AHA Journals, Author Interviews, Exercise - Fitness, Heart Disease / 14.03.2016

MedicalResearch.com Interview with: Pei-JieChen, Ph.D. Professor of Exercise Science, President of Shanghai University of Sport MedicalResearch: What is the background for this study? Dr. Pei-JieChen: Traditional Chinese exercises (such as Tai Chi, Qigong, Baduanjin) have been used for 2000 years with great contributions to human health, which are increasingly popular around the world. And traditional Chinese exercise is a low-risk, promising intervention that could be helpful for improving quality of life and depression in patients with cardiovascular diseases (CVDs).However, there appears to be no consensus agreement that traditional Chinese exercises (TCEs) could be effective for CVDs. Therefore, we performed a systematic review and meta-analysis to estimate the effectiveness of Traditional Chinese exercise for patients with CVDs. MedicalResearch: What are the main findings? Dr. Pei-JieChen: The pooling revealed that TCEs could decrease systolic blood pressure by 9.12 mmHg and diastolic blood pressure by 5.12 mmHg. Patients performing traditional Chinese exercises were also found superior compared with those in the control group in terms of triglyceride, six-minute walk test, Minnesota Living with Heart Failure Questionnaire results, SF-36 physical function, and Profile of Mood States depression. (more…)
Author Interviews, JAMA, Ophthalmology / 14.03.2016

MedicalResearch.com Interview with: Fanny Raguideau Evaluateur en pharmaco-épidémiologie Direction Scientifique et de la Stratégie Européenne Pôle Epidémiologie des produits de santé  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Retinal detachment (RD), including both exudative types often associated with systemic diseases that might be receiving antibiotics for related conditions as well as rhegmatogenous which require prompt surgical intervention to reduce the chance of irreversible severe vision loss, has an annual incidence rate of 1 per 10,000 in the general population. Rhegmatogenous is the most common type. Fluoroquinolones are one of the most commonly prescribed classes of antibiotics. Thanks to their broad-spectrum antibacterial coverage, they are effective in the treatment of a wide variety of community-acquired infections. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several studies have suggested that oral fluoroquinolone use increased the risk of Retinal detachment, however this association remains controversial. We conducted a nationwide self-matched design study to overcome limitations of previous studies. Our finding of a significant increased risk of  Retinal detachment, including both rhegmatogenous and exudative types, following use of oral fluoroquinolone strongly supports the existence of this association. (more…)
Author Interviews, Cancer, Cancer Research, Cost of Health Care / 14.03.2016

MedicalResearch.com Interview with: Hrishikesh Kale School of Pharmacy Virginia Commonwealth University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The cost of cancer care in the United States is extremely high and escalating every year. Because of increased cost sharing, patients are paying higher out-of-pocket costs for their treatments. Along with high medical expenses, cancer survivors face problems such as loss of employment and reduced productivity. It has been well-established in the literature that because of high out-of-pocket costs, many cancer survivors forgo or delay medical care and mental health-related services and avoid filling prescriptions. This puts their physical and mental health at risk. A related issue is the growing number of cancer survivors in the U.S. As of January 2014, there were approximately 14.5 million cancer survivors in the U.S. By 2024, this number is expected to reach 19 million as a result of improved survival among patients with cancer along with an aging population. Therefore, we decided to investigate the prevalence and sources of financial problems reported by a nationally representative sample of cancer survivors from the 2011 Medical Expenditure Panel Survey. We also studied the impact of cancer-related financial burden on survivors’ health-related quality of life and psychological health. (more…)
Alzheimer's - Dementia, Author Interviews, Exercise - Fitness, Lifestyle & Health / 14.03.2016

MedicalResearch.com Interview with: Cyrus A. Raji, MD, PhD Resident in Diagnostic Radiology UCLA Health System  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Raji: The purpose of this study was to investigate the relationship between caloric expenditure from leisure physical activities (15 different ones were assessed from walking to gardening to dancing to swimming etc.). Increased caloric expenditure from these physical activities were related to larger gray matter volumes in key brain areas for memory and learning (hippocampus, precuneus) that are also affected by Alzheimer's. These findings were demonstrated in 876 persons who had MRI scans and caloric expenditure assessed. Five years after the scan a subset of 326 persons from the larger group of 876 were followed cognitively and it was found that those with larger gray matter volumes associated with physical activity in the orbital frontal cortex and precuneus had a 2 fold reduction in the risk for cognitive decline to mild cognitive impairment and Alzheimer's dementia.  (more…)
Author Interviews, Infections, OBGYNE, Pediatrics / 14.03.2016

MedicalResearch.com Interview with: Elaine Tuomanen, MD Chair and Full Member Dept of Infectious Diseases St Jude Children’s Research Hospital 262 Danny Thomas Place Memphis, TN 38105 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Tuomanen: While investigating mechanisms of brain repair during infection in a mouse model system, we found that components from the surfaces of bacteria could traffic from the mother to the fetus. The bacterial components moved across the placenta and into the fetal brain. To our surprise, the fetal brain did not respond with neuronal death like we see in children with meningitis. Rather, fetal neurons proliferated. This response involved the innate immune system (TLR2) inducing the neuronal transcription factor, FoxG1, which is known to drive proliferation. The newly born neurons migrated appropriately to the cortical plate, the area on the surface of the fetal brain that forms the cortex, a major part of the adult brain. Although the neurons moved to the right place in the brain, there were too many and they crowded together in the cortex, changing the architecture of the brain. At birth, affected mice seemed to have no abnormalities. However, when we tested if this change in architecture would affect brain function after birth, mice were shown to progressively develop defects in learning, memory and other cognitive functions. This indicates there is a window during pregnancy where components of bacteria from the mother can change fetal brain architecture and subsequent postnatal behavior (more…)
Allergies, Author Interviews, Immunotherapy / 14.03.2016

MedicalResearch.com Interview with: Stacy L. Rosenberg, MD UPMC Montefiore Allergy and Immunology Fellow MedicalResearch.com: What is the background for this study? Dr. Rosenberg: Allergy shots or allergen immunotherapy (AIT) is an effective therapy for allergic rhinoconjunctivitis (hay fever).  Low adherence has been a significant barrier, whereas rush immunotherapy to environmental allergens provides rapid build-up and offers quicker efficacy, which may improve adherence.  However, there have been concerns for increased risk of systemic reactions with rush protocols.  We describe a new protocol for modified rush AIT that offers quicker build-up towards a maintenance dose with improved safety and lower risk of systemic reactions.  We also hypothesize that there are specific characteristics that distinguish patients who develop systemic reactions in the setting of modified environmental rush immunotherapy (MERIT). MedicalResearch.com: What are the main findings? Dr. Rosenberg: Overall, MERIT has a good safety profile.  A subset of patients did develop systemic reactions, which were mild.  Lower BMI was associated with systemic reactions and there was a trend between history of urticaria (hives) and younger age with development of systemic reactions.  Significantly more patients with systemic reactions had allergen extracts containing cat, dust mite, and weed pollen.  Neither gender, asthma, nor anaphylaxis history were associated with an increased risk of systemic reactions. (more…)
Author Interviews, Nutrition / 12.03.2016

MedicalResearch.com Interview with: Noelle R Noyes PhD Department of Clinical Sciences Colorado State University, Fort Collins MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study is the increasing concern about antibiotic resistant infections, and what we can do as a society to help minimize the development and spread of antibiotic resistance. Antibiotic resistance is a natural and ancient phenomenon in bacteria, but we can do things to bacterial populations to increase the amount of resistant bacteria and to promote the spread of resistant bacteria. It behooves us to try to identify specific practices that might be contributing to increases in antibiotic resistance, and to understand how we can change them to minimize risk. Towards this end, our study utilized new methods for investigating the ecology of antibiotic resistance throughout the process of beef production, from the time cattle enter feedlots through slaughter to the beef products that we eventually buy in the grocery store. Livestock production is thought to play a role in antibiotic resistance, although we have very little understanding of how important this role may be compared to other sectors like human hospitals, municipal wastewater treatment, daycare facilities, etc… We wanted to use new DNA sequence-based methods to try to get a high-level picture of what was happening with antibiotic resistance genes in feedlots and slaughterhouses. This high-level picture could then help us to understand how important cattle production may be in the overall ecology of antibiotic resistance, including the food chain and wider environment. (more…)
Addiction, Author Interviews, Pediatrics / 11.03.2016

MedicalResearch.com Interview with: Yanning Wang, MS Statistical Research Coordinator Department of Pathology, Immunology and Laboratory Medicine Department of Health Outcomes and Policy University of Florida College of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A number of new stimulant medications have been approved for attention deficit/hyperactivity disorder (ADHD) treatment in the past decade. The expansion of this market, along with the increase in ADHD diagnosis, provides greater availability of these drugs. This has raised public health concerns about potential non-medical use of prescription stimulants. Our study analyzed data from the National Monitoring of Adolescent Prescription Stimulants Study, which recruited and surveyed youth aged 10 to 18 years from entertainment venues in 10 US cities. We found that 6.8% of youth (750 out of 11,048) used prescription stimulants in the past 30 days. Among those 750 youth, more than half reported some type of non-medical use, and using someone else’s medication was the most common form (88.4 %). We investigated the difference between two subgroups of non-medical users: youth who only used stimulants non-medically, and those who had a prescription and reported non-medical use in the past 30 days. We found youth who only used stimulants non-medically at higher rate of using other substances and more likely to have close friends who have tried other drugs. (more…)
Author Interviews, Prostate Cancer, Surgical Research / 11.03.2016

MedicalResearch.com Interview with: Naveen Pokala, MD Division of Urology University of Missouri Columbia, MO 65212 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Pokala: The main purpose of the study was to determine survival outcome following salvage prostatectomy in men that fail radiation therapy. Radiation and surgery are the main modalities utilized to treat localized prostate cancer. When patients fail radiation treatment, traditionally, only hormonal treatment was offered. With refinements in surgical techniques, a select few of these patients that have recurrence after radiation may benefit with salvage surgery. Salvage prostatectomy is a complex procedure because prior radiation makes this procedure tenuous, but this procedure is offered in most major tertiary medical centers. (more…)
Author Interviews, Lancet, OBGYNE / 11.03.2016

MedicalResearch.com Interview with: Charles J. Lockwood, MD Member of of the March of Dimes Board of Trustees Dean at Morsani College of Medicine Senior Vice President, USF Health and Professor of Obstetrics & Gynecology, and Public Health The University of South Florida  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Lockwood: There remain questions about the utility of vaginal progesterone therapy in asymptomatic women with singleton gestations at risk for preterm birth. The OPPTIMUM study investigators conducted a double-blind, randomized, placebo-controlled trial of vaginal progesterone delivered via a pessary releasing 200 mg per day (n=618) vs. placebo (n=610) from around 22 to 34 weeks gestation among women at high risk for prematurity on the basis of a characteristic history and/or the presence of cervicovaginal fetal fibronectin or a cervical length less than 25 mm in length on transvaginal ultrasound.  The primary endpoints were fetal death or preterm birth before 34 weeks (obstetrical outcome), or a composite of neonatal mortality or morbidities (neonatal outcome).  The authors found that progesterone had no significant impact on either primary endpoint, with an adjusted OR of 0·86, 95% CI: 0·61-1·22 for obstetrical outcomes and an OR of 0·62, 95% CI:0·38-1·03 for neonatal outcomes. (more…)
Author Interviews, Hospital Readmissions, JAMA, Orthopedics, Surgical Research / 11.03.2016

MedicalResearch.com Interview with: Ronald S. Chamberlain, MD, MPA, FACS Chairman and Surgeon-in-Chief Department of Surgery Saint Barnabas Medical Center Professor of Surgery New Jersey Medical School Rutgers University MedicalResearch.com: What is the background for this study? Dr. Chamberlain:  With the rapidly growing arthritic, aging, and obese population, total hip replacement (THR) has become the most commonly performed orthopedic procedure in the United States (US).  The Affordable Care Act signed by President Barack Obama imposed financial penalties for excess readmissions following certain procedures and diagnoses. While the initial program aimed to reduce readmissions for heart failure, pneumonia, and acute myocardial infarction (AMI), the program expanded to include THR in 2015. With current research estimating a 10%, 30-day readmission rate following a total or partial hip replacement, this study sought to identify factors associated with readmission and to create a scale which could reliably stratify preoperative readmission risk. (more…)
Author Interviews, Cancer Research, JAMA / 11.03.2016

MedicalResearch.com Interview with: Joseph Unger, PhD, MS SWOG Statistical Center Assistant Member, Public Health Sciences Division, Fred Hutchinson Cancer Research Center Affiliate Assistant Professor, Health Services Research, University of Washington Seattle, WA  98109-1024 MedicalResearch.com: What is the background for this study? Dr. Unger: The rate at which trials are positive has previously been examined, and the relationship between trial results and publication rates in the context of publication bias has also been studied. But the comparative scientific impact of positive vs negative clinical trials using citation data has not been investigated We used the phase III trial database of SWOG, a major national cooperative clinical trials group, in combination with its trial publication database and citation data from Google Scholar, to compare the scientific impact of positive vs negative phase III cancer clinical treatment trials. (more…)
Author Interviews, Heart Disease / 11.03.2016

MedicalResearch.com Interview with: Malin Inghammar, MD, PhD Department of Infectious Diseases Skåne University Hospital, Lund Sweden  MedicalResearch.com: What is the background for this study? Dr. Inghammar: Fluoroquinolones are a class of antibiotics with a widespread use in the treatment of common infections. Agents of this drug are generally well tolerated and have few side effects but in some people fluoroquinolones can prolong the QT-interval. QT-prolongation is a sort of electrical disturbance in the heart that can, in rare instances, lead to potentially life-threatening arrhythmia. Some drugs are well known to cause QT-prolongation and to be able to trigger arrhythmia. Fluoroquinolones however, have only weak effect on the QT-time. There have been a few previous studies published reporting an increased risk. Some of these, compared fluoroquinolone treated patients with people who were not treated with antibiotics at all. In these studies, it can’t be ruled out that the infection itself, rather than the antibiotic treatment could have influenced the risk of arrhythmia. In some other previous studies, there have been indications that the patients receiving fluoroquinolones were of poorer general health than the comparison group, which could also have affected the results. Therefore it is not clear if oral fluoroquinolone treatment leads to an increased risk of serious cardiac arrhythmia in an everyday clinical situation. (more…)
Author Interviews, Pain Research, Stanford / 11.03.2016

MedicalResearch.com Interview with: Eric Sun, MD/PhD Instructor Department of Anesthesiology, Perioperative and Pain Medicine Stanford University MedicalResearch.com: What is the background for this study?  Dr. Sun: Epidural steroid injections are frequently used to treat chronic low back pain.  While previous studies have shown they are effective at improving symptoms, whether they reduce spending is unknown.  These concerns are particularly salient because insurers are worried that epidural steroid injections are being overused. MedicalResearch.com: What are the main findings? Dr. Sun: Overall, we find that epidural steroid injections were associated with decreases in spending ranging from five to fifteen percent, depending on the specific indication.  These differences were largely driven by decreases in outpatient spending (e.g., spending on outpatient physician visits). (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Radiology / 10.03.2016

MedicalResearch.com Interview with: Guillermo J. Tearney, MD PhD Mike and Sue Hazard Family MGH Research Scholar Professor of Pathology, Harvard Medical School Wellman Center for Photomedicine Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Dr. Tearney: In this study, we investigated a new, advanced catheter-based imaging technology for identifying the coronary plaques that may potentially precipitate heart attack. The new technique combines intracoronary OCT, that provides images of tissue emicrostructure with near-infrared autofluorescence (NIRAF) that informs on the molecular/biological characteristics of plaque. MedicalResearch.com: What are the main findings? Dr. Tearney: Our main findings were that: 1) Intracoronary OCT-NIRAF is safe and feasible in patients 2) NIRAF was elevated focally in portions of the coronary artery that contained high risk OCT features, and 3) The findings are suggestive that NIRAF may be a new imaging feature that is indicative of inflammation in human coronary lesions in vivo. (more…)
Author Interviews, Diabetes, JAMA, Multiple Sclerosis / 10.03.2016

MedicalResearch.com Interview with: Jorge Correale MD Department of Neurology, Institute for Neurological Research Dr Raúl Carrea Buenos Aires, Argentina MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Correale: First it is now well known that in parallel to the specific treatment of Multiple Sclerosis, those comorbidities that worsen the course of the disease should be treated. For example, cardiovascular diseases. Moreover there are in vitro and in animal models evidence of an anti-inflammatory role of compounds investigated in this publication evidence. (more…)
Author Interviews, Brain Injury, Pediatrics / 10.03.2016

MedicalResearch.com Interview with: Roger Zemek, MD, FRCPC Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion, University of Ottawa Director, Clinical Research Unit, Children’s Hospital of Eastern Ontario Ottawa, ON MedicalResearch.com: What is the background for this study? Dr. Zemek: The number of concussions have dramatically increased over the past decade.  Not only are children and adolescents are at highest risk for getting concussions, they also take longer to recover.  As part of our background work, our team performed a systematic review (published in JAMA Pediatrics) confirming that validated, easy-to-use prognosticators did not exist for clinicians to identify children with concussion who are at the highest risk for persistent post-concussive symptoms (PPCS) and sequelae. MedicalResearch.com: What are the main findings? Dr. Zemek: In this, the largest concussion study in the world to-date, we derived and validated in a large, diverse cohort of children a clinical risk score that is significantly superior to clinicians’ ability to predict future PPCS at the time of ED presentation. Multivariate analysis revealed that age group, female sex, past history of migraine, prior concussion with symptom duration of >1 week, ED presentation with “answering questions slowly”, 4 or more errors on BESS Tandem stance, and the initial symptoms of headache, noise sensitivity and fatigue were all clinically significant and strongly associated with PCS at 1-month. We assigned points based on the adjusted multivariate odds ratio, and the rule incorporating patient demographic factors, past history, early cognitive deficits, balance (an physical exam finding), and early symptoms.  The rule has a maximum of 12 points.  We selected two cut-off points in order to yield three clinically relevant (low, intermediate and high risk) categories for the development of PPCS at one month. (more…)
Author Interviews, BMJ, Nutrition, Sugar, Weight Research / 10.03.2016

MedicalResearch.com Interview with: Euridice Martinez Steele  University of São Paulo, São Paulo MedicalResearch.com: What is the background for this study? Response: Several leading health bodies, including the World Health Organization, the Canadian Heart and Stroke Foundation, the American Heart Association, and the US Dietary Guidelines Advisory Committee have concluded that excess added sugar intake increases the risk not only of weight gain, but also of obesity and diabetes, which are associated with a heightened risk of cardiovascular disease, and tooth decay. All reports recommended limiting intake of added sugars. In the US, the USDGAC recommended limiting added sugars to no more than 10% of total calories. To design and implement effective measures to reduce added sugars, their dietary sources must be clearly identified. Added sugars can be consumed either as ingredients of dishes or drinks prepared from scratch by consumers or cook, or as ingredients of food products manufactured by the food industry. According to market disappearance data from 2014, more than three quarters of the sugar and high fructose corn syrup available for human consumption in the US were used by the food industry. This suggests food products manufactured by the industry could have an important role in the excess added sugars consumption in the US. However, to assess this role, it is essential to consider the contribution of manufactured food products to both total energy intake and the energy intake from added sugars, and, more relevantly, to quantify the relationship between their consumption and the total dietary content of added sugars. To address these questions, we performed an investigation utilizing 2009-2010 National Health and Nutrition Examination Survey (NHANES). (more…)
Author Interviews, JAMA, Rheumatology, Vitamin D / 10.03.2016

MedicalResearch.com Interview with: Changhai Ding, MBBS, MMED, MD Australian Research Council Future Fellow Associate Director (International), Menzies Institute for Medical Research Professor,  University of Tasmania, Australia Honorary Professor, University of Sydney, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ding: Vitamin D can reduce bone turnover and cartilage degradation, thus potentially preventing the development and progression of knee osteoarthritis. Observational studies suggest that vitamin D supplementation is associated with benefits for knee osteoarthritis, but current evidence from clinical trials is contradictory. We  conducted a randomised clinical trial in Hobart, Tasmania and Melbourne, Victoria in Australia. We randomly assigned 413 patients with symptomatic knee osteoarthritis and low 25-hydroxyvitamin D to receive monthly treatment with oral vitamin D3 (50,000 IU; n = 209) or an identical placebo (n = 204) for 2 years. Of 413 enrolled participants (average age, 63 years; 50 percent women), 340 (82 percent) completed the study. Vitamin D supplementation significantly increased blood 25-hydroxyvitamin D levels over 2 years compared with placebo treatment; however, vitamin D supplementation, compared with placebo, did not result in significant differences in change in MRI-measured tibial cartilage volume or a measure of knee pain over 2 years. There were also no significant differences in change of tibiofemoral cartilage defects or change in tibiofemoral bone marrow lesions. Post-hoc analyses indicated that vitamin D supplementation might improve knee physical function and reduce another measure of knee pain and increases in bone marrow lesion. (more…)
Author Interviews, Heart Disease, JACC / 10.03.2016

MedicalResearch.com Interview with: Cathy Handy, MD MPH  Fellow, Department of Oncology Johns Hopkins Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Handy: We explored the relationship between coronary artery calcium and age related diseases.  Coronary artery calcium refers to calcium deposits in the blood vessels of the heart.  It can be seen with a non invasive imaging test and is thought to be a biologic measure of aging.  Previous research has shown coronary artery calcium to be highly correlated with cardiovascular disease and mortality. We found that it is also associated with an increased risk of cancer, pneumonia, chronic kidney disease, chronic obstructive pulmonary disease and hip fractures. (more…)
Author Interviews, BMJ, Exercise - Fitness, Orthopedics / 10.03.2016

MedicalResearch.com Interview with: David Morrissey MB PhD FRCS (Tr&Orth) Orthopaedic Specialist Registrar  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Morrissey: Injury rates in rugby union have increased substantially over the past twenty years, both in the professional and amateur game. The pattern of injury has also changed, reflecting higher grades of trauma. Our institution is a tertiary referral centre for pelvic and acetabular trauma serving a population of 4.5 million. The majority of our cases occur as a result of high velocity trauma such as road traffic accidents. We have not previously seen hip dislocations/acetabular fractures occurring secondary to sporting participation. In the past number of years, however, we have identified four such injuries in three juvenile patients, that occurred during rugby union participation. These injury patterns may have sub-optimal outcomes in up to 30% of patients and can severely affect a young person’s life. The demographic change may be due to changes in the physical development of players as well as an increased emphasis on the tackle/ruck area. In the juvenile game, differing rates of maturation magnify size differences between players, potentially increasing the risk of injury. (more…)
Author Interviews, Dermatology, Microbiome / 09.03.2016

MedicalResearch.com Interview with: Sophie Seite, PhD La-Roche-Posay Dermatological Laboratories Asnières, France MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Seite: These studies were performed in order to confirm the previous results published by H. Kong et al showing that the skin microbiota of atopic dermatitis patients was less diversified and presented an overabundance of S. aureus in comparison to healthy subjects. Because each of us has a specific skin microbiota (huge inter-individual variation) we performed an intra-individual design protocol in order to compare the microbiome of a lesional skin area to those of a non-lesional adjacent area. This strategy showed that the skin diversity in AD patients was reduced in non-lesional area and even more in lesional area and that not only Staphylococcus aureus is overabundant but also Staphylococcus epidermidis and Staphylococcus haemolyticus. Furthermore, for the first time the effect of a topical treatment on the skin microbiome was evaluated. Prebiotic strategies using thermal spring water or biomass lysate of nonpathogenic bacteria demonstrated their efficiency for a long term management of AD patients through an action on the skin microbiome. (more…)
Author Interviews, Breast Cancer, Diabetes / 09.03.2016

MedicalResearch.com Interview with: Dr. Zorana Andersen Department of Public Health Center for Epidemiology and Screening University of Copenhagen  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Andersen: Diabetes is associated with increased risk of breast cancer, but exact mechanisms are unknown. The role of insulin has been debated. High mammographic density (MD) is one of the strongest predictors and a biomarker of breast cancer risk. Few studies have linked diabetes to mammographic density, finding none or weak inverse associations, but none had data on diabetes treatment. We examined whether diabetes and diabetes treatment are associated with mammographic density in a prospective cohort study of Danish women above age of 50 years. MedicalResearch.com: What should clinicians and patients take away from your report? Dr. Andersen: Women with diabetes, as well as clinicians working with diabetes and breast cancer and breast cancer screening, would have interest to know how different diabetes treatment can affect breast density, and hereby possibly breast cancer risk. For example, diabetic women taking insulin may possibly benefit from informing radiologists at breast cancer screening about their insulin use, due to increased breast density and increased risk of masking bias. (more…)
Author Interviews, Gastrointestinal Disease, Lancet, Microbiome, Pediatrics / 09.03.2016

MedicalResearch.com Interview with: Phillip I. Tarr, MD Melvin E. Carnahan MD Professor of Pediatrics Director, Pediatric Division of Gastroenterolgy and Nutrition Washington University in St Louis School of Medicine St Louis, MO 63110, USA MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Tarr: There is a longstanding belief that gut bacteria are relevant to the developing necrotising enterocolitis (NEC). We have established dysbiosis in the gut before NEC occurs, suggesting this ecological perturbation might be causal.

(more…)
Anesthesiology, Author Interviews, Cognitive Issues, Surgical Research / 09.03.2016

MedicalResearch.com Interview with: Unni Dokkedal, M.P.H. Unit of Epidemiology, Biostatistics, and Biodemography University of Southern Denmark MedicalResearch: What is the background for this study?  Response: Early (seven days) postoperative cognitive impairment is common in adult surgical patients of all ages, but elderly patients are at higher risk for this complication. Previous studies have shown that these impairments are detectable up to three months after surgery in patients older than 60 years. Furthermore, the condition may persist for longer than six months in some patients with potential long-term implications of the surgery leading to impaired quality of life and increased mortality risk. We wanted to investigate the contribution of surgery, anesthesia, preexisting conditions and other factors on the postoperative cognitive functioning of elderly patients. MedicalResearch:  What are the main findings? Response: For a sample of 4,299 middle-aged twins younger than 70 years and 4,204 elderly twins over 70 years, all of whom were residents of Denmark, medical records were reviewed from 1977 and until the accomplishment of cognitive tests in the period from 1995 to 2001. Results from five cognitive tests were compared in twins exposed to surgery, classified as major, minor, hip and knee replacement, or other, with those of a reference group without surgery. A statistically significant lower composite cognitive score was found in twins with at least one major surgery compared with the reference group (mean difference, −0.27; 95% CI, −0.48 to −0.06), which is a negligible effect size. None of the other groups differed from the reference group except the knee and hip replacement group that tended to have higher cognitive scores (mean difference, 0.35; 95% CI, −0.18 to 0.87).To consider genetic and shared environmental confounding and to take preoperative cognition into account, intrapair analyses were performed in same-sexed pairs in whom one had a history of major surgery and the other no surgery. No difference was found in the intra-pair analysis. The results suggest that preoperative cognitive functioning and underlying diseases were more important for cognitive functioning in mid- and late life than surgery and anesthesia. (more…)
Author Interviews, Heart Disease / 09.03.2016

MedicalResearch.com Interview with: Anna Gundlund, MB Gentofte Hospital, Kildegårdsvej Hellerup, Denmark MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation seems to accumulate in families and several studies have indicated that a family history of atrial fibrillation may be an important risk factor for developing atrial fibrillation. In addition, three genomic regions associated with atrial fibrillation have been identified in Genome Wide Association Studies. In this study we compared atrial fibrillation patients with or without a family history of atrial fibrillation. MedicalResearch.com: What are the main findings? Response: We found that patients with a family history are diagnosed with atrial fibrillation at a younger age and with more disabling symptoms than those without a family history of atrial fibrillation. When looking at the longitudinal course of the disease, we found no differences in risk of progression of atrial fibrillation (e.g. from paroxysmal to persistent), risk of thromboembolic complications, all-cause hospitalization, or all-cause death when comparing those with a family history of atrial fibrillation with those without a family history. (more…)
Author Interviews, BMJ, Cancer Research, Colon Cancer, Psychological Science / 09.03.2016

MedicalResearch.com Interview with: Benedicte Kirkøen, PhD candidate Bowel Cancer Screening in Norway – a pilot study Cancer Registry of Norway (Kreftregisteret) MedicalResearch.com: What is the background for this study? Response: Randomised controlled trials have demonstrated that screening for colorectal cancer (CRC) can reduce CRC related mortality, but the total benefit and harm of national cancer screening programmes are under debate. Saving relatively few lives requires a large number of people to be screened. Most people who attend screening will never develop cancer, but may be exposed to potential psychological stress by participation. Cancer is one of the largest threats to peoples’ health, and participating in screening for cancer might therefore cause anxiety. In Norway, colorectal cancer incidence has nearly tripled since the 1950s, and currently a large randomised pilot study of a national screening programme (Bowel Cancer Screening in Norway) is investigating the effect of screening on reduction in CRC incidence and mortality. As part of an evaluation of the benefits and harms of the pilot, we investigated the psychological effect of screening participation in a large group of participants. Of particular interest to us were participants who received a positive screening result and were referred to colonoscopy. (more…)
Author Interviews, Biomarkers, Breast Cancer / 09.03.2016

MedicalResearch.com Interview with: Michele Orditura MD, PhD Associate Professor in Medical Oncology Faculty of Medicine, Second University of Naples Naples Italy  MedicalResearch.com: What is the background for this study? Prof. Orditura: In the last few years increasing evidence suggests that cancer-related inflammatory response plays a crucial role in the development and progression of several malignancies. Neutrophil to lymphocyte ratio (NLR), calculated as the neutrophil count divided by the lymphocyte count , may represent an easily measurable and inexpensive marker of systemic inflammation. Several studies have reported NLR as an unfavourable prognostic indicator for patients with gastrointestinal, lung, renal and gynaecological cancers. In the breast cancer setting, the results of published trials evaluating the relationship between NLR and outcome are controversial, and a recent meta-analysis including eight trials published between 2012 and 2014 has shown that elevated NLR is strongly associated with poor survival. In addition, the available data mainly concern women of Asian race and only three papers have included patients of Europe race. The main aim of this study was to clarify the correlation between pre surgery NLR and distant metastasis-free survival in a series of 300 Italian patients with early breast cancer. The propensity score-matched analysis was chosen for statistical evaluation to avoid risk of confounding bias. (more…)
Author Interviews, Brain Injury, Genetic Research / 09.03.2016

MedicalResearch.com Interview with: Dr. Jane McDevitt Temple University in Philadelphia MedicalResearch.com: What is the background for this study? Dr. McDevitt: During a head impact there is a mechanical load that causes acceleration and deceleration forces on the brain within the cranium. The acceleration and deceleration causes stress to the neurons and initiates a neurometabolic cascade, where excitatory neurotransmitters such as glutamate are released and depolarize the cell.  This triggers protein channels to open and allow ions into and out of the cell.  Increases in calcium persist longer and have greater magnitude of imbalance than any other ionic disturbance. One channel responsible for allowing calcium into the cell is r-type voltage-gated calcium channel.  One of the main proteins within this voltage-gated calcium channel is the CACNA1E protein produced by the CACNA1E gene. This protein forms the external pore and contains a pair of glutamate residues that are required for calcium selectivity.   It is also responsible for modulating neuronal firing patterns. A variation within this gene (i.e,CACNA1E ) that regulates expression levels of CACNA1E could be associated with how an athlete recovers following a concussion injury. Upwards of 20% of the concussed population fall into the prolonged recovery category, which puts these athletes at risk for returning to play quicker than they should. Variation in recovery depends on extrinsic factors like magnitude of impact, and sport, or intrinsic factors like age or sex. One intrinsic factor that has not been definitively parsed out is genetic variation. Recovery is likely to be influenced by genetics because genes determine the structure and function of proteins involved in the cell’s resistance and response to mechanical stress. Due to CACNA1E’s relationship to calcium influx regulation, a single nucleotide polymorphism (SNP) could modify the expression level of the protein responsible for regulating calcium. Altered protein levels could lead to athlete’s responding to concussive injuries differently. The main objective of this study was to examine the association between CACNA1E SNPs with concussion recovery in athletes. (more…)