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MedicalResearch.com specializes in exclusive interviews with medical researchers from major and specialty journals and presenters at health care meetings.
Learn directly from the researchers as they discuss the ideas behind their investigations and their plans for future studies. Over 8486 interviews to date! More than 1638 interviews with researchers from JAMA.

Retinopathy in Premature Infants: Low Dose Ranibizumab May Be Effective Without Systemic Side Effects

MedicalResearch.com Interview with:

Prof. Dr. Andreas Stahl
Geschäftsführender Oberarzt
Leiter Arbeitsgruppe Angiogenese
Universitätsaugenklinik Freiburg | University Eye Hospital Freiburg
Freiburg, Germany

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

Response: Retinopathy of prematurity (ROP) is a sight-threatening disease and one of the main reasons for irrreversible bilateral blindness in children. Particularly infants born at very early gestational ages or with very low birth weight are affected. In these infants, vascularization of the retina is unfinished at the time of birth. Severeal weeks into the life of these very prematuerly born infants, angiogenic growth factors, mainly vascular endothelial growth factor (VEGF), become upregulated in the avascular parts of the retina, leading to a re-activation of physiologic vascular growth. If all goes well, these re-activated retinal blood vessels progress towards the periphery and lead to a fully vascularized and functional retina. If, however, the vascular activation by VEGF is too strong, then vascular growth becomes disorganized and vessels are redirected away from the retina and into the vitreous. If left untreated, these eyes can then proceed towards tractional retinal detachment and blindness.

Since the 1990s, the standard method of treating ROP has been laser photocoagulation of avascular parts of the retina. This treatment is sensible because VEGF as the main angiogenic driver of pathologic blood vessel growth is expressed in these avascular parts of the retina. The downside of laser treatment, however, is that treated retinal areas are turned into functionless scar tissue and are lost for visual function. In addition, infants treated with laser need to be under general anesthesia for hours during treatment which can be troublesome in very young and fragile preterm infants. And in the long run, infants treated with laser have a high risk of developing high myopia in later life.

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Statins: Large Disparity Between US/Canadian/UK and European Guidelines

MedicalResearch.com Interview with:

Borge G. Nordestgaard,

Borge G. Nordestgaard

Børge G. Nordestgaard, MD, DMSc
Department of Clinical Biochemistry
Herlev and Gentofte Hospital, Copenhagen University Hospital
Herlev, Denmark

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

Response: Five major organizations recently published guidelines for using statins to prevent atherosclerotic cardiovascular disease  — the American College of Cardiology/American Heart Association (ACC/AHA) in 2013, the United Kingdom’s National Institute for Health and Care Excellence (NICE) in 2014, and in 2016 the Canadian Cardiovascular Society (CCS), the US Preventive Services Task Force (USPSTF), and the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS). We applied these five guidelines to a contemporary study cohort of 45,750 40-75 year olds from the Copenhagen General Population Study.

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Feasibility of Anticoagulating Cancer Patients At Increased Risk of Stroke

MedicalResearch.com Interview with:

Babak B. Navi MD, MS

Dr. Navi

Babak B. Navi MD, MS
Department of Neurology
Weill Cornell Medicine
New York, New York

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

Response: About 10% of patients with ischemic stroke have comorbid cancer and these patients face an increased risk of stroke recurrence. Many strokes in patients with cancer are attributed to unconventional mechanisms from acquired hypercoagulability. Therefore, many physicians recommend anticoagulation, especially low molecular weight heparins, for the treatment of cancer-associated stroke. However, hypercoagulable stroke mechanisms, such as nonbacterial thrombotic endocarditis, are rarely definitively diagnosed in cancer patients antemortem; while atherosclerosis, which is generally treated with antiplatelet medicines such as aspirin, is common in cancer patients. In addition, many historic indications for anticoagulation in ischemic stroke have been disproven by randomized trials because any reductions in stroke risk were offset by increased risks of bleeding. Given these considerations, we believed that a randomized trial comparing anticoagulation with enoxaparin to antiplatelet therapy with aspirin was necessary to determine the superior strategy, prompting implementation of the TEACH pilot randomized trial. The primary aim of TEACH was to determine whether the random assignment of different antithrombotic strategies to cancer patients with acute ischemic stroke would be sufficiently feasible and safe to proceed with a larger efficacy trial.  Continue reading

Multiple Sclerosis: Rituximab Had Better Short and Medium Term Outcomes

MedicalResearch.com Interview with:
Fredrik Piehl MD PhD, prof. of Neurology

Neuroimmunology Unit. Dept Clinical Neuroscience
Neurology Dept.
Karolinska University Hospital (Solna)
Stockholm

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

Response: In recent years we have seen a drastic increase in treatment options for relapsing-remitting multiple sclerosis (RRMS). However, it is difficult to deduce long term performance of different drugs based only on data from randomized controlled trials, since such trials are performed in selected patients without major co-morbidities and perhaps also enriched for those with a milder disease course. In addition, most trials only last for two years and lack relevant comparators. This lack of knowledge makes it difficult to predict if a drug will work or not for a given patient, in turn leading to frequent treatment switches but also different treatment practices across countries, regions or even between centers. This is also the case in Sweden, but with the additional aspect that some regions have opted to treat most newly diagnosed RRMS patients with rituximab (Rituxan/Mabthera), a drug not formally approved for RRMS, but with extensive safety data from other indications.

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High Rates of Amyloid Imaging Positivity in Patients With Primary Progressive Aphasia

MedicalResearch.com Interview with:

Miguel A. Santos-Santos, MD Department of Neurology, Memory and Aging Center University of California San Francisco Autonomous University of Barcelona, Cerdanyola del Valles, Spain

Dr. Miguel A. Santos-Santos

Miguel ASantosSantosMD
Department of Neurology, Memory and Aging Center
University of California San Francisco
Autonomous University of Barcelona, Cerdanyola del Valles, Spain

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

Response: Primary progressive aphasia (PPA) is a clinically and pathologically heterogeneous (generally Frontotemporal lobar degeneration [FTLD, generally tau or tdp proteinopathies] or Alzheimer’s disease [AD] pathology) condition in which language impairment is the predominant cause of functional impairment during the initial phases of disease. Classification of PPA cases into clinical-anatomical phenotypes is of great importance because they are linked to different prevalence of underlying pathology and prediction of this pathology during life is of critical importance due to the proximity of molecule-specific therapies. The 2011 international consensus diagnostic criteria established a classification scheme for the three most common variants (the semantic [svPPA], non-fluent/agrammatic [nfvPPA], and logopenic [lvPPA]) of PPA and represent a collective effort to increase comparability between studies and improve the reliability of clinicopathologic correlations compared to the previous semantic dementia and progressive non-fluent aphasia criteria included in the 1998 consensus FTLD clinical diagnostic criteria. Since their publication, a few studies have reported amyloid imaging and pathological results in PPA, however most of these studies are retrospective in nature and the prevalence of FTLD and Alzheimer’s disease pathological findings or biomarkers in each variant has been inconsistent across the literature, therefore prospective validation with biomarker and autopsy data remains scarce and highly necessary.
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Prevalence of Severe Obesity Drops for First Time Among All Age, Sex and Race/Ethnic Groups

MedicalResearch.com Interview with:
Liping Pan, MD, MPH
Epidemiologist,
Epidemiology & Surveillance Team
Obesity Prevention and Control Branch
Division of Nutrition, Physical Activity and Obesity
National Center for Chronic Disease Prevention & Health Promotion
CDC 

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

Response: Children with severe obesity face significant health and social challenges. Children with obesity and severe obesity are at higher risk for having other chronic health conditions and diseases, such as asthma, sleep apnea, bone and joint problems, and type 2 diabetes. They also have more risk factors for heart disease like high blood pressure, impaired glucose tolerance, and high cholesterol than their normal weight peers.

These lifelong health risks associated with severe obesity during early childhood indicate the importance of preventing and identifying severe obesity. Childhood obesity disproportionately affects children living in low-income families. However, no recent trends on severe obesity in this population have been reported.
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Sauna Bathing as a Positive Way To Improve Cardiac Health

MedicalResearch.com Interview with:
“Sauna • 10 Ellen Street” by Tracey Appleton is licensed under CC BY 2.0
Prof. Jari A. Laukkanen MD, PhD
Cardiologist, Department of Medicine
Institute of Public Health and Clinical Nutrition
University of Eastern Finland
Kuopio, Finland

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

Response: We have shown that sauna bathing is associated with a variety of health benefits, based on a large population study.

Using an experimental setting this time, the research group now investigated the physiological mechanisms through which the heat exposure of sauna may explain positive effects on cardiovascular system.

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Viral Vector Delivered Gene Therapy That Reversed Diabetes in Mice

MedicalResearch.com Interview with:
Xiangwei Xiao, M.D., Ph.D.
Assistant Professor of Department of Surgery,
Children’s Hospital of Pittsburgh
University of Pittsburgh School of Medicine,
Pittsburgh, PA

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

Response: Diabetes is a prevalent chronic disease characterized by persistently high blood glucose. Diabetes has two main subtypes, type 1 diabetes and type 2 diabetes. In type 1 diabetes, the immune system attacks and destroys insulin-producing beta cells in the pancreas, resulting in high blood levels of glucose. In type 2 diabetes, the beta cells do not produce enough insulin or the body is not able to use insulin effectively.

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Non-Cigarette Tobacco Products Double Chances of Youth Smoking Within a Year

MedicalResearch.com Interview with:
“hookah” by Ksenia M is licensed under CC BY 2.0Benjamin Chaffee, DDS MPH PhD

UCSF School of Dentistry
San Francisco, CA 94118

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

Response: Non-cigarette tobacco products, which include electronic cigarettes, hookah (tobacco waterpipe), smokeless tobacco, and non-cigarette combustibles, like cigars, are increasingly popular among young people. Considerable debate surrounds whether use of these non-cigarette products encourages youth to begin smoking conventional cigarettes.

Several previous studies have shown associations between non-cigarette tobacco use and youth smoking. These studies had largely looked at only one type of tobacco product at a time. This study included more than 10,000 adolescents from all over the United States, surveyed at two time points one year apart. Therefore, this study featured enough participants and detailed information about tobacco behaviors to consider all types of tobacco products in a comprehensive way.

We found that each type of non-cigarette tobacco product (i.e., e-cigarettes, hookah, combustibles, or smokeless tobacco) added to smoking risk. Among youth who had never smoked a cigarette at the start of the survey, use of any of the non-cigarette products approximately doubled the odds of cigarette smoking within a year, after adjusting for multiple smoking-related risk factors. Each product independently increased risk. The adolescents most susceptible to future smoking to were those who had tried two or more types of non-cigarette tobacco.

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Review Finds Antioxidant Supplements of Little to No Benefit in Exercise Recovery

MedicalResearch.com Interview with:
“Pills Vitamins Macro April 22, 2012 4” by Steven Depolo is licensed under CC BY 2.0
Dr Mayur Ranchordas, SFHEA
Senior Lecturer in Sport Nutrition and Exercise Metabolism
Sport Nutrition Consultant
Chair of the Sport and Exercise Research Ethics Group
Sheffield Hallam University
Academy of Sport and Physical Activity
Faculty of Health and Wellbeing
Sheffield

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

Response: People engaging in intense exercise often take antioxidant supplements, such as vitamin C and/or E or antioxidant-enriched foods, before and after exercise in the anticipation that these will help reduce muscle soreness. In a new review published in the Cochrane Library we looked at the evidence from 50 studies. These all compared high-dose antioxidant supplementation with a placebo and their participants all engaged in strenuous exercise that was sufficient to cause muscle soreness. Of the 1089 participants included in the review, nearly nine out of ten of these were male and most participants were recreationally active or moderately trained.

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Vitamin D and Calcium Supplements Did Not Lower Fracture Risk In Community-Dwelling Adults

MedicalResearch.com Interview with:
“ZMA och D-vitamin. Intages med dubbelsidig C-brus. #placebomannen” by Robin Danehav is licensed under CC BY 2.0Dr Jia-Guo Zhao

Tianjin Hospital
Department of Orthopaedic Surgery
Tianjin, China

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

Response: The increased social and economic burdens for osteoporotic-related fractures worldwide make its prevention a major public health goal.

Calcium and vitamin D supplements have long been considered a basic intervention for the treatment and prevention of osteoporosis. Survey analysis showed that 30–50% of older people take calcium or vitamin D supplements in some developed countries. Many previously published meta-analyses, from the high-ranking medical journals, concluded that calcium and vitamin D supplements reduce the incidence of fracture in older adults. And many guidelines regarding osteoporosis recommend calcium and vitamin D supplements for older people. The final aim for these supplements is to prevent the incidence of osteoporotic-related fracture in osteoporosis management.

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Sugar Compound In Food Products May Have Encouraged Growth of Dangerous C. diff Bacteria

MedicalResearch.com Interview with:

Professor Robert Britton PhD Therapeutic Microbiology Laboratory Department of Molecular Virology and Microbiology Alkek Center for Metagenomics and Microbiome Research Baylor College of Medicine

Prof. Britton

Professor Robert Britton PhD
Therapeutic Microbiology Laboratory
Department of Molecular Virology and Microbiology
Alkek Center for Metagenomics and Microbiome Research
Baylor College of Medicine

MedicalResearch.com Interview: How would you summarise your findings?

Response: As a brief summary of our work, certain strains of Clostridium difficile have emerged in the past 20 years that have resulted in epidemics worldwide, leading to C. difficile becoming one of the most common causes of hospital acquired infections.  Two ribotypes of C. difficile, RT027 and RT078, emerged as key epidemic ribotypes associated with increased disease prevalence and increased mortality in patients.  We found that both of these ribotypes have acquired the ability to consume the disaccharide trehalose by two completely independent mechanisms.  We further show that trehalose enhances disease severity of C. difficile infection in a manner that requires C. difficile to metabolize trehalose in mice.  We also show that trehalose is present in the distal intestine of mice and humans in concentrations that the RT027 ribotype can metabolize.  Because RT027 and RT078 strains were present in clinics at least 10-20 years prior to their becoming epidemic isolates, we looked where people would acquire trehalose in the diet.

In 2000 the FDA approved trehalose for human consumption (EFSA did so in 2001) and based on the GRAS report from the FDA the amount of trehalose predicted to be consumed once released on the market would vastly increase what people get naturally from the diet.  Our data support that these two ribotypes increased in prevalence due to a change in the human diet.

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Alcohol-Harm Paradox Linked To Drinking Patterns

MedicalResearch.com Interview with:
“Alcohol” by Jorge Mejía peralta is licensed under CC BY 2.0Dr. Eirik Degerud, PhD

Norwegian Institute of Public Health

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

Response: Alcohol-related hospitalisations and deaths are more frequent among individuals with low socioeconomic position, despite that they tend to drink less on average. This is referred to as the alcohol-harm paradox. Alcohol is associated with both higher and lower risk of cardiovascular disease, depending on the drinking pattern. We wanted to assess if the paradox was relevant to these relationship also. Continue reading

Probiotics May Help Colic in Breastfed But Not Formula Fed Babies

MedicalResearch.com Interview with:

Dr Valerie Sung MBBS (Hons) FRACP MPH PhD Department of Paediatrics The University of Melbourne Murdoch Childrens Research Institute Parkville, Australia

Dr. Sung

Dr Valerie Sung MBBS (Hons) FRACP MPH PhD
Department of Paediatrics
The University of Melbourne
Murdoch Childrens Research Institute
Parkville, Australia

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

Response: Infant colic is excessive crying in babies less than 3 months old with no underlying medical cause. It affects 1 in 5 newborns, is very distressing, and is associated with maternal depression, Shaken Baby Syndrome, and early cessation of breastfeeding. Up to now, there has been no single effective treatment for colic. The probiotic Lactobacillus reuteri DSM 17938 has recently shown promise but results from trials have been conflicting. In particular, a previous trial from Australia, the largest in the world so far, did not find the probiotic to be effective in both breastfed and formula-fed infants with colic.

This international collaborative study, which collected raw data from 345 infants from existing trials from Italy, Poland, Canada and Australia, confirms Lactobacillus reuteri to be effective in breastfed infants with colic. However, it cannot be recommended for formula-fed infants with colic.

Compared to a placebo, the probiotic group was two times more likely to reduce crying by 50 per cent, by the 21st day of treatment, for the babies who were exclusively breastfed. The number needed to treat for day 21 success in breastfed infants was 2.6.

In contrast, the formula fed infants in the probiotic group seemed to do worse than the placebo group, but the numbers for this group were limited.

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Male Physicians Receive More Money From Industry Than Women Doctors

MedicalResearch.com Interview with:
“Doctors” by Tele Jane is licensed under CC BY 2.0
Kathryn R. Tringale, MAS
Department of Radiation Medicine and Applied Sciences
University of California San Diego, La Jolla

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

Response: Financial relationships between biomedical industry and physicians are common, and previous work has investigated the potential conflicts of interest that can arise from these interactions.

Data show that even small payments in the form of industry sponsored lunches can influence physician prescribing patterns. Given the concern for the potential influence of biomedical industry over practice patterns and potentially patient care, the Open Payments program was implemented under the Affordable Care Act to shed light on these interactions and make reports of these financial transactions publicly available. We recently published a paper in JAMA on industry payments to physicians that found that men received a higher value and greater number of payments than women physicians and were more likely to receive royalty or licensing payments when grouped by type of specialty (surgeons, primary care, specialists, interventionalists).

The purpose of the Research Letter discussed here was to further examine differences in the value of payments received by male and female physicians within each individual specialty. The main takeaway from this study is that male physicians, across almost every specialty, are receive more money from biomedical industry compared to female physicians. At first glance, this finding can be interpreted as merely another example of gender disparities in the workplace, which we have seen before with gender gaps in physician salaries and research funding. Indeed, this gender gap may be a product of industry bias leading to unequal opportunity for women to engage in these profitable relationships. Alternatively, these data may be more representative of gender differences in physician decision-making. Previous data has shown that industry engagement can lead to changes in practice patterns, so maybe female physicians acknowledge these conflicts of interest and actively choose not to engage with industry. Unfortunately, we cannot tease out these subtleties from our results, but our paper does reveal a remarkable gender difference among physician engagement with industry.

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Benefits of Transplanting Hepatitis C Infected Livers May Outweigh Risks

MedicalResearch.com Interview with:

Jagpreet Chhatwal, PhD Assistant Professor, Harvard Medical School MGH Institute for Technology Assessment Boston, MA

Dr. Chhatwal

Jagpreet Chhatwal, PhD
Assistant Professor, Harvard Medical School
MGH Institute for Technology Assessment
Boston, MA and

Sumeyye Samur PhD Postdoctoral Fellow MGH-Harvard Medical School

Dr. Samur

Sumeyye Samur PhD
Postdoctoral Fellow
MGH-Harvard Medical School

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

Response: The number of patients who are in need of liver transplant continues to rise whereas the availability of organs remains limited, therefore, it becomes is important to utilize all available livers.

Under the current practices, only Hep-C infected patients are eligible to receive infected livers. However, with the advent of high efficacy drugs, number of infected recipients has decreased over the last decade. On the other hand, with the rise of opioid use, number of Hep-C infected organs increased. With this contradiction, it becomes paramount of importance to utilize the infected livers which could help save more lives on the transplant waiting list.

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Migraine Surgery Markedly Reduced Pain Intensity and Disability

MedicalResearch.com Interview with:
“Migraine” by makelessnoise is licensed under CC BY 2.0Lisa Gfrerer, MD PhD

Clinical Fellow in Surgery
Brigham and Women’s Hospital
William Gerald Austen MD
Chief, Plastic and Reconstructive Surgery
Chief, Division of Burn Surgery
Massachusetts General Hospital

 MedicalResearch.com: What are the main findings?

Response: Migraine surgery patients at our institution are chronic pain patients who have failed conservative therapy and are severely disabled by their disease.

We initiated this study to understand two important points. First, it was previously unclear how to categorize these patients in terms of pain intensity and disability on the spectrum of better known pain conditions such as chronic back pain/ nerve pain/ carpal tunnel.  This is very important to appreciate the extent of this disease. Second, instead of collecting migraine characteristic such as decrease in migraine days/ duration/ pain, we wanted to understand how functionally disabled these patients are in their daily lives and how much better they get after surgery. This is ultimately what matters to patients.

We therefore decided to evaluate our outcomes by using the Pain Self Efficacy Questionnaires (PSEQ). This validated pain questionnaire has been used to describe pain intensity/disability in patients with different acute and chronic pain conditions.

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Does Restasis Work For Dry Eye Disease?

MedicalResearch.com Interview with:
Steven Woloshin, MD MS

Steven Woloshin, MD Professor of The Dartmouth Institute Professor of Medicine Professor of Community and Family Medicine

Dr. Steven Woloshin

Professor of The Dartmouth Institute
Professor of Medicine
Professor of Community and Family Medicine
The Center for Medicine in the Media
Dartmouth Institute for Health Policy and Clinical Practice
Lebanon, New Hampshire

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

Response: There has been a lot of debate about the legal maneuvers (ie, transferring patents to the Mohawk Indians) Allergan has employed to delay marketing of generic alternatives to Restasis (cyclosporine ophthalmic emulsion 0.05%).   But there is a more fundamental question that has received little attention:  Does Restasis work?  It is not approved in the European Union, Australia or New Zealand where registration applications were “withdrawn prior to approval due to insufficient evidence of efficacy” in 2001.   Although Canada approved Restasis, its national health technology assessment unit, unconvinced of meaningful benefit, recommended Canada not pay for it – according to our research, no Canadian provincial or federal drug plan currently does.   Nevertheless, Americans have spent $8.8 billion in total sales between 2009 and 2015 on Restasis, including over $2.9 billion in public monies through Medicare Part D.

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Brain Signals Reflect Social Anxiety and Performance Fears in ASD

MedicalResearch.com Interview with:

Tamara Rosen

Tamara Rosen

Tamara Rosen
Graduate student in Clinical Psychology
Stony Brook University

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

Response: Approximately 40 percent of youth with autism spectrum disorder (ASD) are diagnosed with a co-occurring anxiety disorder.  Social anxiety is a common presenting problem for these youth.

Youth with ASD and increased social anxiety have heightened threat sensitivity, particularly in relation to performance fears, as measured by a brain signal response called the error-related negativity (ERN), which measures response to errors. The threat sensitivity-performance fears association remained even after controlling for anxiety symptoms other than social fearfulness.

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Good Relationship With Grandparents Mitigates Feelings Of Ageism

MedicalResearch.com Interview with:
“Grandparents” by Tim Wilson is licensed under CC BY 2.0Allison Flamion, Doctorante

Unité de Psychologie de la Sénescence
Département Psychologies et cliniques des systèmes humains
Université de Liège
LIEGE Belgique

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

Response: Ageism—stereotypes that lead to prejudice and discrimination against older people— occurs frequently in young adults and can even be seen in children as young as 3.

Ageism has deleterious consequences on older people in our aging Western societies. However, the factors influencing this phenomenon in the young are not well known.

To answer this question, we have asked 1151 Belgian children and adolescents to provide their views of the elderly, using especially designed questionnaires and open questions. We found four main influences on their views of the elderly: gender and age of the child, quality of contact with grandparents, and grandparents’ health. Girls had slightly more positive views than boys. Ageist stereotypes fluctuated with age, with 7- to 9-year-olds expressing the most prejudice and 10- to 12-year-olds expressing the least. This finding mirrors other forms of discrimination (e.g., those related to ethnicity or gender) and is in line with cognitive-developmental theories. For example, acquiring perspective-taking skills around age 10 reduces previous stereotypes. With regard to ageism, prejudice seemed to reappear when the participants in this study reached their teen years: 13- to 16-year-olds had higher levels of ageism compared with younger children. Moreover, youths who described their contact with grandparents as good or very good had more favorable feelings toward the elderly than those who described the contact less positively.

Finally, children and adolescents with grandparents in poor health were more likely to hold ageist views than youths with grandparents in better health.

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Multiple Sclerosis: Functional Changes After Inflammation May Partly Explain Clinico-Radiological Paradox

MedicalResearch.com Interview with:
Netta Levin MD PhD
fMRI lab
Neurology Department
Hadassah Hebrew University Medical Center
Jerusalem 

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

Response: Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system, manifesting with episodes of local inflammatory processes, called relapses. The most useful surrogate laboratory test for MS is magnetic resonance imaging (MRI), in which dissemination of demyelinating lesions in space and time are the hallmark of the disease. However, there is a discrepancy between the lesion load – the number, size, and location of the lesions – and the clinical state of the patients, reflected in their disability. This discrepancy is known as the “clinico-radiological paradox” and suggests that something other than the well-known mechanisms of demyelination, remyelination, and axonal loss may tip the scale of recovery from an acute episode. Global effects of the local damage and compensatory mechanisms were suggested as an explanation to this paradox.

In this study, we compared the visual system of patients with clinically isolated syndrome optic neuritis (ON) to patients with clinically isolated episodes in other functional systems, exploring changes, both anatomical and functional, caused to the system following the demyelinating episode. Optic neuritis was deemed a good in vivo model for studying the pathophysiology of tissue damage and repair in MS due to its characteristic clinical manifestation and to the visual pathways’ amenability to investigation using various techniques. To assess anatomical wiring ,i.e the white matter fibers themselves , we used diffusion tensor imaging (DTI). To assess functional networking as reflected by signal synchronization between distinct brain regions, we used resting state fMRI.

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Children with Heart Failure from Dilated Cardiomyopathy are Surviving Longer in the Most Recent Era

This file was derived from Blausen 0165 Cardiomyopathy Dilated.png

Structural categories of cardiomyopathy Wikipedia image

MedicalResearch.com Interview with:
Rakesh K. Singh MD, MS

Department of Pediatrics, University of California–San Diego and
Rady Children’s Hospital
San Diego, California

Steven E. Lipshultz MD
Department of Pediatrics
Wayne State University School of Medicine and
Children’s Hospital of Michigan
Detroit, Michigan 

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

Response: Dilated cardiomyopathy (DCM) is a disease characterized by dilation and dysfunction of the left ventricle of the heart. While DCM is a relatively rare disease in children, nearly 40% of children with DCM require a heart transplant or die within 2 years of diagnosis. Heart transplantation has improved the outcomes of children with DCM over the last 3 decades, but is limited by donor heart availability. Newer therapies, including advanced ICU care and artificial heart machines, are now being used to treat children with DCM.

This study published in the November 28, 2017 issue of the Journal of American College of Cardiology (JACC) sought to determine whether more children with DCM were surviving longer in the more recent era. Specifically, it investigated whether children with DCM were surviving longer without the need for heart transplantation. Rakesh Singh, MD is the first author and an Associate Professor of Pediatrics at UC San Diego/Rady Children’s Hospital, while the senior author is Steven Lipshultz, MD, Professor at Wayne State University School of Medicine/Detroit Medical Center’s Children’s Hospital of Michigan and Director of Children’s Research Center of Michigan.

The Pediatric Cardiomyopathy Registry (PCMR) is a National Heart, Lung, and Blood Institute (NHLBI) sponsored registry from 98 pediatric centers in United States and Canada created to study the outcomes of children with various heart muscle disorders known as cardiomyopathies. For this study, outcomes of 1,199 children diagnosed with DCM from 1990-1999 were compared with 754 children diagnosed with DCM from 2000-2009.

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ACA Pay-For-Performance Programs Not Living Up To Expectations

MedicalResearch.com Interview with:

Dr. Igna Bonfrer PhD Post-Doctoral Research Fellow Harvard T.H. Chan School of Public Health 

Dr. Bonfrer

Dr. Igna Bonfrer PhD
Post-Doctoral Research Fellow
Harvard T.H. Chan School of Public Health  

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

Response: One of the two main elements of the Affordable Care Act, generally known as Obama Care, is the implementation of value based payments through so called “pay-for-performance” initiatives. The aim of pay-for-performance (P4P) is to reward health care providers for high-quality care and to penalize them for low-quality care.

We studied the effects of the P4P program in US hospitals and found that the impact of the program as currently implemented has been limited.

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Characteristics of Poor Outcomes With Incomplete Coronary Artery Revascularization

MedicalResearch.com Interview with:

coronary arteries

Wikipedia image

Edward L. Hannan, PhD, MS, MS, FACC
Distinguished Professor and Associate Dean Emeritus
University at Albany
School of Public Health
Rensselaer, NY 12144

 

 

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

Response: We have done a lot of work on complete revascularization (CR) vs. incomplete revascularization (IR) already, and as a follow-up it seemed as if there may be different types of IR that are associated with even worse outcomes relative to CR and other IR.

Incomplete revascularization is associated with worse outcomes if it involves multiple vessels, vessels with severe stenosis, or significant proximal left anterior descending artery vessel (PLAD) stenosis.

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Stem Cell Transplantation Offers Hope For Severe Scleroderma

MedicalResearch.com Interview with:

“Breastfeeding welcome here” by Newtown grafitti is licensed under CC BY 2.0

Picture of a female patient’s left arm, showing skin lesions caused by Scleroderma
Wikipedia image

Keith M. Sullivan, M.D.
James B. Wyngaarden Professor Of Medicine
Division of Cellular Therapy
Duke University Medical Center
Durham, North Carolina 27710, USA 

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

  • Scleroderma with internal organ involvement is a devastating  autoimmune disorder with considerable morbidity and high mortality which have not changed in 40 years of reporting. Effective new therapies are needed.
  • Despite 2 prior randomized trials showing benefit for reduced-intensity stem cell transplant vs. conventional cyclophosphamide immune suppression, clinical practice in the US did not change due in part due to concern about patient safety and durability of response (attached).
  • The current randomized trial compares 12 monthly infusions of cyclophosphamide with high-dose chemotherapy plus whole-body irradiation designed to wipe-out (myeloablate) the defective, self-reactive immune system and replace with the patients own stem cells which had been treated to remove self-reacting lymphocytes. This was the first study to test if myeloablative autologous could re-establish a normal functioning immune system in patients with scleroderma.

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Program Improves Sleep For Mothers Hospitalized For Delivery

MedicalResearch.com Interview with:
“Now I’m having contractions.” by Remus Pereni is licensed under CC BY 2.0Kathryn A. Lee, RN, CBSM, PhD
Department of Family Health Care Nursing
University of California at San Francisco
San Francisco, California 

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

Response: Sleep deprivation can adversely affect health and wellbeing in any patient population.

In pregnancy, adverse outcomes may include preterm birth, longer labor, cesarean birth, and depression.

We found that women with high-risk pregnancies were sleep deprived even prior to hospitalization. Our sample averaged 29 weeks gestation, and half reported getting only between 5 and 6.5 hours of sleep at home before hospital admission. Our sleep hygiene intervention strategies gave them more control over the environment in their hospital room, and they self-reported significantly better sleep than controls. Interestingly, both groups increased their sleep time to almost 7 hours at night, on average, in the hospital before they were discharged home.

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Should Money Be Used To Encourage Breastfeeding?

MedicalResearch.com Interview with:
“Breastfeeding welcome here” by Newtown grafitti is licensed under CC BY 2.0
Clare Relton, PhD
School of Health and Related Research
University of Sheffield, Sheffield, England

MedicalResearch.com: What are the key findings of your report?

Response: Our five year research project explored whether offering financial incentives (shopping vouchers) for breastfeeding increased breastfeeding. We studied what happened to breastfeeding rates at 6 to 8 weeks post-partum in areas in England with low (<40%) breastfeeding prevalence. Our cluster randomized clinical trial (which included 10 010 mother-infant dyads) showed that areas with the financial incentive had significantly higher rates of breastfeeding at 6 to 8 weeks (37.9% vs 31.7%) compared to usual care.

The financial incentive scheme was widely acceptable to healthcare providers (midwives, health visitors, doctors) and mothers. The financial incentives made it easier for everyone to discuss breastfeeding and mothers reported feeling valued (supported and rewarded) for breastfeeding.

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Even With Preserved Ovaries Hysterectomy Linked To Increased Cardiac and Metabolic Risks

MedicalResearch.com Interview with:

Dr. Shannon Laughlin-Tommaso MD Associate Professor of Obstetrics and Gynecology Consultant, Division of Gynecology, Department of Obstetrics & Gynecology Mayo Clinic, Rochester New York

Dr. Laughlin-Tommaso

Dr. Shannon Laughlin-Tommaso MD
Associate Professor of Obstetrics and Gynecology
Consultant, Division of Gynecology, Department of Obstetrics & Gynecology
Mayo Clinic, Rochester New York 

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

Response: There are increasing data from a number of studies about the long term risks of hysterectomy both with and without removing the ovaries. We studied women who underwent hysterectomy with conservation of both ovaries to determine the long-term risk of cardiovascular disease using the Rochester Epidemiology Project (REP). The advantage of using the REP is that we were able to follow women for an average of 22 years, where previous studies had only been able to follow for 7-10 years and we were able to determine which women already had cardiovascular disease risk factors at the time of hysterectomy.

We found that women who undergo hysterectomy have a 33% increased risk of new onset coronary artery disease, a 13% increased risk of hypertension, a 14% increased risk in lipid abnormalities, and an 18% increased risk of obesity. For women who had a hysterectomy before age 35 years, these risks were even higher: 2.5-fold risk of coronary artery disease and 4.6-fold risk of congestive heart failure.

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Increased Diabetes Risk in African Americans Explained by Greater Obesity Rates

MedicalResearch.com Interview with:

Michael P. Bancks, PhD Northwestern University Chicago, Illinois 

Dr. Bancks

Michael P. Bancks, PhD
Northwestern University
Chicago, Illinois 

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

Response: We know that the disparity in diabetes between black and white youth and young adults is growing, but the reasons why are unclear. We also know that traditional risk factors for diabetes, such as obesity and low socioeconomic status, are more common among blacks as compared with whites.

Our study describes how the unequal rates of these traditional diabetes risk factors explain or account for the higher rates of diabetes among blacks.

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Weaning To Hydrolyzed Infant Formula Did Not Reduce Risk of Type 1 Diabetes

MedicalResearch.com Interview with:
“Baby Bottle” by brokinhrt2 is licensed under CC BY 2.0Mikael Knip, MD, PhD

Professor of Pediatrics
TRIGR PI 

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

Response: Experimental studies have indicated that the avoidance of early exposure to cow’s milk proteins reduces the cumulative incidence of autoimmune diabetes in animal models of human type 1 diabetes, e.g. BB rats and NOD mice. Epidemiological studies in humans have suggested that there may be a link between type 1 diabetes and short breastfeeding or early introduction of infant formulas. All regular infant formulas contain intact cow’s milk proteins.

The main finding was that weaning to an extensively hydrolyzed formula did not reduce the cumulative incidence of Type 1 diabetes in at-risk children by the mean age of 11 years.

The extensively hydrolyzed formula did not contain any intact cow’s milk proteins but only small peptides (maximal size 2000 daltons).

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Program Encouraging Shared Bookreading Improved Vocabulary, Memory and IQ

MedicalResearch.com Interview with:

Adriana Weisleder, PhD Research scientist, Department of Pediatrics NYU Langone Medical Center

Dr. Weislander

Adriana Weisleder, PhD
Research scientist, Department of Pediatrics
NYU Langone Medical Center
New York 

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

Response: An estimated 250 million children in low- and middle-income countries do not reach their developmental potential due to poverty. Many programs in the US, such as Reach Out and Read and Video Interaction Project, have shown success in reducing poverty-related disparities in early child development by promoting parent-child interactions in cognitively stimulating activities such as shared bookreading.

This randomized study sought to determine whether a program focused on supporting parent-child shared bookreading would result in enhanced child development among 2- to 4-year-old children in a low-resource region in northern Brazil. Families in the program could borrow children’s books on a weekly basis and could participate in monthly parent workshops focused on reading aloud.

Findings showed that participating families exhibited higher quantity and quality of shared reading interactions than families in a control group, and children showed higher vocabularies, working memory, and IQ.

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Phase I Study Successfully Targets Metastatic Kidney Cancer

MedicalResearch.com Interview with:

Kevin D. Courtney, M.D., Ph.D.  Assistant Professor UT Southwestern Medical Cente

Dr. Courtney

Kevin D. Courtney, M.D., Ph.D. 
Assistant Professor
UT Southwestern Medical Center

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

Response: Clear cell renal cell carcinoma (ccRCC) is the most common form of kidney cancer. Metastatic ccRCC does not respond to traditional chemotherapy.

Current standard treatments for metastatic ccRCC include drugs called vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR TKIs) that block the growth of new blood vessels that feed the cancer, as well as drugs that inhibit an enzyme called mTOR that is involved in ccRCC growth and immune therapies that rev up the body’s immune response to try to fight the cancer. Each of these treatments can have significant side effects for patients that can make them difficult to tolerate.

Metastatic ccRCC is largely incurable, and we need novel and better-tolerated treatments. A central driver of ccRCC is a protein called hypoxia inducible factor 2alpha (HIF-2alpha). This protein has been very difficult to try to target with a drug. This study is the first to test a drug that targets HIF-2alpha in patients with metastatic ccRCC. The study results showed that the HIF-2alpha inhibitor, PT2385 (Peloton Therapeutics) was active in fighting metastatic ccRCC and was well-tolerated.

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Transcranial Stimulation Has Potential as Add-On Therapy For Bipolar Depression

MedicalResearch.com Interview with:

Yokoi and Sumiyoshi. 2015 tDCS administration at National Center of Neurology and Psychiatry Hospital. A subject (front) sits on a sofa relaxed, and a researcher (behind) controls the tDCS device (a). In this picture, anodal (b) and cathodal (c) electrodes with 35-cm2 size are put on F3 and right supraorbital region, respectively. We use a head strap (d) for convenience and reproducibility, and also use a rubber band (e) for reducing resistance

tDCS administration at National Center of Neurology and Psychiatry Hospital. A subject (front) sits on a sofa relaxed, and a researcher (behind) controls the tDCS device (a). In this picture, anodal (b) and cathodal (c) electrodes with 35-cm2 size are put on F3 and right supraorbital region, respectively. We use a head strap (d) for convenience and reproducibility, and also use a rubber band (e) for reducing resistance
Wikipedia file

Andre Russowsky Brunoni, MD, PhD
Coordinator, Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences  Department and Institute of Psychiatry
Coordinator, Interdisciplinary Center for Applied Neuromodulation, University Hospital
University of São Paulo
São Paulo, Brasil 

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

Response: In this study, our aim was to evaluate the safety and efficacy of transcranial direct current stimulation (tDCS) as an add-on treatment for patients with bipolar depression. There are a only few treatment alternatives for bipolar depression, which often have important side effects. Thus, we wanted to evaluate the efficacy of this non-pharmacological treatment.

We found that active vs. sham tDCS effected greater response and remission for patients with bipolar depression. The frequency of adverse effects was similar, including treatment-emergent affective switches. However, higher rates of skin redness were observed in the active group.

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Hypoglycemia All Too Common In Hospice and End of Life Care

MedicalResearch.com Interview with:
Dr. Laura A. Petrillo MD
Instructor in Medicine
Harvard Medical School, and Palliative Care Physician
Massachusetts General Hospital

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

Response: Hospice is end-of-life care focused on maximizing quality of life. Hospice often involves reducing or stopping treatments that are unlikely to have short-term benefit in order to avoid uncomfortable side effects. About a quarter of Americans die in nursing homes, and some of them receive hospice care in their final days. We looked at whether adults with type 2 diabetes experience low blood sugar while on hospice in veterans’ nursing homes, since low blood sugar signals inappropriately aggressive diabetes treatment in patients close to death and contributes to unnecessary discomfort.

We found that one in nine people experienced low blood sugar at least once while receiving hospice care. Among people who were on insulin, the number was one in three.

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Oral Immunotherapy With Omalizmuab Resulted in Faster Food Desensitization

MedicalResearch.com Interview with:

Sandra Andorf PhD Kim and Ping Li Director of Computational Biology Sean N. Parker Center for Allergy and Asthma Research at Stanford University Instructor, Nadeau Lab Department of Medicine, Division of Pulmonary & Critical Care Medicine Stanford University School of Medicine

Dr. Andorf

Sandra Andorf PhD
Kim and Ping Li Director of Computational Biology
Sean N. Parker Center for Allergy and Asthma Research at Stanford University
Instructor, Nadeau Lab
Department of Medicine, Division of Pulmonary & Critical Care Medicine
Stanford University School of Medicine

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

Response: Food allergies are on the rise in the world. Approximately 15 million Americans have food allergies, which includes around 6 million children. Of people with food allergies, 30-40% are allergic to more than one food and therefore these people have a greater risk for an accidental ingestion resulting in an allergic reaction or anaphylaxis.

Currently there is no FDA approved treatment for food allergies but oral immunotherapy, a treatment in which the patient eats small but slowly increasing doses of their allergen until they can tolerate a specified dose, was shown in research settings to be safe in children and adults for up to 5 foods in parallel.

In this trial, we studied the efficacy and safety of Omalizmuab (an anti-IgE drug) treatment with oral immunotherapy in multifood allergic participants versus placebo with oral immunotherapy for a total of 9 months. We found that 83% of the participants who received Omalizumab could tolerate at least 2 g of at least two different food allergens at the end of the trial compared to 33% of those who received placebo. The participants that received Omalizumab were also desensitized faster, meaning they were on average able to eat 2 g of each of their allergic foods earlier in the treatment. Furthermore, we could show that the use of Omalizumab and the fast updosing is safe.

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Increased Prenatal Care Linked To State Medicaid Expansion

MedicalResearch.com Interview with:

Dr. Laura Wherry credit: UCLA Health

Dr. Laura Wherry
credit: UCLA Health

Laura R. Wherry, Ph.D.
Division of General Internal Medicine and Health Services Research
David Geffen School of Medicine at UCLA
Los Angeles, CA 90024 

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

Response: All states provide Medicaid coverage to pregnant women, but many low-income women do not qualify for the program when they are not pregnant. However, state decisions to expand Medicaid coverage to low-income parents and adults allow low-income women to have Medicaid coverage prior to, and between, their pregnancies. Increased health insurance coverage for low-income women during these non-pregnancy periods may help improve their preconception health and their planning of pregnancies, ultimately leading to healthier pregnancies and infants.

This study examines how state expansions in Medicaid coverage for low-income parents before the Affordable Care Act affected the health insurance status of mothers prior to additional pregnancies (i.e. their pre-pregnancy health insurance status). I also examine whether there are changes in pregnancy intention (i.e. whether the pregnancy was mistimed or unwanted), as better access to pre-pregnancy insurance coverage could increase contraception utilization and improve the planning of pregnancies.

Finally, I examine whether there were changes in insurance coverage during pregnancy and in the utilization of prenatal care, since women who have pre-pregnancy insurance coverage may experience fewer barriers to establishing care during their pregnancies.

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Study Finds Modest Survival Increase in Parkinson’s Patients Who Receive Deep Brain Stimulation

MedicalResearch.com Interview with:
Dr. Frances M. Weaver PhD
Hines VA Hospital
Center of Innovation for Complex Chronic Healthcare
Hines, IL 60141

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

Response: Research has shown that deep brain stimulation (DBS) for Parkinson’s disease (PD) improves motor function and this improvement is sustained. There is also improvement in quality of life after DBS. However, it is not known whether DBS also effects survival. A few studies that have examined survival have had mixed results.

In the current study we compared survival for a large cohort of persons with Parkinson’s disease who underwent DBS to a match group of persons with PD who were managed medically.

We found a modest improvement in survival for persons with Parkinson’s disease who underwent DBS compared to individuals who did not.

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Mitochondrial Link To Cocaine Addiction Explored

“cocaine photo” by Imagens Evangélicas is licensed under CC BY 2.0MedicalResearch.com Interview with:
Mary Kay Lobo, PhD

Associate Professor
University of Maryland School of Medicine
Department of Anatomy and Neurobiology
Baltimore, MD 21201 

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

Response: Altered energy balance has been studied in drug abuse but the fundamental source of energy, mitochondria, has not been well examined.  In this study we found that a molecular regulator of mitochondrial fission (division) is increased in the nucleus accumbens, a major brain reward region, of rodents exposed to repeated cocaine and postmortem samples of cocaine dependent individuals.  We further found that mitochondrial fission is increased in a nucleus accumbens neuron subtype in rodents that self-administer cocaine. Pharmacological blockade of mitochondrial fission can prevent physiological responses to cocaine in this neuron subtype while reducing cocaine-mediated behaviors.  Finally, genetic reduction of mitochondrial fission in this neuron subtype in the nucleus accumbens can reduce drug (cocaine) seeking in rodents previously exposed to cocaine. In contrast, increasing mitochondrial fission, in this neuron subtype, enhances cocaine seeking behavior.

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Early Studies Suggest Blood Pressure Medication Hydralazine May Slow Aging and Neurodegeneration

CrawlingCelegans Wikipedia

Crawling C. elegans
Wikipedia image

MedicalResearch.com Interview with:
Hamid Mirzaei, Ph.D.
Assistant Professor of Biochemistry
University of Texas Southwestern
Department of Biochemistry
Dallas, TX 75390

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

Response: Aging is a complex process at the cellular level with distinct organismal phenotypes. Despite millennia-old obsession with aging and relentless pursuits for ways to stop and reverse it, such elixir has not been found due to the complexity of the involved mechanisms and our limited understanding of the processes that lead to aging. Although progress has been made in recent years in slowing down the aging process in model organisms and human cells.

In this study, we report that and FDA approved antihypertensive drug, hydralazine, decelerates aging in C. elegans by mechanisms that seem to resemble dietary restriction. We show that hydralazine increases the median lifespan of the C. elegans by 25% which is comparable to or better than other known antiaging compounds.

We demonstrate that not only hydralazine-treated worms live longer, they appear to be healthier in general. Because aging is directly linked to neurodegenerative diseases, we tested our drug on both in vitro and in vivo models of neurodegenerative diseases using chemical and biological stressors (rotenone and tau fibrils) and show that hydralazine has neuroprotective properties as well.

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Lack of Folic Acid Supplements During Pregnancy Linked With Increased Autism Risk in Children Exposed to Seizure Drugs In Utero

MedicalResearch.com Interview with:

Dr. Marte Bjørk, MD PhD Department of Clinical Medicine University of Bergen, Department of Neurology Haukeland University Hospital Bergen, Norway

Dr. Marte Bjørk

Dr. Marte Bjørk, MD PhD
Department of Clinical Medicine
University of Bergen,
Department of Neurology
Haukeland University Hospital
Bergen, Norway

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

Response: In utero antiepileptic drug exposure are associated with neurodevelopmental problems in the child. We looked into if maternal folate during pregnancy could reduce the risk of autistic traits in children of women in need of antiepileptic drugs in pregnancy. The rationale for the hypothesis that folate could be beneficial, was that many antiepileptic drugs interact with folate metabolism. Folic acid supplement use is also associated with slightly reduced risk of autism in children of women from the general population.

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Affordable Care Act Linked To Increased Duration of BreastFeeding

MedicalResearch.com Interview with:
“Babies at Brunch!” by TJ DeGroat is licensed under CC BY 2.0
Kandice A. Kapinos, Ph.D.
Economist
Professor
RAND Corporation
Pardee RAND Graduate School

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

Response: In the U.S., we have relatively high rates of breastfeeding initiation – about 80% of mothers will attempt breastfeeding, but rates drop off precipitously in the first few months of an infant’s life. There are tremendous health benefits for both the mother and child from breastfeeding and estimates of significant cost savings from diseases prevented from breastfeeding. However, breastfeeding can be difficult, especially when you need to return to work or school. The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months, but only 22% of mothers breastfeed exclusively for 6 months.

My coauthors, Tami Gurley-Calvez and Lindsey Bullinger, and I were interested in evaluating provisions in recent healthcare legislation (the Affordable Care Act) that required private insurers to cover lactation support services, including breast pumps and visits with lactation consultants, without cost-sharing.

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Ovarian Cancer Trial: Disappointing Results of Paclitaxel With/Without Pazopanib

MedicalResearch.com Interview with:
Debra Richardson, MD, FACOG, FACS
Associate Professor, Section of Gynecologic Oncology,
Oklahoma TSET Phase I Program
Stephensen Cancer Center
The University of Oklahoma

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

Response: Ovarian cancer is the leading cause of gynecologic cancer deaths. Pazopanib is an oral multitarget tyrosine kinase inhibitor of VEGF receptors 1, 2, and 3; platelet-derived growth factor (PDGF) receptors α and β and c-KIT. Weekly paclitaxel is an active agent for recurrent ovarian cancer.

This was a national, randomized, double-blind, placebo controlled phase 2b trial of weekly paclitaxel with or without pazopanib for the treatment of recurrent ovarian cancer. The primary objective was to estimate the progression-free survival (PFS) hazard ratio (HR) of the combination of weekly paclitaxel (80mg/m2 D1, 8, 15 every 28 days) and pazopanib (800mg PO daily) compared with weekly paclitaxel and placebo in women with persistent or recurrent ovarian cancer. 106 women were enrolled. There was no difference in median PFS, overall survival (OS), or proportion responding. Severe hypertension was more common on the pazopanib plus paclitaxel arm. More patients discontinued treatment on the paclitaxel arm for disease progression, and more on the pazopanib plus paclitaxel arm for adverse events. Patients with VEGFA CC genotype may be more resistant to weekly paclitaxel than those with the AC or AA genotype.

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Cervical Pessaries May Reduce Risk of Some Preterm Births

MedicalResearch.com Interview with:
Gabriele Saccone, MD
Department of Neuroscience
Reproductive Sciences and Dentistry
School of Medicine
University of Naples Federico II
Naples, Italy

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

Response: Preterm birth is a major cause of perinatal morbidity and mortality. About 15 million infants were born too soon every year, causing 1.1 million deaths. The cervical pessary is a silicone device that has been studied to prevent preterm birth. However, the efficacy of this device in preventing preterm birth is still subject of debate.

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Employees At Discount Stores May Face More Rude Shoppers

MedicalResearch.com Interview with:
“Lidl Shopping Trolley” by Jeff Djevdet is licensed under CC BY 2.0Alexander P. Henkel, PhD
Business Intelligence and Smart Services (BISS) Institute / Open University, The Netherlands

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

Response: As consumers, we are frequently bombarded with a myriad of marketing tactics. One tactic regularly employed by thrift-oriented brands is to highlight low prices, discounts, and sales promotions. When consumers encounter these low-price signals, they may adopt a price conscious mentality, that is, a singular focus on getting the cheapest deal. A price conscious mentality is likely beneficial for consumers, as it helps them save money. However, it is also possible that it has negative implications, particularly for how consumers perceive and interact with other human beings in the marketplace, such as customer service employees. We investigated this question in a collaboration project between the Business Intelligence and Smart Services (BISS) Institute (founded by the Open University and Maastricht University, both Netherlands) and the University of British Columbia in Canada.

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Complex Issues Drive Young Marital Age in Southeast Asia

MedicalResearch.com Interview with:
“Marriage” by sowrirajan s is licensed under CC BY 2.0Dr Akanksha Marphatia and

co-authors, Dr Alice Reid and Dr Gabriel Amable
Cambridge, UK

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

Response: Although the total prevalence of girls marrying below the UN prescribed minimum age of 18 years has decreased over time, this is mostly due to a decrease in child marriages, <15 years. Marriages during adolescence, between 16-17 years, have increased. Women marring just after 18 years may also experience some of the consequences of those marrying under-age. These patterns are important to recognise because the predictors and consequences of marriage in these age groups are likely to differ.

The aim of our review was to summarise research evidence on why women’s marriage age, independent of early child-bearing, is a major public health issue. In the four South Asian countries of our review, Bangladesh, India, Nepal and Pakistan, marriage precedes reproduction.

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Trumenba Vaccine Helps Protect Against Meningococcal B Infections in Adolescents and Young Adults

MedicalResearch.com Interview with:

Judith Absalon, M.D., M.P.H Senior Director, Vaccines Clinical Research  Pfizer Pharmaceuticals

Dr. Judith Absalon

Judith Absalon, M.D., M.P.H
Senior Director, Vaccines Clinical Research
Pfizer Pharmaceuticals

MedicalResearch.com: What is the background for these two studies?

Response: Invasive serogroup B meningococcal disease (MenB) is uncommon, yet serious, is unpredictable and can strike at any age, including healthy teenagers and young adults, with potentially long-lasting and devastating consequences, including death. The data from these two Phase 3 studies, one in adolescents (Study 1009) and one young adults (Study 1016), highlight that Trumenba can help protect teens and young adults against meningococcal group B disease.

Additionally, these two large Phase 3 studies confirmed the results of earlier studies and supported the transition from Accelerated to Traditional Approval in the US; were pivotal for approvals in Europe, Australia, and Canada earlier this year; and add to the growing portfolio of research for TRUMENBA.

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Does the Working Class Handle Interpersonal Conflicts Better Than The Middle Class?

MedicalResearch.com Interview with:
“working class” by arileu is licensed under CC BY 2.0Igor Grossmann, Ph.D
.
Director, Wisdom and Culture Laboratory
Associate Professor of Psychology
University of Waterloo, Canada
Associate Editor, Emotion

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

Response: Our Wisdom & Culture laboratory studies the concepts of wisdom and cultural factors. For wisdom, we specifically focus on pragmatic reasoning that can help people to better understand and navigate uncertain contexts – strategies that philosophers for millennia discussed as “epistemic virtues.” In our prior work, my colleagues and I have observed that wisdom tends to be lower in situations when self-interests are salient, and higher when one adopted an socially-sensitive interdependent mindset. In other work by myself and several other labs, consistent finding emerged showing that lower social class tends to be more socially interdependent, whereas middle class (both in the US, Russia, and even China) tends to be more self-focused.

This led to the present research, which combines prior insights to examine how wise reasoning varies across social classes. Because lower class situation involves more uncertainty and more resource-scare life circumstances, we questioned whether these situations would also evoke more wise reasoning from people who are in them. Higher class situations are assumed to provide conditions that benefit people in every way. But in so doing, they may also encourage entitlement, self-focus and thereby intellectual humility and open-mindedness – key features of a wise thought. As such, our studies show that it turns out that middle class conditions are not beneficial in at least one way – they may discourage reasoning wisely.

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GERD Associated With Increased Risk of Malignancy of the Upper Aerodigestive Tract

MedicalResearch.com Interview with:

Dr. Edward D. McCoul, MD, MPH Ochsner Medical Center

Dr. McCoul

Dr. Edward D. McCoul, MD, MPH
Ochsner Medical Center

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

Response: Population-level data suggests a link between gastroesophageal reflux disease and cancer of the throat and sinuses in adults over 65 years of age.  T

he strength of association between reflux and cancer is strongest for anatomic sites closest to the esophagus, where acid and other stomach contents may have the greatest exposure.

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Phase 3 Darzalex Trial Demonstrated Meaningful Improvement in Patients with Newly Diagnosed Multiple Myeloma

MedicalResearch.com Interview with:
janseen-oncologyMaria-Victoria Mateos, MD, PhD

University Hospital of Salamanca/IBSAL
Salamanca, Spain

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

Response: The Phase 3 ALCYONE study data showed DARZALEX (daratumumab) in combination with bortezomib, melphalan, and prednisone (VMP) significantly improved clinical outcomes, including reducing the risk of disease progression or death by 50 percent, in newly diagnosed patients with multiple myeloma who are ineligible for autologous stem cell transplantation (ASCT) at a median follow-up of 16.5 months (Hazard Ratio [HR] = 0.50; 95 percent CI [0.38-0.65], p<0.0001).

The median progression-free survival (PFS) for DARZALEX-VMP had not yet been reached, compared to an estimated median PFS of 18.1 months for patients who received VMP alone. In addition to reducing the risk of disease progression or death, DARZALEX significantly improved the overall response rate (ORR) as compared to VMP alone, including more than doubling rates of stringent complete response, significantly improved rates of very good partial response or better and complete response or better (CR).

The most common (≥10 percent) Grade 3/4 treatment-emergent adverse events (TEAEs) for DARZALEX-VMP vs. VMP were neutropenia (40 percent vs. 39 percent), thrombocytopenia (34 percent vs. 38 percent), anemia (16 percent vs. 20 percent) and pneumonia (11 percent vs. 4 percent). One patient in each arm discontinued treatment due to pneumonia, and 0.9 percent of patients discontinued DARZALEX due to an infection. Twenty-eight percent of patients experienced infusion reactions (IRs) due to DARZALEX.. In the DARZALEX-VMP arm, 42 percent of patients experienced a serious adverse event (SAE), compared to 33 percent in the VMP arm.

The study findings were as a late-breaking abstract (Abstract #LBA-4) at the 59th American Society of Hematology (ASH) Annual Meeting in Atlanta, and simultaneously published in the New England Journal of Medicine (NEJM).

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