly involving impaired metabolism of glucose and lipids. In a recent study performed by our group, we observed a significantly increased risk for ischemic stroke among young adults, associated with air pollution exposure. Following these findings, and as a part of the possible theory linking the association air pollution exposure and cardiovascular diseases, we sought to investigate if this association might be mediated through the well-established cardiovascular risk factors such as abnormal lipid and glucose metabolism.
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Standing Desks Increased Work Productivity Over Time

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MedicalResearch.com Interview with:
Gregory Garrett, BS. MA.
Doctoral Research Assistant
School of Public Health
Texas A&M Health Science Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sedentary behavior in office environments is greatly contributing to obesity, increased body discomfort, and possible reductions in employee productivity. Sit-stand desks have been implemented to aid in reducing sedentary behavior, however employers are concerned that benefits may not offset the initial cost of implementation. In this study, employees with stand-capable workstations were compared to traditional seated employees on an objective measurement of productivity in a call center. The employees were monitored for 6 months and those with the stand-capable workstations were ~46% more productive per hour than their seated counterparts. Additionally, 75% of those with the stand-capable desks reported a significant decrease in body discomfort.

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Inflammatory Biomarker CRP Linked To Heart Disease Risk in African American Women

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MedicalResearch.com Interview with:
Norman C. Wang, M.D., M.S., Assistant professor
University of Pittsburgh School of Medicine
Samar R. El Khoudary, Ph.D., M.P.H.,
Assistant professor of Epidemiology
University of Pittsburgh Graduate School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We examined medical records, blood samples and heart CT scans for 372 black and white women from Pittsburgh and Chicago enrolled in the Study of Women’s Health Across the Nation (SWAN). The women averaged just over 51 years old, were not on hormone replacement therapy and had no known heart disease when enrolled. We then looked at blood levels of five biomarkers linked to inflammation. All of the biomarkers were associated with coronary artery calcification, a predictor of heart disease that is measured with a heart CT scan.

Taking into account the participants’ body mass index (BMI), a measure of overall body fat, we found that obesity was a key factor linking most of the elevated inflammation biomarkers and coronary artery calcification. Regardless of BMI, black women with higher levels of one particular biomarker, C-reactive protein, were more likely to have coronary artery calcification than whites. In fact, black women with coronary artery calcification had an average level of C-reactive protein in their blood that was almost double that of their white counterparts.

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Recent Mental Health Problems Increase Risk of Suicide in Enlisted Soldiers

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MedicalResearch.com Interview with:

Robert J. Ursano, M.D. Professor and Chair Department of Psychiatry/ Director Center for the Study of Traumatic Stress Uniformed Services University of the Health Sciences

Dr. Robert Ursano

Robert J. Ursano, M.D.
Professor and Chair
Department of Psychiatry/ Director
Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Ursano: This study is part of STARRS-LS (Study to address risk and resilience in service members-longitudinal study). STARRS is a group of studies that address suicide risk in the US Army. Suicidal behavior includes suicide ideation, plans, attempts and completions. Understanding the transitions between these is an important goal.

One component of STARRS is the examination of data available on all soldiers who were in the Army 2004-2009. This study examines suicide attempts in soldiers serving 2004-2009 in order to understand the association with deployment and the timing of suicide attempts as well as their association with mental health problems. STARRS is directed to identifying the who, when and where of service member risk. Then interventions can better be developed for these soldiers.

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Newly Discovered Phages Can Target Antibiotic Resistance

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MedicalResearch.com Interview with:

Paul E. Turner Chair of Ecology and Evolutionary Biology, Yale University Microbiology Faculty, Yale School of Medicine New Haven, CT 06520

Dr. Paul Turner

Paul E. Turner Ph.D
Chair of Ecology and Evolutionary Biology,
Yale University
Microbiology Faculty,
Yale School of Medicine
New Haven, CT 06520

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Turner:  Our study concerned the problem of multi-drug resistance in the opportunistic pathogen Pseudomonas aeruginosa, especially the search for promising bacteriophage candidates with biological properties to effectively target these bacteria. We tested whether the binding of phage to outer membrane proteins of multidrug efflux pumps would exert selection for bacteria to avoid virus attack by compromising pump performance – thus suffering increased sensitivity to traditional antibiotics. We discovered a naturally occurring phage that forced the desired evolutionary trade-off; we showed that clinical isolates of P. aeruginosa gained phage resistance, while simultaneously becoming susceptible to several antibiotics that are ordinarily useless in controlling these MDR pathogens.

MedicalResearch.com: What should readers take away from your report?

Dr. Turner: Newly discovered phages can be highly effective at targeting antibiotic resistance mechanisms in MDR bacteria, causing these pathogens to become antibiotic sensitive. Medical use of such resistance targeting phages could greatly improve clinical outcomes by reversing antibiotic resistance in MDR bacterial pathogens.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Turner: We recommend utilizing a ‘rational drug design’ approach to combating antibiotic resistance, especially use of phages to target efflux pump systems in MDR bacteria. This approach could greatly reduce the burden to rely on drugs of last resort and would extend the lifetime of our current antibiotic library.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Benjamin K. Chan, Mark Sistrom, John E. Wertz, Kaitlyn E. Kortright, Deepak Narayan, Paul E. Turner. Phage selection restores antibiotic sensitivity in MDR Pseudomonas aeruginosa. Scientific Reports, 2016; 6: 26717 DOI:10.1038/srep26717

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Too Many Cardiovascular Disease Prediction Models Lack Clear Validation

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MedicalResearch.com Interview with:

Johanna Damen, MSc  Julius Center for Health Sciences and  Primary Care Cochrane Netherland  University Medical Center Utrecht,  Netherlands

Johanna Damen

Johanna Damen, MSc
Julius Center for Health Sciences and
Primary Care Cochrane Netherland
University Medical Center Utrecht,
Netherlands

MedicalResearch.com:What is the background for this study?

Response: Prediction models for cardiovascular disease (CVD) estimate the probability that an individual will develop a certain cardiovascular condition in the future. For instance, prognostic models for CVD are typically used to decide which patients need treatment (e.g. antihypertensive or lipid lowering drugs, or life-style interventions) to reduce their 10 year risk. Previous reviews have shown there are a lot of CVD prediction models, but no systematic review has given an overview of which models exist, which predictors they use, which outcome they predict and which models have been externally validated.

MedicalResearch.com: What are the main findings?

Response: We found that there is an excess of prediction models for CVD (363 models in total) with extreme variation in predicted outcomes and included predictors. For instance, the majority of cardiovascular models predicted the risk of coronary heart disease of cardiovascular disease, although more than 70 different definitions were reported for these outcomes. Most models included predictors like age, smoking status, blood pressure, and cholesterol levels, but over 100 other predictors were identified. Remarkably, the performance of these models was almost never validated in new patients or settings, indicating that much more emphasis is placed on repeating the process of identifying new predictors rather than validating existing models. Quality of reporting was often insufficient to actually use the model for individual risk predictions, and model performance was infrequently reported.

MedicalResearch.com: What should readers take away from your report?

Response: Despite a clear excess of CVD prediction models, there is a lack of studies in which their predictive performance and usefulness in clinical practice is assessed. Furthermore, there is a lack of studies in which existing models are compared and the performance in local settings or populations is assessed. Although there are many differences between the available CVD models, most of them predict similar outcomes and use similar predictors.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future research should focus on validating existing prediction models, rather than developing new models. Ideally, models are compared head-to-head to identify the best model in a certain setting.

Furthermore, these models can be combined and tailored to specific settings, and other predictors can be added to improve their predictive performance.

Finally, impact studies are urgently needed to investigate the effect of using CVD prediction models on doctor’s prescription behavior and patient outcomes.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation: Damen Johanna A A G, Hooft Lotty, Schuit Ewoud,Debray Thomas P A, Collins Gary S, Tzoulaki Ioanna et al. Prediction models for cardiovascular disease risk in the general population: systematic review BMJ2016; 353 :i2416

Note: Content is Not intended as medical advice.

Please consult your health care provider regarding your specific medical condition and questions.

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Anger and Stonewalling Lead To Different Medical Vulnerabilities

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MedicalResearch.com Interview with:

Robert W. Levenson, Ph.D. Professor, Department of Psychology Director, Institute of Personality and Social Research (IPSR) University of California Berkeley, CA

Dr. Robert Levenson

Robert W. Levenson, Ph.D.
Professor, Department of Psychology
Director, Institute of Personality
and Social Research (IPSR)
University of California
Berkeley, CA

MedicalResearch.com: What is the background for this study?

Dr. Levenson: This study comes from a 20-year longitudinal study of Bay Area married couples that we began in the late 1980s. The main purpose of the study was to understand the emotional qualities of successful marriages. Couples came to our laboratory every five years so that we could get a snapshot of the way they interacted with each. We also measured their psychological and physical health. This new paper connects the emotional behaviors we observed when couples discussed a problem in their marriage at the start of the study with the kinds of illnesses they developed over the ensuing decades.
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Black Patients Five Times More Likely To Present With Advanced Colon Cancer

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MedicalResearch.com Interview with:

Robert Wong, M.D., M.S. Attending Physician, Gastroenterology & Hepatology Director, GI Education & Research Highland Hospital I A member of Alameda Health System Oakland, CA

Dr. Robert Wong

Robert Wong, M.D., M.S.
Attending Physician, Gastroenterology & Hepatology
Director, GI Education & Research
Highland Hospital I A member of Alameda Health System
Oakland, CA

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Wong:  Colorectal cancer is a leading cause of morbidity and mortality in the United States. Early diagnosis through implementation of effective screening and surveillance programs leads to earlier staged tumor at time of diagnosis, which increases the treatment opportunities and improves overall survival. However, disparities in access to effective screening and surveillance can impair timely diagnosis and lead to advanced disease, limited treatment options and poor outcomes. The current study evaluated race/ethnicity-specific disparities in colorectal cancer epidemiology at a large urban safety net hospital and observed African American patients had significantly more advanced cancer stage at the time of diagnosis. Our study observed that African Americans were over 5 times more likely to have advanced stage 3-4 colon cancer at time of diagnosis compared with non-Hispanic white patients with colon cancer. While these findings are likely multifactorial, it sheds important light on race/ethnicity-specific disparities in colorectal cancer epidemiology and helps target future education and research to improve outcomes.

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Breast and Ovarian Cancers May Have Common Epigenetic Origin

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MedicalResearch.com Interview with:

Sibaji Sarkar Ph.D Instructor of medicine Boston University School of Medicine Boston

Dr. Sibaji Sarkar

Sibaji Sarkar Ph.D
Instructor of medicine
Boston University School of Medicine
Boston

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Sarkar: Although breast and ovarian cancers have different clinical presentations, there are certain molecular events that are conserved between the two types of cancers. For example, mutation in a few genes, such as BRCA1, BRCA2, is an indicator of possible development of both breast and ovarian cancers. ARHI, a pro-apoptotic imprinted gene is epigenetically silenced in both breast and ovarian cancers. A similar pattern was observed in microRNA as well. There are also several genes which are differentially expressed in these two types of cancers but few of these striking resemblances led us to investigate whether they have a common origin. In this paper, we compared genetic and epigenetic events in both breast and ovarian cancers and we hypothesize that they may have similar origin (mechanism of formation of cancer progenitor cells), which should be regulated by epigenetic mechanism.

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New DSM-5 Classification of PTSD May Leave Many Without Appropriate Diagnosis

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MedicalResearch.com Interview with:
Charles W. Hoge, M.D.
Senior Scientist
Walter Reed Army Institute of Research

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Hoge: Psychiatric definitions are revised periodically based on emerging science, with the intention of enhancing diagnostic accuracy, clinical utility, and communication. The latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders was published in 2013 (DSM-5). However, there were an unusually large number of changes to the PTSD definition compared with other common conditions affecting adults, raising concerns with how well these changes truly reflected emerging evidence. Since DSM-5 was published, evidence has accumulated that indicates that the revision did not improve the definition, and more importantly excludes nearly a third of individuals who would have met the previous DSM-IV definition.

This article in JAMA Psychiatry provides a thorough critique of the problems with the new definition. It was written by 12 of the leading PTSD experts in the world, including strong representation from experts with experience treating veterans and service members. An accompanying editorial by U.S. Veterans Affairs researchers criticizes our findings, but lacks the scientific rigor of our analysis; for example, every reference they cite we also cite in direct support of our conclusions.

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Global Economic Downturn Linked To Increase in Cancer Deaths

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MedicalResearch.com Interview with:
Dr Mahiben Maruthappu MD
Senior Fellow to the CEO,NHS England
Imperial College
London, UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Maruthappu: There are over 8 million deaths due to cancer every year.
At the same time, there are around 40 million unemployed people across the OECD, 7
million more than before the recent economic crisis. As a result,
understanding how economic changes affect cancer survival, given the
economic climate, is crucial.

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CHARGE-AF Score May Be Better Predictor of Atrial Fibrillation Risk

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MedicalResearch.com Interview with:

Ingrid Elisabeth Christophersen MD PhD Postdoctoral research fellow Cardiovascular Research Center (CVRC) Massachusetts General Hospital

Dr. Ingrid Elisabeth-Christophersen

Ingrid Elisabeth Christophersen MD PhD
Postdoctoral research fellow
Cardiovascular Research Center (CVRC)
Massachusetts General Hospital

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Christophersen: Several recent studies have utilized the CHA2DS2-VASc risk score to predict risk of atrial fibrillation (AF). However, the CHA2DS2-VASc was developed for prediction of stroke risk in patients with AF and has not been validated for prediction of AF risk. We have evaluated how well the CHA2DS2-VASc performed at predicting risk of AF compared with the most validated clinical risk score for AF – the CHARGE-AF risk score – in the Framingham Heart Study. We showed that the CHARGE-AF risk score performed better at predicting risk of AF than the CHA2DS2-VASc.

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