Author Interviews, Eating Disorders / 04.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32649" align="alignleft" width="143"]Guido K.W. Frank, M.D., FAED Associate Professor of Psychiatry and Neuroscience Associate Director, Eating Disorder Program Director, Developmental Brain Research Program Pediatric Mental Health Institute | Children’s Hospital | University of Colorado Anschutz Medical Campus Colorado Dr. Guido Frank[/caption] Guido K.W. Frank, M.D., FAED Associate Professor of Psychiatry and Neuroscience Associate Director, Eating Disorder Program Director, Developmental Brain Research Program Pediatric Mental Health Institute | Children’s Hospital | University of Colorado Anschutz Medical Campus Colorado MedicalResearch.com: What is the background for this study? Response: Anorexia nervosa is an eating disorder that primarily affects young females and is associated with high mortality. The diagnostic criteria include restriction of energy intake that leads to significantly low body weight and an intense fear of gaining weight or becoming fat. The etiology of anorexia nervosa is complex, and only recently have we begun to better understand its underlying neurobiology. Brain scans of anorexia nervosa patients have implicated brain reward circuits in the disease, brain regions that govern food intake. On the other hand, how much we eat also affects over time reward system response and eating too much or too little has important implications on brain reward function. Previous studies from our lab as well as basic science research suggest that underweight is associated with heightened reward system response. In this study wanted to test whether we would find heightened brain activity in adolescents with anorexia nervosa and whether this would normalize once the patient regained weight.
Asthma, Author Interviews, Cost of Health Care, Pediatrics / 04.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32645" align="alignleft" width="132"]Patrick W. Sullivan, Ph.D. Professor Regis University School of Pharmacy Denver, CO 80221 Dr. Sullivan[/caption] Patrick W. Sullivan, Ph.D. Professor Regis University School of Pharmacy Denver, CO 80221 MedicalResearch.com: What is the background for this study? Response: Asthma is one of the most common chronic disorders among children. It affects 7.1 million children in the U.S. Of these, 4.1 million children suffered an asthma attack in 2011. An asthma attack is an acute period of extreme difficulty breathing. It can be life threatening and is always very frightening for children. Because asthma can be dangerous and frightening, it ends up costing a lot because patients need to go the doctor, hospital or take medications to try to control it. Asthma also has a negative effect on the patient’s health and outlook about their health – both mentally and physically. Previous studies have focused on adults with asthma and have found that it is very expensive – it costs $18 billion in the U.S. to manage adults with asthma. Those studies also showed that adults with asthma have lower quality of life. However, there is not a lot of good evidence on the burden of asthma in children. This study was designed to quantify the cost and mental and physical health of children with asthma in the U.S.
Author Interviews, Electronic Records, Mental Health Research / 04.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32640" align="alignleft" width="79"]Steven K. Dobscha, M.D. Professor, Department of Psychiatry, OHSU Director, VAPORHCS Center to Improve Veteran Involvement in Care Oregon Health & Science University Dr. Dobscha[/caption] Steven K. Dobscha, M.D. Professor, Department of Psychiatry, OHSU Director, VAPORHCS Center to Improve Veteran Involvement in Care Oregon Health & Science University MedicalResearch.com: What is the background for this study?  Response: Several health care systems across the United States now offer patients online access to all of their clinical notes (sometimes referred to as progress notes) through electronic health record portals; this type of access has been referred to as OpenNotes (see www.opennotes.org for more information on the national OpenNotes initiative). Veterans have been able to use OpenNotes in the Veterans Health Care (VHA) system since 2013. However, some individuals have expressed concern that online access to clinical notes related to mental health could cause some patient harms. We are conducting a VA-funded research project with several objectives: 1) to examine benefits and unintended negative consequences of OpenNotes use as perceived by veterans receiving VHA mental health care and by VHA mental health clinicians, and 2) to develop and evaluate brief web-based courses designed to help veterans and clinicians use OpenNotes in ways that optimize Veteran-clinician collaboration and minimize unintended consequences.
Author Interviews, Memory / 04.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32628" align="alignleft" width="200"]Signy Sheldon, PhD Assistant Professor Department of Psychology McGill University Montreal, QC, CAN Dr. Signy Sheldon[/caption] Signy Sheldon, PhD Assistant Professor Department of Psychology McGill University Montreal, QC, CAN MedicalResearch.com: What is the background for this study? Response: It is clear to most people that emotion and memory are strongly linked - thinking about our past experiences is often accompanied with a strong feelings, sometimes good and sometimes bad. In psychological research, many investigations have looked at how emotional memories are remembered differently than non-emotional memories. A lot of this research has found that the valence of a memory, whether it is positive or negative, will impact how detailed a past event can be recalled. Much less research as looked at how the emotions we feel at the time of remembering can also influence the way that memory is recalled. This is a very important area of research. If emotions during remembering can influence what memories are accessed and how we experience these memories, this would suggest that our memories are tagged and organized according to emotions. In this study, we looked at how different aspects of emotion can affect the types of past experiences we bring to mind to further investigate how emotions direct memory retrieval. To do this, we had participants listen to unfamiliar excerpts of music that ranged in both memory valence (positive and negative) and arousal (high or low levels). To each piece of music, participants were asked to think of a past memory and then describe their experience of that event they were remembering.
Addiction, Alcohol, Author Interviews, Cannabis, Mental Health Research / 03.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32622" align="alignleft" width="175"]Emil F. Coccaro, M.D. Ellen C. Manning Professor Department of Psychiatry and Behavioral Neuroscience The University of Chicago Chicago, Illinois 60637 Dr. Emil Coccaro[/caption] Emil F. Coccaro, M.D. Ellen C. Manning Professor Department of Psychiatry and Behavioral Neuroscience The University of Chicago Chicago, Illinois 60637 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Aggressive behavior and drug use have been related for years but this study shows people with problematic aggression (Intermittent Explosive Disorder: IED) are in fact at risk for developing alcohol, tobacco, and cannabis use disorders and that the onset of problematic aggression (IED) begins before the onset of the drug use. The increased risk for alcohol use disorder was nearly six-fold higher, the increased risk for cannabis use disorder was seven-fold higher, and the increased risk for tobacco use disorder  was four-fold higher. In addition, the presence of IED increased the severity of the substance use disorder.
Author Interviews, Pediatrics / 03.03.2017

MedicalResearch.com Interview with: Dr. Hans Jorgen Stensvold, M.D and Dr. Arild Ronnestad, MD PhD Neonatal Department, Oslo University Hospital and the Norwegian Neonatal Network, Oslo, Norway MedicalResearch.com: What is the background for this study? Response:  Over the last decades, advances in perinatal care have led to improved survival of extremely preterm infants in most countries. Still, the decision to initiate or withhold active care for infants at the border of viability is challenging. Different attitudes and traditions in perinatal care influence the rates of stillbirths, admissions to intensive care and outcomes. Consequently, there is a continuous need for up-to-date results to guide caregivers and parents in decision making, and to evaluate current medical practices.
ASCO, Author Interviews, Outcomes & Safety, Pharmacology, Prostate Cancer, University of Michigan / 03.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32608" align="alignleft" width="128"]Megan Elizabeth Veresh Caram MD Clinical Lecturer Internal Medicine, Hematology & Oncology University of Michigan Dr. Caram[/caption] Megan Elizabeth Veresh Caram MD Clinical Lecturer Internal Medicine, Hematology & Oncology University of Michigan   MedicalResearch.com: What is the background for this study? Response: Abiraterone and enzalutamide are oral medications that were approved by the Food & Drug Administration in 2011 and 2012 to treat men with metastatic castration-resistant prostate cancer. Most men with advanced prostate cancer are over age 65 and thus eligible for Medicare Part D. We conducted a study to better understand the early dissemination of these drugs across the United States using national Medicare Part D and Dartmouth Atlas data.
Addiction, Author Interviews, Emergency Care, Opiods / 02.03.2017

MedicalResearch.com Interview with: Alexander Diaz Bode M.D. Candidate University of Miami Leonard M. Miller School of Medicine Miami, FL MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our country is in the midst of an opiate epidemic. This is particularly evident in the emergency department (ED), which continues to see an alarmingly large number heroin overdose. With the shutdown of “pill-mills”, where opioid prescriptions would be prescribed indiscriminately, Florida has seen particularly large increases in opiate use and overdose. In Miami, we noticed that during the summer of 2016, there was a disproportionate increase in heroin overdose being treated at our hospital relative to previous years. Our recently published study showed that fentanyl or fentanyl analog laced heroin likely contributed to this massive spike in heroin overdose observed during the summer of 2016. Fentanyl and its synthetic analogs are opioid receptor agonists that bind with hundreds of times higher affinity than diamorphine, aka heroin. Naloxone, better known by the brand name Narcan®, is used to reverse heroin overdose in the ED. This drug works by competitively inhibiting the opioid receptor, effectively “knocking off” the bound heroin. Using naloxone dosing as a surrogate marker of heroin purity, our study found that during the investigated spike there was a disproportionate increase in the amount of naloxone used in our ED to reverse overdose relative to the increase in opiate overdose. This indicated that a stronger opioid receptor agonist, such as fentanyl or fentanyl analogs, likely was involved in the massive spike in overdose observed during the summer of 2016.
Author Interviews, Heart Disease, JAMA, Lipids / 02.03.2017

MedicalResearch.com Interview with: Dr. Yashashwi Pokharel MD, MSCR Department of Cardiovascular Research Saint Luke’s Mid-America Heart Institute Kansas City, Missouri and Salim S. Virani, MD PhD, FACC, FAHA Associate Professor, Section of Cardiovascular Research Associate Director for Research, Cardiology Fellowship Training Program Baylor College of Medicine Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Houston, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unlike the previous cholesterol management guideline that recommended use of either statin and non-statin therapy to achieve low density lipoprotein cholesterol (LDL-C) target, the 2013 American College of Cardiology/American Heart Association cholesterol management guideline made a major paradigm shift by recommending statin focused treatment in 4 specific patient groups and replaced LDL-C target with fixed statin intensity treatment (moderate to high intensity statin therapy). With this change, it was speculated that a large number of patients would be eligible for statin treatment (in one study, up to 11.1% additional patients were expected to be eligible for statin therapy). Our study provided the real world trends in the use of statin and non-statin lipid lowering therapy (LLT) from a national sample of cardiology practices in 1.1 million patients 14 months before and 14 months after the release of the 2013 guideline. We found a modest, but significant increasing trend in the use of statin therapy in only 1 of the 4 patient groups eligible for statin therapy (i.e., 4.3% increase in the use of moderate to high intensity statin therapy in patients with established atherosclerotic cardiovascular disease). We did not find any significant change in non-statin LLT use. Importantly, about a third to half of patients in statin eligible groups were not receiving moderate to high intensity statin therapy even after the publication of the 2013 guideline.
Author Interviews, BMJ, Environmental Risks, Mental Health Research, Pediatrics, Toxin Research / 02.03.2017

MedicalResearch.com Interview with: Professor Jean-Francois Viel Department of Epidemiology and Public Health University Hospital Rennes, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of pyrethroid insecticides has increased substantially throughout the world over the past several decades, replacing organophosphate and carbamate insecticides, because of their chemical potency against many pests, their relatively low mammalian toxicity and their favorable environmental profiles. However, despite the neurotoxicity of these insecticides at high doses, the potential impact of environmental exposure to pyrethroid insecticides on child neurodevelopment has only just started to receive attention. Using a longitudinal design (PELAGIE mother-child cohort), we were able to assess pyrethroid exposure (trough urine concentrations) both prenatally and during childhood (at 6 years of age). We showed that increased prenatal concentrations of one pyrethroid metabolite (cis-DCCA, a metabolite of permethrin, cypermethrin and cyfluthrin) were associated with internalising difficulties (children showing behaviours that are inhibited and over-controlled). Moreover, for childhood 3-PBA (a common metabolite of up to 20 synthetic pyrethroid insecticides) concentrations, a positive association was observed with externalising difficulties (children showing behaviours that are under-controlled and having generally a more challenging temperament).
Author Interviews, Hospital Acquired, Outcomes & Safety / 02.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32590" align="alignleft" width="200"]Curtis J. Donskey, MD Geriatric Research, Education, and Clinical Center Cleveland Veterans Affairs Medical Center Cleveland, OH 44106 Dr. Curtis J. Donskey[/caption] Curtis J. Donskey, MD Geriatric Research, Education, and Clinical Center Cleveland Veterans Affairs Medical Center Cleveland, OH 44106 MedicalResearch.com: What is the background for this study?  Response: Many hospitals are making efforts to improve cleaning to reduce the risk for transmission of infection from contaminated environmental surfaces. Most of these efforts focus on surfaces like bed rails that are frequently touched by staff and patients. Despite the fact that floors have consistently been the most heavily contaminated surfaces in hospitals, they have not been a focus of cleaning interventions because they are rarely touched. However, it is plausible that bacteria on floors could picked up by shoes and socks and then transferred onto hands. In a recent study, we found that when a nonpathogenic virus was inoculated onto floors in hospital rooms, it did spread to the hands of patients and to surfaces inside and outside the room. Based on those results, we assessed the frequency of floor contamination in 5 hospitals and examined the potential for transfer of bacteria from the floor to hands.
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Sleep Disorders, UT Southwestern / 02.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32582" align="alignleft" width="132"]Ron B. Mitchell, MD Professor and Vice Chairman, Department of Otolaryngology, Head and Neck Surgery William Beckner Distinguished Chair in Otolaryngology Chief of Pediatric Otolaryngology UT Southwestern and Children's Medical Center Dallas Dallas, TX 75207 Dr. Ron Mitchell[/caption] Ron B. Mitchell, MD Professor and Vice Chairman, Department of Otolaryngology, Head and Neck Surgery William Beckner Distinguished Chair in Otolaryngology Chief of Pediatric Otolaryngology UT Southwestern and Children's Medical Center Dallas Dallas, TX 75207 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obstructive Sleep Apnea (OSA) has not been widely studies in adolescents. This is one of a few studies that was targeted at 12-17 year olds who were referred for a sleep study for possible OSA. The study included 224 adolescents (53% male). aged 12 to 17 years. The mean BMI was 33.4 and most were either Hispanic or African American (85.3%). A total of 148 (66.1%) were obese. Most adolescents referred for a sleep study (68%), had  Obstructive Sleep Apnea. Normal-weight adolescents were least likely to have OSA at 48%, while obese children were most likely at 77%. Severe OSA was most likely in obese males with tonsillar hypertrophy.
Author Interviews, Heart Disease, JAMA / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32483" align="alignleft" width="200"]Thomas Engstrøm Senior Consultant dr. sci., MD, PhD The Heart Center | Rigshospitalet | University of Copenhagen | Denmark Professor in cardiology | University of Lund | Sweden Adjunct professor in cardiology | University of Aalborg | Denmark Dr. Engstrøm[/caption] Thomas Engstrøm  MD, PhD The Heart Center | Rigshospitalet | University of Copenhagen | Denmark Professor in cardiology | University of Lund | Sweden Adjunct professor in cardiology | University of Aalborg | Denmark  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Timely reperfusion by primary angioplasty (primary PCI) in patients with ST-elevation myocardial infarction is mandatory. However reperfusion it self can harm the myocardium - so called reperfusion injury. During a number of years ischemic postconditioning (iPOST) by repetitive interruptions of blood flow after reperfusion has been a promising technique to address reperfusion damage. The trial investigated the effect of iPOST in 1200 patients treated with primary PCI and in addition either iPOST or conventional angioplasty.
Author Interviews, NEJM, OBGYNE, Thyroid Disease, UT Southwestern / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32419" align="alignleft" width="70"]Professor, Brian Casey, M.D. Gillette Professorship of Obstetrics and Gynecology UT Southwestern Medical Center Dr. Casey[/caption] Professor Brian Casey, M.D. Gillette Professorship of Obstetrics and Gynecology UT Southwestern Medical Center  MedicalResearch.com: What is the background for this study? Response: For several decades now, subclinical thyroid disease, variously defined, has been associated with adverse pregnancy outcomes.  In 1999, two studies are responsible for increasing interest in subclinical thyroid disease during pregnancy because it was associated with impaired neuropsychological development in the fetus.  One study showed that children born to women with the highest TSH levels had lower IQ levels.  The other showed that children of women with isolated low free thyroid hormone levels performed worse on early psychomotor developmental tests. Together, these findings led several experts and professional organizations to recommend routine screening for and treatment of subclinical thyroid disease during pregnancy. Our study was designed to determine whether screening for either of these two diagnoses and treatment with thyroid hormone replacement during pregnancy actually improved IQ in children at 5 years of age.
ASCO, Author Interviews, Prostate Cancer, Radiation Therapy / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32573" align="alignleft" width="135"]Daniel A. Hamstra, MD PhD The Texas Center for Proton Therapy Irving, TX Dr. Hamstra[/caption] Daniel A. Hamstra, MD PhD Radiation Oncologist Beaumont Hospital Dearborn Michigan MedicalResearch.com: What is the background for the The SpaceOAR phase 3 trial study and the hydrogel spacer? Response: External beam radiation therapy is commonly used to treat men with prostate cancer. As part of this treatment, side effects can occur involving bowel, urinary, and sexual symptoms. This study was performed to test if an absorbable hydrogel placed between the prostate and rectum (using a simple outpatient procedure) could move the rectum away from the prostate and thus result in sparing of the rectum and decreased bowel toxicity. The study randomized 222 men and the three-year data were just published (The International Journal of Radiation Oncology Biology and Physics). With three years of follow-up, we saw that the spacer did improve the radiation plans and decreased both rectal toxicity and urinary toxicity.
Author Interviews, CDC, Fertility, Sexual Health, STD / 01.03.2017

[caption id="attachment_32569" align="alignleft" width="200"]Dr. Kirsten Kreise Dr. Kristen Kreisel[/caption] MedicalResearch.com Interview with: Dr. Kristen Kreisel PhD Epidemiologist at Centers for Disease Control and Prevention Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pelvic inflammatory disease (PID), an infection of the female reproductive tract often associated with STDs, is putting millions of women at risk for infertility, ectopic pregnancy and chronic pelvic pain. Our study looked at data from the National Health and Nutrition Examination Survey to estimate the national burden of PID. Findings show an estimated 4.4 percent of sexually-experienced women aged 18-44, or approximately 2.5 million woman nationwide reported a history of PID.
Author Interviews, Environmental Risks, Global Health / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32565" align="alignleft" width="159"]Dr. Meiyun Lin PhD Research Scholar NOAA and Princeton University’s Cooperative Institute for Climate Science Dr. Meiyun Lin[/caption] Dr. Meiyun Lin PhD Research  Scholar NOAA and Princeton University’s Cooperative Institute for Climate Science MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ground-level ozone, also known as smog, has climbed in the rural West over the past 25 years, even in such seemingly pristine places as Yellowstone National Park. We have found out why – and why cutting our own output of smog-forming chemicals such as nitrogen oxides by 50% hasn’t helped. This study found that increased pollution from Asia, which has tripled its nitrogen oxide emissions since 1990, contribute to the persistence of smog in the West. While ozone in the eastern U.S. has decreased overall, the levels can spike during heat waves, characterized by large-scale air stagnation, warm temperatures, and plentiful radiation needed for ozone formation locally. As heat waves appears to be on the rise due to global climate change, progress in reducing smog in the eastern US is likely to be slower in the coming decades.
AACR, Author Interviews, Diabetes, Genetic Research, Melanoma / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32560" align="alignleft" width="200"]Reeti Behera, Ph.D. Postdoctoral fellow in the Weeraratna lab The Wistar Institute Philadelphia PA Dr. Behera[/caption] Reeti Behera, Ph.D. Postdoctoral fellow in the Weeraratna lab The Wistar Institute Philadelphia PA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Malignant melanoma is an aggressive disease and is the cause of the majority of skin cancer deaths. In particular, older individuals have a much poorer prognosis for melanoma and are more resistant to targeted therapy than compared to young individuals. A recently published study from our lab has shown that age-related changes in secreted factors in the microenvironment can drive melanoma progression and therapy resistance. Klotho is a protein whose expression levels decreases with aging. In this study, we have shown that a decrease in klotho levels in the aged microenvironment drives melanoma aggression and therapy resistance by promoting the oncogenic signaling pathway Wnt5A. We also have shown that reconstituting klotho levels in the aged microenvironment by using rosiglitazone, an FDA-approved drug used to treat diabetes, can reduce tumor burden in aged mice. We also show that Klotho expression is decreased in therapy-resistant melanoma tumors. Reconstituting klotho levels in therapy-resistant melanoma cells by treating with rosiglitazone can inhibit Wnt5A levels and MAPK pathway. We also show that rosiglitazone can significantly decrease therapy-resistant tumor burden in the aged mice, but not in the young.
Author Interviews, Cognitive Issues, Multiple Sclerosis, NYU/NYMC / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32556" align="alignleft" width="149"]Leigh E. Charvet, PhD Associate Professor, Department of Neurology Department of Neurology New York University Langone Medical Center New York, NY Dr. Charvet[/caption] Leigh E. Charvet, PhD Associate Professor, Department of Neurology Department of Neurology New York University Langone Medical Center New York, NY MedicalResearch.com: What is the background for transcranial direct current stimulation? What are the main findings of this study in multiple sclerosis patients? Response: The application of tDCS is a relatively recent therapeutic development that utilizes low amplitude direct currents to induce changes in cortical excitability. When paired with a rehabilitation activity, it may improve learning rates and outcomes. Multiple repeated sessions are needed for both tDCS and cognitive training sessions to see a benefit. Because it is not feasible to have participants come to clinic daily for treatments, we developed a method to deliver tDCS paired with cognitive training (using computer-based training games) to patients at home. Our protocol uses a telemedicine platform with videoconferencing to assist study participants with all the procedures and to ensure safety and consistency across treatment sessions. When testing our methods, we enrolled 25 participants with multiple sclerosis (MS) completed 10 sessions of tDCS (2.0 mA x 20 minutes, dorsolateral prefrontal cortex, left anodal) using the remotely-supervised telerehabilitation protocol. This group was compared to n=20 MS participants who completed 10 sessions of cognitive training only (also through remote supervision). We administered cognitive testing measures at baseline and study end. We found that both the tDCS and cognitive training only group had similar and slight improvements on composites of standard neuropsychological measures and basic attention. However, the tDCS group had a significantly greater gain on computer-based measures of complex attention and on a measure of intra-individual variability in response times.
Author Interviews, BMJ, Cancer Research, Imperial College, Pediatrics, Weight Research / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32473" align="alignleft" width="149"]Dr Maria Kyrgiou MSc, PhD, MRCOG Clinical Senior Lecturer & Consultant in Gynaecologic Oncology IRDB - Department of Surgery and Cancer, Imperial College London West London Gynaecological Cancer Centre, Queen Charlotte's & Chelsea-Hammersmith Hospital, Imperial Healthcare NHS Trust Dr. Kyrgiou[/caption] Dr Maria Kyrgiou MSc, PhD, MRCOG Clinical Senior Lecturer & Consultant in Gynaecologic Oncology IRDB - Department of Surgery and Cancer, Imperial College London West London Gynaecological Cancer Centre, Queen Charlotte's & Chelsea-Hammersmith Hospital, Imperial Healthcare NHS Trust  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obesity has become a major public health challenge and it's prevalence worldwide has more than doubled amongst women n the last four decades. Excess body weight has been associated with an increased risk of developing and dying from numerous cancers. Although the reported associations may be potentially causal, some of the associations may be flawed due to inherent study biases such as residual confounding and selective reporting of positive results. We included 204 meta-analyses investigating associations between adiposity and the development or death from 36 primary cancers and their sub-types. Adiposity was associated with a higher risk of developing esophageal adenocarcinoma, gastric cardia, colon and rectal cancer in men, biliary tract system, pancreatic, postmenopausal breast among HRT non-users, endometrial, ovarian, and kidney cancer and multiple myeloma.
Author Interviews, Gender Differences, Heart Disease, JACC, Metabolic Syndrome / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32345" align="alignleft" width="176"]Mark D. DeBoer, MD Associate Professor of Pediatrics Division of Pediatric Endocrinology University of Virginia Charlottesville, VA 22908 Dr. DeBoer[/caption] Mark D. DeBoer, MD Associate Professor of Pediatrics Division of Pediatric Endocrinology University of Virginia Charlottesville, VA 22908 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Worldwide there remains a need for accurate prediction of cardiovascular disease. One such predictor is the metabolic syndrome, a cluster of individual risk factors including central obesity, high blood pressure, high triglycerides, low HDL cholesterol, and high fasting glucose. Metabolic Syndrome is usually diagnosed using set criteria, where a person is diagnosed if he or she has abnormalities in at least 3 of the individual components. Using these criteria, someone with MetS (compared to without MetS) has a >50% greater chance of developing cardiovascular disease over the ensuing 10 years. The problem is that prior studies showed that having MetS did not increase risk above that seen for having the abnormalities in the individual risk factors themselves. Our study used a continuous MetS severity score that we derived previously and assessed this score as a predictor of future cardiovascular disease in two large cohorts. We found that even when analyzed with abnormalities in the individual Metabolic Syndrome components, higher levels of the MetS severity score conferred higher risk for cardiovascular disease. This suggests the potential for following this score in individuals over time to identify those at higher risk for future cardiovascular disease.
Author Interviews, BMJ, Flu - Influenza, Karolinski Institute, OBGYNE, Pediatrics, Pharmacology / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32424" align="alignleft" width="146"]Dr. Sophie Graner Department of Women's and Childrens Health Karolinska Institute, Stockholm, Sweden Dr. Graner[/caption] Dr. Sophie Graner Department of Women's and Childrens Health Karolinska Institute, Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pregnant women are at increased risks of severe disease and death due to influensa infection, as well as hospitalization. Also influenza and fever increase the risk of adverse pregnancy outcomes for their infants such as intrauterine death and preterm birth. Due to this, the regulatory agencies in Europe and the US recommended post exposure prophylaxis and treatment for pregnant women with neuraminidase inhibitors during the last influenza pandemic 2009-10. Despite the recommendations, the knowledge on the effect of neuraminidase inhibitors on the infant has been limited. Previously published studies have not shown any increased risk, but they have had limited power to assess specific neonatal outcomes such as stillbirth, neonatal mortality, preterm birth, low Agar score, neonatal morbidity and congenital malformations.
Author Interviews, Brigham & Women's - Harvard, JAMA, Outcomes & Safety / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32411" align="alignleft" width="95"]Alisa Khan, MD, MPH Staff Physician Instructor in Pediatrics Boston Children's Hospital Dr. Khan[/caption] Alisa Khan, MD, MPH Staff Physician Instructor in Pediatrics Boston Children's Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​Medical errors are known to be a leading cause of death in the United States. However, the true rate at which errors and adverse events occur in medicine is believed to be even higher than what has been found through the most rigorous patient safety studies. Families are typically excluded from safety surveillance efforts, both in research and operationally in hospitals. We found that including families in safety reporting at four pediatric hospitals led to significantly higher error/adverse event detection rates, compared to the safety surveillance methodology typically considered most rigorous and highest yield in safety research. In addition, families reported errors/adverse events at similar rates as providers and at several-fold higher rates than the hospital incident reports which typically form the basis of operational hospital safety surveillance.
Author Interviews, Heart Disease, JACC, Lifestyle & Health, Race/Ethnic Diversity / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32341" align="alignleft" width="200"]Lu Qi, MD, PhD, FAHA HCA Regents Distinguished Chair and Professor Director, Tulane University Obesity Research Center Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans, LA 70112 Dr. Lu Qi[/caption] Lu Qi, MD, PhD, FAHA HCA Regents Distinguished Chair and Professor Director, Tulane University Obesity Research Center Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans, LA 70112  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adherence to healthy lifestyle (high physical activity, less smoking, moderate alcohol consumption, healthy diet, and low adiposity) has been related to substantially reduced risk of cardiovascular diseases in large cohorts from the US and Europe, however, similar evidence in Asians such as Chinese is lacking.
Author Interviews, Cancer Research, JAMA, Pediatrics, Radiation Therapy / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32379" align="alignleft" width="132"]Lucie Turcotte, MD, MPH University of Minnesota Masonic Children's Hospital Division of Pediatric Hematology-Oncology Assistant Professor Minneapolis, MN 55455 Dr. Lucie Turcotte[/caption] Lucie Turcotte, MD, MPH University of Minnesota Masonic Children's Hospital Division of Pediatric Hematology-Oncology Assistant Professor Minneapolis, MN 55455 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have observed dramatic improvements in the number of survivors of childhood cancer over the last 60 years. As more children are surviving, we have identified many important late health consequences of cancer therapy. One of the most devastating of these late health consequences is the diagnosis of a second cancer. As we have identified late effects, such as second cancers, we have modified therapy in an effort to prevent long-term sequelae of therapy, while still maintaining superior survival rates. For this study, we utilized data from the Childhood Cancer Survivor Study (CCSS), which is a cohort of more than 23,000 survivors of childhood cancer from multiple centers in North America, who were initially diagnosed between 1970 and 1999. Our analysis focused on elucidating whether survivors diagnosed more recently were experiencing fewer second cancers, and determining whether a reduction in second cancers could be associated with treatment modifications. The most important finding from this study is that the reductions in therapeutic radiation exposure that occurred between 1970-1999 resulted in a significant reduction in the second cancers experienced by survivors of childhood cancer.
Author Interviews, Dermatology, Rheumatology / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32535" align="alignleft" width="159"]Lihi Eder MD PhD Rheumatologist, Women’s College Hospital Scientist, Women’s College Research Institute Assistant Professor of Medicine, University of Toronto Toronto, ON, Canada Dr. Lihi Eder[/caption] Lihi Eder MD PhD Rheumatologist, Women’s College Hospital Scientist, Women’s College Research Institute Assistant Professor of Medicine, University of Toronto Toronto, ON, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: There significant delays in the diagnosis of psoriatic arthritis (PsA) among patients with psoriasis. Many patients with psoriasis experience musculoskeletal symptoms. The majority of them do not have PsA, but other non-inflammatory conditions such as fibromyalgia or osteoarthritis. In this study, we aimed to assess whether the presence and the degree of musculoskeletal symptoms in psoriasis patients predict the development of psoriatic arthritis. We analyzed a cohort of 410 psoriasis patients who were followed over a period of 9 years. These patients did not have arthritis at baseline. The patients were assessed annually by a rheumatologist for signs of PsA. A total of 57 patients developed psoriatic arthritis during the follow-up period.
Alzheimer's - Dementia, Author Interviews, Lancet, Vaccine Studies / 01.03.2017

MedicalResearch.com Interview with: [caption id="attachment_32529" align="alignleft" width="200"]Petr Novak, MD, PhD AXON Neuroscience Bratislava, Slovakia Dr. Petr Novak[/caption] Petr Novak, MD, PhD AXON Neuroscience Bratislava, Slovakia MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease is a complex, multifactorial disorder, with many-faceted neuropathology. A hallmark finding is the co-existence of neurofibrillary pathology (such as neurofibrillary tangles) composed of tau protein, and amyloid-β pathology (plaques) [1]. Neurofibrillary pathology is closely correlated with cognitive impairment in Alzheimer’s disease [2], while support for the role amyloid in the disease pathogenesis comes from the ability of certain mutations to induce AD in an autosomal-dominant fashion [3]. The field has explored various anti-amyloid therapies to great extent, and continues to do so with undiminished effort [4]; meanwhile, there is a noticeable paucity of investigated therapies aimed at neurofibrillary tau protein pathology, despite the ability of tau protein dysfunction to cause a multitude of neurodegenerative disorders, collectively named “tauopathies” [5]. AADvac1 is the first tau-targeted immunotherapy investigated in humans [6], a pioneering effort to target the component of AD neuropathology that is proximal to neuronal damage and cognitive loss, and thus to halt or slow the progression of Alzheimer’s disease.
ADHD, Author Interviews, Lancet, MRI, Neurological Disorders / 01.03.2017

MedicalResearch.com Interview with: M. (Martine) Hoogman PhD. Postdoc and PI of ENIGMA-ADHD Radboud universitair medisch centrum Department of Human Genetics Nijmegen, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many neuro-imaging studies aimed at investigating structural brain changes related to ADHD, but the results are often inconclusive. There are two main reasons for this: 1) the small sample size of the studies and 2) the heterogeneous methods used. We tried to address these issues by forming an international collaboration to provide a sample size sufficient to detect even small effects in volume differences. And in addition, we analyzed all the raw scans again using homogenized methods. There are data of more than 1700 patients (aged 4-63 years of age) and more than 1500 healthy controls in our dataset, coming from 23 sites around the world. We studied the possible volume differences between cases and controls of 7 subcortical regions and intracranial volume by performing mega- and meta-analysis.
Author Interviews, Circadian Rhythm, Nutrition, Sleep Disorders, Weight Research / 01.03.2017

MedicalResearch.com Interview with: Mirkka Maukonen MSc (nutrition), PhD Candidate the National Institute for Health and Welfare, Department of Public Health Solutions Helsinki, Finland MedicalResearch.com: What is the background for this study? Response: Recent literature has highlighted the importance of sleep and circadian rhythms in development of obesity and metabolic dysfunctions. Furthermore, it has been suggested that in addition to quality of the diet also meal timing may play role in development of obesity. For example, skipping breakfast and eating at later times in the evening have been associated with higher BMI. However, little is known about how the timing of circadian rhythms (chronotype) affects timing of energy intake and its association with metabolic health.