Author: Marie Benz MD FAAD
09 Aug Young Children At High Risk of Chemical Eye Burns
[caption id="attachment_26785" align="alignleft" width="142"]
Dr. R. Sterling Haring[/caption]
MedicalResearch.com Interview with:
R. Sterling Haring, DO, MPH
Center for Healthcare Quality and Patient Safety
University of Lugano, Switzerland
Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Chemical burns of the eye are among the most serious and emergent of eye injuries. In the worst cases, corrosive chemicals can eat into the eye and damage internal structures, rendering the individual with little or no vision in the affected eye. Given the proximity of the eyes to one another, it is not uncommon for these injuries to be bilateral, further complicating the clinical picture.
Working-age individuals, particularly men, are known to be a high-risk group for these types of injuries. In the first nationwide study on this issue, we found that 1-year old infants were at substantially higher (1.5x) risk of these injuries than the highest-risk age group among adults; 2-year-olds were a close second. These injuries tapered off as children grew older, such that the risk among 1-year-old infants was 13 times higher than that of 7-year-old children. Across all ages, injuries occurred most frequently among lower-income households.
09 Aug CareSkore Allows Hospitals To Do Risk Analysis and Care Planning in Real Time
MedicalResearch.com Interview with:
CareSkore co-founders:
Dr. Puneet Dhillon Grewal MD
CareSkore co-founder and Chief Medical Officer
Dr. Grewal is an Internal Medicine physician and Cardiologist. She had completed her residency from Rosalind Franklin University of Medical Science, and is currently a Cardiology Fellow at the same institution and
Jaspinder Grewal, MBA CareSkore co-founder and Chief Executive Officer,
a graduate from the University of Chicago Booth School of Business and a computer engineer. He has 13 years of experience working with large health systems , managing technology and operations.
MedicalResearch.com: What is the background for the CareSkore company? What is its mission and objectives?
Response: The Affordable Care Act, through penalties and bundled payments, requires hospitals and providers to be accountable for the quality of care they provide. For example, if a patient is readmitted to the hospital within 30-days after discharge, hospital reimbursement is reduced, and in many cases not paid at all.
In order to improve the quality of care, hospitals need to understand the clinical risk of patients, so that they can focus efforts on the patient most likely to face adverse events. The three biggest areas of improvement are readmissions, over utilization of services, and hospital acquired conditions (such as pneumonia and surgical site infections).
09 Aug ACEI and ARBs Had Similar Outcomes in Study of PD Dialysis Patients
MedicalResearch.com Interview with: [caption id="attachment_26841" align="alignleft" width="200"]
Dr. Jenny Shen[/caption]
Jenny Shen, MD, MS
Assistant Professor of Medicine
David Geffen School of Medicine at UCLA
Los Angeles Biomedical Institute at Harbor-UCLA Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: With cardiovascular disease being the No. 1 cause of death in end-stage kidney disease patients on peritoneal dialysis, we examined two classes of medications commonly prescribed to prevent cardiovascular events in these patients and found no significant difference in outcomes.
The two classes of medications, angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-II receptor blockers (ARB), have slightly different mechanisms and could theoretically have differing outcomes. Previous studies had suggested that ACEI may lead to a kinin-mediated increase in insulin sensitivity not seen with ARB. This could potentially lower the cardiovascular risk in patients on peritoneal dialysis because they are exposed to high glucose loads in their dialysate that may lead to insulin resistance and its associated cardiovascular risk.
Using a national database, the U.S. Renal Data System, we surveyed records for all patients enrolled in Medicare Part D who initiated maintenance peritoneal dialysis from 2007 to 2011. Of those, we found 1,892 patients using either drug class. Surveying their medical records, we found no difference in cardiovascular events or deaths between the users for each class of medication.
09 Aug Walk-In Appointments Improved Access To Psychiatric Care
Posted at 00:57h
in Author Interviews, Brigham & Women's - Harvard, Mental Health Research, Primary Care
MedicalResearch.com Interview with:
[caption id="attachment_26837" align="alignleft" width="120"]
Dr. David Kroll[/caption]
David S. Kroll, MD
Harvard Medical School
Department of Psychiatry
Brigham and Women's Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our primary care clinic has the capacity to provide 9 psychiatry evaluations per week, but before we started this project nearly half of the evaluation appointments went unused due to no-shows, and meanwhile the waiting time was two months. We had tried appointment reminders but this had very little impact on the problem—it turns out that forgetting is only a small part of why patients miss their appointments and that instead they have competing obligations—family, housing, legal, etc. Since the traditional model of scheduling and keeping appointments wasn’t working for so many patients, we implemented a referral-based walk-in clinic instead and found that this significantly increased the number of patients who were seen while virtually eliminating our wait list.
08 Aug Vitamin D Levels Fall When Estrogen-Containing Birth Control Pills Stopped
MedicalResearch.com Interview with: [caption id="attachment_26830" align="alignleft" width="100"]
Dr. Quaker Harmon[/caption]
Quaker Harmon M.D., Ph.D.
Epidemiology Branch
National Institute of Environmental Health Sciences
Research Triangle Park, NC 27709
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Vitamin D is important for bone health. In the United States many women are vitamin D deficient. Vitamin D does not naturally occur in many foods, however some foods are fortified with vitamin D. Supplements and sunshine are the most reliable sources of vitamin D.
Previous studies suggested that women using birth control pills containing estrogen had higher levels of vitamin D. These studies were generally small and were not always able to examine important factors such as time spent outside. We were interested in examining the association between hormonal contraception and vitamin D levels in a larger group of women.
We found that women who use estrogen-containing contraception had a 20% increase in their vitamin D levels. This increase was not due to time spent outside or behaviors related to choice of contraception. The magnitude of increase for hormonal contraception was smaller than for regular use of a supplement containing vitamin D.
08 Aug Health Benefits of Insurance Coverage Under ACA Become More Apparent With Time
MedicalResearch.com Interview with: [caption id="attachment_24380" align="alignleft" width="123"]
Dr. Benjamin D. Sommers[/caption]
Benjamin D. Sommers, M.D., Ph.D
Assistant Professor of Health Policy & Economics Department of Health Policy & Management
Harvard T.H. Chan School of Public Health
Assistant Professor of Medicine Division of General Medicine & Primary Care
Brigham & Women’s Hospital / Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: More than half of states have expanded Medicaid under the Affordable Care Act, and several states have taken alternative approaches, such as using federal Medicaid funds to purchase private insurance for low-income adults. Our study looks at the effects of these two different approaches - vs. not expanding at all - in three southern states (Kentucky Arkansas, and Texas). What we find is that expanding coverage, whether by Medicaid (Kentucky) or private insurance (Arkansas), leads to significant improvements in access to care, preventive care, quality of care, and self-reported health for low-income adults compared to not expanding (Texas). The benefits of the coverage expansion also took a while to become evident - the first year of expansion (2014) showed some of these changes, but they become much more apparent in the second year (2015).
08 Aug New Anti-Diabetic Compound May Avoid Bone Loss Seen With Current Medications
MedicalResearch.com Interview with: [caption id="attachment_26825" align="alignleft" width="133"]
Dr. Patrick Griffin[/caption]
Patrick Griffin, PhD
Professor
Department of Molecular Therapeutics
The Scripps Research Institute Florida Campus
MedicalResearch.com: What is the background for this study?
Response: Over the past decade, our laboratory and that of TSRI Associate Professor Theodore Kamenecka, have focused on molecules that increase sensitivity to insulin. Using newly discovered information, we have made significant advances in developing a family of drug candidates that target a receptor known as peroxisome proliferator-activated receptors gamma (PPARγ), a key regulator of stem cells controlling bone formation and bone resorption and a master regulator of fat.
08 Aug ICU Care May Lead To More Tests and Costs Without Necessarily Better Outcomes
Posted at 17:47h
in Author Interviews, Cost of Health Care, Critical Care - Intensive Care - ICUs, JAMA
MedicalResearch.com Interview with:
Dong W. Chang, MD, MS
Dong W. Chang, MD, is a lead researcher at LA BioMed, one of the nation’s leading independent nonprofit research institutes. His research interests include improving the delivery of care to patients with a focus on identifying new healthcare models for reducing hospital re-admission. He also is the director of Medical-Respiratory ICU at Harbor-UCLA Medical Center in Torrance
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: With the use of intensive care units (ICUs) on the rise in many hospitals, researchers at LA BioMed and UCLA examined ICU usage. They found patients who were admitted to these units underwent more costly and invasive procedures but didn’t have better mortality rates than hospitalized patients with the same medical conditions who weren’t admitted to the ICU.
The study, published in JAMA Internal Medicine, examined records from 156,842 hospitalizations at 94 acute care hospitals for four medical conditions where ICU care is frequently provided but may not be medically necessary:diabetic ketoacidosis, pulmonary embolism, upper gastrointestinal hemorrhage and congestive heart failure. The study found the hospitals that utilize ICUs more frequently were more likely to perform invasive procedures and incur higher costs. But the study found these hospitals had no improvement in mortality among patients in the ICU when compared with other hospitalized patients with these four conditions.
Smaller hospitals and teaching hospitals used ICUs at higher rates for patients with the four conditions studied that did larger hospitals. The difference in the average costs ranged from $647 more for upper gastrointestinal hemorrhage care in the ICU to $3,412 more to care for a patient with congestive heart failure in the ICU when compared with hospital care for the same conditions outside the ICU.
08 Aug Traditional Non-Medicaid Insurance Associated With Earlier Testicular Cancer Diagnosis
Posted at 17:35h
in Author Interviews, Brigham & Women's - Harvard, Cancer Research, Cost of Health Care
MedicalResearch.com Interview with:
Sarah C. Markt, ScD, MPH
Research Associate
Harvard T.H. Chan School of Public Health | Department of Epidemiology
Boston, MA 02115
MedicalResearch.com: What is the background for this study?
Response: Age is associated with insurance status, with the greatest proportion of uninsured between the ages of 20 to 34 years. For testicular cancer this is important because the median age of diagnosis is 33 years and the majority of the cases are diagnosed between then ages of 20 and 44 years. Previous studies have shown that people with cancer who are uninsured are more likely to present with worse disease, less likely to receive treatment, and are more likely to die of their disease, compared with those who have private insurance. Furthermore, the associations between Medicaid coverage and cancer outcomes have been conflicting.
08 Aug Sickle Cell Trait Not Associated With Increased Mortality in Military Population
MedicalResearch.com Interview with: D. Alan Nelson, MPAS, PhD Postdoctoral research fellow Stanford Medicine MedicalResearch.com: What is the background for this study? Response: The study was inspired by the uncertainty surrounding sickle cell trait (SCT) and its association with serious exertional collapse events and mortality in active populations. I conducted initial, exploratory analyses on these topics in 2014-15 while examining a range of military readiness predictors and outcomes. The early work indicated that the risk of mortality, rhabdomyolysis and other exertional events arising from SCT might be substantially lower than that suggested by prior work in the research literature. Dr. Lianne Kurina and I decided to conduct further, focused study at the Stanford University School of Medicine to confirm or refute these findings. In considering best approaches, we noted that there was an absence of prior research in which the sickle cell trait status of an entire, large, physically-active study population was known. This limitation could introduce bias to inflate the apparent impact of a theorized predictive factor. Aside from the challenges in studying the impact of SCT on exertional outcomes, with respect to prevention, a further concern is that sickle cell trait is a non-modifiable trait. If it were a serious risk factor for rhabdomyolysis and/or mortality, despite careful exertional injury precautions such as those employed by the Army, this might present great challenges for prevention efforts. To maximize the potential for new research to provide actionable prevention information, our interests included examining a range of modifiable risk factors for rhabdomyolysis. Dr. Kurina and I have employed large, longitudinal military datasets for about five years to examine critical military health outcomes, making this study a natural progression of our joint work. The research proceeded with the support of the Uniformed Services University of the Health Sciences, and in cooperation with a distinguished group of experts who co-authored the paper and advised the project. The study was conducted using de-identified records of all SCT-tested African American US Army soldiers on active duty during 2011 - 2014 (N = 47,944).08 Aug Newly Diagnosed Brugada Syndrome Have a Different Prognosis
MedicalResearch.com Interview with: Ruben Casado-Arroyo, MD, PhD Heart Rhythm Management Center Cardiovascular Division, UZ Brussel–Vrije Universiteit Brussel, Cardiology Department, Arrhythmia Section Erasmus Hospital, Université Libre de Bruxelles Brussels, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of this study is to evaluate the evolution of the presentation of Brugada Syndrome (BrS) during the last 30 years. Only the first diagnosed patient of each family was included. The database was divided in two periods (early and latter group) in relation to the consensus conference of 2002. Aborted sudden death as the first manifestation of the disease occurred most frequently in the earlier period 12.1% versus 4.6% of the latter group. Inducibility (induction of ventricular fibrillation) during programmed electrical stimulation was achieved in 34.4% (earlier) and 19.2% (latter) of patients, respectively. A spontaneous type 1 electrocardiogram pattern that is a coved type ST elevation with at least 2 mm (0.2 mV) J-point elevation a gradually descending ST segment followed by a negative T-wave was presented at diagnosis 50.3% (earlier) versus 26.2% (latter patients). Early group patients had a higher probability of a recurrent arrhythmia (sudden cardiac death or ventricular arrhythmias) during follow-up (19%) than those of the latter group (5%). All these difference were significative. Overall, the predictors of recurrent arrhythmias were previous sudden cardiac death and inducibility. In the latter period, only previous sudden cardiac death was a predictor of arrhythmic events.06 Aug EKG Plus Framingham Score Improves Risk of Cardiovascular Disease
MedicalResearch.com Interview with: [caption id="attachment_26683" align="alignleft" width="133"]
Dr. Amit Shah[/caption]
Dr. Amit J. Shah MD MSCR
Research Assistant Professor
Assistant Professor of Epidemiology
Rollins School of Public Health
Emory University
Adjunct appointment in Medicine (Cardiology)
Atlanta VA Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Nearly ½ of sudden cardiac deaths occur in individuals who were not aware that they had heart disease; this increases the need for primary prevention. We studied whether the electrocardiogram could be a useful tool in helping to measure risk of cardiovascular disease in approximately 10,000 community-based adults aged 40-74 with a simple risk equation that is based on age, sex, and 3 numbers from the ECG: heart rate, T-axis, and QT interval. We found that such an equation estimates risk as well as the Framingham risk equation, which is the standard of care (based on traditional risk factors like smoking and diabetes). When combining both the Framingham and ECG risk assessments together, the accuracy improved significantly, with a net 25% improvement in the risk classification of cardiovascular death compared to using the Framingham equation alone.
06 Aug Optune as Standard Treatment Option for Newly Diagnosed Glioblastoma
Novocure is the developer of Optune, which uses Tumor Treating Fields to treat cancer. Tumor Treating Fields, or TTFields, are low intensity, alternating electric fields within the intermediate frequency range. TTFields disrupt cell division through physical interactions with key molecules during mitosis. This non-invasive treatment targets solid tumors. MedicalResearch.com: What is the background for this study? What are the main findings? Response: The National Comprehensive Cancer Network (NCCN) has recommended Optune as a standard treatment option for newly diagnosed glioblastoma (GBM) in its Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Central Nervous System Cancers. NCCN panel members designated Optune together with temozolomide as a category 2A treatment for newly diagnosed GBM for patients with good performance status, indicating uniform consensus among panel members to add Optune to the guidelines for newly diagnosed GBM. Optune has been included in the NCCN Guidelines as a category 2B treatment option for recurrent GBM since 2015. The recommendation follows the publication of Novocure’s EF-14 phase 3 pivotal trial data in The Journal of the American Medical Association (JAMA) in December, 2015. The EF-14 phase 3 pivotal trial demonstrated that adding TTFields to maintenance temozolomide chemotherapy significantly prolonged progression-free and overall survival in newly diagnosed GBM. Glioblastoma, also called glioblastoma multiforme, or GBM, is a type of primary brain cancer. Approximately 12,500 GBM tumors, or tumors that may transform into GBM, are diagnosed in the U.S. each year. GBM is the most common type of primary brain cancer in adults. It is more likely to appear in older adults and to affect men than women. GBM is one of the deadliest forms of cancer, with patients typically not surviving beyond 15 months after diagnosis.06 Aug IV Iron Administered Post-Op May Improve Surgical Outcomes
MedicalResearch.com Interview with: Clinical Professor Alhossain A.Khalafallah Menzies Institute for Medical Research, University of Tasmania, Australia Consultant Haematologist Senior Staff Specialist Launceston General Hospital, Australia MedicalResearch.com: What is the background for this study? Response: 1. Iron deficiency is one of the most common nutritional deficiencies worldwide, affecting up to one third of the population worldwide. 2. Prevalence of anaemia in orthopaedic surgery ranges between 10-20% with the main cause of anaemia identified as nutritional deficiency. 3. New intravenous iron preparations have been developed at a higher purchase price than oral iron. Iron carboxymaltose, as one example, remains underutilised in the treatment of perioperative anaemia. 4. To our knowledge, this study is the first to compare the efficacy, safety and long term effect on iron stores and length of hospital stay in the postoperative anaemia setting.06 Aug Before Children Enter Kindergarten, They Need To Know How to Count
MedicalResearch.com Interview with: [caption id="attachment_26788" align="alignleft" width="133"]
Dr. David Geary[/caption]
David C. Geary, Ph.D.
Curators’ Distinguished Professor
Thomas Jefferson Fellow
Department of Psychological Sciences
Interdisciplinary Neuroscience Program
University of Missouri
Columbia, MO
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In an earlier study, we found that children’s understanding of numbers and the relations among them (e.g., that 6 = 5 + 1 & 4 + 2 & 3 + 3…) at the beginning of 1st grade predicted their performance on math measures in adolescence, controlling IQ, working memory, family background and other factors. These are measures that predict employability and wages in young adults and thus is practically important. We were interested in understanding the very early quantitative knowledge that predicts children’s later number knowledge. We tested children on a variety of quantitative measures 2 years before they entered kindergarten and in kindergarten gave them the same type of number test that we used in the first study. We found that 3 year olds' cardinal knowledge was critical to their later understanding of number relations, controlling IQ and many other factors. Cardinal knowledge is their understanding of the quantities associated with number words. So, if you ask a child to give you 3 toys, and they give you a handful, they do not understand what ‘three’ means. Young children with poor knowledge of number words, we at risk for poor math outcomes in kindergarten, controlling other factors.
06 Aug Obesity Linked To Prematurely Aged Brains
MedicalResearch.com Interview with: [caption id="attachment_26781" align="alignleft" width="153"]
Dr. Lisa Ronan[/caption]
Dr. Lisa Ronan, PhD
Department of Psychiatry
University of Cambridge Neuroscience
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A growing body of literature relates common markers of aging to those observed in obesity and supports the hypothesis that obesity may accelerate or advance the onset of brain aging. To investigate this relationship at a population level we analysed the white matter volume of the brain in 473 adult subjects ages 20 - 87 years and contrasted these volumes between subjects who were lean (BMI between 18.5 - 25) and those who were overweight / obese (BMI > 25).
Our results suggest that the latter group had significantly smaller white matter volumes when compared to their lean age-matched counterparts. We found that this difference in volume equated to a brain-age increase of 10 years in the overweight / obese group. We found no evidence that obesity impacted on cognitive ability.
05 Aug Preventing Bacteria From Sticking Would Eliminate Need For Antibiotics
MedicalResearch.com Interview with: [caption id="attachment_26775" align="alignleft" width="153"]
Dr. Peter Monk[/caption]
Dr Peter Monk BSc PhD
Faculty Director of International Affairs
Reader in Immunology
Department of Infection, Immunity and Cardiovascular Disease
Sheffield University Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The tetraspanin proteins are found on the surface of all mammalian cells. The cell surface is the place where cells 'socialise': they talk to each other to coordinate activities, stick to each other to form tissues and sometimes crawl across each other to get to where they need to go. Tetraspanins have an important job to do in the organisation of the cell surface, amongst other things enabling the formation of 'sticky patches' (tetraspanin-enriched microdomains or TEM) that cause cells to adhere together or provide traction to allow movement. Some bacteria have evolved ways of hijacking the TEM for their own ends, adhering to tightly to these structures so that the normal things that sweep bacteria away (such as blood, sweat and tears!) are no longer effective. At this point, infection begins.
We have found that the TEM can be partly disrupted, by adding small parts of tetraspanins (peptides) to cells. The peptides seem to work by weakening the tetraspanin glue that holds the TEM together and causing the other components that give the 'stickiness' to the TEM to become more spaced out. We use the analogy of Velcro(TM), where the fabric hooks and loops are held together in woven material; loosen the weave and the hooks and loops fall apart, no longer able to engage strongly with the loops in the opposing piece of fabric.
Using reconstructed human skin, we were able to show that the tetraspanin peptides were both safe and effective; they did not affect wound healing in burned skin, but they could lower the bacterial load in the wound by 50%. This would allow the immune system (including the fluid that 'weeps' from wounds) to deal with the remaining bacteria more easily. Unlike conventional antibiotics that tend to kill bacteria, our peptides simply cause them to get washed away, so not invoking the evolutionary selective mechanisms that lead to resistance.
05 Aug Poor Oral Health in Hospitalized Patients Associated With Dementia and Kidney Disease
Posted at 23:16h
in Author Interviews, Cognitive Issues, Dental Research, Geriatrics, Kidney Disease
MedicalResearch.com Interview with:
[caption id="attachment_26794" align="alignleft" width="164"]
Dr. Danielle Ni-Chroinin[/caption]
Danielle Mairead Maire Ni Chroinin,
MB BCh BAO BMedSc MD MRCPI FRACP
Staff Specialist in Geriatric Medicine
Liverpool Hospital and Senior Conjoint Lecturer UNSW
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Oral disease may have a large impact on older persons’ health and wellbeing, causing pain, impairing speech, adversely affecting nutrition, contributing to systemic infection and harming self-esteem. However, this important issue may be neglected in the acute hospital setting. Our aim was to investigate oral health status and abnormalities in older patients admitted acutely to hospital, exploring the association with medical co-morbidities. We included all individuals aged 70 and older admitted to a geriatric service over 3 months (N=202), and evaluated oral health using a simple bedside tool the Oral Health Assessment Tool (OHAT).
Overall, we found that poor oral health was not uncommon, and was associated with dementia and renal impairment. This association persisted even after adjustment for anticholinergic medication and oral pH, highlighting that patients with these conditions may be particularly vulnerable.
05 Aug Early Hysterectomy With Preserved Ovaries Doubles Risk of Hot Flashes and Night Sweats
MedicalResearch.com Interview with: [caption id="attachment_26763" align="alignleft" width="208"]
Louise Wilson[/caption]
Louise Wilson PhD Candidate
The University of Queensland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Hysterectomy remains one of the most common gynecological procedures worldwide, with rates highest among women aged between 40 and 50. Between 30 and 40% of women aged in their 40s and 50s experience hot flushes and night sweats (vasomotor symptoms) that can greatly impact upon their overall quality of life. There is consistent evidence that women who have a hysterectomy and both ovaries removed are more likely to report more frequent or severe vasomotor symptoms, probably due to the abrupt decline in estrogen levels post-surgery.
For women who have a hysterectomy with ovaries retained, the evidence is less clear. We wanted to increase our understanding of the symptom experiences of these women. We examined 17 years of data from more than 6,000 women in the Australian Longitudinal Study on Women’s Health. Approximately one in five of the women had a hysterectomy with ovarian conservation before the age of 50.
We found that a third of these women experienced hot flushes that persisted in the long term, and around one in five were afflicted by constant night sweats. These rates were double those of women who did not have a hysterectomy over the 17-year study period, and could not be explained by differences in lifestyle or socio-economic factors.
05 Aug BMI1 Gene Expression May Predict Response To Lung Cancer Treatment
MedicalResearch.com Interview with: [caption id="attachment_26759" align="alignleft" width="200"]
Dr. Elena Levantini[/caption]
Dr. Elena Levantini, PhD
Beth Israel Deaconess Medical Center
Instructor, Medicine, Harvard Medical School
Research Associate, Hematology-Oncology
Beth Israel Deaconess Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Lung cancer is one of the deadliest cancers in the world, accounting for 30% of tumor-related deaths. Like many solid tumours, lung cancer is very heterogeneous (consisting of cancer cells which behave and respond differently) and hence there is currently no single efficient drug which is able to treat all patients.
Levantini and colleagues previously showed that non-small cell lung cancer (NSCLC) tumor cells frequently express too little or none of a transcription factor called C/EBPα, a protein that regulates gene expression and cell proliferation in lung tissues. It’s also known to play a role in a form of leukemia, as well as liver cancer, squamous cell skin carcinomas, squamous cell cancers of the head and neck and other cancers. In their previous work, the scientists suspected that C/EBPα may act as a tumor suppressant in normal cells, but the mechanism by which its absence promoted lung cancer tumors remained unclear.
Dr. Levantini went on to develop a mouse model in which deleting C/EBPα resulted in NSCLC. Analysis of this model led to the discovery that C/EBPα suppressed lung tumor formation by inhibiting the expression of BMI1. Dr Levantini then demonstrated that reducing the levels of BMI1 in her mouse model by genetic means, or by using a drug reducing expression of BMI1, led to inhibition of tumor formation. This study has established an important link between C/EBPα and BMI1 for the first time.
05 Aug NYU Researcher Discusses Nanoparticles in Sunscreens and E-Cigs
MedicalResearch.com Interview with: [caption id="attachment_26755" align="alignleft" width="150"]
Dr. Judith Zelikoff[/caption]
Judith T. Zelikoff, PhD, Professor
Department of Environmental Medicine
NYU Langone Medical Center.
MedicalResearch.com: Would you tell us a little about yourself?
Response: I am a tenured full professor in the Department of Environmental Medicine at the NYU School of Medicine with >25 years of experience studying the toxicology of inhaled single contaminants and complex mixtures including metals, nanoparticles, gaseous and particulate (PM) air pollutants, e-cigarettes and combustible products from cigarettes, biomass burning, and diesel exhaust. Over the last decade, studies in my laboratory has focused on the effects of maternal inhalation of environmental toxicants, including fine-sized ambient particulate matter during pregnancy (and/or during neonatal development) on fetal cardiovascular structure, obstetric consequences, and later life disorders including obesity, immune dysfunction, and decreased sociability and reproductive success in adult male and female offspring. Other early life studies associated with inhaled nicotine/tobacco products have demonstrated that maternal and neonatal exposure of mice to aerosols from e-cigarettes (with and without nicotine) alters neurodevelopment and produces hyperactivity in adult male offspring.
Our studies with smokeless tobacco products demonstrate dyslipidemia and non-alcoholic steatohepatitis in prenatally exposed adult offspring. One of my major scientific accomplishments are my early life inhalation exposure studies demonstrating, for the first time in some cases, that prenatal/neonatal exposure to environmental agents can produce effects persistent into adulthood that can increase susceptibility to a variety of disorders, including cardiovascular disease. In addition, I serve as the Community Outreach and Engagement Core (COEC)Director for our NYU NIEHS Core Center. In this regard, our COEC team partners with environmentally-impacted communities in the NY/NJ area to assess community concerns associated with environmental pollution and provide educational information that can help build community infrastructure. I am also extremely active as a leader in the Society of Toxicology having served as Secretary of the Society for 3 years and President of the Metals and Immunotoxicology SOT Specialty Sections where i received an Immunotoxicology Lifetime Achievement Award.
I currently serve as Chairperson of the SOT Committee for Diversity Initiatives and President of the Ethical, Legal and Social Specialty Section. I am currently a full member of a National Institute of Health Study and have also served on several other Federal/State Advisory Panels including the Institute of Medicine and National Research Council, EPA, NASA, NTP, and NJ Department of Environmental Protection. In addition to serving as an Associate Editor and Editorial Board member for numerous toxicology/environmental health journals, I currently serve as vice-President for the NYU School of Medicine Faculty Council.
05 Aug Witnesses More Likely to Confuse Innocent and Guilty Suspects When One Member of Lineup Has Distinctive Feature
MedicalResearch.com Interview with: Melissa F. Colloff PhD student and Kimberley A. Wade PhD, Department of Psychology University of Warwick MedicalResearch.com: What is the background for this study? Response: Eyewitnesses of crimes often have to attempt to make identification decisions as to whether the police suspect is, or is not, the real culprit of the crime. In an identification parade (UK), or a lineup (US), the suspect is presented alongside similar-looking people (who are known to be innocent) and the witness has to identify the real culprit if he or she is there, or state that the real culprit is not present. Eyewitness identification decisions can be very influential in how a case progresses through the criminal justice system. An incorrect identification can result in a guilty person going free, or an innocent person being charged of a crime they did not commit. So generally speaking, our research investigates which identification procedures enhance a person’s ability to identify a guilty suspect. In our study, we wanted to find out how the police should accommodate suspects with distinctive facial features (e.g., tattoos, scars, piercings, bruising) in lineups. If the police suspect stands out in a lineup because he has a distinctive feature, this is not a good test of the witness’s memory. The witness might pick the suspect simply because it is obvious that he is the focus of the police investigation. Alternatively, the witness might pick the suspect just because he is the best match—but not necessarily an exact match—to their memory of the culprit, compared to the other lineup members. Basically, if a distinctive suspect stands out, a witness is likely to pick the distinctive suspect, even if he is not the real culprit. Estimates suggest that over one third of all police suspects have distinctive facial features. But police guidelines on how to accommodate distinctive suspects in lineups are not currently guided by research—in fact, there are thousands of studies on lineups, but only a handful that explore lineups for distinctive suspects. In our study, we examined three techniques currently used by the police to prevent distinctive suspects from standing out and compared these techniques to doing nothing to prevent the distinctive suspect from standing out. Let’s say the suspect has a black eye. One thing the police might do is digitally add a black eye to all of the other faces in the lineup (i.e., “replication”). Or, they might cover up the suspect’s black eye and cover up a similar area on the faces of the other lineup members. In practice, the police can cover up the feature by either overlaying the area of the feature with a black block (i.e., “block”), or by pixelating the area of the feature (i.e., “pixelation”). In our study, we compared replication, pixelation and block lineup techniques against lineups in which nothing was done to prevent a distinctive suspect from standing out—that is, lineups in which the suspect was the only person with a black eye. [caption id="attachment_26748" align="alignleft" width="409"]
Replication[/caption]
05 Aug Data For Risk of Prostate Cancer with Drugs for Erectile Dysfunction Mixed
MedicalResearch.com Interview with: [caption id="attachment_26742" align="alignleft" width="143"]
Dr. Juzar Jamnagerwalla[/caption]
Juzar Jamnagerwalla, MD
Division of Urology, Department of Surgery
Cedars-Sinai Medical Center
Los Angeles, California
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In mouse models phosphodiesterase type-5 inhibitors (PDE-5i) have been shown to have anti-neoplastic activity, and given the routine use of PDE-5i for treatment of erectile dysfunction after prostatectomy several studies have examined the association between PDE-5i use and biochemical recurrence after treatment for prostate cancer with mixed findings. Only one previous study has explored the association between risk of prostate cancer, finding that men on PDE-5i had a lower chance of being diagnosed with prostate cancer. Given this, we tested the relationship between PDE-5i use and risk of prostate cancer in 6,501 men in the REDUCE study finding that PDE-5i use was not associated with prostate cancer diagnosis. On secondary analysis, among North American men who had a much higher baseline use of PDE-5i use, there was an inverse association between PDE-5i use and prostate cancer diagnosis, which approached, but did not reach statistical significance.
05 Aug Formal Education May Reduce Alzheimer’s Risk By Building Stronger Brain Connections
MedicalResearch.com Interview with: [caption id="attachment_26735" align="alignleft" width="160"]
Dr. Auriel Willette[/caption]
Auriel Willette, PhD
Assistant Professor
Departments of Food Science and Human Nutrition, and Psychology
Iowa State University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The Alzheimer's disease (AD) field continues to look for biological markers that can detect onset and progression of the disease, mainly memory decline and atrophy of medial temporal lobe where conscious memories are formed. The immune system has long been known to affect the onset and progression of Alzheimer's disease (AD), usually through a process called inflammation in the brain that causes damage to brain cells called neurons. We wished to examine all available immune system data in a large, well-established cohort across the AD spectrum and discover which immune markers best explained memory decline and medial temporal atrophy over 2 years.
In essence, among dozens of candidate immune markers, we consistently found two to be most relevant: neuronal pentraxin 2 (NPTX2) and chitinase-3-like-protein-1 (C3LP1). NPTX2 is important for facilitating communication between neurons, whereas C3LP1 is related to activation of a part of the immune system that causes inflammation in the brain. To our surprise, higher NPTX2 levels at baseline were potently related to less memory loss and less medial temporal atrophy over 2 years. C3LP1, by contrast, was a relatively poor predictor. NPTX2 also better predicted levels of amyloid and tau in the brain, which are generally thought to help cause AD.
Finally, we found that more years of education led to higher NPTX2 levels, suggesting that more formal learning leads to more stable, stronger connections between neurons that give rise to memory.
05 Aug Biomarker May Predict Response to Common Leukemia Treatment
Posted at 13:11h
in Author Interviews, Biomarkers, Genetic Research, Leukemia, Personalized Medicine
MedicalResearch.com Interview with:
[caption id="attachment_26730" align="alignleft" width="200"]
Dr. Laura Eadie[/caption]
Dr Laura Eadie PhD
Post Doctoral Researcher
Affiliate Lecturer Discipline of Medicine
University of Adelaide
Summary: Researchers based at SAHMRI (South Australian Health and Medical Research Institute) in Adelaide, South Australia have recently demonstrated the significance of early increases in the expression of ABCB1 in predicting long-term response to imatinib therapy. Lead researcher, Dr Laura Eadie, has recently had these findings published in the journal Leukemia and says that she hopes “the evidence provided by the study could be used to inform better patient treatment in the future”.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: ABCB1 (p-glycoprotein) is a membrane transporter known to be involved in the efflux of the tyrosine kinase inhibitors (TKIs) that are used to treat chronic myeloid leukaemia (CML). Overexpression of ABCB1 has also been demonstrated to cause resistance to the TKIs imatinib, nilotinib and dasatinib in vitro. Although studied previously in CML patients, the predictive value of ABCB1 in determining a patient’s long-term response to imatinib had not been realized ... until now.
Previous studies investigating ABCB1 as a predictive biomarker focused on expression levels of ABCB1 at one time point in isolation. For our study, we have measured the levels of ABCB1 at two separate time points specified in the TIDEL II trial protocol: day 1 (prior to the start of imatinib therapy) and day 22 (three weeks on imatinib). We then calculated the fold rise in ABCB1 expression levels at day 22 compared with day 1 and grouped patients about the median into high and low fold rise. When we compared molecular outcomes for patients within these two ABCB1 expression groups we noticed a striking difference in outcome to imatinib therapy.
05 Aug Air Pollution May Shorten Lung Cancer Survival
[caption id="attachment_26722" align="alignleft" width="150"]
Dr. Sandrah Eckel[/caption]
MedicalResearch.com Interview with:
Sandrah P. Eckel PhD
Assistant Professor of Preventive Medicine
USC Division of Biostatistics
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Lung cancer is the most common cancer and it is responsible for 1 in 5 cancer deaths. There is a growing body of evidence that ambient air pollution exposures are linked to lung cancer incidence and mortality, but the effect on survival of exposures after diagnosis are unclear. The International Agency for Research on Cancer recently classified ambient air pollution as carcinogenic. We reasoned that if air pollution drives lung cancer development, it could impact lung cancer progression—and shorten survival—through the same biological pathways.
We used 20 years of data on more than 300,000 newly diagnosed lung cancer cases from the California Cancer Registry and calculated average air pollution exposures at each patient’s residence from the date of diagnosis through the end of follow-up. We found that patients living in areas with higher pollution levels had shorter survival, particularly for patients who were diagnosed at an early stage and for those diagnosed at an early stage with adenocarcinoma histology. Interestingly, adenocarcinoma is the most common histological subtype of lung cancer in non-smokers.
05 Aug Sedentary Lifestyle Linked To Increased Risk of Diabetic Retinopathy
MedicalResearch.com Interview with: [caption id="attachment_26717" align="alignleft" width="132"]
Dr. Paul Loprinzi[/caption]
Paul Dinneen Loprinzi, PhD
Health, Exercise Science and Recreation Management
University of Mississippi
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous research demonstrates that adults who have higher daily sedentary behavior tend to have worse cardiometabolic health profiles. The extent to which sedentary behavior is associated with diabetic retinopathy has yet to be evaluated in the literature before our study. Our findings provided some suggestive evidence that more sedentary behavior was associated with a higher odds of having diabetic retinopathy.
05 Aug Bacteria Causing Dental Caries Transmitted From Family and Friends
MedicalResearch.com Interview with: [caption id="attachment_26712" align="alignleft" width="149"]
Dr. David Macintyre[/caption]
Stephanie S. Momeni, MS, MBA
Doctoral Candidate, Department of Biology
DART Trainee, Department of Pediatric Dentistry & IOHR
UAB School of Dentistry
Birmingham, Alabama 35294-0007
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study was a small part of a large scale of S. mutans in a group of high-caries risk children and their household family members in Perry County, Alabama, USA. Overall dental caries is a dietary and infectious disease that we seek to understand better. We found only 34 rep-PCR genotypes for over 13,000 bacterial isolates from over 594 individual subjects. With so much commonality we wanted to determine if any conclusions could be made about transmission.
The key findings are:
• Children having multiple S. mutans genotypes were 2.3 times more likely to have dental caries.
• Analysis for transmission performed from two perspectives (by child and by genotype) indicating 63% of children shared at least 1 genotype with their mother, but 72% of children had at least 1 genotype not shared with any household family members.
• Child-to-child transmission of some genotypes is highly probable.
• About 1/3 of isolates observed were transient, and may confound the search for strains associated with tooth decay.
05 Aug Suturing With Thicker Thread To Prevent Preterm Delivery Increases Risk of Miscarriage
MedicalResearch.com Interview with: [caption id="attachment_26708" align="alignleft" width="149"]
Dr. David Macintyre[/caption]
Dr David A MacIntyre
MRC Career Development Fellow
Lecturer in Reproductive Systems Medicine
Institute of Reproductive and Developmental Biology
Department of Surgery and Cancer
Imperial College
London UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Preterm birth is the leading cause of death in children under 5 years of age. One of the first things that can happen to a women before suffering a preterm birth is early opening of the cervix, which is the neck of the womb. This also puts her and the baby at risk of infection. One of the few preventative treatments available for these women is a cervical cerclage. This is when a surgeon uses one of two types of suture thread to stitch the cervix closed. This provides mechanical support to the pregnancy and is thought to help prevent infections from ascending from the vaginal into the uterus. One type of suture thread used is thin, monofilament nylon, which appears similar to fishing line. The other is a thicker thread - around 5mm thick - that is comprised of smaller threads woven together like a shoe lace. The thicker woven thread - called multifilament - is used in around 80 per cent of procedures as surgeons believe it to be stronger, and more efficient at holding the cervix closed. In this study, we first looked at 671 women who had the procedure at five UK hospitals over the last ten years. Around half had the thinner 'fishing line' thread, while the other half had the thicker 'shoe lace' thread.
The results revealed the thicker thread was associated with increased rate of intrauterine death compared to the thinner thread (15 per cent compared 5 per cent). The rate of intrauterine death in a normal pregnancy is around 0.5%. The thicker tape was also associated with an increased preterm birth rate compared to the thinner tape - 28 per cent compared to 17 per cent. The rate of preterm birth among the general population is around 7 per cent, but the cervical stitch procedure is only performed on women already deemed at high risk of premature birth. We then conducted a second study with 50 women who were due to have the cervical stitch procedure. Half received the thinner thread, while half received the thicker thread. We monitored the women at 4, 8 and 16 weeks after the procedure through ultrasound scans and analysis of bacteria in their reproductive tract. The results suggested that women who received the thicker thread had increased inflammation around the cervix. There was also increased blood flow, which is associated with the cervix opening before labour. Crucially, we also found that women who received the thicker thread had more potentially harmful bacteria in the vagina and around the cervix.