Blog – Medical Research News and Interviews
12 May After CPR, Some Donor Hearts Still Suitable For Heart Transplantation
MedicalResearch.com Interview with: [caption id="attachment_24272" align="alignleft" width="200"]
Dr. Jaimin Trivedi[/caption]
Jaimin Trivedi, MD, MPH
Instructor
Department of Cardiovascular and Thoracic Surgery
University of Louisville
Louisville, KY 40202
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Trivedi: There is a donor heart shortage in United States and certain donor hearts are likely to be turned down because the donors required cardiopulmonary resuscitation (CPR) prior to procurement. The rationale behind conducting the study was to identify impact of donor CPR and its duration on recipient survival after transplantation.
Our findings show that presence of CPR and duration of CPR does not adversely impact the post heart transplant survival. The study also shows that ejection fraction and peak cardiac troponins between the CPR and non-CPR donors were comparable at time of transplant suggesting recovery of cardiac function.
12 May Heart Attack Gap Between Low and High Income Communities Narrows
MedicalResearch.com Interview with: [caption id="attachment_24209" align="alignleft" width="148"]
Dr. Erica Spatz[/caption]
Erica Spatz, MD, MHS
Assistant Professor, Section of Cardiovascular Medicine
Center for Outcomes Research and Evaluation
Yale University School of Medicine/Yale-New Haven Hospital
New Haven, CT 06520
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Spatz: Rates of heart attack have declined during the last 15 years. But whether communities of different economic status or in different geographic regions experienced similar declines is unknown, especially as efforts to prevent cardiovascular disease and manage heart attacks may not have been equally successful in communities with different resource capacity.
Our study shows that trends in the incidence of and mortality from heart attack were similar in low, average and high income communities. However, low-income communities had higher hospitalization rates than average and high income communities throughout the 15 year study period. Interestingly mortality rates were similar.
12 May Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years
MedicalResearch.com Interview with: [caption id="attachment_24286" align="alignleft" width="156"]
Dr. Anny Xiang[/caption]
Anny H. Xiang, PhD
Kaiser Permanente Southern California Department of Research & Evaluation
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Xiang: Previous studies have identified a link between maternal obesity, diabetes and/or excessive gestational weight gain and long-term obesity risk in children. Our study examined the interplay among all four factors associated with childhood obesity: pre-pregnancy obesity, gestational weight gain, gestational diabetes and breastfeeding. To our knowledge, the interplay among these factors and their independent contributions to childhood obesity with data from a large and multi-ethnic cohort under current standard clinical care had not been previously studied.
The study included 15,710 women who delivered babies at Kaiser Permanente medical facilities in Southern California in 2011. The key findings were:
- A woman being obese (BMI of 30.0 or higher) prior to getting pregnant increased the odds of her child being overweight at age 2 by more than two-fold compared to women who had a normal pre-pregnancy weight (BMI between 18.5 and 25), after adjusting for weight gain during pregnancy, gestational diabetes and breastfeeding.
- A woman being overweight (BMI between 25.0 and 29.9) prior to pregnancy was associated with 50 percent increased odds of her child being overweight at age 2.
- Excessive weight gain during pregnancy was associated with 23 percent increased odds of a child being overweight at age 2 compared to women who had healthy weight gain during pregnancy after adjusting for pre-pregnancy weight, gestational diabetes and breastfeeding.
- Breastfeeding for at least six months was associated with a 24 percent reduction for the odds of a child being overweight at age 2 regardless of a mother’s pre-pregnancy weight, gestational diabetes or excessive weight gain during pregnancy.
- Gestational diabetes was not associated with the risk of a child being overweight at age 2. Women with gestational diabetes in this cohort were treated following standard clinical practice and had 40-49 percent lower rate of excessive weight gain during pregnancy and similar breastfeeding rates compared to women without gestational diabetes.
12 May PSA Screening Clearly Prevents Some Men From Dying of Prostate Cancer
MedicalResearch.com Interview with: [caption id="attachment_24281" align="alignleft" width="150"]
Dr. Jonathan Shoag[/caption]
Jonathan Shoag MD
Urology Resident at
Cornell Department of Urology and
[caption id="attachment_24282" align="alignleft" width="119"]
Dr. Jim Hu[/caption]
Dr. Jim C. Hu MD
Ronald Lynch Professor of Urologic Oncology
Professor of Urology
Director, Lefrak Center for Robotic Surgery
Attending Urologist, New York-Presbyterian Hospital (Cornell campus)
MedicalResearch.com: What is the background for this study?
Response: Prostate Specific Antigen (PSA) is a blood test that is used to detect prostate cancers and to follow a cancer’s response to treatment. PSA was widely implemented as a screening tool for prostate cancer in the early 1990s, and became a routine test during an annual physical for men over 40. Doctors started using it because values above a “normal” threshold were associated with a greater risk of prostate cancer. Following the adoption of PSA screening in the early 1990s, there has been a large increase in the number of men diagnosed with cancer, and a decrease of approximately 50% in the rate of prostate cancer death.
The PLCO trial was a large randomized trial designed and funded by the National Cancer Institute (NCI) to determine the effect of PSA screening on death from prostate cancer. The trial found that men randomized/assigned to prostate cancer screening had the same number of prostate cancer deaths as men in the control group of the trial, arguing that PSA screening does not decrease prostate cancer mortality.
This was a major piece of evidence used by the United States Preventative Services Task Force (USPSTF) to form its 2012 recommendation against PSA screening. The argument was that in spite of the other evidence showing a benefit to PSA testing, including US epidemiologic trends, and another large randomized trial showing PSA screening was effective (the ERSPC), we now had good evidence showing no benefit to PSA testing in the US. Since 2012 we have seen dramatic declines in prostate cancer screening in the US as a result.
11 May Traffic Deaths Related To Cannabis Impaired Drivers Doubled After Legalization
MedicalResearch.com Interview with: [caption id="attachment_24278" align="alignleft" width="200"]
Mr. Brian Tefft[/caption]
Mr. Brian C. Tefft
Senior Research Associate
AAA Foundation for Traffic Safety
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In December 2012, a new law took effect in Washington state that effectively legalized the possession and use of small amounts of marijuana by adults aged 21 years and older for recreational purposes, and also created a legal limit for driving under the influence of marijuana such that having a concentration of 5.00 nanograms or greater of delta-9-tetrahydrocannabinol (THC, the main psychoactive chemical in marijuana) per milliliter of whole blood while driving in the state of Washington is per se driving under the influence.
Data from population-based surveys indicate that the proportion of Washington state residents who report using marijuana increased after this law took effect; however, not much was known about the impact of this new law on traffic safety in the state. To investigate the traffic safety impact of the new law, we examined drug test results from drivers involved in motor vehicle crashes that occurred in years 2010 – 2014 in Washington and resulted in the death of at least one person within 30 days of the crash. Specifically, we looked at the proportion of all drivers involved in fatal crashes who had detectable THC in their blood at or shortly after the time of the crash, which generally suggests that the driver had used marijuana within the past few hours.
Results showed that from 2010 through 2013, approximately 8-9% of drivers in fatal crashes each year were positive for THC, and that proportion was basically flat from 2010 through 2013. In 2014, the proportion basically doubled, to 17%. Our modelling suggests that an increasing trend in the proportion of drivers who were positive for THC began in late 2013, about 9-10 months after the new law took effect.
11 May Videogame Addiction Linked To Adolescent Sleep Loss and Obesity
MedicalResearch.com Interview with: [caption id="attachment_24275" align="alignleft" width="138"]
Dr. Ofir Turel[/caption]
Ofir Turel, Ph.D
Professor, Information Systems and Decision Sciences
California State University, Fullerton
Scholar in Residence, Department of Psychology
University of Southern California
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Turel: The study emerged as a response to the growing societal concern regarding potentially problematic information system use” lifestyles”, including videogame addiction, among adolescents. Much research in this domain has focused on negative psychological (e.g., reduced wellbeing, depression) and social/life functioning (e.g., reduction in normal activities, diminished school performance). Less is known regarding potential physiological outcomes of videogame addiction.
Interestingly, the increase in videogame addiction-like symptoms among adolescents happened in conjunction with an increase in sleep curtailment and obesity in this population. These are too growing concerns in North America and perhaps elsewhere. Medical research implies that these three phenomena may be related. Hence, we hypothesized that videogame addiction will be associated with increased sleep curtailment and increased abdominal adiposity; and consequently, indirectly, with cardio-metabolic deficits.
Our findings suggest that videogame addiction predicts reduced sleep duration which in turn, predicts increased abdominal adiposity. Abdominal adiposity was associated with increased blood pressure, insulin resistance and triglycerides and reduced high density lipoprotein cholesterol levels. Hence, sleep curtailment is an important mediating factor that helps translating videogame addiction into cardio-metabolic deficiencies.
11 May New Drug Candidate Aims To Treat Both Pain and Opioid Addiction
MedicalResearch.com Interview with: [caption id="attachment_24269" align="alignleft" width="133"]
Dr. Richard Mangano[/caption]
Richard M. Mangano, PhD
Chief Scientific Officer at Relmada Therapeutics
Dr. Mangano has extensive experience leading global R&D programs in both large and small pharmaceutical companies including positions in discovery and clinical research at Hoffmann-La Roche, Lederle Laboratories, Wyeth Research and Adolor Corporation. He served as acting Therapeutic Area Director for Neuroscience at Wyeth before joining Adolor as Vice President of Clinical Research and Development. Dr. Mangano’s expertise includes multiple IND/CTC submissions and NDA/MAA approvals in psychiatry, neurology and gastrointestinal therapeutic areas. Dr. Mangano is also an adjunct professor in the Department of Pharmacology and Physiology at the Drexel University School of Medicine. He lectures in the Drug Discovery and Development Program and in the Psychiatry Department’s Resident Training Program. He has authored 30 peer reviewed publications and over 120 abstracts and presentations. Dr. Mangano holds a B.S degree in Chemistry from Iona College and a PhD degree in Biochemistry from Fordham University. Prior to joining the pharmaceutical industry, he was a research faculty member of the Maryland Psychiatric Research Institute at the University of Maryland School of Medicine.
Dr. Mangano discusses the opioid addiction and the development of abuse-resistant medications.
MedicalResearch.com: What is the background for the development of abuse-resistant medications? How extensive is the problem of opioid addiction?
Dr. Mangano: Recognizing the growing incidence of opioid abuse, misuse, and overdose in the United States, pharmaceutical companies, with the guidance of the FDA, are developing products that can mitigate abuse, while recognizing the importance of maintaining the availability of opioid analgesics for the millions of patients in this country who suffer from pain.
Approximately two million people in the U.S. are addicted to opioids. The market for products that treat opioid dependence has grown significantly due to the rapidly escalating problem of prescription opioid misuse and abuse, a recent resurgence of heroin use, and the growing number of physicians treating opioid dependence.
One of our product candidates, REL-1028 (BuTab), is a proprietary formulation of buprenorphine designed to treat both opioid addiction and moderate to severe chronic pain. Although there is the potential for addiction to buprenorphine, the risk is lower because it is a “partial agonist” of the mu opioid receptor compared with “full agonist” opioids like heroin, morphine, oxycodone, and hydrocodone. As a result, products containing buprenorphine, such as BuTab, should have reduced risk of abuse and physical dependence and would be controlled in Schedule III of the Controlled Substances Act (as opposed to the more restrictive Schedule II). We are also considering a formulation that would include an opioid antagonist that would not interfere with analgesia when taken orally as prescribed but would block the action of buprenorphine if it were to be inhaled or injected.
11 May Personalized Virtual Heart Map Allows For Better Prediction of Sudden Death Risk
MedicalResearch.com Interview with: [caption id="attachment_24265" align="alignleft" width="130"]
Dr. Natalia Trayanova[/caption]
Natalia Trayanova PhD, FHRS, FAHA
Murray B. Sachs Endowed Chair
Professor of Biomedical Engineering
Joint Appointment, Medicine
Johns Hopkins University
Institute for Computational Medicine
Johns Hopkins University
Baltimore, MD
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Trayanova: The methodology for modeling cardiac electrical function has matured sufficiently that we can now create computational models of the electrical functioning of the entire heart. My research is focused on translating this methodology into the clinic. The goal is to create, if you will, "a virtual heart for every patient", that will enable the physician to play our scenarios that manifest the heart dysfunction in the given patient, and to enable physicians to make personalized decisions about patient treatment. The present paper is the first application of this overall vision.
The motivation for this particular paper was that determining which patients are at risk for sudden cardiac death represents a major unmet clinical need. Patients at risk receive life-saving implantable defibrillators (ICDs), but because of the low sensitivity and specificity of current approach (based on low ejection fraction), risk assessment is inaccurate. Thus, many patients receive ICDs without needing them, while others die of sudden cardiac death because they are not targeted for ICD therapy under the current clinical recommendations. Our goal was to develop a non-invasive personalized virtual-heart risk assessment tool that has the potential to ultimately prevent sudden cardiac death and avoid unnecessary ICD implantations.
11 May MRI Improves Detection of Prostate Cancer
MedicalResearch.com Interview with: [caption id="attachment_24053" align="alignleft" width="133"]
Dr. Vikas Gulani[/caption]
Dr. Vikas Gulani MD, PhD
Director, MRI, University Hospitals Case Medical Center
Associate Professor, Radiology
CWRU School of Medicine
Cleveland, OH
MedicalResearch.com: What is the background for this study?
Dr. Gulani: For men that have a suspicion for prostate cancer either via the prostate specific antigen (PSA) test or a digital rectal exam, the current standard of care is to perform a transrectal ultrasound (TRUS) guided biopsy to detect cancer. The problem with TRUS biopsy is that most tumors are not visible on ultrasound and hence many significant cancers are missed. At the same time this strategy detects a high number of low risk, indolent cancers, and leads to overtreatment of disease that would be better left untreated.
Diagnostic MRI and MRI-guided biopsy (cognitive, ultrasound-MR fusion, or in-gantry) have been shown to be effective in detecting clinically significant prostate cancer. However, despite these advantages there is reluctance to incorporate MRI into standard practice because it is perceived to be expensive. Our goal was to determine if this presumption is true, and evaluate the cost-effectiveness of the MRI-guided techniques most commonly used.
MedicalResearch.com: What are the main findings?
Dr. Gulani: We found that every MRI strategy we evaluated was cost-effective compared to standard biopsy. Cognitive MRI guided biopsy – where the operator performs an ultrasound biopsy based on knowledge of lesion location from the MRI – was the most cost-effective strategy compared to standard biopsy. In-gantry MRI yielded the highest net health benefits as measured in quality adjusted life years.
11 May Genetic Signatures Reveal Gender Differences In Cancer Biomarkers
MedicalResearch.com Interview with: [caption id="attachment_24254" align="alignleft" width="114"]
Dr. Han Liang[/caption]
Dr. Han Liang PhD
Associate Professor and Deputy Department Chair, Department of Bioinformatics and Computational Biology
The University of Texas MD Anderson Cancer Center
Faculty Member, Baylor College of Medicine
Houston, TX
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Liang: An individual’s sex has been long recognized as a key factor affecting the risk of cancer development and management. However, previous studies on the sex effect have been limited to individual genes, single molecular data types, and single cancer lineages.
We performed a comprehensive analysis of molecular differences between male and female patients in a diversity of cancer types and revealed two sex-effect groups.
One group contains a small number of sex-affected genes, whereas the other shows much more extensive sex-biased molecular signatures. More than half of clinically actionable genes (e.g., therapeutic targets or biomarkers) show sex-biased signatures.
11 May Taking Acetaminophen Reduces Empathy For Others
MedicalResearch.com Interview with: [caption id="attachment_24249" align="alignleft" width="150"]
Dr. Dominik Mischkowski[/caption]
Dominik Mischkowski, co-author of the study
Former Ph.D. student at Ohio State
Now at the National Institutes of Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Mischkowski: We tested in two double blind experiments whether the popular physical painkiller acetaminophen reduces empathy for the pain of other people. In the first experiment (N=80), participants completed measures of empathy (i.e., perceived pain and personal distress) while reading hypothetical about the physical and social mishaps of other people. We found that acetaminophen reduced empathy for pain in these scenarios. In Study 2 (N=114), we replicated and extending these findings, showing that acetaminophen also decreased empathy (i.e., perceived pain, personal distress, and empathic concern) for another study participant experiencing ostracism or painful noise blasts. Furthermore, noise unpleasantness accounted for the effect of acetaminophen on empathy for noise pain.
11 May Intra-operative Radiation For Breast Cancer Better For Patients and Environment
MedicalResearch.com Interview with:
Jayant S Vaidya MBBS MS DNB FRCS PhD
Professor of Surgery and Oncology,
Scientific Director, Clinical Trials Group,
Division of Surgery and Interventional Science,
University College London
Whittington Health - Clinical Lead for Breast Cancer
Royal Free Hospital
University College London Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Prof. Vaidya: TARGIT-A randomised clinical trial (ISRCTN34086741) compared giving TARGIT IORT during lumpectomy vs. traditional EBRT given over several weeks after lumpectomy for breast cancer; local-recurrence-free-survival was similar in the two arms of the trial, particularly when TARGIT was given simultaneously with lumpectomy. Also, there were significantly fewer deaths from other causes with TARGIT IORT.
This study calculated journeys made by patients with breast cancer to receive their radiotherapy, using the geographic and treatment data from a large randomised trial.
The study then assessed the same outcomes (travel distances, travel time and CO2emissions) in two semi-rural breast cancers—the results of this assessment confirm and reinforce the original results: the benefit of the use of TARGIT for patients from two semi=rural breast centres was even larger (753 miles (1212 km), 30 h, 215 kg CO2 per patient).
11 May Nasal Spray Desmopressin – Noctiva- Reduces Nighttime Voiding in Patients With Nocturia
MedicalResearch.com Interview with: [caption id="attachment_24046" align="alignleft" width="133"]
Dr. Jed Kaminetsky[/caption]
Dr. Jed Kaminetsky MD
Clinical Assistant Professor
Department of Urology
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Kaminetsky: Nocturia is a voiding disorder not well treated by available drugs for overactive bladder and benign prostatic hypertrophy. Desmopressin stimulates the kidneys to concentrate the urine which results in a greatly reduced volume of urine formation for a period of time. Serenity Pharmaceuticals has spent many years developing a low dose nasal spray version of desmopressin called Noctiva specifically for nocturia. The study reported now is a large, placebo controlled phase 3 trial to confirm the statistical efficacy and clinical benefit of this treatment for nocturia.
11 May Payments to Physicians For Educational Training Linked To Increased Brand-Name Statin Use
MedicalResearch.com Interview with: [caption id="attachment_24158" align="alignleft" width="120"]
Dr. Yeh[/caption]
Dr. James Song-Jeng Yeh, MD
Brigham and Women's Hospital
Boston MA
MedicalResearch.com: What is the purpose for this study?
Dr. Yeh: A number of factors influence physicians’ prescribing behavior, including physician’s knowledge and understanding of the drugs. Pharmaceutical detailing and financial incentives may affect such behavior. My interest in evidence-based medicine and how medical knowledge is translated into practice lead me to think about how physicians’ financial relationships with the pharmaceutical industry may affect prescribing patterns.
In our study, we linked the Massachusetts physicians open payment database with the Medicare drug prescription claims database to determine if financial relationships with the industry are associated with increased brand-name statin drug prescribing. The open payment database reports payments that physicians receive from pharmaceutical and medical device industries. The open payment database when linked to the drug prescription claims database allowed us to answer this question.
We looked at year 2011, when two of the most commonly prescribed brand-name statin drugs (Lipitor and Crestor) were not yet available in generic formulation.
The outcome measured was what percentage of all statin prescription claims (both generic and brand-name) were brand-names.
11 May Novel Blood Biomarker for SIDS Identified
MedicalResearch.com Interview with: Chris Adamopoulos MD and Angelo Livolsi MD Unit of Cardiopediatrics, Hautepierre University Hospital Strasbourg, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: Apparent life-threatening events (ALTEs) predominantly affect children younger than one year. Fifty percent of these events remain unexplained, which causes great concern to parents and physicians. Yet, there is no easily detectable biomarker associated with these potentially serious, unexplained events. In our previous research we found a very high expression of muscarinic (parasympathetic) receptors in cardiac tissues of infants who died from sudden infant death syndrome (SIDS). In the present study we investigated the expression of the same muscarinic receptors in the peripheral blood of infants who experienced explained and unexplained life-threatening events at the highest end of severity. Our results showed that the infants who experienced unexplained severe events had strikingly higher receptor’s levels (20 to 50 times higher) than the infants with severe events of known cause.11 May Performance of Mammogram Readers Does Not Diminish With Time
MedicalResearch.com Interview with: [caption id="attachment_24117" align="alignleft" width="125"]
Dr. Taylor-Phillips[/caption]
Dr Sian Taylor-Phillips PhD
Assistant Professor of Screening and Test Evaluation
Division of Health Sciences
Warwick Medical School
University of Warwick
Coventry
MedicalResearch.com: What is the background for this study?
Dr Taylor-Phillips : Psychologists have been investigating a phenomenon of a drop in performance with time on a task called ‘the vigilance decrement’ since World War 2. In those days radar operators searched for enemy aircraft and submarines (appearing as little dots of light on a radar screen). People thought that the ability to spot the dots might go down after too much time spent on the task. Many psychology experiments have found a vigilance decrement, but most of this research has not been in a real world setting.
In this research we wanted to know whether there was a drop in performance with time on a task for breast screening readers looking at breast x-rays for signs of cancer. (Breast x-rays or mammograms show lots of overlapping tissue and cancers can be quite difficult to spot). This was a real-world randomised controlled study in UK clinical practice.
In the UK NHS Breast Screening Programme two readers examine each woman’s breast x-rays separately for signs of cancer. They look at batches of around 35 women’s x-rays. At the moment both readers look at the x-rays in the same order as each another, so if they both experience a drop in performance, it will happen at the same time. We tested a really simple idea of reversing the batch order for one of the readers, so that if they have a low ebb of performance it happens when they are looking at different women’s breast x-rays.
11 May Small Trial Paves Way for Larger Study of Fat-Derived Stem Cells for Heart Failure
MedicalResearch.com Interview with: [caption id="attachment_24225" align="alignleft" width="143"]
Dr. Timothy Henry[/caption]
Timothy D. Henry, MD, MSCAI
Director, Division of Cardiology
Cedars-Sinai Heart Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Henry: Heart failure it the #1 cause of morbidity, mortality and cost in the United States today. Patients with Class 3 heart failure, despite optimal medical therapy and device therapy have limited options beyond heart transplantation and left ventricular cyst device.
Transplantation and LVAD are expensive and are challenged by both availability and complications. Therefore, treatment for patients with ongoing symptoms despite medical therapy is an admiral goal. Stem cell therapy appears to be an attractive choice for these patients, in particular patients with ischemic cardiomyopathy.
The ATHENA trial was designed to treat patients with ischemic cardiomyopathy and ongoing ischemia with autologous adipose-derived regenerative cells. Patients would undergo liposuction with onsite processing of their stem cells in 1 ½ - 2 hours, followed by intramyocardial injection of adipose-derived regenerative cells (ADCRs) vs. placebo.
11 May Using Tumor-homing Peptides To Target Drug Delivery to Placenta
MedicalResearch.com Interview with: [caption id="attachment_24222" align="alignleft" width="125"]
Dr. Lynda Harris[/caption]
Lynda Harris PhD
Lecturer in Pharmaceutics
University of Manchester
Manchester Pharmacy School
Maternal and Fetal Health Research Centre
Manchester
MedicalResearch.com: What is the background for this study?
Dr. Harris: Pregnancy complications such as pre-eclampsia and fetal growth restriction remain a problem despite advances in antenatal care, and impact heavily on future health: small size at birth is associated with an increased risk of cardiovascular disease and diabetes in later life. Drugs to improve pregnancy outcome are severely lacking, as pregnant women are considered a high risk cohort by drug companies, who fear expensive lawsuits associated with side effects and teratogenicity. The majority of pregnancy complications are caused by a poorly growing or poorly functioning placenta. A number of potential drugs have been identified that enhance placental function in vitro, and improve fetal growth in animal models; however, there is currently no means of restricting their actions to the placenta, and systemic administration of these drugs to pregnant women is not feasible due to the risk of adverse effects in other tissues. To address this issue, we have identified a series of placental “homing peptides” which we have used to create nanocarriers for targeted delivery of drugs to the placenta.
11 May Weight Loss Improves Quality of Life But Not Atrial Fibrillation Ablation Outcomes
MedicalResearch.com Interview with: Sanghamitra Mohanty, MD MS FHRS Director, translational research, Texas Cardiac Arrhythmia Institute and Associate Professor (affiliate) Dell Medical School What is the background for this study? What are the main findings? Dr. Mohanty: In the last few years, several trials from a research group in Australia have generated tremendous interest in life-style modifications to manage AF more effectively. These studies reported significant decrease in arrhythmia burden and symptom severity and improvement in ablation outcome in patients with paroxysmal and persistent atrial fibrillation. We investigated the impact of weight-loss on procedure outcome in terms of arrhythmia burden, quality of life and arrhythmia-free survival in long-standing persistent (LSPAF) patients undergoing catheter ablation. Our main findings were the following;- In patients with long-standing persistent atrial fibrillation, weight loss improved quality of life but had no impact on symptom burden and long-term ablation outcome
- No change in AF type or status was detected after the weight loss
- Extensive ablation including pulmonary vein (PV) isolation plus ablation of posterior wall and non-PV triggers resulted in comparable outcome in both groups at 1-year follow-up, irrespective of weight-loss interventions (63.8% vs 59.3%, p=0.68).
11 May Poor Outcomes with FIRM-ablation Alone in Non-Paroxysmal Atrial Fibrillation
MedicalResearch.com Interview with: Sanghamitra Mohanty, MD MS FHRS Director, translational research, Texas Cardiac Arrhythmia Institute and Associate Professor (affiliate) Dell Medical School MedicalResearch.com: What is the background for this study? Dr. Mohanty: In patients with atrial fibrillation, Focal Impulse and Rotor Modulation (FIRM)-ablation alone or in combination with pulmonary vein (PV) isolation has been documented to possibly be a better alternative to PV isolation only. However, none of those trials had a randomized study design. The current study was the first attempt to compare 3 ablation strategies namely FIRM ablation alone (group 1), FIRM +PV isolation (group 2) and PV isolation combined with ablation of non-PV triggers (group 3) in a randomized controlled trial in persistent and long-standing persistent AF. MedicalResearch.com: What are the main findings? Dr. Mohanty: Our main findings were the following: 1) Procedure time was significantly shorter in group 3 (no FIRM ablation) compared to group 1 and 2 (with FIRM ablation) 2) FIRM-ablation alone had very poor outcome in terms of arrhythmia recurrence (86%) 3) FIRM ablation plus PV isolation had significantly longer procedure time and lower efficacy than PV isolation + non-PV trigger-ablation (52.4% vs 76%, p=0.02).11 May Prolaris Score Predicts Prostate Cancer Survival and Recurrence in Low Risk Disease
MedicalResearch.com Interview with: Dr. Michael K. Brawer, MD Northwest Prostate Institute Northwest Hospital Seattle, Washington MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Brawer: Prolaris (Cell Cycle Progression Test) is a prostate-cancer prognostic genetic tests that determines how aggressive is a patient’s cancer. The goal is to reduce the over treatment of tumors that are likely to be harmless while still spotting those that are lethal. Our key study at AUA (American Urological Society) is a meta-analysis of 440 prostate cancer patients with a Gleason score less than or equal to 6 who were tested with Prolaris.10 May Multiple Kidney Stones Linked to Increased Coronary Artery Calcium
MedicalResearch.com Interview with: Dr. Ryan Hsi MD Clinical Fellow, UCSF Medical School and Mathew Sorensen, MD, MS Residency Program Director Department of Urology University of Washington Director, Comprehensive Metabolic Stone Clinic Puget Sound VA MedicalResearch.com: What is the background for this study? Response: Kidney stones affect 1 in 11 people, and the incidence is rising. When kidney stones pass, they can be very painful, and if they obstruct urinary flow as they pass, they can be a cause of kidney injury and sepsis. It is well-known that kidney stones are associated with diseases such as coronary artery disease, obesity, diabetes, and hypertension. Less well established is the relationship with kidney stones and pre-clinical markers of these diseases. That is, before a person has a heart attack, a person may develop atherosclerosis first - are kidney stones associated with these early warning signs of future disease? MedicalResearch.com: What are the main findings? Response: This study evaluated the association of coronary artery calcium and kidney stones. Coronary artery calcium is a measure of calcification of the blood vessels that supply the heart, and it is a predictor of future cardiovascular events. Our study of the Muli-Ethnic Study of Atherosclerosis evaluated individuals who had coronary artery calcium measured and compared those who had a history of none, one, or multiple kidney stones. We found that individuals who had a history of multiple kidney stones were associated with higher levels of coronary artery calcium.10 May Four Management Options For Small Kidney Masses
MedicalResearch.com Interview with: [caption id="attachment_24134" align="alignleft" width="180"]
Dr. Hiten Patel[/caption]
Hiten D. Patel, MD, MPH
Resident, Urological Surgery
James Buchanan Brady Urological Institute
The Johns Hopkins Medical Institutions
Baltimore, Maryland 21287
MedicalResearch.com: What is the background for this study?
Dr. Patel: The study reports results of a systematic review contracted by the Agency for Healthcare Research and Quality based on input from stakeholders. Part of the motivation was due to the American Urological Association's desire to use the results as a basis to update relevant clinical guidelines.
There are four major management options for clinically localized small renal masses diagnosed on imaging including active surveillance, thermal ablation, partial nephrectomy, and radical nephrectomy. The body of research evaluating these management options is broad, but many of the studies performing comparative analyses have limitations. Therefore, the systematic review aimed to evaluate a number of outcomes (e.g. overall survival, cancer specific survival, local recurrence, metastasis, renal function, complications, and perioperative outcomes) based on available comparative studies in the literature.
10 May Periodontal Disease Linked To Increased Mortality in Chronic Kidney Disease Patients
MedicalResearch.com Interview with: [caption id="attachment_24212" align="alignleft" width="110"] Mr. Praveen Sharma[/caption] Mr Praveen Sharma BDS, MJDF (RCS Eng.), FHEA NIHR Doctoral Research Fellow Clinical Lecturer in Restorative Dentistry University of Birmingham School of Dentistry Birmingham, UK MedicalResearch.com: What is the background for this study? Mr. Sharma: There is robust evidence that patients with severe gum disease have higher levels...
10 May Lower Dose of tPA Found Safer For Patients With Acute Ischemic Stroke
MedicalResearch.com Interview with: [caption id="attachment_24180" align="alignleft" width="64"]
Prof. Craig Anderson[/caption]
Professor Craig Anderson
Professor of Stroke Medicine and Clinical Neuroscience
Sydney Medical School at the University of Sydney
Institute of Neurosciences of Royal Prince Alfred Hospital
MedicalResearch.com: What is the background for this study?
Prof. Anderson: Intravenous use of the clot-busting drug, alteplase (or rtPA), at a dose of 0.9 mg/kg body weight is the only proven medical treatment of acute ischemic stroke. However, a major drawback to the treatment is an increased risk of major bleeding in the brain, or intracerebral hemorrhage (ICH), that occurs in about 5% of cases, and can be fatal. This balance of effectiveness (recovery from disability) and risks (ICH, and bleeding elsewhere and uncommon drug allergic reactions) has led to much of the controversy over the net benefit of the drug. The optimal dose of the drug has never been established, but the Japanese drug safety regulatory authority, has approved a lower dose (0.6mg/kg) on the basis of a small, non-randomized, open study which showed comparable outcomes and lower risk of ICH than historical controls. This ‘east-west’ divide over the approved dose of alteplase has led to much variation in the dose of alteplase used in clinical practice in Asia – according to a doctor’s perceived risk of ICH in individual patients and the affordability of this relatively expensive treatment in low resource settings. Data from the Get-with-the Guidelines Quality Registry in the United States suggests Asian patients are at higher risk of ICH after standard-dose alteplase than non-Asians.
Our research aimed to resolve this uncertainty over the optimal dose of alteplase, as an international, active-comparator, open-label, blinded outcome assessed, clinical trial of low-dose (0.6 mg/kg) versus standard-dose (0.9mg/kg) in 3310 patients recruited from over 100 hospitals in 13 countries between 2012 and 2015.
10 May Cancer Diagnosis Linked To Aging Symptoms of Physical Decline and Depression
MedicalResearch.com Interview with: [caption id="attachment_24085" align="alignleft" width="200"]
Dr. Corrine Leach[/caption]
Corinne Leach, MPH, MS, PHD
Strategic Director, Cancer and Aging Research
American Cancer Society, Inc.
Atlanta, GA 30303
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Leach: Using linked data from cancer registries and the Medicare Health Outcomes Survey, we prospectively examined the short-term impact of cancer on the functioning, development of and worsening of age-related health conditions among 921 older adults who developed cancer compared to 4,605 propensity score matched controls. We found that cancer groups demonstrated greater declines in activities of daily living and physical functioning compared to controls with the greatest change for lung cancer patients. Having a cancer diagnosis increased risk for depression but did not increase the odds of developing arthritis in the hand/hip, incontinence (except for prostate cancer), or vision/hearing problems. Having a cancer diagnosis also did not exacerbate the severity of arthritis or foot neuropathy.
10 May Canadian Children Less Overweight Than Decade Ago
MedicalResearch.com Interview with: [caption id="attachment_24165" align="alignleft" width="133"]
Dr. Atul Sharma[/caption]
Atul Sharma MD, MSc(Statistics), FRCPC
Researcher, Children’s Hospital Research Institute of Manitoba; Assistant Professor, Department of Pediatrics and Child Health, University of Manitoba; Senior Consultant, Biostatistics Group, George and Fay Yee Center for Healthcare Innovation
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Sharma: Between 1978 and 2004, a previous comparison of directly measured heights and weights demonstrated an alarming increase in the prevalence of overweight or obesity in Canadian children aged 2-17y, from 23.3% (95% CI = 20.5-26.0) to 34.7% (33.0-36.4) based on the new 2007 WHO criteria.
In Canada, the definitions of overweight and obesity changed with the introduction of the new '2010 WHO Growth Charts for Canada’, Previous definitions were based on Body Mass Index (BMI) percentiles from the 2000 Centers for Disease Control and Prevention (CDC) growth chart’s. In addition to revising the percentile thresholds for diagnosing overweight or obesity, the WHO charts were based on a very different reference population. As a result, the proportion of Canadian children being classified as overweight or obese increased with the introduction of the new WHO charts.
Our current study applied current Canadian definitions of overweight and obesity to a contemporary sample of Canadian children age 3-19y to assess recent trends in the rates of overweight and obesity. By pooling data from the Canadian Community Health Survey (CCHS, cycle 2.2) and the Canadian Health Measures Survey (CHMS, cycles 2 and 3), we were able to study a representative sample of more than 14000 Canadian children from the period 2004-2013. The sample was evenly split between boys and girls and approximately 80% white.
10 May Five New Genes Driving Breast Cancer Identified
MedicalResearch.com Interview with: [caption id="attachment_24197" align="alignleft" width="200"]
Dr. Serena Nik Zainal[/caption]
Serena Nik-Zainal MD PhD
Wellcome Beit Fellow & Honorary Consultant in Clinical Genetics
CDF Group Leader
Wellcome Trust Sanger Institute
United Kingdom
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Nik-Zainal: We have used the massive improvement in speed of "sequencing" (reading the human genetic material) in order to obtain comprehensive whole genome maps of 560 human breast cancer patients. This is the largest whole genome sequencing study of a single cancer type in the world. We wanted to forensically search these cancers, find all the important genes that drive breast cancer, find all the important mutation patterns that tell us something about why breast cells turn into cancer cells and then to pull it altogether for each patient. We wanted to be able to "profile" each cancer patient, to see if we could further our understanding of personal cancer genomes.
In all, we had 556 female and four male patients, and they were sought from all over the world – USA, Europe and Asia.