Physical Activity Could Reduce Risk of Parkinson disease, esp. in Men

Posted on September 23, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Fudi Wang, M.D., Ph.D.
Qiushi Chair Professor
Nutrition Discovery Innovation Center
School of Public Health/School of Medicine
Zhejiang University
Hangzhou China

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Parkinson disease (PD) is the second most common neurodegenerative disease affecting approximately 10 million people around the world. To date, the cause of PD remains poorly understood. It is reported that 90% PD cases have no identifiable genetic cause. What’s worse, few therapeutic advances for the treatment of PD have been made in the past decades. Nevertheless, growing prospective longitudinal studies shed lights on the potential beneficial effect of lifestyle factors on reducing the risk of developing Parkinson disease. In this study, we performed a a dose-response meta-analysis of more than half a million participants.

We found that physical activity, particularly moderate to vigorous physical activity, could significantly reduce PD risk.

Continue reading →

Stress-Induced Cortisol During Pregnancy Linked to Smaller Male Babies

Posted on September 23, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Flom

Julie Flom, MD MPH
Clinical Fellow
Division of Allergy & Immunology
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study?

Response: Women who are minorities and of lower socioeconomic have particularly high rates of exposure to chronic ongoing adversity such as poverty as well as traumatic stressors in their lifetime and are also more likely to have low birthweight infants. Not all women exposed to chronic adversity or trauma transfer this risk to the next generation – it is primarily when the trauma results in changes in her bodies’ ability to handle ongoing stress that the developing child can be impacted.

Our group undertook a study to investigate whether women with increased exposure to traumatic stressors over her lifetime were at higher risk of having low birthweight infants and also whether effects of trauma would only be evident among women who produced higher levels of cortisol, the major stress response hormone, while pregnant.

Continue reading →

Folate Metabolites Linked To Increased Risk of Autism Spectrum Disorder

Posted on September 22, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Prof., Hahn

Juergen Hahn PhD, Professor and
Department Head Department of Biomedical Engineerin
Department of Chemical & Biological Engineering Center for Biotechnology and Interdisciplinary Studies
Rensselaer Polytechnic Institute

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Recent estimates indicate that if a mother has previously had a child with autism spectrum disorder, the risk of having a second child with ASD is ~18.7% whereas the risk of ASD in the general population is ~1.7%.

This work investigated if there is a difference in metabolites of the folate one carbon metabolism and the transulfuration pathway between the mothers that have had a child with ASD and those that have not. Furthermore, we investigated if there is a difference among the mothers who have had a child with autism spectrum disorder based upon if the child that they were pregnant with will have an ASD diagnosis by age 3. This part required follow up with the mothers three years later.

The main findings are that there are statistically significant differences in the metabolites between the mothers who have previously had a child with autism spectrum disorder, who have an 18.7% probability of having another child with ASD, and those who have not, who have an 1.7% probability of having a child with autism spectrum disorder.

However, we did not find differences among the mothers based upon if the child will be diagnosed with ASD at age 3.

MedicalResearch.com: What should readers take away from your report?

Response: Based upon the measurements it is not possible to determine during a pregnancy if a child will be diagnosed with ASD by age 3. However, differences in the folate-dependent transmethylation and transsulfuration metabolites are indicative of the risk level (High Risk of 18.7% vs. Low Risk of 1.7%) of the mother for having a child with autism spectrum disorder.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: This study has not been replicated and we also had to make a number of assumptions which are listed in the paper. These points should be looked at in future research. My recommendation would be to replicate the comparison between mothers who have had a child with .autism spectrum disorder and those who have not and focus on recruiting an approximately equal number of mothers for each group and try to match the two groups by age and ethnicity.

Citation:

Maternal metabolic profile predicts high or low risk of an autism pregnancy outcome

KathrynHollowood^abStepanMelnyk^cOleksandraPavliv^cTeresaEvans^cAshleySides^dRebecca J.Schmidt^eIrvaHertz-Picciotto^eWilliamElms^eElizabethGuerrero^eUweKruger^aJuergenHahn^abfS. JillJames^cResearch in Autism Spectrum Disorders

Volume 56, December 2018, Pages 72-82

Sep 22, 2018 @ 3:18 pm

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Most Patients Who Carry BRCA1/2 Pathogenic Variants Are Unaware

Posted on September 22, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Murray

Michael F. Murray, MD, FACMG, FACP
Director for Clinical Operations in the Center for Genomic Health
Yale School of Medicine

MedicalResearch.com: What is the background for this study?

Response: Population screening for the cancer risk associated with the BRCA1 and BRCA2 genes has been suggested by some. We screened a cohort of about 50,000 adult patient volunteers at Geisinger Health System in Pennsylvania for this risk. Continue reading →

Mothers of Infants Born With Major Birth Defect are at Increased Risk of Cardiovasular Disease

Posted on September 22, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Cohen

Eyal Cohen, MD, MSc, FRCP(C)
Associate Scientist and Program Head (interim), Child Health Evaluative Sciences
Research Institute, The Hospital for Sick Children
Staff Physician, Division of Paediatric Medicine, The Hospital for Sick Children
Professor, Paediatrics and Health Policy
Management & Evaluation
The University of Toronto

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Having a child with a major birth defect can be a life-changing and stressful event for the child’s mother. This stress may be associated with higher risk of premature cardiovascular disease.

We found that mothers of infants born with a major birth defect had a 15% higher risk of premature cardiovascular disease that a comparison group of mothers. The risk was more pronounced, rising to 37% among mothers who gave birth to a more severely affected infant (and infant born with major birth defects affecting more than one organ system). The risk was apparent even within the first 10 years after the birth of the child.

Continue reading →

High-Risk Gleason 5 Prostate Cancers Not Resistant to Androgen Deprivation Therapy

Posted on September 22, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Kishan

Amar U. Kishan, MD
Assistant Professor
Department of Radiation Oncology
University of California, Los Angeles

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Three large randomized trials demonstrated an overall survival (OS) benefit when androgen deprivation therapy (ADT) is combined with radiotherapy (RT) for high-risk prostate cancer (PCa). The duration of ADT in these seminal studies ranged from six months to lifelong. Because ADT has multiple attendant adverse effects–including bone loss, altered metabolism, diminished muscle mass, gynecomastia, hot flashes, and possibly increased cardiovascular events–shortening the duration of ADT without compromising oncologic effectiveness has been an area of active study. Five trials have compared various durations of ADT, reaching conflicting conclusions with respect to overall survival outcomes, with some suggesting an improvement with longer durations of ADT and others failing to show a uniform survival benefit.

Most of these trials have amalgamated Gleason grade group 4 (Gleason score 8) PCa with Gleason grade group (GG) 5 (Gleason score 9-10) PCa. Emerging data indicate that GS 9-10 PCa constitutes a distinct subset of high-risk PCa with inferior outcomes and earlier progression than GS 8 disease. With the knowledge that GS 9-10 PCas constitute a distinct, more aggressive form of PCa, one might hypothesize that longer durations of ADT may be more advantageous in both augmenting local control and controlling potential micrometastatic disease. Alternatively, as GS 9-10 lesions by definition contain highly de-differentiated Gleason pattern 5 disease foci and may proceed to a castrate-resistant state more rapidly, one may also hypothesize that GS 9-10 lesions are less responsive to ADT, and longer durations may be counter-productive.

In order to identify differences in the impact of ADT duration on clinical outcomes of patients with GG 4 and GG 5 PCa, we performed an individual patient-level meta-analysis of six randomized trials. Our working hypothesis was that longer durations of ADT would offer significant survival benefits in both groups.

Continue reading →

CDC: Homicide Rates At Least 10 Times Higher For Young Adult Blacks Than Whites

Posted on September 21, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Sheats

Dr. Kameron Sheats PhD
Licensed Psychologist; Behavioral Scientist
Centers for Disease Control and Prevention

MedicalResearch.com: What is the background for this study?

Response: This study updates literature on racial disparities in violence between black and white youth using data capturing different severity levels in violent outcomes such as homicide versus assault. This study also seeks to increase the understanding of the impact of these disparities by examining associations between disparities in childhood adversity (e.g., child abuse and neglect, exposure to violence, household challenges) and adult health conditions.

Continue reading →

Medicare Spends Hundreds of Millions Annually to Treat Precancerous Skin Lesions

Posted on September 21, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Howa Yeung, MD
Assistant Professor of Dermatology
Emory University School of Medicine
Atlanta, GA 30322

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by actinic keratoses?

Response: Actinic keratoses are common precancerous skin lesions caused by sun exposure. Because actinic keratoses may develop into skin cancers such as squamous cell carcinoma and basal cell carcinoma, they are often treated by various destructive methods. We used Medicare Part B billing claims to estimate the number and cost of treated actinic keratoses from 2007 to 2015.

MedicalResearch.com: What are the main findings?

Response: While the number of Medicare Part B beneficiaries increased only moderately, the number of actinic keratoses treated by destruction rose from 29.7 million in 2007 to 35.6 million in 2015. Medicare paid an average annual amount of $413.1 million for actinic keratosis destruction from 2007 to 2015. Independently billing non-physician clinicians, including advanced practice registered nurses and physician assistants, are treating an increasing proportion of actinic keratosis, peaking at 13.5% in 2015.

MedicalResearch.com: What should readers take away from your report?

Response: Readers should understand that the burden of actinic keratosis treatment is increasing in the Medicare population. There is also an increasing proportion of actinic keratoses being treated by advanced practice registered nurses and physician assistants. Continue reading →

Factor in Quality of Life When Deciding Radiotherapy vs Surgery in Patients With Oropharyngeal Cancer

Posted on September 21, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Sher

Dr. David Sher MD MPH
Radiation Oncology,
Harold C. Simmons Comprehensive Cancer Center
UTSouthwestern Medical Center
Associate Senior Editor International Journal of Radiation Oncology

MedicalResearch.com: What is the background for this study?

Response: The prevalence of oropharyngeal cancer is rising rapidly, and the two primary therapeutic approaches – upfront radiation therapy or surgery resection – have both been improving in terms of acute and late toxicity profiles. There is significant debate as to which therapy is better, and comparative data are necessary to help physicians and patients decide which paradigm is preferred for a given clinical scenario. Although there is a lot of anecdotal experience in comparing the two treatments, there really is a lack of published data on the question, and this is where our study fits in.

MedicalResearch.com: What is the background for this study? Were there significant quality-of-life differences between the two treatment modalities?

Response: The main findings were comparable outcomes in long-term survival, toxicity and even cost between primary radiation therapy and primary surgery. This equivalence highlights the importance of patient-centered decision-making and engaging patient preferences in their optimal treatment approach. There was clearly an increase in stomach tube use in patients receiving primary chemoradiotherapy, which may be an important consideration in some patients, depending on the expected functional outcome of initial surgery. This difference became non-significant after a short period of time, but it was real and may influence decision-making.

MedicalResearch.com: What should readers take away from your report?

Response: Readers should take away that there are no particularly large differences between these treatments. Survival, toxicity and cost are all comparable in the long-run. It was quite clear, though, that primary surgery was associated with a lower risk of gastrostomy tube use. Although the difference in tube use was negligible within a few months, the use of any feeding tube may be a deciding factor for some patients. We showed here this difference was due to concurrent chemotherapy during radiotherapy. This result echoes our clinical experience, but we were able to show this finding quite clearly. On the other hand, we also found that the increased dependence with radiation therapy was clearly short-lived, so patients should absolutely not consider this difference as a long-term problem preferentially associated with radiotherapy.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: It is critical for future research to consider the functional and quality-of-life outcomes in future comparisons of these different treatment approaches. Claims-based analyses such as this can uniquely show the “big picture” with respect to complications that require a medical treatment. However, more granular and subtle patient-reported outcomes are not included in this study, and they will be essential to help patients and physicians in the decision-making process.

The study was funded by the Radiation Oncology Institute.

Citation:

Sher DJ, Agiro A, Zhou S, Day AT, DeVries A. Commercial Claims–Based Comparison of Survival and Toxic Effects of Definitive Radiotherapy vs Primary Surgery in Patients With Oropharyngeal Squamous Cell Carcinoma. JAMA Otolaryngol Head Neck Surg. Published online September 20, 2018. doi:10.1001/jamaoto.2018.1929

Sep 21, 2018 @ 3:05 pm

Could a Low-Gluten Diet During Pregnancy Protect Offspring from Diabetes?

Posted on September 21, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Knud Josefsen, senior researcher
Bartholin Institute, Rigshospitalet,
Copenhagen K, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In a large population of pregnant women, we found that the risk of the offspring being diagnosed with type 1 diabetes before the age of 15.6 years (the follow up period) was doubled in the group of women ingesting the highest amounts of gluten (20-66 g/day) versus the group of women ingesting the lowest amounts of gluten (0-7 g/day). For every additional 10 grams of gluten ingested, the risk for type 1 diabetes in the child increased by a factor of 1.31.

It the sense that it was a hypothesis that we specifically tested, we were not surprised. We had seen in animal experiments that a gluten-free diet during pregnancy protected the offspring from diabetes, and we wanted to see if we could prove the same pattern in humans. There could be many reasons why we would not be able to show the association, even if it was there (sample size, low quality data, covariates we could not correct for and so on), but we were off course pleasantly surprised that we found the association that we were looking for, in particular because it is quite robust Continue reading →

Could Household Cleaners Be Making Children Overweight?

Posted on September 20, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Kozyrskyj

Anita Kozyrskyj PhD
Professor in Pediatrics
Faculty of Medicine & Dentistry
School of Public Health
University of Alberta

MedicalResearch.com: What is the background for this study?

Response: Data for this study were collected in the Canadian Healthy Infant Longitudinal Development (CHILD) cohort of over 3,500 full-term infants born between 2009 and 2012. When infants were 3-4 months of age, parents provided a sample of their poop. At that time, parents checked-off responses to questions about their home, including type and frequency of cleaning product use. The infant poop was initially frozen, then thawed later to extract DNA from the sample and identify microbes on the basis of their DNA sequence. Continue reading →

Lowering Triglycerides and Cholesterol Could Reduce Heart Disease and Diabetes Risk

Posted on September 20, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Lotta

Luca A. Lotta, MD, PhD
Senior Clinical Investigator
MRC Epidemiology Unit
University of Cambridge

MedicalResearch.com: What is the background for this study? What are the main findings?

Drugs that enhance the breakdown of circulating triglycerides by activating lipoprotein lipase (LPL) are in pre-clinical or early-clinical development.
It is not known if these drugs will reduce heart attacks or diabetes risk when added to the current first line therapies (statins and other cholesterol-lowering agents).
Studying this would require large randomised controlled trials, which are expensive (millions of GBPs) and time-consuming (years).
Human genetic data can be used to provide supportive evidence of whether this therapy is likely to be effective by “simulating” a randomised controlled trial.
Our study used naturally occurring genetic variants in the general population (study of ~400,000 people) to address this.
Individuals with naturally-lower cholesterol due to their genetic makeup were used as model for cholesterol-lowering therapies (eg. Statins).
Individuals with naturally-lower triglycerides due to genetic variants in the LPL gene were used as model for these new triglyceride-lowering therapies.
We studied the risk of heart attacks and type 2 diabetes in people in different groups.

Continue reading →

Asthma: Add-on Maintenance Treatment with FASENRA (benralizumab) Can Reduce Exacerbations

Posted on September 20, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Tosh Butt

Tosh Butt, MBA
VP Respiratory
AstraZeneca

MedicalResearch.com: What is the background for this study? How is benralizumab different from more traditional treatments for asthma?

- BORA is a randomized, double-blind, parallel-group, Phase III extension, and is one of six Phase III trials in the WINDWARD program in asthma. The current analysis includes results for 1,926 patients from the two placebo controlled exacerbation trials, SIROCCO (48 week) and CALIMA (56 weeks). BORA provides evidence that add on maintenance treatment with FASENRA (benralizumab) resulted in a consistent safety profile over a second year of treatment, with no increase in the frequencies of overall or serious adverse events, and sustained efficacy in terms of reducing asthma exacerbations, and improving lung function and asthma symptoms. The BORA trial results could provide confidence to patients with severe eosinophilic asthma and physicians that the positive outcomes they may be seeing with benralizumab can be maintained over a second year of treatment.
FASENRA, a different kind of respiratory biologic, has a strong clinical profile which includes the ability to show lung function improvement after the first dose, the potential to reduce – or even stop – oral steroid use, and the convenience of 8-week dosing (no other respiratory biologic offers this dosing). FASENRA is approved for add-on maintenance treatment of patients with severe asthma ages 12 years and older, and with an eosinophilic phenotype. FASENRA binds directly to the IL-5a receptor on an eosinophil and uniquely attracts natural killer cells to induce apoptosis, or cell death. Other biologics currently available are anti-IL5s – a passive approach that primarily acts to block differentiation and survival of the eosinophil.

Continue reading →

Women Who Breast Feed Longer Likely to Have More Children

Posted on September 20, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Maralani

Vida Maralani PhD
Associate Professor
Department of Sociology
Cornell University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Breastfeeding is a time-intensive and culturally and emotionally charged topic in the U.S. with many different stakeholders. Women hear the strong message that they should breastfeed their infants for the first year of life, yet it is unambiguously clear that they find these guidelines hard to follow in practice. We were interested in exploring how breastfeeding duration is associated with how many children women go on to have. Our results show that women who breastfeed their first child for five months or longer are more likely to have three or more children, and less likely to have only one child, than women who breastfeed for shorter durations or not at all. Women who initiate breastfeeding did not differ in how many children they expected to have before they started their families. Rather, the number of children women actually bear differs by how long they breastfeed their first child. Women who breastfeed for shorter durations are more likely to have fewer children than they expected than to have more children than expected. In contrast, women who breastfeed longer are as likely to achieve their expectations as to exceed them, and they are nearly as likely to have more children than they expected as they are to have fewer.

Continue reading →

Amyloid Targeting Therapy More Likely To Be Effective Early in Alzheimer’s Disease

Posted on September 20, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Elliott

Dr Christina Elliott PhD
Postdoctoral Researcher
Department of Old Age Psychiatry
King’s College London

MedicalResearch.com: What is the background for this study?

Response: Amyloid-beta (Aβ) and its precursor protein, APP have been long implicated in pathogenesis of Alzheimer’s Disease but how they contribute to disease is not fully understood. This has been further compounded by numerous failed clinical trials which attempted to target Aβ therapeutically.

In Alzheimer’s Disease there is an overproduction of Aβ, which can disrupt how neurons communicate at structures called synapses. It is thought that progressive synapse loss underpins cognitive impairments commonly seen in Alzheimer Disease patients such as memory loss.

Our previous work highlighted a central role of the signalling pathway Wnt signalling in Aβ mediated synapse loss through the induction of dickkopf-1 (Dkk1), a well-known modulator of Wnt signalling.

The aim of this study was to further investigate the molecular mechanisms of Aβ mediated synapse loss and explore whether this is connected to the overproduction of Aβ. By dissecting out the key signalling events involved we hoped this would allow us to identify drugs which could be putative therapeutics for Alzheimer’ Disease. Continue reading →

Cannabinoid Drugs May Slightly Increase Pain Threshold

Posted on September 20, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Martin De Vita, MS
Doctoral Candidate
Clinical Psychology Department
Syracuse University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Despite widely held beliefs that cannabis is effective for pain relief, experimental trials have produced mixed results. As result, the analgesic properties of cannabinoid drugs have remained poorly understood. We aimed to clarify these findings by extracting data from every available experimental pain study and analyzing the results as a whole. We found that numerous aspects of pain were being influenced in different ways. We found that cannabinoid drugs did not significantly reduce the intensity of experimental pain, but they did produce small-sized reductions in pain unpleasantness. Cannabinoids produced significant analgesic effects on pain threshold and tolerance. There was no significant effect of cannabinoids on mechanical hyperalgesia. Continue reading →

USPSTF: Behavior-Based Weight Loss Interventions Associated with Weight Loss and Lower Risk of Diabetes

Posted on September 20, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Doubeni

Chyke Doubeni, M.D., M.P.H.
Harrison McCrea Dickson, M.D. and Clifford C. Baker, M.D. Presidential Professor
Associate Professor of Epidemiology
Senior scholar, Center for Clinical Epidemiology and Biostatistics
University of Pennsylvania School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Obesity is an important public health issue that affects nearly 4 in 10 American adults. It increases the risk for many chronic health conditions as well as premature death from diabetes, coronary heart disease, various types of cancer, and other conditions. As such, it was important for the U.S. Preventive Services Task Force to review the current evidence and update the recommendation on this topic.

Based on a review of the most recent studies, we found that intensive, multicomponent behavioral interventions are safe and effective. They can help people lose weight, maintain their weight loss, and reduce the risk of obesity-related conditions such as diabetes in people with high blood sugar. Therefore, the Task Force is recommending that clinicians offer or refer adults with a body mass index, or BMI, of 30 kg/m2 or higher to these behavioral interventions. Continue reading →

Mediterranean Diet Linked To Stroke Risk Reduction in Women

Posted on September 20, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Professor Phyo Kyaw Myint MBBS MD FRCP(Edin) FRCP(Lond)
Clinical Chair in Medicine of Old Age
Academic Lead: Ageing Clinical & Experimental Research &
Director of Clinical Academic Training Development
The Lead Academic, Aberdeen Clinical Academic Training (ACAT) Programmes
School of Medicine, Medical Sciences & Nutrition
College of Life Sciences & Medicine, University of Aberdeen

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: While Mediterranean Diet has been linked to reduced stroke risk it remains unclear
(1) its impact on populations within non-Mediterranean countries;
(2) its specific impact on different gender;
(3) the effect observed when using more robust dietary assessments; and (4) which specific components of the diet are most protective.

We therefore studied more than 23 thousand men and women (mainly British Caucasian) aged 40 years or older in Norfolk, UK as part of EPIC-Norfolk study and we found that the greater adherence to Mediterranean dietary pattern is linked to a significant reduction in stroke risk in women but not in men. This benefit was seen across the whole middle and older age population (particularly for women) regardless of their existing risk factors such as high blood pressure.

Continue reading →

Using Tau PET Scan to Distinguish Alzheimer Disease from Other Neurodegenerative Disorders

Posted on September 20, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Rik Ossenkoppele –PhD
Lund University & VU University Medical Center
Oskar Hansson – Lund University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: [¹⁸F]flortaucipir is a relatively novel PET tracer that can be used to detect tau pathology in the living human brain. Previous studies have shown a robust signal in patients with Alzheimer’s disease, but in patients with other types of dementia the signal was more variable.

We aimed to assess the ability of [¹⁸F]flortaucipir PET to distinguish Alzheimer’s disease from other neurodegenerative disease in more than 700 study participants. T

he main finding was that [¹⁸F]flortaucipir discriminated Alzheimer’s disease patients from patients with other neurodegenerative diseases with high accuracy. Furthermore, [¹⁸F]flortaucipir PET outperformed established MRI markers and showed higher specificity than amyloid-β PET. Continue reading →

Babies Born During Peak Pollen Season Have IgE in Cord Blood

Posted on September 20, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Bircan Erbas, Associate Professor
Reader/Associate Professor, Department of Public Health
School of Psychology & Public Health
La Trobe University

MedicalResearch.com: What is the background for this study?

Response: Around the world allergic respiratory diseases especially in children is a major problem. Studies have already shown that cord blood IgE can be used to identify children at risk for allergic diseases. Our previous research showed that exposure to high levels of outdoor pollen, especially grass, in the first couple of months after birth increased risk of allergic respiratory diseases. Based on this, we suspected that exposure to high grass pollen during pregnancy could be also important. Continue reading →

Mouth Microbiome Linked to Childhood Obesity

Posted on September 19, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Carnahan Craig

Dr. Sarah J.Carnahan Craig PhD
Postdoctoral Scholar
Makova Lab
Biology Department
Center for Medical Genomics
Penn State University

MedicalResearch.com: What is the background for this study?

Response: This study stems from a long standing collaboration with pediatrician, Ian Paul at Penn State Hershey Medical School (and a co-author on this paper). Ian is very interested in understanding and preventing childhood obesity. It also is part of a much larger, collaborative study objective, lead by Ian and Leann Birch (another co-author), to understand social/behavioral contributors to childhood obesity, how a responsive parenting intervention can prevent childhood overweight/obesity, and the biological factors that contribute to the disease. This is an important research area as childhood obesity is a public health problem — one in three children are overweight or obese. A fuller understanding of factors that contribute to childhood obesity, how to identify children who are at risk for developing childhood obesity, and methods to prevent childhood obesity are of critical importance.

MedicalResearch.com: What are the main findings?

Response: The main finding from this paper is that the oral microbiota (the collection of bacteria that live in the mouth) are significantly related to young child growth patterns. The surprising part of this finding was that we observed this result with the oral microbiota and not the gut microbiota. The oral microbiota (in comparison to the gut microbiota, which has been associated with obesity in many previous studies) are largely understudied, especially in young children. The gut microbiome we found to be strongly influenced by diet; when the two are considered together, there is a significant relationship with child growth patterns.

Additionally, our team developed novel statistical methods to use child growth curves as a more comprehensive outcome rather than an outcome of weight at a single time point (i.e. it uses more of the information about how a child is growing). These methods allow us to better detect the relationship between child growth and the microbiota; they increase our power.

MedicalResearch.com: What should readers take away from your report?

Response: Readers should take away that there are many factors that contribute to obesity and obesity prevention – along with a healthy diet and exercise, biological factors, such as the microbiota for instance, could potentially be an important consideration. Additionally, we’re in the early stages of truly understanding how these microbes influence health. Importantly, we are unable to make any kind of causal conclusions – meaning we don’t know if the microbes are influencing the growth patterns, is health/environment influencing the microbes, or is it both directions.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: One of the limitations of this study is that it looks at the microbiota at a single time point, at two years after birth – this is a dynamic community, so we are really only seeing a snapshot of what is happening. Additionally, the study is retrospective in that the microbiota is sampled at two years and the growth trajectory is made of measurements from birth through two years. Because of this, we might be missing important dynamics happening earlier in life. A more comprehensive study would be to sample the microbiota at all the time points you are sampling growth, health, and other information — this is a study we are currently doing. We hope that by building on this study and examining the microbiota (both oral and gut) longitudinally and in concert with the social, environmental, and health data that we will be closer to a fuller understanding, which could potentially identify children who are most at risk of developing childhood obesity and be prime candidates for obesity intervention programs.

Citation:

Sarah J. C. Craig, Daniel Blankenberg, Alice Carla Luisa Parodi, Ian M. Paul, Leann L. Birch, Jennifer S. Savage, Michele E. Marini, Jennifer L. Stokes, Anton Nekrutenko, Matthew Reimherr, Francesca Chiaromonte, Kateryna D. Makova. Child Weight Gain Trajectories Linked To Oral Microbiota Composition. Scientific Reports, 2018; 8 (1) DOI: 10.1038/s41598-018-31866-9

Sep 19, 2018 @ 9:27 pm

Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health

Posted on September 19, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
John W. Stanifer, MD MSc
Duke Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The key take home for me is that Perfluorinated Chemicals (PFAS) are a globally ubiquitous pollutant with high human exposure and concerning chemical properties that appear to be capable of kidney kidney disease through several plausible different mechanisms; yet, we know almost nothing about long term kidney health outcomes, who is at greatest risk for adverse outcomes, or which communities may be most negatively impacted.

The original impetus for the study was the discovery of GenX in the drinking water of Wilmington NC, a pollutant from a company upstream (see: https://www.newsobserver.com/news/politics-government/state-politics/article199846619.html ). It has been a huge story in NC and every day more and more is being discovered about how pervasive the pollution has become (https://www.usnews.com/news/best-states/north-carolina/articles/2017-12-05/genx-compound-now-detected-in-food-product-in-n-carolina). While this was what caught my attention, as a North Carolinian, I quickly realized that these news stories are all over the place as any quick google search will reveal towns and communities contaminated with these from truly all of the United States. As a health disparities researcher in kidney disease,

I have been studying disparate rural populations in North Carolina, including American Indians, who live in communities with exceptionally high rates of kidney disease, which does not appear to be fully explained by “traditional” risk factors alone such as diabetes, hypertension, obesity, etc. So with that context in mind, I really have begun to focus on these chemicals as potential second-hits or augmenters of kidney disease; we have been doing preliminary studies, in which we have found them in the serum of individuals from these areas, but before we can go further, we really needed to understand what all is known about them and the plausibility that they could cause kidney disease. Therefore, we conducted this comprehensive study to characterize what the potential mechanisms between these chemicals and kidney disease are and where the biggest gaps are.

MedicalResearch.com: Were you surprised by any of the findings?

Response: I was actually surprised by a few things about it. I thought that the link between these chemicals and kidney disease would be pretty weak, with very little to suggest these could be primary drivers of kidney disease. And while the epidemiological studies provided conflicting evidence that mostly but not overwhelmingly pointed toward an association, the toxicology and pharmacokinetic studies demonstrated several key mechanisms that could explain how these chemicals cause kidney disease, including oxidative stress pathways, peroxisome proliferators-activated receptor pathways, NF-E2– related factor 2 pathways, partial epithelial mesenchymal transition, and enhanced endothelial permeability through actin filament modeling.

It was also very interesting to learn that these compounds are taken up by the very same proximal tubule transporters that several known nephrotoxic drugs are taken up, including most notably the herb Aristocholic Acid which was of course responsible for the Balken Endemic Nephropathy that perplexed everyone for so long.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Many gaps still exist. The biggest ones to me are that there are literally 1000s of these compounds, with only slight chemical variations, which make detection and regulation challenging. In fact most are still under proprietary aegis which prevents any type of study on them, and several of the “alternative” or “newer” PFCs (e.g. GEnX) have chemical properties that are particularly concerning, despite being marketed as “less toxic”. It is also very concerning to me that children and adolescents have the highest exposure; yet the long-term consequences are completely unknown and life-course epidemiology studies are very much needed. Finally, in the context of kidney disease, these are like so many other environmental toxins in that we don’t know how they interact to worsen or augment kidney disease in people with other risk factors such as diabetes or hypertension. So for example, wonder if you have diabetic nephropathy and are being exposed to these in high quantities? What does that mean for disparities in kidney disease and outcomes??

None of the authors have any disclosures with regards to this work.

Citation:

Perfluorinated Chemicals as Emerging Environmental Threats to Kidney Health
A Scoping Review

John W. Stanifer, Heather M. Stapleton, Tomokazu Souma, Ashley Wittmer, Xinlu Zhao and L. Ebony Boulware

CJASN September 2018, CJN.04670418; DOI: https://doi.org/10.2215/CJN.04670418

Sep 19, 2018 @ 2:20 pm

Why Do Surgical Mesh Products Fail?

Posted on September 19, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Polypropylene (PP) mesh is currently used in both hernia and pelvic organ prolapses – Wikipedia Image

Professor David Taylor
Trinity Centre for Bioengineering
Trinity College Dublin
The University of Dublin, Ireland

MedicalResearch.com: What is the background for this study?

Response: The study was motivated by the emerging clinical problem of the failure of surgical mesh products used for transvaginal operations. Increasing numbers of women are experiencing the failure of mesh used to treated vaginal prolapse, urinary incontinence and other pelvic organ conditions.

I carried out a survey of all existing research, including medical case reports, meta studies of clinical outcomes and biomechanics research on the material, which is a knitted plastic mesh. A phenomenon known as “mesh erosion” causes damage to surrounding tissues and organs and can leave the person in severe and lasting pain. Continue reading →

Experimental Cap Regrows Hair Using Photostimulation

Posted on September 19, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Han Eol Lee Ph.D.
Flexible and Nanobio Device Lab.
Department of Materials Science and Engineering
KAIST

MedicalResearch.com: What is the background for this study?

Response: Numerous people around the world have suffered from alopecia, which leads to aesthetic issues, low self-esteem, and social anxiety. With the population expansion alopecia patients from middle-age down even to the twenties, a depilation treatment is expected to have social and medical impacts on billions of patients. The causes of alopecia are generally known to be heredity, mental stress, aging, and elevated male hormone. Therapeutic techniques such as thermal, electrical, pharmacological, and optical stimulation have been proposed to treat hair problems. Among them, laser stimulation to hair-lost regions is a promising technique, activating the anagen phase and the proliferation of hair follicles without side effects. However, this laser stimulation technique has drawbacks, such as high power consumption, large size, and restrictive use in daily life (e.g., the difficulty of microscale spatial control and the long time exposure of high-energy laser). Continue reading →

Access to Treatment for Head/Neck Cancer Patients Improved with Medicaid Expansion

Posted on September 18, 2018 by Marie Benz MD FAAD

MedicalResearch.com Interview with:

Dr. Cannon

Richard B. Cannon, MD
Division of Otolaryngology–Head and Neck Surgery
School of Medicine
University of Utah, Salt Lake City

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Patient Protection and Affordable Care Act (ACA) is a nationwide effort to reduce the number of uninsured individuals in the United States and increase access to health care. This legislation is commonly debated and objective data is needed to evaluate its impact. As a head and neck cancer surgeon, I sought to evaluate how the ACA had specifically influenced my patients. Main findings below:

MedicalResearch.com: What should readers take away from your report?

Response: This population-based study found an increase in the percentage of patients enrolled in Medicaid and private insurance and a large decrease in the rates of uninsured patients after implementation of the Patient Protection and Affordable Care Act (ACA). This change was only seen in states that adopted the Medicaid expansion in 2014. The decrease in the rate of uninsured patients was significant, 6.2% before versus 3.0% after. Patients who were uninsured prior to the Patient Protection and Affordable Care Act had poorer survival outcomes.

Continue reading →