Dr. Michelle Holland[/caption]
Dr. Michelle L. Holland
The Blizard Institute, Barts and The London School of Medicine and Dentistry
Queen Mary University of London
London
MedicalResearch.com: What is the background for this study?
Response: There is strong evidence that the early life environment can influence lifelong health-a phenomenon termed ‘developmental programming.’ However, the mechanisms by which this occurs are poorly understood.
Here, we set out to explore whether epigenetic marks-modifications to DNA that influence whether a gene is ‘on’ or ‘off,’ are altered in response to the early life environment and whether this relates to later life health.
Dr. Sofiya Milman[/caption]
Sofiya Milman, MD, MS
Assistant Professor of Medicine
Divisions of Endocrinology and Geriatrics
Albert Einstein College of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Aging is a major risk factor for most chronic diseases, including cancer, cardiovascular disease, diabetes, hypertension, stroke and osteoporosis. However, many very long-lived individuals delay the onset or never develop age-related diseases. This study compared groups of individuals with exceptional longevity (age ≥95 years) of different genetic and ethnic backgrounds to younger referent groups without familial longevity (age 49-93 years). Long-lived individuals from different groups similarly delayed the age of onset of cancer, cardiovascular disease, hypertension, osteoporosis, and stroke. For example, cancer onset was delayed by 30 years and cardiovascular disease by 24 years. The risk of developing any age-related disease was on average 80% lower in individuals with exceptional longevity compared to referents.
Dr. Perak[/caption]
Amanda M. Perak, MD
Division of Cardiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, and
Department of Preventive Medicine
Northwestern University Feinberg School of Medicine
Donald M Lloyd-Jones, MD/ScM (senior author)
Senior Associate Dean for Clinical and Translational Research; Chair, Department of Preventive Medicine
Director, Northwestern University Clinical and Translational Sciences Institute (NUCATS) and Eileen M. Foell Professor
Professor in Preventive Medicine-Epidemiology and Medicine-Cardiology
MedicalResearch.com: What is the background for this study?
Response: Heterozygous familial hypercholesterolemia, or FH, affects up to 1 in 200 individuals in the United States. FH is a genetic disorder that should be suspected in individuals with very high levels of low-density lipoprotein cholesterol (LDL-C; at least 190 mg/dL) plus a first-degree relative with similar degree of high cholesterol or with premature coronary heart disease. Individuals with FH are exposed to high levels of "bad" cholesterol from birth, so if they are not treated with cholesterol-lowering therapy, they are at elevated risk for atherosclerotic cardiovascular disease (ASCVD; diseases related to hardening of the arteries, including heart attack and stroke). However, these risks previously had not been well quantified in untreated individuals with familial hypercholesterolemia in the general US population.
Dr. Marta Nunes[/caption]
Marta C. Nunes, PhD
DST/NRF:Vaccine Preventable Diseases
Respiratory and Meningeal Pathogens Research Unit
University of Witwatersrand
Chris Hani Baragwanath Academic Hospital
Soweto, South Africa
MedicalResearch.com: What is the background for this study?
Response: Young infants are at increased risk for influenza infection and hospitalizations associated with influenza infection. While active annual influenza vaccination is the most efficient mode for the prevention of influenza infection, current vaccines are poorly immunogenic and not licensed for use in infants
Dr. Blayne Welk[/caption]
Blayne Welk, MD, MSc,FRCSC
Assistant Professor of Surgery
Western University
London, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Prior research has demonstrated that gadolinium, which may be used during MRI scans to help visualise the body organs, can be deposited in the body, and remain there for years. The US FDA released a notice last year stating that further research was needed to evaluate the clinical implications of these brain deposits. One of the areas that gadolinium is deposited is the brain, specifically in two regions which control voluntary movement (the globus pallidus and dentate nucleus). Damage to these areas could cause symptoms of Parkinsonism. We used administrative data from Ontario, Canada to evaluate whether people who underwent MRI scans with gadolinium had a higher risk of developing Parkinsonism in the future. In this study, we did not demonstrate an increased risk of Parkinsonism in patients exposed to gadolinium.
Dr. Mary Heitzeg[/caption]
Mary P. Heitzeg, PhD
Assistant Professor
Department of Psychiatry
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We wanted to find out if marijuana use changed the way the brain’s reward system responded to natural rewards. To probe response to natural reward, we used the chance to win some money and we observed brain response using functional magnetic resonance imaging (fMRI). We looked at brain activity when participants were 20 years old on average, and then again 2 years later and 4 years later. We found that over time marijuana use was associated with a decrease in the brain’s reward response to the chance to win money. This finding is consistent with current theories of addiction that suggest that repeated use of a substance may dampen the brain’s reward response to things normally perceived as pleasurable and this alteration may drive the individual to continue substance use.
Dr. Thomas Lancaster[/caption]
Thomas M. Lancaster, PhD
Neuroscience and Mental Health Research Institute
Cardiff University Brain Imaging Research Centre
Cardiff University, Cardiff, United Kingdom
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Psychotic disorders such as schizophrenia and bipolar disorders are heritable. Part of this genetic risk may be conferred by the combined effects of common risk alleles identified via genome wide association studies. Individuals with psychosis are also more likely to experience alterations in the ventral striatum (VS); a key node in the brain’s reward processing network. We hypothesized that common genetic risk for psychosis may confer risk via alterations in the VS. Using functional magnetic resonance imaging (fMRI) data from an adolescent sample (the IMAGEN cohort), we showed that increased psychosis risk was associated with increased BOLD (blood oxygen level dependency) in the VS, during reward processing.
Dr. Wang[/caption]
Daniel (Dong) Wang, MD, ScD, Research Fellow
Department of Nutrition | Harvard T.H. Chan School of Public Health
Boston, MA 02115
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There has been widespread confusion in the biomedical community and the general public about the health effects of specific types of fat in the diet. In particular, the role of unsaturated fats vs. saturated fat in cardiovascular disease prevention remains controversial. Our study is by far the most detailed and powerful examination of this very important research topic, i.e., health effects of specific types of dietary fats, because of very large sample size (more than 120,000 men and women), repeated and validated measurements of diet and lifestyle over an extended follow-up (up to 32 years). In addition, our study is able to examine a much broader range of outcomes, including total mortality and mortality due to cardiovascular disease, cancer, neurodegenerative disease and respiratory disease.
We found that different types of dietary fat had different associations with mortality. Consuming higher amounts of unsaturated fats- mainly from plant-based foods like olive oil, canola oil, soybean oil and nuts - was associated with lower mortality, while higher consumption of saturated-found in red meat, butter, cheese, and ice cream- and trans fats- predominantly from hydrogenated oils- was linked with higher mortality compared with the same number of calories from carbohydrates. Most importantly, replacing saturated fats with unsaturated fats conferred substantial health benefits, including lowering risk of all-cause premature death and premature death due to cardiovascular disease, cancer, neurodegenerative disease and respiratory disease.
Prof. Tom Bourne[/caption]
Professor Tom Bourne Ph.D., FRCOG, FAIUM (hon).
Adjunct Professor, Imperial College, London
Visiting Professor, KU Leuven, Belgium
Consultant Gynaecologist
Queen Charlotte's and Chelsea Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous studies had suggested that complaint investigations might be associated with psychiatric morbidity – including depression and suicide. For example in the United States, malpractice litigation has been reported to be associated with burnout, depression and suicidal ideation. We had also witnessed in our daily practice both the burden that complaints investigations have on colleagues, but also that doctors were often practicing defensive medicine to “protect themselves”. Against this background we embarked on a large survey study on doctors in the UK – with almost 8000 physicians replying to the survey. This survey contained questions relating to validated psychological instruments for depression and anxiety, new metrics for defensive practice (hedging and avoidance) as well as single item questions. We published these data in 20151. We found that recent or current complaints were associated with significant levels or anxiety, depression and suicidal ideation, this was irrespective of the complaints procedure – although this was highest when it involved the main UK regulator the general medical council (GMC). Many doctors reported practising defensive medicine due to a fear of complaints – with over 80% reporting hedging and over 40% reporting avoidance. A number of recommendations were made to improve how complaints procedures might work.
In the final part of the questionnaire we asked three open questions, how the complaints procedure made the doctor feel, what was the most stressful aspects of the procedure and what could be done to improve things. It is the analysis of this qualitative data that is presented in the current paper.
Dr-Genevieve-Marchand[/caption]
Genevieve Marchand Ph.D., RMCCM SCCM(Env)
Microbiologiste agréée & Biochimiste
Chercheure, Prévention des risques chimiques et biologiques
IRSST
MedicalResearch.com: What is the background for this study?
Response: It is well known that Health Care Workers (HCWs) are at risk of occupationally acquired infections. Some procedures, such as bronchoscopies, are recognized to be high-risk tasks. Most researches that have linked infectious risk to specific task in healthcare settings did not measure the real bioaerosol exposure. Those link where mostly made from epidemiology observations. The aim of this study was to qualify and quantify the real bioaerosol concentrations found during bronchoscopy procedures in order to estimate the true occupational risk.
Dr. Samuel Frank[/caption]
Samuel Frank, MD
Director of the Huntington’s Disease Society of America Center of Excellence
Beth Israel Deaconess Medical Center
Boston, MA 02215
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Huntington Disease is a hereditary, progressive neurodegenerative disease characterized by involuntary movements (chorea and dystonia), cognitive dysfunction and psychiatric symptoms. Deutetrabenazine is a novel molecule containing deuterium, which attenuates CYP2D6 metabolism, increases active metabolite half-lives leading to stable systemic exposure. We found that deutetrabenazine significantly reduces chorea. There was also an overall improvement in participants' condition based on patient and clinician measures and improvement in a quality of life measure. There was no worsening, but also no improvement in balance. The improvements in Huntington Disease were seen with a remarkably good safety and tolerability profile.
Dr. Vongpatanasin[/caption]
Wanpen Vongpatanasin, MD
Professor of Medicine
Norman & Audrey Kaplan Chair in Hypertension Research
Director, Hypertension Section
Cardiology Division
UT Southwestern Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Inorganic phosphate has been added to our processed food at an enormous amount as food preservatives and flavor enhancer such that typical American diet contains twice as much as the recommended daily allowance. A high phosphate (Pi) diet was recently shown to trigger blood pressure (BP) elevation in otherwise normal rats but the mechanisms are still unknown.We found that rats treated with high phosphate diet that mimics the excess Pi consumed by the general American population developed high BP related to increased sympathetic nerve activity (SNA), resulting in excessive peripheral vasoconstriction. This exaggerated increase in SNA and BP is evident particularly during exercise. This study is conducted in collaboration with Drs. Masaki Mizuno and Scott Smith, the two leading experts in neural control of circulation at UT Southwestern in the Department of Health Care Sciences.
Dr. Evgenia Gourgari[/caption]
Dr. Evgenia Gourgari MD
Section on Endocrinology and Genetics, Program on Developmental Endocrinology & Genetics (PDEGEN) & Pediatric Endocrinology Inter-institute Training Program
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Bethesda, MD 20892
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Polycystic ovary syndrome (PCOS) is the most common cause of infertility among women of reproductive age ,yet the etiology of this syndrome remains unknown. Women with PCOS can have high androgens, irregular periods, cysts in their ovaries, acne, excessive facial hair. Women with PCOS are also at high risk to develop diabetes. Androgens and cortisol are hormones that produced from the adrenal glands. We wanted to investigate whether a group of women with PCOS have an adrenal disorder as underlying etiology of PCOS.
We found a group of women with PCOS produced more adrenal hormones compared to healthy women and these women also had some characteristics of micronodualr adrenal hyperplasia in their adrenals. Our findings suggest that a problem in the adrenal glands mostly involved in their steroid hormone secretion and how this is regulated may be the underlying cause of PCOS in a subgroup of women with this syndrome.
MedicalResearch.com: What should readers take away from your report?
Response: Some women with PCOS might have a problem with their adrenal gland, but more research is needed to better understand the role of adrenal glands in the development of PCOS syndrome.
Dr. Stephen Ferzoco[/caption]
Stephen Ferzoco, MD, FACS
Chief of General Surgery
Atrius Health in Boston
MedicalResearch.com Editor's Note: Dr. Stephen Ferzoco, a prominent active, academic surgeon, discusses the complexities of surgery for hernia repair.
MedicalResearch.com: What is the background for this surgery? How many patients are affected by clinically significant hernias?
Response: A hernia is a common condition where soft tissue breaches a weak spot in the abdominal wall. Hernias can affect the abdomen (ventral) or the groin (inguinal). In the U.S. there are about 350,000 ventral hernia procedures each year; these hernia patients present a range of complexity to the surgeon, with some of these procedures being among the most difficult cases for surgeons to manage. Inguinal hernias are even more common, with about 750,000 total procedures performed in the U.S. each year.
Dr. David Hughes[/caption]
Dr. David Hughes
Honorary Lecturer, Centre for Systems Medicine
RCSI Physiology & Medical Physics Dept
Royal College of Surgeons in Ireland
Ireland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Liver cancer is the second most common cause of death from cancer worldwide, and the seventh most common cause of death from cancer in Europe (1).
“The incidence of liver cancers is increasing in developed countries, likely due to Western lifestyle and dietary habits. Liver cancers are often diagnosed at late stages and have limited treatment options,” says IARC scientist Dr Mazda Jenab, one of the study’s authors. “Further research is needed into the modifiable determinants of these cancers and effective prevention strategies.”
A growing body of evidence suggests that suboptimal intakes of the micronutrient selenium contribute to the development of several cancers (2). Selenium is a trace mineral micronutrient that is found in foods like shellfish, salmon, Brazil nuts, meat, eggs, grains, and onions. However, selenium levels in foods depend largely on the levels of selenium in the soil where the food is grown and animals graze. Soil levels tend to be low in many regions in Europe, contributing to lower body levels of selenium in those populations compared with people living in regions with higher soil selenium concentrations, such as North America. In humans, selenium is essential, particularly for the effective functioning of the immune system and in controlling oxidative processes linked to cancer development.
This new study shows that the highest levels of blood selenium or of selenoprotein P, the protein that distributes selenium from the liver around the body, are associated with a decreased risk of developing liver cancer (particularly hepatocellular carcinoma), even when all other major liver cancer risk factors are taken into account. The study also shows that selenium level is not associated with the development of gall bladder or biliary tract tumours (3).
The study was based on the European Prospective Investigation of Cancer and Nutrition (EPIC) cohort, headed by the International Agency for Research on Cancer (IARC) in Lyon, France, and composed of more than half a million participants across 10 European countries. We used a case–control design of 121 liver cancers and 140 gall bladder and biliary tract cancers matched to equal numbers of individuals free of cancer within the cohort.
Dr. Kirsten Herrick[/caption]
Dr. Kirsten Herrick Ph.D.
Division of Health and Nutrition Examination Surveys
National Center for Health Statistics
Centers for Disease Control and Prevention
Hyattsville, Maryland
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The benefits of breastfeeding are well established: for children, it offers protection against infections and increases in intelligence; for nursing women, it protects against breast cancer and improves birth spacing. But there is no nationally representative information about whether there are differences in breastfeeding by birth weight (BW).
Using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014, we estimated the proportion of infants ever breastfed (initiated), and those reporting any breastfeeding at 1 month, 4 months, and 6 months by birth weight categories and birth year cohorts. Our sample size was 13,859.
Dr. Vongpatanasin[/caption]
Dr. Wanpen Vongpatanasin MD
The Norman and Audrey Kaplan Chair in Hypertension
UT Southwestern Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Diet rich in fruits, vegetables, and dairy products, known as the DASH diet, is known to reduce blood pressure in hypertensive patients. More recently, the DASH diet was shown to reduce oxidative stress in people with and without high blood pressure . However, the main nutritional ingredient responsible for these beneficial effects of the DASH diet remain unknown. Because the DASH diet is rich in potassium (K), magnesium (Mg), and alkali, we performed a randomized, double-blinded, placebo-controlled study to compare effects of KMg Citrate (KMgCit), K Chloride (KCl), and K Citrate (KCit) to allow dissociation of the three in hypertensive and prehypertensive individuals. This study was conducted in collaboration with Drs. Charles Pak and Orson Moe at UT Southwestern, the two leading experts in the field of Mineral Metabolism. We found that oxidative stress was markedly reduced by KMgCit powder compared to placebo, K Chloride, and K Citrate. On the hand, KMgCit has no significant effects on blood pressure .
MedicalResearch.com Editor's note: DO NOT Take Potassium supplements unless under the direction of your health care provider.
Dr. Venkatesh Murthy[/caption]
Venkatesh Locharla Murthy MD,
PhD, FACC, FASNC
Assistant Professor, Internal Medicine
Frankel Cardiovascular Center
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Technetium-99m, which is very commonly used for cardiac stress testing, has had multiple supply disruptions due to aging nuclear reactors where it is produced coupled with changing regulations to minimize the risk of nuclear proliferation. The most severe of these disruptions occurred over six months in 2010.
We asked whether this disruption lead to changes in patterns of care among Medicare beneficiaries. We found that during this time, use of technetium-99m in nuclear stress testing fell from 64% to 49%, reflecting a shift towards thallium-201, which has higher radiation exposure and lower diagnostic specificity. This was reflected in a 9% increase in the rate of cardiac catheterization after a nuclear stress test during the study period, implying nearly 6,000 additional, possibly unnecessary, catheterizations during that time.
Dr. Aditya Bardia[/caption]
Aditya Bardia, MD, MPH
Massachusetts General Hospital Cancer Center
Harvard Medical School
Boston, MA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: While endocrine therapy is the recommended therapy for Estrogen Receptor positive (ER+) breast cancer, the role of endocrine therapy in neoadjuvant (pre-surgical) setting is unclear. We performed this systematic review and meta-analysis to comprehensively evaluate the efficacy of neoadjuvant endocrine therapy, both alone and in combination with other therapies, compared to neoadjuvant chemotherapy for localized ER+ breast cancer. We found no statistically significant differences between the two treatments in regards to clinical response, imaging response, rates of breast conservation therapy, and achievement of pathologic complete response.
MedicalResearch.com Interview with: [caption id="attachment_25811" align="alignleft" width="200"] Dr. Mostafa Borahay[/caption] Mostafa Borahay, MD, PhD, FACOG Assistant Professor Department of Obstetrics and Gynecology Galveston, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: Uterine fibroids are the commonest tumors of the female reproductive system. More than 50% of women are estimated to...
Dr. Wai Liu[/caption]
Dr Wai Liu
Senior Research Fellow
St George's University of London
London
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Naltrexone is a drug commonly used to wean addicts off alcohol and heroin, but clinical evidence has shown that when the drug is used at lower doses, patients would exhibit alter immunity. The symptoms that patients with a number of autoimmune diseases and those associated with chronic pain would ease significantly. Additionally, a number of reports showed patients with some forms of cancer would experience therapeutic benefit. Interestingly, the doses of the drug was crucial, and the non-conventional effects of naltrexone was only achieved at doses that were lower that what was conventionally used. We set about to understand why a drug could have such different effects when used at differing doses. Our results show that the genetic profile of the drug is subtly different at the two different doses, which helped us identify novel ways in which the drug could be used to induce an anticancer effect.
Jessica Datta[/caption]
Jessica Datta
Department of Social & Environmental Health Research
London School of Hygiene & Tropical Medicine
London
MedicalResearch.com: What is the background for this study?
Response: The paper presents an analysis of data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Natsal-3 is a survey of more than 15,000 women and men aged 16-74 resident in Britain, conducted in 2010-2012, which includes a wide range of questions about sexual relationships and behaviour and reproductive history.
In this paper we analysed responses to the questions: ‘Have you ever had a time, lasting 12 months or longer, when you and a partner were trying for a pregnancy but it didn’t happen?’ and ‘Have you (or a partner) ever sought medical or professional help about infertility?’. As well as calculating the prevalence of experience of infertility and help seeking, we looked at associated factors e.g. education, employment, relationship status.