Dr. Charlie Wray[/caption]
Charlie M. Wray, DO, MS
Assistant Clinical Professor of Medicine
University of California, San Francisco Department of Medicine
San Francisco VA Medical Center
MedicalResearch.com: What is the background for this study?
Response: Since the establishment of residency duty hour regulations in 2010, which subsequently lead to increased discontinuity of inpatient care and more resident shift work, educators and researchers have attempted to establish which shift handoff technique(s) or strategies work best.
National organizations, such as the ACGME, AHRQ, and the Joint Commission have made specific recommendations that are considered "best practice". In our study, using an annual national survey given to Internal Medicine Program Directors, we examined the degree of implementation of these recommended handoff strategies and the proportion of Program Director satisfaction with each of the respective strategies.
Dr. Bernard M Duvivier[/caption]
Bernard M Duvivier
Department of Human Biology and Movement Science
NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre
Maastricht, the Netherlands
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The health benefits of exercise have been well established but sitting is a risk factor for health, independent of exercise.
As many people with type 2 diabetes don’t like to exercise we investigated whether replacing sitting time with light-intensity activities (standing and light walking) is equally effective to exercise when energy expenditure is comparable. Our results suggest that for people with type 2 diabetes, light-intensity activities (light walking and standing) can be an alternative to exercise to improve glucose regulation.
In addition we showed that too much sitting has negative effects on insulin sensitivity which could not be fully compensated by 1 hour of exercise per day.
Dr. Osterberg[/caption]
E. Charles Osterberg, M.D.
Assistant Professor of Surgery
Genitourinary Reconstruction and Trauma
University of Texas- Dell Medical School
Dell-Seton Medical Center / University Hospital
MedicalResearch.com: What is the background for this study?
Response: Pubic hair grooming has become an increasingly common practice among men and women. Perceptions of genital normalcy have changed as modern society’s definition of attractiveness and feelings of femininity and masculinity have changed. Pubic hair grooming has been shown to increase morbidity such as genital injuries, however little is known about the relationship between grooming practices and sexually transmitted infections.
Dr. Adrian Lee[/caption]
Dr. Adrian Lee PhD
Professor, Department of Pharmacology and Chemical Biology
Director, Women's Cancer Research Center
University of Pittsburgh Cancer Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The goal of this study was to understand molecular changes which occur when breast cancers metastasize to the brain, with the eventual of identifying new therapeutic strategies. Brain metastases occur in 10-15% of patients with metastatic breast cancer and are a major clinical challenge. Limited therapeutic options exist for patients with brain metastases. We analyzed molecular changes in pairs of patient-matched primary breast cancers and brain metastases. We found that brain metastases tended to have the same intrinsic subtype as the primary breast cancer, however, there were many genes which changes in gene expression and may represent therapeutic targets.
The most common change was an increase in ErbB2/HER2 which can be targeted clinically.
MedicalResearch.com Interview with: [caption id="attachment_30440" align="alignleft" width="133"] Dr. Harry Bear[/caption] Harry D. Bear, MD, PhD Walter Lawrence, Jr. Distinguished Professor of Oncology; Chair, Division of Surgical Oncology, Department of Surgery; Professor, Departments of Surgery, Microbiology & Immunology, VCU School of Medicine; Director, Breast Health Center, VCU Massey Cancer Center; Medical Director Massey Cancer Center Clinical Trials Office Virginia Commonwealth...
Dr. Dagfinn Aune[/caption]
Dr. Dagfinn Aune
Department of Epidemiology and Biostatistics
School of Public Health
Imperial College London
St. Mary's Campus London UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is a growing body of evidence suggesting that intake of nuts may reduce the risk of coronary heart disease, but the relation between nut intake and other diseases like cancer and stroke, and the relation with mortality and less common causes of death is not clear. Also it is not clear how much nuts are needed to reduce the risk.
So our current meta-analysis reviewed the data from 20 studies (29 publications) on nut intake and different health outcomes. We found that a nut intake of approximately one serving per day (28 g/d or a handful) was associated with a reduced risk of coronary heart disease (by 30%), total cancer (15%), all-cause mortality (22%) and mortality from respiratory disease (50%), diabetes (40%), and infections (75%), although there were few studies in the latter three analyses. We found that most of the benefit was observed up to an intake of around 20 grams per day. Similar results were found for total nuts, tree nuts and peanuts (which are botanically defined as legumes), but peanuts were also associated with reduced risk of stroke, while only tree nuts were associated with reduced cancer risk. We also calculated the number of deaths that potentially could be avoided, under the assumption that the observed associations are causal, and arrived at 4.4 million deaths in North and South America, Europe, Southeast Asia and the Western Pacific (unfortunately we did not have data on nut intake from West Asia and Africa so we were not able to include those areas).
Dr. Steven J. Hardy[/caption]
Steven J. Hardy, Phd
Licensed Clinical Psychologist
Divisions of Hematology and Oncology
Children’s National Health System
Assistant Professor of Pediatrics and Psychiatry & Behavioral Sciences
George Washington School of Medicine and Health Sciences Washington, DC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Children with sickle cell disease exhibit neurocognitive deficits as a consequence of either silent or overt cerebral infarction or disease-related non-infarct central nervous system effects (likely resulting from chronic anemia and hypoxic events). These complications often lead to impairment in executive functioning (e.g., working memory, attention, inhibition, cognitive flexibility), which can make it difficult to focus in class, plan for long-term school projects, remember and carry out multi-step tasks or assignments, and stay organized. The literature on interventions to reduce neurocognitive sequelae of sickle cell disease is extremely limited.
Our research team investigated a promising home-based, computerized cognitive training program (Cogmed) involving repeated practice on performance-adapted exercises targeting working memory with a sample of youth (ages 7 – 16) with sickle cell disease. Of the participants who have enrolled in the study (n = 70), 49% exhibited working memory deficits (<25% in the general population have a working memory deficit) and were randomized to an eight-week waitlist or to begin Cogmed immediately. Participants who used Cogmed demonstrated significant improvements on multiple measures of working memory, while those randomized to the waitlist group only exhibited such improvements after receiving Cogmed. Approximately 25% of participants completed the recommended number of Cogmed sessions (20 – 25 sessions). However, analyses revealed that participants who completed at least 10 sessions (about 50% of the participants) showed comparable levels of working memory improvement.
Uterine Microbiome Plays Key Role in IVF Success How Heart-Healthy Cereals Reduce Cholesterol Healthy Stem Cells Need Just Right Telomere Length Fewer African Americans, More Whites Injecting Drugs Regular Cannabis Use May Slow Down Visual Processing By Retina Who Benefits from an Implantable Defibrillator? Diabetes Drug May Slow Progression...
Dr. Joshua Denson[/caption]
Joshua L Denson MD
Pulmonary and Critical Care Medicine
University of Colorado School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Miscommunication during physician transition in care has been associated with adverse patient events and medical errors; however, an understudied topic is the transition in care that occurs each month when resident physicians switch clinical rotations, also called an end-of-rotation transition. During this handoff, hospitalized patients (up to 10-20) are handed over to an oncoming physician who has never met the patients. We sought to investigate if this type of transition was associated with worse patient outcomes, specifically mortality.
On July 1, 2011, the Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulations limited first-year resident physicians (interns) to 16 continuous hours of work. Although these rules do not appear to have affected overall patient safety outcomes, they have been associated with an increase in shift-to-shift handoffs among training physicians. Given this, we wanted to study how they might impact patient outcomes surrounding end-of-rotation transitions in care.
Dr. Audrey Chu[/caption]
Audrey Chu, Ph.D.
Division of Intramural Research
National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Body shape reflects the underlying adipose tissue distributed throughout different compartments of the body (ectopic fat). Variation in ectopic fat is associated with diabetes, hypertension and heart disease. This is mostly independent of overall adiposity. Ectopic fat can be measured using special x-rays procedures such as CT (“CAT scans”) or MRI and can give more information about fat distribution. Fat distribution characteristics can run in families, suggesting that a person’s genes can help determine the amount of fat that can accumulate in different parts of the body. Identifying genes that are associated with ectopic fat can provide insight into the biological mechanisms leading to differences in cardiometabolic disease risk.
In order to understand which genes might be involved, we examined genetic variants across the genome and their association with ectopic fat in the largest study of its kind including over 18,000 individuals of four different ancestral backgrounds.
Several new genetic regions were identified in association with ectopic fat in addition to confirming previously known regions. The association of the new regions was specific to ectopic fat, since the majority of the regions were not associated with overall or central adiposity. Furthermore, most of these regions were not associated with type 2 diabetes, lipids, heart disease or blood pressure. The major exception was the region surrounding the UBE2E2 gene, which was associated with diabetes.
Dr. Carlos Simón[/caption]
Carlos Simón, M.D., Ph. D.
Professor of Obstetrics & Gynecology. Valencia University, Spain
Scientific Director, Igenomix SL.
Adjunct Clinical Professor, Department of Ob/Gyn, Stanford University, CA
Adjunct Professor, Department of Ob/Gyn, Baylor College of Medicine, TX
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The main findings of this study reside in the concept that the uterine cavity, which has been classically considered as a sterile organ, possess its own microbiome and that the composition of this uterine microbiome have a functional impact on the reproductive outcome of IVF patients.
Dr Nima Gunness[/caption]
Dr Nima Gunness, PhD
Australian Research Council Centre of Excellence in Plant Cell Walls
Centre For Nutrition and Food Sciences
The University of Queensland
Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Soluble dietary fibres (SDFs) such as B-glucan from oat are known to lower blood cholesterol, however their mechanisms of action are unknown. It has previously been hypothesised that they bind to bile acids in the small intestine causing an excess excretion in the faeces. To replenish this loss the body synthesises more bile acid from blood cholesterol, its sole precursor. However, evidence for this mechanism is not convincing.
In our study we’ve used pigs, as a model to study human digestion and relate the findings to diet related diseases such as obesity, type 2 diabetes and cardiovascular disease. We found that the SDF lowered blood total and LDL cholesterol but with a decrease in the circulating levels of bile acids. We also measured a decrease in the diffusion of cholesterol and bile acids across small intestinal epithelial tissue. In the colon we saw enhanced production of a therapeutic ursodeoxycholic acid, suppression of toxic lithocholic acid and transformation of cholesterol into coprostanol, a non-absorbable sterol.
Dr. Catherine Limperopoulos[/caption]
Catherine Limperopoulos, PhD
Director, Developing Brain Research Laboratory
Co-Director of Research, Division of Neonatology
Diagnostic Imaging and Radiology
Children’s National Health System
Washington, DC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Premature birth is a major public health concern in the United States affecting 1 in 10 infants each year. Prematurity-related brain injury is very common and associated with a high prevalence of brain injury and accompanying lifelong neurodevelopmental morbidities.
Early disturbances in systemic and cerebral hemodynamics are thought to mediate prematurity-related brain injury. The extent to which cerebral blood flow (CBF) is disturbed in preterm birth is poorly understood, in large part because of the lack of monitoring techniques that can directly and non-invasively measure cerebral blood flow.
We report for the first time early disturbances in global and regional cerebral blood flow in preterm infants following brain injury on conventional magnetic resonance imaging (MRI) over the third trimester of ex-uterine life using arterial spin labelling images. In terms of regional differences, we saw a marked decrease in blood flow to the thalamus and the pons, regions known to be metabolically active during this time.
Prof. Jan Karlseder[/caption]
Professor Jan Karlseder
Molecular and Cell Biology Laboratory
Donald and Darlene Shiley Chair
Salk Institute for Biological Studies
MedicalResearch.com: What is the background for this study?
Response: Telomeres are repetitive stretches of DNA at the ends of each chromosome whose length can be increased by an enzyme called telomerase. Our cellular machinery results in a little bit of the telomere becoming lopped off each time cells replicate their DNA and divide. As telomeres shorten over time, the chromosomes themselves become vulnerable to damage. Eventually the cells die. The exception is stem cells, which use telomerase to rebuild their telomeres, allowing them to retain their ability to divide, and to develop (“differentiate”) into virtually any cell type for the specific tissue or organ, be it skin, heart, liver or muscle—a quality known as pluripotency. These qualities make stem cells promising tools for regenerative therapies to combat age-related cellular damage and disease.
Dr. Ateev Mehrotra[/caption]
Dr. Ateev Mehrotra MD
Associate professor, Department of Health Care Policy
Harvard Medical School and a
hospitalist at Beth Israel Deaconess Medical Center
Boston, Massachusetts
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: More people in the US are using price transparency websites to shop for care. Some have wondered whether using the information on these websites to choose a doctor will help them actually save money. A relatively small difference in price for visits on the website translated into hundreds of dollars.
Dr. Cyprian Wejnert[/caption]
Cyprian Wejnert, Ph.D.
National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention
CDC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our country is dealing with a devastating epidemic of opioid misuse and overdose that affects individuals, families and communities. We have long known that sharing needles and syringes is an incredibly efficient route for HIV, hepatitis and other infections to spread.
Yet, about 10% of annual HIV diagnoses in the United States occur among people who inject drugs, and there are clusters of hepatitis C infections across the country. These infections can be prevented when people who inject drugs use sterile needles, syringes and other injection equipment. One of the main findings of this study is that use of syringe services programs (SSPs) has increased substantially during the past decade, but most people who inject drugs still don’t always use sterile needles.
The analysis finds that more than half (54%) of people who inject drugs in 22 cities with a high number of HIV cases reported in 2015 they used an SSP in the past year, compared to only about one-third (36%) in 2005. Although syringe services program use has increased, findings indicate that too few people who inject drugs use only sterile needles. One in three (33%) reported in 2015 that they had shared a needle within the past year – about the same percentage that reported sharing a decade ago (36% in 2005).
The report also highlights some successes in HIV prevention among African Americans and Latinos who inject drugs, as well as concerning trends in whites who inject drugs. From our study of 22 urban areas, it appears that fewer African Americans are injecting drugs. However, it also appears there has been an increase in white Americans injecting drugs.
MedicalResearch.com Interview with: Dr Vincent Laprévote Praticien Hospitalier (MD, PhD, HDR) Pôle Hospitalo-Universitaire de Psychiatrie du Grand Nancy Centre Psychothérapique de Nancy MedicalResearch.com: What is the background for this study? What are the main findings? Response: There was evidence in animal studies showing that cannabis use could impact visual processing, but lesser was known in...
Dr. Wayne Levy[/caption]
Wayne C. Levy, MD
Division of Cardiology
University of Washington
Seattle, Washington
MedicalResearch.com: What is the background for this study?
Response: There is uncertainty how effective ICDs are outside of clinical trials in real world patients who are often older with more comorbidities. The recent DANISH ICD only reiterates provider and patient concerns regarding the effectiveness of an ICD, that may be life saving, but does not improve heart failure symptoms or reduce hospitalizations. Many patients die without ever having an ICD shock, so the ICD was not necessary for the patient.
We postulated that the effectiveness of an ICD is not driven by the absolute risk of sudden death (event rate/year) but rather the proportion of all deaths that are due to sudden death vs non sudden death. If a patient has a 3% annual risk of sudden death and this is decreased to 1% with an ICD (a 67% reduction in sudden death), the patient benefit will be much greater if the non sudden death rate is 1%/year than if it is 12%/year. In the first scenario the absolute mortality is decreased from 4% to 2% (a 50% reduction) whereas in the second patient, the mortality would be decreased from 15% to 13% (a 13% benefit).
We developed the Seattle Proportional Risk Model (SPRM) using 10 clinical variables that had a differential impact on the mode of death, sudden vs. non sudden, in ~10,000 patients with ~2,500 deaths. Sudden death was more common in younger patients, male, without diabetes mellitus, NYHA 1 or 2 vs. 3 or 4, lower EF, SBP closer to 140, normal sodium and creatinine, higher BMI, and digoxin use.
Dr. Patrik Brundin[/caption]
Patrik Brundin, M.D., Ph.D.
Director, Center for Neurodegenerative Science
Van Andel Research Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The investigational drug at the heart of our study, MSDC-0160, has been in development to treat type 2 diabetes by improving cellular metabolism.
In Parkinson’s, reductions in cellular metabolism slow down vital housekeeping processes that clear out toxic proteins that otherwise accumulate with age. If these proteins aren’t removed, they clump together, leading to the damage and cell death that causes Parkinson’s hallmark symptoms, such as rigidity and tremor. MSDC-0160 helps keep these housekeeping processes working, ultimately protecting the brain.
We demonstrated that MSDC-0160 has strong, reproducible, positive effects across multiple models of Parkinson’s disease—it rescued dopamine-producing cells, improved behavioral deficits in mouse models and reversed inflammation. Overall, we believe it is a strong candidate for repurposing as a potential treatment that actually may slow the disease’s progression, rather than only mitigating symptoms.
Anneke I. den Hollander, PhD
Department of Ophthalmology and Department of Human Genetics
Donders Institute for Brain, Cognition, and Behaviour
Radboud University Medical Center
Nijmegen, the Netherland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Age-related macular degeneration is caused by a combination of genetic and environmental factors. Rare genetic variants in the complement system have been described in AMD, but their effect remains largely unexplored. In this study we aimed to determine the effect of rare genetic variants in the complement system on complement levels and activity in serum.
MedicalResearch.com: What are the main findings?
Response: Carriers of CFI variants showed decreased FI levels, carriers of C9 Pro167Ser had increased C9 levels, while C3 and FH levels were not altered. Carriers of CFH and CFI variants had a reduced ability to degrade C3b, which for CFI was linked to reduced serum FI levels.
Dr. Lisa Meeks[/caption]
Dr. Steve Xu[/caption]
Steve Xu MD, MSc
Resident Physician
Department of Dermatology
Northwestern Feinberg School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Given the limited data on the effectiveness or safety of the different moisturizers examined in the study, how much do you think parents should decide what to use on their babies based on the "cost-effectiveness" determined in this study? Would you just say cheapest is best since we don't know how well these things work? Or what's the message?
Price. Petrolatum is an extremely effective moisturizer. It also happens to be one of the most affordable. Unlike adults, I don't suspect newborns will complain too much about the greasiness of petrolatum. They're less concerned that their work clothes will get ruined. They are less likely to care about cosmetic elegance.
I also will say that petrolatum is less likely to include any artificial fragrances, preservatives that could serve as irritants or allergens in the future. That's an added bonus.