MedicalResearch.com Interview with
E. Paul Zehr PhD
Professor & Director
Centre for Biomedical Research,
Rehabilitation Neuroscience Laboratory, McKinnon
Division of Medical Sciences
Exercise Science, Physical & Health Education
International Collaboration on Repair Discoveries (ICORD)|
Affiliate, Division of Neurology, Department of Medicine, UBC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: For many years we explored the role of the spinal cord in regulating rhythmic arm and leg movements like we do during walking, running and swimming. Although we humans tend to move and locomote around on our two legs as bipeds, we are basically quadrupeds in terms of how our nervous system controls our limbs during walking. We have an extensive network of brain and spinal cord connections that help coordinate our limbs while we move. A lot of our work showed that using the arms rhythmically, like during arm cycling, strongly affected the activity of the spinal cord controlling leg muscles. Getting the spinal cord for leg muscles more coordinated and activated is a major goal of rehabilitation of walking after neurotrauma so we wanted to see if training the arms could help with this. This is particularly important because a lot of the time, the arms are not engaged at all in rehabilitation training for the legs.
We found that after only 5 weeks of arm cycling (3 x 30 minutes each week), neural excitability, strength, and leg function were increased along with enhanced clinical tests of balance and walking ability.
(more…)
Author Interviews, Lancet, Melanoma, Weight Research / 14.02.2018
Another Obesity Paradox: Obese Males Have Survival Advantage in Melanoma
MedicalResearch.com Interview with:
Jennifer McQuade, M.D., lead author
Melanoma Medical Oncology
The University of Texas MD Anderson Cancer Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Melanoma is the most deadly of the common skin cancers, and for many years we lacked effective therapies for patients with disease that had spread (metastatic). Over the past 7 years, there has been FDA approval of 2 new classes of drugs that have dramatically improved the survival of patients with metastatic melanoma. Checkpoint inhibitor immunotherapies “take the brakes” off patients’ immune system to allow the immune system to eliminate the cancer. Targeted therapies turn off key molecules expressed by some tumors (BRAF mutant) that they rely on for sustained growth and division.
While these types of therapies can result in dramatic long-term disease control in some patients, others may not have any shrinkage of their tumors. Some differences may lie in the tumors themselves, but there is also increasing evidence that “host” factors such as the microbiome and lifestyle choices might influence outcomes in cancer patients.
Obesity has been associated with an increased risk of many cancers, and is in fact poised to overtake smoking as the leading preventable cause of cancer. One of the ways that obesity may increase tumor growth is by increasing levels of insulin and other growth factors which then activate a pathway called the PI3K pathway that leads to continued tumor growth. As that PI3K pathway has also been shown to cause resistance to targeted and immune therapies in melanoma, we hypothesized that obesity would be associated with worse outcomes in patients with metastatic melanoma treated with these therapies.
(more…)
Author Interviews, Hepatitis - Liver Disease, Imperial College, Technology / 14.02.2018
‘Liver-on-a-Chip’ Technology Can Accurately Mimic Hepatitis B Infection
MedicalResearch.com Interview with:
Marcus Dorner, PhD
Non-Clinical Senior Lecturer in Immunology
Wellcome Trust Investigator
Imperial College London
Department of Medicine, Section of Virology
School of Medicine
London United Kingdom
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Hepatitis B virus (HBV) infection globally affects over 250 million people and is currently not curable. This infection can lead to liver cirrhosis and liver cancer and is among the leading causes for liver transplantation. Unfortunately, HBV is among the most difficult viruses to study in the laboratory, since model systems are not very good at recapitulating what happens in infected humans.
We have just described the first model to effectively change this. Using an artificial “Liver-on-a-Chip”, we have developed a tool, which can potentially revolutionise how we study viral infections by merging the study of viruses with tissue engineering. This model is over 10,000-fold more susceptible to HBV infection and accurately mimics, what happens in an infected patient. This can now be utilised to develop novel and potentially curative therapies, which would benefit millions of people currently living with chronic HBV infection. (more…)
MedicalResearch.com Interview with:
Thomas Denson PhD
University of New South Wales
Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Decades of research have shown that alcohol is a powerful psychotropic contributor to aggressive behaviour. Researchers have long suspected that alcohol increases aggression because it dampens activation in the prefrontal cortex, which leads to reduced inhibition, narrows attentional processing, and exaggerates hostile thinking. However, direct evidence has been lacking. We compared brain activity in intoxicated versus sober participants when they were given the opportunity to behave aggressively in the scanner against other men who provoked them.
We gave 50 healthy young men alcohol or a placebo. Participants who consumed alcohol breathalysed at .05. They did show decreased activation in the prefrontal cortex as expected. This was the first evidence to show that when intoxicated participants behave aggressively, they show reduced prefrontal activity. Interestingly, we found a positively correlation between prefrontal cortex activity and aggression, but only among intoxicated men. We think this reflects the fact that the participants in the alcohol condition were likely engaging in more hostile thinking about the provoking men. (more…)
Thomas Denson PhD
University of New South Wales
Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Decades of research have shown that alcohol is a powerful psychotropic contributor to aggressive behaviour. Researchers have long suspected that alcohol increases aggression because it dampens activation in the prefrontal cortex, which leads to reduced inhibition, narrows attentional processing, and exaggerates hostile thinking. However, direct evidence has been lacking. We compared brain activity in intoxicated versus sober participants when they were given the opportunity to behave aggressively in the scanner against other men who provoked them.
We gave 50 healthy young men alcohol or a placebo. Participants who consumed alcohol breathalysed at .05. They did show decreased activation in the prefrontal cortex as expected. This was the first evidence to show that when intoxicated participants behave aggressively, they show reduced prefrontal activity. Interestingly, we found a positively correlation between prefrontal cortex activity and aggression, but only among intoxicated men. We think this reflects the fact that the participants in the alcohol condition were likely engaging in more hostile thinking about the provoking men. (more…)
Author Interviews, Mayo Clinic, Neurology / 13.02.2018
Similar Incidence of Autoimmune and Infectious Brain Inflammatory Disease Encephalitis
MedicalResearch.com Interview with:
Eoin Flanagan, M.B., B.Ch.
Mayo Clinic
Rochester, Minnesota
MedicalResearch.com: What is the background for this study?
Response: Traditionally it has been thought that infections (e.g., viruses) account for the majority of encephalitis cases. Recent discoveries of neural autoantibody markers of encephalitis (e.g., NMDA receptor autoantibodies) have led to an appreciation that encephalitis cases can be caused by the body’s own immune system attacking the brain, what we term autoimmune encephalitis. (more…)
Author Interviews, Diabetes, Occupational Health / 13.02.2018
Irregular or Rotating Night Shifts Linked To Increased Risk of Diabetes
MedicalResearch.com Interview with:
Dr. Céline Vetter
Assistant Professor
Department of Integrative Physiology
University of Colorado at Boulder
Boulder, CO
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Shift work, particularly night shifts, can change our social rhythms, as well as the internal biological rhythms including our sleep, and these effects could explain why shift work is linked to conditions such as obesity and type 2 diabetes. However, we don’t know which type of shift pattern is most strongly linked to type 2 diabetes. In addition, we know that some lifestyle factors can modify the link between a genetic predisposition to a disease and the disease itself, but we don’t know if this applies to shift work and type 2 diabetes.
(more…)
Dr. Céline Vetter
Assistant Professor
Department of Integrative Physiology
University of Colorado at Boulder
Boulder, CO
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Shift work, particularly night shifts, can change our social rhythms, as well as the internal biological rhythms including our sleep, and these effects could explain why shift work is linked to conditions such as obesity and type 2 diabetes. However, we don’t know which type of shift pattern is most strongly linked to type 2 diabetes. In addition, we know that some lifestyle factors can modify the link between a genetic predisposition to a disease and the disease itself, but we don’t know if this applies to shift work and type 2 diabetes.
(more…)
Author Interviews, Education, JAMA, Occupational Health, UCSF / 13.02.2018
Paid Family and Childbearing Leave Policies at Top US Medical Schools Found Lacking
MedicalResearch.com Interview with:
Christina Mangurian, MD, MAS
Associate Professor of Psychiatry
Vice Chair for Diversity, Department of Psychiatry
UCSF Weill Institute for Neurosciences
Director, UCSF Public Psychiatry Fellowship at ZSFG
Core Faculty, UCSF Center for Vulnerable Populations
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We examined paid family and childbearing leave policies at top-10 medical schools across the US. Despite recommendation from national medical societies for 12 weeks paid childbearing leave because of the benefits to both infant and mother, the average leave at these top schools of medicine was only around 8 weeks. In addition, most policies are very difficult to understand, and are at the discretion of departmental leadership – both of which put women at a disadvantage at getting leave they deserve. Additionally, family leave was only available to the parent that identifies as the "primary caregiver" at five universities, disallowing cooperative parenting.
(more…)
Alcohol, Author Interviews, Compliance / 13.02.2018
Why Do Persons With Alcohol Use Disorder Not Adhere To Naltrexone Treatment?
MedicalResearch.com Interview with:
Sarah Dermody PhD
Assistant professor
School of Psychological Science
College of Liberal Art
Oregon State University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Naltrexone is an FDA-approved medication to treat alcohol use disorder. We know that people have difficulty adhering to the prescribed daily medication regimen, and that people who do not adhere to the medication tend not to fair as well in treatment as people who take the medication regularly.
This particular study attempted to address the question of why do people with alcohol use disorder have difficulty taking the medication daily? What we found was that people were less likely to take naltrexone after days of heavy drinking or strong alcohol craving versus typical drinking and craving levels. Furthermore, individuals were less likely to take the medication on weekends versus weekdays, which is particularly worrisome because heaviest drinking episodes tend to happen on the weekends.
(more…)
Sarah Dermody PhD
Assistant professor
School of Psychological Science
College of Liberal Art
Oregon State University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Naltrexone is an FDA-approved medication to treat alcohol use disorder. We know that people have difficulty adhering to the prescribed daily medication regimen, and that people who do not adhere to the medication tend not to fair as well in treatment as people who take the medication regularly.
This particular study attempted to address the question of why do people with alcohol use disorder have difficulty taking the medication daily? What we found was that people were less likely to take naltrexone after days of heavy drinking or strong alcohol craving versus typical drinking and craving levels. Furthermore, individuals were less likely to take the medication on weekends versus weekdays, which is particularly worrisome because heaviest drinking episodes tend to happen on the weekends.
(more…)
Author Interviews, Heart Disease, JACC, Stroke / 13.02.2018
Some Heart Attack Patients Without AFib Still at Increased Risk of Stroke
MedicalResearch.com Interview with:
João Pedro Ferreira, MD, PhD &
Faiez Zannad, MD, PhD
National Institute of Health and Medical Research (INSERM), Center for Clinical Multidisciplinary Research 1433, INSERM U1116, University of Lorraine, Regional University Hospital of Nancy, French Clinical Research Infrastructure Network (F-CRIN) Investigation Network Initiative–Cardiovascular and Renal Clinical Trialists, Nancy, France
Department of Physiology and Cardiothoracic Surgery, Cardiovascular Research and Development Unit, Faculty of Medicine, University of Porto, Porto, Portugal
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It is uncertain whether patients with a myocardial infarction with systolic dysfunction but without atrial fibrillation have increased risk for stroke.
In this study including >22,000 patients and 600 stroke events we found a subgroup of patients at high risk for stroke despite not having atrial fibrillation. These patients are older, have worse renal function, frank signs of pulmonary congestion, hypertension and previous stroke history. We created a simple and “ready to use” score that allows the identification of these patients in routine clinical practice. (more…)
Author Interviews, BMJ, Education, Nutrition, Pediatrics, Weight Research / 13.02.2018
School Based Healthy Lifestyle Program Did Not Bend Childhood Obesity Curve
MedicalResearch.com Interview with:
Peymané Adab, MD
University of Birmingham in England
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Childhood obesity is an increasing problem worldwide. In the UK, the proportion of children who are very overweight doubles during the primary school years. Furthermore during this period inequalities emerge. At school entry there is little difference in the likelihood of being overweight between groups. However on leaving primary school, children from minority ethnic groups and those from more deprived, compared to more affluent backgrounds are more likely to be overweight. Excess weight in children is linked with multiple health, emotional and social problems. As children spend a lot of time at school, it seems intuitive that they are an ideal setting for prevention interventions.
Although a number of studies have investigated the evidence for school obesity prevention programmes, the results have been mixed and methodological weaknesses have prevented recommendations being made. As a result we undertook a major high quality trial to evaluate an intervention that had been developed in consultation with parents, teachers and the relevant community. The 12 month programme had four components. Teachers at participating schools were trained to provide opportunities for regular bursts of physical activity for children, building up to an additional 30 minutes each school day. There was also a workshop each term, where parents came in to cook a healthy meal (breakfast, lunch of dinner) with their children. In conjunction with a local football club, Aston Villa, children participated in a six-week healthy eating and physical activity programme. Finally, parents were provided with information about local family physical activity opportunities.
We involved around 1500 year 1 children (aged 5-6 years) from 54 state run primary schools in the West Midlands. At the start of the study, we measured their height and weight and other measures of body fat, asked the children to complete a questionnaire about their wellbeing, to note everything they ate for 24 hours, and to wear an activity monitor that recorded how active they were. After this, the schools were randomised to either receive the programme or not. We then repeated the measures 15 and 30 months later.
(more…)
Peymané Adab, MD
University of Birmingham in England
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Childhood obesity is an increasing problem worldwide. In the UK, the proportion of children who are very overweight doubles during the primary school years. Furthermore during this period inequalities emerge. At school entry there is little difference in the likelihood of being overweight between groups. However on leaving primary school, children from minority ethnic groups and those from more deprived, compared to more affluent backgrounds are more likely to be overweight. Excess weight in children is linked with multiple health, emotional and social problems. As children spend a lot of time at school, it seems intuitive that they are an ideal setting for prevention interventions.
Although a number of studies have investigated the evidence for school obesity prevention programmes, the results have been mixed and methodological weaknesses have prevented recommendations being made. As a result we undertook a major high quality trial to evaluate an intervention that had been developed in consultation with parents, teachers and the relevant community. The 12 month programme had four components. Teachers at participating schools were trained to provide opportunities for regular bursts of physical activity for children, building up to an additional 30 minutes each school day. There was also a workshop each term, where parents came in to cook a healthy meal (breakfast, lunch of dinner) with their children. In conjunction with a local football club, Aston Villa, children participated in a six-week healthy eating and physical activity programme. Finally, parents were provided with information about local family physical activity opportunities.
We involved around 1500 year 1 children (aged 5-6 years) from 54 state run primary schools in the West Midlands. At the start of the study, we measured their height and weight and other measures of body fat, asked the children to complete a questionnaire about their wellbeing, to note everything they ate for 24 hours, and to wear an activity monitor that recorded how active they were. After this, the schools were randomised to either receive the programme or not. We then repeated the measures 15 and 30 months later.
(more…)
Author Interviews, Infections, Opiods, Vanderbilt / 13.02.2018
Opioids For Pain Can Exacerbate Pneumococcal Infections
MedicalResearch.com Interview with:
Andrew Wiese, PhD
Postdoctoral Research Fellow
Department of Health Policy
Vanderbilt University Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As opioid use has increased in the U.S., the safety of prescription opioids has come under further scrutiny.
In animal studies, use of certain opioids has been associated with increased susceptibility to bacterial infections, including infectious due to Streptococcus pneumoniae, the pathogen that causes invasive pneumococcal disease. Invasive pneumococcal disease includes bacteremia, meningitis, and invasive pneumonia, all of which are associated with high mortality. Although those associations have been well established in animal experiments, it is important to understand the risk of serious infections among humans taking prescription opioid analgesics.
We found that prescription opioid use is associated with a significantly increased risk for laboratory-confirmed invasive pneumococcal diseases, and that this association was strongest for opioids used at high doses, those classified as high potency and long-acting formulations.
The data also showed that opioids previously described as immunosuppressive in prior experimental studies conducted in animals had the strongest association with invasive pneumococcal diseases in humans. (more…)
Author Interviews, Dermatology, Herpes Viruses, Pediatrics / 12.02.2018
Shingles Can Occur At Chickenpox Vaccination Site in Healthy Children
MedicalResearch.com Interview with:
Hannah Song, BA Medical studen Harvard Medical School and Jennifer T. Huang, MD Division of Immunology, Dermatology Program Boston Children's Hospital Boston, MA
MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infection with the varicella-zoster virus leads to chickenpox, or primary varicella. The virus then lies dormant and can later reactivate as shingles, or herpes zoster. Varicella-zoster vaccine is made of an attenuated live virus that prevents most people from getting chicken pox, but rarely can reactivate and cause shingles. There were several pediatric patients who presented to our clinics with shingles/herpes zoster that was localized to one extremity. My hunch was that the extremity where the patients had shingles could be the same limb where they had received vaccination. We called the patient’s pediatricians because pediatricians typically document the extremity where the vaccination is given, and confirmed the theory that shingles in vaccinated children may be more likely to occur at the site of vaccination. Importantly, vaccination may modify the classic appearance of shingles, and you might see pink and red papules and pseudovesicles, rather than classic grouped fluid-filled vesicles on a red base. (more…)
Accidents & Violence, Author Interviews, Cannabis, JAMA / 12.02.2018
More Car Crashes on 4/20 Marijuana Celebration Day
MedicalResearch.com Interview with:
Dr. John A Staples
MD, FRCPC, MPH
Scientist, Centre for Health Evaluation and Outcome Sciences
Clinical Assistant Professor
University of British Columbia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Around 64 million Americans live in states that have legalized recreational marijuana. Many policymakers are trying to figure out what that means for traffic safety.
On April 20th, some Americans participate in an annual "4/20" counterculture holiday that celebrates and promotes the use of cannabis. Some 4/20 events such as those in Denver and San Francisco involve thousands of participants. Much like celebrations at midnight on New Year's eve, public 4/20 events sometimes mark 4:20 p.m. by a countdown followed by synchronized mass consumption of cannabis. We thought this was a perfect natural experiment to evaluate the influence that cannabis intoxication has on the risk of motor vehicle crash.
To examine this question, we analyzed 25 years of data on all fatal traffic crashes in the United States. We compared the number of drivers in crashes between 4:20 p.m. and midnight on April 20th to the number of drivers in crashes during the same time interval on control days one week earlier and one week later.
We found that the risk of crash involvement was 12% higher on April 20th than on control days. In the subgroups of drivers younger than 21 years of age, the risk of crash involvement was 38% higher on April 20th than on control days.
Assuming fewer than 12% of Americans celebrate 4/20, our results suggest that substance use at April 20th celebrations more than doubles the risk of fatal crash.
(more…)
Dr. John A Staples
MD, FRCPC, MPH
Scientist, Centre for Health Evaluation and Outcome Sciences
Clinical Assistant Professor
University of British Columbia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Around 64 million Americans live in states that have legalized recreational marijuana. Many policymakers are trying to figure out what that means for traffic safety.
On April 20th, some Americans participate in an annual "4/20" counterculture holiday that celebrates and promotes the use of cannabis. Some 4/20 events such as those in Denver and San Francisco involve thousands of participants. Much like celebrations at midnight on New Year's eve, public 4/20 events sometimes mark 4:20 p.m. by a countdown followed by synchronized mass consumption of cannabis. We thought this was a perfect natural experiment to evaluate the influence that cannabis intoxication has on the risk of motor vehicle crash.
To examine this question, we analyzed 25 years of data on all fatal traffic crashes in the United States. We compared the number of drivers in crashes between 4:20 p.m. and midnight on April 20th to the number of drivers in crashes during the same time interval on control days one week earlier and one week later.
We found that the risk of crash involvement was 12% higher on April 20th than on control days. In the subgroups of drivers younger than 21 years of age, the risk of crash involvement was 38% higher on April 20th than on control days.
Assuming fewer than 12% of Americans celebrate 4/20, our results suggest that substance use at April 20th celebrations more than doubles the risk of fatal crash.
(more…)
Author Interviews, Flu - Influenza, Vaccine Studies / 12.02.2018
Cochrane Reviews Efficacy of Vaccination To Prevent Flu In Healthy Adults
MedicalResearch.com Interview with:
Dr. Vittorio Demicheli
Servizio Regionale di Riferimento per l'Epidemiologia
SSEpi-SeREMI, Azienda Sanitaria Locale ASL AL
Alessandria, Piemonte, Italy
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The consequences of influenza in adults are mainly time off work. Only vaccination of pregnant women is recommended internationally, while mass vaccination of healthy adults is still matter of debate.
The aim of this Cochrane Review is to assist informed decision making summarizing research that looks at the effects of immunizing healthy adults with influenza vaccines during influenza seasons.
The review process found 52 clinical trials of over 80,000 adults. Only around 15% of the included studies were well designed and conducted. We focused on reporting of results from 25 studies that looked at inactivated vaccines. Injected influenza vaccines probably have a small protective effect against influenza and influenza-like illness (ILI_ (moderate-certainty evidence), as 71 people would need to be vaccinated to avoid one influenza case, and 29 would need to be vaccinated to avoid one case of ILI. Vaccination may have little or no appreciable effect on hospitalizations (low-certainty evidence) or number of working days lost. (more…)
Dr. Vittorio Demicheli
Servizio Regionale di Riferimento per l'Epidemiologia
SSEpi-SeREMI, Azienda Sanitaria Locale ASL AL
Alessandria, Piemonte, Italy
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The consequences of influenza in adults are mainly time off work. Only vaccination of pregnant women is recommended internationally, while mass vaccination of healthy adults is still matter of debate.
The aim of this Cochrane Review is to assist informed decision making summarizing research that looks at the effects of immunizing healthy adults with influenza vaccines during influenza seasons.
The review process found 52 clinical trials of over 80,000 adults. Only around 15% of the included studies were well designed and conducted. We focused on reporting of results from 25 studies that looked at inactivated vaccines. Injected influenza vaccines probably have a small protective effect against influenza and influenza-like illness (ILI_ (moderate-certainty evidence), as 71 people would need to be vaccinated to avoid one influenza case, and 29 would need to be vaccinated to avoid one case of ILI. Vaccination may have little or no appreciable effect on hospitalizations (low-certainty evidence) or number of working days lost. (more…)
Author Interviews, Diabetes, OBGYNE / 12.02.2018
Pregnancy in Type 1 Diabetes: Glucose Control Can Reduce Fetal Overgrowth
MedicalResearch.com Interview with:
Rachel McGrath BSc (Hons), PhD
Senior Research Fellow - Department of Endocrinology, RNSH
Clinical Senior Lecturer - Northern Clinical School
University of Sydney
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Women with type 1 diabetes are significantly more likely to experience complications during pregnancy and to have infants with high birth weights. This can result in adverse outcomes at the time of delivery for both mother and baby, and can also predispose infants to obesity and chronic disease in later life.
The relationship between maternal blood glucose levels and foetal growth in type 1 diabetes in pregnancy has not been completely elucidated. Thus, we examined the association between maternal glycaemic control and foetal growth by examining serial ultrasound measurements and also by determining the relationship between HbA1c (a measure of circulating glucose exposure over a three month time period) and infant birth weight.
We found that maternal glucose levels were directly related to foetal abdominal circumference in the late second and third trimesters and also to birth weight. We also confirmed the results of previous studies to show that the optimal HbA1c during pregnancy to reduce the likelihood of large-for-gestational-age neonates is < 6%. (more…)
Author Interviews, Cognitive Issues, Geriatrics, Kidney Disease, Salt-Sodium / 11.02.2018
Low Sodium Levels Linked To Cognitive Impairment in Older Adults
MedicalResearch.com Interview with:
Dr. Kristen L. Nowak PhD
Division of Renal Diseases and Hypertension
University of Colorado Anschutz Medical Campus
Aurora, CO 80045
MedicalResearch.com: What is the background for this study?
Response: Subtle impairments in cognition are common with aging, even in the absence of clinically apparent dementia. Mild hyponatremia is a common finding in older adults; however, the association of lower serum sodium with cognition in older adults is currently uncertain.
We hypothesized that lower normal serum sodium would be associated with prevalent cognitive impairment and the risk of cognitive decline over time in asymptomatic, community-dwelling older men.
(more…)
Aging, Author Interviews, BMJ, Cost of Health Care, Global Health / 11.02.2018
Patients With Multiple Chronic Diseases Incur High Out-of-Pocket Expenses
MedicalResearch.com Interview with:
Dr Grace Sum Chi-En
National University of Singapore
MedicalResearch.com: What is the background for this study?
Response: Chronic diseases are conditions that are not infectious and are usually long-term, such as diabetes, hypertension, cancer, chronic lung disease, asthma, arthritis, stroke, obesity, and depression. They are also known as non-communicable diseases (NCDs). Multimorbidity, is a term we use in our field, to mean the presence of two or more NCDs. Multimorbidity is a costly and complex challenge for health systems globally. With the ageing population, more people in the world will suffer from multiple chronic diseases.
Patients with multimorbidity tend to need many medicines, and this incurs high levels of out-of-pocket expenditures, simply known as cost not covered by insurance. Even the United Nations and World Health organisation are recognising NCDs as being an important issue.
Governments will meet in New York for the United Nations 3rd high-level meeting on chronic diseases in 2018. Global leaders need to work towards reducing the burden of having multiple chronic conditions and providing financial protection to those suffering multimorbidity.
Our research aimed to conduct a high-quality systematic review on multimorbidity and out-of-pocket expenditure on medicines. (more…)
Author Interviews, Mental Health Research, Psychological Science / 11.02.2018
Benefits and Downsides of Companion Animals in Mental Health
MedicalResearch.com Interview with:
Helen Louise Brooks BSc, MRes, PhD
Psychology of Healthcare Research Group
Department of Psychological Sciences,
Institute of Psychology, Health and Society
University of Liverpool, Liverpool, UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It is increasingly being acknowledged that companion animals can have a positive impact on mental health. However, there has been no systematic review of the evidence related to how pets might benefit people living with mental health problems.
(more…)
Helen Louise Brooks BSc, MRes, PhD
Psychology of Healthcare Research Group
Department of Psychological Sciences,
Institute of Psychology, Health and Society
University of Liverpool, Liverpool, UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It is increasingly being acknowledged that companion animals can have a positive impact on mental health. However, there has been no systematic review of the evidence related to how pets might benefit people living with mental health problems.
(more…)
Accidents & Violence, Author Interviews, Emergency Care, JAMA, Social Issues / 10.02.2018
Distance to Trauma Center & Prehospital Care Influence Outcomes from Injuries
MedicalResearch.com Interview with:
Dr. Molly Jarman PhD
Postdoctoral Research Fellow at
Brigham and Womens Hospital
MedicalResearch.com: What is the background for this study?
Response: Injuries are a leading cause of death and disability in the US, and there are well documented disparities in injury incidence and outcomes. Certain populations (i.e. rural, low income, people of color) experience more injury than others, and are more likely to die following and injury.
Past studies focused on individual health and socioeconomic characteristics as the primary driving force behind these disparities, along with variation in the time required to transport an injured patient to the hospital. We wondered if geographic features of an injury incident location contributed to variation in injury mortality that was not explained by differences in individual patient characteristics.
In other words, we know that who you are contributes to injury mortality, and we wanted to know if it also matters where you are when an injury occurs.
(more…)
Author Interviews, Autism, Stem Cells, Transplantation / 10.02.2018
Umbilical Cord Blood Stem Cells May Improve Symptoms in Children with Autism
MedicalResearch.com Interview with:
Michael G. Chez, M.D.
Director of Pediatric Neurology Sutter Memorial Hospital
Director of the Pediatric Epilepsy and Autism Programs
Sutter Neuroscience Group
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The study looked at possible use of autologous cord blood as a source of stem cells in patients with autism. The patients had to have fairly good genetic screening per protocol and had confirmation of autism to participate.
The use of cord blood was a pilot cross over double blind study with hypothesis that a post natal factor or immune dysregulation may add to the autism clinical phenotype.
Cord blood ( the baby’s own from birth) is a safe source of mixed stem cell types and should be safe from rejection or autoimmune reaction in theory.
Infusion /placebo or placebo/infusion was randomized and observed and tested every 3 months with switch to other wing of treatment at 0 and 6 months. Total observation was over 1 year.
(more…)
Author Interviews, Biomarkers, Cancer Research, Gastrointestinal Disease, UT Southwestern / 09.02.2018
Adding Blood Biomarker To Ultrasound Improves Liver Cancer Detection
MedicalResearch.com Interview with:
Amit Singal MD MS
David Bruton Jr. Professor in Clinical Cancer Research
Associate Professor of Medicine
Medical Director of Liver Tumor Program
Clinical Chief of Hepatology
University of Texas Southwestern
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Hepatocellular carcinoma, the most common form of primary liver cancer, often has a very poor prognosis because most cancers are found at a late stage when curative treatment is not available. However, if the cancer is found early, curative therapies are possible and patients can typically live longer than 5 years.
There is currently debate how at-risk patients with chronic liver disease should be screened - with an abdominal ultrasound alone or using a combination of abdominal ultrasound and a blood test called alpha fetoprotein. Many professional societies have traditionally recommended the former, i.e. ultrasound alone, given few data showing a benefit of adding alpha fetoprotein.
Our study examines all available literature examining this question and found using the two tests in combination significantly increases the likelihood of finding the cancer at an early stage. Whereas abdominal ultrasound misses over half of all cancers, using it in combination with alpha fetoprotein can detect two-thirds of cancers at an early stage. (more…)
Author Interviews, Electronic Records, Emergency Care / 09.02.2018
Study Finds Patients Equally Likely To Fill Paper vs Electronic Prescriptions
MedicalResearch.com Interview with:
Shannon Toohey, MD, MAEd
Associate Residency Director, Emergency Medicine
Assistant Clinical Professor, Emergency Medicine
University of California, Irvine
Editor-in-Chief
Journal of Education and Teaching in Emergency Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Electronic prescriptions (e-prescriptions) are now the predominant form of prescription used in the US. Concern has been raised that this form of prescription may be more difficult for emergency department (ED) patients to utilize than traditional printed prescriptions, given the unplanned nature of most ED visits at all times of day.
While there are disincentives for physicians who choose not to use them, many emergency physicians are still concerned that it could decrease compliance in their patients.
This study evaluated prescription compliance in insured patients at a single center. In our studied population, we found that patients were as equally likely to fill paper and e-Prescriptions.
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Author Interviews, Depression, Dermatology / 09.02.2018
Acne Sufferers At Increased Risk of Depression
MedicalResearch.com Interview with:
Isabelle Vallerand, Ph.D.
Epidemiologist, MD Student
Dept. of Community Health Sciences
Cumming School of Medicine
University of Calgary
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Over the past few years, there have been numerous reports that an acne drug called isotretinoin (Accutane) has been linked to psychiatric disorders. We recently published a systematic review on this topic and did not find an increased risk of psychiatric disorders among people treated with isotretinoin, so we wondered if acne itself may be contributing to mental illness. While it is well known that acne can have negative effects on mood, we wanted to assess if there was an increased risk of true clinical depression using medical records data.
Therefore, we conducted the current study and found that acne increased the risk of developing clinical depression by 63% in the first year following an acne diagnosis and that this risk remained elevated for 5 years after the initial acne diagnosis.
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Isabelle Vallerand, Ph.D.
Epidemiologist, MD Student
Dept. of Community Health Sciences
Cumming School of Medicine
University of Calgary
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Over the past few years, there have been numerous reports that an acne drug called isotretinoin (Accutane) has been linked to psychiatric disorders. We recently published a systematic review on this topic and did not find an increased risk of psychiatric disorders among people treated with isotretinoin, so we wondered if acne itself may be contributing to mental illness. While it is well known that acne can have negative effects on mood, we wanted to assess if there was an increased risk of true clinical depression using medical records data.
Therefore, we conducted the current study and found that acne increased the risk of developing clinical depression by 63% in the first year following an acne diagnosis and that this risk remained elevated for 5 years after the initial acne diagnosis.
(more…)
Author Interviews, Electronic Records, Technology / 08.02.2018
Timicoin First Mobile Platform to Deploy Blockchain Technology to Store and Access Medical Records
MedicalResearch.com Interview with:
Will Lowe, Timicoin CEO
Mr. Lower discusses the first cryptocurrency blockchain mobile platform for storing medical records that can be safely accessed from anywhere.
MedicalResearch.com: What is the background for this announcement? Would you briefly explain what is meant by blockchain technology? How does it allow for more efficient storage and transmittal of encrypted medical records?
Response: We do not store the data on any cloud storage to avoid any threat to data security and server overhead for data processing as well as to avoid temporary potential data unavailability.
When a certain kind of data is queried by the consumer, our cloud engine first passes on the query to each of the providers (our gateway applications that are running on their node) and see if there are enough query results, it shows a sample to the consumer and if consumer decides to pay, it creates a Blockchain channel between the providers and the consumer that queried the data and all the provider nodes propagate the queried data onto that channel.
So a common trust is built between the nodes and the consumer on that Blockchain channel and the shared query stays there as the trust builder. Then the consumer can anytime access the data needed from that blockchain channel. (more…)
Will Lowe, Timicoin CEO
Mr. Lower discusses the first cryptocurrency blockchain mobile platform for storing medical records that can be safely accessed from anywhere.
MedicalResearch.com: What is the background for this announcement? Would you briefly explain what is meant by blockchain technology? How does it allow for more efficient storage and transmittal of encrypted medical records?
Response: We do not store the data on any cloud storage to avoid any threat to data security and server overhead for data processing as well as to avoid temporary potential data unavailability.
When a certain kind of data is queried by the consumer, our cloud engine first passes on the query to each of the providers (our gateway applications that are running on their node) and see if there are enough query results, it shows a sample to the consumer and if consumer decides to pay, it creates a Blockchain channel between the providers and the consumer that queried the data and all the provider nodes propagate the queried data onto that channel.
So a common trust is built between the nodes and the consumer on that Blockchain channel and the shared query stays there as the trust builder. Then the consumer can anytime access the data needed from that blockchain channel. (more…)
Author Interviews, Breast Cancer, JAMA, Surgical Research / 08.02.2018
With or Without Reconstruction, Hard To Predict How You Will Feel After Mastectomy
MedicalResearch.com Interview with:
Dr. Clara Nan-hi Lee, MD
Comprehensive Cancer Center
The Ohio State University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The decision about breast reconstruction is very challenging because it’s unfamiliar, involves complex risk information, affects very personal concerns, and happens at a stressful time. One of the challenges is to predict how one will feel after the surgery. We know from psychology research that people often mis-predict their future emotions. So we were interested to see how well women predict their future well being after surgery.
The main findings are that patients having mastectomy without reconstruction believed they would be less satisfied than they turned out to be. And patients having mastectomy with reconstruction believed they would be more satisfied than they turned out to be. (more…)
Dr. Clara Nan-hi Lee, MD
Comprehensive Cancer Center
The Ohio State University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The decision about breast reconstruction is very challenging because it’s unfamiliar, involves complex risk information, affects very personal concerns, and happens at a stressful time. One of the challenges is to predict how one will feel after the surgery. We know from psychology research that people often mis-predict their future emotions. So we were interested to see how well women predict their future well being after surgery.
The main findings are that patients having mastectomy without reconstruction believed they would be less satisfied than they turned out to be. And patients having mastectomy with reconstruction believed they would be more satisfied than they turned out to be. (more…)
Author Interviews, Infections, Vaccine Studies / 08.02.2018
Vaccination Against Yellow Fever Has Reduced Size of Outbreak
MedicalResearch.com Interview with:
Dr. Daihai He
Assistant Professor
Department of Applied Mathematics
Hong Kong Polytechnic University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Yellow fever (YF) is a life-threatening mosquito-borne infection. The 2016-2017 Yellow fever outbreak in Angola, Democratic Republic of the Congo (DRC) and Uganda is the largest YF outbreak in decades. Vaccination is an effective measure to mitigate the YF outbreak. As a result, 30 million people have been vaccinated in DRC and Angola. 962 cases and 137 deaths were confirmed in these two countries. Suspected cases and deaths are 7334 and 498 respectively. The true effect of this large-scale vaccination campaign is unclear. Using mathematical modeling and statistical inference, we found that if the vaccination campaign was not implemented, the size of the outbreaks (in term of cases and deaths) could be 5-6 fold higher in Luanda province Angola, the hit-hardest region.
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Author Interviews, OBGYNE, Sexual Health, Social Issues / 08.02.2018
Relationship Status Helps Determine Contraception Choice
MedicalResearch.com Interview with:
Marie Harvey, DrPH MPH
Lisa P. Oakley, PhD MPH
College of Public Health and Human Sciences
Oregon State University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Because decisions about contraceptives are often made by young adults in the context of their relationships and specific partners, the characteristics of that relationship and feelings about that partner will likely influence how those decisions are made. Many studies have previously investigated individual factors that affect contraceptive choice and when examining partner influences have used questions that were not specific to a particular partner. Intuition, however, suggests that feelings for a specific partner would likely influence one’s perception of risk for disease acquisition, and thereby, their contraceptive choice. So, it was important to us to look at the influences of each specific partner and how the unique dynamics of each partnership influence contraceptive use.
In this study, we investigated how relationship qualities and dynamics (such as commitment and sexual decision-making) impact contraceptive choice above and beyond individual factors. We also used partner-specific questions.
We found that both individual and partner-specific relationship qualities and dynamics predicted contraceptive use, but these factors varied by contraceptive method. For example, young adults who reported greater exclusivity with a specific partner and more relationship commitment were less likely to use only condoms with that partner. Additionally, individuals who felt they played a strong role in making sexual decisions in their relationship were also more likely to only use condoms. (more…)
Marie Harvey, DrPH MPH
Lisa P. Oakley, PhD MPH
College of Public Health and Human Sciences
Oregon State University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Because decisions about contraceptives are often made by young adults in the context of their relationships and specific partners, the characteristics of that relationship and feelings about that partner will likely influence how those decisions are made. Many studies have previously investigated individual factors that affect contraceptive choice and when examining partner influences have used questions that were not specific to a particular partner. Intuition, however, suggests that feelings for a specific partner would likely influence one’s perception of risk for disease acquisition, and thereby, their contraceptive choice. So, it was important to us to look at the influences of each specific partner and how the unique dynamics of each partnership influence contraceptive use.
In this study, we investigated how relationship qualities and dynamics (such as commitment and sexual decision-making) impact contraceptive choice above and beyond individual factors. We also used partner-specific questions.
We found that both individual and partner-specific relationship qualities and dynamics predicted contraceptive use, but these factors varied by contraceptive method. For example, young adults who reported greater exclusivity with a specific partner and more relationship commitment were less likely to use only condoms with that partner. Additionally, individuals who felt they played a strong role in making sexual decisions in their relationship were also more likely to only use condoms. (more…)
Author Interviews, Genetic Research, OBGYNE / 08.02.2018
How Much Genetic Information From Prenatal Testing Do Pregnant Women Want?
MedicalResearch.com Interview with:
Professor Jane Halliday, PhD
Group Leader, Public Health Genetics
Genetics
Murdoch Childrens Research Institute
The Royal Children’s Hospital
Parkville, Victoria AUS
MedicalResearch.com: What is the background for this study?
Response: The aim of the study was to examine the choice that pregnant women make about the amount of genetic information they want from their pregnancy. Women who underwent prenatal testing via chorionic villus sampling (CVS) or amniocentesis were recruited from across seven sites in Victoria.
Provision of this choice is not routinely offered but we thought it was important to look at this issue carefully, in a real-time setting, because, over the last five years, advances in technology have transformed how genetic abnormalities can be detected during a pregnancy. Rather than examining genetic material (chromosomes) down the microscope, it is now possible to use a technique called ‘microarray’ which can do the analysis with 100 times greater depth than can be achieved using a microscope. The plus side is that the microarray technique can detect a far greater number of potentially important genetic differences; but a down side is that it can also detect many changes for which the impact on the health of the baby is unknown or uncertain.
Examples of genetic differences that carry certainty are major chromosome abnormalities such as the trisomies e.g. Down Syndrome, and deletions associated with severe intellectual disability in 100% of cases, e.g. 1p.36 deletion. Uncertain findings are the various small deletions and duplications that are known to only have an adverse outcome in 10-20% of people with them.
All participants were provided with a decision aid which described in detail the choice available in regards to the genetic information. The options were ‘targeted’, where only the information that would affect health of the baby was provided, or ‘extended’, where all information, even the uncertain aspects, was provided. Participants were asked to read the decision aid, complete a ten minute survey along with indicating their choice of genetic information.
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AHA Journals, Author Interviews, Stroke / 07.02.2018
Real World Studies Compares Dabigatran with Rivaroxaban or Apixaban in Nonvalvular AFib
MedicalResearch.com Interview with:
Todd C. Villines, M.D. FSCCT
Professor of Medicine
Uniformed Services University School of Medicine
Director of Cardiovascular Research and Cardiac CT
Cardiology Fellowship Program Director
Walter Reed National Military Medical Center
Bethesda, Maryland
Assistant Professor of Medicine
Georgetown School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study was a retrospective, observational real-world analysis assessing the safety and effectiveness of novel oral anticoagulants (NOACs) among patients with non-valvular atrial fibrillation (NVAF) treated through the U.S. Department of Defense Military Health System. The study examined major bleeding and stroke rates in NVAF patients who had initiated treatment with dabigatran compared to those treated with rivaroxaban or apixaban.
The study examined two cohorts: one that resulted in 12,763 propensity score matched dabigatran (150 mg bid) and rivaroxaban (20 mg daily) patients, and another that resulted in 4,802 propensity score matched dabigatran (150 mg bid) and apixaban (5 mg bid) patients. Dabigatran patients demonstrated lower rates of major bleeding compared to rivaroxaban patients (2.08 percent vs 2.53) percent and similar rates of stroke (0.60 percent vs 0.78 percent). In the exploratory analysis, dabigatran and apixaban patients showed similar rates of major bleeding (1.60 percent vs 1.21 percent) and stroke (0.44 percent vs 0.35 percent). (more…)
Author Interviews, Cannabis, Cost of Health Care, Opiods / 07.02.2018
Marijuana Dispensaries Have Ability To Reduce Opioid Overdoses and Substance Abuse
MedicalResearch.com Interview with:
David Powell PhD
Economist; Core Faculty, Pardee RAND Graduate School
RAND, Santa Monica
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There has been some research suggesting that the adoption of state medical marijuana laws leads to reductions in prescriptions for opioid analgesics among certain populations and opioid-related overdoses overall. However, medical marijuana laws are very different across states and they have changed over time as well. We wanted to understand what components of a medical marijuana law could potentially lead to reductions in overdoses and substance abuse. We focused specifically on the role of dispensaries, given their importance in providing access to medical marijuana, and tested for different effects in states with and without legally-protected and operational dispensaries.
We found that dispensaries are critical to reduce opioid-related overdoses and substance abuse. We also found evidence that more recently-adopting states have experienced smaller reductions in overdoses and opioid substance abuse, potentially because the more recent adopters tend to enforce more stringent guidelines for dispensaries than the early adopters. (more…)