Author Interviews, Cancer Research, Immunotherapy, NEJM / 02.05.2016

MedicalResearch.com Interview with: Paul Nghiem, MD, PhD Professor & Head, University of Washington Dermatology George F. Odland Endowed Chair Affiliate Investigator, Fred Hutchinson Cancer Research Center Professor, Adjunct, of Pathology and Oral Health Sciences Clinical Director, Skin Oncology, Seattle Cancer Care Alliance UW Medical Center at Lake Union Seattle WA 98109   MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Nghiem: Merkel cell carcinoma (MCC) is about 30 times less common than malignant melanoma, but about 3 times more likely to kill a patient than a melanoma. There is no FDA-approved therapy for this cancer & chemotherapy typically only provides about 90 days prior to the cancer progressing. Because of the strong links between MCC and the immune system, including the fact that most MCCs are caused by a virus, there was interest in trying to use immune checkpoint therapy to treat advanced Merkel cell carcinoma. The response to immune stimulation with anti-PD1 therapy was about as frequent as to chemotherapy (56% of patients responded) but importantly, among the responders, 86% remained in ongoing responses at a median of 7.6 months.  While still early, this appears to be strikingly more durable than responses to chemotherapy. (more…)
Author Interviews, Biomarkers, Prostate Cancer / 02.05.2016

MedicalResearch.com Interview with: Stephen J. Freedland, MD Associate Director, Faculty Development Samuel Oschin Comprehensive Cancer Institute Co-Director, Cancer Genetics and Prevention Program Director, Center for Integrated Research in Cancer and Lifestyle Professor, Surgery Warschaw Robertson Law Families Chair in Prostate Cancer Cedars-Sinai, Los Angeles  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Freedland:   PSA is a marker of prostate pathology.  While often used to screen for prostate cancer, it is not prostate specific and can be elevated due to inflammation or enlarged prostate or other reasons.  Whether it predicts the development of urinary symptoms is not clear.  Among men with minimal to no urinary symptoms, we found that the higher the PSA, the greater the risk of future development of urinary symptoms. MedicalResearch.com: What should clinicians and patients take away from your report? Dr. Freedland: The readers should know that if a man has an elevated PSA and a negative prostate biopsy, the higher the PSA, the greater the risk of future urinary symptoms.  These are men who may need closer follow-up. (more…)
Author Interviews, Epilepsy, NYU / 01.05.2016

MedicalResearch.com Interview with: Jacqueline French, MD Professor, Department of Neurology Director Translational Research& Clinical Trials Epilepsy NYU Langone Medical Center  MedicalResearch.com: What is the background for this study? Dr. French:  Tuberous sclerosis complex (TSC) is a disease associated with abnormal cell growth, caused by dysfunction of the TSC1 or TSC2 genes and dysruption of the MTOR pathway, which leads to cortical malformations, neuronal hyperexcitability, and seizures. Seizures in patients with TSC often start within the first year of life, and tend not to respond to traditional treatments. Everolimus is a marketed drug that has been used to treat other manifestations of TSC (including giant cell tumors of the brain, renal angiomyolipomas, and angiofibromas of the skin). This study was a placebo-controlled add-on study of everolimus for the treatment of refractory seizures in children and adults with epilepsy.Following an 8-week baseline phase, patients aged 2-65 years (stratified by age) with TSC and refractory seizures on 1-3 antiepileptic drugs were randomized to EVE LT or HT Cmin target ranges or placebo, and treated in an 18 week Core Phase (6-wk titration + 12-wk maintenance). Primary endpoints were change from baseline in average weekly frequency of TSC-seizures (seizures not previously shown to be generalized in onset by EEG), expressed as response rate (≥50% reduction [RR]), and percentage reduction. MedicalResearch.com: What are the main findings? Dr. French:  Overall, 366 patients were randomized to EVE LT (n=117), HT (n=130), or placebo (n=119). The median percentage reduction in TSC-seizures was significantly greater with EVE LT (29.3%, P=0.003) and HT (39.6%, P<0.001) vs placebo (14.9%). RR was also significantly greater with EVE LT (28.2%, P=0.008) and HT (40%, P<0.001) vs placebo (15.1%). The most frequent ≥10% all grade adverse events (AEs) reported with EVE LT/HT vs placebo included stomatitis (28.2%/30.8% vs 3.4%), diarrhea (17.1%/21.5% vs 5%), mouth ulceration (23.9%/21.5% vs 4.2%), nasopharyngitis (13.7%/16.2% vs 16%), upper respiratory tract infection (12.8%/15.4% vs 12.6%), aphthous ulcer (4.3%/14.6% vs 1.7%), and pyrexia (19.7%/13.8% vs 5%). Discontinuations due to AEs (5.1%/3.1% vs 1.7%) were low. (more…)
AACR, Author Interviews, Biomarkers, Cancer Research, Personalized Medicine, Stanford / 01.05.2016

MedicalResearch.com Interview with: Dr. Elodie Sollier Chief Scientific Officer at Vortex Biosciences MedicalResearch.com: What is the background for this study? What are the main findings? Response: Circulating Tumor Cell (CTC) burden may be a useful biomarker of response to targeted therapy in PDX (Patient Derived Xenograft) mouse models. Vortex Biosciences’ technology has been proven to enrich CTCs from human blood, but use of the technology with mouse blood had not yet been explored. In this poster, human CTCs are isolated with both high efficiency and purity from xenograft model of breast cancer using Vortex’s technology. Circulating Tumor Cell enumeration increased as the tumor burden increased in the mouse demonstrating its utility as a biomarker for drug treatment response. (more…)
Alzheimer's - Dementia, Author Interviews, Dermatology / 01.05.2016

MedicalResearch.com Interview with: Alexander Egeberg, MD PhD National Allergy Research Centre, Departments of Dermato-Allergology and Cardiology Herlev and Gentofte University Hospital University of Copenhagen Hellerup, Denmark  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Egeberg: Certain proteins and inflammatory processes have been found in increased levels in the skin of patients with rosacea, and these have also been linked to dementia, in particular Alzheimer's disease. While this may be one potential explanation, we cannot say for sure that this is the cause. Our team have recently shown a link between rosacea and other neurological diseases, and single-case reports have previously described a possible association between rosacea and Alzheimers disease. However, this is the first comprehensive investigation of Alzheimer's disease in a large population of patients with rosacea. We found a slightly increased risk of dementia, in particular Alzheimer's disease in patients with rosacea. (more…)
Author Interviews, JAMA, Nutrition, Pediatrics / 01.05.2016

MedicalResearch.com Interview with: Stephen B. Freedman MDCM, MSc, Associate Professor Department of Paediatrics, Sections of Emergency Medicine and Gastroenterology; ACHRI Healthy Outcomes Theme Group Leader Alberta Children’s Hospital, and Alberta Children’s Hospital Research Institute University of Calgary, Calgary, Canada MedicalResearch.com: What is the background for this study? Dr. Freedman: As a pediatric emergency medicine physician I continue to see large numbers of children who are brought for emergency care because of vomiting and diarrhea. In speaking with their caregivers it is clear that many of them try to administer electrolyte maintenance solutions at home but the children either refuse to drink them or they continue to vomit. As a researcher I have noticed that many children continue to receive intravenous rehydration despite not being significantly dehydrated and it appeared that this was often a physician’s response to a failed oral rehydration challenge in the emergency department, either due to refusal to consume the electrolyte maintenance solution supplied or because the children became more nauseous due to the poor palatability of the solution. It appeared that perhaps a less dogmatic approach aimed at providing fluids that children actually like, might overcome these problems leading to improved outcomes. MedicalResearch.com: What are the main findings? Dr. Freedman: Children with mild gastroenteritis and minimal dehydration experienced fewer treatment failures when offered dilute apple juice followed by their preferred fluid choice compared with those instructed to drink electrolyte maintenance solution to replace fluid losses. We found the benefit was greatest in those 24 to 60 months of age. The group provided and instructed to take their preferred fluids were administered intravenous rehydration less frequently. (more…)
Author Interviews, Autism, Pediatrics, Toxin Research / 01.05.2016

MedicalResearch.com Interview with: Steven Daniel Hicks, M.D., Ph.D. Penn State Hershey Medical Group Hope Drive, Pediatrics Hershey, PA 17033  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Hicks:  This research was inspired by results of the CHARGE study (examining environmental influences on autism) which showed that specific pesticides (including pyrethroids) increased the risk of autism and developmental delay, particularly when mothers were exposed in the 3rdtrimester. We recognized that the department of health sprayed pyrethroids from airplanes in a specific area near our regional medical center every summer to combat mosquito borne illnesses. We asked whether children from those areas had increased rates of autism and developmental delay. We found that they were about 25% more likely to be diagnosed with a developmental disorder at our medical center than children from control regions without aerial spraying of pyrethroids. (more…)
Author Interviews, Biomarkers, JAMA, Melanoma, Ophthalmology / 30.04.2016

MedicalResearch.com Interview with:
J. William Harbour, M.D.
Leader, Eye Cancer Site Disease Group
Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Harbour:  Uveal melanoma (UM) is the most common primary cancer of the eye which has the fatal tendency to metastasis to the liver. The molecular landscape of UMs have been well characterized and can be categorized by gene expression profiling (GEP) into two molecular classes associated with metastatic risk: Class 1 (low risk) and Class 2 (high risk). The Class 2 profile is strongly associated with mutations in the tumor suppressor BAP1. This GEP-based test is the only prognostic test for UM to undergo a prospective multicenter validation, an it is available commercially as DecisionDX-UM (Castle Biosciences, Inc).  It is routinely used in many North American centers. The identification of driver mutations in cancer has become a focus of precision medicine for prognostic and therapeutic decision making in oncology. In UM, thus far, only 5 genes have been reported to be commonly mutated:  BAP1, GNA11, GNAQ, EIF1AX, and SF3B1. In this study, we analyzed the associations between these 5 mutations, and with GEP classification, clinicopathologic features, and patient outcomes. The study showed that GNAQ and GNA11 are mutually exclusive, probably occur early in tumor formation, and are not associated with prognosis.  In contrast, BAP1, SF3B1, and EIF1AX, which are also nearly mutually exclusive, likely occur later in tumor formation and do have prognostic value in UM. (more…)
Author Interviews, CDC, OBGYNE, Race/Ethnic Diversity / 29.04.2016

MedicalResearch.com Interview with: Lisa Romero DrPH, MPH  Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion CDC MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Romero: Since 2006, teen birth rates have fallen almost half among Hispanic and black teens; dropping the national teen birth rate to an all-time low. While dramatic declines among Hispanic and black teens have helped reduce gaps, birth rates remain twice as high for these teens nationally compared to white teens, and more than three times as high in some states. Data also highlight the role socioeconomic conditions play, finding that higher unemployment and lower income and education are more common in communities with the highest teen birth rates, regardless of race. This research highlights the importance of teen pregnancy prevention interventions that address socioeconomic conditions like unemployment and lower education levels, for reducing disparities in teen births rates. State and community leaders can use local data to better understand teen pregnancy in their communities and to direct programs and resources to areas with the greatest need.  To generate these findings, we analyzed national- and state-level data from the National Vital Statistics System (NVSS) to examine trends in births to American teens aged 15 to 19 years between 2006 and 2014. County-level NVSS data for 2013 and 2014 offer a point-in-time picture of local birth rates. To better understand the relationship between key social and economic factors and teen birth rates, researchers examined data from the American Community Survey between 2010 and 2014. (more…)
Author Interviews, Science, Stem Cells / 29.04.2016

MedicalResearch.com Interview with: Keir Menzies PhD Assistant Professor University of Ottawa Brain and Mind Research Institute University of Ottawa  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Menzies: Currently there is significant amount of research identifying the power of stem cells to regenerate damaged or aging tissue. Our research discovered that reduced stem cell health was linked to unusually low levels of a small molecule called NAD, one of the most important cellular molecules to maintain the performance of mitochondria, the engine of the cell. Then by boosting NAD levels, using a special form of vitamin B3 called nicotinamide riboside, stem cells could be rejuvenated during aging by improving mitochondrial function.  We then go on to show that by improving stem cell function we could prolong the lifespan of mice, even when the treatment began at a relatively old age. (more…)
Author Interviews, Education, Pediatrics, Pediatrics / 29.04.2016

MedicalResearch.com Interview with: Jorijn Hornman, BSc (MD PhD student) Departments of Health Sciences University Medical Center Groningen University of Groningen, Netherlands MedicalResearch.com: What is the background for this study? Response: Preterm children are at increased risk of emotional and behavioral problems compared to full-term children. Prevalences vary with degree of prematurity and assessment age. Unknown was whether stability of these problems upon school entry differs between preterm and full-term children. MedicalResearch.com: What are the main findings? Response: We found that preterm children had higher rates than full-term children of persistent (7.2% versus 3.6%), emerging (4.3% versus 2.3%), and resolving (7.5% versus 3.6%) emotional and behavioral problems. Early preterm children –born at <32 weeks gestation- had the highest rates of persistent (8.2%) and emerging (5.2%) problems, and moderately preterm children –born at 32-35 weeks gestation- the highest rates of resolving problems (8.7%). (more…)
Author Interviews, Pediatrics, Pharmacology / 29.04.2016

MedicalResearch.com Interview with: Jonathan Slaughter, MD, MPH Assistant Professor of Pediatrics Center for Perinatal Research Nationwide Children's Hospital/The Ohio State University Columbus, OH 43205  MedicalResearch.com: What is the background for this study? Dr. Slaughter:   Increasing data has emerged over the last decade showing potential harm following acid suppression use in newborns, older children, and adults.  There are virtually no published data that show acid suppression via histamine-2-receptor antagonists (H2RAs) or proton-pump inhibitors (PPIs) is effective for gastroesophageal reflux disease (GERD) treatment or for other indications (stress ulcer prophylaxis, post-operative acid suppression) in healthy or sick newborns. Given the potentially limited effectiveness of these medications and increasing safety concerns following H2RA/PPI use in infants, we wanted to evaluate the frequency and duration of H2RA/PPI use among infants hospitalized within US children's hospital neonatal intensive care units (NICUs) to determine if these drugs appeared to be overused and if use appears to have changed over time.  We also evaluated neonatal diagnoses associated with acid suppression to identify targets for future studies that may evaluate the usefulness of acid suppression in neonates following a given diagnosis. (more…)
Author Interviews, Pediatrics, Weight Research / 29.04.2016

MedicalResearch.com Interview with: Ashley Wendell Kranjac, PhD Department of Sociology and Kinder Institute for Urban Research Rice University Houston, Texas and Robert L. Wagmiller, Jr. Associate Professor Department of Sociology Temple University Philadelphia, PA 19122 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Center for Disease Control recently reported a decline in child obesity amongst 2-to5-year old children between 2003/4 and 2011/12 (see, Ogden et al. 2014). We aimed to identify the sources of this decline because this change occurred in a relatively short period of time. What we found is that the decline in obesity did not occur due to the things that you might expect like changes in physical activity or dietary practices (although there were some differences in these factors across years). But, rather, what we found is that because there were differences in obesity rates for the youngest and oldest children in this age range in 2003/4, but not in 2011/12, that the decline in obesity exists. In other words, because the oldest children in 2003/4 had significantly higher obesity rates than the youngest children in this time period, but this effect is not observable in 2011/12, we see a decline in obesity. (more…)
Addiction, Author Interviews, Genetic Research, PNAS / 29.04.2016

MedicalResearch.com Interview with: Shelly B. Flagel, PhD Molecular and Behavioral Neuroscience Institute Department of Psychiatry University of Michigan, Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Flagel: We used a unique genetic animal model to examine individual differences in addiction liability. This model of selectively bred rat lines allowed us to examine the brains of “addiction-prone” and “addiction-resilient” rats before and after they were exposed to cocaine. I mportantly, even though all rats were exposed to the same amount of drug, only a certain subset exhibited addiction-like behavior. We focused our neurobiological analyses on two molecules that have been previously implicated in response to drugs of abuse – the dopamine D2 receptor and fibroblast growth factor (FGF2). We examined gene expression and the epigenetic regulation of these molecules and found that low levels of FGF2 in the core of the nucleus accumbens, a brain region known for regulating motivated behavior, may protect individuals from becoming addicted; whereas low levels of D2 in this brain region may predispose individuals to addiction. Further, this is the first study to show that epigenetic modulation of these molecules may be a predisposing factor and that, the epigenetic regulation of D2 may be especially important in susceptibility to relapse. (more…)
Author Interviews, Endocrinology, Gender Differences, Kidney Disease / 28.04.2016

MedicalResearch.com Interview with: A.Univ.-Prof. Dr. Judith Lechner Div. Physiology Medical University of Innsbruck Innsbruck Austria MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Lechner: Women are not just small men. Sex differences affect most, if not all the organ systems in the body. Over the past decades biomedical researchers have been mainly using male models. Therefore, there is a significant gap in knowledge of female physiology except for organ functions involved in reproduction. While the necessity to fill in these gaps has been advocated, our understanding of sex and gender differences in human physiology and pathophysiology is still limited. This holds especially true for the kidneys, e.g. while international registries show that fewer women than men are in need of renal replacement therapy due to end stage renal disease, the potentially underlying causes are still not known. The aim of our study was to find out, if hormone changes due to the female menstrual cycle would affect normal renal cells. For this purpose, urinary samples of healthy women of reproductive age were collected daily and analyzed for menstrual cycle-associated changes of marker proteins. Specifically, two enzymes (Fructose-1,6-bisphosphatase, Glutathione-S-transferase alpha) were measured, which are intracellular components of proximal tubular cells, a key population of renal cells. Upon cell damage, these enzymes are released into the urine, qualifying them as clinical markers for early detection of tubular injury. Since even in healthy persons low amounts of these enzymes can be detected in the urine, we used these marker proteins to analyze potential effects of the female hormone cycle on normal functioning of this cell population. As a result, we could detect transient increases of Fructose-1,6-bisphosphatase and Glutathione-S-transferase alpha correlating with specific phases of the female hormone cycle, namely ovulation and menses. This finding suggests that cyclical changes of female hormones might affect renal cell homeostasis, potentially providing women with an increased resistance against kidney damages. Thus, recurring changes of sex hormone levels, as during the natural menstrual cycle, might be involved in periodic tissue re-modeling not only in reproductive organs, but to a certain extent in the kidneys as well. (more…)
Author Interviews, Cancer Research, Cost of Health Care / 28.04.2016

MedicalResearch.com Interview with: Stacie B. Dusetzina, PhD Assistant Professor Division of Pharmaceutical Outcomes and Policy Eshelman School of Pharmacy University of North Carolina at Chapel Hill Chapel Hill, NC  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Dusetzina: Drug prices are of significant policy interest, particularly the prices for so-called “specialty” medications which are used to treat rare and/or complex conditions like cancer. In this study I estimated monthly price for orally-administered cancer treatments that were approved between 2000 and 2014. First I looked at the price of the drug during the year of initial FDA approval and then I looked at annual changes in the price after the year of approval. The main findings are that, even after inflation adjustment, the monthly price paid for orally-administered cancer treatments is increasing rapidly both at the time of approval and in subsequent years. As an example, if you compare average monthly prices during the first year post-approval for treatments approved between 2000-2010 to those approved after 2010 there was a major increase in launch prices from $5,529 per month to $9,013 per month. Year-to-year changes in price after launch varied a lot by drug ranging from decreases in price of -2.7% per year to increases of 11.4% per year. However, nearly all of the products studied increased in price over time. (more…)
Author Interviews, Cancer Research, JAMA, Karolinski Institute, Mental Health Research / 28.04.2016

MedicalResearch.com Interview with: Donghao Lu MD, PhD candidate Department of Medical Epidemiology & Biostatistics, Karolinska Institutet Stockholm MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Lu: Psychiatric comorbidities are common among cancer patients. However, whether or not there is already increased risk of psychiatric disorders during the diagnostic workup leading to a cancer diagnosis was largely unknown. We found that, among cancer patients, the risks for several common and potentially stress-related mental disorders, including depression, anxiety, substance abuse, somatoform/conversion disorder and stress reaction/adjustment disorder started to increase from ten months before cancer diagnosis, peaked during the first week after diagnosis, compared to cancer-free individuals in Sweden. (more…)
Author Interviews, Cost of Health Care / 28.04.2016

MedicalResearch.com Interview with: Andrew L. Pecora, M.D., F.A.C.P., C.P.E.
COTA Founder and Executive Chairman
Chief Innovations Officer and Vice President of Cancer Services at Hackensack University Medical Center
  Background: Key leadership of health care informatics company, COTA, Inc., will travel to Vatican City after being invited to speak at The Vatican’s Third International Conference on the Progress of Regenerative Medicine and Its Cultural Impact. COTA’s founder, Dr. Andrew Pecora, will discuss health care inequality and how new therapies only exacerbate the problem due to high costs. He will talk about the approaches COTA takes to address the problem, increasing access and affordability.  MedicalResearch.com: What is the background and mission of COTA? Dr. Pecora: Right now, up to 30 percent of health care delivered in the United States is not ideal, meaning doctors are providing treatments that do not necessarily need to be provided or do not precisely align with what is best for the client – a factor called ‘adverse variance.’ The fundamental problem we’re facing today is that we haven’t been able to successfully recognize and predict adverse variance. This is an issue that the entire world is dealing with, and COTA’s mission is to remove that variance and make the best care completely clear to patients, doctors, hospitals, payers and the government. COTA’s aim is to ensure patients are getting the best possible care, leading to the best possible outcome at the best possible price. (more…)
Author Interviews, Hearing Loss, Rheumatology / 28.04.2016

MedicalResearch.com Interview with: Dr. Amir Emamifar, MD Department of Rheumatology Odense university Hospital Svendborg Hospital, Denmark   Associate Professor Dr. Inger Marie Jensen Hansen, PhD, DMsci Department of Rheumatology Odense university Hospital Svendborg Hospital University of Southern Denmark   MedicalResearch.com: What is the background for this study? Response: Rheumatoid arthritis is a systemic, inflammatory disease that affects 1% of the general population. Apart from main articular manifestations, rheumatoid arthritis may involve other organs including heart, lung, skin, and eye. The auditory system can be affected during the course of the disease as well; however the association between rheumatoid arthritis and hearing impairment has not been clearly defined. It seems that hearing impairment in rheumatoid arthritis is a multifactorial disease affecting by environmental factors and disease and patient characteristics. We did a comprehensive review of all published data to reveal the potential link between rheumatoid arthritis and hearing impairment. (more…)
Author Interviews, Blood Pressure - Hypertension, Insomnia, Sleep Disorders / 28.04.2016

MedicalResearch.com Interview with: Haicong Li Director and Professor, Department of Geriatrics China-Japan Friendship Hospital Beijing, China.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Based on our clinical observations over the years, we noticed two common phenomena:
  • One is that the occurrence of hypertension in patients with chronic sleep disorders tend to be higher than those with normal sleep conditions;
  • The other is that the blood pressure of some hypertensive patients cannot be lowered to normal level even with anti-hypertensive treatments, of which group many have sleep disorders.
So we hypothesized that the improvement of insomnia can effectively help lower the of hypertensive patients and the combination of anti-hypertensive medication and sedative-hypnotic drugs can achieve better therapeutic effects. In our experiment, a total of 402 patients with a diagnosis of insomnia and hypertension were selected and randomly divided into two groups. The treatment group (202 cases) received standard antihypertensive treatment with Estazolam and the control group (200 cases) received standard antihypertensive treatment with placebo. We measured the sedentary diastolic (SiSBP) and systolic blood pressure (SiDBP) before the treatment and every 7 days during the experiment. To assess the sleep quality and anxiety and depression levels of patients, we reported the scores of the Pittsburgh Sleep Quality Index (PSQI), the Hamilton Anxiety Rating Scale (HAMA) and the Hamilton Depression Scale-17 (HAMD 17) at the same time points. At the conclusion of the experiment, PSQI, HAMA, and HAMD17 scores were significantly lower than those of the control group (P&lt;0.001). The insomnia treatment efficacy of Estazolam in the treatment group was 67.3%, significantly higher than that (14.0%) of the control group (P &lt; 0.001). The blood pressure of the treatment group showed significant improvement throughout the experiment. By Day 28, the decrease of SiSBP and SiDBP in the treatment group was significantly greater than that of the control group (SiSBP: 10.5±3.9 vs. 3.4±2.5; DiSBP: 8.1±3.6 vs. 2.7±2.1, mmHg, P&lt;0.001) and the compliance rate of goal BP (&lt;140/90 mmHg) was 74.8% with Estazolam, compared to 50.5% with placebo (P&lt;0.001). Thus, our findings indicated that the improvement of insomnia can significantly help lower the blood pressure in hypertensive patients. (more…)
Author Interviews, Compliance, Gender Differences, Heart Disease / 28.04.2016

MedicalResearch.com Interview with: Sherry L. Grace, PhD Professor, School of Kinesiology and Health Science York University Sr. Scientist, Cardiorespiratory Fitness Team Toronto Rehabilitation Institute, University Health Network Toronto Western Hospital Toronto, ON MedicalResearch.com: What is the background for this study? Dr. Grace: Cardiac rehabilitation is an outpatient chronic disease management program. It is a standardized model of care, comprised of risk factor assessment and management, exercise training, patient education, as well and dietary and psychosocial counseling. Patients generally attend two times a week for several months. Participation in cardiac rehab has been shown to reduce death and disability. This is a dose-response association, such that more cardiac rehab participation is associated with even less death, etc. Therefore, it is important that patients adhere to the program, or participate in all the prescribed sessions. No one has ever reviewed patient adherence to cardiac rehab in a systematic way. It has always been assumed that patients only attend about half of prescribed sessions. Also, many studies have shown that women attend fewer sessions than men. However, this has been known for some time, so we would hope that in the current era, this sex difference would not exist. No study has ever aggregated and analyzed sex differences in program adherence, so we set out to do this. (more…)
Author Interviews, Nutrition, Weight Research / 28.04.2016

MedicalResearch.com Interview with: Evelyn Parr Research Officer / PhD Candidate | Centre for Exercise and Nutrition Mary MacKillop Institute for Health Research Australian Catholic University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Results from previous investigations suggest that compared to a healthy 'control' diet, increased consumption of dairy foods in an energy restricted diet lead to improved body composition (i.e., a loss of fat mass and the maintenance of lean mass). We investigated the effects of manipulating  the type of dairy foods (i.e., low- or high fat) within high protein, energy restricted diets on body composition and selected health parameters. Eighty-nine middle-aged (35-59 y), male and females who were overweight or obese completed a 16 week intervention comprising 3 d/wk supervised resistance training and 4 d/wk unsupervised aerobic -based exercise (i.e. walking). During this time they consumed a diet that was energy restricted by 250 kcal/d comprising either 1) high protein, moderate carbohydrate (4-5 normal fat dairy product servings), 2) high protein, high carbohydrate (4-5 low-fat, carbohydrate sweetened dairy product servings or 3) a control diet of moderate protein, high carbohydrate diet (1-2 dairy servings). We found that in the face of energy restriction, when protein intakes were above the recommended daily intakes (>0.8 g/kg body mass) and regular exercise was completed, there was no difference in the loss of fat mass  (~8 kg) when participants consumed 4-5 serves of dairy products in either low- or high-fat. Furthermore, participants maintained  lean (muscle) mass throughout the energy restricted period. (more…)
Author Interviews, Biomarkers, Dermatology / 28.04.2016

MedicalResearch.com Interview with: Professor Rudi Beyaert VIB - Inflammation Research Center Ghent University Department for Biomedical Molecular Biology Unit of Molecular Signal Transduction in Inflammation Technologiepark Ghent) Belgium  MedicalResearch.com: What is the background for this study? What are the main findings? Prof. Beyaert: The interest of my laboratory is in understanding the molecular mechanisms that are responsible for the development of inflammatory diseases such as Crohn's disease, multiple sclerosis, rheumatoid arthritis and also psoriasis, which is the topic of the published study. We already know that genetic factors can determine the onset of these inflammatory diseases, but how these genetic factors drive an inflammatory response is still largely unclear. We were specifically interested in the CARD14 gene, because patients with mutations in CARD14 have a very high chance to develop psoriasis. Psoriasis-associated mutations in CARD14 trigger specific skin cells (keratinocytes) to produce and release large amounts of other proteins that recruit and activate specific white blood cells driving an inflammatory response. We now discovered that this effect is dependent on the physical interaction of CARD14 with the protease MALT1 in keratinocytes, leading to the activation of its enzymatic activity and the MALT1-mediated cleavage and inactivation of a number of cellular proteins that normally keep our immune system in check. Treatment of skin cells with small compound MALT1 inhibitors prevents the CARD14-induced production of several pro-inflammatory mediators. (more…)
Author Interviews, Cognitive Issues, JAMA / 28.04.2016

MedicalResearch.com Interview with: Babak Hooshmand, MD, PhD, MPH Center for Alzheimer Research–Aging Research Center Karolinska Institutet Stockholm University, Stockholm, Sweden Department of Neurology, Klinikum Augsburg Augsburg, Germany MedicalResearch.com: What is the background for this study? What are the main findings?  Dr. Hooshmand: Low and subnormal levels of vitamin B12 as well as high levels of homocysteine (a vascular risk factor and neurotoxic amino-acid associated with B12 deficiency) are common conditions in the elderly and are associated with a variety of disorders, including cardiovascular and cerebrovascular conditions. Our study showed that over 6-year of follow-up, both low vitamin B12 status and high homocysteine levels are associated with accelerated brain atrophy in older adults, which precedes clinical dementia. (more…)
Asthma, Author Interviews, JAMA / 28.04.2016

MedicalResearch.com Interview with: Prof Dr. med. J. Christian Virchow, FRCP, FCCP, FAAAA University of Rostock, Germany What is the background for this study? What are the main findings? Dr. Virchow: House Dust mite related allergic asthma is a very frequent chronic disease. Allergen Immunotherapy (AIT) for this condition in asthma has not been well studied and subcutaneous treatment has been associated with (systemic, potentially serious) side effects. Aim of the study was to investigate, if sublingual AIT can improve a patient relevant endpoint, namely reduce the frequency of exacerbations (primary endpoint: time to first exacerbation compared to placebo) . (more…)
AHA Journals, Author Interviews, Heart Disease, Tobacco Research / 28.04.2016

MedicalResearch.com Interview with: Tanush Gupta, MD Chief Resident & Instructor of Medicine Department of Medicine New York Medical College & Westchester Medical Center Valhalla, NY  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Gupta: Cigarette smoking is the leading preventable cause of premature death in the United States (U.S.). Approximately one-third of all coronary artery disease related deaths in the U.S. annually can be attributed to cigarette smoking. However, studies from the pre-thrombolytic and thrombolytic eras have shown that mortality in smokers with ST-segment elevation myocardial infarction (STEMI) may be lower than in nonsmokers, a phenomenon called the “smoker’s paradox.” The majority of STEMI patients in contemporary practice are treated with primary percutaneous coronary intervention (pPCI). Data on the association of smoking with outcomes in STEMI patients undergoing pPCI are limited and also conflicting as to whether the smoker’s paradox exists in this population. Hence, the purpose of our study was to examine the association of smoking status with in-hospital outcomes in a nationwide cohort of STEMI patients undergoing pPCI, included in the U.S. National Inpatient Sample, over a 10-year time period from 2003 to 2012. Our primary outcome of interest was in-hospital mortality and secondary outcomes were post-procedure hemorrhage, in-hospital cardiac arrest, and average length of stay. Of 985,174 STEMI patients who underwent pPCI in the U.S. over this time period, 438,954 (44.6%) were smokers. Smokers were on an average 8 years younger than nonsmokers and had lower prevalence of most cardiovascular comorbidities. Smoking status was associated with lower risk-adjusted in-hospital mortality (2.0% vs. 5.9%, adjusted OR 0.60, p<0.001), lower incidence of post-procedure hemorrhage (4.2% vs. 6.1%, adjusted OR 0.81, p<0.001) and in-hospital cardiac arrest (1.3% vs. 2.1%, adjusted OR 0.78, p<0.001), and shorter average length of stay (3.5 days vs. 4.5 days, p<0.001). To assess whether younger age of smokers was influencing the association with in-hospital mortality, we also performed an age-stratified analyses in different age groups. The smoker’s paradox largely persisted in age-stratified analyses suggesting that younger age of smokers was not the sole explanation for this paradox. We performed additional assessment for confounding to explore whether the paradoxically lower risk-adjusted in-hospital mortality in smokers with STEMI was driven by differences in baseline demographics and comorbidities between hospitalized smokers and nonsmokers in general. To test for such confounding, we examined the association of smoking with in-hospital mortality in 2 conditions in which this association has not been previously studied – hip fractures and severe sepsis – using similar statistical regression models. In both these study populations, smokers were on average younger than nonsmokers and had lower risk-adjusted in-hospital mortality, but, the paradoxical association in both these conditions was weaker in magnitude than in STEMI patients. Since there is no cogent biological hypothesis to explain the lower mortality in smokers with sepsis or hip fractures, it is likely that the smoker’s paradox in STEMI is also at least partly driven by residual confounding due to inadequate adjustment for the biological effects of age. However, as this paradox was stronger in STEMI patients than in patients with hip fractures or severe sepsis, we believe that additional true biological differences between smokers and nonsmokers with STEMI also contribute to the paradoxically lower in-hospital mortality. (more…)
Author Interviews, Flu - Influenza, Vaccine Studies / 27.04.2016

MedicalResearch.com Interview with: Dr Anna C. Phillips PhD CPsychol AFBPsS Reader in Behavioural Medicine School of Sport, Exercise & Rehabilitation Sciences University of Birmingham Edgbaston Birmingham MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Phillips: We know that various factors can affect the response to vaccination and that older adults have a poorer response than younger people, i.e. they produce fewer antibodies.  We also know that many immune messengers and important hormones have daily rhythms in their levels and wanted to test whether the antibody response to vaccination might also be affected by time of day.  We randomised surgeries to giving morning or afternoon vaccinations and tested before and one month after the vaccination for levels of antibodies. Two of the three flu strains (viruses) contained in the vaccine showed a higher antibody response in the morning than in the afternoon, up to 4 x higher to one of the strains (A/California) and 1.5 x higher to the B strain. None of the potential mechanisms we measured (immune messengers, hormones) seemed to be driving this effect. (more…)
Alzheimer's - Dementia, Author Interviews, Biomarkers / 27.04.2016

MedicalResearch.com Interview with: Dr Anne Poljak Leader of the Proteomics Group Centre for Healthy Brain Ageing (CHeBA) UNSW, Australia  MedicalResearch.com: What is the background for this study?  Dr Poljak: Amyloid-beta (Aβ) peptides are found in abundance in the plaque particles which build up in the Alzheimer’s brain and small blood vessels of the brain, and are therefore considered hallmark features of Alzheimer’s disease. However they are also found in blood which is a convenient body fluid for sampling purposes. We therefore wished to assay them in plasma samples from one of our longitudinal population based studies of older age individuals (70 – 90 years) – the Centre for Healthy Brain Ageing’s Sydney Memory and Ageing Study. Other research groups had previously measured these peptides in plasma, but there was controversy in the area because of differences in outcomes across laboratories. So one of the main questions was whether plasma levels of Aβ peptides have any relationship with what is happening in the brain, or are they a red-herring? We wanted to see how the levels we found would compare with the findings of others in relation to Alzheimer’s disease and mild cognitive impairment. A further question was how our plasma levels would relate to other clinical measures including cognition and brain volumetrics. One of the precautions we took was to use an assay kit with very well characterized antibodies, so we could be confident that our method was specific for the two full length Aβ peptides (Ab1-40 and Ab1-42). (more…)