Author: Marie Benz MD FAAD
02 Jul Links Between Breast Cancer and Obesity Studied
MedicalResearch.com Interview with
Sai-Ching Jim Yeung, MD, PhD, FACP
Professor of Medicine
The University of Texas MD Anderson Cancer Center
Department of Emergency Medicine
Department of Endocrine Neoplasia & Hormonal Disorders
Houston, Texas 77230-1402
MedicalResearch: What are the main findings of the study?
Dr. Yeung: We believe that this study has bridged a significant gap in knowledge between epidemiological data (the association of obesity and poor breast cancer prognosis) and biological mechanisms mediating the impact of obesity on cancer. This study provides an important mechanistic insight into the causal relationship between obesity and breast cancer growth.
- Direct evidence for the links between obesity-associated changes in the biological processes and hallmarks of cancer in human estrogen receptor-positive (ER+) breast cancer.
- Experimental evidence that obesity causes accelerated oncogene-driven ER+ breast cancer carcinogenesis.
01 Jul Asymptomatic Atrial Fibrillation Relatively Common In Cryptogenic Stroke
MedicalResearch.com Interview with: Dr. Tommaso Sanna MD Institute of Cardiology Catholic University of the Sacred Heart Rome, Italy MedicalResearch: What are the main findings of the study? Dr. Sanna: In patients with cryptogenic stroke, continuous ECG monitoring with an implantable device, called the Reveal XT Insertable Cardiac Monitor (ICM), discovered Atrial Fibrillation in 6.4 times more patients than conventional diagnostic strategies at six months, 7.3 times more patients at 12 months, and 8.8 times more patients at 36 months. In more detail, after 36 months of follow-up, 30% of patients with cryptogenic stroke had at least one episode of atrial fibrillation.01 Jul Aspirin and Lifestyle Changes May Modulate Colon Cancer Risk
MedicalResearch.com Interview with:
Kaspar Truninger, MD, FMH
Gastroenterology and Internal Medicine
Langenthal, Switzerland
MedicalResearch: What are the main findings of the study?
Dr. Truninger: In our study, we investigated the effect of lifestyle exposure on DNA methylation. We measured genome-wide promoter CpG methylation in 1092 normal colon biopsies from 546 healthy females. We observed that fewer CpGs acquired age-dependent methylation in users of aspirin and hormonal replacement therapy compared with nonusers, whereas more CpGs were affected in smokers and individuals with a body mass index > 25 compared with nonsmokers and less obese females. Half of the CpGs showing age-dependent methylation gain were hypermethylated in tissue of colorectal cancer. These loci gained methylation with a higher rate and were particularly susceptible to lifestyle exposure compared to age-only methylated CpGs. In addition, these CpGs were enriched for polycomb regions. Finally, all effects were different according to the anatomic location along the colon.
01 Jul Women May Be More Comfortable Seeking Mental Health Support Than Men
MedicalResearch.com Interview with:
Dr. Flora I Matheson PhD
Centre for Research on Inner City Health
St. Michael's Hospital
Toronto, ON, Canada
MedicalResearch: What are the main findings of the study?
Dr. Matheson:
- We found that women were 10 per cent more likely to use mental health services than men.
- And that within any 3-year period, women with physical illness used medical services for mental health treatment 6 months earlier than men.
01 Jul Small Changes Improve Geographic Disparity in Kidney Transplantation
MedicalResearch.com Interview with
Daniela P Ladner, MD, MPH, FACS
Assistant Professor Transplant Surgery
Department of Surgery, Division of Organ Transplantation
Director Northwestern University Transplant Outcomes Research Collaborative (NUTORC)
Comprehensive Transplant Center
Feinberg School of Medicine, Northwestern University
MedicalResearch: What are the main findings of the study?
Dr. Ladner: With the current kidney organ allocation system, there exists significant geographic disparity between the 58 Donor Services Areas (DSAs) in the US, which are distributed among 11 regions. This means that depending on where a patient lives it might take shorter or longer to receive a kidney organ for transplantation. Despite efforts, this has not improved over the course of 20 years and in most regions this has worsened. In 1991 and 1992 respectively, two states changed their kidney allocation system, such that kidneys would first be allocated with the DSA of procurement, then statewide, then regionally (which may include several states) and then nationally. Usually kidneys don’t get allocated statewide before regionally.
The main finding of this study is that in those two states (FL, TN), where a minor change to the kidney allocation was put into place, there was significant reduction in the geographic disparity between their Donor Services Areas. In other comparable states (equal numbers of DSAs within the state) the geographic disparity did not improve and in many the geographic disparity worsened.
01 Jul Slowdown In US Health Care Costs Largely Due to Flat Physician Reimbursement, Use of Generic Drugs
MedicalResearch.com Interview with: M Luca Lorenzoni OECD Organisation for Economic Co-operation and Development Health Accounts, Asian Health and Social Policy Outreach ELS/Health Division MedicalResearch: What are the main findings of the study? Answer:- The United States is an outlier in the scenery of OECD as it ranks first for health care expenditure, but last for coverage.
- The slowdown in US health care spending during the past decade brought the growth rate closer to that of other high-spending countries -Canada, France, Germany, the Netherlands and Switzerland- at around 1%. Previously in 2002, the US's health expenditure growth was around 7%, much higher than the approximate 3% which was the average for the other countries examined in the study
- Higher health-sector prices (e.g., hospital care and prescription drugs) are thought to be the main driver of expenditure differences between the US and other high-spending countries, and recent price dynamics largely explain declines in health expenditure growth.
01 Jul Diabetes: Intensive Treatment May Cause More Quality-of-Life Loss than Gain
MedicalResearch.com Interview with:
Sandeep Vijan, MD, MS
Center for Clinical Management Research
Ann Arbor Veterans Affairs Hospital,
Department of Internal Medicine, University of Michigan,
Ann Arbor Michigan
MedicalResearch: What are the main findings of the study?
Dr. Vijan: The main finding was that the burdens and side effects of intensive glycemic treatment significantly detract from the overall benefit of lower risks of diabetes complications, often to the point where the treatments cause more loss than gain in quality of life. It takes many (often 15-20) years to gain benefit from treatment, but the burdens begin right away and continue throughout treatment. By the time you might experience treatment benefit in terms of reduced complication risk, you've had a lot of years to have the downsides of treatment - which commonly include significant weight gain, low blood sugars, gastrointestinal symptoms, not to mention having to take multiple pills or injections on a daily basis.
01 Jul Combat Factors Associated With Pain and Opioid Use Among Veterans
MedicalResearch.com Interview with:Dr. Robin L. Toblin LCDR Robin L. Toblin, PhD, MPH (USPHS) Clinical Research Psychologist Walter Reed Army Institute of Research MedicalResearch: What are the main findings of your study? Dr. Toblin: Our study focused on chronic pain and opioid use in an infantry brigade three months after returning from war. We surveyed...
01 Jul Oral HIV Prophylaxis May Also Provide Some Protection Against Herpes
MedicalResearch.com: Interview with
Connie Celum, MD, MPH
Professor of Global Health and Medicine
Director, International Clinical Research Center
University of Washington
Harborview Medical Center
Seattle WA 98104
MedicalResearch: What are the main findings of the study?
Dr. Celum: We conducted a randomized, double blind study of daily oral tenofovir and tenofovir combined with emtricitabine (FTC) as oral pre-exposure prophylaxis (PrEP) for HIV among HIV serodiscordant couples (in which onepartner had HIV and the other partner did not) in Kenya and Uganda. Because of recent studies showing that tenofovir gel could reduce the chances of becoming HSV-2 infected, we studied the subset of HIV-uninfected partners who did not have HSV-2 and compared the rates who became HSV-2 infected during follow-up among those who received oral pre-exposure prophylaxis versus those who received placebo. We found that oral pre-exposure prophylaxis reduced HSV-2 acquisition by 30%.
30 Jun Diabetes: Switching Off A Single Gene Allows GI Cells To Produce Insulin
MedicalResearch.com: Interview with
Dr. Domenico Accili MD
Professor of Medicine
Department of Medicine
Columbia University College of Physicians and Surgeons
New York, New York 10032
MedicalResearch: What are the main findings of the study?
Dr. Accili: By switching off a single gene (foxo1), scientists at Columbia University’s Naomi Berrie Diabetes Center have converted human gastrointestinal cells into insulin-producing cells, demonstrating in principle that a drug could retrain cells inside a person’s GI tract to produce insulin.
30 Jun Many Knee Replacement Surgeries Classified As Inappropriate
MedicalResearch.com Interview with:
Daniel L. Riddle, PT, Ph.D., F.A.P.T.A.
Otto D. Payton Professor
Assistant department chair
Department of Physical Therapy
Virginia Commonwealth University
MedicalResearch: What are the main findings of the study?
Dr. Riddle: We used a classification system developed by researchers in Spain in the late 1990s and found that classifications of appropriate, inappropriate and inclusive ratings for persons undergoing knee replacement surgery were 44.0%, 21.7%, and 34.3%, respectively. We studied 175 persons who underwent unilateral total knee replacement in the Osteoarthritis Initiative study, an NIH and privately funded multi-year cohort study of persons with are at high risk for knee osteoarthritis. These findings need to be considered cautiously because the classification system was developed more than 15 years ago and was designed to place greatest priority on persons with end stage knee osteoarthritis and severe pain and functional loss.
30 Jun Exchanging Medical Data Between Providers Leaves Room For Improvement
MedicalResearch.com Interview with
John D’Amore, President & CTO
Diameter Health
1005 Boylston St #304
Newton MA 02461
MedicalResearch: What are the main findings of the study?
Answer: We examined C-CDA (Consolidated Clinical Document Architecture) documents from electronic health records and other health information technology vendors. C-CDA documents are an XML format for transmitting patient data (e.g. problems, allergies, medications, results, vital signs, smoking status). Usage of C-CDA documents is required for Stage 2 of Meaningful Use in the United States. Overall, we were readily able to extract data elements from these documents, but we found many places where clinical content could be improved. This leads to policy recommendations on improving C-CDA production and consumption. Since thousands of hospitals and many more physicians will be required to exchange these documents in the coming year, we believe our findings to be important and timely for those seeking to improve care continuity and information exchange.
30 Jun Cardiac CT Associated With Enhanced Preventative Medical Care
MedicalResearch.com Interview with:
Eddie Hulten, MD MPH FACC FSCCT and
Ron Blankstein, MD FACC
Cardiovascular Imaging Noninvasive Cardiovascular Imaging
Walter Reed National Military Medical Center Brigham and Women’s Hospital
Bethesda, MD Boston, MA
MedicalResearch: What are the main findings of the study?
Answer: Although any medical test should be used to change management, the extent to which CCTA (Cardiac computed tomography angiography) findings are associated with medication changes (aspirin and lipid lowering) is not previously extensively studied.
Thus, we conducted the largest and one of the longest follow up studies of preventive cardiovascular medications before and after coronary computed tomography angiography (CCTA). We demonstrated that CCTA findings are associated with significant changes in preventive medications after CCTA.
29 Jun Maternal Anxiety Disorders Linked To Excessive Infant Crying
MedicalResearch.com Interview with:
Johanna Petzoldt
Institute of Clinical Psychology and Psychotherapy
Chemnitzer Straße
Dresden, Germany
MedicalResearch: What are the main findings of the study?
Answer: We investigated 286 mother-infant couples from the Maternal Anxiety in Relation to Infant Development (MARI) Study from Dresden (Germany) via standardized interview and questionnaire. We found a robust relation from maternal lifetime anxiety disorders as early as prior to pregnancy to excessive crying in the offspring. Also, the association increased when considering incident anxiety disorders during pregnancy and after delivery.
29 Jun Passive Exposure to Tobacco Linked to Increased Allergies in Children
MedicalResearch.com Interview with
Dr. Wojciech Feleszko
Department of Pediatric Respiratory Diseases and Allergy
The Medical University of Warsaw
Działdowska Warsaw, Poland
MedicalResearch: What are the main findings of the study?
Dr. Feleszko: We combined data from nineteen population-based cohort studies of 24 000 children and we found that household exposure to tobacco smoke after birth has immunomodulating effects. We demonstrated an increased sensitivity to allergens, measured by serum IgE and skin testing which may contribute to the increased development of allergy in children exposed postnatally to household tobacco smoke.
28 Jun Increasing Fruits & Vegetables In Diet May Not Lead To Weight Loss
MedicalResearch.com Interview with:
Kathryn A. Kaiser, Ph.D.
Department of Biostatistics
Ryals Public Health Bldg,
University of Alabama at Birmingham
Birmingham, AL 35294
MedicalResearch: What are the main findings of the study?
Dr. Kaiser: Recommendations to increase or home delivery of fruits and vegetables to increase intake results in no significant weight loss or gain in adults studied over 8-16 weeks.
27 Jun Diabetes: Gastric Bypass Surpassed Medical Management in Weight Loss and Metabolic Control
MedicalResearch.com Interview with:
Su Ann Ding, MBBS
Research Fellow
Joslin Diabetes Center
Boston, Massachusetts
MedicalResearch: What are the main findings of the study?
Answer: We conducted a randomized controlled trial comparing the effectiveness of Roux-en- Y gastric bypass with an intensive diabetes and weight management program. We recruited 38 obese individuals (BMI 30-42 kg/m2) with type 2 diabetes. Participants had suboptimal glucose control and mean diabetes duration of 10 years.
Both surgical and non-surgical interventions led to patients losing a clinically significant amount of weight and keeping it off for 2 years, with average loss of approximately 57 pounds (25% of initial body weight) for the surgery group and 13 pounds (6% of initial weight) for the lifestyle and medication modification group. Other important health goals also improved more in the surgical group, including improvements in blood sugar control, blood pressure and lipid levels which together may contribute to reducing risk of developing coronary heart disease.
27 Jun Pulmonary Arterial Hypertension Guidelines Discussed
MedicalResearch.com Interview with: James R. Klinger, MD, FCCP Professor of Medicine, Brown University Darren Taichman, MD, PhD, FCCP Adjunct Associate Professor of Medicine, University of Pennsylvania Greg Elliott, MD, MACP, FCCP Professor of Medicine, University of Utah School of Medicine Background: The authors discuss the June 17, 2014 CHEST publication: Pharmacological Therapy for Pulmonary Arterial Hypertension in Adults: CHEST Guideline MedicalResearch: How widespread is the problem of Pulmonary Arterial Hypertension (PAH)? Greg Elliott: PAH is an uncommon, but important disorder because untreated it is usually progressive and fatal, AND there are effective treatments. This makes the guidelines important for physicians, patients and insurers. MedicalResearch: What are the most common causes of PAH? Greg Elliott: Common causes are connective tissues diseases like scleroderma, toxins like methamphetamine and cases for which the cause is not known, i.e. idiopathic. Some (about 20 %) idiopathic cases are caused by gene mutations.27 Jun Kidney Cancer: Nervous System Protein May Provide New Therapeutic Target
MedicalResearch.com Interview with:
Dr. John A. Copland, PhD
Associate Professor of Biochemistry/Molecular Biology
Professor of Cancer Biology
Cancer Basic Science
Mayo Clinic, Jacksonville, Florida
MedicalResearch: What are the main findings of the study?
Dr. Copland: In our study we identified a pro-cancerous role for a novel protein- neuronal pentraxin 2 (NPTX2). This protein, normally found expressed in brain and nervous system tissues, is highly overexpressed in kidney tumors at all stages of disease. It has never previously been associated with kidney cancer, nor has it been associated with an oncogenic function in any other cancer. NPTX2 appears to play a significant role in not only tumor cell survival, but it also promotes tumor cell migration through activation of the ionotropic glutamate receptor 4 (GluR4). GluR4, also commonly associated with nervous system tissues, appears to be manipulating the flow of calcium into the tumor cell. Both NPTX2 and GluR4 are not components of normal kidney cell function. Because calcium is an important co-factor for many signaling pathways controlling cell growth, survival, and mobility, unconstrained calcium levels in a cell can promote malignancy. We show that calcium calmodulin kinase and AKT, two oncogenic signaling pathways are activated by NPTX2 via calcium influx.
27 Jun COPD: New BODE Index May Be Better Predictor of Mortality
MedicalResearch.com Interview with:
Dr. Juan P de Torres
Pulmonary Department
Clínica Universidad de Navarra
Pamplona, Spain;
MedicalResearch: What are the main findings of the study?
Dr. Torres: The BODE Index (BMI, Obstruction, Dyspnea, Exercise ) predicts mortality better than the GOLD ABCD (The Global Obstructive Lung Disease) grading and adding the COTE (Copd cO-morbidity TEst ) comorbidity Index to the BODE Index is complementary and provides an excellent predictive capacity for all-cause mortality in COPD patients.
27 Jun PCOS: Adding Anti-Inflammatory Drug Roflumilast to Metformin May Reduce Obesity
MedicalResearch.com Interview with: Mojca Jensterle Department of Endocrinology. Diabetes and Metabolic Diseases. University Medical Centre. Zaloska 7. Slovenia. MedicalResearch: What are the main findings of the study? Answer: This is the first report demonstrating that selective phosphodiesterase enzyme (PDE) 4 inhibitor roflumilast added to metformin (MET) was superior to metformin alone in reducing mean body weight after 12 weeks of treatment in obese women with polycystic ovary syndrome (PCOS), primarily due to a loss of fat mass. 31 women with PCOS diagnosed by the National Institute of Child Health and Human Development criteria aged 33.8 ± 7.4 years with BMI 36.4 ± 5.1 kg/m2concluded the study. They were randomized to MET 1000 mg BID or combined treatment (COM) with MET 1000 mg BID and roflumilast 500 mcg QD. The primary outcome were changes in anthropometric measures of obesity. At study endpoint subjects treated with COM lost on average 4.2 ± 2.8 kg compared to a 0.9± 2.5 kg weight gain in METgroup (p<0.001). BMI decreased for 1.6 ± 1.1 kg/m2 in COM arm compared to increase for 0.9 ± 2.4 kg/m2 in MET arm (p= 0.001). Total body fat decreased for 0.7±0.4 % in COM as opposed to 0.2 ± 0.1 % increase in MET and visceral adipose tissue (VAT) area as assessed by DXA decreased for 15.5 ± 1.6 cm2 in COM as opposed to 11.4 ± 5.3 cm2 increase in MET. The greater waist circumference reduction was noted in COM (4.2 ± 1 cm) compared with MET (0.8 ± 0.7 cm). The improvements of obesity measures were associated with beneficial effects on fasting glucose levels, insulin resistance and resolution of metabolic syndrome in affected women. The hypothesis behind the weight decrease and beneficial metabolic impact observed with roflumilast is based on the PDE4 regulation of signaling pathways linked to GLP-1 release. In experimental rodent model a single treatment with roflumilast enhanced plasma GLP-1 levels up to 2.5 -fold.27 Jun Neurosurgical Study Finds Long Term Disabled May Adapt To Severe Disability
MedicalResearch:com Interview with: Stephen Honeybul FDS RCS (Eng), FRCS (SN), FRACS Consultant Neurosurgeon Sir Charles Gairdner Hospital HOD Royal Perth Hospital Perth WA Australia MedicalResearch: What are the main findings of this study? Dr. Honeybul: Amongst those patients who had been adjudged severely disabled or in a vegetative state at 18 months, remained as such at the three years follow up. Most patients who were able to provide a response said that they would have provided consent to the "life saving" intervention even if they had known their final outcome26 Jun Adults with Asperger Syndrome May Experience Increase Risk of Suicidal Thoughts
MedicalResearch.com Interview with:
Dr Sarah Cassidy PhD
Autism Research Centre,Department of Psychiatry
University of Cambridge, Cambridge, UK
MedicalResearch.com: What are the main findings of the study?
Dr. Cassidy: We found that adults with late diagnosis of Asperger Syndrome (31 years on average), were at significantly higher risk of contemplating suicide during their lifetime (66%) than those from the general UK population (17%), and a sample of patients with Psychosis (59%).
We also found that adults diagnosed with Asperger Syndrome with a history of depression, were significantly more likely to experience suicidal thoughts, and suicide plans or attempts, than those with Asperger Syndrome without a history of depression. A higher level of autistic traits was also a significant risk factor for having planned or attempted suicide.
26 Jun Association of Surgery On Very Low Birth Weight Infants and Subsequent Neurodevelopmental Impairment
MedicalResearch.com Interview with:
Frank H. Morriss, Jr., MD, MPH
Professor of Pediatrics - Neonatology
University of Iowa Carver College of Medicine
MedicalResearch: What are the main findings of the study?
Dr. Morriss: Our aim was to assess the association between surgery performed during the initial hospitalization of very low- birth-weight infants and subsequent death or neurodevelopmental impairment at 18-22 months’ corrected age. We conducted a retrospective cohort analysis of patients who were prospectively enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998 to 2009. Surgery was classified by the expected anesthesia type as either major surgery that likely would have been performed under general anesthesia; or minor surgery, that is, procedures that could have been performed under non-general anesthesia and in general were shorter in duration. There were 2,186 major surgery patients and 784 minor surgery patients and more than 9,000 patients who did not undergo surgery.
We found that any surgical procedure increased the adjusted risk of death or neurodevelopmental impairment in low birth weight infants by about 30%. Not all surgical procedures were associated with increased risk, however. Compared with those who did not undergo surgery, patients who were classified as having major surgery had a risk-adjusted odds ratio of death or neurodevelopmental impairment of 1.52 (95% confidence interval 1.24-1.87). However, those who were classified as having minor surgery had no increased adjusted risk. Among survivors who had major surgery compared with those who did not undergo surgery the risk-adjusted odds ratio for neurodevelopmental impairment was 1.56 (95% confidence interval 1.26-1.93), and the risk-adjusted mean Bayley II Mental Developmental Index and mean Psychomotor Developmental Index values were significantly lower.
26 Jun PCOS Linked To Increased Risk of Diabetes
MedicalResearch.com Interview with: Dr Anju Joham PhD student, SPHPM Endocrinologist, Monash Health MedicalResearch: What is the background for your study? Dr. Joham: This research led by Professor Helena Teede and Dr Anju Joham, from the School of Public Health and Preventive Medicine at Monash University analysed a large-scale epidemiological study, called the Australian Longitudinal Study of Women’s Health (ALSWH). Polycystic Ovary Syndrome (PCOS) is a condition affecting nearly 20% of Australian women. Women with PCOS may experience irregular menstrual cycles, reduced fertility, increased risk of diabetes, high cholesterol and psychological features such as depression and reduced quality of life. MedicalResearch: What are the main findings of the study? Dr. Joham: Approximately 6000 women aged between 25-30 years were monitored for nine years, including nearly 500 women with diagnosed PCOS. Our research found that there is a clear link between PCOS and type 2 diabetes. The incidence and prevalence of type 2 diabetes was three to five times higher in women with PCOS. In analysing the key contributing factors to the increased diabetes risk, we found that having PCOS was in itself a key contributing factor.25 Jun Epilepsy: Readmissions Increased By Refractory Seizures and Psychiatric Comorbidities
Posted at 23:29h
in Author Interviews, Dartmouth, Hospital Readmissions, Neurological Disorders, Neurology
MedicalResearch.com Interview with:
Tracie A. Caller, MD , MPH
Neurophysiology Fellow
Dartmouth-Hitchcock Medical Center
1 Medical Center Dr., Lebanon NH 03756, USA
MedicalResearch: What are the main findings of the study?
Dr. Caller: We identified factors that appeared to increase the risk for a 30 day readmissions in the epilepsy population, which included refractory seizures but also coexistence of nonepileptic seizures and psychiatric comorbidities.
25 Jun Whooping Cough Can Still Cause Significant Cough Even In Fully Vaccinated Children
MedicalResearch.com: Interview with
Kay Wang
Academic Clinical Lecturer
Nuffield Department of Primary Care Health Sciences
University of Oxford, Oxford, UK
MedicalResearch: What are the main findings of the study?
Dr. Wang: We have found evidence of recent whooping cough infection in 1 in 5 school age children who see their doctor with a persistent cough and in 1 in 6 children who have been fully vaccinated against whooping cough. We have also shown that whooping cough can still cause clinically significant cough in fully vaccinated children.