Testosterone Replacement Did Not Increase Cardiovascular Risk In Androgen-Deficient Men

MedicalResearch.com Interview with:

Dr-Cheetham-Craig.jpg

Dr. Craig Cheetham

T. Craig Cheetham, PharmD, MS
Southern California Permanente Medical Group
Department of Research & Evaluation
Pasadena, CA 91101

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

Response: Concerns have been raised about the cardiovascular safety of testosterone replacement therapy. Patient selection criteria may have been a factor in the findings from studies reporting an increased cardiovascular risk with testosterone replacement therapy. Many men who were receiving testosterone replacement therapy don’t fall into the categories of ‘frail elderly’ or ‘high cardiovascular risk’. We therefore studied testosterone replacement therapy in a population of androgen deficient men within Kaiser Permanente Northern and Southern California. Continue reading

Married Men Live Longer, Wealthier Lives and Have More Sex

MedicalResearch.com Interview with:

Nicholas H. Wolfinger PhD Professor, Department of Family and Consumer Studies Adjunct Professor, Department of Sociology University of Utah Salt Lake City, UT 84112-0080

Dr. Nicholas Wolfinger

Nicholas H. Wolfinger PhD
Professor, Department of Family and Consumer Studies
Adjunct Professor, Department of Sociology
University of Utah
Salt Lake City, UT 84112-0080

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

Response: W. Bradford Wilcox and I have been studying marriage and divorce for fifteen years. Last year we published Soul Mates: Religion, Sex, Love and Marriage among African Americans and Latinos (Oxford University Press). We’re always looking for opportunities to present our findings to the public, so Valentines Day is a great excuse!

It’s probably too strong a statement to call our new research brief a study, as we’re not offering any novel findings. Instead, we’re just compiling data from different sources—some published by other scholars, some based on our own analysis of national data—to reaffirm a basic point: marriage is good for men in myriad ways (Marriage is also good for women, but they await their own research brief.) In particular, marriage offers these benefits to men:

  • Higher earnings, greater assets and more job stability. Married men make about $16,000 a year more than their single peers with otherwise similar backgrounds.
  • Better sex lives compared to both single and cohabiting men. According to data from the National Health and Social Life Survey, 51 percent of married men report they are extremely emotionally satisfied with sex, compared to 39 percent of cohabiting men and 36 percent of single men.
  • Longer and happier lives. Men who get and stay married live almost 10 years longer than their unmarried peers. Also, young married men are about twice as happy: 43 percent of married men report they are “very happy” with life, compared to 20 percent of single men and 24 percent of cohabiting men.

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One Fatty Meal Results In Metabolic Disturbances

MedicalResearch.com Interview with:

Prof. Dr. Michael Roden Director, German Diabetes Center (DDZ) Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf Chair/Professor, Endocrinology and Metabolic Diseases Heinrich Heine University Düsseldorf Director, Department of Endocrinology and Diabetology University Hospital Düsseldorf Düsseldorf, Germany

Prof. Michael Roden

Prof. Dr. Michael Roden
Director, German Diabetes Center (DDZ)
Leibniz Center for Diabetes Research
at Heinrich Heine University Düsseldorf
Chair/Professor, Endocrinology and Metabolic Diseases
Heinrich Heine University Düsseldorf
Director, Department of Endocrinology and Diabetology
University Hospital Düsseldorf
Düsseldorf, Germany

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

Response: The prevalence of obesity, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) continue to increase at an alarming rate. Their occurrence has been associated with intake of saturated fats, for example that of palm oil. This study aimed to shed light on how dietary fat initiates metabolic changes which lead to the aforementioned diseases. To this end we provided 14 young healthy volunteers an oral dose of palm oil or placebo randomly, in a crossover manner, with an 8-week washout period between each intervention.

One acute dose of palm oil leads to insulin resistance in the main insulin sensitive tissues of the body: the liver, skeletal muscle and adipose tissue. In the liver, it also results in increased accumulation of triglycerides, increased production of glucose from lipid and amino acid precursors (rather than from glycogen), and increased energy metabolism, as denoted by increased hepatic adenosine triphosphate (ATP) content. Moreover, a similar experiment in mice revealed that one dose of palm oil differentially regulates genes and pathways which are known or suspected regulators of NAFLD, such as lipopolysaccharide (LPS), members of the peroxisome proliferator-activated receptor (PPAR) family and nuclear factor kappa-light-chain-enhancer of activated B-cells.

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Intensive Systolic Blood Pressure Control Would Risk Side Effects But Save Lives

MedicalResearch.com Interview with:

Dr. Adam Bress, PharmD, MS. Assistant Professor, Population Health Sciences Division of Health System Innovation and Research University of Utah

Dr. Adam Bress

Dr. Adam Bress, PharmD, MS.
Assistant Professor, Population Health Sciences
Division of Health System Innovation and Research
University of Utah

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

  • Observational studies show a strong and graded association between higher blood pressure, beginning at 115 mm Hg systolic, and increased cardiovascular disease events.
  • Despite this, hypertension is diagnosed and treated among people with a blood pressure threshold, typically 140/90 mm Hg SBP/DBP.
  •  Until recently, randomized trials did not provide definitive evidence supporting lower SBP goals in high-risk sub-populations.
  • The Systolic Blood Pressure Intervention Trial showed that among U.S. adults at high cardiovascular disease risk but without diabetes, stroke, or heart failure, treating to a systolic blood pressure goal of 120 mm Hg compared to the standard goal of 120 mm Hg compared to the standard goal of <140 mm Hg, resulted in a 27 % reduction in all-cause mortality.
  • However, intensive treatment cause a higher rate of treatment-related serious adverse events (SAEs).

MedicalResearch.com: What are the main findings?

  • To quantify the potential benefits and risks of SPRINT intensive goal implementation, we estimated the deaths prevented and excess SAEs incurred if the SPRINT intensive SBP goal (i.e., – Based on population estimates of U.S adults that would have been eligible for the SPRINT trial and their observed 5-year mortality rate and the treatment effects observed in SPRINT, we found that if intensive treatment is widely adopted and achieved in all of these people, about 100,000 deaths per year could be prevented.
  • It could also give rise to about 56,100 episodes of hypotension, 34,400 episodes of syncope, 43,400 serious electrolyte disorders, and 88,700 cases of acute kidney injury per year compared to standard blood pressure treatment.

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

  • The public health impact of wide-spread implementation of intensive blood pressure treatment in the right patients is large.
  • However, careful patient selection and implementation are important because intensive treatment is associated with increased risk of hypotension, syncope, electrolyte abnormalities, and acute kidney injury.

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

  • More research is needed to determine which patients derive the largest absolute benefit from intensive blood pressure treatment in order to maximize health benefits and minimize harms.
  • Research and development of tools to enhance shared decision making between providers and patients is also needed to maximize the positive public health impact of intensive blood pressure treatment.

MedicalResearch.com: Is there anything else you would like to add?

Response: I am a member of the SPRINT Research Group

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

Citation:

Circulation. 2017 Feb 13. pii: CIRCULATIONAHA.116.025322. doi: 10.1161/CIRCULATIONAHA.116.025322. [Epub ahead of print]
Potential Deaths Averted and Serious Adverse Events Incurred from Adoption of the SPRINT Intensive Blood Pressure Regimen in the U.S.: Projections from NHANES.
Bress AP1, Kramer H2, Khatib R3, Beddhu S4, Cheung AK4, Hess R5, Bansal VK6, Cao G3, Yee J7, Moran AE8, Durazo-Arvizu RA3, Muntner P9, Cooper RS3

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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Memory Retrieval and Extinction Reduces Craving For Cigarettes

MedicalResearch.com Interview with:

Michael E. Saladin, Ph.D. Professor, Department of Health Sciences and Research College of Health Professions Medical University of South Carolina Charleston, SC

Dr. Michael Saladin

Michael E. Saladin, Ph.D.
Professor, Department of Health Sciences and Research
College of Health Professions
Medical University of South Carolina
Charleston, SC

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

Response: To the extent that learning and memory processes govern all aspects of behavior, they also govern dysregulated or maladaptive behaviors such as addiction and anxiety states. In the former case, stimuli associated with drug administration can acquire the ability to control drug-related motivational states (urges and craving) as well as drug seeking behavior. To illustrate the point, the simple act of observing a person light up a cigarette will cause the typical smoker to desire a cigarette and engage in smoking. A nonsmoker, by contrast, would not be similarly affected because they have no history where stimuli associated with smoking (e.g., sight of a lighter, cigarettes, plumes of smoke) are reliably paired with, or followed by, the rewarding effects of nicotine.

The research we conducted recently was based on neuroscience research showing that retrieved drug-associated memories (prompted with drug-paired cues) can be updated with information that decreases drug craving and/or administration. One such study showed that heroin craving in heroin addicts can be decreased by retrieving memories for heroin use via a brief heroin cue presentation (video of people using heroin) and then, a short time later, presenting an extensive variety of heroin cues (video, pictures and heroin use paraphernalia) over a 1-hour period. The logic of this intervention was that once the heroin memories were prompted into a labile state by the brief video presentation, the extensive heroin cue exposure would serve to update the content of the original memories with new information (i.e., cues are not followed by heroin reward) that is inconsistent with the original cue-drug contingency (i.e., cues are followed with heroin reward). Remarkably, just two sessions of this type of training, which we call retrieval-extinction training, resulted in significant reductions in heroin craving that persisted for six months. This study was done with heroin addicts who were inpatients so there was no way to assess the effects of this treatment on actual heroin use.

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Poor Kids More Likely To Have More Than One Chronic Health Condition

MedicalResearch.com Interview with:

Christian D. Pulcini, MD, MEd, MPH Pediatric Resident, Children's Hospital of Pittsburgh of UPMC Chair, Section on Pediatric Trainees (SOPT) American Academy of Pediatrics

Dr. Christian Pulcini

Christian D. Pulcini, MD, MEd, MPH
Pediatric Resident
Children’s Hospital of Pittsburgh of UPMC
Chair, Section on Pediatric Trainees (SOPT)
American Academy of Pediatrics

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

Response: Poverty influences the well-being of children and adolescents in a negative way. Poor children are often exposed to toxic health stressors, including violence, environmental toxins, and inadequate nutrition. Children in poverty with chronic health conditions also are more likely to have higher rates of secondary disorders and worse outcomes. We studied children with asthma, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), to describe the how much disease and if the children had multiple (comorbid) conditons and how these vary by poverty status.

Parents reported through the National Survey of Children’s Health that asthma and ADHD rose 18% and 44% from 2003-2011/2012, respectively, whereas the lifetime prevalence of ASD rose 32% from 2007-2011/2012 in all income levels. For asthma, the rise was most among the poor at 25.8%. For ADHD, the percent change among the poor was similar, however the rise in autism spectrum disorder was associated with being non-poor. Publicly insured children with asthma, ADHD, and ASD also had a significant higher chance (1.9×, 1.6×, 3.0×, respectively) of having higher more than one chronic condition. In addition, kids who were poor with asthma and ADHD.
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Tele-Rehabilitation Can Improve Physical Function In Chronic Knee Pain Patients

MedicalResearch.com Interview with:
Rachel Nelligan, BPhysio
Physiotherapist & Research Physiotherapist
Department of Physiotherapy | Centre for Health, Exercise and Sports Medicine
The University of Melbourne
Victoria Australia

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

Response: This novel study investigated the efficacy of an internet delivered model of service delivery that combined online education, Skype delivered exercise physiotherapy and an Internet-based interactive pain coping skills training program for people with persistent knee pain.

Osteoarthritis, the leading cause of chronic knee pain and disability globally, has a significant individual, societal and economic burden. On an individual level knee osteoarthritis causes loss of function, reduced quality of life, and psychological distress. Clinical guidelines recommend adoption of a biopsychosocial approach to management which should include nondrug, nonsurgical treatments. Specifically exercise, education and psychological interventions (including pain coping skills training (PCST)) that foster self-management are recommended. Evidence identifies that many knee OA sufferers are not receiving adequate management due in part to challenges of accessing these effective treatments. There is an urgent need for new models of health service delivery to rectify this.

Tele-rehabilitation is growing in acceptance as an effective, time efficient and convenient means for people to access effective health interventions. In knee OA internet delivered interventions specifically remotely delivered physiotherapy exercise using specialised tele-rehabilitation equipment and an Internet-based interactive PCST program (PainCOACH), designed to translate key therapeutic elements of clinician-delivered face-to-face PCST, have shown improved patient outcomes. Prior to this study the combination of these two internet-based treatments has not been investigated.

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State Same-Sex Marriage Policies Associated With Reduced Adolescent Suicide Attempts

MedicalResearch.com Interview with:
Julia R.G. Raifman, ScD

Post-doctoral fellow
Johns Hopkins Bloomberg School of Public Health 

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

Response: Suicide is the second leading cause of death among adolescents between the ages of 15 and 24 years old in the United States. Gay, lesbian, and bisexual adolescents have elevated rates of suicide attempts. In our study, we found that 29% of gay, lesbian, and bisexual adolescents reported attempting suicide in the past year relative to 6% of heterosexual adolescents.

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Female Career Vietnam War Veterans Report Leading Happy, Productive Lives

MedicalResearch.com Interview with:

Jeanne Mager Stellman, PhD Professor Emerita & Special Lecturer Department of Health Policy & Management Mailman School of Public Health Columbia University York NY 10032

Dr. Jeanne Stellman

Jeanne Mager Stellman, PhD
Professor Emerita & Special Lecturer
Department of Health Policy & Management Mailman
School of Public Health Columbia University
York NY 10032

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

Response: We examined the experiences of 1285 American women, military and civilian, who served in Vietnam during the war and responded to a mail survey conducted approximately 25 years later in which they were asked to report and reflect upon their experiences and social and health histories.

The data were collected as part of a much larger study that centered about methodological approaches to studying health effects of the military herbicides used in Vietnam. To our knowledge, this is the first study

(a) to describe the experiences of civilian women deployed to a war zone and to compare them to those of military women;

(b) to differentiate the experiences and outcomes among military women by the length of their military career service;

(c) to contextualize the general health and happiness, marital characteristics, and childbearing patterns of women deployed to Vietnam and those of their peers by comparing them to a contemporaneous nationally representative age-matched cohort, the General Social Survey (GSS).

Overall, this paper provides insight into the experiences of the understudied women who served in Vietnam, and sheds light on subgroup differences within the sample.

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SWORD Study Demonstrates Two-Drug Control of HIV

MedicalResearch.com Interview with:

Kati Vandermeulen Senior Director, Global Regulatory Leader and Compound Development Team Lead IDV Janssen

Kati Vandermeulen

Kati Vandermeulen
Senior Director, Global Regulatory Leader and Compound Development Team Lead
IDV Janssen

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

Response:  SWORD is the first large trial program specifically conducted to look at the combination of dolutegravir and rilpivirine as a complete, two-drug antiretroviral regimen. Results of the two identical Phase III SWORD studies have been positive and demonstrate that the two-drug regimen of dolutegravir and rilpivirine is as effective, with comparable tolerability, to traditional three- or four-drug (integrase inhibitor-, non-nucleoside reverse transcriptase inhibitor-, or boosted protease inhibitor-based) antiretroviral regimens for the maintenance treatment of HIV.
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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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