Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, OBGYNE / 03.10.2017

MedicalResearch.com Interview with: Andrew L. Beam, PhD Instructor in Biomedical Informatics Department of Biomedical Informatics Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is one piece of a larger story regarding the use of 17-alpha-hydroxyprogesterone caproate (17P) to treat recurrent preterm birth. This drug was originally only available in a compounded form, but since receiving an orphan drug designation in 2011, a branded and manufactured form was marketed under the name "Makena". This branded form was then sold for a much higher price than the compounded version, but a study that provided concrete data on pricing and outcomes had not been done. (more…)
Author Interviews, Infections, OBGYNE, Pediatrics, Vaccine Studies / 03.10.2017

MedicalResearch.com Interview with: Tami H Skoff Centers for Disease Control and Prevention Atlanta, GeorgiaTami H Skoff Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infants are at greatest risk for severe pertussis (whooping cough) morbidity and mortality, especially during the first months of life before infant immunizations begin.  CDC and the Advisory Committee on Immunization Practices (ACIP) currently recommend that women receive a dose of Tdap during the third trimester of each pregnancy.  This recommendation has been in place since 2012.  By getting Tdap, pregnant women pass critical short-term protection to their unborn babies. This helps protect babies until they are old enough to start getting their own whooping cough vaccines at 2 months of age. The purpose of our study was to evaluate the effectiveness of maternal Tdap during pregnancy at preventing whooping cough in infants <2 months of age. In our evaluation, Tdap administration during the third trimester of pregnancy prevented more than 3 in 4 (78%) infant cases.  Additionally, Tdap vaccination during pregnancy was even more effective (90%) at preventing whooping cough serious enough that the baby had to get treatment in a hospital. (more…)
Author Interviews, JAMA, Lung Cancer / 03.10.2017

MedicalResearch.com Interview with: Raymond U. Osarogiagbon, MBBS, FACP Translational Lung Cancer Research Multidisciplinary Thoracic Oncology Program Baptist Centers for Cancer Care Memphis, TN  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most long-term survivors of lung cancer are among the patients who were fortunate enough to be identified early enough to undergo curative-intent surgery. In the US, 60,000 individuals undergo curative-intent surgery for lung cancer every year. This number is likely to increase over the next few years as lung cancer screening becomes more widely adopted. Unfortunately, fewer than 50% of patients who undergo curative-intent surgery actually survive up to 5 years. We show that the quality of surgery, especially the quality of pathologic nodal staging is a powerful driver of survival differences between groups of patients. In general, pathologic nodal staging (important as it is stratifying patients into risk groups so those at high risk can be offered additional treatments to increase the chances of cure while those at truly low risk can be left alone without exposure to cost and side-effects of additional treatments) is very poorly done. We show how the percentage of patients whose pathologic staging met sequentially more stringently-define thoroughness of staging metrics falls off sharply, while the survival sequentially increases. (more…)
Author Interviews, CDC, Menopause, Sleep Disorders / 02.10.2017

MedicalResearch.com Interview with: Dr. Anjel Vahratian PhD MPH Maternal and Child Health Epidemiologist Branch Chief at the National Center For Health Statistics   Centers for Disease Control and PreventionDr. Anjel Vahratian PhD MPH Maternal and Child Health Epidemiologist Branch Chief at the National Center For Health Statistics Centers for Disease Control and Prevention MedicalResearch.com: Why did you conduct this study? Response: Our research focuses on the health of women as they age and transition from the childbearing period. During this time, women may be at increased risk for chronic health conditions such as diabetes and cardiovascular disease. As insufficient sleep is a modifiable behavior that is associated with these chronic health conditions, we wanted to examine how sleep duration and quality varies by menopausal status. (more…)
Author Interviews, CMAJ, Cost of Health Care, Health Care Systems, Hospital Readmissions / 02.10.2017

MedicalResearch.com Interview with: Dr. Lauren Lapointe-Shaw, MD Physician at University Health Network Department of Medicine University of Toronto  MedicalResearch.com: What is the background for this study? Response: Readmissions after hospital discharge are common and costly. We would like to reduce these as much as possible. Early physician follow-up post hospital discharge is one possible strategy to reduce readmissions. To this end, incentives to outpatient physicians for early follow-up have been introduced in the U.S. and Canada. We studied the effect of such an incentive, introduced to Ontario, Canada, in 2006. (more…)
Author Interviews, BMJ, Gender Differences, Heart Disease / 02.10.2017

MedicalResearch.com Interview with: Min Zhao PhD student Julius Center for Health Sciences and Primary Care, Clinical Epidemiology University Medical Center Utrech MedicalResearch.com: What is the background for this study? Response: Heart disease is still one of leading causes of deaths and disability worldwide. Management of modifiable risk factors, including both medical treatment target and healthy lifestyle, reduce the chance of new heart attack among those who survived a previous heart attack (so-called secondary prevention). Previous studies have demonstrated that the secondary prevention of heart disease is poorer among women than men. However, most studies were performed in Western populations. We aimed to assess whether sex differences exist on risk factor management and to investigate geographic variations of any such sex differences. Our study is a large-scale international clinical audit performed during routine clinic visit. We recruited over 10,000 patients who had survived a previous heart attack from 11 countries in Europe, Asia, and the Middle East. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Emergency Care, Heart Disease / 02.10.2017

MedicalResearch.com Interview with: Alexis Cournoyer MD Université de Montréal Hôpital du Sacré-Cœur de Montréal Institut de Cardiologie de Montréal, Montréal, Québec, Canada.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Out-of-hospital advanced cardiac life support (ACLS) is frequently provided to patients suffering from cardiac arrest.  This was shown to improve rates of return of spontaneous circulation, but there was no good evidence that it improved any patient-oriented outcomes.  Given the progress of post-resuscitation care, it was important to reassess if ACLS improved survival in out-of-hospital cardiac arrest.  Also, with the advent of extracorporeal resuscitation, a promising technique that needs to be performed relatively early in the course of the resuscitation and which seems to improve patients' outcome, we wanted to evaluate if prolonged prehospital resuscitation with ACLS was effective in extracorporeal resuscitation candidates. In this study, we observed, as was noted in previous study, that prehospital advanced cardiac life support  did not provide a benefit to patients regarding survival to discharge, but increased the rate of prehospital return of spontaneous circulation.  It also prolonged the delay before hospital arrival of around 15 minutes.  In the patients eligible for extracorporeal resuscitation, we observed the same findings. (more…)
Author Interviews, Boehringer Ingelheim, Pharmacology, Pulmonary Disease / 02.10.2017

MedicalResearch.com Interview with: Professor Carlo Vancheri Professor of Respiratory Medicine, University of Catania, Italy and Director of the Regional Referral Centre for Rare Lung Diseases and the Laboratory of Experimental Respiratory Medicine. MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The aim of Boehringer Ingelheim’s INJOURNEY trial was to investigate the safety profile of Ofev (nintedanib) in combination with pirfenidone in treating patients with idiopathic pulmonary fibrosis (IPF). Nintedanib and pirfenidone, the only two FDA-approved drugs for the treatment of IPF, are able to slow down the progression of the disease, reducing the forced vital capacity (FVC) decline of about 50%, but this is not a cure. The target for the future is to have even more effective treatments. In the meanwhile, it is necessary to optimize the use of the available drugs. The medical treatment of other pulmonary diseases such as COPD, asthma or pulmonary hypertension is already based on different combinations of drugs. This 12-week, open-label, randomized study was designed to evaluate the safety, tolerability and pharmacokinetics of nintedanib with add-on pirfenidone, compared with nintedanib alone in patients with IPF. Change in FVC, the established efficacy endpoint in IPF trials, was evaluated as an exploratory endpoint. The primary endpoint of the INJOURNEY trial was the percentage of patients with on-treatment gastrointestinal adverse events from baseline to week 12 of randomized treatment, and the results showed that the combination of nintedanib and add-on pirfenidone resulted in a manageable safety and tolerability profile, similar to the profile of each drug individually in the majority of patients. Results also indicated there may be a slower decline in FVC in patients treated with pirfenidone along with nintedanib compared with nintedanib alone, suggesting a potential benefit of the combination. However, further research will be necessary to fully evaluate the efficacy of the combination. (more…)
Author Interviews, Cancer Research, JAMA, Lung Cancer, Radiation Therapy / 02.10.2017

MedicalResearch.com Interview with: Florence K Keane MD Resident, Radiation Oncology Harvard Radiation Oncology Program Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: Checkpoint inhibitors (CPIs) have recently transformed the management of patients with metastatic lung cancer, demonstrating significant improvements in overall and progression-free survival in both the first-line setting in patients with increased expression of PD-L1 (≥50%) and in patients with previously treated NSCLC who have progressed on chemotherapy. CPIs are also moving into the treatment of patients with localized lung cancer, with the recently published PACIFIC trial demonstrating a significant improvement in progression-free survival in patients with inoperable stage III NSCLC treated with adjuvant durvalumab after definitive chemoradiotherapy. However, CPIs are associated with unique toxicities as compared to cytotoxic chemotherapy, including pulmonary, endocrine, neurologic, gastrointestinal, and dermatologic adverse events, which may be fatal in some cases. The risk of autoimmune pneumonitis with checkpoint inhibitors is estimated to be on the order of 5%. Many patients with lung cancer will require radiotherapy for palliation of symptoms. Thoracic radiotherapy (TRT) is also a risk factor for pneumonitis, with a dose- and volume-dependent impact on risk. However, it is unknown whether treatment with CPIs and TRT is associated with increased risk of toxicity. (more…)
Author Interviews, Diabetes, Gastrointestinal Disease, Lancet, Mayo Clinic, Weight Research / 29.09.2017

MedicalResearch.com Interview with: Prof Michael Camilleri, MD Gastroenterologist, Professor of Medicine, Pharmacology and Physiology at Mayo Clinic Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Mayo Clinic, Rochester, MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Liraglutide is approved for treatment of obesity; the precise mechanisms for the beneficial weight loss are unclear. We are interested to learn whether it is possible to identify people who are more likely to benefit from this treatment. (more…)
Author Interviews, Columbia, Genetic Research / 29.09.2017

MedicalResearch.com Interview with: Carlos Eduardo G. Amorim PhD Columbia University Department of Systems Biology Irving Cancer Research Center  MedicalResearch.com: What is the background for this study? Response: More generally, we were interested in understanding the determinants of the frequencies of mutations that cause disease in humans. More specially, we wanted to test if a long-standing theory in population genetics (namely mutation-selection balance) was a good explanation for the observed frequencies of disease mutations in humans. (more…)
Author Interviews, Blood Pressure - Hypertension, JCEM, OBGYNE, Pediatrics, Weight Research / 28.09.2017

MedicalResearch.com Interview with: Duo Li, PhD Chief professor of Nutrition Institute of Nutrition and Health Qingdao University, China.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Childhood obesity is becoming an emerging public health issue worldwide, owing to its association with a variety of health problems at younger ages in adulthood, including obesity, type 2 diabetes and cardiovascular diseases. Identification of prenatal and early life risk factors is key for curbing the epidemic of the childhood obesity. Main finding of the present study is that among pregnant women, elevated blood pressure is associated with a greater risk of overweight and obesity for their children. (more…)
Asthma, Author Interviews, CDC, Occupational Health, Pulmonary Disease / 28.09.2017

MedicalResearch.com Interview with: Katelynn Dodd MPH Respiratory Health Division National Institute for Occupational Safety and Health Centers for Disease Control and Prevention Morgantown WV 26505 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adults with asthma are at increased risk for pneumococcal infection. Adults with asthma who get pneumococcal pneumonia are at risk for additional complications including asthma exacerbation and invasive pneumococcal disease. Our results indicated that adults with work-related asthma were more likely to have received a pneumococcal vaccine than adults with non-work-related asthma—54 percent compared to 35 percent respectively; however, pneumococcal vaccination coverage among all adults with asthma, work-related or not, who have ever been employed in this study falls short of achieving the coverage public health experts recommend. Among adults with work-related asthma, pneumococcal vaccine coverage was lowest among Hispanics (36 percent), those without health insurance (39 percent), and adults aged 18 to 44 years (42 percent). (more…)
Author Interviews, Columbia, Heart Disease, Orthopedics / 28.09.2017

MedicalResearch.com Interview with: Dr. Mathew Maurer, Medical Director The Hypertrophic Cardiomyopathy Center NewYork-Presbyterian/Columbia University Medical Center. MedicalResearch.com: What is the background for this study? Response: Transthryretin cardiac amyloidosis (TTR-CA) is an underdiagnosed type of cardiomyopathy in which TTR (transthyretin, also known as prealbumin), a protein that forms amyloid fibrils, deposits in the heart. The deposits cause thickening of the ventricular wall and diastolic as well as systolic dysfunction. It is usually discovered around age 75 and presents more commonly in men than in women. With advances in non-invasive diagnostic modalities and growing awareness, TTR-CA is being diagnosed increasingly more frequently. Additionally, there are several emerging treatments that are under active investigation. Most of these therapies prevent disease progression and don’t address the amyloid already deposited in the heart. Accordingly, it is imperative that we diagnose TTR-CA before patients develop significant amyloid heart disease. However, this presents a great challenge since there are few known clinical predictors that might alert even the most astute physician that a patient is at such risk. With identification of predictors that may appropriately raise the index of clinical suspicion, clinicians may begin to pick up more subtle (and perhaps not yet clinically significant) forms of TTR-CA and initiate treatment before significant damage occurs. The few known clinical predictors of TTR-CA include bilateral carpal tunnel syndrome and lumbar spinal stenosis, and numerous studies found TTR on biopsies and autopsies of other musculoskeletal sites, particularly in hip and knee joints. (Just last week, and also discussed here on MedicalResearch.com, biceps tendon rupture was also shown to occur more frequently in TTR-CA!) We suspected that patients who ultimately develop TTR-CA may first develop clinically significant hip and knee disease, enough to even warrant a hip (THA) or knee (TKA) replacement. (more…)
Author Interviews, Dermatology, JAMA, Surgical Research / 28.09.2017

MedicalResearch.com Interview with: P. Daniel Ward, MD, MS, FACS Facial Plastic Surgeon WardMD Form Medical SpaAdjunct Associate Professor, University of Utah School of Medicine Salt Lake City, Utah 84121 MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a facial plastic surgeon with an interest in finding treatments for patients with facial paralysis, we are always looking for ways to improve the care that our patients receive. One of those treatments is to treat the effects of abnormal and asymmetric facial motion with botulinum, which decreases the deformity that results from facial nerve disorders by decreasing muscular hyperactivity. This study was based on the fact that there are three commercially available types of botulinum available for treatment of the face. There have been studies that have compared the different types of botulinum for cosmetic purposes, but there have not been any studies that specifically looked to see if there were any differences between the different types of botulinum when used for treatment of facial nerve disorders. The main finding of the study is that the three different types of botulinum are essentially equivalent with the exception being that one type of botulinum, incobotulinum toxin, was slightly less effective than the other two types of botulinum at the 4-week follow up point. Of note, all three types were equivalent at all other time points. (more…)
Allergies, Author Interviews, Dermatology, JAMA, Pediatrics / 28.09.2017

MedicalResearch.com Interview with: Elena Netchiporouk, MD, FRCPC, MSc Dermatology Resident - PGY5 and Dr. Moshe Ben-Shoshan, MD, FRCPC, MSc McGill University MedicalResearch.com: What is the background for this study? Response: We have followed a pediatric cohort of 139 patients with chronic urticaria (CU) (hives) between 2013 and 2015 in a single tertiary care center and assessed the comorbidities, the rate of resolution and determined predictors of resolution. (more…)
Author Interviews, Cancer Research, Cannabis / 27.09.2017

MedicalResearch.com Interview with: Jiries Meehan-Atrash Department of Chemistry, Portland State University Portland, Oregon MedicalResearch.com: What is the background for this study? What are the main findings? Response: The need for this study stems from the rising popularity of cannabis, and specifically the fact that many consumers are under the belief that vaporizing extracts thereof is safer than smoking. While this may in fact have some truth to it, it is clear that we must assess the safety of vaporization a route of administration. The main findings are that vaporizing terpenes under dabbing conditions generates some levels of methacrolein (a noxious irritant) at all temperatures that are hot enough to vaporize cannabinoids, but significant levels arise at higher temperatures that are more commonly used. To do this, you'll need to make sure your dab rig is in excellent condition. At the highest temperature used by consumers, significant levels of benzene arise, a compound that is a potent carcinogen and should be avoided at all costs. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Nutrition / 27.09.2017

MedicalResearch.com Interview with: Seth A. Berkowitz, MD, MPH Division of General Internal Medicine Diabetes Population Health Unit Harvard Medical School Massachusetts General Hospital, Boston MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is ever growing pressure to contain healthcare costs in the US. Increasingly, attention is turning to programs that address social determinants of health--that is, those factors which affect health but lie outside the realm of clinical medicine. Prior research has highlighted food insecurity as having a clear association with poor health and higher healthcare costs. SNAP is the nation's largest program to combat food insecurity. However, we did not know whether SNAP participation would be associated with any difference in healthcare costs, compared with eligible non-participants. This study found that participating in SNAP was associated with approximately $1400 lower healthcare expenditures per year in low-income adults. (more…)
Author Interviews, Mayo Clinic, Weight Research / 27.09.2017

MedicalResearch.com Interview with: Dr. W. Stephen Brimijoin PhD Department of Molecular Pharmacology and Experimental Therapeutics Mayo Clinic, Rochester, MN 55905 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study was: 1) Ordinary C57 black mice readily become obese when given unrestricted access to high-fat mouse chow. 2) If the obese mice are put on a forced calorie restricted diet they will regain their previous normal healthy weight.  However, if they are given unrestricted access to their previous “normal” low-fat mouse chow, they will rebound into obesity.  This effect can be seen as a model of human obesity and the difficulties that formerly obese men and women face in maintaining healthy body mass gained after dieting. 3) The literature on obesity provided reason to believe that this self-defeating behavioral cycle involves ghrelin, the so-called “hunger hormone.” 4) We had recently shown that the plasma enzyme called “butyrylcholinesterase” was a key regulator of active ghrelin. Therefore, it seemed plausible that raising enzyme levels would reduce ghrelin and, in turn, would blunt food craving. (more…)
Author Interviews, Gender Differences, Psychological Science / 27.09.2017

MedicalResearch.com Interview with: Patti J. Fisher, Ph.D. Associate Professor in Consumer Studies AHRM Department Virginia Tech MedicalResearch.com: What is the background for this study? Response: Risk tolerance is one of the most important factors contributing to wealth accumulation and retirement. It is important to understand why women are less risk tolerant so that financial planners can better serve their needs because women, on average, live longer than men and often need more retirement savings. (more…)
Author Interviews, Autism, Genetic Research, JAMA / 27.09.2017

MedicalResearch.com Interview with: Sven Sandin, PhD Assistant Professor Department of Psychiatry Icahn School of Medicine at Mount Sinai New York, NY 10029  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2014, we estimated the heritability of autism to be approximately 50%. Motivating us then was the lack of studies in autism heritability using population based and the findings from a twin-study in California finding the heritability to be substantially lower than the 80-90% estimated in previous studies. Since then continued efforts working with the questions on heritability and environmental factors for autism we found differences between different methods and different samples. When we went back to our previous data we found the heritability of autism to be higher than previously estimated. We found that our previous result was due to a methodological artifact where the adjustment for differences in follow-up used in that manuscript underestimated the heritability. Using methods used in other heritability studies the heritability is now estimated to 84%. Importantly, as previously concluded, there is no support for any ‘shared environmental factors’ in the etiology of autism, e.g. environmental factors shared between two siblings. (more…)
Author Interviews, Prostate Cancer, Radiation Therapy / 26.09.2017

MedicalResearch.com Interview with: Dr. Shuang George Zhao, MD House Officer, Radiation Oncology University Hospital Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? Response: Targeting cancer through the immune system has been a longstanding goal of cancer research, and with recent advances in immunotherapy, it is now a reality. However, the role of immunotherapy in prostate cancer is still being defined. Sipuleucel-T was the first FDA approved immunotherapy in prostate cancer, and is a personalized cellular therapy that has been shown to prolong survival in patients with metastatic prostate cancer. On the other hand, two recent phase III randomized trials looking at ipilimumab, a CTLA-4 checkpoint inhibitor in metastatic prostate cancer have both been negative for their primary endpoint of OS. Interestingly, there was a PSA response, suggesting that there may be some therapeutic effect in a subset of patients. Therefore, understanding the immune infiltrate is likely critical to selecting patients and therapeutic strategies utilizing the immune system. Unfortunately, it is difficult and laborious to histologically assess immune infiltrate directly. Therefore, we used existing high throughput transcriptomic data with new computational methods in order to more fully characterize the immune landscape of localized prostate cancer. (more…)
Accidents & Violence, Author Interviews, Emergency Care / 26.09.2017

MedicalResearch.com Interview with: Gary Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? Response: Previous studies have documented the frequency and characteristics of stair-related injuries among children and older adults. Numerous studies have examined gait characteristics of different age groups and their relationship to falls. In addition, it is estimated that the direct medical and indirect costs of non-fatal stair-related injuries are $92 billion annually in the US. The current study investigates the epidemiological characteristics of stair-related injuries among all ages using a nationally representative sample over a multi-year period. Our study also expands upon prior research on this topic to investigate the mechanisms of stair-related injuries and examine trends. (more…)
Anesthesiology, Author Interviews, JAMA, Pediatrics, Pulmonary Disease / 26.09.2017

MedicalResearch.com Interview with: Shabih U. Hasan, MD, DCH, FRCPC Professor and Staff Neonatologist, Alberta Health Services Department of Pediatrics, Cumming School of Medicine University of Calgary MedicalResearch.com: What is the background for this study? Response: Approximately 8% of all infants are born prematurely (preterm birth <37 weeks postmenstrual age). Preterm infants have many challenges including establishment of adequate pulmonary gas exchange. Due to not yet fully developed lungs, preterm infants require respiratory support consisting of respirators and other forms of non-invasive ventilation modalities and supplemental oxygen.  Bronchopulmonary dysplasia (BPD) is the commonest morbidity among very low birth weight infants as 40% of survivors at postmenstrual age <30 weeks develop BPD. This is a serious condition as it can lead to short- and long-term pulmonary complications, increased hospital visits and neurodevelopmental impairment. BPD is defined where preterm infants require respiratory support and/or supplemental oxygen at 36 weeks postmenstrual age. A number of therapeutic and non-therapeutic modalities have been used to prevent BPD including inhaled nitric oxide (iNO).  In 2006, the NO CLD trial demonstrated that iNO prevented BPD (Relative benefit 1.81; CI 1.27-2.59, P = 0.006) if used according to the NO CLD Protocol (Ballard et al., New England Journal of Medicine, 355:343-353, 2006). Our study (NEWNO; Newborns treated with Nitric Oxide) was designed to replicate the NO CLD study. (more…)
Author Interviews, Pain Research / 24.09.2017

MedicalResearch.com Interview with: Mark A. Lumley, Ph.D. Distinguished Professor and Director of Clinical Psychology Training Department of Psychology Wayne State University Detroit, Michigan  48202 and Howard Schubiner, M.D Founder and Director Mind-Body Medicine Center Providence-Providence Park Hospitak Warren, MI 48092  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Fibromyalgia is a condition that afflicts many people with chronic pain and other symptoms, which are often severe. There is no clear evidence of tissue damage or other peripheral causes of the symptoms, and experts agree that the pain is real, and its primary source is the brain. Medications for fibromyalgia have limited effectiveness, so psychological and behavioral therapies are core to treatment. Research documents a strong relationship between emotions and pain, and many patients with FM struggle with negative emotions related to difficult life circumstances, such as trauma, abuse, or relationship conflicts. Ironically, most psychological therapies for FM do not address these problems, but rather teach people how to manage their symptoms. Emerging research, however, demonstrates that therapies that help patients engage rather than avoid their difficult emotional experiences improve both psychological and physical symptoms, including pain. Therefore, we developed an emotion-focused therapy, which we call Emotional Awareness and Expression Therapy (EAET), and compared it to both an active education-based control condition and to the leading psychological intervention for fibromyalgia, cognitive-behavior therapy (CBT). The EAET condition was substantially better on multiple outcomes that the control condition 6 months after treatment. Importantly, although EAET did not differ from CBT on many outcomes, EAET was superior than CBT on reducing widespread and in the percentage of individuals achieving substantial pain reduction (that is, at least 50% pain reduction from baseline). (more…)
Author Interviews, Breast Cancer / 23.09.2017

MedicalResearch.com Interview with: Rebekah Nagler PhD Assistant professor Hubbard School of Journalism and Mass Communication University of Minnesota  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Both the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) have stated that women in their 40s--or, in the case of ACS, women ages 40-44--should have the choice to decide when they want to start screening for breast cancer. These organizations recommend that women in this age group weigh the benefits and risks of mammography screening, with the goal of making an informed decision about when to start screening. Yet recent research has shown that women are more aware of the benefits of mammography screening than the harms, including overdiagnosis and overtreatment (doi:10.1001/jamainternmed.2017.2247). We therefore wondered whether women actually have the information they need to make informed screening decisions. In a population-based sample of 429 U.S. women ages 35-55, we found that awareness of breast cancer overdiagnosis (16.5%) and overtreatment (18.0%) was low. Moreover, we found that most women did not find statements about these harms to be believable and persuasive. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Orthopedics / 22.09.2017

MedicalResearch.com Interview with: Avinainder Singh, M.B.B.S. Research Fellow Cardiovascular Medicine Brigham & Women's Hospital Harvard Medical School Boston, MA MedicalResearch.com: What is the background for this study? Response: Amyloidosis due to aberrant folding of proteins. These misfolded proteins can deposit in various parts of the body and lead to organ dysfunction. The two most common types of amyloidosis affecting the heart include transthyretin and light chain amyloidosis. Transthyretin is a protein produced by the liver which supports the transport of thyroxine and retinol. Wild-type transthyretin amyloidosis (ATTRwt, previously known as senile amyloidosis) occurs due to deposition of misfolded fibrils derived from transthyretin and primarily affects elderly men. Once considered a rare disease, it is now reported to be responsible for nearly 13% of heart failure with preserved ejected fraction and increased wall thickness. Rupture of the biceps tendon is a rare occurrence in the general population (<1 per 1000). We noticed a ruptured biceps tendon in several patients with wild-type transthyretin amyloidosis and performed this study to further evaluate this finding in a group of patients with wild-type transthyretin amyloidosis and in a control group of age-matched patients with non-amyloid heart failure. (more…)
Aging, Author Interviews, Exercise - Fitness / 22.09.2017

MedicalResearch.com Interview with: Dr. Daniel Aggio, PhD UCL Department of Primary Care and Population Health UCL Medical School University College London PA Research Group London, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Maintaining a physically active lifestyle into old age is associated with optimal health benefits. While we know that levels of physical activity in youth predict physical activity levels in adulthood, how physical activity in midlife predicts physical activity in old age is not as well understood. It is also unclear how different types of physical activity predict physical activity in later life. Using data from the British Regional Heart Study, an ongoing prospective cohort study involving men recruited between 1978 and 1980, we assessed how physical activity tracks over 20 years from midlife to old age. The study of over 3400 men showed that being active in midlife more than doubled the odds of being active 20 years later. Interestingly, sport participation in midlife predicted physical activity in old age more strongly than other types of physical activity, such as walking and recreational activity. The odds of being active in old age were even stronger for those men who took up sport from a younger age prior to midlife. Sport was the most stable activity across the follow up, with just under half of men reporting playing sport at least occasionally at each survey. However, walking was the least stable; the proportion of men who reported high levels of walking rose from just under 27% at the start of the study to 62% at the 20 year survey, possibly because retirement might free up more time. (more…)
Author Interviews, Pediatrics / 22.09.2017

MedicalResearch.com Interview with: Maureen Pirog PhD Rudy Professor of Policy Analysis School of Public and Environmental Affairs Indiana University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We analyzed parenthood, education and income statistics over a long time span from two groups of about 10,000 people -- those born in 1962-64 and those born in 1980-82.
  • Teen fathers and mothers came increasingly from single-mother families with disadvantaged backgrounds.
  • The proportion of teen mothers or fathers living with their partners didn't change, but far fewer were married.
  • The birth rates to teenage girls across the two groups didn't change, but the reported rate of teenage fatherhood increased, a seemingly contradictory conclusion. For example, 1.7 percent of the men in the older group were fathers by the time they were 17, while in the younger group, nearly double that number were dads. About 8 percent of the 17-year-old females in both groups were mothers.
(more…)