Asthma, Author Interviews, JAMA / 28.04.2016

MedicalResearch.com Interview with: Prof Dr. med. J. Christian Virchow, FRCP, FCCP, FAAAA University of Rostock, Germany What is the background for this study? What are the main findings? Dr. Virchow: House Dust mite related allergic asthma is a very frequent chronic disease. Allergen Immunotherapy (AIT) for this condition in asthma has not been well studied and subcutaneous treatment has been associated with (systemic, potentially serious) side effects. Aim of the study was to investigate, if sublingual AIT can improve a patient relevant endpoint, namely reduce the frequency of exacerbations (primary endpoint: time to first exacerbation compared to placebo) . (more…)
AHA Journals, Author Interviews, Heart Disease, Tobacco Research / 28.04.2016

MedicalResearch.com Interview with: Tanush Gupta, MD Chief Resident & Instructor of Medicine Department of Medicine New York Medical College & Westchester Medical Center Valhalla, NY  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Gupta: Cigarette smoking is the leading preventable cause of premature death in the United States (U.S.). Approximately one-third of all coronary artery disease related deaths in the U.S. annually can be attributed to cigarette smoking. However, studies from the pre-thrombolytic and thrombolytic eras have shown that mortality in smokers with ST-segment elevation myocardial infarction (STEMI) may be lower than in nonsmokers, a phenomenon called the “smoker’s paradox.” The majority of STEMI patients in contemporary practice are treated with primary percutaneous coronary intervention (pPCI). Data on the association of smoking with outcomes in STEMI patients undergoing pPCI are limited and also conflicting as to whether the smoker’s paradox exists in this population. Hence, the purpose of our study was to examine the association of smoking status with in-hospital outcomes in a nationwide cohort of STEMI patients undergoing pPCI, included in the U.S. National Inpatient Sample, over a 10-year time period from 2003 to 2012. Our primary outcome of interest was in-hospital mortality and secondary outcomes were post-procedure hemorrhage, in-hospital cardiac arrest, and average length of stay. Of 985,174 STEMI patients who underwent pPCI in the U.S. over this time period, 438,954 (44.6%) were smokers. Smokers were on an average 8 years younger than nonsmokers and had lower prevalence of most cardiovascular comorbidities. Smoking status was associated with lower risk-adjusted in-hospital mortality (2.0% vs. 5.9%, adjusted OR 0.60, p<0.001), lower incidence of post-procedure hemorrhage (4.2% vs. 6.1%, adjusted OR 0.81, p<0.001) and in-hospital cardiac arrest (1.3% vs. 2.1%, adjusted OR 0.78, p<0.001), and shorter average length of stay (3.5 days vs. 4.5 days, p<0.001). To assess whether younger age of smokers was influencing the association with in-hospital mortality, we also performed an age-stratified analyses in different age groups. The smoker’s paradox largely persisted in age-stratified analyses suggesting that younger age of smokers was not the sole explanation for this paradox. We performed additional assessment for confounding to explore whether the paradoxically lower risk-adjusted in-hospital mortality in smokers with STEMI was driven by differences in baseline demographics and comorbidities between hospitalized smokers and nonsmokers in general. To test for such confounding, we examined the association of smoking with in-hospital mortality in 2 conditions in which this association has not been previously studied – hip fractures and severe sepsis – using similar statistical regression models. In both these study populations, smokers were on average younger than nonsmokers and had lower risk-adjusted in-hospital mortality, but, the paradoxical association in both these conditions was weaker in magnitude than in STEMI patients. Since there is no cogent biological hypothesis to explain the lower mortality in smokers with sepsis or hip fractures, it is likely that the smoker’s paradox in STEMI is also at least partly driven by residual confounding due to inadequate adjustment for the biological effects of age. However, as this paradox was stronger in STEMI patients than in patients with hip fractures or severe sepsis, we believe that additional true biological differences between smokers and nonsmokers with STEMI also contribute to the paradoxically lower in-hospital mortality. (more…)
Author Interviews, Flu - Influenza, Vaccine Studies / 27.04.2016

MedicalResearch.com Interview with: Dr Anna C. Phillips PhD CPsychol AFBPsS Reader in Behavioural Medicine School of Sport, Exercise & Rehabilitation Sciences University of Birmingham Edgbaston Birmingham MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Phillips: We know that various factors can affect the response to vaccination and that older adults have a poorer response than younger people, i.e. they produce fewer antibodies.  We also know that many immune messengers and important hormones have daily rhythms in their levels and wanted to test whether the antibody response to vaccination might also be affected by time of day.  We randomised surgeries to giving morning or afternoon vaccinations and tested before and one month after the vaccination for levels of antibodies. Two of the three flu strains (viruses) contained in the vaccine showed a higher antibody response in the morning than in the afternoon, up to 4 x higher to one of the strains (A/California) and 1.5 x higher to the B strain. None of the potential mechanisms we measured (immune messengers, hormones) seemed to be driving this effect. (more…)
Alzheimer's - Dementia, Author Interviews, Biomarkers / 27.04.2016

MedicalResearch.com Interview with: Dr Anne Poljak Leader of the Proteomics Group Centre for Healthy Brain Ageing (CHeBA) UNSW, Australia  MedicalResearch.com: What is the background for this study?  Dr Poljak: Amyloid-beta (Aβ) peptides are found in abundance in the plaque particles which build up in the Alzheimer’s brain and small blood vessels of the brain, and are therefore considered hallmark features of Alzheimer’s disease. However they are also found in blood which is a convenient body fluid for sampling purposes. We therefore wished to assay them in plasma samples from one of our longitudinal population based studies of older age individuals (70 – 90 years) – the Centre for Healthy Brain Ageing’s Sydney Memory and Ageing Study. Other research groups had previously measured these peptides in plasma, but there was controversy in the area because of differences in outcomes across laboratories. So one of the main questions was whether plasma levels of Aβ peptides have any relationship with what is happening in the brain, or are they a red-herring? We wanted to see how the levels we found would compare with the findings of others in relation to Alzheimer’s disease and mild cognitive impairment. A further question was how our plasma levels would relate to other clinical measures including cognition and brain volumetrics. One of the precautions we took was to use an assay kit with very well characterized antibodies, so we could be confident that our method was specific for the two full length Aβ peptides (Ab1-40 and Ab1-42). (more…)
Author Interviews, Breast Cancer, Compliance, Genetic Research, Mammograms / 27.04.2016

MedicalResearch.com Interview with: Stamatia Destounis, MD, FSBI, FACR Elizabeth Wende Breast Care, LLC, Clinical Professor of Imaging Sciences University of Rochester School of Medicine and Dentistry  Rochester NY 14620  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Destounis: Identification of women who have an increased risk of breast cancer is important, as they are often eligible for additional screening methods, such as breast MRI. One criterion for eligibility for screening breast MRI is >20% lifetime risk of breast cancer, as determined by risk assessment models through genetic counseling. At my facility, we have incorporated a genetics program. Through the program we are flagging and identifying a large volume of patients who are potentially eligible for additional services. This study was conducted to determine the value of screening MRI in the patient subgroup who have undergone genetic counseling at my facility. In this group we found 50% of patients who were referred for counseling were also recommended to have screening MRI. However, only 21.3% of those recommended actually pursued the exam. Of those patients who did have a screening MRI, 4 were diagnosed with breast cancer, all of which were invasive and node negative. We ultimately had a 10% biopsy rate and 50% cancer detection rate in this subgroup. (more…)
Author Interviews, Breast Cancer, JAMA, Mammograms / 27.04.2016

MedicalResearch.com Interview with: Elizabeth A. Rafferty, MD Department of Radiology, Massachusetts General Hospital, Boston Now with L&M Radiology, West Acton, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Rafferty: Breast tomosynthesis has been approved for mammographic screening in the United States for just over 5 years, and many single center studies have demonstrated its improved performance for screening outcomes over digital mammography alone. Our previously published multi-center analysis, (JAMA 2014;311(24), the largest study on this topic to date, demonstrated significantly improved cancer detection and reduced recall rates for women undergoing tomosynthesis compared with digital mammography alone.  In the current issue of JAMA we evaluate the differential screening performance after implementation of breast tomosynthesis as a function of breast density. While tomosynthesis continues to be increasingly available, questions remained about which women should be imaged with this technique. In particular, does this technology offer additional benefit for all women, or only for women with dense breasts. The size of the database compiled by the centers participating in this study allowed us to evaluate this important question. The most critical finding of our study was that the use of tomosynthesis for breast cancer screening significantly improved invasive cancer detection rates while simultaneously significantly reducing recall rates both for women with dense and non-dense breast tissue. Having said that, the magnitude of the benefit was largest for women with heterogeneously dense breast tissue; for this population, tomosynthesis increased the detection of invasive cancers by 50% while simultaneously reducing the recall rate by 14%. (more…)
Accidents & Violence, Author Interviews, Global Health, Pediatrics / 27.04.2016

MedicalResearch.com Interview with: Prof Naeemah Abrahams South African Medical Research Council Chief  Specialist Scientist:  Gender & Health Research Unit Cape Town | Western Cape MedicalResearch.com: What is the background for this study? What are the main findings? Prof Abrahams: Violence is a common feature of the South African social landscape and the murder of children is the most severe form of violence against children.  A national child homicide study reflecting 2009 murdered was done. Information was collected from mortuaries and police detectives. We identified the demographic detail of the child, the perpetrator information (if available) and the motive of the killings. In this manuscript we look in greater detail at children under the age of 5 years as this group represent the 2nd largest group of children killed. We also have a focus on neonaticides. We estimated that 454 children under the age of 5 years were killed in South Africa in 2009. This means more than 1 young child killed per day. The study showed the first 6 days of life are the time point of highest risk for being killed among children under 5 years with more than half (53.2%) of the children killed within the 1st month of their lives and nearly two thirds of the children (74.4%)  killed as infants.  This is amongst the highest reported rates for neonaticide and infanticide. Parents, in particular mothers, were the most common perpetrator of the younger children – this is most likely due to them being responsible for the care of young children. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lifestyle & Health / 27.04.2016

MedicalResearch.com Interview with: Dr. Céline Vetter,  Dr.Phil. Instructor in Medicine Harvard Medical School Associate Epidemiologist Channing Division of Network Medicine Brigham and Women's Hospital Boston, MA, 02115 MedicalResearch.com: What is the background for this study? Response: Heart Disease is still the leading cause of death in the US, with 1 in every 4 deaths being attributed to heart disease. On the other hand, it is estimated that approximately 15 millions Americans work evening shifts, night shift, rotating shifts or any other kind of irregular schedule that is arranged by the employer. The link between shift work and coronary heart disease has been studied for decades now, but because shift work can take so many forms, results have not been consistent. Another contributing factor to this inconsistency might be that few studies could actually track individuals over long periods of time, so that some studies might have missed when participants did actually develop coronary heart disease. Our study was based on the Nurses' Health Studies I and II, where women about 189,000 registered female nurses completed every two years mailed questionnaires that comprise items about their health status, medical history, and known or suspected risk factors for cancer and heart disease. They also reported their lifetime history of rotating night shift work in 1988 and 1989, respectively. Across the 24 years of the study periods, we observed more than 10,000 cases of coronary heart disease (i.e. myocardial infarction, CHD death, angiogram-confirmed angina pectoris, and procedures related to coronary heart disease, i.e. angioplasty, coronary artery bypass graft surgery or stents). (more…)
Author Interviews, Cancer Research / 27.04.2016

MedicalResearch.com Interview with: E. Premkumar Reddy, Ph.D. Professor, Department of Oncological Sciences and Department of Structural and Chemical Biology Director, Experimental Cancer Therapeutics Mount Sinai School of Medicine New York, NY 10029  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Reddy: It is now well established that  cancer cells harbor mutations in their genome which are responsible for uncontrolled proliferation.  Nearly 30 years ago, we as well as two other groups discovered that RAS genes are often mutated in human cancers.  Later studies showed that nearly 25-30% of human cancers contain this mutation and these mutations can be caused by chemical carcinogens such as tobacco smoke.  Since then there has been an intense effort to understand the biological functions of RAS and to develop drugs that block the activity of these mutant RAS genes.  Although molecular oncologists have made significant headway in understanding these mutations and their impact on cellular signaling, little progress has been made towards developing drugs that systematically target the RAS oncogenes.  This lack of progress has led many in the field to label RAS as “undruggable”.  However, basic research conducted by scientists in this field has revealed that RAS proteins function as ON-OFF switches to signal cells to grow or not to grow because of their ability to bind to a large number of cellular proteins and transmit this signal to their binding partners.  These findings also revealed that mutations in RAS genes leaves them in a permanent “ON” position which continues to transmit growth signals permanently.  Since most efforts to develop drugs that bind to RAS proteins and reverse their activity failed, we took a different approach to block these signals.  Since transmission of growth signals by RAS genes requires their interaction with cellular proteins, all of which contain a domain called “RAS-Binding Domain (RBD)” we created a drug named “Rigosertib” that binds to these RBDs and block their binding to RAS, thereby interrupting RAS signals.  When Rigosertib was tested in animals, it could readily inhibit the growth of human tumors that contain RAS mutations.  Our studies also show that Rigosertib is a very safe drug with minimal side-effects. (more…)
Author Interviews, Sleep Disorders, Stanford / 27.04.2016

MedicalResearch.com Interview with: Maurice M. Ohayon, MD, DSc, PhD Chief of the Division of Public Mental Health and Population Sciences Director of the Stanford Sleep Epidemiology Research Centre (SSERC) John-Arrillaga PI & Professor of Psychiatry and Behavioral Sciences School of Medicine, Stanford University Palo Alto, CA 94303  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ohayon: Artificial Lights at night are known to be powerful disruptors of the normal sleep/wake cycle. Light exposure at night acts on suppressing and delaying melatonin secretion and exciting the central nervous system. In this study we focused on the effects of the outdoor lights at night, (such as street lights and lights, outdoor light fixtures and advertising boards) as measured at nighttime by satellite observations. We analyzed the sleep habits of a representative sample of the American general population that had been interviewed with the artificial intelligence system Sleep-EVAL. We found that individuals living in areas at high level of radiance, such as can be found in the downtowns of metropolitan areas, have a delayed bedtime, delayed wake up time and, overall, shorter sleep duration, than people living in areas with low nighttime radiance. (more…)
AACR, Author Interviews, Biomarkers, Cancer Research, Colon Cancer, Technology / 27.04.2016

MedicalResearch.com Interview with: Dr. Elodie Sollier PhD Chief Scientific Officer at Vortex Biosciences MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vortex Biosciences has developed a fast and simple way to isolate and collect intact circulating tumor cells (CTCs) directly from whole blood in less than an hour using a process based on microfluidics. To better understand the utility of the technology for the clinical setting, PCR-based Sanger sequencing was used to profile the mutations of CTCs isolated from blood from metastatic Colorectal cancer patients. The mutations were compared to primary tumor biopsies, secondary tumor biopsies and ctDNA. There are 3 primary take-aways:
  1. The Vortex technology captures CTCs with enough purity to perform sensitive and accurate PCR-based Sanger sequencing.
  2. Mutations present in primary and secondary tumors can be identified in both CTCs and ctDNA making liquid biopsies a valuable alternative to tissue biopsies.
  3. While there is general consistency of mutations identified, some mutations are only identified in CTCs while others only in ctDNA demonstrating how these are indeed complimentary.
(more…)
Author Interviews, Genetic Research, PLoS, Vitamin D / 27.04.2016

MedicalResearch.com Interview with: Haidong Zhu, MD, PhD Associate Professor of Pediatrics Georgia Prevention Institute Medical College of Georgia Augusta University MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Zhu: Vitamin D plays an important role in a wide range of body functions beyond bone health. Vitamin D deficiency is associated with increased risk of cancer and cardiovascular disease. Vitamin D deficiency is common among darker skin individuals, particularly African-Americans, which could contribute to health disparity. We want to understand underlying molecular mechanism (i.e. global DNA methylation) for how vitamin D deficiency causes cancer, cardiovascular disease and impaired immune function. DNA methylation, a chemical modification to our genome, is one of the ways that our body adapts to the environment. Low rate of global DNA methylation is a common event in cancer, which may lead to disturbances in the genome, make the genome more vulnerable to environmental damage and increase disease risk. Our study shows that majority of black teens are vitamin D deficient and have a lower rate of global DNA methylation than white teens. We further demonstrate that vitamin D3 supplementation for 16 weeks increases global DNA methylation in black teens and young adults. Our study provides an important piece of evidence that vitamin D plays a role in epigenetic regulation in humans, which could be an underlying mechanism for vitamin D-deficiency related disease risk and health disparity. (more…)
Author Interviews, MRI, Prostate Cancer / 26.04.2016

MedicalResearch.com Interview with: Dr. Nelly Tan MD David Geffen School of Medicine Department of Radiology UCLA MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Tan: Standard of care for prostate cancer diagnosis has been to perform ultrasound guided random (non-targeted) prostate biopsy (TRUS) which is neither sensitive or specific. The main limitation had been our inability to detect and localize prostate cancer through imaging. Over the past 10 years, MRI has taken center stage for detection and localization of prostate cancer and has shown to improve prostate cancer diagnosis, risk stratification, and staging of the disease. Over the past few years, MRI guided biopsy techniques (in the form of Ultrasound-MRI (US-MRI) fusion and in-bore direct MRI guided biopsy) have been reported. We reported our performance of direct in-bore MRI guided biopsy at UCLA. Our study showed a prostate cancer diagnosis of 59% in all patients and 80% of patients with prostate cancer had clinically significant cancer. (more…)
Author Interviews, JAMA, Outcomes & Safety / 26.04.2016

MedicalResearch.com Interview with: Maricruz Rivera-Hernandez, PhD Investigator Department of Health Services, Policy & Practice Center for Gerontology and Health Care Research Brown University, Providence, RI  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Rivera-Hernandez: Over three-quarters of Medicare-eligible residents in Puerto Rico enroll in Medicare Advantage plans, making them the primary source of health care coverage for the island’s seniors. Puerto Rican Medicare Advantage plans have a long history of receiving lower payments than Medicare Advantage plans located in the United States. The study’s purpose was to compare the quality of care provided to Medicare Advantage enrollees in Puerto Rico with that delivered to Medicare Advantage enrollees in the 50 states and the District of Columbia. We found significantly worse quality for Puerto Rican Medicare Advantage enrollees compared to their US counterparts for 15 of the 17 quality indicators. These indicators measured whether patients received the recommended treatment and achieved desired outcomes in diabetes care, cardiovascular disease, and cancer screening and whether they received any inappropriate medications in 2011. (more…)
Author Interviews, Sexual Health, Social Issues / 26.04.2016

MedicalResearch.com Interview with: Lindsey Hicks Doctoral Student Social Psychology Florida State University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: My colleagues and I are very interested in the factors that differentially predict peoples’ self-reported relationship satisfaction and their gut-level feelings about their partners—the spontaneous feelings they have and may not articulate. Because explicit self-reports require conscious deliberation they are subject to the influence of biases and beliefs about relationships; gut-level, automatic attitudes do not require conscious deliberation and thus appear to better track actual experience. With that in mind, we examined whether sexual frequency influences automatic but not explicit evaluations of the partner. Previous research has yielded inconsistent results regarding the influence of sexual frequency on relationship satisfaction, and we thought such inconsistencies may stem from the influence of deliberate reasoning and biased beliefs regarding the sometimes taboo topic of sex. Thus, we tested the association between partners’ sexual frequency and their gut-level feelings about each other. Basically we found that the frequency with which couples have sex has no influence on whether or not they report being happy with their relationship, but their sexual frequency does influence their more spontaneous, automatic, gut-level feelings about their partners. This is particularly important in light of previous research done by my colleagues demonstrating that it these automatic attitudes ultimately predict whether or not they’ll end up becoming dissatisfied with their relationship. (more…)
Author Interviews, Education, Pediatrics, PNAS, Social Issues / 26.04.2016

MedicalResearch.com Interview with:

Joan L. Luby, MD Samuel and Mae S. Ludwig Professor of Child Psychiatry Director, Early Emotional Development Program Washington University School of Medicine St. Louis, Missouri

MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Luby: The study was designed to investigate brain development in early onset mental disorders. The main findings validate depression in preschoolers with brain change evident this young similar to that known in adults. We also found effects of maternal support on brain development in this process which is what the current paper focuses on . (more…)
Author Interviews, Breast Cancer, JAMA / 26.04.2016

MedicalResearch.com Interview with: Ahmad Awada, MD, PhD Medical Oncology Clinic Institut Jules Bordet Université Libre de Bruxelles Bruxelles, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Awada: This Study compared, in a randomized fashion, paclitaxel + trastuzumab to paclitaxel + neratinib in the first line setting of metastatic breast cancer. All outcome endpoints (PFS, OS, ORR) were similar. In addition, paclitaxel + neratinib delayed the appearance and decreased the incidence of central nervous system (CNS) events (secondary end point) MedicalResearch.com: What should clinicians and patients take away from your report? Dr. Awada:  Paclitaxel + neratinib is as effective as paclitaxel + trastuzumab. The data suggested that neratinib could influence the pattern of CNS events in HER2+ metastatic breast cancer. These emerging data on CNS events are under validation in the NALA trial. (more…)
Author Interviews, Brain Injury, Exercise - Fitness / 26.04.2016

MedicalResearch.com Interview with: Jaclyn B. Caccese MS The University of Delaware PhD Candidate Biomechanics and Movement Science  MedicalResearch.com: What is the background for this study? Response: Recently, there has been increased concern regarding the adverse effects of repetitively heading soccer balls on brain function. While some studies have shown impaired balance and vision, it is unclear if these deficits are acute or chronic adaptations. Therefore, the purpose of this study was to identify changes in postural control and vestibular/ocular motor function immediately following an acute bout of 12 purposeful soccer headers. MedicalResearch.com: What are the main findings? Response: The main finding of this study was that women's soccer players showed an increase in sway velocity, but no other changes in balance or vestibular/ocular motor function were identified. (more…)
Author Interviews, C. difficile, Hospital Acquired, JAMA, McGill / 26.04.2016

MedicalResearch.com Interview with: Yves Longtin, MD, FRCPC Chair, Infection Prevention and Control Unit Montreal Jewish General Hospital - SMBD Associate professor of Medicine, McGill University MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Longtin: Clostridium difficile is a major cause of infection in hospitalized patients. Current infection control measures to prevent the spread of C. difficile in hospitals focuses almost entirely on patients who present symptoms. Patients with symptoms of diarrhea due to C difficile are placed under isolation in hospitals (for example, healthcare workers will wear a gown and gloves when caring for them). However, many studies have shown that some patients may be asymptomatic carriers of C. difficile. These patients carry the C difficile bacteria in their digestive tract without being sick. It was known that these asymptomatic carriers could spread the bacteria to other patients, but it was unclear whether putting them into isolation would help prevent the spread of the microbe in hospitals. Our study tested the hypothesis that placing asymptomatic carriers under isolation could lead to a decrease in the number of infections with C  difficile. (more…)
Author Interviews, Heart Disease, Stroke / 25.04.2016

MedicalResearch.com Interview with: Professor Ralph Stewart MBChB (Otago), FRACP, FCSANZ, MD Auckland City Hospital University of Auckland, New Zealand MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Stewart: A number of studies have suggested a favorable effect of a Mediterranean dietary pattern on the risk of heart disease, but few large studies have evaluated this dietary pattern in a global population of patients with known coronary heart disease.  We assessed a Mediterranean diet score based on frequency of consumption of common foods using a very simple questionnaire.  Globally this included a very broad range of diets – showing the benefits of this dietary pattern  can be achieved with many different foods. We founds that greater adherence to this diet was associated with a lower risk of recurrent heart attacks, strokes and deaths from any cause.  In contrast a western diet score, which measured more consumption of foods thought to be unhealthy, including processed carbohydrates, sweetened foods and drinks and deep fried foods were not associated with the risk of cardiovascular events. (more…)
Accidents & Violence, Author Interviews, Pediatrics, Toxin Research / 25.04.2016

MedicalResearch.com Interview with: Dr. Gary Smith, MD PhD Director, Center for Injury Research and Policy Nationwide Children's Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Smith: Laundry detergent packets are relatively new to the U.S. market (introduced in 2012). As their popularity has increased, so have calls to poison centers for detergent packet exposures. The study analyzed calls to poison centers and compared exposures to young children from dishwasher and laundry detergent packets as well as traditional (liquid and powder) dishwasher and laundry detergents. Incidents related to laundry detergent packets saw the biggest rise - increasing 17% over the two-year study period. Poison control centers received more than 30 calls a day on average about a child who had been exposed to a laundry detergent packet, which is about one call about every 45 minutes. Claims made by others that the rate of exposures is decreasing are misleading – these claims are based on an inappropriate use of numbers. Children exposed to laundry detergent packets were significantly more likely to be admitted to a healthcare facility or have a serious medical outcome than those exposed to other types of detergent. They were also more likely to have serious clinical effects. Coma, pulmonary edema, respiratory arrest, and death were only observed among children exposed to laundry detergent packets. (more…)
AACR, Author Interviews, Breast Cancer, Cancer Research, Pediatrics, Radiation Therapy / 25.04.2016

MedicalResearch.com Interview with: Lindsay M. Morton, PhD Senior investigator in the Radiation Epidemiology Branch of the Division of Cancer Epidemiology and Genetic National Cancer Institute Bethesda, Maryland MedicalResearch.com: What is the background for this study? Dr. Morton: We know that childhood cancer survivors, particularly those who received radiotherapy to the chest, have strongly increased risk of developing breast cancer. We studied about 3,000 female survivors of childhood cancer to identify whether inherited genetic susceptibility may influence which survivors go on to develop breast cancer. MedicalResearch.com: What are the main findings? Dr. Morton: In this discovery study, we found that specific variants in two regions of the genome were associated with increased risk of breast cancer after childhood cancer among survivors who received 10 or more gray of chest radiotherapy. A variant at position q41 on chromosome 1 was associated with nearly two-fold increased risk and one at position q23 on chromosome 11 was associated with a more than three-fold increased risk for each copy of the risk alleles. However, the variant alleles didn’t appear to have an effect among survivors who did not receive chest radiotherapy. (more…)
Author Interviews, Biomarkers, Lancet, Pulmonary Disease / 25.04.2016

MedicalResearch.com Interview with: Danny McBryan, MD Vice president, Clinical Development & Medical Affairs, Respiratory Boehringer Ingelheim Pharmaceuticals, Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Dr. MvBryan: The new post-hoc analysis from the WISDOM study shows a routine blood test could help identify the small minority of patients with severe or very severe COPD who may benefit from the addition of inhaled corticosteroids (ICS). This post-hoc analysis was recently published online in The Lancet Respiratory Medicine. For 80 percent of patients in the WISDOM study, the use of ICS on top of SPIRIVA HANDIHALER (a long-acting muscarinic antagonist – LAMA) and salmeterol (a long-acting beta-agonist – LABA) had no additional benefit in reducing the risk of exacerbations, compared to SPIRIVA HANDIHALER and the LABA without ICS. The post-hoc analysis shows that these patients can be easily identified by measuring the level of white blood cells, called eosinophils. Patients with levels lower than 4 percent (300 cells/µL) were associated with a lack of response to ICS. The WISDOM study evaluated stepwise withdrawal of inhaled corticosteroids (ICS) in severe to very severe COPD patients with a history of exacerbation. WISDOM was a 12-month, double-blind, parallel-group, active-controlled study in which all patients received triple therapy (tiotropium 18 μg once daily, salmeterol 50 μg twice daily and fluticasone 500 μg twice daily) for a six-week run-in period. Patients were randomized 1:1 to continue triple therapy or stepwise withdrawal of ICS over 12 weeks (dose reduction every six weeks). The WISDOM data show that in patients with severe to very severe COPD, the risk of moderate/severe exacerbations during one year of follow-up was non-inferior between those patients who continued on inhaled corticosteroids and those where ICS therapy was withdrawn in a stepwise manner. (more…)
Addiction, Author Interviews, Cocaine, Methamphetamine, Opiods, University of Pittsburgh / 25.04.2016

MedicalResearch.com Interview with: Jeanine Buchanich, Ph.D. Deputy director of the Graduate School of Public Health’s Center for Occupational Biostatistics and Epidemiology Research assistant professor in Pitt Public Health’s Department of Biostatistics University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Buchanich: Using the Mortality and Population Data System, a unique repository and retrieval system for detailed death data from the National Center for Health Statistics, housed at the University of Pittsburgh Graduate School of Public Health, my team examined overdose deaths in the U.S. from 1979 to 2014. We started with 1979 because changes in reporting cause of death make it impossible to make comparisons with previous years. 2014 is the most recent year for which data are available. The counties with the largest increases in overdose death rates were clustered in southern Michigan; eastern Ohio and western Pennsylvania; eastern Pennsylvania, New Jersey and much of southeastern New York; and coastal New England. Counties in the Midwest, California and Texas have seen little to no increase in overdose death rates. We cross-referenced the mortality data with counties in the High Intensity Drug Trafficking Areas program, which was created by Congress in 1988 to provide 31 high drug-trafficking areas of the U.S. with coordinated law enforcement resources dedicated to reducing trafficking and production. High Intensity Drug Trafficking Areas with high overdose death rates were mostly concentrated in Appalachia and the Southwest U.S., whereas such areas with lower death rates were near the borders in California, Texas and southern Florida. (more…)
Aging, Author Interviews, Mental Health Research / 25.04.2016

MedicalResearch.com Interview with: Dr. Jesus Bertran-Gonzalez, Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute University of Queensland Brisbane Australia MedicalResearch.com: What is the background for this study? Response: It has long been recognized that elderly people often show behavioural inflexibility, for example they may have difficulties in finding alternative routes to reach a previously known place in neighbourhoods that have changed, or they may find it difficult to remember new episodes in their life, as opposed to very old ones. The question that we wanted to address in this study is how this memory rigidity in old individuals affects their goal-directed performance, as this can directly impair their capacity to adjust their behaviour to new demands in the environment. Specifically, we wanted to investigate the changes in the brain that occur with normal ageing that have these negative effects on adaptation, and that can potentially keep old people from achieving their needs. (more…)
Author Interviews, Breast Cancer, JAMA / 25.04.2016

MedicalResearch.com Interview with: Sherene Loi, MBBS(Hons), FRACP, PhD Associate Professor, University of Melbourne Consultant Medical Oncologist, Breast Unit Head, Translatonal Breast Cancer Genomics and Therapeutics Lab Cancer Council Victoria John Colebatch Fellow Peter MacCallum Cancer Centre, East Melbourne Victoria, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Loi: Even though HER2 amplification/overexpression is such a strong oncogenic driver in breast cancer, clinical and biological heterogeneity is still evident. Our study was performed to investigate the hypothesis that a subgroup of patients with ER-positive, HER2-positive primary breast cancers seem to have lower responses to anti-HER2 therapy, in this case trastuzumab (trade name Herceptin), and we could better identify this group using both ER and HER2 levels. Our study was designed to try to better define this group so we could potentially evaluate the efficacy of future treatment strategies in this group, particularly as combination anti-HER2 therapy (i.e. trastuzumab and pertuzumab) is currently being investigated in the adjuvant setting. (more…)
Author Interviews, BMJ, Heart Disease, Pediatrics / 25.04.2016

MedicalResearch.com Interview with: Hans Van Brabandt, M.D. Brussel, Belgium MedicalResearch.com: What is the background for this study? Dr. Van Brabandt: We have been asked by the Belgian government to assess the benefits and harms of pre-participation screening of young athletes. A number of Belgian cardiologists and screening physicians are intensely promoting such screening through mass media and were asking governmental support. MedicalResearch.com: What are the main findings? Dr. Van Brabandt:  There is no solid evidence on the benefit of cardiovascular pre-participation screening, and certainty of harms it induces through numerous false-positives, making that such screening in young athletes cannot be defended. -          Italian investigators assert they have provided evidence for the benefit of screening. The single study on which they base their claim however is far from convincing. Unfortunately, more than 10 years after their first paper, they still did not make the majority of their data publicly available. (more…)
Author Interviews, Heart Disease, JAMA / 25.04.2016

MedicalResearch.com Interview with: Dr. Fredrik Björck, MD Umea University Umea, Sweden MedicalResearch.com: What is the background for this study? Dr. Björck: Vitamin K antagonist (eg, warfarin) use is nowadays challenged by the non–vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in non-valvular atrial fibrillation (AF). NOAC studies were however based on comparisons with warfarin arms with times in therapeutic range (TTRs) of 55.2% to 64.9%, making the results less credible in health care systems with higher TTRs. Historically Sweden has had the best international normalized ratio (INR) control in the world. By this study we wanted to evaluate the efficacy and safety of real life well-managed warfarin therapy in patients with non-valvular AF, the risk of complications, especially intracranial bleeding, in patients with concomitant use of aspirin, and the impact of INR control. We therefore performed a retrospective, multicenter cohort study based on Swedish registries, especially AuriculA, a quality register for AF and oral anticoagulation. A total of 40 449 patients starting warfarin therapy owing to non-valvular AF during the study period were monitored until treatment cessation, death, or the end of the study. The study was conducted from January 1, 2006, to December 31, 2011.  By associating complications with risk factors and individual INR control, we evaluated the efficacy and safety of warfarin treatment in patients with concomitant aspirin therapy and those with no additional antiplatelet medications. (more…)
Author Interviews, Outcomes & Safety, Stroke / 25.04.2016

MedicalResearch.com Interview with: Mathew J. Reeves, PhD Department of Epidemiology and Biostatistics Michigan State University East Lansing, MI  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Reeves:   The transfer of stroke patients with ischemic stroke to primary and comprehensive stroke centers so they can receive specialized care including tPA (thrombolysis) and endovascular (catheter based) care is becoming increasingly important with the release or trial data showing substantial benefit for endovascular treatment in eligible patients.   A major goal of integrated stroke systems of care is to ensure that stroke patients requiring specialized care beyond the capability of the initial hospital are identified and transferred to a specialist center as quickly as possible.   Surprisingly, there is relatively little written about the frequency and outcomes of stroke patients who are transferred between hospitals, especially in the context of large quality improvement registries such as the Coverdell Stroke Registry or Get-With-The- Guidelines- Stroke (more…)