Author: Marie Benz MD FAAD

29 Jul

Posted at 22:12h in Author Interviews, Exercise - Fitness, Global Health, Lancet, Lifestyle & Health
MedicalResearch.com Interview with: [caption id="attachment_22664" align="alignleft" width="180"]Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow/Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney Dr. Melody Ding[/caption] Ding Ding (Melody), Ph.D., MPH NHMRC Early Career Senior Research Fellow Sydney University Postdoctoral Research Fellow Prevention Research Collaboration Sydney School of Public Health The University of Sydney MedicalResearch.com: What is the background for this study? Response: Understanding the true burden of a pandemic is indispensable for informed decision making. After decades of research, we now have established knowledge about how physical inactivity contributes to pre-mature deaths and chronic diseases, but the economic burden of physical inactivity remains unquantified at the global level. Through estimating the economic burden of physical inactivity for the first time, we hope to create a business case for investing in cost-effective actions to promote physical activity at the global levels.

29 Jul

Posted at 22:09h in Author Interviews, Gastrointestinal Disease, Genetic Research, JAMA
MedicalResearch.com Interview with: [caption id="attachment_26492" align="alignleft" width="133"]Amitabh Chak, MD University Hospitals Case Medical Ctr Cleveland, OH, 44106 Dr-Amitabh-Chak[/caption] Amitabh Chak, MD University Hospitals Case Medical Ctr Cleveland, OH, 44106 MedicalResearch.com: What is the background for this study? What are the main findings? Response: About 20 years ago we discovered that Barrett's esophagus and esophageal cancer aggregate in a small proportion of families suggesting there might be a genetic basis to these complex diseases. As we started looking at these families, we identified a rare family with multiple members who had Barrett's esophagus and multiple members who had passed away from esophageal cancer at a young age. Advances in exome sequencing have now allowed us to identify a mutation in a gene whose function is not known that predisposes this family to develop Barrett's esophagus. Functional studies suggest that this gene, VSIG10L, is involved in maturation of normal squamous esophagus.

29 Jul

Posted at 22:04h in Author Interviews, Depression, Medical Imaging, Mental Health Research, Radiology
[caption id="attachment_26646" align="alignleft" width="200"]Maria A. Oquendo, M.D. Professor of Psychiatry Vice Chair for Education Columbia University Medical Center American Psychiatric Association, President International Academy of Suicide Research, President Dr. Maria Oquendo[/caption] MedicalResearch.com Interview with: Maria A. Oquendo, M.D. Professor of Psychiatry Vice Chair for Education Columbia University Medical Center American Psychiatric Association, President International Academy of Suicide Research, President MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our team has worked for years on identifying the biological underpinnings of both risk for suicidal behavior (SB) and for predicting the lethality or medical consequences of suicidal behavior. We have shown that if you compare those who are depressed and have had SB to those who are depressed but do not have suicidal behavior, you can see clear differences in the serotonin system using Positron Emission Tomography and a molecule tagged with radioactivity. We predicted that if you could see these differences cross-sectionally, then their presence might also predict suicidal behavior and its lethality in the future. Our study showed that those with higher serotonin 1a binding in the raphe nuclei, which likely indicates low serotonin functioning, made more medically damaging suicide attempts in the two years that followed. They also suffered from more pronounced suicidal ideation in the subsequent year.

29 Jul

Posted at 22:00h in Author Interviews, Exercise - Fitness, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_26655" align="alignleft" width="155"]Dr Per Ladenvall Department of Molecular and Clinical Medicine Sahlgrenska Academy University of Gothenburg Sweden Dr. Ladenvall[/caption] Dr Per Ladenvall Department of Molecular and Clinical Medicine Sahlgrenska Academy University of Gothenburg Sweden MedicalResearch.com: What is the background for this study? Response: Aerobic capacity has been shown in other studies with shorter duration to be of importance for mortality. In the 1963 a population based study including every third man living in Gothenburg started. These men have since been followed up repeatedly until 100 years. For the present analysis men were invited to do a bicycle exercise test in 1967 and were followed up to 99 years.

29 Jul

Posted at 17:45h in Author Interviews, Cancer Research, Genetic Research, Lancet, Lymphoma
MedicalResearch.com Interview with: Jin-Xin BEI, Ph.D. Principal Investigator State Key Laboratory of Oncology in South China Sun Yat-sen University Cancer Center Guangzhou China MedicalResearch.com: What is the background for this study? Response: Natural killer T-cell lymphoma (NKTCL) is a rare and aggressive malignancy with remarkable prevalence in Asian and Latin populations, suggesting that the heritable components contribute to the disease risk. Epstein-Barr virus (EBV) infection has been thought to be major factor associated with NKTCL, and EBV DNA load in plasma has been applied in clinical managements, including diagnosis, treatment response and prognosis. However, the genetic component leading to NKTCL predisposition has not been identified.

29 Jul

Posted at 14:54h in Author Interviews, JAMA, Melanoma
MedicalResearch.com Interview with: [caption id="attachment_26588" align="alignleft" width="184"]Dr. Michael Pignone MD MPH Task Force member Professor of medicine and Inaugural Chair Department of Internal Medicine at the Dell Medical School The University of Texas at Austin. Editor’s note: Dr. Pignone discusses the recent US Preventive Services Task Force Recommendation Statement on the effectiveness of screening for skin cancer with a clinical visual skin examination Dr. Michael Pignone[/caption] Dr. Michael Pignone MD MPH Task Force member Professor of medicine and Inaugural Chair Department of Internal Medicine Dell Medical School The University of Texas at Austin. Editor’s note: Dr. Pignone discusses the recent US Preventive Services Task Force Recommendation Statement on the effectiveness of screening for skin cancer with a clinical visual skin examination MedicalResearch.com: What is the background for this recommendation? How Does the USPSTF Grade Preventive Services? Response: The Task Force’s primary concern is the health of Americans, and all of our recommendations are based on an assessment of the evidence of both the benefits and harms of a particular preventive service. For this recommendation statement, we looked at all available evidence on a visual skin exam, including studies of exams conducted by both primary care clinicians and dermatologists, to see how effective this exam was at preventing death from skin cancer. Unfortunately, there is not enough evidence to know with certainty whether or not a visual skin exam leads to a reduction in death from skin cancer, which resulted in the Task Force issuing an I statement. The Task Force encourages more research that could provide future evidence on the effectiveness of visual screening to prevent death from skin cancer.

29 Jul

Posted at 11:03h in Author Interviews, Breast Cancer, JAMA, Technology
MedicalResearch.com Interview with: [caption id="attachment_26499" align="alignleft" width="150"]Lauren P. Wallner, PhD, MPH Assistant Professor, Departments of Medicine and Epidemiology University of Michigan Ann Arbor, MI Dr. Lauren Wallner[/caption] Lauren P. Wallner, PhD, MPH Assistant Professor, Departments of Medicine and Epidemiology University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? What are the main findings? Response: Online communication tools like email and social media could be used to support patients through their cancer treatment decision making and ongoing care. Yet, we know very little about whether and how newly diagnosed cancer patients use these tools and whether using online communication influences patients appraisals of their treatment decision making process. We surveyed 2,460 women with newly diagnosed breast cancer as part of the iCanCare Study about their use of email, texting, social media and web-based support groups following their diagnosis. Our findings suggest that women who more often used these online communication tools deliberated more about their surgical treatment and were more satisfied with their treatment decision. However, the use of social media in this diverse population was lower than we expected (12%), and was less common in older women, those with less education, and Black and Latina women.

29 Jul

Posted at 00:05h in Author Interviews, Global Health, Lancet, Methamphetamine, OBGYNE, STD
MedicalResearch.com Interview with: [caption id="attachment_26580" align="alignleft" width="200"]N. Saman Wijesooriya Public Health Advisor/Technical Advisor Centers for Disease Control and Prevention N. Saman Wijesooriya[/caption] N. Saman Wijesooriya Public Health Advisor/Technical Advisor Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: The article Global burden of maternal and congenital syphilis in 2008 and 2012: a health systems modeling study by Wijesooriya, et al published in the August 2016 issue of The Lancet Global Health (Open source - http://dx.doi.org/10.1016/S2214-109X(16)30135-8) estimates the incidence and prevalence of maternal and congenital syphilis for both time periods and identifies gaps antenatal care access and syphilis testing and treatment services to assess progress in the global elimination of congenital syphilis, or mother-to-child transmission of syphilis, as a public health problem. Untreated maternal syphilis is understood to be transmitted from mother-to-child in utero in 50% of cases resulting in tragic adverse pregnancy outcomes, or congenital syphilis infections, including early fetal death, stillbirth, preterm birth, low birthweight, neonatal death, and congenital infections in infants. Since most maternal syphilis infections are asymptomatic, it is recommended that screening for syphilis use a combination of serological tests for pregnant women and treatment of syphilis seropositive women with at least 2.4 million units of benzathine penicillin intramuscularly early in pregnancy to prevent most congenital syphilis infections. In 2007, the World Health Organization responded to estimates indicating 2 million maternal and 1.5 congenital syphilis infections would occur annually without treatment and launched the global initiative for the Elimination of Congenital Syphilis (ECS). The strategy includes reducing the prevalence of syphilis in pregnant women and mother-to-child transmission of syphilis. The objective is for countries to achieve high performing antenatal care systems providing access to antenatal care to more than 95% of pregnant women, syphilis testing for more than 95% of pregnant women, and treatment for more than 95% of seropositive women to attain a congenital syphilis rate of 50 or fewer cases per 100,000 live births.

28 Jul

Posted at 21:53h in Author Interviews, Brigham & Women's - Harvard, Dermatology, Science, Technology
MedicalResearch.com Interview with: [caption id="attachment_26574" align="alignleft" width="138"]Mei X. Wu, Ph.D. Associate Professor Wellman Center for Photomedicine Massachusetts General Hospital Dermatology Department Harvard Medical School Dr. Mei Wu[/caption] Mei X. Wu, Ph.D. Associate Professor Wellman Center for Photomedicine Massachusetts General Hospital Dermatology Department Harvard Medical School MedicalResearch.com: What is the background for this study? Response: An abnormally low count of platelets, a disorder called thrombocytopenia, is life-threatening owing to a high risk of uncontrollable bleeding. The disorder can be caused by a variety of conditions like trauma, an autoimmune disorder that attacks platelets, side-effects of some drugs especially chemotherapeutic drugs, and in premature newborns and patients with HIV-infection or a genetic defect leading to insufficient platelet generation. Platelet transfusion is the most effective modality to treat the disorder, but it is associated with complications including allergic reaction, fever, infection, and immunosuppression and limited only to the most severe patients. Several FDA-approved drugs are currently used in the clinics or clinical trials to increase platelet levels, which however must be carefully dosed to avoid excessive platelet production that is also dangerous and are not suitable to many forms of thrombocytopenia.

28 Jul

Posted at 21:07h in Aging, Author Interviews, Gender Differences, Genetic Research, Menopause, UCLA
MedicalResearch.com Interview with: [caption id="attachment_26577" align="alignleft" width="136"]Morgan Elyse Levine, PhD Postdoctoral Fellow Department of Human Genetics University of California, Los Angeles Dr. Levine[/caption] Morgan Elyse Levine, PhD Postdoctoral Fellow Department of Human Genetics University of California, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: From an evolutionary perspective, aging and reproduction are two processes that are linked. For instance, in order to maximize fitness, an individual has to survive and remain healthy enough to: 1) reproduce and 2) insure offspring survive to reproductive age. Thus, the rate of aging is tied to a species’ timing of reproductive senescence and necessary length of parental involvement. There is also evidence that among humans, women with longer reproductive stages (later age at menopause, ability to conceive at older ages) are more likely to live to age 100, which we hypothesize is because they age slower. Using an epigenetic biomarker believed to capture biological aging (previously developed by the Principle Investigator of this study, Steve Horvath), we tested whether age at menopause, surgical menopause, and use of menopausal hormone therapies were associated with a woman’s aging rate. We found that the blood of women who experienced menopause at earlier ages (especially those who underwent surgical menopause) was “older” than expected, suggesting they were aging faster on a biological level than women who experienced menopause at later ages. We also found that buccal epithelium samples (cells that line the inside of the cheek) were epigenetically younger than expected (signifying slower aging) for post-menopausal women who had taken menopausal hormone therapy, compared to post-menopausal women who had never taken any form of menopausal hormone therapy. Finally, we had a number of results that suggested that the previously mentioned findings were a result of the process of menopause directly speeding up the aging process—rather than the alternative explanation, which would have been that women who aged faster experience menopause earlier.

28 Jul

Posted at 01:01h in Author Interviews, Cost of Health Care, Health Care Systems, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_26484" align="alignleft" width="160"]Richard Hoehn, MD Resident in General Surgery College of Medicine University of Cincinnati Dr. Richard Hoehn[/caption] Richard Hoehn, MD Resident in General Surgery College of Medicine University of Cincinnati MedicalResearch.com: What is the background for this study? What are the main findings? Response: A recent study from our research group (Hoehn et al, JAMA Surgery, 2015) found that safety-net hospitals perform complex surgery with higher costs compared to other hospitals, and that these higher costs are potentially due to intrinsic differences in hospital performance. In this analysis, we decided to simulate different policy initiatives that attempt to reduce costs at safety-net hospitals. Using a decision analytic model, we analyzed pancreaticoduodenectomy performed at academic hospitals in the US and tried to reduce costs at safety-net hospitals by either 1) reducing their mortality, 2) reducing their patients’ comorbidities and complications, or 3) sending their patients to non-safety-net hospitals for their surgery. While reducing mortality had a negligible impact on cost and reducing comorbidities/complications had a noticeable impact on cost, far and away the most successful way to reduce costs at safety-net hospitals, based on our model, was to send patients away from safety-net hospitals for their pancreaticoduodenectomy.

28 Jul

Posted at 00:29h in Accidents & Violence, Author Interviews, Cannabis, Pediatrics
MedicalResearch.com Interview with: Graeme Gordon CEO and Founder at SneakGuard - Home of Safe Responsible StorageGraeme Gordon CEO and Founder at SneakGuard - Home of Safe Responsible Storage MedicalResearch.com: What is the background for SneakGuard™? Response: SneakGuard™ creator and founder, Graeme Gordon recognized the urgent need to keep adventurous young snoopers from unintentionally ingesting cannabis. Founded in 2014, SneakGuard™ is a locking, vacuum and thermally insulated container that provides responsible storage of medications and cannabis, with the passion to protect, save and enhance everyday quality of life. Gordon explains “As a father of a 8 year old I understand how pressing it is for adults to protect children, teens, and even pets from unintended ingestion, so I created a unique storage unit to provide a solution.”

27 Jul

Posted at 23:34h in Author Interviews, Gastrointestinal Disease, Gluten, Immunotherapy
MedicalResearch.com Interview with: [caption id="attachment_26555" align="alignleft" width="173"]Armin Alaedini, PhD Assistant Professor Department of Medicine & Institute of Human Nutrition Columbia University Medical Center New York, NY 10032 Dr. Armin Alaedini[/caption] Armin Alaedini, PhD Assistant Professor Department of Medicine & Institute of Human Nutrition Columbia University Medical Center New York, NY 10032 MedicalResearch.com: What is the background for this study? Response: It has been a mystery why some people experience a range of symptoms in response to the ingestion of wheat and related cereals, even though they do not have celiac disease (an autoimmune disorder) or wheat allergy. Both gastrointestinal (GI) symptoms, most commonly abdominal pain, diarrhea, and bloating, as well as extra-intestinal symptoms, such as fatigue, anxiety, depressed mood, and cognitive difficulties are reported by patients. The identity of the component(s) of wheat responsible for triggering the symptoms remains uncertain and it is not clear if gluten or non-gluten molecules are involved. There is evidence to indicate that wheat sensitivity also affects a subset of patients with irritable bowel syndrome (IBS), a common disorder. Despite the interest from the medical community and the general public, the causes and mechanism of the associated symptoms have remained unknown and no biomarkers are available to aid in the diagnosis of patients.

27 Jul

Posted at 21:56h in Author Interviews, Pancreatic
MedicalResearch.com Interview with: Dr-Dewi-VernereyDewi Vernerey PhD Epidemiologist / Statistician Methodology and quality of Life in oncology unit University Hospital of Besançon MedicalResearch.com: What is the background for this study? Response: The management of locally advanced pancreatic cancer (LAPC) patients is still controversial. Better discrimination for the prediction of overall survival (OS) at diagnosis is needed. Currently, there is a lack of a staging system and an absence of a consensus regarding patient-specific risk profile for OS that can lead to confusion about the development of research strategy and to potentially inappropriate management of patients with locally advanced pancreatic cancer.

27 Jul

Posted at 21:32h in AHA Journals, Author Interviews, Cannabis, Pulmonary Disease, UCSF
MedicalResearch.com Interview with: [caption id="attachment_26428" align="alignleft" width="200"]Matthew L. Springer, Ph.D. Professor of Medicine Division of Cardiology University of California, San Francisco San Francisco, CA Dr. Matthew Springer[/caption] Matthew L. Springer, Ph.D. Professor of Medicine Division of Cardiology University of California, San Francisco San Francisco, CA MedicalResearch.com: What is the background for this study? Response: We've known for many years that secondhand smoke from tobacco cigarettes is harmful, and the vast majority of deaths thought to result from secondhand smoke are from cardiovascular disease. However, very little has been known about cardiovascular consequences of exposure to secondhand smoke from marijuana, and people tend to mistake the lack of evidence that it is harmful, for evidence that is it not harmful. As a result, many people seem relatively unconcerned about smoking marijuana and being exposed (or exposing others) to marijuana secondhand smoke. Politicians and policy makers also seem less willing to limit where people can smoke marijuana (under legal circumstances) than tobacco. What has been lacking is research into how exposure to marijuana smoke affects cardiovascular health. It has been difficult to do such experiments because marijuana is illegal in the eyes of the federal government. However, we have been studying the harmful effects of secondhand tobacco smoke on the function of rat blood vessels, which is similar to its harmful effects on human blood vessels, and we now have studied how the function of rat blood vessels is affected by exposure to secondhand marijuana smoke.

27 Jul

Posted at 21:21h in Author Interviews, Environmental Risks, Genetic Research, Nature
MedicalResearch.com Interview with: [caption id="attachment_26542" align="alignleft" width="120"]Dalton Conley PhD Department of Sociology Princeton University Princeton, NJ 08644 Dr. Dalton Conley[/caption] Dalton Conley PhD Department of Sociology Princeton University Princeton, NJ 08644 MedicalResearch.com: What is the background for this study? What are the main findings? Response: An increasing number of nationally representative social science surveys are now genotyping respondents. The Health and Retirement Study, which follows a representative group of Americans 50 and older since 1992, genotyped its subjects in 2006 and 2010. The range of birth cohorts allowed us to see if genetic effects increased or decreased across the middle half of the twentieth century for a number of outcomes. We found that for height and weight, genetics increased in importance, but for heart disease and education, genes became less important.

27 Jul

Posted at 20:16h in Author Interviews, Columbia, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_26379" align="alignleft" width="132"]Ajay J. Kirtane, MD, SM, FACC, FSCAI Associate Professor of Medicine at Columbia University Medical Center Chief Academic Officer, Center for Interventional Vascular Therapy Director, NYP/Columbia Cardiac Catheterization Laboratories New York, NY 10032 Dr. Ajay Kirtane[/caption] Ajay J. Kirtane, MD, SM, FACC, FSCAI Associate Professor of Medicine at Columbia University Medical Center Chief Academic Officer, Center for Interventional Vascular Therapy Director, NYP/Columbia Cardiac Catheterization Laboratories New York, NY  10032 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with inpatient heart failure are a higher-risk patient population who can benefit from the identification and treatment of coronary artery disease. We sought to identify how frequently these patients in fact underwent testing for coronary artery disease.

27 Jul

Posted at 20:11h in Author Interviews, Heart Disease, Race/Ethnic Diversity, Stroke
MedicalResearch.com Interview with: [caption id="attachment_26293" align="alignleft" width="151"]Dr. Mary Vaughan Sarrazin PhD Associate Professor Department of Internal Medicine University of Iowa Roy and Lucille Carver College of Medicine, and Iowa City VA Medical Center, Center for Comprehensive Access & Delivery Research and Evaluation (CADRE) Iowa City Dr. Mary Vaughan Sarrazin[/caption] Dr. Mary Vaughan Sarrazin PhD Associate Professor Department of Internal Medicine University of Iowa Roy and Lucille Carver College of Medicine, and Iowa City VA Medical Center, Center for Comprehensive Access & Delivery Research and Evaluation (CADRE) Iowa City MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation is associated with a higher risk of stroke. The CHA2DS2VASc score (congestive heart failure, hypertension, age 75 or older, diabetes, previous stroke, vascular disease, age 65-74, female sex) reflects stroke risk and is used to guide decisions regarding anticoagulation. Our prior work suggests that African Americans have a higher risk of stroke compared to other patients with atrial fibrillation, even after risk factor adjustments. In the current study, we used Medicare data to test whether addition of black race to CHA2DS2VASc score improves stroke prediction in patients with atrial fibrillation.

27 Jul

Posted at 20:07h in Author Interviews, Outcomes & Safety, Prostate Cancer, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_26533" align="alignleft" width="139"]Prof Robert A Gardiner AM The University of Queensland Centre for Clinical Research Royal Brisbane & Women’s Hospital, Herston Brisbane,Australia Prof. Robert Gardiner[/caption] Prof Robert A Gardiner AM The University of Queensland Centre for Clinical Research Royal Brisbane & Women’s Hospital, Herston Brisbane,Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to determine whether one approach gave better results than the other at 12 weeks and 24 months after surgery with respect to the quality of life outcomes of urinary, sexual and bowel function and return to usual activities as well as oncological outcomes. There was no significant statistical difference between the robotic and open surgical approach for these parameters at the early time-point of 12 weeks follow-up.

27 Jul

Posted at 19:51h in AHA Journals, Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_26317" align="alignleft" width="133"]Andrea K. Chomistek, MPH, ScD Assistant Professor Department of Epidemiology and Biostatistics School of Public Health Indiana University-Bloomington Dr. Andrea K. Chomistek[/caption] Andrea K. Chomistek, MPH, ScD Assistant Professor Department of Epidemiology and Biostatistics School of Public Health Indiana University-Bloomington MedicalResearch.com: What is the background for this study?  Response: Previous studies of exercise and  coronary heart disease have been primarily conducted in middle-aged and older adults, so we thought it was important to examine this association in younger women as mortality rates in young women have not declined in recent years like they have in other age groups.

27 Jul

Posted at 18:43h in Author Interviews, Infections, PNAS
MedicalResearch.com Interview with: [caption id="attachment_26526" align="alignleft" width="119"]Adam Hayward PhD Impact Research Fellow University of Stirling Dr. Adam Hayward[/caption] Adam Hayward PhD Impact Research Fellow University of Stirling MedicalResearch.com: What is the background for this study? Response: Adult life expectancies in industrialized countries have increased dramatically in the last 150 years, even once we’ve accounted for the fact that previously common deaths in childhood and now very rare. One hypothesis seeking to explain this increase is that childhood infections cause chronic inflammation, which are then linked with heart disease and stroke in later life, reducing lifespan. Since such childhood infections were previously common but are now, thanks to vaccine and sanitation, much rarer, chronic inflammation should be lower and people should live longer and be less likely to die from early-onset heart disease. If this hypothesis is correct, we should see that higher exposure to infections in early life leads to increased adult mortality and deaths from heart disease and stroke.

27 Jul

Posted at 18:15h in Author Interviews, Gastrointestinal Disease, Lancet, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_26515" align="alignleft" width="200"]Mr Steven Brown MBChB, BMedSci, FRCS, MD Reader in Surgery Honorary Secretary to the ACPGBI Consultant colorectal surgeon University of Sheffield, UK Mr. Steven Brown[/caption] Mr Steven Brown MBChB, BMedSci, FRCS, MD Reader in Surgery Honorary Secretary to the ACPGBI Consultant colorectal surgeon University of Sheffield, UK MedicalResearch.com: What is the background for this study? Response: Haemorrhoids are common. One in 4 of us will at some time have symptoms that can be directly attributed to piles. Whilst most symptoms will settle spontaneously or with improvement to our lifestyle, there remains a large group of patients who require intervention to reduce symptomatology. Numerous interventions exist ranging from relatively minor office therapy to procedures that may take several weeks to recover from. Haemorrhoidal artery ligation (HAL) is one of the more recent surgical operations for haemorrhoidal therapy. It has been introduced certainly into the UK associated with a significant element of media hype purporting ‘painless surgery for piles’. Substantial subsequent medical literature has also suggested an efficacy rivaling other more invasive procedures. Too good to be true? Perhaps. Several systematic reviews have highlighted the lack of good quality data as evidence for the advantages of the technique. A well designed randomized controlled trial was required. The existing literature on  haemorrhoidal artery ligation at the time of the trial suggested the procedure was most effective for less symptomatic haemorrhoids (those that are associated with bleeding and/or minor prolapse; grade II or mild III piles). These type of haemorrhoids also tend to be the most common requiring intervention. The most frequently used alternative procedure for these grade of haemorrhoids in the UK is rubber band ligation (RBL), a simple office therapy not requiring anaesthetic. Hence participants with this grade of haemorrhoids were chosen as the participants with RBL as the comparator. Multiple outcomes were investigated but a patient reported outcome measure of recurrence was chosen as the primary outcome.

27 Jul

Posted at 00:58h in Author Interviews, Cancer Research, Chemotherapy, Nature, Technology
MedicalResearch.com Interview with: [caption id="attachment_26504" align="alignleft" width="157"]Natalie Artzi PhD Assistant Professor at Brigham and Women’s Hospital, Harvard Medical School Associate member of the Broad Institute of Harvard and MIT. Dr. Natalie Artzi[/caption] Natalie Artzi PhD Assistant Professor at Brigham and Women’s Hospital, Harvard Medical School Associate member of the Broad Institute of Harvard and MIT. MedicalResearch.com: What is the background for this study? Response: We have shown in the last years that dendrimer:dextran adhesive hydrogels represent a platform with ahuge potential for delivery. In 2015, we were able to report that these gels doped with smart nanoparticles could sense and differentially react with the disease microenvironment (e.g. can sense the tissue microenvironment by detecting the expression of specific genes related with multidrug resistance, Conde et al. PNAS 2015), potentiating targeted drug release and uptake in certain disease settings. Later, these hydrogels prove to be incredibly useful for miRNA delivery by using the self-assembly of a triple-helix forming miRNA structure that lead to nearly 90% levels of tumor shrinkage two weeks post-gel implantation (Conde et al. Nature Materials 2016a). Here, we took a step-forward, and used these hydrogels to develop a prophylactic patch for gene, chemo and phototherapy in a triple-combination approach to achieve complete tumor resection when applied to non-resected tumors and to the absence of tumor recurrence when applied following tumor resection (Conde et al. Nature Materials 2016b). This study also identifies the molecular and genetic pathways triggered in response to the three therapeutic modalities − photo-, gene- and chemo-therapy − by tumor gene expression profiling in treated mice.

26 Jul

Posted at 23:43h in Author Interviews, Genetic Research, Imperial College, Nutrition
MedicalResearch.com Interview with: [caption id="attachment_26495" align="alignleft" width="149"]Prof. Majid Ezzati, PhD Faculty of Medicine, School of Public Health Chair in Global Environmental Health Imperial College, London Adjunct Professor of Global Health and Department of Global Health and Population Harvard T.H. Chan School of Public Health Prof. Majid Ezzati[/caption] Prof. Majid Ezzati, PhD Faculty of Medicine, School of Public Health Chair in Global Environmental Health Imperial College, London Adjunct Professor of Global Health and Department of Global Health and Population Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Human height is strongly influenced by the environment that we grow up in, from pregnancy through to late adolescence. If we have good nutrition, few illnesses and good healthcare, we are more likely to grow taller. In turn, height has a strong effect on our health in adulthood. Taller people on average live longer, have lower risk of heart disease (although they do have slightly elevated risks of some cancers). We have collated the largest-ever database of height. We analysed 1472 studies with measured height on 18.6 million individuals. We made estimates of height for 18-year-old men and women from 1914 and 2014. Height has increased in every country in the world, but this has been very uneven. The tallest men in the world are now the Dutch, and the tallest women are the Latvians. The countries that have seen the most growth are South Korea for women and Iran for men. We have seen large increases in height in East Asia, and stagnation in much of the West over the last few decades. In parts of Africa height has actually decreased by 5-10 cm over this period.

26 Jul

Posted at 22:39h in Asthma, Author Interviews
MedicalResearch.com Interview with: [caption id="attachment_26488" align="alignleft" width="167"]Hans Michael Haitchi, MD, MMed (INT), PhD, PD, FHEA, PGcert Associate Professor in Respiratory Medicine Clinical and Experimental Sciences Faculty of Medicine, University of Southampton United Kingdom Dr. Hans Michael Haitchi[/caption] Hans Michael Haitchi, MD, MMed (INT) PhD, PD, FHEA, PGcert Associate Professor in Respiratory Medicine Clinical and Experimental Sciences Faculty of Medicine, University of Southampton United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is estimated that 300 million people worldwide suffer from asthma with 1 in 10/11 (USA/UK) children and 1 in 12 (USA & UK) adults suffering from the disorder. In children asthma is the most common long-term medical condition. ADAM33 is an asthma gene. Small changes in the gene have been associated with increased twitchiness of the airways (bronchial hyperresponsiveness), loss of lung function in children and decline in lung function in the general population. ADAM33 makes an enzyme, which is attached to cells in the airway muscles. When the enzyme loses its anchor to the cell surface, it is prone to going rogue around the lung causing poorer lung function in people who have asthma. Our research, published in The Journal of Clinical Investigation (JCI) Insight, analysed human tissue samples and mice. Our experiments suggest that the human rogue ADAM33 protein is increased and enzymatically active in asthma. Furthermore, ADAM33 protein initiates airway remodelling (more muscle and blood vessels around the airways) without causing any inflammation in early life. However, when we switch off ADAM33 or prevent it from going rouge, the features of asthma - airway remodelling (more muscle and blood vessels around the airways), twitchiness and inflammation - will be reversed or reduced. These findings identify ADAM33 as a novel target for disease modifying therapy in asthma.

26 Jul

Posted at 20:48h in Accidents & Violence, Author Interviews, Race/Ethnic Diversity
MedicalResearch.com Interview with: [caption id="attachment_26444" align="alignleft" width="110"]Ted Miller, PhD Senior Research Scientist II Pacific Institute for Research and Evaluation Calverton, Maryland Dr. Ted Miller[/caption] Ted Miller, PhD Senior Research Scientist II Pacific Institute for Research and Evaluation Calverton, Maryland MedicalResearch.com: What are the main findings? Response: Police use of undue force is an enduring tinderbox issue in America. We tried to solve it by passing the 14th Amendment after the civil war, thru the civil rights movement, the riots of the 1960s, the Rodney King riot. The discussion has focused on racial disparities in per capita rates of deaths, stops, and arrests. This article digs deeper. Its aims are to use health data sets to examine nonfatal injuries inflicted during police action and apply better denominators. Looking at nonfatal injuries is especially important as shootings with firearms or tasers account for virtually all deaths but few other injuries in police encounters. This study measures exposure as the sum of arrests plus traffic stops with search plus stops on the street. Those data come from FBI arrest reports, state arrest reports, and the 2011 Police-Public Contact Survey. Blacks have long had the highest per capita rates of stops and arrests. We believe this study is the first to assess the probability of being arrested when stopped. Those probabilities also are skewed, with police arresting 85% of Blacks and 82% of Hispanics who are stopped, well above the 71% of Whites and Native Americans and 61% of Asian-Americans. Arrest probabilities do not differ by sex or age group. The study used a newspaper census of deaths and took injury counts from the 2012 Health Care Cost and Utilization Program nationwide samples, counting people whose injuries resulted from “legal intervention.” In 2012, US police killed or injured an estimated 55, 400 people during stops and arrests. The daily toll was 3 deaths and 150 hospital-treated injuries. In 1 in 11 US homicides and legal intervention deaths, a police officer pulled the trigger. Surprisingly, the probability that a serious injury was fatal did not vary by race. Nor did the ratio of serious and fatal injuries to stops and arrests. Teenagers and to a lesser extent young adults were less likely than people age 30 and over to die or suffer a hospital-treated injury when stopped or arrested.

26 Jul

Posted at 20:42h in Author Interviews, Diabetes, PLoS, Primary Care, Telemedicine
MedicalResearch.com Interview with: Brian McKinstry MD Professor of primary care e-health and General practitioner MacKenzie Medical Centre EdinburghBrian McKinstry MD Professor of primary care e-health and General practitioner MacKenzie Medical Centre Edinburgh MedicalResearch.com: What is the background for this study?  Response: The prevalence of diabetes is rising as the population ages and becomes more obese. Clinical services are increasingly stretched, so much so that it will be difficult for doctors and nurses to continue to look after patients using the same service delivery they have used in the past. Increasingly patients are being asked to self-manage long-term illnesses, but particularly with type 2 diabetes they find this stressful. One solution is to encourage self-management but with monitoring at a distance through telehealth. We performed a randomised controlled trial in family practices in four regions of the United Kingdom among 321 people with type 2 diabetes and glycated haemoglobin (HbA1c) ( a measure of control over the previous three months) >58 mmol/mol. The supported telemonitoring intervention involved self-measurement and transmission to a secure website of twice weekly morning and evening glucose for review by family practice clinicians. The control group received usual care, with at least annual review and more frequent reviews for people with poor glycaemic or blood pressure control in the context of incentives in family practice based on a sliding scale of financial rewards for achieving glycaemic and blood pressure control targets. HbA1c assessed at nine months was the primary outcome. Intention-to-treat analyses were performed.

26 Jul

Posted at 20:36h in Author Interviews, JAMA, Schizophrenia
MedicalResearch.com Interview with: [caption id="attachment_26441" align="alignleft" width="133"]Prof. Jayashri Kulkarni Prof. Jayashri Kulkarni[/caption] Professor Jayashri Kulkarni MBBS, MPM, FRANZCP, PhD Director, Monash Alfred Psychiatry research centre Vic Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Schizophrenia is a complex psychiatric disorder and many patients are not able to achieve remission on the available treatments. There are clear sex differences in many aspects of the illness, which not only implicates a role for the sex hormone estrogen in schizophrenia, but also highlights the need for sex-specific treatments. Our group has conducted many clinical trials using adjunctive estradiol treatment, with excellent improvement in psychotic symptoms- however, there can be physical side effects with longer term estradiol use. Raloxifene and other selective estrogen receptor modulators ( SERMs) - the so-called "brain estrogens", with their more specific brain impacts and less body side effects - provide an option to use longer term estrogen in people with refractory schizophrenia. We conducted the first ever pilot study of raloxifene in 2010, and now present findings from a bigger study of adjunctive raloxifene treatment in schizophrenia.

26 Jul

Posted at 20:33h in Author Interviews, Genetic Research, JAMA, Pediatrics, Surgical Research
MedicalResearch.com Interview with: Dr. Katherine Nelson MD Staff Paediatrician with the Paediatric Advanced Care Team at SickKids and PhD student University of Toronto MedicalResearch.com: What is the background for this study? Response: Trisomy 13 and 18 are rare genetic conditions that cause problems in multiple organ systems, including heart defects and severe neurologic impairment.  A majority of children with trisomy 13 and 18 die in the first days to weeks after birth, though a small number survive beyond one year.  For years, health care providers have debated the effectiveness and ethics of surgical interventions in these populations.

25 Jul

Posted at 22:04h in Author Interviews, Cannabis, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_26469" align="alignleft" width="144"]George Sam Wang MD FAAP Assistant Professor of Pediatrics Section of Emergency Medicine, Medical Toxicology Department of Pediatrics University of Colorado Anschutz Medical Campus Children's Hospital Colorado Dr. Wang[/caption] George Sam Wang MD FAAP Assistant Professor of Pediatrics Section of Emergency Medicine, Medical Toxicology Department of Pediatrics University of Colorado Anschutz Medical Campus Children's Hospital Colorado MedicalResearch.com: What is the background for this study? Response: Many states have allowed medical and now recreational marijuana. The impact on pediatric population has not been fully described. MedicalResearch.com: What are the main findings? Response: Unintentional exposures presenting to our children's hospital and calls to our regional poison center significantly increased after our state allowed recreational marijuana. MedicalResearch.com: What should readers take away from your report? Response: Exposures in children are increasing in our state that allows medical and recreational Marijuana, many were edible products. Marijuana products should be treated like medications and household products in home and properly and safely stored. States looking to legalize marijuana need to consider safety rules and regulations during rule making processes.