Blog – Medical Research News and Interviews
06 Oct Do People Wearing Activity Trackers Really Exercise More?
MedicalResearch.com Interview with: Aarti Sahasranaman, PhD Duke-NUS Gradaute Medical School Singapore MedicalResearch.com: What is the background for this study? Response: More than half of adults in developed countries do not achieve recommended levels of physical activity. Despite the popularity of activity trackers as a tool for motivating and monitoring activity levels, little research exists on whether they can help people lead healthier lives, or if financial incentives could encourage people to wear them for longer and achieve higher fitness levels. One in ten US adults owns an activity tracker but research suggests that about a third of people abandon them within 6 months of purchase.06 Oct Payments to Ophthalmologists for Anti-VEGF Agents
MedicalResearch.com Interview with: [caption id="attachment_28618" align="alignleft" width="166"]
Dr. Aleksandra Rachitskaya[/caption]
Aleksandra Rachitskaya, MD
Assistant Professor of Ophthalmology
Retina Service, Department of Ophthalmology
Cole Eye Institute
Cleveland, OH 44195
MedicalResearch.com: What is the background for this study?
Response: The Centers for Medicare and Medicaid Services (CMS) Open Payments database lists payment records from drug and device manufacturers to physicians. Anti-vascular endothelial growth factor (anti-VEGF) agents such as ranibizumab (Lucentis®, Genentech, Inc., San Francisco, CA), aflibercept (Eylea™, Regeneron, Tarrytown, NY) and off-label bevacizumab (Avastin®, Genentech, Inc., San Francisco, CA) are used for a variety of indications in ophthalmology.
The current study examined the payments made to ophthalmologists related to ranibizumab and aflibercept and correlated those payments to provider usage of these medications. The former was achieved by utilizing Centers for Medicare and Medicaid Services (CMS) Provider Utilization and Payment database.
06 Oct Lower Salt Intake Linked To Decreased Blood Pressure, Heart Disease and Mortality
Posted at 11:22h
in Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Heart Disease, JACC, Salt-Sodium
MedicalResearch.com Interview with:
[caption id="attachment_28435" align="alignleft" width="130"]
Dr. Nancy Cook[/caption]
Nancy Cook ScD
Professor of Medicine, Harvard Medical School
Professor in the Department of Epidemiology
Harvard T.H. Chan School Public Health
Brigham & Women’s Hospital Division of Preventive Medicine
Boston, MA 02215
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The association of sodium intake with later mortality has been controversial. While there is a well-accepted effect on blood pressure, the effects of sodium on later cardiovascular disease, and particularly mortality, have been subject to dispute. While the adverse effects of high sodium are now widely accepted, effects at lower levels of sodium intake are less clear. Some recent studies have found a J-shaped relationship, with increased disease rates among those consuming lower levels of sodium, contrary to the effects on blood pressure.
In contrast, we found a direct linear relationship of usual intake of sodium with later mortality over 20 years of follow-up. Those with the lowest sodium intake experienced the lowest mortality. Our measure of intake was based on the average over 1-3 years of several measures of 24hr urine sodium excretion, the gold standard of sodium measurement. This is much more precise than measurements based on a single 24hr sodium excretion or especially on a spot urine sample, which is used in many publications that found the J-shaped curve. Our data were assessed in a healthy cohort of men and women without hypertension or cardiovascular disease, so had less potential bias due to these factors. We thus believe that our results showing the lowest mortality among those consuming the lowest levels of sodium are more accurate.
06 Oct Pre-K ParentCorps Reduces Educational Disparities and Mental Health Issues
MedicalResearch.com Interview with: [caption id="attachment_28494" align="alignleft" width="144"]
Dr. Laurie Brotman[/caption]
Laurie Miller Brotman, PhD
Bezos Family Foundation Professor of Early Childhood Development
Director, Center for Early Childhood Health and Development
Department of Population Health
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Children attending high-poverty schools are often exposed to an accumulation of stressors and adverse childhood experiences that can interfere with optimal mental health and learning. This study examines mental health and academic outcomes through second grade in nearly 800 Black and Latino children who participated in a randomized controlled trial of ParentCorps--a family-centered, school-based intervention in pre-kindergarten.
In the original trial, elementary schools with pre-k programs serving primarily Black and Latino children from low-income families were randomized to receive ParentCorps or standard pre-k programming. ParentCorps includes professional development for pre-k and kindergarten teachers on family engagement, social-emotional learning, and behavioral regulation, and a program for families and pre-k students provided over four months at the school by specially trained pre-k teachers and mental health professionals. ParentCorps creates a space for families to come together, reflect on their cultural values and beliefs, and set goals for their children. Parents learn a set of evidence-based strategies and choose which ones fit for their families—such as helping children solve problems and manage strong feelings, reinforcing positive behavior, setting clear rules and expectations, and providing effective consequences for misbehavior. Teachers and parents help children learn social, emotional and behavioral regulation skills such as identifying feeling sad, mad, or scared, calming bodies during stressful situations, paying attention, and solving problems together.
This three year follow-up study finds that ParentCorps as an enhancement to pre-k programming in high-poverty schools results in fewer mental health problems (behavioral and emotional problems) and better academic performance through second grade.
06 Oct Children using stimulant medications may be at risk for lower bone density
Posted at 11:09h
in Author Interviews, Bone Density, JAMA, Mental Health Research, Mineral Metabolism, Pediatrics
MedicalResearch.com Interview with:
Alexis Jamie Feuer MD
Assistant Professor of Clinical Pediatrics
Weill Cornell Medical College
MedicalResearch.com: What is the background for this study?
Response: Osteoporosis is a debilitating disorder characterized by low bone density and increased risk of fractures. Adolescence and young adulthood are critically important times for accruing peak bone density and failure to obtain adequate bone mass by early adulthood may result in future osteoporosis. In children, the use of certain medications can lead to a decrement in the acquisition of bone mass. Past studies have shown that stimulant medications, such as those used to treat Attention Deficit Hyperactivity Disorder (ADHD), may slow the rate of linear growth in children. To date, little research has been done to see what effects stimulant use may have on bone density and bone accrual in children. Stimulants exert their effects via activation of the sympathetic nervous system, and as there is mounting evidence that indicates the sympathetic nervous system plays a critical role in the acquisition of bone density, we sought to determine if there is any association between stimulant medication use and bone mass in the pediatric population.
06 Oct Digital Mobile Technology Gives Some Arm Function To Stroke Patients
MedicalResearch.com Interview with: [caption id="attachment_28589" align="alignleft" width="149"]
Dr Paul Bentley[/caption]
Dr Paul Bentley MA MRCP PhD
Clinical Senior Lecturer in Clinical Neuroscience
Honorary Consultant Neurologist
Neurology Dept
Imperial College NHS Healthcare Trust
Charing Cross Hospital
London
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: gripAble was designed to help people with arm disability practise physiotherapy when a physiotherapist is not available, or in between physiotherapy sessions. We know that the amount of physiotherapy provision in the UK, after stroke or arm injury, is typically below that which is recommended by professional bodies. Furthermore, increasing research suggests that higher-intensity training can boost functional outcomes. The innovation was designed to help people with a range of disabilities including severe paralysis engage with computer games with their weak arm. At the same time its designed to be portable for use at home or in bed, and low-cost.
gripAble also enables remote measurement and monitoring of arm function, by setting users a series of calibrated tasks played out on the tablet screen. This way doctors and physiotherapists can assess the needs of a patient, and gain an idea of how well a patient is responding to home physiotherapy.
06 Oct Syphilis Skyrockets Among MSM
MedicalResearch.com Interview with: [caption id="attachment_28584" align="alignleft" width="200"]
Dr. Alex de Voux[/caption]
Alex de Voux, PhD, Epidemiologist
Centers for Disease Control
Division of STD Prevention
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Reported cases of primary and secondary syphilis have been increasing steadily in the United States since 2001, with men-who-have-sex-with-men (MSM) accounting for 83% of male primary and secondary syphilis cases with information on sex of sex partner in 2014.
However calculating the true disparity of primary and secondary syphilis cases relative to the MSM population size has been difficult because census data does not routinely collect information on sexual orientation or same-sex behavior. Through a recent collaboration with Emory University and CDC, Grey and colleagues developed refined estimates of the population size of MSM by state allowing us to calculate state-specific rates of primary and secondary syphilis for the first time. Looking at data from 44 states that had information on sex of sex partner for at least 70% of their male primary and secondary syphilis cases, the overall rate of syphilis was 309 per 100,000.
The state level data found syphilis rates among gay and bisexual men ranged widely among the 44 states, from 73.1 per 100,000 in Alaska to 748.3 per 100,000 in North Carolina. Some of the highest rates among MSM were in states in the Southeast and the West.
Comparing rates of syphilis among MSM to men reporting sex with women only (MSW), the overall rate for MSM was 107 times the rate for MSW. By state, the rate among MSM was at least 40 times the rate among MSW – and at most, 340 times the rate among MSW.
05 Oct UV Sensitive ‘Band-aid’ Makes Monitoring Sun Exposure Easy
MedicalResearch.com Interview with: [caption id="attachment_28574" align="alignleft" width="164"]
Dr. Andrea M Armani[/caption]
Dr. Andrea M Armani PhD
Fluor Early Career Chair and Associate Professor
Mork Family Department of Chemical Engineering and Materials Science
University of Southern California, Los Angeles, California
MedicalResearch.com: What is the background for this study?
Response: The “Internet of Things” (IoT) has seen an explosion in online sensor technologies, including UV sensors and monitors; for example, those from Apple and Samsung. However, they require connectivity and power, and they are integrated into delicate electronic systems that are not compatible with outdoor, athletic activities such as swimming, which is precisely when you should monitor UV exposure. Therefore, somewhat ironically, the technologies developed to meet the demands of the IoT are not ideal for cumulative UV exposure detection.
Our goal was to develop a single use patch – like a smart “band-aid” – for the beach to alert users when they had been in the sun for an hour and needed to re-apply sunscreen or get out of the sun altogether. This application required a rugged system that was waterproof, bendable, and compatible with sunscreen. Additionally, the sensor readout needed to be easy to interpret. These requirements influenced our design and material selection.
05 Oct Perinatal Adverse Events Linked To Increased Risk of OCD
MedicalResearch.com Interview with: Gustaf Brander Department of Clinical Neuroscience Karolinska Institutet MedicalResearch.com: What is the background for this study? Response: Obsessive-compulsive disorder (OCD) is believed to be caused by a complex interaction between genetic and environmental factors. Whereas genetic studies are well underway, the research on environmental factors has been lagging behind. As they explain a significant portion of the variance, are potentially malleable, and are essential for understanding how the genetic component works, this area of research is of great importance.05 Oct Acne Linked To Longer Telomeres and Better Aging
MedicalResearch.com Interview with: [caption id="attachment_18697" align="alignleft" width="112"]
Dr. Simon Ribero[/caption]
Simone Ribero, M.D., Ph.D.
University of Turin
Department of Medical Sciences
Turin. Italy &
King’s College London
Department of Twin Research and Genetic Epidemiology
St Thomas’ campus
London
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: For many years dermatologists have identified that the skin of acne sufferers appears to age more slowly than in those who have not experienced any acne in their lifetime.
We have demonstrated in our paper that there is an association between acne and longer telomere length that means that acne patients , with the same anagraphic age , have a younger chronological age.
05 Oct Electronic cigarettes increase endothelial progenitor cells in the blood of healthy volunteers
MedicalResearch.com Interview with: [caption id="attachment_28559" align="alignleft" width="180"]
Dr. Lukasz Antoniewicz[/caption]
Lukasz Antoniewicz MD, PhD candidate
Karolinska Institutet
Department of Clinical Sciences
Danderyd University Hospital
Stockholm, Sweden
MedicalResearch.com: What is the background for this study?
Response: Electronic cigarette sales increase exponentially on a global scale without knowledge about possible negative effects on human health. We performed an exposure study in young healthy volunteers and analyzed blood samples for endothelial progenitor cells and microvesicles. Increase in those markers may reflect vascular injury, inflammation and platelet activation.
05 Oct Depression Common in Lung Cancer and Linked To Mortality
MedicalResearch.com Interview with: [caption id="attachment_28555" align="alignleft" width="96"]
Dr. Donald Sullivan[/caption]
Donald R. Sullivan, M.D., M.A.
Assistant Professor, Division of Pulmonary & Critical Care Medicine
Oregon Health & Science University
Investigator, VA Portland Health Care System
MedicalResearch.com: What is the background for this study?
Response: There is an inextricably link between physical and mental health, and all too often clinicians focus solely on the physical components of disease. A life-threatening diagnosis such as cancer often evokes significant psychological distress and lung cancer patients are at significantly risk. Up to 44% of lung cancer patients experience depression symptoms and 5-13% major depressive disorder, higher than most other cancers. Previous studies have demonstrated the development of depression or depression symptoms at lung cancer diagnosis can increase patient mortality, but there is a paucity of research exploring how longitudinal changes in depression symptoms impact patient outcomes.
04 Oct Autoimmune Specialty Drug Spending Doubles, Accounting for 10 Percent of Drug Expenses
MedicalResearch.com Interview with: [caption id="attachment_28545" align="alignleft" width="125"]
Dr. Kevin Bowen[/caption]
Kevin Bowen MD MBA
Senior Health Outcomes Researcher
Prime Therapeutics LLC
1305 Corporate Center Drive
Eagan, MN 55121
MedicalResearch.com: What is the background for this study? What are the main findings?
• Autoimmune specialty drugs now account for about one of every 10 dollars of combined drug expense through the medical and pharmacy benefits in a commercially insured population.
• The autoimmune drug class is one of the fastest growing, with this study finding a doubling in autoimmune drug expenditures and a 38 percent increase in utilization, in the most recent four years.
• Integrated analysis of medical and pharmacy claims is essential for this category of drugs because more than 25 percent of autoimmune specialty drug use is paid through the medical benefit and medical claims diagnosis coding provides a means of determining what conditions were treated with drugs covered by pharmacy claims.
04 Oct Cosentyx Offers Longer-Term Treatment Option for Patients With Moderate To Severe Plaque Psoriasis
MedicalResearch.com Interview with: [caption id="attachment_28541" align="alignleft" width="135"]
Dr. Craig Leonardi[/caption]
Craig Leonardi, MD
Adjunct Professor of Dermatology
Saint Louis University School of Medicine
Saint Louis, Missouri
MedicalResearch.com: What is the background for this study?
Response: A2304E1 is a multicenter, double-blind and open-label extension study to evaluate the long-term safety and efficacy of Cosentyx in patients with moderate to severe plaque psoriasis. Patients who completed 52 weeks of the core SCULPTURE and STATURE studies and re-consented to treatment were eligible for the extension, and continued the same Cosentyx dose and regimen that they were receiving in their core study. Patients did not have to achieve a PASI 75 response at the end of their core study to enroll.
A total of 642 patients entered the extension study: 168 continued on Cosentyx 300 mg every 4 weeks, 152 continued on Cosentyx 150 mg every 4 weeks, 172 continued on Cosentyx 300 mg retreatment-as-needed, and 150 continued on Cosentyx 150 mg retreatment-as-needed. At the end of Week 156, the study was open-label and patients could continue their assigned dose and regimen or switch to 300 mg every 4 weeks based on the investigator’s judgment.
Results presented at EADV focus on those patients from the SCULPTURE core study who enrolled in the extension study. The primary endpoint of this extension study was overall safety and tolerability. Secondary efficacy measures included the proportion of patients achieving PASI 75, PASI 90 and PASI 100.
04 Oct Epidemic of HPV Associated Throat Cancer in Men
MedicalResearch.com Interview with: [caption id="attachment_28537" align="alignleft" width="133"]
Dr. Eric Genden[/caption]
Eric M Genden, MD, FACS
Isidore Friesner Professor and Chairman
Department of Otolaryngology-Head and Neck Surgery
The Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this report? How has the clinical picture of HPV infections of oral and throat cancers changed over the past two decades?
Response: There has been no change however there has been a epidemic of viral induced throat cancer in men. The HPV virus has been established a the causative agent in cervical cancer in women. It has now been identified as a major causative agent in tonsillar and base of tongue cancer.
04 Oct Breast Cancer Mortality Varies By Latina Subgroups
MedicalResearch.com Interview with: [caption id="attachment_28533" align="alignleft" width="200"]
Bijon Hunt[/caption]
Bijou R. Hunt, MA
Sinai Urban Health Institute, Sinai Health System
Chicago, IL
MedicalResearch.com: What is the background for this study?
Response: Breast cancer is the most commonly diagnosed cancer in Hispanic women, as well as the leading cause of cancer death for this group. Research has shown that there are differences by Hispanic subgroup in various causes of death, including cancer, but we haven’t seen data on breast cancer specifically among Hispanic subgroups. The most important question we wanted to address with this study was: do breast cancer prevalence and mortality vary by Hispanic subgroup?
04 Oct Leukoencephalopathy As Marker of Cognitive Impairment After Chemotherapy For Childhood ALL
Posted at 00:06h
in Author Interviews, Cancer Research, Cognitive Issues, Education, Lancet, Leukemia, Mental Health Research, Pediatrics
MedicalResearch.com Interview with:
Yin Ting Cheung, PhD
Department of Epidemiology and Cancer Control and
Noah D Sabin, MD
Department of Diagnostic Imaging
St Jude Children's Research Hospital
Memphis, TN
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Long-term survivors of childhood acute lymphoblastic leukemia (ALL) who are treated with high-dose intravenous methotrexate or intrathecal chemotherapy are at risk for neurocognitive impairment, particularly in cognitive processes such as processing speed, attention and executive function. However, many children who receive these therapies do not experience significant impairments, suggesting the need for biomarkers to identify patients at greatest risk. Prior research from our team demonstrated that, during chemotherapy, patients were at risk for white matter changes in the brain, also known as leukoencephalopathy. No studies documented the persistence or impact of brain leukoencephalopathy in long-term survivors of childhood ALL treated on contemporary chemotherapy-only protocols.
In this study, we included prospective neuroimaging from active therapy to long-term follow-up, and comprehensive assessment of brain structural and functional outcomes in long-term survivors of ALL treated with contemporary risk-adapted chemotherapy. We demonstrated that survivors who developed leukoencephalopathy during therapy displayed more neurobehavioral problems at more than 5 years post-diagnosis. Moreover, these survivors also had reduced white matter integrity at long-term follow-up, and these structural abnormalities were concurrently associated with the neurobehavioral problems.
03 Oct Mechanism of Injury Makes A Difference In Risk of Venous Thromboembolism
Posted at 17:51h
in Accidents & Violence, Author Interviews, Clots - Coagulation, JAMA, Surgical Research, Thromboembolism
MedicalResearch.com Interview with:
Charles A. Karcutskie IV, MD, MA
Postdoctoral Research Fellow
University of Miami Miller School of Medicine
Department of Surgery
Divisions of Trauma, Surgical Critical Care, and Burns
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our research group at the Ryder Trauma Center have recently done several studies showing various differences in outcomes and risk based on mechanism of injury. Additionally, venous thromboembolism (VTE) is another topic that our group has focused on in the past several years. Because trauma patients are inherently at a higher risk for VTE due to the nature of their injury, we questioned whether the most important risk factors for VTE were different after blunt or penetrating trauma. At our institution, we assess VTE risk with the Greenfield Risk Assessment Profile, which is a list of several risk factors that each have weight toward an overall risk score. We took these risk factors and analyzed them individually based on mechanism of injury. We found that the factors that contribute to the VTE risk are different based on injury mechanism: After blunt trauma, transfusion status, neurologic status, and pelvic fracture contributed most. After penetrating trauma, vascular injury, severe abdominal injury, and age 40-59 years contributed most. This tells us that mechanism of injury may need to be incorporated into the risk assessment in order to discover the highest risk patients.
03 Oct Current Web-Based Risk Tool May Overestimate Risk of Pre-Diabetes
MedicalResearch.com Interview with: [caption id="attachment_28458" align="alignleft" width="200"]
Dr. Saeid Shahraz[/caption]
Dr. Saeid Shahraz
Assistant Professor of Medicine
Tufts Medical Center
MedicalResearch.com: What is the background for this study?
Response: American Diabetes Association (ADA) has set up a lower cut point for diagnosing prediabetes ( those with Impaired Fasting Glucose 100 mg/dL) compared to the World Health Organization's cut point, which is 110 mg/dL. This arbitrariness in cut point definition triples the number of cases labeled as prediabetes.
Along with lowering the diagnostic threshold by the ADA, the Centers for Disease Control and Prevention (CDC), the American Medical Association (AMA), and the ADA endorsed and advertised a web-based risk model to define high-risk population for prediabetes. The risk engine asks a few questions ( age, sex, family history of diabetes, history of gestational diabetes and high blood pressure, physical activity and weight) and outputs a score that defines if the person is at risk for prediabetes. We suspected that the risk engine might overestimate the risk.
03 Oct The “Surprise Question” May Help Stimulate Palliative Care Discussions
MedicalResearch.com Interview with: [caption id="attachment_28516" align="alignleft" width="155"]
Dr. Joshua Lakin[/caption]
Joshua R. Lakin, MD
Assistant Professor of Medicine
Harvard Medical School
Dana Farber Cancer Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Research has increasingly shown the benefits of early palliative care interventions, especially in those around communication about patient goals and preferences in serious illness. These benefits include improved quality of life and psychological outcomes for patients as well as eased bereavement and decision making for loved ones. We have a large gap to fill in initiating early goals and values conversations with our patients and there are a myriad of systems failures and clinician barriers that do not allow us to do this work in a timely and effective way. Doing so with limited resources, both in specialty palliative care and in the many frontline clinicians doing this work, requires targeting our resources carefully.
Doing these conversations earlier means identifying patients upstream, before they are in the last days of life. The Surprise Question – “Would you be surprised if this patient died in the next year?” – has emerged as an attractive option for screening for early palliative care interventions. It has been studied primarily in dialysis and cancer patients and has been demonstrated to have a strong association with risk of death. We set out to test it in a more diverse primary care population.
03 Oct Urinary Citrate Excretion May Be Indirect Biomarker of Bone Health
MedicalResearch.com Interview with: Jonas Esche Dipl.-Mol. Biomed University of Bonn Institute of Nutritional and Food Sciences DONALD Study MedicalResearch.com: What is the background for this study? Response: Modern western diets increase diet-dependent acid load and net acid excretion which are suggested to have adverse long-term effects on bone. Urinary potential renal acid load (uPRAL) is an established parameter to assess nutritional acid load. Urinary citrate, on the other hand, integrates nutritional and also systemic influences on acid-base homeostasis with high citrate indicating prevailing alkalization. Against this background urinary citrate excretion was used as a new index of acid-base status and its relationship with bone strength and long-term fracture risk was examined.03 Oct Cell Biomarkers To Distinguish Deadly From Less Aggressive HPV Oral Cancers
MedicalResearch.com Interview with: [caption id="attachment_28510" align="alignleft" width="200"]
Dr. Elizabeth Franzmann[/caption]
Elizabeth Franzmann, M.D.
Scientific Founder and Chief Scientific Officer
Vigilant Biosciences
MedicalResearch.com: What is the background for this study?
Response: Head and neck cancer involves cancers of the oral cavity, oropharynx and larynx. It is difficult to treat. Part of the challenge is that it is distinguishing the patients with tumors that are going to behave aggressively from those with less aggressive disease. As a result, many patients undergo treatment that may be more intensive and morbid than they need while others need more aggressive treatment. Tissue markers associated with prognosis may be able to help clinicians differentiate patients who need more aggressive treatment from those whose treatment can be less intensive. CD44 is a cell surface glycoprotein and tumor-initiating marker. CD44 and another surface protein, EGFR, are involved in tumor extension and are associated with poor prognosis. Certain forms of Human Papillomavirus (HPV) are known to cause oropharyngeal cancer and are associated with a good prognosis. P16 is a surrogate marker for the kind of HPV that causes cancer. Understanding the relationships between how these markers are expressed in cancer tissue may direct patient treatment in the future.
03 Oct Detecting Underlying Cardiovascular Disease in Young Competitive Athletes
MedicalResearch.com Interview with: Dr. James McKinney MD MSc FRCP(C) Division of Cardiology University of British Columbia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sudden cardiac death (SCD) is the leading medical cause of death in young athletes. Sporting activity may predispose athletes with underlying cardiovascular conditions to develop life threatening ventricular arrhythmias during physical exercise. Despite being a relatively rare event, the death of a young healthy person is a tragic event that is difficult to comprehend. The prevalence of an underlying cardiovascular disorder in young athletes that predisposes to SCD is approximately 0.3%. Sudden cardiac death is often the first clinical manifestation of an underlying cardiovascular condition; up to 80% of athletes are previously asymptomatic. Pre-participation screening is the systematic practice of medically evaluating athletes for the purpose of identifying (or raising suspicion of) abnormalities that could provoke sudden death. There is agreement amongst sporting and medical bodies that athletes should undergo some form of pre-participation screening. An Achilles’ heel of screening is the significant number of false-positive screens that require subsequent costly secondary testing to rule out disease. Prevention of sudden cardiac death among athletes is a common goal, however the optimal strategy for its achievement is uncertain.03 Oct What Interventions Can Reduce Epidemic Physician Burnout?
MedicalResearch.com Interview with: [caption id="attachment_28502" align="alignleft" width="166"]
Dr. Colin West[/caption]
Colin P. West, MD, PhD, FACP
Divisions of General Internal Medicine and Biomedical Statistics and Informatics
Departments of Internal Medicine and Health Sciences Research
Mayo Clinic
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Physician burnout has reached epidemic levels, as documented in national studies of both physicians in training and practicing physicians demonstrating burnout rates in excess of 50%. Consequences include negative effects on patient care, professionalism, physicians’ own care and safety, and the viability of health-care systems. We conducted a systematic review and meta-analysis to better understand the quality and outcomes of the literature on approaches to prevent and reduce burnout.
We identified 2617 articles, of which 15 randomized trials including 716 physicians and 37 cohort studies including 2914 physicians met inclusion criteria. Across interventions, overall burnout rates decreased from 54% to 44%, emotional exhaustion score decreased from 23.82 points to 21.17 points, and depersonalization score decreased from 9.05 to 8.41. High emotional exhaustion rates decreased from 38% to 24% and high depersonalization rates decreased from 38% to 34%.
03 Oct Police Body-Worn Cameras Drastically Reduce Complaints Against Police
MedicalResearch.com Interview with: Barak Ariel, PhD Jerry Lee Fellow in Experimental Criminology and Lecturer in Experimental Criminology University of Cambridge Alex Sutherland, D.Phil. RAND Europe MedicalResearch.com: What is the background for this study? Response: The very first randomised-controlled experiment on cameras in Rialto (California) was originally intended to ‘cut red tape’, but Rialto Police Department decided instead to look at whether wearing the cameras could help reduce complaints and police use-of-force. That study found that cameras did cut use-of-force and complaints, with the latter almost to zero in the 12 months of the experiment. Given that each complaint costs, millions of dollars in the US, there was a lot of interest following that study, and that research was seen as crucial in the widespread adoption of Body-Worn Cameras in the US and other countries. Although Rialto is typical of a lot of mid-sized police forces in the US, it is just one location at one time – so the roll out that was taking place had a very weak evidence base. The same results might not be found in other locations and given that many police forces started to roll out cameras without evidence, there was a strong justification for replicating the study. This paper (and two others already published) report results from x10 RCTs that took place in the UK and US, with more than 2 million residents, over a period of a year.03 Oct Sharp Rise in Heroin Use Among Young Adults Who Use Nonmedical Prescription Opioids
MedicalResearch.com Interview with: [caption id="attachment_28490" align="alignleft" width="165"]
Dr. Silvia Martins[/caption]
Silvia S. Martins, MD, PHD
Associate Professor of Epidemiology
Department of Epidemiology
Mailman School Of Public Health
Columbia University
New York, NY 10032
MedicalResearch.com: What is the background for this study?
Response: Given the high probability of nonmedical use among adolescents and young adults, the potential development of prescription opioid use disorder secondary to nonmedical use among youth represents an important and growing public health concern. Still, no study had investigated time trends, specifically if prescription opioid use disorder has increased in the past decade among adolescents, emerging adults and young adults who are nonmedical users of prescription opioids.
30 Sep No Link Found Between Vasectomy and Developing or Dying From Prostate Cancer
Posted at 23:01h
in Author Interviews, Journal Clinical Oncology, Prostate Cancer, Surgical Research, Urology
MedicalResearch.com Interview with:
[caption id="attachment_28482" align="alignleft" width="134"]
Dr. Eric Jacobs[/caption]
Eric Jacobs, PHD
Strategic Director, Pharmacoepidemiology
American Cancer Society, Inc.
250 Williams St.
Atlanta, GA 30303
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Vasectomy is a common, inexpensive, and very effective method of long-term birth control. However, in 2014, an analysis from a large epidemiologic cohort study, the Health Professionals Follow-Up Study, found that vasectomy was associated with about 10% higher overall risk of prostate cancer and about 20% higher risk of fatal prostate cancer. Together with other researchers at the American Cancer Society, I analyzed the association between vasectomy and fatal prostate cancer among more than 363,000 men in the Cancer Prevention Study II (CPS-II) cohort, age 40 and older, who were followed for up to 30 years. This is the largest prospective analysis of vasectomy and fatal prostate cancer to date. We also examined vasectomy and prostate cancer in a subset of about 66,000 CPS-II study participants who were followed for new diagnoses of prostate cancer.
We found no link between having had a vasectomy and risk of either developing or dying from prostate cancer.
30 Sep Mibefradil Dihydrochoride with Hypofractionated Radiation for Recurrent Glioblastoma
MedicalResearch.com Interview with: [caption id="attachment_28487" align="alignleft" width="175"]
Dr. Nataniel Lester-Coll[/caption]
Nataniel Lester-Coll, MD
Chief Resident in Radiation Oncology at Yale
New Haven, Connecticut
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Recurrent Glioblastoma Multiforme (GBM) has limited treatment options and the prognosis is poor. Mibefradil diydrochloride was identified using a high-throughput compound screen for DNA double stranded break repair inhibitors. Mibefradil was found to radiosensitize GBM tumor cells in vitro and in vivo. Based on these findings, we sought to determine the maximum tolerated dose of mibefradil and radiation therapy in a Phase I recurrent GBM study. Eligible patients with recurrent Glioblastoma Multiforme received Mibefradil over a 17 day period, with hypofractionated radiation (600 cGy x 5 fractions). There are 18 patients currently enrolled who have completed treatment. Thus far, there is no clear evidence of radionecrosis. A final dose level of 200 mg/day was reached as the maximum tolerated dose. The drug was very well tolerated at this dose. We saw intriguing evidence of enhanced local control in selected cases. Patients enrolled in a translational substudy who received Mibefradil prior to surgery were found to have adequate levels of Mibefradil in resected brain tumor tissue.
30 Sep Histone Switch Allows Some Cancer Cells To Become Immortal
MedicalResearch.com Interview with: [caption id="attachment_28461" align="alignleft" width="180"]
Dr. Paola Scaffidi[/caption]
Paola Scaffidi, PhD
Group Leader
Cancer Epigenetics Laboratory
The Francis Crick Institute
London
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Every cancer is different, but even within the same tumor cells are highly diverse, and only some of them are truly immortal and drive tumor growth. This is quite surprising if we think that cancer arises from one cell that keeps replicating itself. So why are some cancer cells more dangerous than others? And why do some cells "get tired" along the way and, at some point, stop dividing?
In our study we describe one cellular mechanism that provides some answers to these questions. We have found that to be able to divide indefinitely, cancer cells have to strongly reduce the levels of a nuclear protein called histone H1.0. This is needed to allow activation of many genes important for cancer cell proliferation, which otherwise would be somehow "hidden" within the cell nucleus. Importantly, though, while tumors grow, some cells raise back the levels of H1.0, which hides these genes again and makes the cells stop proliferating. So the end result is that within the same tumor we have a mix of cells, some which keep these important genes on, while others switch them off and, as a consequence, lose their ability to divide, and differentiate into a more mature state.