Author Interviews, Blood Pressure - Hypertension, NEJM / 20.04.2018

MedicalResearch.com Interview with: “Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0José R. Banegas, M.D. Department of Preventive Medicine and Public Health Universidad Autónoma de Madrid Madrid, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Population-based studies and a few relatively small clinical investigations have defined the prognostic role of ambulatory blood pressure monitoring (ABPM) in hypertensive patients. However, previous studies were mostly limited by relatively small number of outcomes. Our study is the largest worldwide and provides unequivocal evidence that ABPM is superior to clinic pressure at predicting total and cardiovascular mortality across a wide range of clinical scenarios – the differences are striking. Also, whether white-coat hypertension is a benign phenotype is still debated. Our study demonstrates that white-coat hypertension was not benign. Lastly, masked hypertension patients (clinic BP normal but ABPM elevated) experienced the greatest risk of death.   (more…)
Annals Internal Medicine, Author Interviews, ENT, Environmental Risks, Hearing Loss / 19.04.2018

Christine Marie Durand, M.D. Assistant Professor of Medicine Johns Hopkins Medicine MedicalResearch.com Interview with: Dr. Véronique J. C. Kraaijenga MD Department of Otorhinolaryngology–Head and Neck Surgery Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands MedicalResearch.com: What is the background for this study? Response: During the past two decades, the frequency of hearing loss among young people has increased and going to music concerts, clubs and festivals may part of the reason. Noise-induced hearing loss because of recreational noise exposure is reduced by using earplugs. Our study evaluated 51 adults who attended an outdoor music festival in Amsterdam, the Netherlands, in September 2015. The study measured music festival visit for 4.5 hours (intervention); temporary hearing loss (outcome). (more…)
Alzheimer's - Dementia, Author Interviews, NIH, PNAS, Sleep Disorders / 19.04.2018

MedicalResearch.com Interview with: Nora D. Volkow MD Senior Investigator Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism National Institutes of Health, Bethesda, MD 20892 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Findings from animal studies had shown that sleep deprivation increased the content of beta-amyloid in brain, which is a risk factor for Alzheimer’s disease.  We wanted to test whether this also happened in the human brain after one night of sleep deprivation. We found that indeed one night of sleep deprivation led to an accumulation of beta amyloid in the human brain, which suggest that one of the reasons why we sleep is to help clean our brain of degradation products that if not removed are toxic to brain cells.  (more…)
Author Interviews, Diabetes, Geriatrics / 19.04.2018

MedicalResearch.com Interview with: “Diabetes Mellitus” by Steve Davis is licensed under CC BY 2.0Matthew James O'Brien MD Assistant Professor, Medicine General Medicine Division Assistant Professor, Preventive Medicine Northwestern University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The USPSTF is an expert group that makes recommendations for screening and other preventive services. In December 2015, they recommend that providers screen for diabetes in patients who are 40-70 years old and also overweight/obese. The same recommendation stated that clinicians “should consider screening earlier” in patients who have any of the following risk factors: non-white race/ethnicity, family history of diabetes, or personal history of gestational diabetes or polycystic ovarian syndrome. Using nationally representative data, we studied the performance of the “limited” criteria based on age and weight alone vs. the “expanded criteria” mentioned above. The main findings were that following the “limited” screening criteria of age and weight would result in missing over 50% of adults with prediabetes and diabetes. In other words, if providers followed the “limited” criteria, over 50% of adults with prediabetes and diabetes would not get screened. The “expanded” criteria exhibited much better performance, resulting in 76.8% of adults with prediabetes and diabetes who would be screened.  (more…)
Author Interviews, Cancer Research, Dermatology, JAMA, Melanoma, Primary Care, University of Pittsburgh / 18.04.2018

MedicalResearch.com Interview with: Laura K. Ferris MD, PhD Associate Professor, University of Pittsburgh Clinical and Translational Science Institute Director of Clinical Trials, UPMC Department of Dermatology University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Dermatology is one of the greatest utilizers of physician extenders, including physician assistants (PAs) in medicine. The scope of practice of PAs has also expanded over time from a role in assisting the dermatologist to taking a more independent role and many PAs now do skin cancer screening examinations and make independent decisions about which lesions are suspicious for skin cancer and need to be biopsied. Our main findings were that, overall, in comparison to board-certified dermatologists, PAs were more likely to perform biopsies of benign lesions. For every melanoma that they found, PAs biopsied 39 benign lesions whereas dermatologists biopsied 25. In addition, PAs were less likely than dermatologists to diagnose melanoma in situ, the earliest and most curable, but also hardest to identify and diagnose, form of melanoma. However, PAs had a similar rate of diagnosing the more clinically-obvious forms of skin cancer, including invasive melanoma, basal cell carcinoma, and squamous cell carcinoma. (more…)
Author Interviews, Cancer Research, Chemotherapy, Erectile Dysfunction / 18.04.2018

MedicalResearch.com Interview with: Dr Pan Pantziarka, PhD Program Director, Drug Repurposing: Anticancer Fund Coordinator: Repurposing Drugs in Oncology (www.redo-project.org)  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Repurposing Drugs in Oncology (ReDO) project is an on-going collaboration assessing the evidence of anticancer activity in a wide range of already licensed non-cancer drugs. A subset of these drugs have a sufficient level of evidence to support clinical investigation and these are profiled in detail in order to synthesise the existing evidence and to bring it to the attention of clinical researchers. In the case of the PDE5 inhibitors sildenafil, tadalafil and vardenafil the evidence is clear that these drugs have multiple anticancer mechanisms of action at clinically relevant dosing. In particular there is evidence that these drugs target anti-tumour immune responses, as shown from a small number of early stage clinical trials. This opens up the prospect of using these cheap and widely available drugs in combination with existing therapies to improve the number and duration of responses. The chance to increase the therapeutic effectiveness of immune checkpoint inhibitors is especially compelling and definitely warrants clinical research. (more…)
AACR, Author Interviews, Genetic Research / 18.04.2018

MedicalResearch.com Interview with: Ed Liu, M.D President and CEO The Jackson Laboratory (JAX) MedicalResearch.com: What is the background for this study? What are the main findings? Response: A few years ago we and others identified a complex genomic instability profile commonly found in the genomes of breast, ovarian and endometrial carcinomas, which is characterized by hundreds of isolated head-to-tail duplications of DNA segments, called tandem duplications. We refer to this configuration as the tandem duplicator phenotype, or TDP. In this study, we perform a meta-analysis of over 2,700 cancer genomes from over 30 different tumor types and provide a detailed description of six different types of TDP, distinguished by the presence of tandem duplications of different sizes. Collectively, these profiles are found in ~50% of breast, ovarian and endometrial carcinomas as well as 10-30% of adrenocortical, esophageal, stomach and lung adeno-carcinomas. We show that distinct genetic abnormalities associate with the distinct TDPs, clearly suggesting that distinct molecular mechanisms are driving TDP formation. In particular, we provide strong evidence of a casual relationship between joint abrogation of the BRCA1 and TP53 tumor suppressor genes and the emergence of a short-span (~11 Kb) TDP profile. We also observe a significant association between hyper-activation of the CCNE1 pathway and TDP with medium-span (~230 Kb) tandem duplications, and between mutation of the CDK12 gene and medium- and large-span TDP (coexisting 230 Kb and 1.7 Kb tandem duplications). Importantly, we find that different forms of TDP result in the perturbation of alternative sets of cancer genes, with short-span TDP profiles leading to the loss of tumor suppressor genes via double transections, and larger-span TDP profiles resulting in the duplication (i.e. copy number gain) of oncogenes and gene regulatory elements, such as super-enhancers and disease-associated SNPs.  (more…)
Author Interviews, Environmental Risks, Infections, Pediatrics, Respiratory / 18.04.2018

MedicalResearch.com Interview with: Benjamin D. Horne, PhD Director of Cardiovascular and Genetic Epidemiology Intermountain Heart Institute Intermountain Medical Center Salt Lake City, Utah  MedicalResearch.com: What is the background for this study? Response: Evidence suggests that short-term elevations (even for just a few days) of fine particulate matter air pollution (PM2.5, which is particulate matter less than 2.5 um or about one-thirtieth the diameter of a human hair) is associated with various poor health outcomes among adults, including myocardial infarction, heart failure exacerbation, and worsening of chronic obstructive pulmonary disease symptoms. Studies of long-term exposure to moderately elevated levels of PM2.5 indicate that chronic daily air pollution exposure may contribute to death due to pneumonia and influenza. Research regarding the association of short-term elevations in PM2.5 has provided some limited evidence of a possible association between short-term PM2.5 increases and infection with respiratory syncytial virus (RSV) or bronchiolitis in children, but scientifically these reports have been weak and unreliable, probably because they have only looked at a period of a few days to a week after short-term PM2.5 elevations. An evaluation of a very large population in a geographic location that provides a wide variation in PM2.5 levels from lowest to highest levels and that examines longer periods of time after the PM2.5 elevations is needed to determine whether a PM2.5 association with lower respiratory infection exists. (more…)
Author Interviews, Heart Disease, JAMA, Lipids / 17.04.2018

MedicalResearch.com Interview with: Dr. Jennifer Robinson, MD MPH Professor, Departments of Epidemiology & Medicine Director, Prevention Intervention Center Department of Epidemiology University of Iowa MedicalResearch.com: What is the background for this study? Response: Compared to previous placebo-controlled statin trials, the FOURIER trial where all patients were on high or moderate intensity statin, had no reduction in cardiovascular or total mortality and the reduction in cardiovascular events was less than expected.  However, other PCSK9 inhibitor trials performed in populations with higher baseline low density lipoprotein cholesterol (LDL-C) had cardiovascular risk reductions similar to that in the statin trails. (more…)
Author Interviews, Blood Clots, Cancer Research / 17.04.2018

MedicalResearch.com Interview with: Dr. Jens Sundbøll Department of Clinical Epidemiology Aarhus University Hospital Aarhus, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: The incidence of acute peripheral arterial occlusion is approximately 1.5 cases per 10,000 person-years. In comparison, the incidence rate of deep venous thrombosis is about 5-10cases per 10,000 person-years. It has been established previously that deep venous thrombosis in the lower limb and pulmonary embolism may be presenting symptoms of cancer and is associated with a poor cancer prognosis. However, whether arterial thromboembolism of the lower limb also can represent prodromal symptoms of occult cancer and worsen cancer prognosis has never been investigated. (more…)
AACR, Author Interviews, Baylor College of Medicine Houston, Blood Pressure - Hypertension, Pancreatic / 17.04.2018

MedicalResearch.com Interview with: Zhensheng Wang, M.P.H., Ph.D. Postdoctoral Associate Duncan Cancer Center-Bondy Baylor College of Medicine Houston, TX MedicalResearch.com: What is the background for this study? Response: Our prior research consistently found a significant inverse association between circulating levels of soluble receptor for advanced glycation end products (sRAGE), an anti-inflammatory factor, and risk of pancreatic cancer. It has also been found that sRAGE levels or RAGE signaling are modulated by anti-hypertensive (anti-HT) medications, including angiotensin-converting-enzyme inhibitors (ACEi), β-blockers, and calcium channel blockers (CCBs). These medications have been shown in prior pre-clinical or experimental research to either increase sRAGE concentrations, decrease formation of advanced glycation end-products (AGEs), or dampen pro-inflammatory receptor for AGE (RAGE) signaling pathway. We therefore hypothesized that there would be an inverse association between use of anti-HT medications and risk of developing pancreatic cancer. Pancreatic cancer is a major public health concern in the United States, as it is the 4th leading cause of cancer-related mortality with an estimated of 43,090 deaths in 2017. Pancreatic cancer typically occurs in elderly individuals who also have chronic comorbid medical conditions, such as hypertension. Anti-HT medication use in individuals ≥ 18 years old has increased from 63.5% in 2001-2002 to 77.3% in 2009-2010, according to the National Health and Nutrition Examination Survey in the U.S. Therefore, it is of great public health significance to address the potential association between anti-HT medication use and risk of pancreatic cancer in the general population. (more…)
AACR, Author Interviews, Cancer Research / 17.04.2018

MedicalResearch.com Interview with: Mark E. Hatley, M.D., Ph.D. Assistant Member Molecular Oncology Division, Department of Oncology St. Jude Children's Research Hospital Memphis, TN 38105 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma occurring in children. Tumors appear histologically and genetically as undifferentiated skeletal muscle and are thus thought to solely originate from early skeletal muscle cells. However, tumors occur throughout the body, including sites devoid of skeletal muscle. In addition, tumor location is a key feature of staging and 40% of patients develop RMS in the head and neck. Interestingly, head and neck muscle development is distinct from the development of trunk and limb muscle. Previously we described a model of rhabdomyosarcoma which occurred specifically in the head and neck and originated from non-muscle cells. In this study we investigated how normal development programs are hijacked to drive rhabdomyosarcoma location. We demonstrated that RMS can originate from immature blood vessel cells that lie in between muscle fibers specifically in the head and neck. During development, these cells are hijacked, and become reprogrammed into rhabdomyosarcoma rather than mature endothelial cells. These RMS cells express factors important in head and neck muscle development. Our findings highlight that cell of origin contributes to RMS location and may explain why a high proportion of RMS occurs in the head and neck.  (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA, Primary Care / 16.04.2018

MedicalResearch.com Interview with: “Doctors” by Tele Jane is licensed under CC BY 2.0Doug Einstadter, MD, MPH Center for Health Care Research and Policy MetroHealth System and Case Western Reserve University  MedicalResearch.com: What is the background for this study?   Response: Despite the recognized importance of blood pressure (BP) control for those with hypertension, based on national surveys only 54% of patients with hypertension seen in primary care have their BP controlled to less than 140/90 mm Hg. Blood pressure measurement error is a major cause of poor BP control. Reducing measurement error has the potential to avoid overtreatment, including side effects from medications which would be intensified or started due to a falsely elevated blood pressure. One way to reduce measurement error is to repeat the BP measurement during an office visit. The American Heart Association recommends repeating a blood pressure at the same clinic visit with at least 1 minute separating BP readings, but due to time constraints or lack of evidence for the value of repeat measurement, busy primary care practices often measure BP only once. Repeating the BP at the same office visit when the initial blood pressure measurement is high has the potential to improve clinical decision-making regarding BP treatment. Several studies have described the effect of a repeat BP measurement in the inpatient setting, but there are little data available to characterize the effect of repeating blood pressure measurement in an outpatient primary care setting. (more…)
Author Interviews, Cancer Research, JAMA / 16.04.2018

MedicalResearch.com Interview with: Lindor Qunaj BSc MD'19 Medical student, Warren Alpert Medical School of Brown University Brown Center for Biomedical Informatics Providence, Rhode Island MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study was motivated by growing concerns that incomplete or delayed release of clinical trial data may put patients at risk of harm or suboptimal treatment and slow the pace of biomedical innovation. Especially in a field as rapidly evolving as oncology, complete and timely dissemination of clinical trial results is critical to the advancement of both patient care and scientific discovery. In an analysis of press releases from eight large pharmaceutical companies, we found that the median delay from presumed availability of Phase 3 trial data to peer-reviewed publication or public posting of results was 300 days. Studies reporting positive findings were published more rapidly than those with negative results. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, JAMA, Stroke / 16.04.2018

MedicalResearch.com Interview with: Dr. Joshua Goldstein MD, PhD J. Philip Kistler Stroke Research Center Division of Neurocritical Care and Emergency Neurology, Department of Neurology MGH Harvard Medical School, Boston Department of Emergency Medicine Massachusetts General Hospital for the Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 (ATACH-2) and the Neurological Emergencies Treatment Trials (NETT) Network Investigators   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: It’s hard to know how aggressively to lower blood pressure in acute intracerebral hemorrhage (ICH).  Randomized controlled trials have been conflicting. We thought that we could use the presence of severe small vessel disease (SVD) - manifested by microbleeds seen on brain magnetic resonance imaging (MRI) – to guide treatment decisions.  On the one hand, those with severe SVD may be most vulnerable to continued bleeding, and specifically need more intensive blood pressure lowering.  On the other hand, if they have impaired regulation of cerebral blood flow, they might be harmed by rapid drops in blood pressure, and maybe we have to be more careful with them. To answer this, we performed a subgroup analysis of the multi-centre ATACH-2 clinical trial of intensive blood pressure lowering. This was the first study to assess the effect of randomized acute stroke treatment on patients with more severe SVD, manifested by microbleeds.  We found that no matter what your small vessel disease burden on MRI, you’ll respond the same to early blood pressure management. (more…)
Author Interviews, Infections, Nature, NIH, PLoS, Rheumatology / 16.04.2018

MedicalResearch.com Interview with: John B. Harley, MD, PhD Professor and Director David Glass Endowed Chair Center for Autoimmune Genomics and Etiology (CAGE) Department of Pediatrics University of Cincinnati Cincinnati Children’s Hospital Medical Center Cincinnati, Ohio 45229 MedicalResearch.com: What is the background for this study? Response: Previous work has shown that Epstein-Barr virus infection is associated with systemic lupus erythematosus and studies of the origins of the autoimmune response have also suggested that the autoimmunity of this disease may originate with the immune response against this virus. In the meantime, many investigators have been studying the genetics of lupus over the past 25 years. They have found about 100 convincing genes that alter the risk of developing lupus. (more…)
Author Interviews, Breast Cancer, JNCI, UT Southwestern / 16.04.2018

MedicalResearch.com Interview with: Yingfei Wang, Ph.D. and Weibo Luo, Ph.D. Department of Pathology UT Southwestern Medical Center Dallas TX 75390 MedicalResearch.com: What is the background for this study? Response: Breast cancer is the most commonly diagnosed cancer in women. Tumor metastasis is frequently found in breast cancer patients and causes more than 90% of cancer death. There is currently no cure for this deadly disease. We have known that breast tumor is not supplied with sufficient oxygen (a phenomenon known as hypoxia), which makes breast cancer cells more aggressive and may be responsible for tumor recurrence, metastasis, and therapy resistance. Hypoxia-inducible factor (HIF) is a master regulator frequently detected in the hypoxic regions and switches on many oncogenes needed for breast cancer cells to grow and spread around the body. The role of HIF in gene regulation is precisely controlled and shutting down of HIF’s activity would be a promising strategy for the treatment of metastatic breast cancer. (more…)
Author Interviews, Pediatrics, Pulmonary Disease / 15.04.2018

MedicalResearch.com Interview with: Gustavo Nino, M.D. Children’s National Health System pulmonologist Study senior autho MedicalResearch.com: What is the background for this study? Response: The epidemiology of respiratory disorders is largely influenced by the individual’s sex resulting in overall higher risk for males than females, particularly during early life. Hormonal, anatomical and behavioral differences are postulated to play a role, but these sex-based respiratory differences are already present at birth, suggesting a strong genetic component. However, the genetic differences in the airways of males and females during early life have been remarkably understudied and are largely unknown. (more…)
Author Interviews, Mental Health Research, Pediatrics, Primary Care / 15.04.2018

MedicalResearch.com Interview with: Anna Scandinaro Medical student Penn State College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Dr. Usman Hameed, a child and adolescent psychiatrist, and Dr. Dellasega wrote a previous paper called "What is irritability?" which examined the idea and concept of what irritability in school aged children can encompass. After considering possible definitions of irritability, we wanted to see how the concept manifested in clinical practice, especially with the controversy around the new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) in the DSM 5. The main findings of this study are that primary care providers (PCP)​identified a need for more training and education in how to assess irritability in pediatric and adolescent populations. In contrast, the child and adolescent psychiatrists we interviewed thought more triage from PCPs who care for school aged children with irritability would be helpful.  (more…)
Author Interviews, Depression, Eating Disorders, JAMA, Mental Health Research, Pediatrics / 13.04.2018

MedicalResearch.com Interview with: Tracy Vaillancourt, Ph.D. Full Professor and Canada Research Chair Children’s Mental Health and Violence Prevention Counselling Psychology, Faculty of Education School of Psychology, Faculty of Social Sciences University of Ottawa MedicalResearch.com: What is the background for this study? Response: Although there have been a few studies that have looked at the relation between being bullied and disordered eating, most studies have looked at it from the perspective of does being bullied lead to disordered eating and does depressive symptoms mediate (i.e., explain) the link. We wanted to look more closely at how bullying, disordered eating, and depression were related over time among teenagers by examining all possible pathways. Another novel aspect of our study was the focus on disordered eating behaviour only (e.g., vomiting, using diet pills, binge eating). Most previous work has examined behaviour and thoughts together, but because disordered eating thoughts are so common (termed normative discontent; e.g., fear of fat, dissatisfaction with body shape or size), particularly among girls and women, we wanted to focus on behaviour, which is more problematic in terms of physical and psychiatric health. (more…)
Author Interviews, Colon Cancer, Supplements / 13.04.2018

MedicalResearch.com Interview with: Nathalie Scheers PhD Asst. Professor Chalmers University of Technology Dept of Biology and Biological Engineering Food and Nutrition Science Göteborg, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many different forms of iron supplements are used to treat iron deficiency symptoms or as phosphate binders in patients with renal disease. two of these iron supplements, the chelates ferric citrate and ferric EDTA have been observed to drive colon cancer in mice. In the newly published study in Oncotarget, we are reporting our work on how these iron compounds differ compared to the simple salt ferrous sulphate, which is another common iron supplement. The main finding of this study was that ferric citrate and ferric EDTA promoted the cancer biomarker amphiregulin which in turn activated the MAP kinase ERK in gut epithelial cancer cells. There were no such effects in ferrous sulphate-treated cells.  (more…)
Author Interviews, Hepatitis - Liver Disease, Microbiome, Nutrition, Weight Research / 13.04.2018

MedicalResearch.com Interview with: “Turkish Food” by Garry Knight is licensed under CC BY 2.0Jasmohan S. Bajaj, M.D. Associate Professor Department of Internal Medicine Division of Gastroenterology Virginia Commonwealth University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Altered gut microbiota composition can occur due to diseases and due to changes in the dietary practices. The interaction between these two and their linkage with clinical outcomes in liver diseases, such as cirrhosis is not clear from an international standpoint. In this study we enrolled healthy subjects, and patients with cirrhosis who were either early or advanced in their process from USA and Turkey. We found that the Turkish subjects, who followed a Middle-eastern diet rich in vegetables and fermented milk products, had high microbial diversity, which was in turn associated with lower hospitalizations over 3 months. There was also an additional beneficial effect of coffee and tea intake. This protection persisted even when the clinical factors were accounted for. (more…)
Author Interviews, Sleep Disorders / 12.04.2018

MedicalResearch.com Interview with: “Sleep” by Spencer Smith is licensed under CC BY 2.0Kristen L. Knutson, PhD Associate Professor Center for Circadian and Sleep Medicine Department of Neurology Northwestern University Feinberg School of Medicine Chicago, IL  60611​ MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has shown that “night owls” (people who prefer the evening) have higher rates of diseases such as diabetes or high blood pressure.  We wanted to determine whether mortality risk was also higher in night owls. We used data from the UK Biobank of almost a half million people who were asked whether they were morning or evening types. We found that the night owls had a 10% increased risk of dying over a 6 ½ year period compared to the morning types, even after taking into account existing health problems. (more…)
Author Interviews, Microbiome, Nutrition, Sugar, Weight Research / 12.04.2018

MedicalResearch.com Interview with: Eugene B. Chang, MD Martin Boyer Professor of Medicine Knapp Center for Biomedical Discovery University of Chicago Chicago, IL  60637 and Kristina Martinez-Guryn, Ph.D., R.D.
Assistant Professor 
Biomedical Sciences Program
Midwestern University
Downers Grove IL MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Martinez-Guryn: The original goal of this study was to understand why mice devoid of all microorganisms (germ free mice) are protected from diet-induced obesity. We demonstrate that these mice display severely impaired lipid absorption even when fed a high fat diet. Dr. Chang: We found that many of the processes of dietary lipid digestion and absorption are dependent on and modulated by the gut microbiome which itself responds to dietary cues to adjust the small intestine’s ability and capacity to handle dietary lipids appropriately. This interplay is important for general health, but the findings are also relevant to conditions of overnutrition (obesity, metabolic syndrome) and undernutrition (starvation, environmental enteropathy).  In conditions of overnutrition, high fat, simple sugar, low fiber foods typical of western diets promote small intestinal microbes (which have been largely neglected by the scientific community) that promote fat digestion and absorption. This increases our capacity to assimilate dietary fats which can contribute to the overnutrition problem.  In conditions of undernutrition, these types of gut microbes are lost or minimally represented.  Thus, when nutritional repletion is started, the gut’s ability to upregulate its capacity for dietary lipid digestion and absorption is compromised. (more…)
Author Interviews, Heart Disease, JACC, Outcomes & Safety, Surgical Research, University of Michigan / 12.04.2018

MedicalResearch.com Interview with: Donald Likosky, Ph.D., M.S. Associate Professor Head of the Section of Health Services Research and Quality Department of Cardiac Surgery. University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Michigan was one of several states to expand Medicaid. Current evaluations of the Michigan Medicaid expansion program have noted increases in primary care services and health risk assessments, but less work has evaluated its role within a specialty service line. There has been concern among some that Medicaid patients, who have traditionally lacked access to preventive services, may be at high risk for poor clinical outcomes if provided increased access to cardiovascular interventions. Using data from two physician-led quality collaboratives, we evaluated the volume and outcomes of percutaneous coronary interventions and coronary artery bypass grafting 24mos before and 24mos after expansion. We noted large-scale increased access to both percutaneous coronary interventions (44.5% increase) and coronary artery bypass grafting (103.8% increase) among patients with Medicaid insurance. There was a decrease in access for patients with private insurance in both cohorts. Nonetheless, outcomes (clinical and resource utilization) were not adversely impacted by expansion.  (more…)
Author Interviews, Endocrinology, Mental Health Research, OBGYNE / 12.04.2018

MedicalResearch.com Interview with: Aled Rees, MD, PhD Neuroscience and Mental Health Research Institute Cardiff University School of Medicine, Health Park Cardiff United Kingdom MedicalResearch.com: What is the background for this study?   Response: PCOS is a common condition, affecting 5-10% of women globally, in which elevated male hormone levels can cause a range of distressing and life-limiting symptoms, including reduced fertility, irregular periods, excessive facial and body hair, and acne. Previous studies have suggested a link between PCOS and poor mental health in women but the studies were small and did not adequately take other factors that can affect mental health into consideration. In addition, high levels of testosterone during pregnancy have been reported to increase the risk of neurodevelopmental disorders, such as ADHD and autism, in children. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Epilepsy / 12.04.2018

MedicalResearch.com Interview with: Britta Haenisch, PhD Pharmacoepidemiology in Neurodegenerative Disorders German Center for Neurodegenerative Diseases, DZNE  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Antiepileptic drugs (AEDs) have been shown to affect cognition by suppressing neuronal excitability and increasing inhibitory neurotransmission. Previous studies suggested that AEDs may be associated with cognitive adverse effects. Therefore, we evaluated the association between AED use and incident dementia and Alzheimer’s disease (AD). We utilized large longitudinal datasets from Finnish health registers and from German health insurance data. The case-control analyses was adjusted for several potential confounders like comorbidities and polypharmacy. The inclusion of a lag time between . Antiepileptic drugs use and dementia diagnosis allowed minimization of protopathic bias. Our study provides an association between regular prescription of  antiepileptic drugs with known cognitive adverse effects and the occurrence of dementia and AD in patients aged 65 years and older.  (more…)
Author Interviews, JAMA, Mental Health Research, OBGYNE, Pediatrics / 11.04.2018

MedicalResearch.com Interview with: Jiook Cha, PhD Assistant Professor Division of Child and Adolescent Psychiatry Columbia University Medical Center New York, NY 10032 MedicalResearch.com: What did we already know about the connection between maternal SSRI use during pregnancy and infant brain development, and how do the current study findings add to our understanding? What’s new/surprising here and why does it matter for mothers and babies? Response: Prior studies have shown mixed results in terms of the associations between maternal SRI use during pregnancy and offspring’s brain and cognitive development. Neurobiological studies with animal models suggest that SSRI use perturbs serotonin signaling and that this has important effects on cognitive development (a study conducted an author of this paper, Jay Gingrich, MD, PhD: Ansorge et al., 2004, Science). The human literature has been more mixed in terms of the associations of prenatal exposure to SSRI with brain and cognitive development. In our study, we used neonatal brain imaging because this is a direct, non-invasive method to test associations between SSRI use and brain development at an early developmental stage, limiting the effects of the post-natal environment. In our study, we had two different control groups, that is, a non-depressed SSRI-free group (healthy controls), and depressed but SSRI-free (SSRI controls) group. Also, in our study we used rigorous imaging analytics that significantly improve the quantitative nature of MR-derived signals from the brain structure using two of the nation’s fastest supercomputers (Argonne National Laboratory and Texas Advanced Computing Center) and allows robust reconstruction of brain’s grey and white matter structure in the infants’ brains. We report a significant association of prenatal exposure to SSRI with a volume increases within many brain areas, including the amygdala and insula cortex, and an increase in white matter connection strength between the amygdala and insular cortex. We were surprised by the magnitude of the effects (or the statistical effect size), compared with other brain imaging studies in psychiatry with children or adults’ brains. Importantly, it should be noted that our estimates of brain structure are still experimental and for research-purpose only. This means that our data need to be replicated and rigorously tested against confounders in order to make a firm conclusion. While our study suggests a “potential” association between prenatal exposure to SSRI and a change in fetal or infant brain development, we still need more research.  tracts_in_the_brain (more…)
Author Interviews, Infections, Lipids / 11.04.2018

MedicalResearch.com Interview with: Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry Herlev and Gentofte Hospital Copenhagen University Hospital, Denmark  MedicalResearch.com: What is the background for this study? Response: For decades research into the role and function of high-density lipoprotein (HDL) has revolved around the believe that HDL protects against atherosclerotic cardiovascular disease. However, results from large genetic studies and from large randomized clinical trials with HDL cholesterol elevating drugs have all indicated that there is no causal association between HDL cholesterol and risk of atherosclerotic cardiovascular disease. Given the hitherto strong focus on cardiovascular disease, little is known about the possible role of HDL in other aspects of human health and disease. Preclinical evidence has indicated that HDL might be of importance for normal function of the immune system and susceptibility to infectious disease, but it had never previously been investigated if levels of HDL cholesterol is associated with the risk of infectious disease in individuals from the general population. In the present study we tested this hypothesis in more than 100.000 Danes from the population at large. (more…)
Author Interviews, Global Health, Infections, Pediatrics / 10.04.2018

MedicalResearch.com Interview with: Georgies Mgode PhD Sokoine University of Agriculture Pest Management Centre African Centre of Excellence for Innovative Rodent Pest Management and Biosensor Technology Development Morogoro, Tanzania MedicalResearch.com: What is the background for this study? Response: The background of this study is the APOPO and Sokoine University of Agriculture together with NIMR and NTLP interest to explore a cheap, reliable and sustainable means of addressing TB problem in high-burden countries with limited access to advanced sensitive tests. This refers to countries where to-date TB diagnosis is mainly by microscopy that is less sensitive leaving majority of patients undetected. We were driven to explore how these rats can contribute to diagnosis of TB in children that is known to be difficult and rats are known to have a better and advanced sense of smell. According to WHO " an estimated 1 million children became ill with TB and 250 000 children died of TB in 2016 and the actual burden of TB in children is likely higher given the challenge in diagnosing childhood TB.  (more…)