Aging, Author Interviews, Breast Cancer, JAMA, Mammograms, NYU / 21.04.2017

MedicalResearch.com Interview with: Cindy S. Lee, MD Department of Radiology and Biomedical Imaging University of California, San Francisco, San Francisco Now with Department of Radiology NYU Langone Medical Center, Garden City, New York MedicalResearch.com: What led you and colleagues to conduct this study? Response: I am a breast imager. I see patients who come in for their screening mammograms and I get asked, a lot, if patients aged 75 years and older should continue screening, because of their age. There is not enough evidence out there to determine how breast cancer screening benefits women older than 75. In fact, all previously randomized trials of screening mammography excluded people older than 75 years. Unfortunately, age is the biggest risk factor for breast cancer, so as patients get older, they have higher risks of developing breast cancer. It is therefore important to know how well screening mammography works in these patients. (more…)
Aging, Author Interviews, Hepatitis - Liver Disease, Nutrition / 21.04.2017

MedicalResearch.com Interview with: Leyuan Liu, Ph.D., Assistant Professor Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M University Houston, Texas 77030 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our research team has been working on the question why people develop cancers and how we can prevent or cure them. In contrast to public views, we concluded from our studies that cancers, similar to our age-related diseases, originate from inefficiencies of our body to clean up cellular wastes accumulated during our lifespan. The most important pathway to clean up those wastes is called autophagy, or cellular self-eating behavior. We study how autophagy is regulated, how autophagy causes cancers, and whether we can control autophagy to prevent or cure cancers. Previously we found autophagy is regulated by a protein called MAP1S and mice without MAP1S are more likely to develop liver cancer. We have been seeking ways to improve MAP1S-mediated autophagy to prevent liver cancer. Our current study show that spermidine, a natural component existing in many foods, can increase the stability of MAP1S proteins and activate MAP1S-mediated autophagy. Concurrent with the benefits of expand mouse lifespans ours also reported, spermidine can suppress the development of liver fibrosis and liver cancer specifically through MAP1S if we add spermidine into the daily drinking water of mice. (more…)
Author Interviews, Cannabis, Dermatology / 21.04.2017

MedicalResearch.com Interview with: Jessica S. Mounessa, BS University of Colorado School of Medicine Aurora, Colorado and Robert Dellavalle, MD, PhD, MSPH Professor of Dermatology and Public Health University of Colorado School of Medicine Colorado School of Public Health Chief, Dermatology Service US Department of Veterans Affairs Eastern Colorado Health Care System Denver, CO 80220  MedicalResearch.com: What is the background for this study? What are the main findings? Response: One in 10 adult cannabis users in the U.S. use it for medicinal purposes. Medicinal cannabis is well studied for its uses in chronic pain, anorexia, and nausea. Numerous recent studies have highlighted other medicinal uses for cannabinoids and related compounds. We conducted a comprehensive review of the literature on the potential role of cannabinoids in conditions affecting the skin. Our study reveals the potential benefit of topically prepared cannabinoid compounds, especially for pruritus and eczema.  For example, creams containing Palmitoylethanolamide (PEA), which enhances cannabinoid-receptor binding, have been successful in relieving itch both in the literature, and anecdotally in our clinics. Though not strictly considered an endocannabinoid, as it does not directly bind to CB1 and CB2 receptors, PEA works by enhancing endocannabinoid binding to these receptors.** Furthermore, the majority of the cannabinoid compounds we studied did not contain psychoactive effects. (more…)
Accidents & Violence, Author Interviews / 21.04.2017

MedicalResearch.com Interview with: Julia Wolfson, PhD MPP Assistant Professor Department of Health Management and Policy University of Michigan School of Public Health Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? Response: Gun violence is a serious public health problem that in 2015, the most recent year for which data is available, was responsible for more than 36,000 deaths. High profile shootings in public places such as schools, nightclubs and airports have focused national attention on the threat of gun violence in public places. Many states have recently passed new laws that expand the public places where people can legally carry guns either openly or concealed on their person. (more…)
Author Interviews, Inflammation, JAMA / 20.04.2017

MedicalResearch.com Interview with: Andrew Dick FRSB FMedSci Professor of Ophthalmology Bristol Eye Hospital, University of Bristol, Bristol, England National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital, Institute of Ophthalmology, University College London, London, England and John Sheppard, MD President, Virginia Eye Consultants Professor of Ophthalmology, Eastern Virginia Medical School MedicalResearch.com: What should readers take away from your report? Dr. Andrew Dick: These findings demonstrate that adalimumab is associated with clinically meaningful improvements in visual functioning for patients with non-infectious intermediate uveitis, posterior uveitis, and panuveitis. The emphasis of this work is that for the first time in uveitis we have seen patient reported outcome benefit of a biologic treatment. This analysis supports the use of adalimumab as a promising new treatment option, having demonstrated improvements in both clinical and visual functioning outcomes in patients with active and inactive uveitis. Dr. John Sheppard: Uveitis has a substantial effect on individuals’ physical, professional, psychological, avocational and social functioning in day-to-day life. Adalimumab, an anti-inflammatory drug that binds to tumor necrosis factor, was recently approved for the treatment of non-infectious intermediate uveitis, posterior uveitis, and panuveitis. It is the first systemic therapy specifically approved for uveitis.  The analyses in this study provide evidence that patients with noninfectious uveitis treated with adalimumab experience significant and clinically meaningful improvements in vision-related quality of life, compared with those who received placebo. (more…)
Author Interviews, Blood Pressure - Hypertension, Gender Differences, JAMA, Race/Ethnic Diversity / 20.04.2017

MedicalResearch.com Interview with: Shakia Hardy, MPH, CPH. PhD Department of Epidemiology The University of North Carolina at Chapel Hill MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies characterizing blood pressure levels across the life course have relied on prevalence estimates at a given age. Our study was interested in identifying critical ages at which net transitions between levels of blood pressure occurred. We used data from the National Health and Nutrition Examination Survey (2007-2012) to estimate age-, race-, and sex-specific annual net transition probabilities between ideal blood pressure, prehypertension and hypertension. We found that African Americans and men were more likely to transition from ideal levels of blood pressure in childhood or early adulthood compared to white Americans and women, which puts them at increased risk of developing prehypertension and hypertension earlier in life. (more…)
Author Interviews, Diabetes, NEJM, Ophthalmology, Personalized Medicine / 20.04.2017

MedicalResearch.com Interview with: John M. Lachin, Sc.D. Research Professor of Biostatistics and of Epidemiology, and of Statistics The George Washington University Biostatistics Center and David Matthew Nathan, M.D. Professor of Medicine, Diabetes Unit Massachusetts General Hospital  MedicalResearch.com: What is the background for this study? Response: Traditional guidelines for screening for retinopathy, based on indirect evidence, call for annual examinations. The automatic annual screening for retinopathy, without considering potential risk factors for progression,  appears excessive based on the slow rate of progression through sub-clinical states of retinopathy. (more…)
Author Interviews, Heart Disease, Surgical Research / 20.04.2017

MedicalResearch.com Interview with: Emmanouil S. Brilakis, MD, PhD Director, Center for Advanced Coronary Interventions Minneapolis Heart Institute Minneapolis, Minnesota 55407 Adjunct Professor of Medicine University of Texas Southwestern Medical School at Dallas MedicalResearch.com: What is the background for this study? What are the main findings? Response: Calcification in the coronary arteries might hinder lesion crossing, equipment delivery and stent expansion and contribute to higher rates of in-stent restenosis, as well as stent thrombosis. In this project we sought to examine the impact of calcific deposits on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in a contemporary, multicenter registry. We analyzed the outcomes of 1,476 consecutive CTO PCIs performed in 1,453 patients between 2012 and 2016 at 11 US centers. Data collection was performed in a dedicated online database (PROGRESS CTO: Prospective Global Registry for the Study of Chronic Total Occlusion Intervention, Clinicaltrials.gov Identifier: NCT02061436). (more…)
Author Interviews, Kidney Disease / 20.04.2017

MedicalResearch.com Interview with: Francesco Violi MD Department of Internal Medicine and Medical Specialties e Sapienza University Rome, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: The paper reports on the protocol of a trial where we will test the effect of aspirin on renal disease progression in diabetic patients. The study will start shortly and will be terminate next year. (more…)
Author Interviews, Compliance, Heart Disease, JAMA / 20.04.2017

MedicalResearch.com Interview with: Robert Rosenson, MD Professor of Medicine and Cardiology Icahn School of Medicine at Mount Sinai New York MedicalResearch.com: What is the background for this study? What are the main findings? Response: High intensity statin therapy is underutilized in patients with acute coronary syndromes. In 2011, 27% of patients were discharged on a high intensity statin (Rosenson RS, et al. J Am Coll Cardiol). In this report, we investigate the factors associated with high adherence to high intensity statin. High adherence to high intensity statins was more common among patients who took high intensity statin prior to their hospitalization, had fewer comorbidities, received a low-income subsidy, attended cardiac rehabilitation and more visits with a cardiologist. (more…)
Author Interviews, Breast Cancer, Chemotherapy, JAMA, MD Anderson, Surgical Research / 20.04.2017

MedicalResearch.com Interview with: Audree Tadros, MD, MPH Chief Administrative Fellow, Breast Surgical Oncology Training Program Department of Breast Surgical Oncology MD Anderson Cancer Center and Henry M. Kuerer, MD, PhD, FACS Executive Director, Breast Programs MD Anderson Cancer Network PH and Fay Etta Robinson Distinguished Professor in Cancer Research Dept of Breast Surgical Oncology Director, Breast Surgical Oncology Training Program MedicalResearch.com: What is the background for this study? Response: Neoadjuvant chemotherapy (NCT) has the ability to confer a pCR (pathologic complete response-when no residual cancer is found) in both the breast and axillary lymph nodes. We know that this is most likely to occur in women with HER2 positive and triple negative disease. The high rate of pCR among these patients raises the question of whether surgery is still required, particularly among those who will receive adjuvant radiation therapy. Until recently, we lacked the ability to pre-operatively predict patients who achieved a breast pCR. Recently, we completed a clinical feasibility trial examining the ability of image-guided biopsy to predict a pCR after neoadjuvant chemotherapy. Our biopsy technique was able to accurately predict a pCR in 98% of patients with only a 5% false negative rate. Based upon these findings, we believe we can accurately determine which patients achieve a breast pCR. This led us to develop a clinical trial to see if breast surgery is redundant in patients who achieve a pCR. An important question that remained was if we are going to omit breast surgery in these exceptional responders, can we also omit axillary surgery? (more…)
Annals Internal Medicine, Author Interviews, Biomarkers, Heart Disease / 19.04.2017

MedicalResearch.com Interview with: Martin P. Than, MBBS Emergency Department, Christchurch Hospital and Dr John W Pickering, PhD Associate Professor Senior Research Fellow in Acute Care Emergency Care Foundation, Canterbury Medical Research Foundation, Canterbury District Health Board | Christchurch Hospital Research Associate Professor | Department of Medicine | University of Otago Christchurch New Zealand MedicalResearch.com: What is the background for this study? Response: Patients being investigated for possible acute coronary syndrome comprise one of the largest groups of patients presenting to emergency rooms. Troponin assays have developed such that they can now measure with greater accuracy much lower concentrations of troponin. A large retrospective registry based study and a couple of smaller prospective studies suggested that patients with a very low concentrations of troponin T (below the current limit of detection of 5 ng/L) measured with Roche Diagnostic’s high-sensitivity troponin T (hsTnT) assay on presentation to the emergency department (ie single blood draw) are very unlikely to be having a myocardial infarction (MI). Our study gathers the current best evidence for using concentrations below the limit of detection in conjunction with no evidence of new ischaemia on ECG to safely risk stratify patients to a very low-risk group for MI and, therefore, potentially identify patients safe for early discharge. (more…)
Author Interviews, Heart Disease, JACC, Medical Imaging, MRI / 19.04.2017

MedicalResearch.com Interview with: Pr. Juerg Schwitter MD Médecin Chef Cardiologie Directeur du Centre de la RM Cardiaque du CHUV Centre Hospitalier Universitaire Vaudois - CHUV Suisse  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Coronary artery disease (CAD) is still one of the leading causes of death in the industrialized world and as such, it is also an important cost driver in the health care systems of most countries. For the European Union, the estimated costs for CAD management were 60 billion Euros in 2009, of which approximately 20 billion Euros were attributed to direct health care costs (1). In 2015, the total costs of CAD management in the United States were estimated to be 47 billion dollars (2). Substantial progress has been achieved regarding the treatment of CAD including drug treatment but also revascularizations procedures. There exists a large body of evidence demonstrating myocardial ischemia as one of the most important factors determining the patient’s prognosis and reduction of ischemia has been shown to improve outcome. On the other hand, techniques to detect CAD, i.e. relevant myocardial ischemia, were insufficient in the past. Evaluation of myocardial perfusion by first-pass perfusion cardiac magnetic resonance (CMR) is now closing this gap (3) and CMR is recommended by most international guidelines for the work-up of known or suspected CAD (4,5). Still, a major issue was not clarified until now, i.e. “how much ischemia is required to trigger revascularization procedures”. Thus, this large study was undertaken to assess at which level of ischemia burden, patients can be safely deferred from revascularization and can be managed by risk factor treatment only. Of note, this crucial question was addressed in both, patients with suspected CAD but also in patients with known (and sometimes already advanced) CAD, thereby answering this question in the setting of daily clinical practice. (more…)
Author Interviews, Diabetes, Nutrition, PLoS / 19.04.2017

MedicalResearch.com Interview with: Huaidong Du Senior Research Fellow China Kadoorie Biobank Medical Research Council Population Health Research Unit Clinical Trial Service Unit & Epidemiological Studies Unit Nuffield Department of Population Health Oxford UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: This research article describes findings from the China Kadoorie Biobank study which is a large population based prospective cohort study including about 0.5 million adults recruited from 10 areas in China. The main reason for us to perform this study is because previous evidence on potential benefit of fruit consumption in diabetes prevention and management is very limited. The sugar content of fruit has led to concerns in many parts of the world (e.g. China and several other Asian countries) about its potential harm for people with (high risk of) diabetes. This has consequently Chinese people diagnosed with diabetes tend to restrict their fruit intake. With the rapid increase of diabetes incidence in China and many other Asian countries, it is critically important to investigate the associations of fruit consumption with the incidence diabetes and, among those with diabetes already, diabetic macro- and microvascular complications. Through analysing data collected during 7 years of follow-up, the study found that people who eat fresh fruit more frequently are at lower risk of developing diabetes and diabetes related vascular complications. Compared with non-consumers, those who ate fresh fruit daily had a 12% lower risk of developing diabetes. Among participants with diabetes at the start of the study, higher fresh fruit consumption also showed health benefits, with a 100g portion of fruit per day associated with 17% lower overall mortality, 13% lower risk of developing diabetes-related complications affecting large blood vessels (e.g. ischaemic heart disease and stroke) and 28% lower risk of developing complications affecting small blood vessels (e.g. kidney and eye diseases). (more…)
Author Interviews, Autism, Depression, JAMA, OBGYNE, Pediatrics / 19.04.2017

MedicalResearch.com Interview with: Simone Vigod, MD, MSc, FRCPC Psychiatrist and Lead, Reproductive Life Stages Program Women’s Mental Health Program Women’s College Hospital Toronto, ON MedicalResearch.com: What is the background for this study? What are the main findings? Response: Depression is one of the most common problems that can complicate a pregnancy. Untreated, or incompletely treated, it can be associated with significant harm to mother and child. While psychotherapies alone may be effective for women with mild (or even moderate) severity symptoms, sometimes antidepressant medication is required. In these cases, the benefits of treatment must be weighed against potential risks. Previous research suggested that there may be an increased risk for autism in children exposed to antidepressant medication during pregnancy. However, previous studies were limited in their ability to account for other potential causes of autism in their analyses. In our study, we used several different strategies to try to compare children whose pregnancy exposures were very similar, except for exposure to an antidepressant. The main finding was that after using these strategies, there was no longer a statistically significant association between in-utero antidepressant exposure and autism. (more…)
Author Interviews, JAMA / 19.04.2017

MedicalResearch.com Interview with: Neha Pagidipati, MD MPH Duke Clinical Research Institute Duke University Durham, North Carolina MedicalResearch.com: What is the background for this study? What are the main findings? Response: The 2013 ACC/AHA guidelines for treatment of blood cholesterol to prevent cardiovascular disease created a new paradigm for lipid management and raised numerous ongoing controversies. In 2016, the US Preventive Services Task Force released recommendations for primary prevention statin therapy which were different in some important ways from the 2013 ACC/AHA guidelines. We aimed to understand the practical difference between these two sets of guidelines in terms of the number of Americans who would be potentially eligible for statin therapy. Using U.S. cross-sectional survey data between 2009 and 2014, we found that, if fully implemented, the USPSTF recommendations would reduce the percentage of US adults age 40-75 who should initiate statin therapy from 24% to 16% as compared to the 2013 ACC/AHA guidelines. Those newly recommended for statin therapy would be in addition to the 21% of US adults already taking lipid-lowering therapy. Of the approximately 9 million adults who would no longer be recommended to receive statin therapy under the new USPSTF recommendations, over half of them would be younger adults with a high long-term risk of cardiovascular disease (about 1 in 3), and over one quarter would be individuals with diabetes. (more…)
AACR, Author Interviews, Cancer Research, Genetic Research, Hepatitis - Liver Disease / 18.04.2017

MedicalResearch.com Interview with: Sara Torrecilla Recio PhD Student Mount Sinai Liver Cancer Program - Division of Liver Diseases Icahn School of Medicine at Mount Sinai New York, NY MedicalResearch.com: What is the background for this study? Response: Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, which represents the second-leading cause of cancer related death worldwide. The landscape of molecular alterations in HCC has been thoroughly explored using next-generation sequencing technologies in single biopsies of tumors. However, in the recent years it has been demonstrated that not all the regions of a tumor harbor the same molecular alterations. This intra-tumor heterogeneity may lead to a misinterpretation of the molecular landscape of the malignancy since not all the molecular alterations would be captured by single-biopsies. (more…)
Author Interviews, Baylor College of Medicine Houston, Genetic Research, PLoS / 18.04.2017

MedicalResearch.com Interview with: Daryl Armstrong Scott, M.D., Ph.D Associate Professor Molecular and Human Genetics Baylor College of Medicine Houston, TX, US MedicalResearch.com: What is the background for this study? What are the main findings? Response: This case started with a male child with intellectual disability, developmental delay, hypotonia, hypermobile joints and relative macrocephaly (large head size). Clinical testing showed that he carried a small deletion on chromosome Xp11.22. Since the deleted region had not been previously associated with human disease, the patient was referred to our clinic for additional testing. However, a more detailed analysis revealed that mice that were missing one of the genes located in the deletion interval, Maged1, had neurocognitive and neurobehavioral problems. This sparked additional inquiries which resulted in the identification of three other males from two other families who carried small, overlapping Xp11.22 deletions and had similar features. In all cases, their deletions were inherited from their asymptomatic mothers. We concluded that deletion of an ~430 kb region on chromosome Xp11.22 that encompasses two pseudogenes (CENPVL1 and CENPVL2) and two protein-coding genes (MAGED1 and GSPT2) causes a novel, syndromic form of X-linked intellectual disability characterized by developmental delay, hypotonia, hypermobile joints and relative macrocephaly. (more…)
Author Interviews, Cognitive Issues, Exercise - Fitness, Mental Health Research / 18.04.2017

MedicalResearch.com Interview with: Brian Levine, Ph.D., C.Psych, ABPP-cn Senior Scientist, Rotman Research Institute, Baycrest Professor, Departments of Psychology and Medicine (Neurology) University of Toronto MedicalResearch.com: What is the background for this study? Response: There is growing concern about the effects of concussion on brain function with aging. Retired professional athletes provide a unique perspective on this question, as many of them have a high concussion exposure before retirement in their 20’s or 30’s. Yet much of the research on professional athletes has been in post-mortem samples. There is a need for more research in retired athletes during life. (more…)
Author Interviews, Heart Disease, Inflammation, Nature / 18.04.2017

MedicalResearch.com Interview with: Borja Ibáñez MD Spanish National Centre for Cardiovascular Research Madrid MedicalResearch.com: What is the background for this study? What are the main findings? Response: Acute myocardial infarction (heart attack) is a severe condition responsible for thousands of deaths every year and with important long-term consequences for survivors. Best treatment for acute myocardial infarction is a rapid coronary reperfusion. Upon reperfusion, all inflammatory cells and mediators accumulated in the circulation during the infarction process, enter into the myocardium and causes an extra damage to the heart. Activated neutrophils play a critical role in this damage occurring upon reperfusion. The final size of infarction is the main determinant for mortality and long-term morbidity. The possibility of limiting the extent of infarcted tissue is of paramount importance. Betablockers have been used in patients for more than 4 decades, mainly to treat arrhythmias and high blood pressure. Recently the same group of investigators demonstrated that the very early administration (i.e. during ambulance transfer to the hospital) of the betablocker “metoprolol” was able to reduce the size of infarction in patients. The mechanism by which metoprolol was protective in patients suffering a myocardial infarction was unknown. (more…)
Author Interviews, Cancer Research, Genetic Research, JAMA / 18.04.2017

MedicalResearch.com Interview with: Fergus J. Couch, Ph.D. Zbigniew and Anna M. Scheller Professor  of Medical Research Chair, Division of Experimental Pathology Department of Laboratory Medicine  and Pathology Mayo Clinic Rochester, MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: The main finding is that RAD51D, BARD1, and MSH6 can now be included in the list of moderate risk breast cancer genes. In contrast, other genes such as MRE11A and RAD50 do not increase risk of breast cancer. In addition, we provide initial estimates of the level of breast cancer risk associated with mutations in the genes that cause breast cancer. The "new" breast cancer genes may now be useful for identifying women who can benefit from enhanced screening. These new data will need to be considered by the National Comprehensive Cancer Network (NCCN) which provides guidelines for clinical management of individuals with mutations in cancer predisposition genes. These results will also be useful for identifying members of families who are at increased risk of breast cancer. (more…)
Author Interviews, JAMA, Opiods, Surgical Research, University of Michigan / 18.04.2017

MedicalResearch.com Interview with: Chad M. Brummett, MD Division of Pain Medicine, Department of Anesthesiology University of Michigan Medical School Ann Arbor, MI 48109  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The opioid epidemic has received considerable attention, but most of the focus has been on chronic pain and primary care. However, surgeons prescribe ~40% of the opioids in the US, and little attention has been given to the importance of prescribing after surgery. In this study, we found that among patients not using opioids in the year prior to surgery, ~6% of patients continued to use opioids long after what would be considered normal surgical recovery. Furthermore, there was no difference between patients undergoing minor and major surgeries, thereby suggesting that some patients continue to use opioids for reasons other than pain related to surgery. (more…)
Author Interviews, JAMA, Johns Hopkins, Mammograms / 18.04.2017

MedicalResearch.com Interview with: Archana Radhakrishnan MD MHS Division of General Internal Medicine Johns Hopkins University Baltimore, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: We were interested in understanding the current practice trends in breast cancer screening recommendations by doctors in light of the guideline changes.  We performed a national survey of primary care providers and gynecologists asking about their breast cancer screening practices. We found that a large number of doctors recommend breast cancer screening to younger and older women—upwards of 80% of doctors recommend it for younger women (ages 40-44) and almost 70% for women 75 and older.  But this varies by the type of doctor that a woman see.  Gynecologists were, in general, more likely to recommend routine mammograms. (more…)
Author Interviews, Pain Research / 18.04.2017

MedicalResearch.com Interview with: Paul Shekelle, MD PhD MPH Chief of General internal Medicine VA Greater Los Angeles Healthcare System MedicalResearch.com: What is the background for this study? What are the main findings? Response: Back pain is one of the commonest symptoms for adult patients to seek health care. For a number of years now, VA has had chiropractic care integrated into the ambulatory care available at many large VA medical centers. Most patients referred from VA primary care to chiropractic clinic have chronic back pain. VA was interested in an evidence synthesis of the use of spinal manipulative therapy in acute low back pain. Spinal manipulative therapy is a manual technique delivered by almost all chiropractors, but also delivered by some physical therapists, osteopathic physicians, and some medical doctors. The main findings are that spinal manipulative therapy is associated with, on average, a modest beneficial effect on pain and function. However, there are large difference sin outcome across studies, and this suggests that some patients may respond much better, and other may respond not at all. (more…)
Aging, Author Interviews, Neurological Disorders, PLoS / 18.04.2017

MedicalResearch.com Interview with: Dr. Hector Zenil Co-director Information Dynamics Lab Unit of Computational Medicine, SciLifeLab Center for Molecular Medicine Karolinska Institute, Stockholm, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The generation of randomness is known to be related to cognitive abilities. It has also recently been shown that animals can recur to random behaviour to outsmart other animals or overcome certain situations. Our results that humans can best outsmart computers in generating randomness at a certain age (25). The results correspond to what it was suspected, that cognitive abilities peak at an early age before declining and that no other factor was important. We quantified a type of mathematical randomness that is known to be the true type of randomness as opposed to e.g. 'statistical randomness'. Something that is random is difficult to describe in a succinct way. Unlike 'statistical randomness', 'algorithmic randomness' does not only produce something that appears random but also that is very difficult to generate or produce. Conversely, something that may look random for the standard of statistical randomness may not turn out to be truly random. (more…)
Author Interviews, Heart Disease, HIV, JAMA, Vanderbilt / 18.04.2017

MedicalResearch.com Interview with: Matthew S Freiberg, MD, MSc Associate Professor of Medicine, Division of Cardiovascular Medicine Vanderbilt Translational and Clinical Cardiovascular Research Center MedicalResearch.com: What is the background for this study? Response:  HIV infected people are living longer and are at risk for cardiovascular diseases. While acute myocardial infarction has been studied and the increased risk of Acute Myocardial Infarction (AMI) among HIV+ people compared to uninfected people is well documented, there are less data describing the risk of HIV and different types of heart failure, including reduced and preserved ejection fraction heart failure. Understanding more about the link between HIV and different types of HF is important because reduced and preserved ejection fraction heart failure differ with respect to underlying mechanism, treatment, and prognosis. Moreover, as cardiovascular care has improved, HIV infected people who experience an AMI are likely to survive but may live with a damaged heart. Understanding more about the link between HIV and heart failure may help providers and their patients prevent or reduce the impact of HF on the HIV community. (more…)
Addiction, Author Interviews, BMJ, Ophthalmology / 17.04.2017

MedicalResearch.com Interview with: Dr. Rebecca Rewbury Sussex Eye Hospital Brighton and Sussex University Hospitals Trust Brighton, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: ‘Poppers’ are recreational drugs which are illegal to sell for human ingestion, but are sold under the guise of household cleaning products. Inhalation leads to a brief sense of euphoria, enhanced sexual arousal and smooth muscle relaxation. The Psychoactive Substances Act 2016 was due to outlaw poppers, but they were excluded on the basis that they do not act directly on the central nervous system. The main constituent of poppers, isopropyl nitrite, replaced isobutyl nitrite when the latter was classified as a carcinogen in 2006. Since then, there have been several case reports of ‘poppers maculopathy.’ We noted an increase in patients presenting with central visual disturbances after using poppers and describe 12 such cases. They all demonstrated similar disruption of the photoreceptor layer on retinal imaging. Onset of symptoms was frequently linked to specific brands of poppers, with 3 people having used poppers for many years and only developing side effects on changing brand. Chemical analysis showed that these products contained isopropyl nitrite. One brand of poppers, used without side effects by one patient, contained amyl nitrite, 2-methyl butyl nitrite and isobutyl alcohol, but no isopropyl nitrite. The outcome of poppers maculopathy varied, but following abstention, visual disturbances and retinal damage tended to improve over months, if not fully resolve. Although in some cases, symptoms and/or imaging findings were prolonged. Ongoing use of implicated brands led to persistent, but not worsening maculopathy, whereas one patient that switched back to another brand showed full recovery. (more…)
AstraZeneca, Author Interviews, Autism, Boehringer Ingelheim, Depression, Eli Lilly, J&J-Janssen, JAMA, Merck, OBGYNE / 17.04.2017

MedicalResearch.com Interview with: Florence Gressier MD PhD Insermk Department of psychiatry CHU de Bicêtrem Le Kremlin Bicêtre France MedicalResearch.com: What is the background for this study? What are the main findings? Response: Results from recent studies have suggested an increased risk for Autism Spectrum Disorders (ASDs) in children exposed to antidepressants in utero. We performed a systematic review of and a meta-analysis of published studies to assess the association between ASDs and fetal exposure to antidepressants during pregnancy for each trimester of pregnancy and preconception. Our systematic review and meta-analysis suggests a significant association between increased ASD risk and maternal use of antidepressants during pregnancy; however, it appears to be more consistent during the preconception period than during each trimester. In addition, the association was weaker when controlled for past maternal mental illness. Maternal psychiatric disorders in treatment before pregnancy rather than antenatal exposure to antidepressants could have a major role in the risk for Autism Spectrum Disorders. (more…)
Author Interviews, Dermatology, Technology / 17.04.2017

MedicalResearch.com Interview with: Paul J.D. Whiteside, doctoral candidate and Dr. Heather Hunt, assistant professor of bioengineering University of Missouri MedicalResearch.com: What is the background for this technology? What are the barriers to the use of conventional laser treatment of tattoos? Response: Traditional laser treatments rely on the concept of selective photothermolysis (laser-induced heating) to specifically target certain structures for treatment, while leaving other parts of the skin unaffected. The problem with traditional laser treatments is that the laser needs to transmit through the epidermis, which acts as a barrier to laser transmission both due to its reflective properties and because it is filled with light-absorbing melanin, the pigment that gives our skin its color. Sonoillumination acts to change the properties of the epidermis temporarily using painless ultrasound technology, thereby allowing more laser light to penetrate deeper into the skin to impact desired targets, such as hair follicles, tattoos, and blood vessels. Funding for clinical trials is currently being sought to provide evidence for what we surmise may be benefits of this technology relative to traditional laser treatments. These benefits may include being able to treat darker-skinned people more effectively, being able to provide laser therapy with less risk of scarring or pigment changes, and being able to do treatments with less discomfort, fewer treatments, and lower laser energy settings. (more…)
Author Interviews, Neurological Disorders, PNAS / 17.04.2017

MedicalResearch.com Interview with: Zhiyong Zhao, Ph.D. Associate Professor Department of Obstetrics, Gynecology & Reproductive Sciences University of Maryland School of Medicine Baltimore, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: Diabetes in early pregnancy can cause neural tube defects in fetus. The defects are a result of failure in neural tube closure, due to excess cell death. The aim of this study was to delineate molecular processes that induce cell death. The main findings of this study are: (1) Hyperglycemia disrupts protein folding. The misfolded proteins, including the ones that are associated with neurodegenerative diseases, form aggregates, indicating similar molecular processes in both fetal neural tube defects and adult neurodegenerative diseases. (2) Protein aggregation leads to formation of a neurodegenerative disease-related cell death inducting mechanism. (more…)