Abca1 Deficiency Protects the Heart Against Myocardial Infarction-Induced Injury

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MedicalResearch.com Interview with:

Dr. Mieke Louwe (1) and 
Prof. dr. Miranda van Eck (2)
1Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
2Leiden Academic Centre for Drug Research, Leiden University, Leiden,
The Netherlands

Dr-Mieke-Louwe

Dr. Mieke Louwe

Prof. dr. Miranda van

Prof. dr. Miranda van Eck

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

Response: ATP-binding cassette transporter A1 (Abca1) is a key protein facilitating the production of high-density lipoprotein (HDL) and the maintenance of macrophage cholesterol homeostasis. Patients and mice with mutations in the Abca1 gene have virtually no HDL in their circulation. Since HDL plays a key protective role in atherosclerosis, by exerting several cardioprotective functions, up regulation of Abca1 is considered as an important novel therapeutic strategy to prevent atherosclerotic cardiovascular disease. Although the role of Abca1 in atherosclerosis is extensively studied, the interplay between Abca1 and myocardial infarction, an acute cardiovascular event often resulting from rupture of advanced atherosclerotic plaques, has not yet been investigated.

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Some Over-the-Counter Nasal Strips and Clips Found To Be Effective Dilators

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MedicalResearch.com Interview with:
Christopher Badger, MS3
PRIME-LC
UC Irvine School of Medicine

MedicalResearch.com: Which over-the-counter mechanical nasal dilators are effective at relieving nasal valve obstruction?

Response: In this systemic review, 33 over-the-counter mechanical nasal dilators were identified and classified by mechanism. Ten peer reviewed articles identified six effective devices.

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

Response: External nasal dilators and nasal clips may be an effective treatment for the relief of nasal valve obstruction.

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Telehealth System Improved Mental Health and Depression in Army Study

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MedicalResearch.com Interview with:

Bradley E. Belsher, Ph.D. Chief of Research Translation and Integration, Deployment Health Clinical Center, Defense Center of Excellence for PH and TBI Research Assistant Professor, Department of Psychiatry Uniformed Services University of the Health Sciences

Dr. Bradley Belsher

Bradley E. Belsher, Ph.D.
Chief of Research Translation and Integration,
Deployment Health Clinical Center,
Defense Center of Excellence for PH
and TBI
Research Assistant Professor, Department of Psychiatry
Uniformed Services University of the Health Sciences


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

Response: One out of five U.S. military service members returning from overseas military conflicts meets screening criteria for at least one mental health condition, yet fewer than half of service members will receive help from a mental health professional. The consequences of inadequate mental health treatment are considerable and can lead to significant social and functional problems for service members and their families. In response to these mounting concerns, the Military Health System (MHS) has increased efforts to expand and improve the identification and treatment of mental health disorders. Given that the average service member visits primary care three times each year, the MHS has invested considerable resources into the integration of mental health services into the primary care setting. Collaborative care is an effective model for integrating mental health services into primary care and has demonstrated effectiveness in treating different mental health conditions to include depression and anxiety disorders. However, no previous studies have examined whether the concept can work in the MHS.

Recently, the first large-scale, randomized effectiveness trial evaluating an integrated health care model in primary care for PTSD and depression in the DoD was conducted. This trial randomized 666 military members treated across six large Army bases to a centrally-assisted collaborative telecare (CACT) approach for PTSD and depression or to the existing standard of care (usual collaborative care). This effectiveness trial targeted a large population of service members as they came into primary care and minimized exclusion criteria to improve the generalizability of the findings and broaden the applicable reach of the intervention.

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Testosterone Therapy Improved Sexual Function in Older Men

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MedicalResearch.com Interview with:
Glenn Cunningham, MD
Departments of Medicine and Molecular and Cellular Biology
Division of Diabetes, Endocrinology and Metabolism
Baylor College of Medicine and Baylor St. Luke’s Medical Center
Houston, Texas 77030

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

Response: The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of testosterone in symptomatic men ≥65 years with unequivocally low testosterone levels. Previous studies in older men have been limited and the results have been conflicting. Initial results of the Sexual Function Trial showed that testosterone improved sexual activity, sexual desire and erectile function.

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Embryonic HOX Genes May Predict Response of Ovarian Cancer to Treatment

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MedicalResearch.com Interview with:

Professor Richard Morgan Director, The Institute of Cancer Therapeutics University of Bradford Richmond Road Bradford UK

Prof. Richard Morgan

Professor Richard Morgan
Director, The Institute of Cancer Therapeutics
University of Bradford
Richmond Road
Bradford UK

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

Response: Ovarian cancer is the 5th most common cause of cancer-related death in woman and the most deadly gynaecological cancer. One of the reasons for this is its resistance to conventional chemotherapy. Although tumours often respond well at first, showing dramatic shrinkage in the first few months of treatment, they usually grow again and at this point they are no longer sensitive to the drugs. We studied the role of HOX genes in ovarian cancer. The HOX genes play an important role in the early development of the embryo but are usually switched off in adult cells. However, many cancers, including ovarian cancer, turn them back on. Previous work suggested that they might have an important role in promoting the rapid proliferation of cancer cells.

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Antidepressant Did Not Reduce Hospitalizations or Death in Heart Failure Patients

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MedicalResearch.com Interview with:

Prof. Dr. med. Christiane E. Angermann, FESC, HFA Deutsches Zentrum für Herzinsuffizienz Würzburg Comprehensive Heart Failure Center (CHFC) Universitätsklinikum Würzburg Würzburg

Prof. Christiane Angermann

Prof. Dr. med. Christiane E. Angermann, FESC, HFA
Deutsches Zentrum für Herzinsuffizienz Würzburg
Comprehensive Heart Failure Center (CHFC)
Universitätsklinikum Würzburg
Würzburg

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

Response: Previous meta-analysis indicates that depression prevalence in patients with heart failure is much higher than in the general population, 10 percent to 40 percent, depending on disease severity. Depression has been shown to be an independent predictor of mortality and rehospitalization in patients with heart failure, with incidence rates increasing in parallel with depression severity. Furthermore, it is associated with poor quality of life and increased healthcare costs.

It would, against this background, seem desirable to treat the depression, and when planning the study we hypothesized that by doing so we might be able to improve depression and thus reduce mortality and morbidity of this population. Long-term efficacy and safety of selective serotonin reuptake inhibitors (SSRIs), which are widely used to treat depression and have proven efficacious in individuals with primary depression, is unknown for patients with heart failure and (comorbid) depression.

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GW Radiologist Discusses Implications of Breast Density Notification Laws

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MedicalResearch.com Interview with:

Rachel Brem, MD Professor of Radiology and Director of Breast Imaging and Intervention George Washington University School of Medicine.

Dr. Rachel Brem

Rachel Brem, MD
Professor of Radiology and
Director of Breast Imaging and Intervention
George Washington University School of Medicine.

MedicalResearch.com Editor’s note: Many states now have laws regarding patient notification of breast density after mammography screening.
Dr. Brem discusses the background and implications of the new mandatory notification laws.

MedicalResearch.com: What is meant by ‘breast density?’ Is breast density a risk factor for breast cancer? Is breast cancer more difficult to detect in dense breasts?

Dr. Brem: Breast density is a measure used to describe the proportion of fat versus breast tissue, which includes fibrous and glandular tissue. Dense breasts contain more fibrous and glandular tissue and less fatty tissue. This is important because on a mammogram dense breast tissue is white and breast cancer is white. The lack of contrast can make detecting cancer more difficult.

You can only tell if your breasts are dense from the mammogram. You can’t feel dense breast tissue or see it.

An estimated 40 percent of women have dense breast tissue that may mask the presence of cancerous tissue in standard mammography. Dense breast tissue decreases with age, but remains important throughout life. Over 75 percent of women in their 40s have dense breast tissue but over a third of women in their 70s have dense breast tissue.

As breast density increases, mammography sensitivity decreases. This is significant, but we must consider the increased risk of breast cancer in women with dense breast tissue. Women with dense breast tissue have up to a four-fold increased risk of developing breast cancer. So, breast density is essentially the “perfect storm” where the ability to detect cancer decreases while the risk for breast cancer increases. Therefore, optimal approaches to individualized breast cancer screening are needed.

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Iron Deficiency Common In Heart Failure Patients and Linked To Worse Outcomes

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MedicalResearch.com Interview with:

John G. F. Cleland, MD, FRCP, FESC Department of Cardiology Hull York Medical School, University of Hull, Castle Hill Hospital, Kingston-Upon-Hull National Heart and Lung Institute Royal Brompton and Harefield Hospitals Imperial College London, United Kingdom

Dr. John Cleland

John G. F. Cleland, MD, FRCP, FESC
Department of Cardiology
Hull York Medical School, University of Hull, Castle Hill Hospital, Kingston-Upon-Hull
National Heart and Lung Institute
Royal Brompton and Harefield Hospitals Imperial College
London, United Kingdom

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

Response: This analysis shows that iron deficiency is very common in patients with heart failure and often leads to anaemia and that the prevalence of both iron deficiency and anaemia are highly sensitivity to the criteria used to define them. The World Health Organization defines anaemia as a haemoglobin concentration of <13g/dL in men and <12g/dL in women but doctors should realise this is the lower limit of normal and haemoglobin concentrations should ideally be about 2g/dL higher than this. A man with a haemoglobin of 12g/dL is quite severely anaemic. This study suggest that iron deficiency is common when haemoglobin drops below 14g/dL for men and 13g/dL for women.

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New Approach May Cure Autoimmune Diseases By Targeting Just Autoantibody Cells

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MedicalResearch.com Interview with:

 credit Paul Foster, Penn Medicine for the photo.

from left to right:
Aimee Payne, MD, PhD – co-senior author
Christoph Ellebrecht, MD – first author
Michael Milone, MD, PhD – co-senior author

Aimee S. Payne, M.D., Ph.D.
Albert M. Kligman Associate Professor of Dermatology
University of Pennsylvania
Philadelphia, PA 19104

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

Dr. Payne: Autoimmunity occurs when the body’s immune system mistakenly attacks itself, instead of foreign viruses and bacteria. The most common way we treat autoimmunity is to suppress the immune system, but that can be dangerous, with risk of serious and even fatal infections. We have developed a method to use the body’s own immune system to specifically kill the disease-causing autoimmune cells, while sparing the “good” immune cells that protect from infection.

If you think about the way we used to treat cancer, we had no way of targeting the cancer cells specifically, so we just targeted all dividing cells, but this approach led to terrible side effects and even death from therapy. Over the last several decades, tremendous advances have been made identifying cell markers and signaling pathways that are specific to cancer cells, which has greatly reduced the toxicity of cancer treatments. Recently, researchers discovered that they could direct the body’s own immune cells to seek out and kill cancer cells, using a so-called “chimeric antigen receptor” or CAR, a breakthrough in medical technology that has cured previously incurable cancers.

We have re-engineered the CAR approach to specifically target the autoantibody-producing cells, by using the disease autoantigen in a “chimeric autoantibody receptor” or CAAR. We are hopeful that this approach might similarly prove to be a breakthrough in autoimmune disease therapy, since the concept can be extended to any autoantibody-mediated disease for which the autoantigen is known.

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

Dr. Payne:  Ideally, the CAAR targeted therapy approach would be a one-time disease treatment that would cure autoantibody-mediated diseases, without the risks of generalized immune suppression. In contrast, our current therapies use chronic immune suppression for the goal of disease control, which can greatly reduce the quality of life for affected patients.

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

Dr. Payne: We are actively seeking to move this technology forward into human clinical trials. Our immediate focus is to use CAAR technology to cure pemphigus in dogs. Dogs are one of the only animals other than humans that naturally develop pemphigus. If we could safely treat and potentially cure pemphigus in dogs, that would be compelling evidence to encourage doctors and patients to enroll for clinical trials of CAAR therapy.

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

Citation:

Reengineering chimeric antigen receptor T cells for targeted therapy of autoimmune disease

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

More Medical Research Interviews on MedicalResearch.com.

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Patient Satisfaction with LASIK Surgery For Nearsightedness Exceeded Contact Lenses Over Three Year Period

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MedicalResearch.com Interview with:

Marianne Price, Ph.D. Executive Director Cornea Research Foundation of America Indianapolis, Indiana

Dr. Marianne Price,

Marianne Price, Ph.D.
Executive Director
Cornea Research Foundation of America
Indianapolis, Indiana

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

Dr. Price: Over 40% of Americans are near-sighted and the rate of near-sightedness continues to increase. The most common treatments are glasses, contact lenses, or laser refractive surgery (LASIK).

The purpose of this study was to find how patient satisfaction compares with contact lenses and with LASIK. We enrolled 1800 participants at 20 sites across the USA; 694 participants (39%) continued wearing contact lenses and 1106 (61%) had LASIK. Participants were surveyed at baseline, 1, 2 and 3 years.

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Pathway That May Grow New Blood Vessels After Heart Attack Discovered

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MedicalResearch.com Interview with:

Mark Mercola, Ph.D. Professor, Development, Aging and Regeneration Program, Sanford-Burnham-Prebys Medical Discovery Institute Professor, Stanford Cardiovascular Institute and Stanford University School of Medicine La Jolla, California 92037

Dr. Mark Mercola

Mark Mercola, Ph.D.
Professor, Development, Aging and Regeneration Program, Sanford-Burnham-Prebys Medical Discovery Institute
La Jolla, California 92037
Professor, Stanford Cardiovascular Institute and Stanford University School of Medicine
Stanford, CA, 94305,

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

Response: Heart disease, especially after heart attack (myocardial infarction) is a major cause of death worldwide, accounting for over 13% of all human mortality. There is a major search for ways to treat the immediate cause or lessen the effect of a heart attack. One way researchers have considered is to boost the blood vessels that nourish the heart muscle. The heart muscle is nourished by many small blood vessels. We found a normal protein that acts as a high level regulator of blood vessel formation in the heart. This protein, known as RBPJ, suppresses the factors that make vessels grow. Therefore, we found that inhibiting this protein made more vessels, and consequently protected the hearts from the damage of a heart attack.

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NYU Neurologist Comments On New Guidelines For Emergency Room Treatment of Migraines

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MedicalResearch.com Interview with:

Dr. Mia T. Minen, MD, MPH Director, Headache Services at NYU Langone Medical Center Assistant professor, Department of Neurology

Dr. Mia T. Minen

Mia Minen, MD, MPH
Assistant Professor of Neurology
NYU Langone Medical Center

MedicalResearch.com Editor’s note: The American Headache Society has issued new guidelines on “The Management of Adults With Acute Migraine in the Emergency Department” (1,2)

Dr. Minen, Director of Headache Services at NYU Langone Medical Center, discusses these new guidelines below.

MedicalResearch.com: What is the background for these new guidelines?
How common/severe is the issue of migraine or headache presentation to the ER?

Dr. Minen: These guidelines were needed because previous research shows that there are about 1.2. million visits to the emergency department (ED) each year for migraine, and over 25 different medications are sometimes used for treatment. Many of these medications don’t have evidence-based data to back their usage, and opioids are especially likely to be prescribed in between 60 and 70 percent of these cases, despite their lack of efficacy and risks. The American Headache Society convened an expert panel to review the existing evidence on all the medications used to treat migraines in the ED, and we developed these new treatment guidelines.

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