Blog – Medical Research News and Interviews
25 Mar Vitamin C Rich Diet, Not Supplements, May Slow Progression of Cataracts
MedicalResearch.com Interview with: [caption id="attachment_22861" align="alignleft" width="151"]
Dr. Chris Hammond[/caption]
Christopher J. Hammond, MD, FRCOphth
Departments of Ophthalmology & Twin Research
King's College London
St. Thomas' Hospital
London UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Hammond: Twin studies allow us to quantify the influence of genes vs environment on a trait and this study suggests 65% of variation of cataract progression is due to environmental factors.
Vitamin C has long been linked to cataract because the lens of the eye is bathed in fluid rich in ascorbate, a derivative of vitamin C. We showed that, even in a relatively well-nourished UK population, those in the highest third of vitamin C dietary intake (equating to something like 3 times the RDA of 60mg) had a third less progression of lens opacities.
24 Mar Dual and Concordant Vaginal and Oral HPV Infections in Women
MedicalResearch.com Interview with: [caption id="attachment_22854" align="alignleft" width="200"]
Dr. Ryan Orosco[/caption]
Ryan K. Orosco, MD
Division of Head and Neck Surgery
Department of Surgery
University of California, San Diego
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Orosco: Our group at UC San Diego is interested in HPV as it relates to diseases of the head and neck. HPV is a well-publicized cause of cervical cancer, and awareness about its link to throat (oropharynx) cancer is rapidly increasing.
Less well-known, is the relationship between HPV and benign (non-cancerous) diseases such as genital warts and papilloma of the throat. As we strive to understand how to best care for patients with HPV-related disorders, it is important to understand the entire process of disease progression, which begins with HPV infection. Our group wanted to explore the relationship between HPV infection in the two most commonly infected body sites: oral and vaginal.
24 Mar Conservative Management Could be a Reasonable Alternative to Renal Replacement Therapy in Select Patients
MedicalResearch.com Interview with: Dr. Wouter R. Verberne Koekoekslaan 1 The Netherlands MedicalResearch.com: What is the background for this study? Dr. Verberne: The number of older patients with End Stage Renal Disease (ESRD) is increasing worldwide. When ESRD is approaching, patients need to be advised on the renal replacement therapy (RRT) necessary to remove toxic products and fluid from the body when their own kidneys are no longer able to do so. ESRD can be treated with kidney transplantation, hemodialysis or peritoneal dialysis. With increasing technical possibilities and with the widespread availability of dialysis treatment, age no longer limits dialysis treatment. It has been questioned whether older patients with ESRD, who often have multiple comorbidities, are likely to benefit from renal replacement therapy. Dialysis treatment comes with high treatment burden. Generally patients are treated in a dialysis facility 3 times per week, 3 to 4 hours per time. Patients with an anticipated poor prognosis on RRT may choose to forego dialysis and decide to be treated conservatively instead. Conservative management (CM) entails ongoing care with full medical treatment, including control of fluid and electrolyte balance and correcting anemia, and provision of appropriate palliative and end of life care. Shared decision making has been recommended to come to a joint decision on renal replacement therapy by considering potential benefits and harms of all treatment options and the patient’s preferences. Data on outcomes, including survival and quality of life, are needed to foster the decision making. However, adequate survival data, specifically on older patients, are limited. A number of studies, predominantly from the United Kingdom, have determined survival of older patients managed conservatively compared with renal replacement therapy. In these studies, the numbers of recruited patients are generally small, the studies are performed in heterogeneous study populations, and there is significant variability in starting points used in survival analyses. We performed the first Dutch study in a large series of older patients slowly approaching ESRD, enabling the use of several starting points in survival analyses. The aims of the study were to compare survival in patients with ESRD ages ≥ 70 years old choosing either conservative management or renal replacement therapy and determine predictors of survival.24 Mar Miscarriage Risk Reduced by Daily Multivitamins Before and After Conception
MedicalResearch.com Interview with: [caption id="attachment_22845" align="alignleft" width="133"]
Dr-Germaine M. Buck-Louis[/caption]
Germaine M. Buck Louis, Ph.D., M.S.
Office of the Director
Division of Intramural Population Health Research
Eunice Kennedy Shriver National Institute of Child Health and Human Development
Rockville, Maryland 20852.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: To understand the association between couples’ lifestyles and risk of pregnancy loss. Couples were recruited upon discontinuing contraception to try for pregnancy and followed daily for up to one year of trying or until pregnancy. Pregnant women were followed daily for 7 weeks following conception then monthly.
23 Mar Many Patients Do Not Tell Their Primary Care Physician About Alternative Medicine Use
MedicalResearch.com Interview with: [caption id="attachment_22775" align="alignleft" width="200"]
Judy Jou[/caption]
Judy Jou, MA PhD Candidate
PhD Candidate in Health Services Research, Policy, & Administration
Division of Health Policy and Management
University of Minnesota, Twin Cities
Minneapolis, MN
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Use of complementary and alternative medicine (CAM) is rising among U.S. adults, but CAM is often poorly integrated into patients’ treatment and self-care routines. We analyzed nearly 7,500 responses from the 2012 National Health Interview Survey (NHIS) and found that over two-fifths of U.S. adults who used CAM during the past year did not disclose their complementary and alternative medicine use to their primary health care providers, with rates of disclosure varying by the type of CAM used. We also examined reasons for non-disclosure and found that, in contrast to prior studies, lack of provider-initiated conversation about complementary and alternative medicine was the most commonly cited reason, rather than patients’ concerns about negative reactions from their providers regarding their complementary and alternative medicine use.
22 Mar Caregivers and Patients with LVAD Face Confusion Over End of Life Decisions
MedicalResearch.com Interview with: [caption id="attachment_22837" align="alignleft" width="200"]
Dr. Colleen McIlvennan[/caption]
Colleen K. McIlvennan, DNP, ANP-BC
Assistant Professor of Medicine
Division of Cardiology
Section of Advanced Heart Failure and Transplantation
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: As technology continues to advance, more people are becoming eligible for advanced therapies for end-stage illness. One such therapy, the left ventricular assist device (LVAD) is an option for carefully selected individuals suffering from end-stage heart failure. Use of this innovative technology has expanded from its original indication as a bridge to transplantation to also include destination therapy, in which patients live with the device for the remainder of their lives. Significant focus has been placed on developing and expanding LVAD programs, with less thought about the eventual end-of-life process awaiting patients whose LVAD is indicated for destination therapy.
We performed semi-structured interviews about experiences surrounding end of life with 8 caregivers of patients who died with an LVAD. There was a wide range of case histories represented by these patients; however, three main themes emerged that coalesced around feelings of confusion:
1) the process of death with an LVAD,
2) the legal and ethically permissible care of patients approaching death with an LVAD, and
3) the fragmented integration of palliative and hospice care.
21 Mar Pathologists Often Disagree On Atypia or DCIS in Breast Biopsies
MedicalResearch.com Interview with: [caption id="attachment_22799" align="alignleft" width="161"]
Dr. Joann Elmore[/caption]
Joann G. Elmore M.D., M.P.H.
Professor of Medicine,
Adjunct Professor of Epidemiology,
University of Washington School of Medicine
Harborview Medical Center
Seattle, WA 98104-2499
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Elmore: Our team began studying diagnostic agreement among pathologists while interpreting breast biopsies in 2009. Early findings from the Breast Pathology Study (B-Path) were published in March 2015 in the Journal of the American Medical Association and indicated strong agreement among pathologists when diagnosing invasive breast cancer or benign breast tissue. Agreement, however, was much lower for ductal carcinoma in situ (DCIS) and atypia. Results from this study raised concerns that a high percentage of breast biopsies may be inaccurately diagnosed. These concerns were amplified in the media with statements like “as many as one-in-four biopsies are incorrectly diagnosed.” Statements like this inaccurately depicted the results of our study, which included a test set weighted heavily with DCIS and atypia cases. It is important to consider the percentage that each outcome category contributes to the overall number of biopsies in the U.S. population as we found that the agreement rate of pathologists varies drastically across these diagnostic categories.
In the new work published in Annals of Internal Medicine, we have analyzed the B-Path results to reflect variation among diagnoses of women using U.S. population-adjusted estimates,
In an effort to help physicians and patients better understand what the B-Path results mean for women, we have analyzed the B-Path results to reflect variation among diagnoses of women using U.S. population-adjusted estimates. When adjusted using population-based predictive value estimates, the B-Path results indicate that pathologists’ overall interpretations of breast biopsies would be confirmed by an expert panel 92 out of 100 biopsies, with more of the initial diagnoses over-interpreted rather than under-interpreted.
Of concern, our results noted that among 100 breast biopsies given an initial diagnosis of atypia, less than half of these cases would be given a diagnosis of atypia after review by a panel of three experienced breast pathologists. Over half of the biopsies would be downgraded from atypia to a diagnosis of benign without atypia after review.
21 Mar Rosacea Should Be Considered More Than Cosmetic Disorder
MedicalResearch.com Interview with: [caption id="attachment_21019" align="alignleft" width="200"]
Dr. Alexander Egeberg[/caption]
Alexander Egeberg, MD PhD
National Allergy Research Centre, Departments of Dermato-Allergology and Cardiology
Herlev and Gentofte University Hospital
University of Copenhagen
Hellerup, Denmark
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Egeberg: Rosacea skin shows an up-regulation of various cytokines (small proteins that are important in cell signalling), and displays increased activation and expression of matrix metalloproteinases (MMPs). Both rosacea and Parkinson’s disease have been associated with small intestinal bacterial overgrowth and Helicobacter pylori infection, and MMPs. MMPs are enzymes that are involved in tissue remodeling, organ development, and regulation of inflammatory processes.
Parkinson’s is a progressive neurological disease that results from the gradual loss of brain cells that produce dopamine, a chemical that sends messages to the part of the brain that controls movement and coordination. Importantly, MMPs have also been implicated in the pathogenesis of Parkinson’s disease and other neurodegenerative disorders, and MMPs contribute to loss of dopamine producing brain cells.
Rosacea is often characterized by flare-ups and remissions and typically presents as a redness on the cheeks, nose, chin or forehead. In our study, we found a significantly (approximately two-fold) increased risk of developing Parkinson's disease, a chronic and progressive movement disorder, among patients with rosacea. Also, we found that treatment with tetracycline, an oral antibiotic, was associated with a slightly decreased risk of Parkinson's disease.
21 Mar Role of microRNAs in Driving Breast and Lung Cancer Metastases Identified
MedicalResearch.com Interview with: [caption id="attachment_22816" align="alignleft" width="149"]
Dr. Olivier Pardo[/caption]
Dr Olivier E Pardo PhD
Team Leader
Imperial College
Division of Cancer
Hammersmith Hospital
London UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Pardo: Metastatic dissemination, the ability of tumour cells to go and colonise organs distant from the primary disease site, is the principal cause for failing to cure patients with cancer. This is particularly true in the case of breast cancer where resection of local disease offers good chances of cure but metastatic dissemination that may appear at a later stage carries very poor prognosis. Surgical resection is also the only true curative strategy for localised lung cancer. Hence, a better understanding of the mechanisms controlling the dissemination of tumour cells is likely to propose novel targets for combination therapy that will improve the survival of cancer patients.
Here, we showed that an enzyme, named MARK4, controls the ability of lung and breast cancer cells to move and invade. When we lower MARK4 levels, it prevents cancer cells from moving by changing their internal architecture, making them unfit to invade. Consequently, these cells were unable to efficiently form metastasis in mouse cancer models. Confirming the role of this enzyme in cancer, we show that breast and lung cancer patients with increased levels of MARK4 in their tumours have poorer prognosis.
We found that what controls the levels of MARK4 in cells is miR-515-5p, a small oligonucleotide sequence called a microRNA. When present in the cells, miR-515-5p prevents the expression of MARK4. Incidentally, the loss of miR-515-5p correlates with increased metastasis and poorer prognosis in mouse cancer models and patients, respectively.
21 Mar Truck Drivers With Sleep Apnea Who Don’t Use Their CPAP Have More Preventable Crashes
Posted at 14:06h
in Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, Obstructive Sleep Apnea
MedicalResearch.com Interview with:
[caption id="attachment_22418" align="alignleft" width="130"]
Dr. Stefanos Kales[/caption]
Stefanos N. Kales, MD, MPH, FACP, FACOEM
Associate Professor, Harvard Medical School &
Harvard TH Chan School of Public Health
Director, Occupational Medicine Residency
Division Chief OEM, Cambridge Health Alliance
MedicalResearch: What is the background for this study?
Dr. Kales: Up to 20% of all large truck crashes are due to drowsy or fatigued driving, which would account for almost 9,000 fatalities and up to 220,000 serious injuries. OSA is the most common medical cause of excessive daytime sleepiness or fatigue, and has been linked with negative impacts on attention, working memory, vigilance, and executive functioning. Past studies primarily of passenger car drivers have linked untreated OSA with a several-fold increased risk of motor vehicle accidents. They have also shown that effective treatment with CPAP reduces this risk close to that of unaffected drivers.
Although commercial truck drivers undergo a biennial examination to determine their medical fitness to safely operate a vehicle, there are currently no mandatory standards for OSA screening or diagnosis, in part because there have been no large-scale studies evaluating the crash risk of commercial drivers diagnosed with OSA.
Our study examined the results of the first large-scale employer program to screen, diagnose, and monitor OSA treatment adherence in the U.S. trucking industry
21 Mar Slow Sparse Ketamine Infusions Show Promise For Resistant Depression
MedicalResearch.com Interview with: Theodore Henderson, MD, PhD Neuroluminance Ketamine Infusion Centers MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Henderson: Depression is a widespread problem. Psychotropic medications or therapy are the standard treatments, but they are often disappointing. Some studies have shown that the response rate to antidepressant medications is only 12-17% better than placebo response rate. Newer non-pharmacetical treatments, like transcranial magnetic stimulation, appear to have only a 50% response rate at best. The seminal study by Berman and colleagues in 2000 showed that sub-anesthetic dose infusions of the anesthetic, ketamine, produced a rapid antidepressant response. Many clinics across the United States focus on these rapid effects. Our clinic has been treating patients with treatment-resistant depression (defined as failing five or more antidepressants) for over three years. Our response rate is 80% based on multiple depression rating scales. We report here on 100 of the over 300 patients in our clinic who agreed to share their data in a research study. We treated patients with ketamine infusions no more frequently than once per week, unlike the clinical studies and many other ketamine clinics. We found our patients did equally well or better and received fewer treatments. The neurobiology of ketamine and its mechanism of action hold the key. Ketamine is a potent activator of the growth factor, brain derived neurotrophic factor (BDNF). This growth factor reverses the damage that depression causes to the brain – loss of synapses, dearborization of dendrites, and neuronal death. Ketamine’s ability to activate BDNF over time is responsible for a persistent antidepressant effect upon the brain.20 Mar Biomarker of Mutant Stromal Cells May Detect Breast Cancer Early
MedicalResearch.com Interview with: [caption id="attachment_22795" align="alignleft" width="133"]
Dr. Lan Ko[/caption]
Lan Ko MD PhD
Augusta University
Cancer Center
Augusta, GA 30912, USA
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Lan Ko: Cancer development hijacks normal cell differentiation. Understanding the normal is where we could begin to unlock the secret of cancer. In normal breast tissue, stem or progenitor cells produce supporting stromal cells in normal breast development. In breast cancer, the progenitor cells are mutated leaving mutant stromal cell offspring with altered activities to induce tumor. Mutant stem or progenitor cells may have longer lifespan than their mutant descendents so that they can fuel cancer growth for years. Eliminating those mutant progenitors at the source, at least in theory, will efficiently stop cancer.
Each subgroup of breast tumor stromal cells has been previously described by other scientists. However, the connections among these cells were unclear in the past. Like blind men feeling elephant, we scientists are often obscured from seeing the entire picture. The finding of mutant breast tumor stromal cells using GT198 as a marker provides a critical puzzle piece that fits the rest of puzzle together. When cancer problems can be viewed in multiple aspects with great simplicity, their connections emerge. We now know why breast cancer stromal cells are important, and how should we target them.
19 Mar Meta-analysis Reassesses Omega 3 Fatty Acids in Major Depressive Disorders
MedicalResearch.com Interview with: [caption id="attachment_22787" align="alignleft" width="106"]
Dr. RJT Mocking[/caption]
Dr. Roel JT Mocking
Program for Mood Disorders
Department of Psychiatry
Academic Medical Center
University of Amsterdam, The Netherlands
MedicalResearch.com: What is the background for this study?
Response: Omega-3 polyunsaturated fatty acid supplementation (popularly referred to as fish oil) is being promoted as (add-on) treatment for depression. Thus far, many studies have been performed that tested the effects of omega-3 fatty acids in depression. In order to overcome differences between these results of individual studies, a meta-analysis can be performed. A meta-analysis pools the results of all individual studies, and thereby provides a more definitive conclusion regarding the effect of omega-3 fatty acids in depression. Moreover, using the differences between the individual studies, a meta-analysis can point to factors that are associated with a better effect of the supplementation, for example supplementation dose or duration.
There have been meta-analyses performed previously, but they seemed to contain several inconsistencies. For example, they accidentally included the same study two or three times, which results in errors. In addition, these meta-analyses did not only include studies performed in patients with the psychiatric disorder "major depressive episode", but also subjects from the general population with less severe depressive complaints. This makes it more difficult to interpret the results. Therefore, we performed a meta-analysis that included only studies performed in patients with major depressive disorder, and corrected errors from earlier meta-analyses.
19 Mar Bypass Pathways Allow Some Cancers To Resist Kinase Inhibitor Drugs
MedicalResearch.com Interview with: Douglas.A. Lauffenburger PhD Ford Professor of Biological Engineering, Chemical Engineering, and Biology Head, Department of Biological Engineering Massachusetts Institute of Technology Cambridge, MA 02139 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Lauffenburger: We aimed to advance understanding concerning causes of tumor resistance to kinase inhibitor drugs, which limits effectiveness for many therapeutics even when indicated by specific genetic mutations in the new ‘personalized medicine’ paradigm. We discovered a new mechanism underlying this resistance at least for a number of otherwise promising drugs currently in clinical use as well as further clinical trials. Our discovery was based on realizing that the same oncogenic signaling driving tumor cell proliferation and invasiveness at the same time activates proteolytic shedding of receptor tyrosine kinases not involved in the targeted oncogenic pathway, shutting down additional signaling inputs. Thus, when the targeted pathway is inhibited by the intended drug, this shedding is concomitantly diminished — now permitting “bypass" pathways to be activated downstream of these alternative receptor inputs. Moreover, we showed that measurement of a set of key shed receptors (primarily AXL and MET, in our examined case of MEK pathway inhibitors for melanoma and triple-negative breast tumors) in patient blood serum samples could predict effectiveness of these inhibitors: when the shed levels were high, the drugs were less effective because of the correspondingly great potential for bypass signaling upon drug treatment. In follow-up mouse experiments, we demonstrated increased effectiveness of a MEK inhibitor when combined with either an AXL inhibitor or a proteolysis inhibitor, thereby confirming the mechanism and proving an avenue for overcoming it.19 Mar Promising Biologic Stimulates Blood Flow Into Critical Limb Ischemia
MedicalResearch.com Interview with: [caption id="attachment_22778" align="alignleft" width="120"]
Dr. Emerson Perin[/caption]
Dr. Emerson C. Perin MD, PhD
Texas Heart Institute
Medical Director, BSLMC Catheterization Laboratory
Director, Research in Cardiovascular Medicine
Medical Director, Stem Cell Center
MedicalResearch.com: What is the background for this study?
Dr. Perin: Critical limb ischemia (CLI) is a devastating and debilitating disease characterized by reduced blood flow to the legs, frequently as a consequence of atherosclerosis. Patients with CLI have a poor prognosis and live with chronic pain and disability. The disease manifests clinically as pain during rest and compromised wound healing, often resulting in ulcers that don’t heal, which can lead to amputation. Moreover, Critical limb ischemia is a deadly disease, with an annual mortality rate of about 20%. The only effective treatment option is revascularization, but not all CLI patients are good candidates for this approach, and even for those who are, procedures can fail. These patients face a dismal prospect as no other effective treatment options are available. Clearly, new therapeutic strategies are desperately needed for this group of patients.
One of the most exciting new approaches for Critical limb ischemia patients who have no options is the concept of therapeutic angiogenesis—improving regional blood flow by facilitating the growth of blood vessels. This can be accomplished by delivering angiogenic factors to the area in need of improved blood supply. Hepatocyte growth factor (HGF) is a promising novel biologic for use in this way because it’s a powerful angiogenic agent that stimulates cell proliferation and migration. Delivering HGF into the ischemic limbs of patients with CLI may result in beneficial effects that help restore compromised blood flow to the area and encourage better healing of wounds. VM202 is a plasmid DNA that simultaneously expresses two isoforms of HGF, mimicking the way the body produces HGF. On the basis of favorable results from phase 1 clinical trials showing that gene therapy with VM202 was safe, well-tolerated, and potentially beneficial in patients with ischemic diseases, we conducted a phase 2, dose-escalation clinical trial in patients with Critical limb ischemia.
18 Mar Informatics and Financial Incentives Can Lead To Safer Drug Prescribing
MedicalResearch.com Interview with: [caption id="attachment_22771" align="alignleft" width="159"]
Prof. Bruce Guthrie[/caption]
Prof. Bruce Guthrie
Primary Care Medicine and Honorary Consultant NHS Fife
University of Dundee
Dundee, Scotland
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Guthrie: Most drug-related harm is caused by commonly prescribed drugs with moderate risk. This prescribing is not always inappropriate, because risk of harm may be outweighed by benefit in an individual, but we have previously shown that high-risk prescribing like this is common and highly variable between primary care practices, consistent with it being improvable. We therefore developed a complex intervention combining education, informatics to make it easy to identify and review patients, and a small financial incentive to review. We evaluated this intervention in a cluster-randomised trial in 33 Scottish primary care practices, targeting nine measures of high-risk non-steroidal anti-inflammatory drug (NSAID) and antiplatelet prescribing (for example, prescription of an NSAID to someone with chronic kidney disease; prescription of an antiplatelet to someone taking an anticoagulant without also prescribing a gastroprotective drug).
The intervention reduced the targeted prescribing by just over one third, and this reduction was sustained in the year after the intervention (including the payment to review) ceased. We also observed reductions in related hospital admissions with gastrointestinal bleeding and heart failure, although not acute kidney injury which was reduced but not statistically significantly.
18 Mar Arimidex and Tamoxifen Both Useful for Early Breast Cancer But with Different Safety Profiles
MedicalResearch.com Interview with: [caption id="attachment_22766" align="alignleft" width="136"]
Prof. Jack Cuzick[/caption]
Professor Jack Cuzick, PhD, FMedSci, FRCP(hon)
Director, Wolfson Institute of Preventive Medicine and
Head, Centre for Cancer Prevention
Queen Mary University of London.
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Cuzick: Ductal carcinoma in situ (DCIS) is a very early form of breast cancer, where cancer cells are present in milk ducts, but have not spread to the surrounding breast tissue. It is estimated that approximately a fifth of all screen-detected breast cancers are DCIS, with around 4,800 people diagnosed with DCIS in the UK each year.
Our IBIS-II DCIS trial looked at 2,980 postmenopausal women with DCIS in 14 countries, who were either given anastrozole or tamoxifen for five years after surgery.
The two groups had a similar number of cases of the disease recurring, whether they took tamoxifen or anastrozole. Those who took anastrozole had an 11 per cent lower rate of recurrence of DCIS or invasive cancer than those who took tamoxifen, but this difference was not significant. The similar NSABP B-35 trial found a 29% reduction with anastrozole and the combined analysis of the two trials indicated a significant 21% reduction.
The key difference between the two groups were in the side effects of the medication. Women who took anastrozole experienced fewer womb and ovarian cancers and non melanoma skin cancers, and fewer deep vein thromboses and gynecological issues, compared with those who took tamoxifen. However more fractures and musculoskeletal side effects were seen among those receiving anastrozole.
18 Mar Nightmares Linked to Increased Suicide Risk in PTSD
MedicalResearch.com Interview with: Donna L. Littlewood PhD Student School of Psychological Sciences University of Manchester, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Every year over 800,000 people die by suicide, and for every individual’s death, it is estimated that another 20 people will make a suicide attempt. Therefore, to be able to prevent suicide, we need to understand the different factors that can combine to make an individual think about ending their own life. Recent research indicates that nightmares are associated with suicidal thoughts and behaviours, and that this association is independent of other related suicide risk factors, such as, depression and PTSD. However, it is now important for research to examine the mechanisms that underpin this association, as this information will support the development of clinical interventions to prevent subsequent suicide attempts and deaths18 Mar Alcohol May Undo the Therapeutic Benefit of Tamoxifen in Breast Cancer
[caption id="attachment_22760" align="alignleft" width="133"]
Dr. Chin Yo Lin[/caption]
MedicalResearch.com Interview with:
Chin-Yo Lin, Ph.D.
University of Houston
Center for Nuclear Receptors and Cell Signaling
Department of Biology and Biochemistry
Science and Engineering Research Center (SERC)
Houston, TX 77204-5056
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Lin: Many studies have established that alcohol consumption is a risk factor for breast cancer. Breast cancers associated with drinking tend to be hormone receptor-positive, the type is commonly treated with the drug tamoxifen which blocks the actions of estrogen in driving tumor growth in pre-menopausal women. Alcohol consumption has also been shown to increase the risk of disease recurrence in patients. Our study shows that alcohol can enhance the effects of estrogen by increasing cancer cell division and also reduce the efficacy of tamoxifen. The key mechanistic insight from the study is that alcohol treatment of breast cancer cells increased the expression of BRAF, a cancer-causing gene that is commonly mutated and activated in other types of cancers.
18 Mar New ThoraXS Device Rapidly Decompresses Pneumothorax
Posted at 12:56h
in Author Interviews, Critical Care - Intensive Care - ICUs, Pulmonary Disease, Surgical Research, Technology
MedicalResearch.com Interview with:
[caption id="attachment_22754" align="alignleft" width="133"]
Dr. Ariel Drori[/caption]
Dr. Ariel Drori MD
Hadassah Medical Center
MedicalResearch.com: What is the background for the ThoraXS device?
Dr. Drori: The initial recognition of the need for a device like ThoraXS first came to me on an operational deployment during my reserve service where I serve as a military doctor. While serving on the Gazan border, I was called to a battle scene to treat a soldier who was suffering from pneumothorax after being shot in the chest. A quick evacuation by helicopter meant that I didn't have the time to perform the entire procedure and I was forced to hand over a partially-treated patient whose condition was unstable.
The reality of constant combat injuries mixed with a rising number of daily civilian terror attack casualties led us to understand that we need to provide a cheap, easy to use, robust and reliable solution that on the one hand can withstand the most extreme combat conditions and on the other, be used by any paramedic and in any pre-hospital and hospital setting.
This line of thought eventually led to the adoption of ThoraXS's simple yet sophisticated mechanical mechanism that ticks all the boxes.
18 Mar ProtonPump Inhibitor Prevacid Did Not Affect Antiplatelet Therapy in PRODIGY Trial
MedicalResearch.com Interview with: Giuseppe Gargiulo MD Research fellow in Cardiology Inselspital, University of Bern, Bern, Switzerland MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Gargiulo: Every year millions of people with coronary artery disease are treated worldwide with percutaneous coronary intervention (PCI). Consequently, they receive a dual (DAPT) in order to prevent thrombotic life-threatening complications, such as stent thrombosis. DAPT often consists of aspirin and clopidogrel, but some studies have questioned the efficacy of clopidogrel in case of concomitant therapy with proton-pump inhibitors (PPI) due to pharmacodynamic interactions. Indeed, clopidogrel is a pro-drug needing to be activated, and this could be potentially affected by PPI. This is a relevant topic given that many patients treated with DAPT commonly receive also a PPI to prevent gastrointestinal complications (ulceration and bleeding) or due to pre-existing gastric disease. Some studies demonstrated that the use of a PPI, mainly omeprazole, was associated with an increased risk of cardiovascular adverse events, indeed the Food and Drug Administration (FDA) and the European Medicine Agency (EMA) discouraged the concomitant use of omeprazole and clopidogrel. On the contrary, some other studies did not confirm this finding. We performed a detailed analysis of the impact of PPI therapy on the 2-year clinical outcomes of 1970 patients undergoing PCI with stent implantation enrolled in the PRODIGY trial (a randomized trial comparing 2 DAPT regimens: 6-month versus 24-month DAPT). In our study population, 738 patients (38%) were treated with a PPI (lansoprazole 90%) concomitantly to DAPT. We found that the ischemic and bleeding events at 2 years of follow-up were similar in patients treated with or without a PPI, irrespective of DAPT duration (6-month or 24-month). These findings support the concept that the concomitant use of PPI, when clinically indicated, in patients receiving clopidogrel is not associated with adverse clinical outcomes.18 Mar Preclinical Engineered Troponin Keeps Heart Beating Longer
MedicalResearch.com Interview with: [caption id="attachment_22748" align="alignleft" width="137"]
Dr. Jonathan Davis[/caption]
Jonathan P. Davis , Ph.D.
Associate ProfessorThe Ohio State University Medical Center
Department of Physiology & Cell Biology.
Columbus, OH 43210
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Davis: Myocardial infarction (MI) is a leading cause of heart failure and death in the US. Since the infarcted heart does not contract as well, therapeutics have been designed (i.e. positive inotropes) to help the heart contract better. While current positive inotropes help the patients in the short-term, they have detrimental long-term effects (“feel better but die sooner”). There is a dire need to be able to increase cardiac contraction without the deleterious side effects. We have achieved this goal by engineering the Ca2+-dependent switch in the heart, troponin C, to be able to better bind Ca2+. Combining gene therapy with our smartly formulated TnC, we demonstrated that our novel strategy not only protected the mouse from the negative consequences of an MI, but was also therapeutic when given after the MI.
18 Mar High School Girls Using Long-Acting Reversible Contraception Less Likely To Use Condoms
MedicalResearch.com Interview with: [caption id="attachment_22743" align="alignleft" width="200"] Riley Steiner[/caption] Riley Steiner MPH Epidemiologist in the Division of Adolescent and School Health Centers for Disease Control and Prevention MedicalResearch.com: What is the background for this study? What are the main findings? Response: Using data from the 2013 national Youth Risk Behavior Survey (YRBS), our analysis looks at...
18 Mar Multiple Chronic Conditions Accumulating Over Time Lead To Frailty
MedicalResearch.com Interview with: [caption id="attachment_22739" align="alignleft" width="125"]
Dr. Alanna Chamberlain[/caption]
Alanna Chamberlain, PhD
Assistant Professor of Epidemiology
Mayo Clinic College of Medicine
MedicalResearch.com: What is the background for this study?
Dr. Chamberlain: The number of elderly individuals in the US will double by the year 2050 and these individuals will become increasingly frail as they get older. Frailty has been recognized by doctors and researchers as an important contributor to poor health and declines in quality of life among older adults. However, it is difficult to measure frailty because it’s not due to a single condition. Instead, multiple health problems tend to accumulate over time until a person becomes increasingly frail. It is important to understand how frailty develops as patients age and how changes in frailty are related to outcomes. To address these questions, we followed individuals over 8 years to identify changes in frailty over time, to describe how people cluster (follow similar trajectories of frailty over time), and to examine how these changes relate to emergency department visits, hospitalizations, and death in a large population from Olmsted County, MN.
18 Mar Xenon Lessens Hypoxic Brain Damage After Cardiac Arrest
MedicalResearch.com Interview with: Ruut Laitio, MD, PhD Department of Anaesthesiology and Intensive Care Division of Perioperative Services, Intensive Care Medicine and Pain Management Turku University Hospital, Turku, Finland MedicalResearch.com: What is the background for this study? Dr. Laitio: Numerous animal studies with different types of brain injury (hypoxic, toxic,stroke, traumatic brain injury) have established the neuroprotective effect of xenon during the last 15 years. We designed a proof-of-concept study to find out whether xenon has neuroprotective effect in humans. An important finding from animal studies was that xenon has at least additive or even synergistic neuroprotective interaction with hypothermia and the results were based on histopathological and functional outcomes. These putative neuroprotective properties had not been reported in humans until now.18 Mar Older Adults with Chronically High Depressive Symptoms May Be At Higher Risk of Dementia
MedicalResearch.com Interview with: Allison R. Kaup, PhD Assistant Adjunct Professor, UCSF Department of Psychiatry Clinical Research Psychologist / Clinical Neuropsychologist and Kristine Yaffe MD Professor of Psychiatry, Neurology and Epidemiology Chief of Geriatric Psychiatry and Director of the Memory Evaluation Clinic San Francisco VA Medical Center MedicalResearch.com: What is the background for this study? Response: Previous research has shown that older adults with depression are more likely to develop dementia. But, most studies have only examined an older adult’s depressive symptoms at one point in time. This is an important limitation because we know that depressive symptoms change over time and that older adults show different patterns of depressive symptoms over time. For the present study, older adults were followed for several years. We assessed what patterns of depressive symptoms they tended to have during the early years of the study, and then investigated whether these different patterns were associated with who developed dementia during the later years of the study. MedicalResearch.com: What are the main findings? Response: Older adults in this study tended to show one of 3 different patterns of depressive symptoms. Most tended to have few, if any, symptoms over time. Some tended to have a moderate level of depressive symptoms at the beginning of the study, which increased over time. And others tended to have a high level of depressive symptoms at the beginning of the study, which increased over time. We found that older adults with the high-and-increasing depressive symptoms pattern were almost twice as likely to develop dementia than those with minimal symptoms, even when accounting for other important factors. While older adults with the moderate-and-increasing depressive symptom pattern were also somewhat more likely to develop dementia, this association was not as strong and did not hold up in our statistical models when we accounted for what individuals’ cognitive functioning was like during the early years of the study.18 Mar Familial Hypercholesterolemia Likely Underrecognized
MedicalResearch.com Interview with: [caption id="attachment_22561" align="alignleft" width="140"]
Dr. Sarah de Ferranti[/caption]
Dr. Sarah de Ferranti MD MPH
Boston Children’s Hospital
Director, Preventive Cardiology Program
Assistant Professor of Pediatrics
Harvard Medical School
MedicalResearch.com: What are the main findings?
Dr. de Ferranti: Familial hypercholesterolemia, or FH, is a genetic condition that causes severely elevated cholesterol levels from birth and is a leading cause of early heart attack. It is generally slowly progressive without symptoms until there is serious heart disease in the 3rd and 4th decade of life, making it important to look for it at a young age. Prior to this analysis it was thought that FH affected about 1 in 500 adults. The current study used data from 36,949 adults who took part in the 1999-2012 National Health and Nutrition Examination Survey (NHANES) and extrapolated to the 210 million U.S. adults aged 20 years and older. We identified cases of probably or definite Familial hypercholesterolemia in our analysis by using a combination of high levels of low-density-lipoprotein cholesterol (considered “bad” because it contributes to plaque buildup in arteries) and early heart disease in a person or close relative.
18 Mar Better Cardiovascular Health Associated With Better Cognitive Functioning
MedicalResearch.com Interview with: Hannah Gardener, ScD Department of Neurology, Miller School of Medicine University of Miami Miami, FL MedicalResearch.com: What is the background for this study? Response: At the beginning of the study, 1,033 participants in the Northern Manhattan Study (average age 72; 65 percent Hispanic, 19 percent black and 16 percent white), were categorized using the American Heart Association’s “Life’s Simple Seven®” definition of cardiovascular health, which includes tobacco avoidance, ideal levels of weight, physical activity, healthy diet, blood pressure, cholesterol and glucose. The participants were tested for memory, thinking and brain processing speed. Brain processing speed measures how quickly a person is able to perform tasks that require focused attention. Approximately six years later, 722 participants repeated the cognitive testing, which allowed us to measure performance over time. The cardiovascular health factors, which have been shown to predict risk of stroke and myocardial infarction, were then examined in relation to cognitive performance and impairment over time.18 Mar Maternal Weight, Blood Glucose and Blood Pressure Affect Baby’s Birth Weight
Posted at 00:47h
in Author Interviews, Blood Pressure - Hypertension, Diabetes, JAMA, Weight Research
MedicalResearch.com Interview with:
Debbie Lawlor PhD
School of Social and Community Medicine
University of Bristol, Oakfield House, Oakfield Grove
Medical Research Council Integrative Epidemiology Unit
University of Bristol, UK and
Rachel Freathy PhD,
University of Exeter, Institute of Biomedical and Clinical Science,
Royal Devon and Exeter Hospital, Exeter UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A healthy birth weight is important for babies’ health and wellbeing in the first year of their life. It reflects how well the baby has grown and developed in the womb. The experience of fetuses in the womb and how well they grow and develop might also determine their future health, even into adulthood. Both being too light or too heavy at birth is not good for the baby. Lots of studies have shown that mothers who are fatter at the start of their pregnancy have babies who are more likely to be heavier. But is it not clear whether the mother being fatter causes their baby to be bigger at birth. If mothers’ fatness does cause their baby to be heavier at birth, why this happens is not clear.
We used genes to find out whether being fatter in pregnancy causes babies to be born heavier. We also tested whether risk factors in the mother that are affected by her fatness, such as her blood pressure, and the level of glucose (sugar) and lipids (fats) in her blood stream affect how heavy her baby is.
Our results showed that being fatter during pregnancy did cause a mothers’ baby to be born heavier. We also showed that having higher blood levels of glucose in pregnancy also caused a mothers’ baby to be heavier. But we did not find any effect of mothers’ blood levels of lipids in pregnancy on their baby’s weight. Whilst mothers who are heavier in pregnancy will tend to have higher blood pressure in pregnancy we found that higher blood pressure caused the women’s babies to be lighter.