Author: Marie Benz MD FAAD
22 Apr PARP Inhibitor Combo For Cancer Patients With and Without BRCA Mutation
MedicalResearch.com Interview with:
Timothy Yap, MD, PhD, NIHR BRC
The Institute of Cancer Research and
The Royal Marsden NHS Foundation Trust
London, United Kingdom.
Medical Research: What is the background for this study? What are the main findings?
Dr. Yap: This is a novel phase I trial assessing for the first time if the PARP inhibitor olaparib can be combined with the AKT inhibitor AZD5363. The study was undertaken at the Royal Marsden and The Institute of Cancer Research in London, England. This targeted combination was based on strong preclinical rationale demonstrating synergy between both drugs in BRCA positive tumors and also antitumor activity in non-BRCA positive tumors. Although olaparib was recently approved by the FDA for treating advanced ovarian cancer associated with defective BRCA genes, antitumor efficacy in different non-BRCA tumors is yet to be established.
The key finding for this study was that it was indeed possible to combine both drugs safely, with multiple patients with different cancers responding, including patients with and without BRCA1/2 mutations. We also assessed a new intrapatient dose escalation phase I trial design in this study, and demonstrated that the novel design could be successfully implemented, with completion of the dose escalation phase in 2 schedules of the combination with just 20 patients in 7.5 months.
22 Apr CPAP For Sleep Apnea May Decrease Atrial Fibrillation Recurrence
Posted at 00:54h
in Author Interviews, Heart Disease, JACC, NYU/NYMC, Obstructive Sleep Apnea, Sleep Disorders
MedicalResearch.com Interview with:
Dr. Larry Chinitz MD
Professor of Medicine and Director, Cardiac Electrophysiology
NYU Langone Medical Center
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Chinitz: The treatment algorithms proposed currently for maintenance of sinus rhythm in patients with atrial fibrillation focus on use of anti-arrhythmic drugs and catheter ablation. Data available to evaluate the effect of modification of known adverse clinical factors on atrial fibrillation recurrence is scant.
Obstructive sleep apnea in a known factor associated with both new onset atrial fibrillation as well as its recurrence after catheter ablation. Through a meta-analysis of available data we found that use of continuous positive airway pressure in patients with sleep apnea was associated with a 42% relative risk reduction in recurrence of atrial fibrillation. This effect was similar across patient groups irrespective of whether they were medically managed or with catheter ablation.
21 Apr Targeted Melanoma Panel Identifies Genetic Subsets of Melanoma
Posted at 23:42h
in AACR, Author Interviews, Genetic Research, Melanoma, NYU/NYMC, Personalized Medicine, Wistar
MedicalResearch.com Interview with:
Melissa Wilson, MD, PhD
Assisstant Professor
Perlmutter Cancer Center
NYU Langone Medical Center
New York, NY
Medical Research: What is the background for this study? What are the main findings?
Dr. Wilson: Metastatic cutaneous melanoma is an extremely aggressive form of skin cancer. Traditionally, it has been characterized by clinicopathologic characteristics. More recently, melanoma tumors have also been stratified by common somatic mutations for which targeted therapies have been developed or are under investigation, including BRAF, NRAS and KIT. In addition to somatic mutations, aberrant intracellular signaling pathways and cell cycle disruption contribute to melanoma pathogenesis. Indeed, recent next generation sequencing studies have identified a number of new genes involved in melanomagenesis. A comprehensive evaluation and understanding of concurrent and mutually exclusive mutations in tumors has been lacking. Therefore, we developed a comprehensive custom targeted capture of 108 genes previously implicated in melanoma pathogenesis. We used the targeted panel to perform massively parallel sequencing on 94 well-established human melanoma cell lines, 67 patient-derived xenografts (PDX), and 5 cell lines made from PDX, all untreated.
Samples were clustered based on deleterious mutations. Eighty-three percent of samples had deleterious mutations in the MAPK signaling pathway (including BRAF, RAS) and NF1. Ten percent of samples had PI3K pathway mutations which were predominantly associated with BRAF mutations. TP53 was found to be mutated in 24% of the samples and were also associated with mutations in the MAPK pathway. Mutations in chromatin remodeling genes were mutually exclusive with each other, but were associated with BRAF and NRAS mutations. Of particular interest, five of the 10 NF1mutated samples harbored likely deleterious mutations in MAP3K5 or MAP3K9, suggesting the potential involvement of JNK signal transduction pathway in a cohort of samples.
21 Apr Epigenetic Changes May Account For How Some Lymphoma Tumors Change Over Time
MedicalResearch.com Interview with: Olivier Elemento, PhD Associate Professor Head, Laboratory of Cancer Systems Biology Department of Physiology and Biophysics Institute for Computational Biomedicine Weill Cornell Medical College New York, NY, 10021 Medical Research: What is the background for this study? What are the main findings? Dr. Elemento: In many cancer patients, initial treatment with chemotherapy or targeted therapy...
21 Apr World Trade Center Emergency Workers At High Risk Of Health Conditions
MedicalResearch.com Interview with:
Dr Mayris P Webber Dr.PH. MPH
Bureau of Health Services Fire Department of the City of New York Brooklyn, NY
Professor of Clinical Epidemiology & Population Health
Montefiore Medical Center NY
Medical Research: What is the background for this study? What are the main findings?
Dr. Webber:
- To date, we and others have found adverse health outcomes associated with World Trade Center (WTC) exposure among New York City’s first responders such as firefighters, police officers, and other rescue and recovery workers. We conducted the first study to concentrate on the health impact of the disaster on emergency medical service (EMS) workers.
- In keeping with previous research on WTC’s first responders, we found that the WTC attacks adversely affected the physical and mental health of approximately 2,000 New York City Fire Department (FDNY) EMS who performed rescue and recovery work at the site.
- We analyzed selected physical and mental health conditions that have been certified as being linked to the aftermath of the WTC attacks under the James Zadroga 9/11 Health and Compensation Act of 2010.
- Over a 12 year period, between September 11 2001 and December 31 2013, the proportion of newly diagnosed cases of gastroesophageal reflux disease (GERD) was 12.1%; obstructive airways disease (OAD) 11.8%; rhinosinusitis 10.6%; and cancer 3.1%.
- In their most recent mental health survey, nearly 17% of EMS workers reported symptoms consistent with depression; 7% with post-traumatic stress disorder (PTSD); and 3% with harmful alcohol use.
- Compared with EMS workers who did not work at the WTC site, EMS workers who worked at the WTC site in the morning of 9/11 (i.e., most intensely exposed) were at greatest risk for nearly all of the health conditions analyzed.
- For example, they were almost four times as likely to have GERD and rhinosinusitis, seven times as likely to have probable PTSD, and twice as likely to have probable depression. (We use the term probable because we used screening questionnaires instead of professional diagnoses for these mental health conditions).
21 Apr Norovirus and Enteroviruses May Be Resistant to Alcohol Based Hand Disinfectants
MedicalResearch.com Interview with:
Erwin Duizer, PhD
Head of section Enteric Viruses
Centre for Infectious Diseases Control
National Institute for Public Health and the Environment
The Netherlands
Medical Research: What is the background for this study?
Dr. Duizer: Hand hygiene is important for interrupting the transmission chain of viruses through hands. Alcohol-based hand disinfectants are widely used in hospitals and healthcare facilities, due to convenience, rapidity, and broad acceptance by healthcare personnel. The effectiveness of alcohol-based hand disinfectant has been shown for bacteria and enveloped viruses but their effectiveness in reducing transmission of non-enveloped viruses, such as norovirus, is less certain. Therefore we tested, in a joint project of the RIVM and Wageningen University, the virucidal activity of a propanol based product and an ethanol based product in quantitative carrier tests. Additionally, the virus reducing effect of hand washing (according to health care guidelines) and the use the propanol based product was tested in a quantitative finger pad test.
21 Apr Decreased Medicare Payment Did Not Mean Increased Volume For Most Glaucoma Procedures
MedicalResearch.com Interview with:
Dan Gong BA
Yale University School of Medicine
------------
James C. Tsai, M.D., M.B.A.
President - New York Eye and Ear Infirmary of Mount Sinai
Delafield-Rodgers Professor and Chair Department of Ophthalmology Icahn School of Medicine at Mount Sinai
Medical Research: What is the background for this study? What are the main findings?
- Congress first introduced the Medicare Physician Fee Schedule built on the resource-based relative value scale (RBRVS) in the Omnibus Budget Reconciliation Act of 1989. Until recently, Medicare payments to physicians were adjusted annually based on the sustainable growth rate (SGR) formula.
- When adjusting physician payments, one controversial belief by policymakers was the assumption that in response to fee reductions, physicians would recuperate one-half of lost revenue by increasing the volume and complexity of services.
- This study questioned this assumption that this inverse relationship between Medicare payment and procedural volume is uniform across all procedures. In particular, glaucoma procedures have not been studied in the past.
- Using a fixed effects regression model, we found that for six commonly performed glaucoma procedures, four did not have any significant Medicare payment and procedural volume relationship (laser trabeculoplasty, trabeculectomy with and without previous surgery, aqueous shunt to reservoir). Two procedures, laser iridotomy and scleral reinforcement with graft, did have significant and inverse associations between Medicare payment and procedural volume.
21 Apr Osteoporosis May Increase Risk of Hearing Loss
MedicalResearch.com Interview with:
Dr. Kai-Jen Tien MD
Division of Endocrinology and Metabolism, Department of Internal Medicine
Chi Mei Medical Center, Tainan, Taiwan
Medical Research: What is the background for this study? What are the main findings?
Response: Previous studies investigating the relationship between osteoporosis and sudden sensorineural hearing loss were rare. Most of the studies were of small sample size, or cross-sectional designs and their results were inconclusive. Our population-based study found an approximately 1.76-fold increase in the incidence of sensorineural hearing loss for patients with osteoporosis compared with the comparison group.Patients with more severe osteoporosis may have a higher risk of SSNHL than patients with osteoporosis of milder severity.
21 Apr Selective Estrogen Receptor Degrader May Help Patients With Resistant ER+ Breast Cancer
MedicalResearch.com Interview with:
Presented by Dr. Maura N. Dickler MD
Associate member of the Breast Medicine Service at
Memorial Sloan Kettering Cancer Center and
Weill Medical College of Cornell University in New York
Medical Research: What is the background for this study?
This year, breast cancer will claim the lives of nearly 40,000 women in the United States, and up to half of these women will have a disease that is driven by the estrogen receptor.
- Although medicines have been approved for the treatment of hormone receptor-positive breast cancer for decades, more treatment options are needed.
- Resistance to endocrine therapies causes morbidity and mortality for women with metastatic estrogen receptor-positive (ER+) breast cancer as many patients relapse or develop resistance to available hormonal agents via estrogen-dependent and estrogen-independent mechanisms.
- Dual-acting investigational Selective Estrogen Receptor Degrader (SERDs) could potentially lead to a new treatment option for people with hormone receptor-positive breast cancer and may help overcome resistance to current anti-hormonal medicines.
- GDC-0810 is a dual-acting investigational next-generation oral SERD that works in a number of ways to prevent estrogen fueling tumor growth. It is not only designed to target the estrogen receptor (ER) as an antagonist, but also to cause degradation of the ER protein. In preclinical studies, GDC-0810 was shown to induce tumor regressions in both tamoxifen sensitive and tamoxifen resistant tumor models in vivo.
- Clinical data from the dose-escalation portion of a Phase I/IIa study evaluating GDC-0810 appears to have an acceptable safety profile with encouraging anti-tumor activity in postmenopausal women with advanced breast cancer positive for the estrogen receptor (ER), all of whom were previously treated with standard endocrine therapy.
- Promising anti-tumor activity was observed in 38% of patients on study for six months or longer. At all doses tested, there was robust engagement of the estrogen receptor by GDC-0810 as demonstrated by fluoroestradiol (FES) PET scans. Overall, the most common adverse events of any grade related to GDC-0810 were diarrhea, nausea and fatigue.
20 Apr Chk1 Inhibition Plus Gemcitabine May Be Safe and Effective In Some Solid Tumors
MedicalResearch.com Interview with:
Presented by Dr. Jeffrey R. Infante, MD
2015 American Association for Cancer Research
Director of the Drug Development Program
Sarah Cannon Research Institute in Nashville, Tennessee.
Medical Research: What is the background for this study?
- Inhibition of Checkpoint Kinase 1 (Chk1) may be effective at enhancing the effects of chemotherapeutic agents in tumor cells that lack other key cell cycle checkpoint regulators, such as the tumor suppressor protein p53 (p53 mutant tumors).
- In a broad range of pre-clinical models, GDC-0425, an oral, selective Chk1 inhibitor, enhanced the efficacy of the chemotherapy drug gemcitabine. Greater efficacy was also observed in cancer cell lines lacking p53 activity.
- Based on its proposed mechanism of action in enhancing the cytotoxicity of DNA damaging chemotherapy, GDC-0425 was evaluated in combination with a standard dose of gemcitabine.
20 Apr Antifungal Drug May Be Repurposed As An Anti-Cancer Agent
MedicalResearch.com Interview with:
Pan Pantziarka, PhD
Member of the ReDO project and the Anticancer Fund
Research from the Repurposing Drugs in Oncology (ReDO) project
MedicalResearch: What is the background for this study?
Dr. Pantziarka: This study is one of a number initiated by the Repurposing Drugs in Oncology (ReDO) project. ReDO is an international collaboration between the Belgian foundation the Anticancer Fund and the US not-for-profit GlobalCures. ReDO includes researchers based in the UK, Belgium and the US. The project aims to identify the most promising non-cancer drugs which have evidence that they may be effective additions to oncological treatments. Itraconazole, the subject of this study, is a well-characterised and commonly used anti-fungal agent that is available internationally and at relatively low cost.
MedicalResearch: What are the main findings?
Dr. Pantziarka: We have summarised a broad range of in vitro, in vivo and clinical evidence of anti-cancer activity in itraconazole. In particular there is strong evidence that itraconazole has activity against the Hedgehog signalling pathway, which is active in a variety of different cancer indications. Our study also includes details of a number of positive clinical trials which have reported, and includes details of some still in progress. The level of evidence is particularly striking in basal cell carcinoma, prostate and lung cancer.
20 Apr PIM Kinase Inhibitors May Offer New Melanoma Therapeutic Target
MedicalResearch.com Interview with:
Adina Vultur, Ph.D.
Staff Scientist
Meenhard Herlyn Laboratory
Melanoma Research Center
The Wistar Institute, Philadelphia
Medical Research: What is the background for this study? What are the main findings?
Dr. Vulture: Our goal was to identify new drugs with anti-melanoma activity but with minor effects on normal cells. We screened structurally distinct kinase inhibitors first, against multiple cell lines and normal cells, and identified the organometallic compound SM200 as being the most effective and selective molecule, capable of halting melanoma cell growth and invasion. Further characterization of SM200 indicated that PIM kinases are highly inhibited by this compound compared to other targets. We then confirmed the contribution of PIM kinases to melanoma pathobiology by knockdown studies and by using a clinically available PIM-inhibitor. Encouraging results with PIM kinase inhibition in multiple melanoma models including xenografts suggests that this could be a useful strategy against melanoma.
20 Apr Assay May Determine Which Triple Negative Breast Cancers Respond To Platinum Chemotherapy
MedicalResearch.com Interview with:
Steven Jay Isakoff, MD, PhD
Hematology/Oncology Department of Medicine
Massachusetts General Hospital
Medical Research: What is the background for this study? What are the main findings?
Dr. Isakoff: Metastatic triple negative breast cancer remains a challenging clinical problem with no specific therapies targeted validated for this population. From a number of preclinical studies and because of a link between BRCA1 associated breast cancer and triple negative breast cancer, platinum chemotherapy has emerged as a potential chemotherapy with activity in triple negative breast cancer. However, it is not yet clear how to predict which triple negative breast cancer patients are more likely to respond to platinum chemotherapy. We set out to answer several questions.
- First, what is the response rate to platinum chemotherapy in the first or second line for metastatic triple negative breast cancer?
- Second, can we identify biomarkers to predict response to platinum agents? The results of our study showed that among 86 patients treated with platinum chemotherapy (either cisplatin or carboplatin), the response rate was about 25%. We identified 11 BRCA mutation carriers in our population and the response rate among carriers was about 55% compared to about 20% in the non-carriers. In addition, we found that a new assay called the Hologous Recombination Deficiency assay, which may identify tumors with a BRCA-like phenotype, seemed to predict which cancers were more likely to respond, whereas other biomarkers we looked at were not able to do so.
- Another exciting finding was that 6 patients who had major responses have become long term responders with no subsequent progression, some whom for over 5 years so far. Surprisingly, none of the long term responders are BRCA mutation carriers.
20 Apr Some Periodontal Bacteria May Be Cancer-Promoting
MedicalResearch.com Interview with:
Xiaodan Mai MBBS
University at Buffalo, The State University of New York
Buffalo, NY
MedicalResearch: What is the background for this study? What are the main findings?
Response: Periodontal disease is a condition that is highly prevalent amongst the elderly, and is characterized by chronic polymicrobial infection and inflammation of gum tissue. Periodontal disease has been associated with increased cancer risk, and these findings may be partially explained by extra-oral translocation of subgingival bacteria that subsequently modulates host cell environment and function. However, there is limited research on whether the presence of certain subgingival bacteria influences cancer risk. .
Oral bacteria have been categorized into color-coded complexes by their timing of colonization and strength of association with periodontal disease. Using data from an ancillary study of the Women’s Health Initiative conducted in Buffalo, New York (a cohort of 1300 postmenopausal women), we therefore investigated the associations between the presence of three early-colonizing periodontal pathogens (Fusobacterium nucleatum, Prevotella intermedia, and Campylobacter rectus, i.e., "orange complex" bacteria moderately associated with PD), the presence of two late-colonizing periodontal pathogens (Porphyromonas gingivalis, Tannerella forsythia, i.e., "red complex" bacteria strongly associated with PD) in dental plaque and cancer risk. We found borderline associations between presence of any early-colonizing pathogens and increased risk of total cancer and lung cancer. Individual pathogens were not associated with total cancer or site-specific cancers when analyzed singly. Presence of any pathogens or presence of any late-colonizing pathogens was not associated with total or site-specific cancer.
20 Apr Prolonging Duration Of Nightly Fast May Reduce Breast Cancer Risk
MedicalResearch.com Interview with:
Catherine Marinac
Doctoral Candidate
UC San Diego/San Diego State University
Joint-Doctoral Program in Public Health
La Jolla, CA 92093
MedicalResearch: What is the background for this study? What are the main findings?
Response: The dietary advice for cancer prevention usually focuses on limiting consumption of red meat, alcohol, and refined grains, and increasing consumption of plant foods. However, new evidence suggests that other fundamental aspects of diet, such when and how often people eat, can also play a role in cancer risk. For example, research in mice suggests that decreasing the number of hours we eat during the day, and increasing the length of time we fast overnight can improve metabolic parameters and reduce risk of developing a number of chronic diseases including cancer.
Similar to the data from animal models, we found that women who fasted for longer periods of time overnight had significantly better control over blood glucose concentrations – and these effects were independent of how much women ate. This finding is relevant to cancer research because people who have poor glucose control are significantly more likely to develop certain types of cancer. It is hypothesized that high concentrations of circulating glucose may fuel cancer growth and progression.
19 Apr ‘Chemobrain’: Cognitive Impairment May Be a Form Of Cancer-Related PTSD
MedicalResearch.com Interview with:
Dr. Kerstin Hermelink
Senior psychologist
Dept. of Gynecology and Obstetrics
Ludwig Maximilian University of Munich
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Hermelink: Many breast cancer patients report problems of cognitive functioning that interfere considerably with their professional and private lives. In the last two decades, a number of studies have confirmed that subgroups of breast cancer patients show at least subtle cognitive impairment. Initially, the condition has entirely been attributed to chemotherapy effects and has therefore colloquially been named “chemobrain”. Meanwhile, however, cognitive impairment has also been found in patients who were managed without chemotherapy and, surprisingly, even in patients who had not yet received any systemic treatment at all.
Several hypotheses on the causation of cognitive impairment that occurs already pretreatment have been put forward; for instance, biological effects of the cancer itself might affect cognitive functioning, or there might be shared genetic vulnerability for cancer and cognitive impairment. None of these hypotheses have been empirically confirmed; thus, pretreatment cognitive impairment is as yet unexplained.
Our study was designed to investigate the effects of cancer-related post-traumatic stress on cognitive function in breast cancer patients before the start of treatment. Stress has a substantial influence on cognitive functioning, and post-traumatic stress disorder (PTSD) is associated with impairment of cognitive function. While the incidence of full diagnosis of stress disorder is low among breast cancer patients, many of these patients show symptoms of PTSD, with a peak shortly after diagnosis.
We did not find an elevated risk of overall cognitive impairment in pretreatment breast cancer patients compared with matched non-cancer controls; however, the cancer patients scored worse than the controls on a small fraction of the cognitive indices that were used. Performance on these indices was indeed robustly associated with PTSD symptoms.
Our results therefore indicate that pretreatment cognitive impairment in breast cancer patients may be largely caused by the stress of being diagnosed with cancer.
18 Apr 5% of Patients Account For 47% VA Health Care Costs
MedicalResearch.com Interview with:
Donna Zulman MD MS
Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park
Division of General Medical Disciplines, Stanford University, Stanford California, USA
Medical Research: What is the background for this study?
Dr. Zulman: Within the United States, a small number of individuals account for disproporationate health care spending. Many of these high-cost patients have complex chronic conditions such as heart failure and diabetes. Others have complicated mental health conditions. But the vast majority have multiple chronic conditions, which can create challenges when patients are navigating their health care. For this study, we examined patterns of chronic conditions among high-cost patients in the Veterans Affairs (VA) Health Care System, and studied the relationship between different chronic conditions patterns and health care utilization and costs.
Medical Research: What are the main findings?
Dr. Zulman: We found that within the VA, the 5% highest cost patients accounted for 47% of total VA health care costs. Approximately two-thirds of these patients had chronic conditions affecting 3 or more body systems (for example, cardiovascular disease, asthma, and depression). However, patients with severe, dominating diseases such as cancer and schizophrenia were less likely to have a lot of comorbid conditions.
In addition, we found that even among these high-cost patients, having more conditions was associated with greater use of outpatient and inpatient services. However, as patients' multimorbidity across body systems increased, a greater share of their costs was generated in the outpatient setting and a smaller share of their costs was generated in the inpatient setting. This suggests that interventions focusing on high-cost patients should not only target costly hospitalizations, but should also coordinate and maximize efficiency of outpatient services across multiple conditions.
17 Apr Physical Activity Including Housework Linked To Better Physical and Emotional Aging
MedicalResearch.com Interview with:
Kathy Wright, PhD, RN, GCNS-BC, PMHCNS-BC
KL2 Postdoc, Clinical Instructor 2011-13 SAMHSA Scholar
2010-12 National Hartford Center of Gerontological Nursing Excellence
Patricia G. Archbold Scholar
Frances Payne Bolton School of Nursing
Case Western Reserve University Cleveland, Ohio
MedicalResearch: What is the background for this study?
Dr. Wright: This study was a secondary analysis of baseline data from the After Discharge Care Management of Low Income Frail Elderly (Agency for Healthcare Research and Quality grant #1 R01 HS014539-01A1). The participants were aged 65 and older enrolled during an acute care hospitalization. Each participant had at least one deficit in activities of daily living (e.g., bathing, dressing) or two deficits in instrumental activities of daily living (e.g., transportation, paying bills). The purpose of the study was to test House’s Conceptual Framework for Understanding Social Inequalities in Health and Aging in Medicare-Medicaid enrollees in a group of low-income older adults to determine the relationships between socio-demographic factors (i.e., race, education, age, gender, income, and neighborhood poverty), health behaviors, and physical function and emotional well-being. As a part of the health behavior component, participants were interviewed and asked questions regarding the amount of physical activity they engaged in during the week.
17 Apr CDC Discusses Best Practices and Resources For Childhood ADHD
MedicalResearch.com Interview with:
Susanna N. Visser, DrPH
Epidemiologist at the National Center on Birth Defects and Developmental Disabilities
CDC
Medical Research: What is the background for this study? What are the main findings?
Dr. Visser: Attention-Deficit/Hyperactivity Disorder, or ADHD is one of the most common chronic conditions of childhood. It often persists into adulthood. When children diagnosed with ADHD receive proper treatment, they have the best chance of thriving at home, doing well at school, and making and keeping friends.
In 2011, the American Academy of Pediatrics (AAP) updated their guidelines for ADHD treatment. The new guidelines give this advice to healthcare providers, psychologists, educators, and parents of children with ADHD:
- For preschoolers ages 4-5 with ADHD, use behavioral therapy before medication.
- For older children and teens with ADHD, use behavioral therapy along with medication.
- Less than 1 in 3 children with ADHD received both medication treatment and behavioral therapy, the preferred treatment approach for children ages 6 and older.
- Only half of preschoolers (4-5 years of age) with ADHD received behavioral therapy, which is now the recommended first-line treatment for this group.
- About half of preschoolers with ADHD were taking medication for ADHD, and about 1 in 4 were treated only with medication.
17 Apr Gas Cavity Produces That Sound When You Crack Your Joints
MedicalResearch.com Interview with: Gregory N. Kawchuk Ph.D. Department of Physical Therapy Faculty of Rehabilitation Medicine University of Alberta Edmonton, Alberta, Canada Medical Research: What is the background for this study? What are the main findings? Response: Jerome Fryer, one of our co-authors, had a new idea for why joints crack. So before delving into this, we went to...
17 Apr Relatively Small Drop In Price Leads To More Fruit and Vegetable Consumption
MedicalResearch.com Interview with: Professor Kylie Ball PhD Centre for Physical Activity and Nutrition Research, Deakin University, Australia. Medical Research: What is the background for this study? What are the main findings? Response: Most Australians (95% of adults) do not eat enough fruits or vegetables for good health. This is concerning as low fruit and vegetable intakes are linked with increased risk for a range of adverse health outcomes, including hypertension, coronary heart disease, stroke and certain cancers. One of the commonly cited barriers to fruit and vegetable consumption is the high cost of these foods. At Deakin University's Centre for Physical Activity and Nutrition Research (C-PAN), we undertook a randomised controlled trial study in a supermarket setting to test whether addressing this barrier would help people to consume more fruits and vegetables. We found that a fairly small price reduction (20%) was effective in prompting people to buy more fruits and vegetables – about 2-3 more serves of fruit per week, and about 3 more serves of vegetables per week. These findings are exciting, as even small increases in fruit and vegetable consumption across the population can substantially improve the health of Australians.16 Apr B vitamins and Omega-3 May Protect Against Brain Shrinkage
MedicalResearch.com Interview with:
Dr. Fredrik Jernerén PhD
Postdoctoral Research Fellow
Department of Pharmacology
University of Oxford
Oxford, United Kingdom
Medical Research: What is the background for this study? What are the main findings?
Dr. Jernerén: Development of dementia and Alzheimer’s disease is associated with an accelerated rate of brain shrinkage. Identifying ways to reduce the brain atrophy rate at an early stage may offer new strategies to prevent or delay the onset of dementia. In this study on elderly subjects diagnosed with Mild cognitive impairment (MCI), who are at increased risk of developing dementia, we investigated whether the effect of B vitamin supplementation on reducing the brain atrophy rate was influenced by circulating levels of omega-3 fatty acids. We have found that this indeed was the case. The higher the baseline concentration of the combined omega-3 fatty acids (DHA+EPA), the greater the protective effect of the B vitamin treatment. In subjects with high omega-3 concentrations who at the same time had elevated homocysteine levels (indicating a lack of B vitamins), B vitamin treatment reduced the brain atrophy rate by about 70% compared with the placebo group.
16 Apr Oxytocin Facilitates Mother-Baby Bonding
MedicalResearch.com Interview with:
Bianca Jones Marlin, PhD
Froemke Laboratory
New York University Langone School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Marlin: Oxytocin is a hormone that plays an important role in the expression of social and parental behaviors, but little is know about how it works in the brain to produce these behaviors. Virgin mice will usually ignore, and sometimes cannibalize newborn mouse pups. Our study has shown that oxytocin works in the auditory cortex of virgin mice to change both their neural responses, and eventually their behaviors, to mirror the maternal response.
16 Apr Triggers For Exercise-Related Sudden Cardiac Death Identified
MedicalResearch.com Interview with: Tomi Toukola Medical Research Center Oulu Oulu University Hospital and University of Oulu, Finland Medical Research: What is the background for this study? What are the main findings? Response: Previously, only few large-scale autopsy studies has been performed of exercise-related sudden cardiac death victims in the general population. FinGesture study project was established in 1998. All consecutive victims of autopsy-verified sudden cardiac death in our study area in northern Finland were included, so microscopic studies and histological examinations were performed alongside forensic autopsies in all cases. In Oulu area there were 328 (mean age, 62 years) cases of exercise-related sudden cardiac death between the years 1998 and early 2007. Male gender, ischemic heart disease and myocardial scarring were findings more commonly associated with exercise-related sudden cardiac death. Another interesting finding was that skiing, cycling and snow shoveling were frequent triggers of sudden cardiac death.16 Apr Acetaminophen May Reduce Both Pain and Emotional Response
MedicalResearch.com Interview with: Geoff Durso PhD Candidate Department of Psychology The Ohio State University Medical Research: What is the background for this study? What are the main findings? Response: Recent research has shown that acetaminophen blunts negative emotions beyond those arising from physical pain (e.g., social rejection). We hypothesized that this was the case because acetaminophen was having a broader effect on individuals' evaluative and emotional processing, given past psychological theory (e.g., differential susceptibility, personality differences in emotionality, etc) and related neurological evidence (acetaminophen affects serotonin neurotransmission in the brain, reduces inflammatory signaling in the brain, and decreases activation in the brain areas responsible for emotion, for instance--any one or combination of these effects could be responsible for the psychological outcomes that we observe on individuals' blunted negative and positive evaluations). So we conducted two double-blind studies (neither participants nor experiments were aware of participants' assignment to condition). What we found was that participants taking an acute dose of acetaminophen (compared to those taking an inert placebo control) reported diminished negative evaluations of displeasing stimuli (photographs of starving children, wartorn city blocks, disgusting toilets) as well as diminished positive evaluations of pleasing stimuli (photographs of children playing with kittens, a large pile of money, a couple in bed together). Participants taking acetaminophen also reported experiencing diminished emotional responses to the photographs overall. These findings supported our predictions that acetaminophen works to reduce pain in part because it has a broader blunting effect on individuals' evaluations and emotional experience.16 Apr Patients May Still Be Getting Unnecessary Pre-Cataract Surgery Testing
MedicalResearch.com Interview with:
Catherine L. Chen M.D., M.P.H.
UCSF Dept of Anesthesia
Medical Research: What is the background for this study? What are the main findings?
Dr. Chen: Cataract surgery is a very common and safe surgery that most older adults have in their 70's or 80's. It usually happens as a same-day surgery and most patients only need eye drops to numb the eye with little or no intravenous sedation for a procedure that on average is only 18 minutes long. Given their age, these patients typically have other concurrent medical problems, so even though multiple research studies and professional societies have concluded that routine preoperative testing is not necessary before cataract surgery, we found that this testing still frequently occurs in these patients. More than half of the patients in our study had at least one preoperative test performed in the month before their surgery.
We hypothesized prior to undertaking this study that the older and sicker patients were the ones who were most likely to get preoperative testing. Instead, what we found was that the most important factor that determined whether or not a patient got tested was the ophthalmologist who operated on the patient. This is an important finding because it shows that most patients are not getting extra testing, but the few that do are getting testing because that's the way their ophthalmologist typically prepares his patients for surgery. Most of the time, this testing is not needed and will not affect how well the patient does during and after surgery.
15 Apr Which Pancreatic Cysts Carry Malignant Potential?
MedicalResearch.com Interview with:
Michael B. Wallace, M.D., MPH
Mayo Clinic
Jacksonville, FL 32224
Medical Research: What is the background for this study?
Dr. Wallace: Since its first consideration as an independent entity in 1996,1 intraductal papillary mucinous neoplasms (IPMN) of the pancreas have been diagnosed with increasing frequency. Detection and resection of IPMN offer a unique opportunity to cure and prevent adenocarcinoma of the pancreas, an otherwise highly lethal disease. The main clinical concern related to intraductal papillary mucinous neoplasms is its wide-ranging potential for malignancy from low-risk indolent lesions to those with high incidence of malignant degeneration. It is well-established that this malignant progression varies based on the morphological subtypes. The current methods of predicting malignant potential are limited to clinical, morphological, and cyst fluid cytology and biomarker data.
Medical Research: What are the main findings?
Dr. Wallace: Of 1126 patients, 84 were diagnosed with invasive carcinoma/high-grade dysplasia and were compared to the rest of the cohort. Multivariate logistic analysis showed no statistically significant association between cancer/high-grade dysplasia and gender, age or alcohol consumption. Smoking history and body mass index was significantly related with cancer/ high-grade dysplasia. Jaundice and steatorrhea were also associated with cancer/ high-grade dysplasia; however, weight loss was not. Univariate analysis showed no association between malignancy and the cyst number/location, although a strong association was shown for cyst size. The presence/size of nodules, and main duct involvement were strongly related with malignancy.
15 Apr Cancer Treatments Can Trigger Insomnia
MedicalResearch.com Interview with:
Josée Savard, Ph.D.
School of Psychology, Laval University
Cancer Research Center
Quebec City, Quebec, Canada
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Savard: This paper reports on a secondary analysis of an 18-month longitudinal study initially conducted in 962 patients about to receive surgery for various types of cancer. The main results of this larger study indicated that insomnia is a significant problem in cancer patients. More precisely, it was found to affect up to 59% of patients at the peri-operative period. In addition, 32% of patients who were good sleepers developed insomnia symptoms at some point during the study (Savard et al., 2009; Savard et al., 2011).
The goal of this particular analysis was to determine the role of cancer treatments and their side effects in triggering/aggravating insomnia symptoms during the 18-month follow-up. Study participants completed questionnaires assessing insomnia severity and somatic symptoms at baseline, as well as 2, 6, 10, 14 and 18 months later. This analysis was conducted separately in women treated for breast cancer (n=465) and men treated for prostate cancer (n=263). In breast cancer patients, chemotherapy and radiation therapy, but not hormone therapy, were found to be associated with increased insomnia severity. This deleterious effect appeared to be due to a number of side effects (e.g., nausea, night sweats, urinary symptoms). In prostate cancer patients, androgen-deprivation therapy was associated with aggravation of insomnia, an effect that was mainly due to the occurrence of night sweats.
15 Apr Divorce Raises Risk of Heart Attack, Especially For Women
MedicalResearch.com Interview with:
Matthew E. Dupre, PhD
Associate Professor of Medicine
Department of Community and Family Medicine
Department of Sociology
Duke Clinical Research Institute
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Dupre: The negative health consequences of divorce have been known for some time. However, we showed that lifetime exposure to divorce can have a lasting impact on ones’ cardiovascular health, particularly in women. This is a good example of why people going through a divorce need a good divorce lawyer chicago in order to keep their stress levels down and help their cardiovascular health. Results from our study showed that risks for acute myocardial infarction (AMI) were significantly higher in women who had one divorce, two or more divorces, and among the remarried compared with continuously married women after adjusting for multiple risk factors. Risks for AMI were elevated only in men with a history of two or more divorces relative to continuously married men. We were especially surprised to find that women who remarried had risks for AMI that were nearly equivalent to that of divorced women. Men who remarried had no significant risk for acute myocardial infarction.
The results of this study provide strong evidence that cumulative exposure to divorce increases the risk of acute myocardial infarction in older adults. Also somewhat unexpected was that the associations remained largely unchanged after accounting for a variety socioeconomic, psychosocial, behavioral, and physiological factors. However, we lacked information on several factors that we suspect may have contributed to the risks related to divorce – such as elevated stress, anxiety, and the loss of social support; as well as possible changes is medication adherence or other prophylactic behaviors.
MedicalResearch: What should clinicians and patients take away from your report?