Reward Circuit in Brain Localized To Central Amygdala

MedicalResearch.com Interview with:
Joshua Kim, researcher
RIKEN-MIT Center for Neural Circuit Genetics at The Picower Institute for Learning and Memory, Department of Biology and Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
Howard Hughes Medical Institute, Massachusetts Institute of Technology
Cambridge, MA 02139

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

Response: We previously identified to populations of neurons in a structure known as the basolateral amygdala, one that is capable of mediated fear-related behaviors and the other reward-related behaviors. Both of these basolateral amygdala populations send projections to a structure known as the central amygdala.

For this study, we wanted to examine the function of 7 different populations of central amygdala neurons in regard to fear-related and reward-related function and how each of these 7 populations are connected to the 2 basolateral amygdala populations.

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Association Between Cardiovascular Risk Factors and Aortic Stenosis

MedicalResearch.com Interview with:
Andrew T. Yan, MD
Terrence Donnelly Heart Centre
St Michael’s Hospital
University of Toronto
Toronto, Ontario, Canada

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

Response: The pathogenesis of aortic stenosis is complex and incompletely understood. Previous experimental data and epidemiologic studies (mostly cross-sectional) have demonstrated an association between conventional cardiovascular risk factors such as hypertension, diabetes, and dyslipidemia, and aortic sclerosis or stenosis. However, there is a paucity of longitudinal data from large population studies. Therefore, we sought to examine the relationship between conventional cardiovascular risk factors and incident severe aortic stenosis during extended follow-up in a large unselected elderly population in Ontario, Canada.

In over 1 million individuals older than 65 who were followed for a median of 13 years, hypertension, diabetes and dyslipidemia were all significantly and independently associated with development of severe aortic stenosis requiring hospitalization or intervention. Furthermore, we observed a positive dose-response relationship between the number and duration of cardiac risk factors, and the risk of aortic stenosis. Together, these risk factors accounted for approximately one third of the incidence of severe aortic stenosis at a population level.

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Development and Assessment of BPX-01, a Novel Topical Minocycline Gel for Treatment of Acne Vulgaris


MedicalResearch.com Interview with:
Usha Nagavarapu, PhD

Senior director of preclinical drug development
BioPharmX

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

Response: Acne vulgaris is a complex chronic inflammatory disease known to be linked with P. acnes and can have profound social and psychological effects. Though a number of treatments exist, there is promise of a long-term benefit for acne patients. BioPharmX’s in vitro and in vivo studies have revealed that a low-dose, topical 1% minocycline gel (BPX-01) provided a localized and targeted delivery of adequate minocycline to the epidermis and pilosebaceous units that can potentially limit systemic exposure and may reduce treatment related side effects.

At the intended clinical dose, toxicity and safety animal studies found that BPX-01 was well tolerated with no significant local or systemic toxic effects. A comparative animal study with oral minocycline demonstrated that topical application of minocycline can limit systemic exposure while delivering sufficient minocycline to the skin to treat acne vulgaris.

Along the same lines, a 4-week clinical study with extended release oral minocycline to assess the skin and plasma concentrations of minocycline was conducted. A marked reduction of mean acne lesion counts from baseline was seen with oral minocycline with presence in plasma. On the contrary no minocycline was identified in the skin from periauricular biopsies.

Recently, BioPharmX completed a 4-week Phase 2 clinical repeat-dose study of BPX-01. The minocycline gel was well tolerated and over 90% of P. acnes were eliminated.

A 12-week Phase 2 dose-finding clinical trial to further assess the efficacy and safety of BPX-01 for the treatment of moderate-to-severe, non-nodular inflammatory acne vulgaris has been initiated. The dose-finding study will provide additional support for the planned Phase 3 clinical trial program with BPX-01.

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Educational Disparities in Mortality Between Adults Aged 50–64 and 66–79 Years, U.S.

MedicalResearch.com Interview with:
Jiemin Ma PhD MHS
Strategic Director, Cancer Interventions Surveillance
American Cancer Society, Inc.
Atlanta, GA 30303

Jiemin Ma PhD MHS Strategic Director, Cancer Interventions Surveillance American Cancer Society, Inc. Atlanta, GA 30303

Dr. Jiemin Ma

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

Response: Previous studies have shown that educational disparities are smaller in the elderly than in working-aged Americans. The differences may partly be explained by the higher health insurance coverage among the elderly (near universal coverage through Medicare for adults aged 65), as well as some aging-related changes in lifestyle and social factors (e.g. retirement). Some of the previous studies were limited by the use of proxy-reported educational information, which tended to be inaccurate for the elderly.

Our study used self-reported educational attainment to estimate relative differences in educational disparities in mortality rates between adults aged 50–64 and 66–79 years in a national representative cohort from the National Longitudinal Mortality Study (NLMS).

We found that educational disparities in all-cause mortality for ages 66–79 years were about 41% and 61% lower than those for ages 50–64 years in non-Hispanic whites and non-Hispanic blacks, respectively. Diminished disparities in the elderly were also found for deaths from cardiovascular disease and cancer among non-Hispanic Americans.

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Intracoronary Nitroglycerin, the Forgotten Stepchild of Cardiovascular Guidelines

MedicalResearch.com Interview with:
Alec Vishnevsky, MD
Cardiology Fellow and First Author
Thomas Jefferson University Hospital
Michael P. Savage, MD FACC FSCAI FACP
Ralph J. Roberts Professor of Cardiology
Sidney Kimmel Medical College at Thomas Jefferson University
Director, Cardiac Catheterization Laboratory

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

Response: Percutaneous coronary intervention (PCI) has been a mainstay treatment for patients with symptomatic coronary artery disease. While current guidelines emphasize the importance of periprocedural antithrombotic medications, they fail to mention the use of nitroglycerin prior to PCI to rule out coronary artery spasm as the etiology of a stenosis seen on coronary angiography. This distinction is paramount as it can avoid unnecessary stenting procedures.

In this case series, we described a series of patients presenting with chest pain and angiographically significant stenoses that resolved with administration of intracoronary nitroglycerin (IC NTG) prior to planned PCI. The study group consisted of 6 patients with a mean age of 52, all of whom had anginal symptoms and significant stenoses seen on coronary angiogram.  In each case, giving intracoronary nitroglycerin resulted in resolution of the stenosis, and all 6 patients were successfully managed medically without stenting.

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Autism Increases Risk of Death From Injury, Especially Drowning

MedicalResearch.com Interview with:
Joseph Guan

MPH Candidate in Epidemiology, Certificate in Chronic Diseases Epidemiology
Columbia University Mailman School of Public Health

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

Response: The prevalence of autism has been increasing especially in the past two decades. With an estimate of more than 3.5 million people living with autism in the US, approximately 500,000 of them are children under 15 years old. Current studies show that males are approximately four times as likely than females to be diagnosed with autism. There is also evidence that people with autism are at a heightened risk of injury. However, the research on the relationship between autism and injury is understudied.

We found that 28% of deaths in individuals with autism were due to injury, compared to 7% of deaths in the general population. Injury deaths in individuals with autism occurred at a much younger age (29.1 years) on average compared to injury deaths in the general population (54.7 years). Our study show that drowning was the leading cause of injury death among individuals with autism, followed by suffocation and asphyxiation. Children under the age of 15 years were 160 times more likely to die from drowning.

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Diabetic Retinopathy: OCTA May Improve Staging, Diagnosis and Monitoring

MedicalResearch.com Interview with:

José Cunha-Vaz, M.D., Ph.D. Emeritus Professor of Ophthalmology University of Coimbra, Portugal President of AIBILI Association for Innovation and Biomedical Research on Light and Image Editor-in-Chief of Ophthalmic Research Coordinator, Diabetic Retinopathy and Retinal Vascular Diseases, European Vision Institute Clinical Research Network (EVICR.net)

Dr. Cunha-Vaz

José Cunha-Vaz, M.D., Ph.D.
Emeritus Professor of Ophthalmology
University of Coimbra, Portugal
President of AIBILI
Association for Innovation and Biomedical Research on Light and Image
Editor-in-Chief of Ophthalmic Research
Coordinator, Diabetic Retinopathy and Retinal Vascular Diseases,
European Vision Institute Clinical Research Network (EVICR.net) 

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

Response: In this study, we evaluated the clinical utility of quantitative measures of microvasculature in optical coherence tomographic angiography (OCTA). Although several studies have demonstrated the potential value of measures of microvasculature in the management of diabetic retinopathy (DR), our study uses the ROC curve to compare the overall value of different approaches. In this age matched population with a range of disease, the mean vessel density measured in the SRL had the highest AUC, indicating that it is best among the methods tested at differentiating normal eyes from eyes with diabetic retinopathy.

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Cigarettes Continue To Vastly Outweigh Sales Of E-Cigarettes

MedicalResearch.com Interview with:

Kristy Marynak Master of Public Health Public Health Analyst at Centers for Disease Control and Prevention Centers for Disease Control and Prevention Duke University

Kristy Marynak

Kristy Marynak, Master of Public Health
Public Health Analyst at Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
Duke University

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

Response: The background for our study is that in recent years, self-reported cigarette smoking has declined among youth and adults, while electronic cigarette (e-cigarette) use has increased. However, sales trends for these products are less certain. Our study assessed national and state patterns of U.S. cigarette and e-cigarette unit sales using retail scanner data from convenience and grocery stores; mass merchandisers like Walmart; drug, dollar, and club stores; and military commissaries.

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Health Care Attitudes: How Do The Generations Compare?

MedicalResearch.com Interview with:

Mitch Rothschild MA, MBA Co-founder of Vitals

Mitch Rothschild

Mitch Rothschild MA, MBA
Co-founder of Vitals

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

Response: There’s so much in the news about health care today. It’s on people’s mind more than ever before due to rising costs and deductibles and, of course, the repeal debate.

With that in mind, we wanted to see how the current landscape affects two things: 1) People’s trust in the health system in general; and 2) Their attitude towards the doctor-patient relationship.

It shouldn’t be surprising that different generations had different perceptions. But we were amazed by how some generational stereotypes held true when it came to doctor-patient relationships and the health care attitudes.

Millennials – Health Care Idealists

Being in their 20s and 30s, Millennials are young and in general a healthy bunch. For the most part, they’ve utilized less health care services than other generations. Only 35 percent have a primary care provider, and one in four say they use an alternative care facility, like an urgent care center, when they are sick.

Often characterized as optimistic and idealistic, those traits may help explain why they have a high degree of trust in the system and in their doctors. They’re the least likely to question their doctor’s authority or their integrity when it comes to fessing up to medical mistakes.

Confident and idealistic, Millennials are often labeled as over-sharers for their habits both on social media and in the real world. But this translates into an open doctor-patient relationship. Millennials are more likely than other generations to say they can tell their doctor “anything.” Perhaps a byproduct of their parents raising them to believe their voice matters, Millennials have an expectation that they can and should engage authority. Yet, that collaborative and open dialogue leads to another positive: They’re the most likely to follow their doctor’s medical advice.

Millennials have grown up as digital natives. As such, they’re the most likely to use online reviews to “check up” on a new doctor. Yet, their familiarity with technology leads them to be the least suspicious of pitfalls. More than other generations, Millennials trust health facilities with their personal health information.

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Neither Vitamin E or Selenium Found To Prevent Dementia

MedicalResearch.com Interview with:

Richard J. Kryscio, Ph.D. Statistics and Chair, Biostatistics and Sanders-Brown Center on Aging Sanders-Brown Center on Aging University of Kentucky

Dr. Richard Kryscio

Richard J. Kryscio, Ph.D.
Statistics and Chair, Biostatistics and Sanders-Brown Center on Aging
Sanders-Brown Center on Aging
University of Kentucky 

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

Response: At the time the trial was initiated (2002), there was ample evidence that oxidative stress is an important mechanism in brain aging. Research showed that protein oxidation is linked to the brain’s response to the abnormal proteins seen in Alzheimer disease (amyloid beta plaques in particular) leading to inflammation, DNA repair problems, reduced energy production, and other cellular changes that are identified mechanisms in the Alzheimer brain.

Both vitamin E and selenium are antioxidants. Antioxidants, either through food or supplements, are believed to reduce oxidative stress throughout the body. In the brain, they may reduce the formation of amyloid beta plaques, reduce brain inflammation, and improve other brain processes. Studies in humans support these hypotheses. The Rotterdam study in the Netherlands, as an example, showed that initial blood levels of vitamin E could predict dementia risk. Those people with higher vitamin E levels were 25% less likely to develop dementia. Also, selenium deficiency results in cognitive difficulties and several population-based studies have shown an association between selenium level and cognitive decline (lower selenium levels are linked to thinking changes in the elderly).
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Critical Neural Pathways Identified in OCD Behavior

MedicalResearch.com Interview with:

Dr. Melanie Ullrich PhD Universität Würzburg Physiologisches Institut Würzburg

Dr. Ullrich

Dr. Melanie Ullrich PhD
Universität Würzburg
Physiologisches Institut
Würzburg

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

Response: Shortly after the first description of SPRED proteins in 2001, their in vivo functions, especially that of SPRED2, were completely unexplored. Thus we generated a mouse model which lacks functional SPRED2 expression. In our previous study, we identified SPRED2 as a critical regulator of stress hormone release from the hypothalamic-pituitary-adrenal (HPA) axis. In SPRED2 KO mice levels of corticotropin-releasing hormone, adrenocorticotropic hormone, and corticosterone are elevated, a feature often associated with obsessive-compulsive disorders (OCD) in humans. In fact SPRED2 KO mice showed clear signs of OCD-like behavior demonstrated by excessive self-grooming up to the level of self-inflicted lesions. Treatment with the selective serotonin reuptake inhibitor (SSRI) fluoxetine alleviated excessive grooming, confirming the OCD-like nature of the disease.

Therefore, the first main finding of our study is that mutations in the SPRED2 gene have to be considered as a possible risk factor for the development of OCD-like diseases.

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High risks of mortality following bleeding and ischemic events occurring 1 year after coronary stenting

MedicalResearch.com Interview with:

Eric A. Secemsky, MD, MSc Interventional Cardiology Fellow Massachusetts General Hospital Harvard Medical School Baim Institute for Clinical Research

Dr. Eric Secemsky

Eric A. Secemsky, MD, MSc
Interventional Cardiology Fellow
Massachusetts General Hospital Harvard Medical School
Baim Institute for Clinical Research 

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

Response: We know from previous trials that continuing dual antiplatelet therapy longer than 12 months after coronary stenting decreases ischemic events, including spontaneous myocardial infarction and stent thrombosis. However, extending dual antiplatelet therapy is also associated with some increase in bleeding risk. For instance, in the DAPT Study, more than 25,600 patients were enrolled and received both aspirin and a thienopyridine antiplatelet drug (clopidogrel or prasugrel) for one year after stenting. Of these patients, 11,648 participants who had followed the study protocol and had no serious cardiovascular or bleeding events during that first year were then randomized to either continue with dual therapy or to receive aspirin plus a placebo for another 18 months. The overall findings of the DAPT study were that, compared with switching to aspirin only after one year, continuing dual antiplatelet therapy for a total of 30 months led to a 1.6 percent reduction in major adverse cardiovascular and cerebrovascular events – a composite of death, myocardial infarction, stent thrombosis and ischemic stroke – and a 0.9 percent increase in moderate to severe bleeding events.

The prognosis following early ischemic and bleeding events has previously been well described. However, data for events occurring beyond 1 year after PCI are limited. As such, we sought to assess the cumulative incidence of death following ischemic and bleeding events occurring among patients in the DAPT Study beyond 1 year after coronary stenting.

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