Author Interviews, Blood Pressure - Hypertension, Cleveland Clinic, JAMA / 16.06.2016

MedicalResearch.com Interview with: Krishna Patel, MD, PG Y3 Resident Internal Medicine Residency Program Cleveland Clinic Cleveland, OH 44195 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Patel: In our outpatient resident clinic practice, we found that patients with poorly controlled hypertension presenting with blood pressures in the hypertensive urgency range (SBP>=180mmHg or DBP >=110 mmHg) but with no symptoms of end-organ damage were common, however there was no clear cut manner in which these patient's blood pressures were treated. According to the comfort level of the physician, these patients were managed in the office and on serial outpatient visits and some of the patients would be referred to the emergency department for management of these elevated blood pressures. Given there was not much prior literature on this topic, we decided to study the prevalence and short term cardiovascular outcomes for this population of patients. We found that hypertensive urgency is quite common in the office setting (4.6% in our study). In absence of symptoms of end organ damage, the short term risk of major cardiovascular events was very low around 1%, and patients who were referred to the ED for management of blood pressures had a lot of unnecessary testing and more hospital admissions than those who were managed as an outpatient. (more…)
Aging, Author Interviews, Gender Differences / 16.06.2016

MedicalResearch.com Interview with: Kathleen Fischer, PhD Department of Biology UAB | University of Alabama Birmingham Birmingham, AL MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Fischer: Aging is by far the greatest risk factor for most of the chronic, non-communicable diseases (e.g. cardiovascular disease, cancer, diabetes). By discovering the basic mechanisms responsible for aging we can find ways to extend healthy and productive life and reduce the burdens of chronic disease and disability experienced by individuals and society. Sex differences in longevity can provide novel insights into the basic biology of aging; however this aspect of aging has been largely ignored. Demographic data show that women outlive men in every society during every historical period and in every geographic area. In spite of this robust survival advantage, women suffer far greater morbidity late in life—a phenomenon described as the morbidity-mortality paradox. It is not clear whether this is a general mammalian pattern or something unique to humans. Research on sex differences in aging and age-related diseases in humans and a range of species will be crucial if we are going to identify the basic mechanisms responsible for the patterns we observe. (more…)
Author Interviews, JAMA, Schizophrenia / 16.06.2016

MedicalResearch.com Interview with: Kate Merritt PhD Post-Doctoral Research Worker NOC Study (Nitric Oxide in Cognition) Institute of Psychiatry De Crespigny Park London MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Merritt: Research has indicated that levels of one of the main chemicals in the brain, glutamate, may be abnormal in schizophrenia. Almost sixty studies have measured glutamate levels in schizophrenia, however the findings are inconsistent, and it is thought that changes in glutamate levels may vary with the length or the severity of illness. This study therefore analysed all the published reports of glutamate in schizophrenia. The main findings are that, overall, schizophrenia is associated with elevated glutamate in several brain regions; namely the medial temporal cortex, the basal ganglia and the thalamus. These changes also differed with the stage of illness; in the medial frontal cortex, glutamate was increased in people at risk for developing schizophrenia, but not in people who had been diagnosed with schizophrenia for several years, whereas in the medial temporal lobe the opposite pattern was detected. (more…)
AHRQ, Author Interviews, Cost of Health Care / 16.06.2016

MedicalResearch.com Interview with: Celeste M. Torio, Ph.D., M.P.H Scientific Review Officer AHRQ MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Torio: Hospital care expenditures constitute the largest single component of health care spending. These expenses are of significant concern to policymakers because of their impact on governments, consumers and insurers. MedicalResearch.com: What are the main findings? • Aggregate hospital costs for 35.6 million hospital stays totaled $381.4 billion in 2013. • Septicemia, osteoarthritis, newborn infants, complication of device, and acute myocardial infarction are the five most expensive conditions, and account for 1/5 of the total aggregate costs for hospitalizations. • Sixty-three percent of aggregate hospital costs were covered by Medicare and Medicaid, while 28 percent were covered by private insurance and 5 percent were covered by the uninsured. (more…)
Author Interviews, Pediatrics, Pediatrics, Toxin Research / 16.06.2016

MedicalResearch.com Interview with: Leland McClure, PhD Director in Medical Affairs for Quest Diagnostics Fellow of the American Board of Forensic Toxicology MedicalResearch.com: What is the background for this study? Dr. McClure: Quest Diagnostics is the leading provider of diagnostic information services, providing clinical lab testing to about one in three American adults each year. As a result, we've amassed the largest private clinical laboratory database in the United States, based on 20 billion data points from lab testing. Quest uses this data (in de-identified, HIPAA compliant form) to perform research -- called Quest Diagnostics Health Trends(TM) -- to reveal insights on important health issues to inform clinical patient management and health policy. Other Health Trends reports have focused on diabetes, pregnancy and influenza, among others. (more…)
Author Interviews, Erectile Dysfunction, Melanoma, PLoS / 16.06.2016

MedicalResearch.com Interview with: Anthony Matthews Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine London, United Kingdom MedicalResearch.com: What is the background for this study? Dr. Mathews: :The drug Viagra, which is used to treat erectile dysfunction, is one of a class of drugs called PDE5 inhibitors. Laboratory studies of cells from the skin cancer, malignant melanoma, suggest that PDE5 inhibitors might promote their growth, so there have been some concerns that people using these drugs might have an increased risk of malignant melanoma. Two previous studies comparing melanoma rates in PDE5 inhibitor users and non-users came to differing conclusions so we wanted to look further into this. To carry out the study we used anonymised GP records from the UK identifying over 150,000 men with a PDE5 inhibitor prescription, and over 500,000 men of a similar age, and from the same areas, who didn’t have a PDE5 inhibitor prescription. We then looked for later diagnoses of malignant melanoma to see how people’s exposure to PDE5 inhibitors affected their future risk of being diagnosed with melanoma. (more…)
Author Interviews, Colon Cancer, JAMA / 16.06.2016

MedicalResearch.com Interview with: Jennifer S. Lin, MD, MCR, FACP Director, Kaiser Permanente Research Affiliates Evidence-based Practice Center Investigator, The Center for Health Research, Kaiser Permanente Northwest Portland, OR 97227 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Lin: Our systematic review was commissioned by the USPSTF, in tandem with a separate modeling exercise, to help update their 2008 colorectal cancer screening recommendations. Since the previous recommendation, there has been a wealth of new evidence, including more evidence on the long-term effectiveness of flexible sigmoidoscopy for reducing colorectal cancer mortality, the screening accuracy and decreasing radiation exposure from CT colonography, and the screening accuracy for a number FDA-approved stool tests using fecal immunochemical testing (FIT). While we have large, well-designed RCTs demonstrating that screening for colorectal cancer using flexible sigmoidoscopy and older generation stool testing reduces colorectal cancer mortality, these screening tests are no longer widely used in the United States. Well-designed diagnostic accuracy studies of screening colonoscopy, CT colonography, and various stool based tests using FIT demonstrate adequate sensitivity and specificity to detect adenomas and/or colorectal cancer, making each of them viable screening options. However, each screening option has potential harms associated with their use, particularly those allowing for direct visualization of the colon. Colonoscopy harms include perforations and major bleeding events. CT colonography requires exposure to radiation; and CT colonography not uncommonly results in detection of extra-colonic findings which necessitate additional diagnostic follow-up which may result in a benefit or harm. (more…)
Author Interviews, Heart Disease, Kidney Disease / 15.06.2016

MedicalResearch.com Interview with: Burns C. Blaxall, PhD, FAHA, FACC, FAPS Director of Translational Science, Heart Institute Co-Director, Heart Institute Research Core & Biorepository Professor, UC Department of Pediatrics MedicalResearch.com: What is the background for this study? Dr. Blaxall: The development of kidney disease subsequent to chronic heart failure is known clinically as cardiorenal syndrome 2, and is associated with dual organ failure and reduced survival. Furthermore, patients undergoing invasive cardiac procedures that require heart-lung bypass are at significant risk for developing kidney injury. According to the National Kidney Foundation, cardiorenal syndrome 2 presents a considerable economic burden of around $30 billion annually. Previous work has demonstrated the role of G protein-coupled receptor (GPCR) signaling and the activation of G protein βγ (Gβγ) subunits in the development and progression of heart failure, however little is known regarding the role of this signaling pathway in kidney disease. (more…)
Author Interviews, CDC, HIV, Sexual Health, Technology / 15.06.2016

MedicalResearch.com Interview with: Dr. James M. Smith Ph.D Laboratory Branch, Division of HIV/AIDS Prevention Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: What is the background for this study? Dr. Smith: Our laboratory has been developing a macaque model for testing drug release, safety and efficacy of intravaginal rings (IVR) for preexposure prophylaxis (PrEP) against HIV for several years. The initial studies involved both matrix rings, where the drug is dispersed in the silicone matrix of the device, and reservoir rings, which are essentially a polymer tube filled with drug. In collaboration with the Oak Crest Institute of Science and Auritec Pharmaceuticals, Inc., we began testing a new type of intravaginal ring, the pod-IVR. In this innovative design the ring itself is a scaffold that contains compressed polymer-coated drug tablets, or pods, within the ring. Each pod is separate, allowing for a customizable release rate for each drug by varying the number and diameter of the drug release ports for each individual pod. The macaque pod-IVR can accommodate up to six pods whereas the human pod-IVR can accommodate up to 10 pods. The IVR design was developed to allow the delivery of drug combinations and for simple, cost-effective manufacturing. (more…)
Author Interviews, Hematology, HIV, Stem Cells, Transplantation / 15.06.2016

MedicalResearch.com Interview with: Joseph Alvarnas, MD Associate clinical professor Department of hematology and Director of value-based analytics City of Hope National Medical Center Duarte, CA MedicalResearch.com: What is the background for this study? Dr. Alvarnas: Patients with HIV infection have a significantly increased risk of non-Hodgkin lymphoma and Hodgkin lymphoma. Prior to the availability of effective anti-retroviral therapy, HIV-infected patients with lymphoma had very poor treatment outcomes. Following the availability of effective anti-HIV therapy, patient outcomes for HIV-infected patients now parallel those of non-infected patients. Historically, however, HIV infection has been used as a criterion for not offering patients autologous blood stem cell transplantation outside of centers with unique expertise. The purpose of this trial was to evaluate outcomes, complication rates, and immunological reconstitution of HIV-infected patients following autologous blood stem cell transplantation. (more…)
Author Interviews, Diabetes, Pharmacology / 15.06.2016

MedicalResearch.com Interview with: Professor Philip Home D.M., D.Phil Professor of Diabetes Medicine Newcastle University MedicalResearch.com: What is the background for this study? What are the main findings? Prof. Home: MK1293 is a biosimilar insulin designed with the same amino acid sequence, manufacturing process and formulation as originator insulin glargine (Lantus). This is the clinical proving study in type 1 diabetes, being a 24-week randomized study in 508 participants between MK1293 and Lantus. The primary efficacy endpoint of non-inferiority of HbA1c was met, as was a secondary of equivalence (difference in change from baseline 0.04 (95% CI -0.11, 0.19) %-units), with other measures including hypoglycaemia, insulin antibodies and adverse events also consistent with similarity. (more…)
Author Interviews, Circadian Rhythm, Sleep Disorders, Weight Research / 15.06.2016

MedicalResearch.com Interview with: Kelly Glazer Baron, PhD, MPH, C. B.S.M. Diplomate, Academy of Cognitive Therapy Northwestern University Feinberg School of Medicine Chicago, IL 60611 MedicalResearch.com: What is the background for this study? What are the main findings? Response: In contrast to several previous studies, being a late sleeper was not associated with higher BMI (good news for late sleepers!!) but it was associated with less healthy behaviors, more fast food, fewer vegetables, lower dairy. It may be possible that these late sleepers who are able to get enough sleep can compensate for their poor diet by controlling overall calories or it could possibly lead to weight gain over time if their habits continue over time. (more…)
Annals Internal Medicine, Author Interviews, Chemotherapy, Heart Disease, Karolinski Institute, Leukemia / 15.06.2016

MedicalResearch.com Interview with: Torsten Dahlén MD Centre for Hematology Karolinska University Hospital Solna Stockholm Sweden MedicalResearch.com: What is the background for this study?  Dr. Dahlén: Patients diagnosed with CML have had a dramatic increase in life-expectancy since the widespread introduction of tyrosine kinase inhibitors (TKI) in 2001. However, treatment is today regarded as life-long. We thus need to observe for late-effects of continuous TKI exposure. Recent reports have demonstrated a linkage between TKI treatment, especially more potent 2nd and 3rd generation drugs, and to the occurrence of peripheral arterial occlusive disease (PAOD). This study aimed to use real-world data utilizing Swedish population based registries together with the dedicated Swedish CML registry which contains data and follow-up on more than 98% of all CML patients diagnosed in Sweden since 2002. (more…)
Author Interviews, JAMA, Pharmacology, UCSD, Weight Research / 15.06.2016

MedicalResearch.com Interview with: Siddharth Singh, MD, MS Postdoctoral Fellow, NLM/NIH Clinical Informatics Fellowship Division of Biomedical Informatics Clinical Assistant Professor of Medicine, Division of Gastroenterology, Department of Internal Medicine, University of California San Diego, La Jolla MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Singh: Over the last 4 years, four new medications have been approved for long-term use for weight loss by the FDA. We sought to evaluate the comparative effectiveness and tolerability of these medications through a systematic review and network meta-analysis. Based on 28 trials in over 29,000 overweight or obese patients, we observed that magnitude of weight loss achieved with these agents is variable, ranging from 2.6kg with orlistat to 8.8kg with phentermine-topiramate. Over 44-75% of patients are estimated to lose at least 5% body weight, and 20-54% may lose more than 10% of body weight; phentermine-topiramate was the most efficacious, whereas lorcaserin was the best tolerated. (more…)
Author Interviews, Cancer Research, Chemotherapy, Immunotherapy / 15.06.2016

MedicalResearch.com Interview with: Professor Frances Balkwill OBE, FMedSci Lead, Centre for Cancer and Inflammation Barts Cancer Institute Queen Mary University of London London MedicalResearch.com: What is the background for this study? Prof. Balkwill: We wanted to find out if chemotherapy altered patients immune system especially the immune cells that co-exist with cancer cells in tumors. We studied women with ovarian cancer who often receive chemotherapy after diagnosis but before surgery. This meant, at least in some of them, we could study a biopsy taken before treatment began and also a biopsy taken during the operation. (more…)
Accidents & Violence, Author Interviews, Emergency Care / 15.06.2016

MedicalResearch.com Interview with: Angela Sauaia MD PhD Professor of Public Health, Medicine, and Surgery University of Colorado Denver MedicalResearch.com: What is the background for this study? What are the main findings? Authors: Americans mourn firearm related fatalities every day. Mass shootings are just the tip of the iceberg of the daily tragedy witnessed by trauma surgeons in emergency rooms. Industries strive to reduce the perils associated with motor vehicles, pedestrian and bicycles accidents, just to cite a few, through technology and education. Firearms move in the exact opposite direction. They are becoming progressively more dangerous and we have done little in terms of education to prevent accidents. The same trend is true for monitoring statistics. It is not difficult to obtain statistics on which type of car was associated with more accidents or fatalities. Conversely, trying to obtain data on which type of firearms are more likely to result in accidents or death is extremely difficult. We used the best data we could find and found that, contrary to every other injury mechanism, firearm injuries are becoming more lethal. In simple words, if you get into a car accident today, you are more likely to survive it due to improvements in trauma care and safety of vehicles than 10 years ago. On the other hand, if you get shot today, you are more likely to die than if you were shot 10 years ago, despite our excellent trauma care. (more…)
Author Interviews, Brigham & Women's - Harvard, Diabetes, Nutrition, PLoS / 15.06.2016

MedicalResearch.com Interview with: Ambika Satija Departments of Nutrition & Epidemiology Harvard T. H. Chan School of Public Health Boston, MA MedicalResearch.com: What is the background for this study? Response: In this study, we followed more than 200,000 male and female health professionals across the U.S. for more than 20 years who had regularly filled out questionnaires on their diet, lifestyle, medical history, and new disease diagnoses as part of three large long-term studies. (more…)
Author Interviews, Cognitive Issues, Sleep Disorders / 14.06.2016

MedicalResearch.com Interview with: Anna Alkozei, Ph.D. Postdoctoral Research Fellow SCAN Lab, Psychiatry Department University of Arizona Tucson, AZ 85724-5002 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Alkozei: We know that exposure to blue wavelength light, which is similar to the kind of light that we get on a bright sunny day, can improve attention and alertness during the day as well as at night. We wanted to extend previous findings by investigating whether blue light exposure can affect cognitive functioning after the blue light exposure period had already ended. We found that thirty minutes of exposure to blue wavelength light during the day, in comparison to an amber light exposure led to subsequently faster reaction times on a cognitive task forty minutes after the light exposure had already ended. Participants who were exposed to blue light also showed more efficient responding, which means they answered more items correctly per second, than individuals who were exposed to amber placebo light. Finally, we also found that individuals who were exposed to blue light showed greater activation within the prefrontal cortex when performing the task, an area necessary for optimal cognitive performance, than individuals who were exposed to amber light. (more…)
Author Interviews, Pharmacology, Sleep Disorders / 14.06.2016

MedicalResearch.com Interview with: Anna-Therese Lehnich Zentrum für Klinische Epidemiologie (ZKE) c/o Institut für Medizinische Informatik Biometrie undEpidemiologie (IMIBE) MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sleep disturbances and their consequences are often underestimated but they are of high importance with respect to public health. We were interested in the question whether drugs labeled as sleep disturbing in the summary of product characteristics actually lead to more sleep disorders like difficulties falling asleep, difficulties maintaining sleep, and early morning arousal. To answer this question, we analyzed data of 4,221 persons from Germany. (more…)
Author Interviews, Mental Health Research / 14.06.2016

MedicalResearch.com Interview with: Dr. Alexandra Pitman BA MSc(Econ) MBBS MRCPsych FHEA PhD Honorary Research Associate & Consultant Psychiatrist, Division of Psychiatry University College London London MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Pitman: We conducted this study to settle a long-standing debate over whether bereavement by suicide is more stigmatising than bereavement due to other causes of sudden death. This is important because the more we understand about the stigma of suicide bereavement, the better equipped we are to design services to support this group. Providing support for people bereaved by suicide is one of five key messages in WHO suicide prevention strategy, and features prominently in the suicide prevention strategies of high income countries such as England, Wales, Northern Ireland, the US, and Australia. The evidence to date suggests that we lack effective interventions to address their known risk of suicide and mental health problems, constituting a failure to tackle an important public health problem. Although suicide is commonly believed to be highly stigmatising for bereaved relatives and friends, qualitative work suggests that people bereaved by other causes of death also feel stigmatised by their loss. For example, a British study of people bereaved by suicide and other unnatural causes of death found that interviewees in both groups described societal pressure to contain their grief and even to hide it. Our earlier systematic review in the Lancet Psychiatry had identified studies comparing health and mortality outcomes in people bereaved by suicide and other causes of death, among which 7 studies had compared perceived stigma scores using a validated measure. In all cases the measure was the stigmatization subscale of the Grief Experience Questionnaire. Taken together these studies were inconclusive as to whether people bereaved by suicide and other unnatural mortality causes differed in relation to stigma scores. Partly the problem seemed to be one of sample size in having insufficient statistical power to demonstrate score differences, should they exist. We decided to conduct a large-scale British study to compare grief outcomes such as stigma, shame, responsibility and guilt, as well as clinical outcomes such as suicide attempt. Previously published findings from this study, reported in BMJ Open, show an increased risk of suicide attempt in people bereaved by suicide, whether related to the deceased or not. (more…)
ASCO, Author Interviews, Breast Cancer, Genetic Research, Journal Clinical Oncology, NIH / 14.06.2016

MedicalResearch.com Interview with: Valentina Petkov, MD, MPH Health Scientist/Program Officer NIH/NCI/DCCPS/Surveillance Research Program MedicalResearch.com: What is the background for this study? Dr. Petkov: The number of breast cancer diagnoses is increasing in older patients because of increasing life expectancy and changing population demographics. Despite high incidence, little is known about breast cancer biology and outcomes in patients older than 70, which are often under-represented in clinical trials. The 21-gene Oncotype DX Breast Recurrence Score assay has been used in clinical practice to predict distant recurrence risk and chemotherapy benefit in lymph node negative, hormonal receptor positive (estrogen and/or progesterone receptor positive) invasive breast cancer since 2004. The goal of our study was to evaluate the role of the 21 gene assay in older patients at population level. We used Surveillance Epidemiology and End Results (SEER) data. We included in the analysis 40,134 patients who were diagnosed with invasive breast cancer between 2004 and 2011, had negative nodes and their tumors were hormonal receptor positive and HER2 negative. Breast Cancer Specific Mortality (BCSM) was assessed at 5 years after diagnosis in patients with low risk (Recurrence Score <18), intermediate risk (Recurrence Score 18-30) and high risk (Recurrence Score >30). (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JACC / 14.06.2016

MedicalResearch.com Interview with: Duk-Woo Park, MD, PhD Division of Cardiology, Asan Medical Center University of Ulsan College of Medicine and National Evidence-based Healthcare Collaborating Agency Seoul, Republic of Korea MedicalResearch.com: What is the background for this study? What are the main findings? Response: Currently, less restrictive blood pressure (BP) target by the 2014 hypertension guidelines (JNC-8) and more intensive BP target of the SPRINT is now conflicting, which causes uncertainty and confusion among clinicians. In our study, the proportion of persons who would meet the SPRINT BP goals is substantially less than those who would meet the 2014 guideline blood pressure goals. There is a positive association between the risk of major cardiovascular events and increasing levels of BP control status under different 2014 guideline and SPRINT criteria. Our study reconfirmed the findings of the SPRINT trials in real-world population. (more…)
Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, JAMA, Stroke / 14.06.2016

MedicalResearch.com Interview with: Alessandro Biffi, MD Behavioral Neurology and Neuropsychiatry Departments of Neurology and Psychiatry Massachusetts General Hospital / Harvard Medical School MedicalResearch.com: What is the background for this study? Dr. Biffi: Intracerebral Hemorrhage (ICH) is the most severe form of stroke. It is a form of hemorrhagic (i.e. bleeding) stroke that accounts for ~ 15% of all acute cerebrovascular conditions, affecting ~ 70,000 Americans every year. However, because of its severity it is responsible for almost half of all stroke-related disability worldwide. Survivors of ICH are at very high risk for cognitive impairment (up to and including dementia) following the acute cerebral bleeding event. However, we possess very limited understanding of the time dynamics and risk factors for post-ICH dementia. In particular, prior to our study it was unclear whether the acute cerebral injury due to ICH would be the only mechanism potentially responsible for subsequent development of dementia. This question is motivated by prior observations suggesting that Intracerebral Hemorrhage represents the acute manifestation of cerebral small vessel disease, a progressive degenerative disorder of small caliber arteries of the central nervous system. There exist two major subtypes of small vessel disease: 1) cerebral amyloid angiopathy, caused by the deposition of a toxic protein product, beta-amyloid, in the blood vessels (in a process similar to the formation of beta-amyloid plaques that cause Alzheimer's disease); 2) arteriolosclerosis, caused by long-standing elevated blood pressure. ICH survivors have been previously shown to harbor very severe small vessel disease, which has been linked to dementia in patients without cerebral bleeding. Our hypothesis was that early-onset dementia (occurring in the first 6 months after ICH) is a manifestation of the acute neurological damage associated with cerebral bleeding, whereas delayed onset dementia (developing beyond 6 months from the acute ICH event) is associated with known markers of small vessel disease, including imaging findings on CT/MRI and genetic markers (such as the APOE gene). (more…)
AHA Journals, Author Interviews, Brigham & Women's - Harvard, Nutrition / 14.06.2016

MedicalResearch.com Interview with: Geng Zong, Ph.D. Research fellow at Harvard T.H. Chan School of Public Health Boston, Massachusetts. MedicalResearch.com: What is the background for this study? What are the main findings? Response: The refining process of grains removes most of fiber, minerals, vitamins, polyphenols and alkyl resorcinols that mainly exist in the outer layer of a kernel, thus enriches grains with carbohydrate and energy. Whole grains, on the other hand, are cereal grains or processed cereal grains that contains bran and germ, in addition to the inner most endosperm, as their natural proportions in the kernel. Observational studies have repeatedly linked whole grain intake with major chronic diseases, including obesity, diabetes, cardiovascular diseases, and cancer, but findings regarding mortality are inconsistent and have not been quantitatively summarized. By meta-analyzing 14 existing or unpublished prospective cohort studies, our investigation found that whole grain intake is inversely associated with mortality risk from all-causes, CVD, and cancer. Among people with whole grain consumption, estimated all-cause mortality risk was 7% (for 10 grams/day), 16% (for 30 grams/day), 20% (for 50 grams/day), and 22% (for 70 grams/day) lower than people with no whole grain consumption. Similar dose-response relationship was observed for CVD and cancer mortality. (more…)
Author Interviews, Biomarkers, Cancer Research, Infections, Technology, University of Pittsburgh / 13.06.2016

MedicalResearch.com Interview with: Donald S. Burke, M.D. Dean of the University of Pittsburgh Graduate School of Public Health Director of the University of Pittsburgh Center for Vaccine Research MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Burke: At the University of Pittsburgh we developed a unique method for detecting antibodies in the blood of patients in a proof-of-principle study that opens the door to development of simple diagnostic tests for diseases for which no microbial cause is known, including auto-immune diseases, cancers and other conditions. We used a technique pioneered by co-author Thomas Kodadek, Ph.D., of the Scripps Research Institute, that synthesizes random molecular shapes called “peptoids” hooked onto microscopic plastic beads. The technique can produce millions of molecular shapes. The peptoids are not organic, but if they match to the corresponding shape on an antibody, that antibody will connect to them, allowing the scientist to pull out that bead and examine that peptoid and its corresponding antibody. My team chemically generated a huge library of random molecular shapes. Then, using blood from HIV-infected patients and from non-infected people, we screened a million of these random molecular shapes to find the ones that bound only to antibodies present in the blood of HIV-infected patients, but not the healthy controls. No HIV proteins or structures were used to construct or select the peptoids, but the approach, nonetheless, successfully led to selection of the best molecular shapes to use in screening for HIV antibodies. We then resynthesized that HIV-antibody-targeting peptoid in mass and tested it by screening hundreds of samples from the Multicenter AIDS Cohort Study (MACS), a confidential research study of the natural history of treated and untreated HIV/AIDS in men who have sex with men (supported by the National Institutes of Health). Study co-author Charles Rinaldo, Ph.D., chair of Pitt Public Health’s Department of Infectious Diseases and Microbiology and director of the Pittsburgh arm of the MACS, selected the samples, but blinded the testers to which samples were HIV-positive or -negative. The test distinguished between the samples of HIV-positive blood and HIV-negative blood with a high degree of accuracy. (more…)
Author Interviews, Diabetes, Kidney Disease, Pharmacology / 13.06.2016

MedicalResearch.com Interview with: Doctor Hiddo Lambers Heerspink Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: SGLT2 inhibitors, including canagliflozin, have beneficial effects on multiple cardiovascular and renal risk parameters. This suggests that SGLT2 inhibitors may confer cardiovascular and renal protection. A recent large clinical trial with the SGLT2 inhibitor empagliflozin demonstrated marked reductions in cardiovascular morbidity and mortality and suggested possible renoprotective effects. Whether SGLT2 inhibition slows the progression of kidney function decline independent of its glucose-lowering effect, however, is unknown. We therefore assessed whether canagliflozin slows the progression of kidney function decline by comparing the effects of canagliflozin versus glimepiride on eGFR and albuminuria. (more…)
Author Interviews, Biomarkers, Pain Research / 13.06.2016

MedicalResearch.com Interview with: Dr. Gretchen Tietjen MD Professor and Chair of Neurology Director of UTMC Headache Treatment and Research Program Director of the UTMC Stroke Program MedicalResearch.com: What is the background for this study? Dr. Tietjen : C-reactive protein (CRP) is a well-established biomarker of inflammation. Elevated levels of CRP predict future cardiovascular events, such as myocardial infarction (heart attack) and stroke. Evidence linking higher CRP levels with migraine is limited and results from large population-based studies are conflicting. The National Health and Nutrition Examination Survey (NHANES) data for children and adolescents linked elevated CRP to headache, particularly in girls, and the Women’s Health Study showed an association of CRP with migraine in women over 45 years of age. In the Reykjavik study, CRP levels in persons with migraine were similar to levels in those without migraine. The aim of our study was to examine the relationship of CRP and migraine in a large population-based sample of over 9,000 young adults (24 to 32 years old) from The National Longitudinal Study of Adolescent to Adult Health (Add Health). (more…)
Author Interviews, JAMA, Microbiome, Pediatrics, Weight Research / 13.06.2016

MedicalResearch.com Interview with: Dr. Katri Korpela, PhD University of Helsinki Helsinki MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Korpela: Previous studies have shown that breastfeeding reduces the frequency of infections in the child and is associated with lower risk of childhood overweight. Conversely, antibiotic use in early life is associated with increased BMI. Both antibiotic use and breastfeeding are known to influence the infant's microbiota. However, these two factors have not been studied together and it was not known whether antibiotic use could modify the beneficial effects of breastfeeding. We collected data on lifetime antibiotic use, breastfeeding duration, and BMI in a group of daycare-attending children aged 2-6 years. We found that the beneficial effects on long breastfeeding, particularly as regards BMI development, were evident only in the children who did not get antibiotics in early life. Antibiotic use before or soon after weaning seemed to eliminate the protection against elevated BMI in preschool age and weaken the protection against infections after weaning. (more…)
Author Interviews, Sleep Disorders, University of Pennsylvania / 12.06.2016

MedicalResearch.com Interview with: Richard J. Schwab, MD Professor, Department of Medicine Division of Sleep Medicine Pulmonary, Allergy and Critical Care Division Co-Director, Penn Sleep Center University of Pennsylvania Medical Center Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Schwab: Hypoglossal nerve stimulation is a pacemaker (a tiny generator and a sensing lead) placed in the right side of the chest, but instead of using electrical pulses to control the heart, the device stimulates the hypoglossal nerve which is the nerve that controls the motion of the tongue. Patients use a remote control to turn on the device before going to sleep and turn it off upon waking up. Stimulation of the tongue moves the tongue forward which enlarges the upper airway. (more…)
Author Interviews, Cannabis, CHEST, Pulmonary Disease / 12.06.2016

MedicalResearch.com Interview with: Stefania I. Papatheodorou, MD, PhD Cyprus International Institute for Environmental and Public Health Limassol, Cyprus MedicalResearch.com: What is the background for this study? What are the main findings? Response: Marijuana is the most commonly used illicit drug in the United States. Despite increasing use and acceptance of marijuana, both medically and recreationally, gaps remain in our knowledge regarding potential health effects. In this study, we aimed to evaluate associations between recent marijuana use, exhaled Nitric Oxide (eNO) and pulmonary function. We performed a cross-sectional study of 10,327 US adults participating in the National Health and Nutrition Examination Survey (NHANES) in the years 2007 to 2012. Exhaled Nitric Oxide was lower among participants who used marijuana in the past 0 to 4 days and those who last used marijuana 5 to 30 days before the examination compared with the never users. FEV1 was higher among participants who used marijuana within 0 to 4 days before the examination compared with those who never used marijuana, while FVC was higher in both past and current marijuana users compared with never users. The FEV1/FVC ratio was significantly lower among those who used marijuana in the 0 to 4 days before the examination compared with never users. (more…)