Targeted Radiosurgery Beats Whole Brain Radiation For Brain Tumor Survival

MedicalResearch.com Interview with:

N. Scott Litofsky, M.D. Chief of the Division of Neurological Surgery University of Missouri School of Medicine

Dr. N. Scott Litofsky,

N. Scott Litofsky, M.D.
Chief of the Division of Neurological Surgery
University of Missouri School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Radiosurgery is being used more often for treatment of brain metastases to avoid potential side effects of whole-brain radiation, such as cognition and mobility impairment. After surgical resection of a brain metastases, some radiation treatment is generally needed to control brain disease. Few studies have directly compared efficacy of tumor control between surgery followed by whole-brain radiation and surgery followed by radiosurgery.

Our objective was to compare outcomes in two groups of patients – one whose brain metastasis was treated with surgery followed by whole-brain radiation and one whose surgery was followed by radiosurgery to the post-operative tumor bed.

We found that tumor control was similar for both groups, with survival actually better in the radiosurgery group. The complications of treatment were similar.

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Oxytocin Enhances Paternal Bonding With Their Children

MedicalResearch.com Interview with:

James K. Rilling, PhD Professor, Anthropology, Psychiatry and Behavioral Science Emory University School of Medicine

Dr. James Rilling

James K. Rilling, PhD
Professor, Anthropology, Psychiatry and Behavioral Science
Emory University School of Medicine

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

Response: It has been known for a long time that female mammals experience hormonal changes during pregnancy that prepare them to care for their offspring. More recently, it has been shown that some mammalian males, including humans, can also experience hormonal changes that prepare them to care for their offspring. For example, oxytocin levels can increase in human fathers and studies have shown that oxytocin facilitates paternal physical stimulation, play and emotional synchrony with their children. We examined the effects of intranasal oxytocin on brain function in human fathers. We found that intranasal oxytocin increased activation in brain areas involved with reward and empathy when human fathers viewed pictures of their children, but not unknown children.

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Prostate Cancer: Genetic Biomarker Predicts Response To Androgen Deprivation Therapy

MedicalResearch.com Interview with:

Neeraj Agarwal, MD Associate Professor, Division of Oncology, Department of Medicine University of Utah School of Medicine

Dr. Neeraj Agarwal

Neeraj Agarwal, MD
Associate Professor, Division of Oncology, Department of Medicine
University of Utah School of Medicine

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

Response: Biomarkers predicting response to cancer therapy help guide physicians personalize medicine. Significant advances have been made in the development of therapeutic biomarkers in various malignancies, but not in prostate cancer. Dr. Nima Sharifi’s group at the Cleveland Clinic recently discovered that a germline inherited polymorphic variant (1245A→C) in the HSD3B1 gene correlates with shorter duration of response to androgen deprivation therapy (ADT) in hormone sensitive prostate cancer (HSPC). HSD3B1 gene encodes the enzyme 3β-hydroxysteroid dehydrogenase-1 (3βHSD1), which catalyzes adrenal androgen precursors into dihydrotestosterone, the most potent androgen.

The authors found that the variant allele of HSD3B1 led to decreased progression-free survival in a dose-dependent manner in post-prostatectomy biochemical recurrence and metastatic HSPC (mHSPC). These results needed external validation before application in the clinic. In our study, we sought to provide the first independent validation of these results in patients with mHSPC.

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Penile Length One Year After Radical Prostatectomy Not Statistically Different Than Pre-Op

MedicalResearch.com Interview with:
Yoshifumi Kadono, MD. PhD.
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science,
Kanazawa, Ishikawa, Japan 

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

Response: I had experienced some patients who underwent radical prostatectomy (RP) complained penile shortening after RP. Once I checked that kind of reports, some reports mentioned the phenomenon of penile shortening (PS) after radical prostatectomy; however, the results were little bit different and the reasons of PS after RP were not well elucidated.

Therefore, we started our study to obtain our data. In our study, the penile length (PL) was measured before, 10 days after, and at 1, 3, 6, 9, 12, 18, and 24 months after RP. And the PL at 10 days after RP was shortest, and it gradually recovered thereafter. Penile length at 12 months after radical prostatectomy was not significantly different from preoperative penile length. Based on MRI investigation, slight vertical repositioning of the membranous urethra after radical prostatectomy caused chronological changes in penile length.

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Human Genetics Contributes To Zika-Induced Brain Damage

MedicalResearch.com Interview with:

Ping Wu, MD, PhD John S. Dunn Distinguished Chair in Neurological Recovery Professor, Department of Neuroscience & Cell Biology University of Texas Medical Branch Galveston, TX 77555-0620

Dr. Ping Wu

Ping Wu, MD, PhD
John S. Dunn Distinguished Chair in Neurological Recovery
Professor, Department of Neuroscience & Cell Biology
University of Texas Medical Branch
Galveston, TX 77555-0620

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

Response: Zika viral infection poses a major global public health threat, evidenced by recent outbreaks in America with many cases of microcephaly in newborns and other neurological impairments. A critical knowledge gap in our understanding is the role of host determinants of Zika-mediated fetal malformation. For example, not all infants born to Zika-infected women develop microcephaly, and there is a wide range of Zika-induced brain damage. To begin to fill the gap, we infected brain stem cells that were derived from three human donors, and found that only two of them exhibited severer deficits in nerve cell production along with aberrant alterations in gene expression.

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Educating Religious Leaders Improves Uptake of Male Circumcision in Tanzania

MedicalResearch.com Interview with:

Jennifer A. Downs, M.D., Ph.D. Assistant Professor of Medicine and Microbiology & Immunology Department of Medicine Weill Cornell Medicine Center for Global Health New York, NY 10065

Dr. Jennifer Downs

Jennifer A. Downs, M.D., Ph.D.
Assistant Professor of Medicine and Microbiology & Immunology
Department of Medicine
Weill Cornell Medicine
Center for Global Health
New York, NY 10065

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

Response: Between 2002 and 2006, three large randomized controlled trials in sub-Saharan Africa demonstrated that male circumcision reduces new HIV infections in men by approximately 60%. Based on these findings, the World Health Organization recommended male circumcision as an HIV prevention strategy in countries with high levels of HIV and a low prevalence of male circumcision. This led to prioritization of 14 countries in Eastern and Southern Africa for massive scale-up of male circumcision beginning in 2011.

In many of these countries, the uptake of male circumcision was lower than expected. In northwest Tanzania, where we work, there are a number of barriers to male circumcision. Some of these barriers are cultural, tribal, economic, and religious. We conducted focus group interviews in 2012 that showed that many Christian church leaders and church attenders in our region in Tanzania had major concerns about whether male circumcision was compatible with their religious beliefs. This led us to hypothesize that the uptake of male circumcision could be increased when religious leaders were taught about male circumcision, with the goal that they would then be equipped to discuss this issue with their congregations.
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5-alpha reductase inhibitors For BPH Linked to Higher, Not Lower, PSA Levels

MedicalResearch.com Interview with:
Teemu J Murtola, MD, PhD, adjunct professor
University of Tampere, Faculty of Medicine and Life Sciences
Tampere University Hospital, Department of Urology
Tampere, Finland

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

Response: A previous study called Prostate Cancer Prevention Trial
(PCPT) showed that finasteride, which belongs to a drug group called
5alpha-reductase inhibitors lowers serum PSA and increases sensitivity
of PSA to detect high-grade prostate cancer in men who had little or
no symptoms of the lower urinary tract. We postulated that this effect
would increase the accuracy and benefits of PSA-based prostate cancer
screening.

Finnish Randomized Study of Screening for Prostate Cancer was a large
trial of over 80,000 men randomized either to be screened for prostate
cancer with a PSA test at 4-year intervals or to be followed for
prostate cancer incidence and mortality via national registries. Three
consecutive screening rounds were commenced between 1996-2008. In the
current study we compared the effects of PSA-based screening on
prostate cancer risk and mortality separately among men who were using
5alpha-reductase inhibitors finasteride or dutasteride and among men
who were not.

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Air Pollution Linked To Millions of Preterm Births

MedicalResearch.com Interview with:

Chris Malley PhD The Stockholm Environment Institute University of York

Dr. Chris Malley

Chris Malley PhD
The Stockholm Environment Institute
University of York

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

Response: When a baby is born preterm (at less than 37 weeks of gestation, an indicator of premature birth), there is an increased risk of infant death, or long-term physical and neurological disabilities. For example, 965,000 infant deaths in 2013 (35% of all neonatal deaths) have been estimated to be due to preterm birth complications. In 2010, an estimated 14.9 million births were preterm – about 4–5% of the total in some European countries, but up to 15–18% in some African and South Asian countries. The human and economic costs are enormous.

There are many risk factors for preterm birth – from the mother’s age, to illness, to poverty and other social factors. Recent research has suggested that exposure to air pollution could also be a risk factor. Our study quantifies for the first time the global impact of pregnant women’s exposure to outdoor fine particulate matter (PM2.5) by combining data about air pollution in different countries with knowledge about how exposure to different levels of air pollution is associated with preterm birth rates.

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HUD Housing Assistance, But Not Vouchers, Linked To Improvement in Health Measurements

MedicalResearch.com Interview with:

Andrew Fenelon PhD Assistant Professor, Department of Health Services Administration University of Maryland School of Public Health. College Park, MD 20742

Dr. Andrew Fenelon

Andrew Fenelon PhD
Assistant Professor, Department of Health Services Administration
University of Maryland School of Public Health.
College Park, MD 20742

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

Response: Despite the relatively large public investment in housing assistance at the federal level, there have been few nationwide analyses of the impacts of these programs on health and well-being. And as policymakers seek solutions to health disparities that incorporate some of the non-medical determinants of health (such as housing quality), our study can make an important contribution to both health and housing policy.

We use an innovative data linkage program which links individuals in a federal household health survey and administrative housing records from the U.S. Department of Housing and Urban Development (HUD). We examine the health impacts of three HUD housing programs: public housing, housing choice vouchers, and multifamily housing. We find that public housing and multifamily housing lead to an improvement in self-reported health status, and public housing leads to a reduction in serious psychological distress. We do not find health impacts associated with housing choice vouchers.

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Long Term Fampridine (AMPYRA) Improves Gait Function in Multiple Sclerosis

MedicalResearch.com Interview with:

Linard Filli, PhD Gait Research Lab Department of Neurology University Hospital Zurich Zürich

Dr. Linard Filli

Linard Filli, PhD
Gait Research Lab
Department of Neurology
University Hospital Zurich
Zürich

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

Response: Gait dysfunction is common in patients with multiple sclerosis (MS) and is perceived as the most restricting of symptoms. Fampridine (4-aminopyridine, dalfampridine), a blocker of voltage-gated potassium channels, is currently the only approved medication for the symptomatic treatment of walking disorders in patients in both the early and late phases of  multiple sclerosis.

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Gestational Diabetes Linked To Adverse Pregnancy Outcomes

MedicalResearch.com Interview with:

Dr Sophie Jacqueminet Praticien Hospitalier Service de Diabétologie Pole Cardio Métabolisme Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix

Dr Sophie Jacqueminet

Dr Sophie Jacqueminet
Praticien Hospitalier
Service de Diabétologie
Pole Cardio Métabolisme
Hôpitaux Universitaires
Pitié Salpêtrière – Charles Foix

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

Response: The proportion of women who are overweight or obese is increasing in almost all countries worldwide, and this is being accompanied by an increased risk of developing both type 2 diabetes (T2D) (whether pregnant or not) and gestational diabetes (GDM). While other studies have analysed the links between GDM and adverse outcomes in babies, very large studies that draw on an entire national database, study, are rare.
In our research, all 796,346 deliveries taking place after 22 weeks in France in 2012 were included by extracting data from the hospital discharge database and the national health insurance system. Outcomes were analysed according to the type of diabetes and, in the GDM group, whether or not diabetes was insulin-treated.

The cohort of 796,346 deliveries involved 57,629 (7.24%) mothers with gestational diabetes mellitus. Data linking the mother to the child were available for 705,198 deliveries (88% of the total). The risks of adverse outcomes were two to four times higher for babies of mothers with type 2 diabetes before pregnancy (pregestational diabetes) than for those with GDM. We then adjusted our data, limiting the analysis to deliveries after 28 weeks to ensure all women diagnosed with GDM were included (since diagnosis of GDM in most cases takes place at or after 28 weeks).

Following adjustment, the increased risk of various complications for mothers with gestational diabetes versus mothers without GDM were: preterm birth 30%; Caesarean section 40%; pre-eclampsia/eclampsia 70%; babies born significantly larger than average size (macrosomia) 80%; respiratory distress 10%; birth trauma 30%; and cardiac malformations 30%. While these increased risks combine women with both insulin- and diet-treated GDM, most of the increased risk is found in women with insulin-treated GDM. This is because as stated above, the diabetes is more serious and blood sugar more difficult to control in women who need insulin treatment, resulting in a higher risk of complications than in those women treated with diet only.

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Genomic Testing Can Improve Confidence in Prostate Cancer Treatment Strategy

MedicalResearch.com Interview with:

Dr. John L. Gore, MD Associate Professor Adjunct Associate Professor-Surgery Department of Urology University of Washington

Dr. John Gore

Dr. John L. Gore, MD
Associate Professor
Adjunct Associate Professor-Surgery
Department of Urology
University of Washington

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

Response: The rationale for our study derives from the uncertainty that both patients and clinicians confront when trying to make decisions about adjuvant therapy for prostate cancers found to have aggressive pathologic features at the time of radical prostatectomy. There is level 1 evidence in support of adjuvant radiation therapy in this setting, but several factors restrain providers from recommending adjuvant radiation. We found that interjecting a genomic test that predicts the risk of clinical metastases 5 years after surgery impacts the treatment recommended and helps men and clinicians feel more confident in the decision they are making or recommending.

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