Author Interviews, Depression, JAMA, Pharmacology, Yale / 23.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32285" align="alignleft" width="160"]Adam Chekroud PhD Candidate Human Neuroscience Lab Adam Chekroud[/caption] Adam Chekroud PhD Candidate Human Neuroscience Lab Department of Psychology Yale University MedicalResearch.com: What is the background for this study? Response: We know that depression includes a wide range of symptoms, from low mood and feeling worthless, to problems sleeping, slowed thinking, and suicidal ideation. We wanted to know whether antidepressants work well in treating all of these symptoms, or whether they are primarily effective on certain kinds of symptoms.
Author Interviews, Heart Disease, JAMA, Testosterone, UCLA / 23.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32281" align="alignleft" width="140"]Ronald S. Swerdloff, MD Chief of the Division of Endocrinology, Department of Medicine and Director of a World Health Organization Collaborative Center in Reproduction a Mellon Foundation Center for Contraceptive Development and a NIH Contraceptive Clinical Trial Center Director of the Harbor-UCLA Reproductive Program LA BioMed Lead Researcher David Geffen School of Medicine UCLA Health Dr. Ronald Swerdloff[/caption] Ronald S. Swerdloff, MD Chief of the Division of Endocrinology, Department of Medicine and Director of a World Health Organization Collaborative Center in Reproduction a Mellon Foundation Center for Contraceptive Development and a NIH Contraceptive Clinical Trial Center Director of the Harbor-UCLA Reproductive Program LA BioMed Lead Researcher David Geffen School of Medicine UCLA Health MedicalResearch.com: What is the background for this study? Response: While we have long known that testosterone levels decrease as men age, very little was known about the effects of testosterone treatment in older men with low testosterone until last year. Our team of researchers from LA BioMed and 12 other medical centers in the U.S., in partnership with the National Institute on Aging, conducted a coordinated group of seven trials known as The Testosterone Trials (TTrials). We studied the effects of testosterone treatment for one year as compared to placebo for men 65 and older with low testosterone. The TTrials are now the largest trials to examine the efficacy of testosterone treatment in men 65 and older whose testosterone levels are low due seemingly to age alone. The first published research from the TTrials last year reported on some of the benefits to testosterone treatment. We have now published four additional studies in the Journal of the American Medical Association (JAMA) and JAMA Internal Medicine that found additional benefits and one potential drawback.
Author Interviews, Depression, JAMA, Telemedicine / 23.02.2017

MedicalResearch.com Interview with: Eirini Karyotaki, MSc Department of Clinical Psychology and EMGO Institute for Health and Care Research Vrije Universiteit Amsterdam Amsterdam, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Depression is broadly acknowledged as a major health issue associated with a great risk of mortality and morbidity. Nevertheless, help-seeking rates are low among individuals with depression. Some of the barriers that impede help seeking are the limited availability of trained clinicians, the fear of stigmatisation and the cost of treatment. Self-guided Internet based Cognitive behavioural therapy (iCBT) has the potential to overcome many of these treatment barriers. However, recent randomised controlled trials (RCTs) have produced mixed evidence regarding the effects of self-guided iCBT in treating adults with depressive symptoms. To gain more insight in the effectiveness of self-guided iCBT, an Individual Participant Data meta-analysis was performed. 3876 individual participant data across 13 RCTs were collected and analysed.
Author Interviews, Environmental Risks, Heart Disease, Radiology / 22.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32304" align="alignleft" width="150"]Alessandro Sciahbasi, MD, PhD Sandro Pertini Hospital Rome, Italy Dr. Sciahbasi[/caption] Alessandro Sciahbasi, MD, PhD Sandro Pertini Hospital Rome, Italy MedicalResearch.com: What is the background for this study? Response: Radiation exposure is an important issue for interventional cardiologists due to the deterministic and stochastic risks for operators, staff and patients. Consequently, it is important to know which are the determinants of operator radiation exposure during percutaneous coronary procedures in order to reduce radiation exposure. Despite different studies have already evaluated the radiation dose during percutaneous coronary procedures, most data were obtained using an indirect measure of the operator dose expressed in term of fluoroscopy time or dose area product (DAP) and only in a minority of studies dedicated operator dosimeters were used. The aim of our study was to evaluate operator radiation exposure during percutaneous coronary procedures with dedicated electronic dosimeters in a high volume center for transradial procedures.
Author Interviews, Heart Disease, JAMA, Testosterone / 21.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32221" align="alignleft" width="142"]Dr-Cheetham-Craig.jpg Dr. Craig Cheetham[/caption] T. Craig Cheetham, PharmD, MS Southern California Permanente Medical Group Department of Research & Evaluation Pasadena, CA 91101 MedicalResearch.com: What is the background for this study? Response: Concerns have been raised about the cardiovascular safety of testosterone replacement therapy. Patient selection criteria may have been a factor in the findings from studies reporting an increased cardiovascular risk with testosterone replacement therapy. Many men who were receiving testosterone replacement therapy don’t fall into the categories of ‘frail elderly’ or ‘high cardiovascular risk’. We therefore studied testosterone replacement therapy in a population of androgen deficient men within Kaiser Permanente Northern and Southern California.
Author Interviews, Sexual Health, Social Issues / 21.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32260" align="alignleft" width="150"]Nicholas H. Wolfinger PhD Professor, Department of Family and Consumer Studies Adjunct Professor, Department of Sociology University of Utah Salt Lake City, UT 84112-0080 Dr. Nicholas Wolfinger[/caption] Nicholas H. Wolfinger PhD Professor, Department of Family and Consumer Studies Adjunct Professor, Department of Sociology University of Utah Salt Lake City, UT 84112-0080 MedicalResearch.com: What is the background for this study? What are the main findings? Response: W. Bradford Wilcox and I have been studying marriage and divorce for fifteen years. Last year we published Soul Mates: Religion, Sex, Love and Marriage among African Americans and Latinos (Oxford University Press). We’re always looking for opportunities to present our findings to the public, so Valentines Day is a great excuse! It’s probably too strong a statement to call our new research brief a study, as we’re not offering any novel findings. Instead, we’re just compiling data from different sources—some published by other scholars, some based on our own analysis of national data—to reaffirm a basic point: marriage is good for men in myriad ways (Marriage is also good for women, but they await their own research brief.) In particular, marriage offers these benefits to men:
  • Higher earnings, greater assets and more job stability. Married men make about $16,000 a year more than their single peers with otherwise similar backgrounds.
  • Better sex lives compared to both single and cohabiting men. According to data from the National Health and Social Life Survey, 51 percent of married men report they are extremely emotionally satisfied with sex, compared to 39 percent of cohabiting men and 36 percent of single men.
  • Longer and happier lives. Men who get and stay married live almost 10 years longer than their unmarried peers. Also, young married men are about twice as happy: 43 percent of married men report they are “very happy” with life, compared to 20 percent of single men and 24 percent of cohabiting men.
Author Interviews, Diabetes, Metabolic Syndrome, Weight Research / 21.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32269" align="alignleft" width="142"]Prof. Dr. Michael Roden Director, German Diabetes Center (DDZ) Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf Chair/Professor, Endocrinology and Metabolic Diseases Heinrich Heine University Düsseldorf Director, Department of Endocrinology and Diabetology University Hospital Düsseldorf Düsseldorf, Germany Prof. Michael Roden[/caption] Prof. Dr. Michael Roden Director, German Diabetes Center (DDZ) Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf Chair/Professor, Endocrinology and Metabolic Diseases Heinrich Heine University Düsseldorf Director, Department of Endocrinology and Diabetology University Hospital Düsseldorf Düsseldorf, Germany MedicalResearch.com: What is the background for this study? What are the main findings? Response: The prevalence of obesity, type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) continue to increase at an alarming rate. Their occurrence has been associated with intake of saturated fats, for example that of palm oil. This study aimed to shed light on how dietary fat initiates metabolic changes which lead to the aforementioned diseases. To this end we provided 14 young healthy volunteers an oral dose of palm oil or placebo randomly, in a crossover manner, with an 8-week washout period between each intervention. One acute dose of palm oil leads to insulin resistance in the main insulin sensitive tissues of the body: the liver, skeletal muscle and adipose tissue. In the liver, it also results in increased accumulation of triglycerides, increased production of glucose from lipid and amino acid precursors (rather than from glycogen), and increased energy metabolism, as denoted by increased hepatic adenosine triphosphate (ATP) content. Moreover, a similar experiment in mice revealed that one dose of palm oil differentially regulates genes and pathways which are known or suspected regulators of NAFLD, such as lipopolysaccharide (LPS), members of the peroxisome proliferator-activated receptor (PPAR) family and nuclear factor kappa-light-chain-enhancer of activated B-cells.
Author Interviews / 21.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32250" align="alignleft" width="142"]Michael E. Saladin, Ph.D. Professor, Department of Health Sciences and Research College of Health Professions Medical University of South Carolina Charleston, SC Dr. Michael Saladin[/caption] Michael E. Saladin, Ph.D. Professor, Department of Health Sciences and Research College of Health Professions Medical University of South Carolina Charleston, SC MedicalResearch.com: What is the background for this study? Response: To the extent that learning and memory processes govern all aspects of behavior, they also govern dysregulated or maladaptive behaviors such as addiction and anxiety states. In the former case, stimuli associated with drug administration can acquire the ability to control drug-related motivational states (urges and craving) as well as drug seeking behavior. To illustrate the point, the simple act of observing a person light up a cigarette will cause the typical smoker to desire a cigarette and engage in smoking. A nonsmoker, by contrast, would not be similarly affected because they have no history where stimuli associated with smoking (e.g., sight of a lighter, cigarettes, plumes of smoke) are reliably paired with, or followed by, the rewarding effects of nicotine. The research we conducted recently was based on neuroscience research showing that retrieved drug-associated memories (prompted with drug-paired cues) can be updated with information that decreases drug craving and/or administration. One such study showed that heroin craving in heroin addicts can be decreased by retrieving memories for heroin use via a brief heroin cue presentation (video of people using heroin) and then, a short time later, presenting an extensive variety of heroin cues (video, pictures and heroin use paraphernalia) over a 1-hour period. The logic of this intervention was that once the heroin memories were prompted into a labile state by the brief video presentation, the extensive heroin cue exposure would serve to update the content of the original memories with new information (i.e., cues are not followed by heroin reward) that is inconsistent with the original cue-drug contingency (i.e., cues are followed with heroin reward). Remarkably, just two sessions of this type of training, which we call retrieval-extinction training, resulted in significant reductions in heroin craving that persisted for six months. This study was done with heroin addicts who were inpatients so there was no way to assess the effects of this treatment on actual heroin use.
Accidents & Violence, Author Interviews, Pediatrics, Social Issues, University of Pittsburgh / 21.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32246" align="alignleft" width="160"]Christian D. Pulcini, MD, MEd, MPH Pediatric Resident, Children's Hospital of Pittsburgh of UPMC Chair, Section on Pediatric Trainees (SOPT) American Academy of Pediatrics Dr. Christian Pulcini[/caption] Christian D. Pulcini, MD, MEd, MPH Pediatric Resident Children's Hospital of Pittsburgh of UPMC Chair, Section on Pediatric Trainees (SOPT) American Academy of Pediatrics MedicalResearch.com: What is the background for this study? What are the main findings? Response: Poverty influences the well-being of children and adolescents in a negative way. Poor children are often exposed to toxic health stressors, including violence, environmental toxins, and inadequate nutrition. Children in poverty with chronic health conditions also are more likely to have higher rates of secondary disorders and worse outcomes. We studied children with asthma, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), to describe the how much disease and if the children had multiple (comorbid) conditons and how these vary by poverty status. Parents reported through the National Survey of Children's Health that asthma and ADHD rose 18% and 44% from 2003-2011/2012, respectively, whereas the lifetime prevalence of ASD rose 32% from 2007-2011/2012 in all income levels. For asthma, the rise was most among the poor at 25.8%. For ADHD, the percent change among the poor was similar, however the rise in autism spectrum disorder was associated with being non-poor. Publicly insured children with asthma, ADHD, and ASD also had a significant higher chance (1.9×, 1.6×, 3.0×, respectively) of having higher more than one chronic condition. In addition, kids who were poor with asthma and ADHD.
Annals Internal Medicine, Author Interviews, Pain Research, Telemedicine / 21.02.2017

MedicalResearch.com Interview with: Rachel Nelligan, BPhysio Physiotherapist & Research Physiotherapist Department of Physiotherapy | Centre for Health, Exercise and Sports Medicine The University of Melbourne Victoria Australia MedicalResearch.com: What is the background for this study? Response: This novel study investigated the efficacy of an internet delivered model of service delivery that combined online education, Skype delivered exercise physiotherapy and an Internet-based interactive pain coping skills training program for people with persistent knee pain. Osteoarthritis, the leading cause of chronic knee pain and disability globally, has a significant individual, societal and economic burden. On an individual level knee osteoarthritis causes loss of function, reduced quality of life, and psychological distress. Clinical guidelines recommend adoption of a biopsychosocial approach to management which should include nondrug, nonsurgical treatments. Specifically exercise, education and psychological interventions (including pain coping skills training (PCST)) that foster self-management are recommended. Evidence identifies that many knee OA sufferers are not receiving adequate management due in part to challenges of accessing these effective treatments. There is an urgent need for new models of health service delivery to rectify this. Tele-rehabilitation is growing in acceptance as an effective, time efficient and convenient means for people to access effective health interventions. In knee OA internet delivered interventions specifically remotely delivered physiotherapy exercise using specialised tele-rehabilitation equipment and an Internet-based interactive PCST program (PainCOACH), designed to translate key therapeutic elements of clinician-delivered face-to-face PCST, have shown improved patient outcomes. Prior to this study the combination of these two internet-based treatments has not been investigated.
Author Interviews, Gender Differences, JAMA, Johns Hopkins, Mental Health Research, Pediatrics / 21.02.2017

MedicalResearch.com Interview with: Julia R.G. Raifman, ScD Post-doctoral fellow Johns Hopkins Bloomberg School of Public Health  MedicalResearch.com: What is the background for this study? Response: Suicide is the second leading cause of death among adolescents between the ages of 15 and 24 years old in the United States. Gay, lesbian, and bisexual adolescents have elevated rates of suicide attempts. In our study, we found that 29% of gay, lesbian, and bisexual adolescents reported attempting suicide in the past year relative to 6% of heterosexual adolescents.
Accidents & Violence, Author Interviews, Gender Differences / 20.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32239" align="alignleft" width="165"]Jeanne Mager Stellman, PhD Professor Emerita & Special Lecturer Department of Health Policy & Management Mailman School of Public Health Columbia University York NY 10032 Dr. Jeanne Stellman[/caption] Jeanne Mager Stellman, PhD Professor Emerita & Special Lecturer Department of Health Policy & Management Mailman School of Public Health Columbia University York NY 10032 MedicalResearch.com: What is the background for this study? Response: We examined the experiences of 1285 American women, military and civilian, who served in Vietnam during the war and responded to a mail survey conducted approximately 25 years later in which they were asked to report and reflect upon their experiences and social and health histories. The data were collected as part of a much larger study that centered about methodological approaches to studying health effects of the military herbicides used in Vietnam. To our knowledge, this is the first study (a) to describe the experiences of civilian women deployed to a war zone and to compare them to those of military women; (b) to differentiate the experiences and outcomes among military women by the length of their military career service; (c) to contextualize the general health and happiness, marital characteristics, and childbearing patterns of women deployed to Vietnam and those of their peers by comparing them to a contemporaneous nationally representative age-matched cohort, the General Social Survey (GSS). Overall, this paper provides insight into the experiences of the understudied women who served in Vietnam, and sheds light on subgroup differences within the sample.
Author Interviews, HIV, Pharmacology / 20.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32236" align="alignleft" width="200"]Kati Vandermeulen Senior Director, Global Regulatory Leader and Compound Development Team Lead IDV Janssen Kati Vandermeulen[/caption] Kati Vandermeulen Senior Director, Global Regulatory Leader and Compound Development Team Lead IDV Janssen MedicalResearch.com: What is the background for this study? What are the main findings? Response:  SWORD is the first large trial program specifically conducted to look at the combination of dolutegravir and rilpivirine as a complete, two-drug antiretroviral regimen. Results of the two identical Phase III SWORD studies have been positive and demonstrate that the two-drug regimen of dolutegravir and rilpivirine is as effective, with comparable tolerability, to traditional three- or four-drug (integrase inhibitor-, non-nucleoside reverse transcriptase inhibitor-, or boosted protease inhibitor-based) antiretroviral regimens for the maintenance treatment of HIV.
Author Interviews, Brain Cancer - Brain Tumors, Radiation Therapy / 20.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32224" align="alignleft" width="120"]N. Scott Litofsky, M.D. Chief of the Division of Neurological Surgery University of Missouri School of Medicine Dr. N. Scott Litofsky,[/caption] N. Scott Litofsky, M.D. Chief of the Division of Neurological Surgery University of Missouri School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Radiosurgery is being used more often for treatment of brain metastases to avoid potential side effects of whole-brain radiation, such as cognition and mobility impairment. After surgical resection of a brain metastases, some radiation treatment is generally needed to control brain disease. Few studies have directly compared efficacy of tumor control between surgery followed by whole-brain radiation and surgery followed by radiosurgery. Our objective was to compare outcomes in two groups of patients – one whose brain metastasis was treated with surgery followed by whole-brain radiation and one whose surgery was followed by radiosurgery to the post-operative tumor bed. We found that tumor control was similar for both groups, with survival actually better in the radiosurgery group. The complications of treatment were similar.
Author Interviews, Pediatrics, Social Issues / 20.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32213" align="alignleft" width="149"]James K. Rilling, PhD Professor, Anthropology, Psychiatry and Behavioral Science Emory University School of Medicine Dr. James Rilling[/caption] James K. Rilling, PhD Professor, Anthropology, Psychiatry and Behavioral Science Emory University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been known for a long time that female mammals experience hormonal changes during pregnancy that prepare them to care for their offspring. More recently, it has been shown that some mammalian males, including humans, can also experience hormonal changes that prepare them to care for their offspring. For example, oxytocin levels can increase in human fathers and studies have shown that oxytocin facilitates paternal physical stimulation, play and emotional synchrony with their children. We examined the effects of intranasal oxytocin on brain function in human fathers. We found that intranasal oxytocin increased activation in brain areas involved with reward and empathy when human fathers viewed pictures of their children, but not unknown children.
Author Interviews, JAMA, Prostate Cancer / 20.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32209" align="alignleft" width="142"]Neeraj Agarwal, MD Associate Professor, Division of Oncology, Department of Medicine University of Utah School of Medicine Dr. Neeraj Agarwal[/caption] Neeraj Agarwal, MD Associate Professor, Division of Oncology, Department of Medicine University of Utah School of Medicine MedicalResearch.com: What is the background for this study? Response: Biomarkers predicting response to cancer therapy help guide physicians personalize medicine. Significant advances have been made in the development of therapeutic biomarkers in various malignancies, but not in prostate cancer. Dr. Nima Sharifi’s group at the Cleveland Clinic recently discovered that a germline inherited polymorphic variant (1245A→C) in the HSD3B1 gene correlates with shorter duration of response to androgen deprivation therapy (ADT) in hormone sensitive prostate cancer (HSPC). HSD3B1 gene encodes the enzyme 3β-hydroxysteroid dehydrogenase-1 (3βHSD1), which catalyzes adrenal androgen precursors into dihydrotestosterone, the most potent androgen. The authors found that the variant allele of HSD3B1 led to decreased progression-free survival in a dose-dependent manner in post-prostatectomy biochemical recurrence and metastatic HSPC (mHSPC). These results needed external validation before application in the clinic. In our study, we sought to provide the first independent validation of these results in patients with mHSPC.
Author Interviews, Prostate Cancer, Urology / 19.02.2017

MedicalResearch.com Interview with: Yoshifumi Kadono, MD. PhD. Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan  MedicalResearch.com: What is the background for this study? What are the main findings? Response: I had experienced some patients who underwent radical prostatectomy (RP) complained penile shortening after RP. Once I checked that kind of reports, some reports mentioned the phenomenon of penile shortening (PS) after radical prostatectomy; however, the results were little bit different and the reasons of PS after RP were not well elucidated. Therefore, we started our study to obtain our data. In our study, the penile length (PL) was measured before, 10 days after, and at 1, 3, 6, 9, 12, 18, and 24 months after RP. And the PL at 10 days after RP was shortest, and it gradually recovered thereafter. Penile length at 12 months after radical prostatectomy was not significantly different from preoperative penile length. Based on MRI investigation, slight vertical repositioning of the membranous urethra after radical prostatectomy caused chronological changes in penile length.
Author Interviews, Neurological Disorders, Zika / 19.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32197" align="alignleft" width="134"]Ping Wu, MD, PhD John S. Dunn Distinguished Chair in Neurological Recovery Professor, Department of Neuroscience & Cell Biology University of Texas Medical Branch Galveston, TX 77555-0620 Dr. Ping Wu[/caption] Ping Wu, MD, PhD John S. Dunn Distinguished Chair in Neurological Recovery Professor, Department of Neuroscience & Cell Biology University of Texas Medical Branch Galveston, TX 77555-0620 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Zika viral infection poses a major global public health threat, evidenced by recent outbreaks in America with many cases of microcephaly in newborns and other neurological impairments. A critical knowledge gap in our understanding is the role of host determinants of Zika-mediated fetal malformation. For example, not all infants born to Zika-infected women develop microcephaly, and there is a wide range of Zika-induced brain damage. To begin to fill the gap, we infected brain stem cells that were derived from three human donors, and found that only two of them exhibited severer deficits in nerve cell production along with aberrant alterations in gene expression.
Author Interviews, Global Health, HIV, Lancet / 19.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32187" align="alignleft" width="132"]Jennifer A. Downs, M.D., Ph.D. Assistant Professor of Medicine and Microbiology & Immunology Department of Medicine Weill Cornell Medicine Center for Global Health New York, NY 10065 Dr. Jennifer Downs[/caption] Jennifer A. Downs, M.D., Ph.D. Assistant Professor of Medicine and Microbiology & Immunology Department of Medicine Weill Cornell Medicine Center for Global Health New York, NY 10065 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Between 2002 and 2006, three large randomized controlled trials in sub-Saharan Africa demonstrated that male circumcision reduces new HIV infections in men by approximately 60%. Based on these findings, the World Health Organization recommended male circumcision as an HIV prevention strategy in countries with high levels of HIV and a low prevalence of male circumcision. This led to prioritization of 14 countries in Eastern and Southern Africa for massive scale-up of male circumcision beginning in 2011. In many of these countries, the uptake of male circumcision was lower than expected. In northwest Tanzania, where we work, there are a number of barriers to male circumcision. Some of these barriers are cultural, tribal, economic, and religious. We conducted focus group interviews in 2012 that showed that many Christian church leaders and church attenders in our region in Tanzania had major concerns about whether male circumcision was compatible with their religious beliefs. This led us to hypothesize that the uptake of male circumcision could be increased when religious leaders were taught about male circumcision, with the goal that they would then be equipped to discuss this issue with their congregations.
Author Interviews, Biomarkers, Pharmacology, Prostate Cancer / 19.02.2017

MedicalResearch.com Interview with: Teemu J Murtola, MD, PhD, adjunct professor University of Tampere, Faculty of Medicine and Life Sciences Tampere University Hospital, Department of Urology Tampere, Finland MedicalResearch.com: What is the background for this study? Response: A previous study called Prostate Cancer Prevention Trial (PCPT) showed that finasteride, which belongs to a drug group called 5alpha-reductase inhibitors lowers serum PSA and increases sensitivity of PSA to detect high-grade prostate cancer in men who had little or no symptoms of the lower urinary tract. We postulated that this effect would increase the accuracy and benefits of PSA-based prostate cancer screening. Finnish Randomized Study of Screening for Prostate Cancer was a large trial of over 80,000 men randomized either to be screened for prostate cancer with a PSA test at 4-year intervals or to be followed for prostate cancer incidence and mortality via national registries. Three consecutive screening rounds were commenced between 1996-2008. In the current study we compared the effects of PSA-based screening on prostate cancer risk and mortality separately among men who were using 5alpha-reductase inhibitors finasteride or dutasteride and among men who were not.
Author Interviews, Environmental Risks, Global Health, OBGYNE, Pediatrics / 18.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32176" align="alignleft" width="120"]Chris Malley PhD The Stockholm Environment Institute University of York Dr. Chris Malley[/caption] Chris Malley PhD The Stockholm Environment Institute University of York MedicalResearch.com: What is the background for this study? Response: When a baby is born preterm (at less than 37 weeks of gestation, an indicator of premature birth), there is an increased risk of infant death, or long-term physical and neurological disabilities. For example, 965,000 infant deaths in 2013 (35% of all neonatal deaths) have been estimated to be due to preterm birth complications. In 2010, an estimated 14.9 million births were preterm – about 4–5% of the total in some European countries, but up to 15–18% in some African and South Asian countries. The human and economic costs are enormous. There are many risk factors for preterm birth – from the mother’s age, to illness, to poverty and other social factors. Recent research has suggested that exposure to air pollution could also be a risk factor. Our study quantifies for the first time the global impact of pregnant women's exposure to outdoor fine particulate matter (PM2.5) by combining data about air pollution in different countries with knowledge about how exposure to different levels of air pollution is associated with preterm birth rates.
Abuse and Neglect, Author Interviews, Social Issues / 18.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32170" align="alignleft" width="135"]Andrew Fenelon PhD Assistant Professor, Department of Health Services Administration University of Maryland School of Public Health. College Park, MD 20742 Dr. Andrew Fenelon[/caption] Andrew Fenelon PhD Assistant Professor, Department of Health Services Administration University of Maryland School of Public Health. College Park, MD 20742 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the relatively large public investment in housing assistance at the federal level, there have been few nationwide analyses of the impacts of these programs on health and well-being. And as policymakers seek solutions to health disparities that incorporate some of the non-medical determinants of health (such as housing quality), our study can make an important contribution to both health and housing policy. We use an innovative data linkage program which links individuals in a federal household health survey and administrative housing records from the U.S. Department of Housing and Urban Development (HUD). We examine the health impacts of three HUD housing programs: public housing, housing choice vouchers, and multifamily housing. We find that public housing and multifamily housing lead to an improvement in self-reported health status, and public housing leads to a reduction in serious psychological distress. We do not find health impacts associated with housing choice vouchers.
Author Interviews, JAMA, Multiple Sclerosis, Neurology / 18.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32165" align="alignleft" width="180"]Linard Filli, PhD Gait Research Lab Department of Neurology University Hospital Zurich Zürich Dr. Linard Filli[/caption] Linard Filli, PhD Gait Research Lab Department of Neurology University Hospital Zurich Zürich MedicalResearch.com: What is the background for this study? Response: Gait dysfunction is common in patients with multiple sclerosis (MS) and is perceived as the most restricting of symptoms. Fampridine (4-aminopyridine, dalfampridine), a blocker of voltage-gated potassium channels, is currently the only approved medication for the symptomatic treatment of walking disorders in patients in both the early and late phases of  multiple sclerosis.
Author Interviews, Diabetes, OBGYNE / 18.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32182" align="alignleft" width="166"]Dr Sophie Jacqueminet Praticien Hospitalier Service de Diabétologie Pole Cardio Métabolisme Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix Dr Sophie Jacqueminet[/caption] Dr Sophie Jacqueminet Praticien Hospitalier Service de Diabétologie Pole Cardio Métabolisme Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix MedicalResearch.com: What is the background for this study? What are the main findings? Response: The proportion of women who are overweight or obese is increasing in almost all countries worldwide, and this is being accompanied by an increased risk of developing both type 2 diabetes (T2D) (whether pregnant or not) and gestational diabetes (GDM). While other studies have analysed the links between GDM and adverse outcomes in babies, very large studies that draw on an entire national database, study, are rare. In our research, all 796,346 deliveries taking place after 22 weeks in France in 2012 were included by extracting data from the hospital discharge database and the national health insurance system. Outcomes were analysed according to the type of diabetes and, in the GDM group, whether or not diabetes was insulin-treated. The cohort of 796,346 deliveries involved 57,629 (7.24%) mothers with gestational diabetes mellitus. Data linking the mother to the child were available for 705,198 deliveries (88% of the total). The risks of adverse outcomes were two to four times higher for babies of mothers with type 2 diabetes before pregnancy (pregestational diabetes) than for those with GDM. We then adjusted our data, limiting the analysis to deliveries after 28 weeks to ensure all women diagnosed with GDM were included (since diagnosis of GDM in most cases takes place at or after 28 weeks). Following adjustment, the increased risk of various complications for mothers with gestational diabetes versus mothers without GDM were: preterm birth 30%; Caesarean section 40%; pre-eclampsia/eclampsia 70%; babies born significantly larger than average size (macrosomia) 80%; respiratory distress 10%; birth trauma 30%; and cardiac malformations 30%. While these increased risks combine women with both insulin- and diet-treated GDM, most of the increased risk is found in women with insulin-treated GDM. This is because as stated above, the diabetes is more serious and blood sugar more difficult to control in women who need insulin treatment, resulting in a higher risk of complications than in those women treated with diet only.
Author Interviews, Biomarkers, Genetic Research, Personalized Medicine, Prostate Cancer / 17.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32155" align="alignleft" width="132"]Dr. John L. Gore, MD Associate Professor Adjunct Associate Professor-Surgery Department of Urology University of Washington Dr. John Gore[/caption] Dr. John L. Gore, MD Associate Professor Adjunct Associate Professor-Surgery Department of Urology University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: The rationale for our study derives from the uncertainty that both patients and clinicians confront when trying to make decisions about adjuvant therapy for prostate cancers found to have aggressive pathologic features at the time of radical prostatectomy. There is level 1 evidence in support of adjuvant radiation therapy in this setting, but several factors restrain providers from recommending adjuvant radiation. We found that interjecting a genomic test that predicts the risk of clinical metastases 5 years after surgery impacts the treatment recommended and helps men and clinicians feel more confident in the decision they are making or recommending.
Author Interviews, Cost of Health Care, Heart Disease, JAMA / 17.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32148" align="alignleft" width="142"]James E. Udelson, MD Chief, Division of Cardiology Director, Nuclear Cardiology Laboratory Professor, Tufts University School of Medicine Dr. James Udelson[/caption] James E. Udelson, MD Chief, Division of Cardiology Director, Nuclear Cardiology Laboratory Professor, Tufts University School of Medicine   MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are millions of stress tests done every year in the United States and many of them are normal,” said James Udelson, MD, Chief of the Division of Cardiology at Tufts Medical Center and the senior investigator on the study. “We thought that if we could predict the outcome of these tests by using information we already had from the patient before the test, we could potentially save the health care system money and save our patients time and worry.”   We were able to get a strong prediction of the possibility of having entirely normal testing and no clinical events such as a heart attack, by developing a risk prediction tool using ten clinical variables that are commonly available to a physician during an evaluation”
Author Interviews, Dermatology / 17.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32200" align="alignleft" width="128"]Neelam A. Vashi, MD Assistant Professor of Dermatology Boston University Center of Ethnic Skin Dr. Vashi[/caption] Neelam A. Vashi, MD Assistant Professor of Dermatology Boston University Center of Ethnic Skin  and [caption id="attachment_32217" align="alignleft" width="125"]Mayra B. C Maymone, MD, DSc Doctor of Science, Dermatology Boston University School of Medicine Boston, MA Dr.-Maymone[/caption] Mayra B. C Maymone, MD, DSc Doctor of Science, Dermatology Boston University School of Medicine Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Disorders of hyperpigmentation are common in clinical practice and frequently observed in dark-skinned individuals, a subset of the population that reportedly engages less with sunscreen use and other sun-protective behaviors. With the expected shift in US demographics to become a more racially and ethnically diverse population, there is growing interest in finding out more about the sun-protective habits in those with cutaneous hyperpigmentation. In this cross-sectional study, we found a surprisingly high rate of sunscreen use (67.5%). This is much higher than that observed in the general population and similar to rates observed in individuals with photosensitive disorders and skin cancer. However, the frequency of sunscreen reapplication and other sun-protective measures such as seeking shade and wearing hats were less commonly adopted in our study participants, emphasizing that even in a highly motivated population there is still room for improvement.
Author Interviews, NEJM, OBGYNE, Pediatrics / 17.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32143" align="alignleft" width="200"]Carla M. Bann, Ph.D. Division of Statistical and Data Sciences RTI International Research Triangle Park, NC Dr. Carla Bann[/caption] Carla M. Bann, Ph.D. Division of Statistical and Data Sciences RTI International Research Triangle Park, NC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several medical advances have been made over the past two decades to improve the care and survival of infants born pre-term. However, approaches to care differ greatly among providers for infants born at the limits of viability (22 to 24 weeks gestation), far earlier than the 40 weeks generally expected for a pregnancy to reach full-term. Little is known about the outcomes of these infants, particularly whether those who survive experience significant neurodevelopmental impairments. RTI served as the data coordinating center for this research that examined the survival and neurodevelopmental impairment at 18-22 months corrected age of over 4,000 infants born at 22 to 24 weeks gestation during 2000 to 2011 at medical centers participating in a national research network funded by the NIH. In this group of babies, infant survival improved over time from survival rates of 30 percent in 2000-2003 to 36 percent in 2008-2011. The proportion of infants who survived without a neurodevelopmental impairment also increased from 16 percent in 2000-2003 to 20 percent in 2008-2011.
Author Interviews, Immunotherapy, Pulmonary Disease / 17.02.2017

MedicalResearch.com Interview with: [caption id="attachment_32136" align="alignleft" width="133"]Prof. Hossein-Ardeschir Ghofrani University of Giessen and Marburg Lung Center Giessen, Germany, and Member of the German Center of Lung Research and Department of Medicine Imperial College London London, UK Prof. Ghofrani[/caption] Prof. Hossein-Ardeschir Ghofrani University of Giessen and Marburg Lung Center Giessen, Germany, and Member of the German Center of Lung Research and Department of Medicine Imperial College London London, UK MedicalResearch.com: What is the background for this study? Response: Pulmonary arterial hypertension (PAH) is characterised by increased pulmonary vascular resistance (increased resistance to blood flow in the pulmonary circulation), which can lead to right heart failure and death. Riociguat is the first of a new class of drugs – the soluble guanylate cyclase stimulators. It has been approved for the treatment of PAH based on the impressive efficacy and safety results from two pivotal Phase III studies: PATENT-1 and its long-term extension phase, PATENT-2. PATENT-1 was a 12-week, double-blind, randomized, placebo-controlled trial to evaluate the safety and efficacy of riociguat in patients with PAH. Patients who completed PATENT-1 without ongoing riociguat-related serious adverse events (AEs) could enter PATENT-2, in which they received open-label riociguat. PATENT-1 admitted patients whether they were treatment-naïve or already receiving targeted PAH therapies, such as endothelin receptor antagonists (ERAs) and prostanoids. This current analysis compared the safety and efficacy of riociguat between treatment-naïve and pretreated patients in the PATENT-2 long-term extension study.