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) 

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 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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Psychiatric Side Effects of 5 Alpha Reductase Inhibitors for BPH

MedicalResearch.com Interview with:

Blayne Welk, MD, FRCSC Assistant Professor of Surgery Western University

Dr. Blayne Welk

Blayne Welk, MD, FRCSC
Assistant Professor of Surgery
Western University

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

Response: Concerns have been raised by regulatory agencies and patients about possible serious psychiatric side effects associated with the use of 5 alpha reductase inhibitors. These medications can be used for both enlarged prostates and alopecia.

We used administrative data to assess for potential psychiatric side effects associated with finasteride and dutasteride usage in older men with benign prostatic enlargement.

In our study we found that there was no increased risk of suicide associated with the use of these medications. However, there was a small increase in both self-harm and new onset depression associated with the use of 5 alpha reductase inhibitors.
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Discovery of New Gene That Causes Sudden Death in Young Athletes

MedicalResearch.com Interview with:
Lia Crotti, MD, PhD

Department of Cardiovascular, Neural and Metabolic Sciences
San Luca Hospital
IRCCS Istituto Auxologico Italiano

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

Response: Sudden cardiac death in one of the major cause of death in Western Countries and among the causes of these deaths in young people under the age of 35, inherited forms of cardiomyopathy have a prominent role. Among these cardiomyopathies, Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) plays a major role. In ARVC, the heart tissue is replaced by fatty and fibrous tissue. This process encourages the development of life-threatening arrhythmias, such as ventricular fibrillation, that causes a cardiac arrest and sudden death in few minutes without a ready device to shock the heart. Intense physical activity favors the progression of the disease and arrhythmias are frequently triggered by adrenergic activation: those are the reason why young athletes with this disease are at high risk.

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70-Gene Signature Changes 50% of Breast Cancer Chemotherapy Advice

MedicalResearch.com Interview with:
Anne Kuijer, MD

Departments of Surgery and Radiology
University Medical Center Utrecht and
Thijs van Dalen, PhD
Department of Surgery
Netherlands Cancer Institute, Amsterdam

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

Response: In recent years it has become evident that clinicopathological factors fail to accurately determine prognosis in hormone receptor positive early stage breast cancer patients at intermediate risk of developing metastases. Gene-expression profiles, such as the 70-gene signature (MammaPrint) are therefore increasingly used for chemotherapy decision-making. In the current multicentre study we assessed the impact of 70-gene signature use on chemotherapy decisions in these patients. We demonstrated that, without the use of the 70-gene signature, half of patients was advised chemotherapy, which reflects the current controversy regarding chemotherapy benefit. Use of the 70-gene signature changed the chemotherapy advice in half of all patients and adherence to the 70-gene signature result was high.

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LGBTQ+ Youth Not As Safe At School As We Like To Think

MedicalResearch.com Interview with:

Tasseli McKay, MPH Violence and Victimization Research Program Center for Justice, Safety and Resilience RTI International

Tasseli McKay

Tasseli McKay, MPH
Violence and Victimization Research Program Center for Justice, Safety and Resilience
RTI International

MedicalResearch.com: What is the background for this study?
Response: Prompted by a mass murder of LGBTQ+ individuals in Orlando in 2016 and a range of pending legislation affecting LGBTQ+ communities, RTI researchers analyzed 20 years’ worth of published studies on violence and LGBTQ+ communities.  The systematic review identified patterns of evidence across 102 peer-reviewed studies as well as a few unpublished analyses and non-peer-reviewed papers. With The Henne Group, RTI also carried out a series of focus-group discussions to elicit the perspectives of members of LGBTQ+ communities on the violence and victimization issues identified in the review.  These were conducted with LGBTQ+ communities in San Francisco; New York City; Durham, North Carolina; and rural Wyoming.

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Sustained Consumer Response Two Years After Implementing A Sugar-Sweetened Beverage Tax in Mexico

MedicalResearch.com Interview with:

Shu Wen Ng, Ph.D., FTOS Research Associate Professor, Department of Nutrition Gillings School of Global Public Health Fellow, Carolina Population Center Duke-UNC Center for Behavioral Economics and Healthy Food Choice Research University of North Carolina at Chapel Hill

Dr. Shu Wen Ng

Shu Wen Ng, Ph.D., FTOS
Research Associate Professor, Department of Nutrition
Gillings School of Global Public Health
Fellow, Carolina Population Center
Duke-UNC Center for Behavioral Economics and Healthy Food Choice Research
University of North Carolina at Chapel Hill

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

Response: The Mexican government enacted a 1 peso per liter tax on sugar sweetened beverages (SSB) after studies showed that more than 70 percent of the country’s population was overweight or obese, and that in excess of 70 percent of the added sugar calories in the Mexican diet were coming from SSBs. We were interested in learning how purchases of SSBs and other beverages changed in the 2 years after the tax was implemented in Mexico. The Health Affairs study titled “In Mexico, Evidence Of Sustained Consumer Response Two Years After Implementing A Sugar-Sweetened Beverage Tax” found that in the two-year period spanning 2014 to 2015, the tax resulted in a 5.5 percent reduction in the first year and continued to decline, averaging 9.7 percent the second year, with lower socioeconomic households, for whom health care costs are most burdensome, lowered their purchases of sweetened beverages the most. Meanwhile, purchases of untaxed beverages such as bottled water increased 2.1 percent.

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Patients Can Expect To Return To Normal Function Relatively Quickly After Knee Arthroscopy

MedicalResearch.com Interview with:

Patients Can Expect To Return To Normal Function Relatively Quickly After Knee Arthroscopy MedicalResearch.com Interview with: Alexis Colvin, MD Associate Professor, Orthopaedics Icahn School of Medicine at Mount Sinai James N. Gladstone, MD Co-Chief, Sports Medicine Service, The Mount Sinai Hospital Associate Professor, Orthopaedics, Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Knee arthroscopy is one of the most commonly performed procedures in the U.S. There is minimal literature on when patients can expect to return to daily activity. We sought to help patients understand when they could expect to return to a number of basic activities, specifically in an urban environment where patients need to be mobile early. MedicalResearch.com: What are the main findings? Response: Our findings included: • Patients are off narcotics within 7 days, • Patients stop use of a cane/crutches at 8 days • Patients can drive after 14 days • Patients can go up subway stairs at 20 days • Patients sit on a toilet comfortably at 14 days • Patients return to work at 15 days MedicalResearch.com: What should readers take away from your report? Response: Patients can expect to return to relatively normal function within a short amount of time. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Response: We will also be looking at what other factors, such as age, BMI, medical co-morbidities, etc. can also influence how fast patients recover from this very common surgery. MedicalResearch.com: Is there anything else you would like to add? Response: MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community. Citation: 2017 AAOS abstract Return to Daily Life After Meniscectomy Alexis C. Colvin, MD, New York, NY James Dieterich, BA, New York, NY James N. Gladstone, MD, New York, NY Diana Patterson, MD, New York, NY Arthroscopic meniscectomy is a frequently performed procedure, but minimal guidelines exist for counseling patients on functionality during the recovery period or time to return to daily activities. http://www.aaos.org/uploadedFiles/2017%20Final%20Program_compressed.pdf 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

Dr. Colvin

Alexis Colvin, MD
Associate Professor, Orthopaedics
Icahn School of Medicine at Mount Sinai

James N. Gladstone, MD Co-Chief, Sports Medicine Service, The Mount Sinai Hospital Associate Professor, Orthopaedics, Icahn School of Medicine at Mount Sinai

Dr. Gladstone

James N. Gladstone, MD
Co-Chief, Sports Medicine Service, The Mount Sinai Hospital
Associate Professor, Orthopaedics, Icahn School of Medicine at Mount Sinai

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

Response: Knee arthroscopy is one of the most commonly performed procedures in the U.S. There is minimal literature on when patients can expect to return to daily activity.

We sought to help patients understand when they could expect to return to a number of basic activities, specifically in an urban environment where patients need to be mobile early.

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