MedicalResearch.com Interview with:
R. Scott Turner, MD, PhD
Director of the Memory Disorders Program
Georgetown University Medical Center
Medical Research: What is the background for this study? What are the main findings?Dr. Turner: The resveratrol trial originated from the extensive scientific literature demonstrating that caloric restriction (consuming only 2/3 usual calories) prevents or delays diseases of aging - including Alzheimer's disease (AD) in laboratory animals. The molecular mechanism is thought to involve sirtuins - a group of genes/proteins that sense energy balance to regulate gene expression. Sirtuins are activated by caloric restriction (a mild stressor) to express genes that promote resilience of the organism. Resveratrol is a potent activator of sirtuins - thus bypassing the requirement for caloric restriction. On the opposite side of the coin - caloric excess, midlife obesity, and diabetes are strong risk factors for Alzheimer's disease. And we have long-known that resveratrol is found in red grapes, red wine, and other foods that promote general health.
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MedicalResearch.com Interview with:
Joshua W. Miller, PhD
Professor and Chair Dept. of Nutritional Sciences Rutgers
The State University of New Jersey
New Brunswick, NJ 08901Medical Research: What is the background for this study? What are the main findings?
Response: In recent years, there has been a growing scientific literature on the associations between low vitamin D status in older adults and risk of Alzheimer's disease/dementia, cognitive impairment and decline, and brain atrophy. The vast majority of these studies have been conducted in predominantly white populations. The relatively unique aspect of our study was that over half of the cohort consisted of African Americans and Hispanics. What we found in our cohort (mean age ~75y, n=382 at baseline) was that participants with vitamin D deficiency (serum 25-hydroxyvitamin D <12 ng/ml) or vitamin D insufficiency (serum 25-hydroxyvitamin D between 12 ng/ml and <20 ng/ml) on average experienced faster rates of cognitive decline in episodic memory and executive function than participants with adequate vitamin D status. Importantly, the association between vitamin D status and the rate of decline in cognitive function was independent of race/ethnicity. However, the prevalence of low vitamin D status in the study participants was significantly higher in the African American and Hispanic participants compared with the White participants. This is most likely due to the fact that darker skin pigmentation reduces the ability of sunlight to induce vitamin D synthesis in the skin. It may also reflect differences in dietary intake of vitamin D and supplement use between the different race/ethnicity groups, though we did not assess this in our study. Thus, though the rate of cognitive decline in African Americans and Hispanics does not seem to be more or less affected by low vitamin D status than in Whites, because African Americans and Hispanics have a higher prevalence of low vitamin D status, as subpopulations they may be more prone to rapid cognitive decline in old age. Further studies addressing this possibility are needed.
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MedicalResearch.com Interview with:
Monika Goyal, MD
Pediatric emergency medicine
Children’s National Hospital
Washington, DC
Medical Research: What is the background for this study? What are the main findings?
Dr. Goyal: Appendicitis is a painful surgical condition and adequate analgesia, particularly with opioids, are considered one of the mainstays of management. We found that almost half of all children diagnosed with appendicitis did not receive any analgesia. Furthermore, among the patients that did receive analgesia, there were marked racial differences with black children having lower rates of opioid medication receipt than white children, even after we took pain scores or acuity level into account.
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MedicalResearch.com Interview with:Wisit Cheungpasitporn, MD
Nephrology Fellow
Departments of Nephrology and Hypertension
Mayo Clinic, Rochester, MN
Program director: Suzanne Norby, MD
Co-authors: Charat Thongprayoon, MD, Andrew M. Harrison, BS and Stephen B. Erickson, MD
Project mentors: Stephen B. Erickson, MD Departments of Nephrology and Hypertension
Mayo Clinic, Rochester, MN
Medical Research: What is the background for this study?
Dr. Cheungpasitporn: Uric acid has been linked to acute kidney injury (AKI) through crystal-dependent pathways and crystal-independent mechanisms, including reduced renal blood flow and glomerular filtration rate. Serum uric acid measurement has recently been examined as a marker for early AKI detection, especially in the setting of postoperative AKI following cardiovascular surgery. The effect of admission serum uric acid levels on the risk of in-hospital AKI in the general hospitalized patients, however, was unclear. Thus, we conducted a study to assess the risk of AKI in all hospitalized patients across different serum uric acid levels. The findings of our study data were recently published in Clinical Kidney Journal.
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MedicalResearch.com Interview with:
Miguel Ángel Martínez González MD
Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid
IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
Medical Research: What is the background for this study?
Response: Several observational studies and mechanistic experiments in animal models and cell lines suggested that the Mediterranean diet and minor components of extra-virgin olive oil may reduce the risk of developing breast cancer.
The PREDIMED study was a randomized primary prevention trial for cardiovascular disease among high risk patients initially free of cardiovascular disease. The participants were 7,447 men and women (60-80 years old).
We have used the data from women in this trial to assess the effect of the randomized diets on the occurrence of new cases of breast cancer.
Medical Research: What are the main findings?
Response: Among 4,152 women randomized to 3 different diets
(1.- Mediterranean diet with free provision of extra-virgin olive oil;
2.- Mediterranean diet with free provision of tree nuts; and
3.- Advice to follow a low-fat diet, i.e. control group)
We confirmed 35 new cases of invasive breast cancer during 4.8 of follow-up. A statistically significant 68% relative reduction in the risk of breast cancer in the Mediterranean diet with free provision of extra-virgin olive oil versus the control group was found. There was a significant trend of risk reduction associated with progressive increments in the intake of extra-virgin olive oil during the trial (with repeated yearly measurements of diet) when the 3 groups were assessed together.
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MedicalResearch.com Interview with:
Dr. Kristi Elisabeth Heiberg PhD Post.doc
Department of Medical Research
Baerum Hospital
Vestre Viken Hospital Trust
Medical Research: What is the background for this study?
Dr. Heiberg: This study is a long term follow-up of 60 patients who suffered from hip osteoarthritis and were treated with total hip arthroplasty (THA) approximately 5 years earlier. In a prior study, the patients participated in a RCT study, examining the effects of a supervised walking skill training program on physical functioning, pain and self-efficacy (1). The training program was performed between three and five months after surgery, and it was compared to a control group without supervised physiotherapy in the same time span. The results showed that immediately after the walking skill training intervention was completed, several outcome variables were statistically significant more improved in the training group than in the control group, and at one year after surgery the statistically significant effect on walking capacity (measured by the 6-min walk test) still sustained. Few long-term follow-up of RCTs regarding physical functioning in patients after total hip arthroplasty are previously published. Furthermore in another prior study, we examined the recovery of the total group of the same patients from preoperatively to one year after surgery (2). The results showed that the patients were statistically significant improved in all outcomes of physical functioning, pain and self-efficacy during the first year, but they still did not quite reach the level of healthy peers in walking capacity. In line with this, they also reported one year after surgery that they wanted to further improve their ability to walk and to participate in recreational activities (3). However, it seems that patients’ desires regarding physical activity are poorly understood and have received relatively little evaluation, although regular physical activity is considered to be one of the most important lifestyle behaviors affecting health. Only few prior studies have examined the long term recovery of physical functioning and the impact on physical activity.
Therefore, in this present 5-year follow-up study after total hip arthroplasty the aims were threefold.
First, to examine the long-term effect from the supervised walking skill training program on physical functioning, pain and self-efficacy;
Second, to examine the long-term recovery of physical functioning from one to five years; and
Third, to identify predictors of physical activity outcome five years after THA among personal and preoperative variables (4).
MedicalResearch.com Interview with:
Patricia Sancho, PhD, Lecturer
Barts Cancer Institute - a Cancer Research UK Centre of Excellence
Queen Mary University of London
Centre for Stem Cells in Cancer & Ageing / John Vane Science Centre, Charterhouse Square, London
Medical Research: What is the background for this study? What are the main findings?
Dr. Sancho: Cancer cells commonly rely on glycolysis, the type of metabolism that does not use oxygen to generate their energy however, we have now found that not all cancer cells are alike when it comes to metabolism. Pancreatic Cancer Stem cells (PancCSCs) can make use of a more efficient form of metabolism, called oxidative phosphorylation or OXPHOS, which does use oxygen. OXPHOS uses a part of the cell called mitochondria and it is this which can be targeted with anti-diabetic drug, metformin. Some PancSCs are however able to escape this treatment by being much more flexible in their metabolism, leading to a recurrence of the cancer, but we also found a way to prevent such resistance and force all Pancreatic Cancer Stem cells to keep using OXPHOS.
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MedicalResearch.com Interview with:
Mike Bancks, MPH
NHLBI Cardiovascular Disease Epidemiology & Prevention Pre-doctoral Fellow
University of Minnesota School of Public Health
[email protected]Medical Research: What is the background for this study? What are the main findings?
Response: We chose to research this topic because marijuana is the most commonly used illicit drug in the United States and use can be expected to increase as the effort to legalize marijuana for recreational and medicinal use grows. We found that individuals who reported using marijuana in excess of 100 times during young adulthood had 40% greater risk for developing prediabetes by middle adulthood. However, we did not find an association between marijuana use and overt diabetes during this same period in adulthood, suggesting that marijuana use may be a risk factor for the early stage of diabetes.
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MedicalResearch.com Interview with: Thomas N. Darling, MD, PhD
Department of Dermatology
Uniformed Services University of the Health Sciences
Bethesda, MD 20814
Medical Research: What is the background for this study? What are the main findings?
Dr. Darling: Many people with tuberous sclerosis complex (TSC) have skin tumors that can bleed or cause distress. Only surgical approaches were useful for treating these skin tumors in the past. Recently, drugs called mTOR inhibitors, including sirolimus, were shown to shrink internal tumors in those affected by tuberous sclerosis complex. We wanted to document what happens to the skin tumors in those being treated with oral sirolimus. We found that most patients taking oral sirolimus showed improvement in their skin tumors, and that these effects were maintained during a couple years of treatment. We did not observe any evidence for the skin tumors becoming resistant to the drug.
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MedicalResearch.com Interview with:
Dr. Mauricio F. FarezCenter for Research on Neuroimmunological Diseases (CIEN)
Raúl Carrea Institute for Neurological Research (FLENI)
Buenos Aires, Argentina
Medical Research: What is the background for this study? What are the main findings?
Dr. Farez: We were intrigued by our initial observation that Multiple Sclerosis (MS) relapses have a clear seasonal occurrence with less relapses during fall and winter. We found that melatonin levels (a hormone secreted by the pineal gland in the absence of light) have an inverse correlation with Multiple Sclerosis relapses. Moreover, melatonin controls the generation of pathogenic Th17 cells, while it boosts the generation of regulatory Tr1 cells. By affecting the immune balance of those cells it may prevents the occurrence of relapse.
Medical Research: What should clinicians and patients take away from your report?Dr. Farez: Melatonin and drugs alike targeting its pathways may be a future alternative in Multiple Sclerosis treatment. Until a proper clinical trial is conducted, melatonin SHOULD NOT be used as Multiple Sclerosis therapy. I would like to emphasize this, because melatonin is a complex hormone with receptors present basically in every cell. We do not know yet the dosage and administration form needed to obtain similar effects as the one observed in our in vitro and animal studies.
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MedicalResearch.com Interview with:
Dr. Tahereh Orouji Jokar, MD
International research fellow and
Dr Joseph Bellal Joseph, MD
Division of Trauma, Emergency Surgery, Critical Care, and Burns
Department of Surgery
University of Arizona, Tucson
Medical Research: What is the background for this study?
Response: Domestic violence is a social evil and bears significant social, financial, medical, and personal implications. Frequently victims of domestic violence, present in a trauma center due to injuries from domestic violence. However, despite bearing such grievous significance, there is no standardized practice to screen for domestic violence. In this study we sought out to identify the incidence and trends of domestic violence to highlight the burden of the disease.
Medical Research: What are the main findings?
Response: In our study we reported an overall incidence of domestic violence to be 569.564/100,000 trauma admissions. Over the study period the rate of domestic violence increased from 490/100,000 (2007) to 680/100,000 (2012) trauma admissions. We observed an increasing trend of domestic violence in children, adults, and elderly. On sub-analysis of adults, we observed an increasing trend of violence in both male and female victims.
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MedicalResearch.com Interview with:
Markus Jansson-Fröjmark PhD
Associate professor, clinical psychologist
Department of Psychology
Stockholm University
Medical Research: What is the background for this study? What are the main findings?
Response: There is ample evidence suggesting that how people regulate their emotions might influence several types of psychopathology, including anxiety and mood disorders. The purpose of our longitudinal investigation was therefore to examine the association between emotion regulation and how insomnia develops over time. Our main finding was that people whose ability to regulate their emotions had diminished were more likely to develop insomnia and that it was more likely to be persistent. A reduced ability to regulate emotions was associated with an 11% increased risk of developing a new bout of insomnia or reporting persistent insomnia. For anyone that has to deal with insomnia on a daily basis, they may find that is can effect a large part of their lives. Sleep is important for even, as it allows us all to function properly throughout the day. When it comes to Insomnia, there is medication out there that people can take that may help them with this issue. A popular method of treatment is through the use of medical marijuana. If this is something that you have been planning on trying, you would need to obtain your medical marijuana card in Cincinnati (if you live in this city) before you could start receiving product. Hopefully this will help with your insomnia and provide you with a better quality of sleep.
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MedicalResearch.com Interview with:
Binbin Wang, PhD
Center for Genetics, National Research Institute for Family Planning
Beijing China
Medical Research: What is the background for this study? What are the main findings?
Dr.Wang:Homosexuality has become an important issue all around the world, as well as in China. Beside of the human right problems it poses, the reality that more and more HIV cases are infected through homosexual activity,especially men who have sex with men
(MSM), should be concerned. People are wondering how homosexuality develops.
As a genetic researcher, I'd like to find the answers in the field of genetics.
This study is based on previous evidence that genes may have impact on homosexuality. Besides, animal models have provided clues that abnormality in some neurotransmitters, such
as dopamine, may alter the sex behavior of animals. Therefore, we choose COMT (the gene catechol-O-methyltransferase) as the
target, which is important for the synthesis of dopamine. We find that an amino acid
residue change in COMT could increase the risk of developing male homosexuality.
Our results provide some evidence that male homosexuality is connected with genes.
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MedicalResearch.com Interview with:
Merja Nermes, MD
Dept. of Pediatrics
Turku University Hospital
Turku, Finland
Medical Research: What is the background for this study? What are the main findings?
Response: Earlier it was thought that exposure to pets early in childhood was a risk factor for developing allergic disease. Later epidemiologic studies have given contradictory results and even suggested that early exposure to pets may be protective against allergies, though the mechanisms of this protective effect have remained elusive. Our results are the first to show that specific bifidobacteria present in pets can be transferred to the infant gastrointestinal tract during a close contact. Bifidobacteria in general are a part of the microbiota in healthy breast fed infants, and many studies have shown that human-specific bifidobacteria have beneficial effects to health, e.g. lower the risk of allergic disease. The same might hold true for bifidobacteria of animal origin which may enhance and strengthen the development of the infants´ immune system to be protective against allergies.
Our results showed that animal-derived bifidobacteria were found in a higher proportion in infants of pet-keeping families than in those without such exposure. We also found that B. thermophilum (pet-derived Bifidobacterium) was associated with a lower risk for atopic sensitization at 6 months of age.
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MedicalResearch.com Interview with:
Dr.Manuel Fernández-Real MD, PhD
Biomedical Research Institute of Girona (IDIBGI) CIBERobn
Obesity Hospital of Girona
Medical Research: What is the background for this study? What are the main findings?
Response: Obesity is an important determinant of increased cardiovascular risk. Increased fat mass has been assumed to constitute the main prominent contributor to changes in carotid intima-media thickness (c-IMT). A link among fat free mass and total blood volume, stroke volume and cardiac output has been also previously reported.
In this manuscript we describe that carotid intima-media thickness was positively associated with lean body mass in men (r =0.328, p <0.0001) and women (r = 0.268 p =<0.0001). c-IMT values increased across lean mass quartiles (p < 0.0001). Stepwise linear regression analysis showed that age and lean mass (but not fat mass or traditional cardiovascular risk factors) contributed to 46.2% of c-IMT variance in men (p=<0.0001).
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MedicalResearch.com Interview with:
Dr. Fang LiDepartment of Epidemiology and Health Statistics, The Medical College of Qingdao University, Qingdao, Shandong Province, People's Republic of China
Medical Research: What is the background for this study? What are the main findings?
Response: Fish, rich in multiple beneficial nutrients, including n-3 polyunsaturated fattyacids, high-quality protein, vitamins and minerals, have been hypothesized to protect against chronic diseases generally , such as cardiovascular disease and cancer. Depression is a common mental health disorder,with an estimated 350 million people affected. We hypothesis that fish consumption may be benefical in depression prevention. Several epidemiological studies have investigated associations between fish intake and depression risk, but the findings are inconsistent. Therefore we conducted a meta-analysis to expect to find this association.
A total of 26 studies involving 150 278 participants were included in the present meta-analysis.The pooled relative risk of depression for the highest versus lowest consumption of fish was 0.83 (95% CI 0.74 to 0.93). The findings remained significant in the cohort studies.This meta-analysis indicates that high-fish consumption can reduce the risk of depression.
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MedicalResearch.com Interview with: Megan Colleen McHugh, PhD
Research Assistant Professor
Center for Healthcare Studies
Feinberg Institute for Public Health and Medicine and Emergency Medicine
Northwestern University
Medical Research: What is the background for this study? What are the main findings?
Dr. McHugh: There have been many large efforts to improve the delivery of health care in the U.S., for example, the Robert Wood Johnson Foundation’s Aligning Forces for Quality Program and the Institute for Healthcare Improvement’s 100,000 Lives Campaign. One of the challenges to understanding whether these programs work is that the intervention “dose” – the quality and quantity of the intervention – often varies across different participating sites.
As evaluators of multi-site quality improvement programs, we want to better understand how to measure the dose of a quality improvement intervention at participating sites. We identified four different approaches to measuring dose. These approaches resulted in different conclusions about which sites are “low dose” and “high dose” intervention sites.
Medical Research: What should clinicians and patients take away from your report?Dr. McHugh: The main audience for this paper is program evaluators. They should take away the following:
1) Variation in dose scores across intervention sites suggests that dose may be a contributor to the effectiveness of a quality improvement intervention.
2) It is feasible to measure the dose of a quality improvement intervention, but measuring QI dose presents many challenges, including subjective decisions about which approach to measurement to use and the need for extensive data collection.
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MedicalResearch.com Interview with:
Brian A. Primack, MD, PhD
Associate Professor of Medicine, Pediatrics, and Clinical and Translational Science
Director, Center for Research on Media, Technology, and Health
Assistant Vice Chancellor for Research on Health and Society
University of Pittsburgh School of Medicine
Pittsburgh, PA 15213
Medical Research: What is the background for this study?
Dr. Primack: Adolescents and young adults who have never smoked traditional cigarettes are now using e-cigarettes. It is unclear whether these people are at risk for progression to traditional cigarette smoking. Therefore, we followed 694 non-smokers ages 16-26 who did not intend on taking up smoking for 1 year.
Medical Research: What are the main findings?
Dr. Primack: At baseline, only 16 of the 694 participants had used e-cigarettes. However, those individuals were significantly more likely to start smoking traditional cigarettes by the 1-year follow-up. In fully adjusted models, baseline e-cigarette use was independently associated with both progression to smoking (AOR = 8.3, 95% CI = 1.2-58.6) and to susceptibility (AOR = 8.5, 95% CI = 1.3-57.2).
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MedicalResearch.com Interview with:
Chan-Won Kim, M.D.
Clinical Associate Professor
Center for Cohort Studies
Kangbuk Samsun Hospital
Sungkyunkwan University School of Medicine
Seoul, South Korea
Medical Research: What is the background for this study?
Dr. Chan-Won Kim: In modern society, inadequate sleep either in quantity or in quality is a common problem and widely recognized as a potential determinant of adverse health outcomes including cardiovascular health. Very long or very short duration of sleep are associated with an increased risk for clinical cardiovascular events such as coronary heart disease and strokes. In these previous studies, however, it was possible that extreme sleep duration or poor sleep quality was a consequence of previous co-morbidities such as depression and obesity, and it was still unclear if these co-morbidities were really responsible for the effects of sleep disturbances. Therefore, we evaluated the association of sleep duration and quality with early markers of subclinical arterial disease in asymptomatic apparently healthy men and women.
Medical Research: What are the main findings?
Dr. Chan-Won Kim: In our study, we found that sleep duration had a U-shaped association with two early markers of vascular disease. Both short and long sleep duration were associated with a greater amount of calcification in the coronary arteries, a very good measure of subclinical atherosclerosis that predicts the risk of a heart attack. We also found a similar pattern of association with arterial stiffness, a marker of vascular aging. For both markers, we found the lowers risk in study participants who reported 7 hours of sleep. In addition, poor subjective sleep quality was also associated with these markers of vascular disease. Few studies had explored these associations before, and they were inconsistent partly because of small sample sizes. Our research also indicates that these associations were present irrespective of traditional risk factors such as hypertension, hypercholesterolemia, or diabetes.
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MedicalResearch.com Interview with:
Dr. Daniel HertzbergM.D., Ph.D. Student
Department of Medicine, Solna
Karolinska University Hospital
Medical Research: What is the background for this study?
Dr. Hertzberg: Acute Kidney Injury (AKI) is a common complication in patients undergoing cardiac surgery. It is associated with increased short and long-term mortality, myocardial infarction, heart failure and chronic kidney disease. Diabetes is often considered as a risk factor for AKI. However, when we searched the literature we did not find any studies which specifically studied diabetes as a risk factor for AKI. In addition, in observational studies, it is uncommon that diabetes is subtyped into type 1 or type 2 even though they have different etiologies and thus may have different impact on risk of adverse outcomes. Thus, we designed this study in order to study the association between the two subtypes of diabetes and risk of AKI.
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MedicalResearch.com Interview with:
Dr. Glen Taksler, PhD
Medicine InstituteCleveland Clinic Main Campus
Medical Research: What is the background for this study? What are the main findings?
Dr. Taksler: Although young, healthy adults who develop influenza are usually able to recover, they may spread the flu to other people in the community who have a higher risk of hospitalization or other serious complications. These higher-risk people have a limited ability to protect themselves from influenza, because flu vaccines are less effective in the elderly and in people with weakened immune systems.
To better understand whether young, healthy adults could help the community-at-large by getting a flu vaccine, we looked at data on more than 3 million Medicare beneficiaries across 8 influenza seasons.
We found that the elderly had 21% lower odds of developing influenza if they lived in areas where more nonelderly adults (people aged 18-64 years old) got a flu vaccine.
Importantly, we found these benefits even in elderly adults who obtained an influenza vaccine, perhaps because flu vaccines are less effective in the elderly. This means that elderly adults who were proactive to try to prevent influenza still benefited from communitywide vaccination.
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MedicalResearch.com Interview with:
Dr. Morgan Elyse Levine PhD
Postdoctoral Fellow
Department of Human Genetics
University of California, Los Angeles
Medical Research: What is the background for this study? What are the main findings?
Dr. Levine: Studies using mice, worms, and flies have suggested that longevity may be linked to stress resistance. All of us are constantly encountering things that damage our cells and tissue and disrupt physiological functioning. Therefore, people who are genetically predisposed to better prevent or repair this damage may age slower. Smoking is one of the most damaging things someone can do to their health, yet some smokers are able to survive to extreme ages. This study looked at long-lived smokers to see if we could identify a "genetic signature". We generated a genetic risk score that was found to be associated with longevity both in smokers and non-smokers, and also appeared to be associated with cancer risk.
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MedicalResearch.com Interview with:
Audrey J. Gaskins, Sc.D. Postdoctoral Fellow
Department of Nutrition
Harvard T.H. Chan School of Public Health
Boston, MA 02115
Medical Research: What is the background for this study? What are the main findings?
Dr. Gaskins: Infertility, defined as the inability to conceive after 12 months of unprotected intercourse, is a common reproductive disorder affecting ~15% of couples who attempt to become pregnant. Assisted reproductive technologies (ART), which include in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI), have become the main treatment modalities for couples facing infertility. Pre-conceptional folate and vitamin B12 have been linked to many beneficial early pregnancy outcomes among couples undergoing assisted reproductive technologies treatment in Europe but mixed results have been found in regards to clinical pregnancy and live birth rates. Therefore, we sought to investigate whether higher levels of serum folate and vitamin B12 could increase reproductive success in a cohort of women undergoing assisted reproductive technologies at an academic medial center in the United States.
We found that high concentrations of folate and vitamin B12 in serum are associated with increased chance of live birth following assisted reproduction. Moreover, women with higher concentrations of both serum folate and vitamin B12 had the greatest likelihood of reproductive success. Analysis of intermediate endpoints suggests that folate and vitamin B12 may exert their favorable effects on pregnancy maintenance following implantation.
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MedicalResearch.com Interview with:
Augustine T. Choko MSc
Malawi–Liverpool–Wellcome Trust Clinical Research Programme
Blantyre, Malawi
Medical Research: What is the background for this study?
Response: Despite rapid scale up of HIV testing in the sub Saharan African region, half of people living with HIV are unware of their status. We investigated a novel approach of HIV self testing as an additional strategy to existing HIV testing options.
Medical Research: What are the main findings?
Response: Population uptake of HIV self testing was high at the first offer and remained high at the second offer 12 months later. The approach saw high numbers of adolescents and men testing.
Community participants with 8% illiterate were able to do the test and correctly interpret it on their own with minimal training.
People who self-tested positive were able to link into the clinic for antiretroviral therapy eligibility assessment.
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MedicalResearch.com Interview with:
Lynn Webster, M.D.
Vice President of Scientific Affairs
PRA Health Sciences
(lead study investigator, and former President of the American Academy of Pain Medicine)Medical Research: What is the background for this study? What are the main advantages of the buccal film?Dr. Webster: Because of its partial agonist activity and high affinity for mu-opioid receptors, buprenorphine has the potential to precipitate withdrawal in patients who are already on mu-opioid full agonists. As a result, the current practice is to taper patients who are on around-the-clock (ATC) opioid therapy to a morphine sulfate equivalent (MSE) dose before switching to buprenorphine. But tapering can result in a loss of pain control for patients. For this study, we wanted to determine if patients on around-the-clock opioid full agonist therapy could be safely transitioned to buprenorphine HCl buccal film – an opioid partial agonist administered through the buccal mucosa – without the need for an opioid taper, and without inducing opioid withdrawal or sacrificing pain control. Buprenorphine HCl buccal film is the first pain product in development to combine the efficacy of buprenorphine with this unique delivery system, which allows for efficient and convenient delivery of buprenorphine into the bloodstream.
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MedicalResearch.com Interview with:
Henrik Ullman, MD, PhD Candidate
Department of Neuroscience
Karolinska Institutet
Stockholm, Sweden
Megan Spencer-Smith, PhD
School of Psychological Sciences
Monash University
Melbourne, Australia
Medical Research: What is the background for this study? What are the main findings?
Response: Infants born preterm are at risk for school-age cognitive and academic impairments. While some will suffer severe impairments, many more will experience mild impairments, and it is these children who might not raise sufficient concern for referral and intervention. Identifying early markers and methods for classifying preterm infants at risk for school-age impairments, many years before difficulties emerge, would provide important information for clinicians in advising families regarding intervention and ongoing monitoring.
Brain alterations are common in preterm populations. Any brain alterations associated with school-age impairments are likely already present in the neonatal period but are not detected with the current standard clinical and radiological evaluations.
In this study we wanted to see how well we could use advanced analysis of volumetric and diffusion MRI collected in the neonatal period from 224 very preterm children to predict cognitive functions at five and seven years of age. We used statistical models to look for localised regions as well as machine learning methods to correlate patterns in the neonatal MRI data that could predict school-age outcomes.
We found that localised volumes in the insula and basal ganglia as well as a distributed patterns of diffusion MRI could predict working memory and early mathematical skills even after co-varying for important perinatal clinical factors.
It has previously been shown that quantitative and pattern analysis can catch subtle patterns in MRI data not easily detected by eye and may predict cognitive development. The current study builds further on these results showing clinically relevant predictions in preterm children.
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MedicalResearch.com Interview with:
Dr. Quanhe Yang PHD
Epidemiologist
CDC’s Division for Heart Disease and Stroke Prevention
Medical Research: What is the background for this study? What are the main findings?
Dr. Yang: One in every three Americans dies of cardiovascular disease. For both men and women, it is the number one cause of death. Heart age is the predicted age of a person’s vascular system based on his or her cardiovascular risk factor profile. The concept was created as a way to more effectively illustrate an individual’s future risk of developing or dying from a heart attack or stroke. Using information from the Framingham Heart Study and data collected from every U.S. state, this study is the first to provide population-level estimates of heart age and to highlight disparities in heart age nationwide.
Our research found one in two U.S. men and two in five U.S. women have a heart age that is five or more years older than their chronological age, a sign they are at higher risk for heart attacks and stroke. In all, we found nearly 69 million adults between the ages of 30 and 74 have a heart age five or more years older than their actual age. That’s about the number of people living in the 130 largest U.S. cities combined. In addition, there are variations in heart age based on gender, race/ethnicity, region and other demographics.
The good news is, heart age can be lowered through lifestyle changes or appropriate medication. U.S. adults both young and old can use this information to take charge of their own heart health and take immediate steps to prevent future heart attacks or strokes.
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MedicalResearch.com Interview with:
Antti Latvala PhD
Post-doctoral researcher
Department of Public Health, University of Helsinki
Helsinki, Finland
Medical Research: What is the background for this study?
Dr. Latvala: Motivation for the study came from the fact that antisocial and aggressive behavior has been associated with lower resting heart rate in children and adolescents. Heart rate, being regulated by the autonomic nervous system, has been viewed as an indicator of stress responding or autonomic arousal, and the association has been hypothesized to indicate low levels of stress or a chronically low level of autonomic arousal in antisocial individuals. However, empirical evidence for such an association in adulthood has been very limited.
Medical Research: What are the main findings?
Dr. Latvala: We found that men with lower resting heart rate had an increased risk of violent and nonviolent criminality. Specifically, men in the lowest fifth of the heart rate distribution had an estimated 39% increased risk for violent criminality and a 25% increased risk for nonviolent crimes compared with men in the highest fifth. These are estimates after adjusting for physical, cardiovascular, cognitive and socioeconomic covariates. When we further adjusted for cardiorespiratory fitness, which was available in a subsample, the associations were even stronger.
In addition to the crime outcomes, we found that low resting heart rate predicted exposure to assaults and accidents, such as traffic crashes, falls and poisonings, in a very similar fashion.
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MedicalResearch.com Interview with:
Emmanuele A. Jannini, MD
Chair of Endocrinology and Medical Sexology
Department of Systems Medicine
Tor Vergata University of Rome
Roma, Italy
Medical Research: What is the background for this study? What are the main findings?
Prof. Jannini: The background is due to the large experience of the researcher of my team, Dr. Giacomo Ciocca, on homophobia, a largely diffuse phenomenon in various forms. Although many social and cultural factors predispose to homophobic attitude, we have hypothesized that some psychological aspects of personality were in association with homophobia. Therefore, we found that psychoticism, a dysfunctional trait of thought, immature defense mechanisms, i.e., primitive responses to anxiety states, and a fearful model of relationship with other due to an insecure attachment style, could be considered risk factors for homophobic attitude.
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MedicalResearch.com Interview with:
Professor Sheena McCormack
Clinical EpidemiologyMedical Research Council Clinical Trials Unit
University College London
Medical Research: What is the background for this study? What are the main findings?
Prof. McCormack: PROUD is the first study of pre-exposure prophylaxis (PrEP) to prevent HIV carried out in the UK. The results show that PrEP could play a major role in reducing the number of new infections among men who have sex with men who are at risk of catching HIV.
Pre-exposure prophylaxis (PrEP) is a HIV prevention strategy that involves HIV-negative people taking some of the drugs we use for treatment of HIV to reduce the risk of becoming infected. The PROUD study (www.proud.mrc.ac.uk) looked at whether offering daily PrEP to men who have sex with men was an effective way to prevent HIV infection. The results show that pre-exposure prophylaxis is highly protective, reducing the risk of infection for this group by 86%.
The drug used in the trial – the antiretroviral Truvada – was already known to reduce the incidence of HIV infection compared to placebo (a dummy pill). The PROUD study was designed to see how good Truvada would be found as pre-exposure prophylaxis in a real world situation when participants knew they were taking an active drug. It aimed to address outstanding questions such as whether taking PrEP would change sexual risk behaviour – for example increasing the number of partners they did not use condoms with and increasing the rate of other sexually transmitted infections (STIs) – and whether or not it would be cost-effective to make it available on the NHS.
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MedicalResearch.com Interview with:
R. Scott Turner, MD, PhD
Director of the Memory Disorders Program
Georgetown University Medical Center
Medical Research: What is the background for this study? What are the main findings?
Dr. Turner: The resveratrol trial originated from the extensive scientific literature demonstrating that caloric restriction (consuming only 2/3 usual calories) prevents or delays diseases of aging - including Alzheimer's disease (AD) in laboratory animals. The molecular mechanism is thought to involve sirtuins - a group of genes/proteins that sense energy balance to regulate gene expression. Sirtuins are activated by caloric restriction (a mild stressor) to express genes that promote resilience of the organism. Resveratrol is a potent activator of sirtuins - thus bypassing the requirement for caloric restriction. On the opposite side of the coin - caloric excess, midlife obesity, and diabetes are strong risk factors for Alzheimer's disease. And we have long-known that resveratrol is found in red grapes, red wine, and other foods that promote general health.
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