Author Interviews, Biomarkers, Melanoma, NYU, Personalized Medicine / 24.02.2015

Iman Osman, MD Professor, Departments of Dermatology, Medicine and Urology Associate Director, NYU Cancer Institute Director, Interdisciplinary Melanoma Program New York University Langone Medical Center New York, NY 10016MedicalResearch.com Interview with: Iman Osman, MD Professor, Departments of Dermatology, Medicine and Urology Associate Director The Laura and Isaac Perlmutter Cancer Center Director, Interdisciplinary Melanoma Program New York University Langone Medical Center New York, NY 10016 MedicalResearch: What is the background for this study? What are the main findings? Dr. Osman: We were interested in exploring molecules that could be biomarkers or functional regulators of metastasis in melanoma in early-stage tumor lesions on the skin. Though these tumors are treated largely the same (by surgical removal ), patients with these tumors have vastly different outcomes (apparent cure vs. metastatic spread of the disease). The reasons for these disparities are unclear and we have little ability to identify or predict the patients that will be cured and those that won’t. We also don’t have much data to know even if these tumors have differences at the molecular level. Our findings indicate that there are molecular differences in these tumors and that some of these differences contribute to tumor spread.  (more…)
AHA Journals, Author Interviews, Gender Differences, Heart Disease, Women's Heart Health / 24.02.2015

Jennifer L. Cook, MD FAHA Assistant Professor of Medicine | Heart Failure and Transplantation Medical Director Left Ventricular Assist Device Program Medical University of South Carolina Charleston, SC 29425MedicalResearch.com Interview with: Jennifer L. Cook, MD FAHA Assistant Professor of Medicine | Heart Failure and Transplantation Medical Director Left Ventricular Assist Device Program Medical University of South Carolina Charleston, SC 29425 Medical Research: What is the background for this study? What are the main findings? Dr. Cook: Although the incidence of heart failure is similar in men and women, women are more likely to die from it.  Despite this fact a common misperception persists that men are at greater risk.  Although advanced therapies such as mechanical support are as effective in women as in men, women are less likely to receive mechanical support.  In clinical trials investigating mechanical support as a bridge to transplant less than 30% of patients were women.  In trials investigating mechanical support for patients ineligible for heart transplant even fewer were women, less than 20%.  . Medical Research: What should clinicians and patients take away from your report? Dr. Cook: It has been shown that women with heart failure are more likely to remain under the care of a primary physician instead of being referred for specialized cardiovascular care.  The explanation for this pattern is not understood.  It is important to raise awareness and emphasize the high risk of heart failure mortality among women. (more…)
Allergies, Author Interviews, Microbiome, Pediatrics / 24.02.2015

Dr. Bill Hesselmar University of Gothenburg SwedenMedicalResearch.com Interview with: Dr. Bill Hesselmar University of Gothenburg Sweden MedicalResearch: What is the background for this study? What are the main findings? Dr. Hesselmar: The hygiene hypothesis is the background for this study, and the hypothesis states that children’s immune system need to be stimulated by bacteria and microbes to mature in a proper way prevent the children from developing immune mediated diseases such as allergies. There are increasing support for the hygiene hypothesis, with less allergies found in children from milieus with a rich microbial exposure such as: growing up on a farm or in a developing country, in children with many siblings, and after vaginal delivery as compared to caesarean section. Even though these findings are interesting from a theoretical point of view, they can’t be use in primary prevention since you can’t recommend anyone to live by a farm. We are investigating if there are harmless “microbial sources” in different daily life-situations that are good enough to stimulate children’s immune system. So far we have observed two such possible sources, the sharing of children’s pacifier (Pediatrics 2013) and hand dishwashing (this study). These are, however, only observational data – we have only found an association between hand dishwashing and a lower risk of allergy, we don’t know for sure that the lower risk of allergy was just because of the hand dishwashing. So far we regard it as an “interesting observation”, which need to be confirmed in new studies before any general conclusions could be made. The main findings was a lower risk of allergy (Odds Ratio 0,57) in children from hand dishwashing families as compared to children from families who use machine dishwashing.        (more…)
AHA Journals, Author Interviews, Gender Differences, Heart Disease, University of Michigan, Women's Heart Health / 24.02.2015

Claire Duvernoy, MD Chief, Cardiology Section VA Ann Arbor Healthcare System Professor of Medicine University of Michigan Health System Ann Arbor, MI MedicalResearch.com Interview with: Claire Duvernoy, MD Chief, Cardiology Section VA Ann Arbor Healthcare System Professor of Medicine University of Michigan Health System Ann Arbor, MI MedicalResearch: What is the background for this study? What are the main findings? Dr. Duvernoy: We wanted to look at the indications and outcomes for women veterans undergoing cardiac catheterization procedures as compared with men veterans, given that we know that there are significant gender differences in the non-veteran population between women and men undergoing cardiac catheterization. (more…)
Author Interviews, Dermatology, Nature / 23.02.2015

Chwee Teck (C.T.) LIM PhD Provost’s Chair Professor, Deputy Head, Department of Biomedical Engineering & Department of Mechanical Engineering Principal Investigator, Mechanobiology Institute Faculty Fellow, Singapore-MIT Alliance for Research & Technology (SMART) National University of Singapore Faculty of Engineering, SingaporeMedicalResearch.com Interview with: Chwee Teck (C.T.) LIM PhD Provost’s Chair Professor, Deputy Head, Department of Biomedical Engineering & Department of Mechanical Engineering Principal Investigator, Mechanobiology Institute Faculty Fellow, Singapore-MIT Alliance for Research & Technology (SMART) National University of Singapore   Medical Research: What is the background for this study? What are the main findings? Professor Chwee Teck Lim: Epithelial cells have a natural tendency to close gaps and this feature plays a crucial role in many biological processes such as embryological development and wound healing. For example, skin does consist of epithelial cells that when wounded, will elicit closure to initiate healing.  How epithelial cells close such gaps has always fascinated researchers from across many disciplines. It is generally accepted that two major mechanisms exist that underlie such a closure. The first is a "cell-crawling" mechanism wherein cells at the edge of the gap actively send protrusions or lamellipodia and use them as footholds to migrate over the gap. However, such a migration requires that the gap is conducive for cells to attach and form adhesions or footholds. The second mechanism is based on a coordinated contraction of multiple bundles of cellular cytoskeletal components (bundles of actin) in a manner similar to that of a "purse-string". Despite many studies, it has always been difficult to understand and characterize these processes separately since most often they co-exist. In this study, we show that keratinocyte monolayers have a tendency to close circular non-adhesive gaps (gaps that have been coated with a polymer that does not allow cells to adhere or form foot-holds) through contraction of bundles of actin within cells at the edge of the gap. We find that such as closure is strongly affected by the size of the gap (gaps more than 150 um in diameter have a tendency to close only partially), curvature of the gap (gaps with high curvature show better closure), and strength of intercellular adhesion (poor intercellular adhesion completely inhibits closure of non-adhesive gaps). (more…)
Author Interviews, Gender Differences / 23.02.2015

photo_Vasileios ZikosMedicalResearch.com Interview with: Dr. Vasileios Zikos Assistant Professor Research Institute for Policy Evaluation and Design (RIPED) and School of Economics University of the Thai Chamber of Commerce (UTCC) Bangkok, Thailand Medical Research: What is the background for this study? What are the main findings? Dr. Zikos: Economic studies that look at subjective well-being typically focus on how and why life circumstances affect an individual’s life satisfaction. While such studies provide valuable insights on the average effects of life changes, they often find substantial variability in the way individuals react to life events. In this study we take a step toward identifying sources of individual heterogeneity by focusing on the link between physical or mental illnesses and health satisfaction and asking whether gender and personality can explain how people cope with becoming ill. Earlier studies in psychology suggest that personality traits might be relevant to health and health-related behaviors. This allows us to hypothesize what could be the specific role of personality traits when people confront being ill. Our study is based on data collected in the British Household Panel Survey, a national longitudinal data set from the United Kingdom. The survey asked people about their happiness and satisfaction with aspects of their life. It also asked about their physical and mental health and about their personalities, among other things. Our study separates people into three groups: with physical illness only, with mental illness only and with both physical and mental types of illness. Because earlier studies found evidence of personality differences between genders, we conduct our analysis separately for men and women. We found that illness implies a strong negative effect on the individual’s health satisfaction. Men are less affected by a single-symptom illness than women, but are more affected when more than one symptom is present. The number of symptoms doesn’t change how women are affected. Moreover, women with one of two distinct personality types are less affected by mental illness than all other personality types. The first personality type, high levels of agreeableness, experience high quality relationships in their lives. The second type, women with low levels of conscientiousness, have little need for achievement, order or persistence. For men, however, we did not find statistical evidence that personality affects how they cope with illness. (more…)
Author Interviews, Hepatitis - Liver Disease / 23.02.2015

Andrew L. Mason MBBS MRCPI Professor of Medicine, Senior Scholar, Alberta Heritage Foundation for Medical Research Director, The Applied Genomic Core, Division of Gastroenterology and Hepatology University of Alberta, EdmontonMedicalResearch.com Interview with: Andrew L. Mason MBBS MRCPI Professor of Medicine, Senior Scholar, Alberta Heritage Foundation for Medical Research Director, The Applied Genomic Core, Division of Gastroenterology and Hepatology University of Alberta, Edmonton Medical Research: What is the background for this study? What are the main findings? Response: The study of viruses resembling mouse mammmary tumour virus (MMTV) dates back to the 1970s when virus like particles were discovered in breast milk of breast cancer patients. The virus was detected at low levels and ultimately researchers met a stalemate by the 1980s because no one could prove the existence of this agent. Interest waned in the study of betaretroviruses in humans when HIV was discovered in the 1980s. We first found a similar agent in patients with primary biliary cirrhosis, an autoimmune liver disease in 2003. History repeated itself in as much as others could not find the virus and challenged us to show that a significant amount of patients had evidence of proviral integrations into the human genome, the gold standard for providing proof of retroviral infection. This we achieved by isolating biliary epithelium from patients undergoing liver transplantation and then investigating the presence of betaretrovirus proviral integrations in DNA extracted from liver, lymph nodes and biliary epithelial cells using a ligation mediated PCR technique coupled with next generation sequencing. The majority of patients with primary biliary cirrhosis had viral integration and RNA detected in their biliary epithelium, the site of disease and lymph nodes; however, the virus was difficult to detect in whole liver, reflecting the problem with prior studies. (more…)
Allergies, Microbiome / 23.02.2015

Christine Cole Johnson, PhD, MPH Senior Staff Epidemiologist & Henry Ford Distinguished Scientist Department Chair Department of Public Health Sciences Henry Ford Hospital and Health System Detroit MichiganMedicalResearch.com Interview with: Christine Cole Johnson, PhD, MPH Senior Staff Epidemiologist & Henry Ford Distinguished Scientist Department Chair Department of Public Health Sciences Henry Ford Hospital and Health System Detroit Michigan   Medical Research: What is the background for this study? What are the main findings? Dr. Johnson: Our research group is focused on the environmental and infant gut microbiomes. We are interested in studying what environmental, lifestyle and behavioral factors affect the microbial community of the baby's gastrointestinal tract, and how that microbial community composition affects the development of allergic disorders. We have been following a birth cohort called WHEALS in Detroit and its suburbs since 2003, collecting data on potential risk and preventive factors as well as environmental samples and stool samples from the babies. We have used sequencing of the v4 region of the 16s rRNA gene, common and unique to all bacteria, to develop a fingerprint of the bacterial community in the stool samples. We have found that many variables shown in the past by ourselves and others to allergic disorders are associated with different types of bacterial communities, such as breastfeeding, mode of delivery, first born status, socioeconomic status, pets in the home, levels of endotoxin in the home, and environmental tobacco smoke. Current breastfeeding is the most important variable at both 1 and 6 months, and at one month, mode of delivery is next most important. Endotoxin levels in house dust samples, a crude marker of bacteria levels, are important at 1 month but even more important at 6 months. We also found that certain bacterial community patterns in the baby's gut impact whether or not they have parental-reported allergic symptoms when exposed to cats and dogs when the children are about 4 years of age. (more…)
Author Interviews, Melanoma, Yale / 22.02.2015

Douglas E. Brash, PhD Professor of Therapeutic Radiology and Dermatology Yale School of Medicine New Haven, CTMedicalResearch.com Interview with: Douglas E. Brash, PhD Professor of Therapeutic Radiology and Dermatology Yale School of Medicine New Haven, CT MedicalResearch: What is the background for this study? What are the main findings? Dr. Brash: We wanted to know whether the origin of melanoma differed from other cancers because of the melanin. It has long been known that blondes and redheads are sensitive to sunlight, but the prevailing view was that this was because their skin is light. But there are light-skinned, dark-haired people in countries near the equator and they don't have the high skin cancer incidence seen in Australia. Several labs, including ours, had irradiated cells or mice with UV and found more cell death in cells containing melanin than cells lacking melanin. In the last couple of years, two papers have focused attention on the issue; one study found that irradiating mice with UVA only gave melanomas if the skin contained melanin and the other study found that mice genetically predisposed to UV-induced melanoma developed melanomas even without UV if they also had red melanin. The most important findings are: First, our skin continues to be damaged by sunlight even when we're out of the sun. Second, the melanin pigment in your skin is bad for you as well as good: it may be carcinogenic as well as protective. Third, the chemistry underlying these events, chemical excitation of electrons, has not been seen in mammals before. (more…)
Author Interviews, Hormone Therapy, Lancet, Prostate Cancer, Radiation Therapy / 22.02.2015

Almudena Zapatero MD PhD Senior Consultant Dpt Radiation Oncology Instituto Investigación Sanitaria IIS-IP Hospital Universitario de la Princesa MadridMedicalResearch.com Interview with: Almudena Zapatero MD PhD Senior Consultant Dpt Radiation Oncology Instituto Investigación Sanitaria IIS-IP Hospital Universitario de la Princesa Madrid Medical Research: What is the background for this study? What are the main findings? Dr. Zapatero: There is a significant body of evidence from randomized trials showing a significant improvement in clinical outcome with the combination of androgen deprivation and conventional-dose radiotherapy (≤70 Gy) in patients with high-risk and intermediate-risk prostate cancer. However, the optimal duration the optimum duration of androgen deprivation in the setting of high-dose radiotherapy remained to be determined. The results of our trial (DART01/05) show that 2 years of adjuvant androgen deprivation is superior to 4 months androgen deprivation when combined with plus high-dose radiotherapy  in terms of biochemical control, freedom from metastasis and overall survival, particularly in patients with high-risk prostate cancer. (more…)
Author Interviews, Surgical Research / 22.02.2015

Dr. Y. Eltahir University Medical Centre Groningen Department of Plastic Surgery Groningen, The NetherlandsMedicalResearch.com Interview with: Dr. Y. Eltahir University Medical Centre Groningen Department of Plastic Surgery Groningen, The Netherlands Medical Research: What is the background for this study? What are the main findings? Dr. Eltahir: There are different options for breast reconstruction. They are divided into two main groups; autologous or implant breast reconstructions. all may have their effect on the quality of life and might have surgical complications. We were interested to know which breast reconstruction method may provide a better quality of life. However, we wanted to know this information from the patients point of view, that’s why we used the Breast-Q which is a case specific instrument, to compare the two groups. We found out that women with autologous breast reconstruction were more satisfied their breast than the implant group. However, this group has more secondary corrections than the control group. Further were no differences between the two groups. (more…)
Author Interviews, Brain Injury, Stroke / 22.02.2015

Bruno Meloni PhD Centre for Neuromuscular and Neurological Disorders The University of Western Australia, Nedlands, Western Australia, AustraliaMedicalResearch.com Interview with: Bruno Meloni PhD Centre for Neuromuscular and Neurological Disorders The University of Western Australia, Nedlands, Western Australia, Australia MedicalResearch: What is the background for this study? A/Prof Meloni: Due to the lack of clinically available neuroprotective drugs to minimize brain injury after stroke we had been working in the neuroprotection field for some years within the Stroke Research Group at the WA Neuroscience Research Institute. With respect to the latest findings, we were using arginine-rich peptides for several years as delivery vehicles to introduce experimental “neuroprotective peptides” into brain cells and the brain. Peptides are small chains of amino acids and the building blocks of protein.  Arginine is one of the twenty amino acids naturally produced in the body.  Arginine-rich peptides have an unique property in that they can transverse cell membranes and gain entry into cells, and even cross the blood brain barrier, which is unusual as most drugs able unable to do so. Using in vitro neuronal cell culture stroke models we soon discovered that poly-arginine and arginine-rich peptides on their own possessed potent neuroprotective properties.  Furthermore, we showed that as the length of the poly-arginine peptide increased so did the peptides neuroprotective properties.  Excitingly, the poly-arginine peptides were even more potent than the ”neuroprotective peptides” we had been working with and peptides developed by other overseas researchers. We have now confirmed using a laboratory animal stroke model that poly-arginine peptides could reduce brain damage when administered up to 1-hour after the stroke. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Prostate Cancer, Radiation Therapy / 22.02.2015

Ann Caroline Raldow, M.D. Brigham and Women's Hospital Resident in Radiation OncologyMedicalResearch.com Interview with: Ann Caroline Raldow, M.D. Brigham and Women's Hospital Resident in Radiation Oncology Medical Research: What is the background for this study? What are the main findings? Dr. Raldow: Active surveillance (AS) means monitoring the course of prostate cancer (PC) with the expectation to start treatment if the cancer progresses. Men who enter an AS program are able to defer and possibly avoid the side effects of prostate cancer treatment. According to the National Comprehensive Cancer Network (NCCN) guidelines, active surveillance is currently considered as an initial treatment approach for men with low-risk PC and a life expectancy of at least 10 years. However, no direct comparison has been made between favorable intermediate-risk and low-risk PC with regard to PC-specific mortality or all-cause mortality following treatment with high-dose radiation therapy such as brachytherapy, where radioactive seeds are placed inside the prostate to kill the cancer. We therefore assessed whether the risks of prostate cancer-specific mortality and all-cause mortality following brachytherapy were increased in men with favorable intermediate-risk versus low-risk prostate cancer. The study consisted of more than 5,000 men who were treated with brachytherapy at the Prostate Cancer Foundation of Chicago. After a median follow-up of 7.69 years, there were no significant differences in prostate cancer-specific mortality and all-cause mortality between men with low-risk and favorable intermediate-risk prostate cancer, suggesting that men with favorable intermediate-risk prostate may also be candidates for AS. (more…)
Author Interviews, CDC, Opiods, Pharmacology / 21.02.2015

Dr. Zhou Yang Office of the Associate Director for Policy Centers for Disease Control and Prevention, Atlanta, GAMedicalResearch.com Interview with: Dr. Zhou Yang Office of the Associate Director for Policy Centers for Disease Control and Prevention, Atlanta, GA Medical Research: What is the background for this study? Response: Prescription drug misuse and abuse, largely those involving opioid painkillers, have been characterized as an epidemic. According to a CDC report, drug-related overdose has surpassed traffic crashes to become the leading cause of injury death in the U.S. in 2009. Medicaid programs in most states implement Patient Review and Restriction (PRR) programs, also called ‘lock-in’ program. The PRR programs use a set of behavioral indicators to identify patients at higher risk of opioid drug misuse and abuse, and ‘locks’ them in to a designated provider, pharmacy, or both. Pharmacy shopping is one of the key indicators employed by the PRR program. However, definition of pharmacy shopper varies widely across states. In addition, the PRR programs have not paid attention to the indicators of prescribing overlapped drugs, which we see as a missed opportunity to help the PRR program to better target users at high risk of overdose. Medical Research: What are the main findings? Response: Among a number of currently used definitions of pharmacy shopping, we found that the definition of ‘four or more pharmacies visited within any 90-day period’ is the most effective one. We also found that having overlapping opioid prescriptions is associated with an elevated risk of overdose. In fact, patients who exhibited both pharmacy shopping and having overlapping prescription had more than twice the risk of overdose than those who only exhibited pharmacy shopping. (more…)
Author Interviews, BMJ, NIH, Pediatrics, Weight Research / 21.02.2015

Yeyi Zhu, PhD IRTA Postdoctoral Fellow Epidemiology Branch Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIHMedicalResearch.com Interview with: Yeyi Zhu, PhD IRTA Postdoctoral Fellow Epidemiology Branch Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH MedicalResearch: What is the background for this study? What are the main findings? Dr. Zhu: Currently in the US, nearly two thirds of reproductive-aged women are overweight or obese. Moreover, the amount of weight gained during pregnancy can have immediate and long-lasting impacts on health of a woman and her infant. Previous evidence implicates that excessive gestational weight gain above the Institute of Medicine guidelines is related to high birthweight (>4000 g), a marker of intrauterine over-nutrition which may impose a greater risk of offspring’s obesity and metabolic diseases in later life. Given that more than one third of children and adolescents are overweight or obese in the US, it is of great public health significance to improve our understanding of determinants and mediators of childhood obesity. The length of breast feeding and age at introduction of solid foods are infant feeding practices that are potentially modifiable in early life. We therefore examined whether birthweight and infant feeding practices, specifically length of breast feeding, mediate the relationship between maternal gestational weight gain and childhood growth in the National Children’s Study Formative Research in Anthropometry, a cross-sectional multi-ethnic study of 1387 mothers and their children aged 0-5.9 years in the US (2011-2012). We illustrated that the intergenerational relationship between maternal gestational weight gain and early childhood growth (i.e., z scores for weight-for-age, weight-for-height, and body mass index-for-age) largely acts through birthweight rather than directly on childhood growth. Further, given the negative association of breastfeeding duration with childhood anthropometrics, longer length of breastfeeding suppressed the positive associations of gestational weight gain and birthweight with childhood growth. In addition, analysis by ethnicity revealed that these associations were only significant in non-Hispanic White and non-Hispanic Black participants as opposed to Hispanics and other ethnicities. (more…)
Author Interviews, Electronic Records / 21.02.2015

Rally HealthMedicalResearch.com Interview with: Brian Dolan Chief Strategy and Partner Integration Officer Rally Health MedicalResearch.com Editor’s note: On February 3, 2015, Rally Health launched a New HIPPA compliant Digital Engagement platform that gives consumers the support and tools they need to better manage their health and well-being. Brian Dolan, the Chief Strategy and Partner Integration Officer at Rally Health, was kind enough to answer questions regarding the new health care interface for the readers of MedicalResearch.com. MedicalResearch: What is the background or vision for the Rally Health digital engagement platform? Mr. Dolan: We designed the platform to give consumers the support and tools they need to better manage their health and well-being. Rally leverages the power of personal health data, social networking, and gamification to encourage consumers to take control of their health. Rally’s proven behavior-changing technology encourages consumers to manage their own health by inspiring sustained action and offering intrinsic and extrinsic value-based incentives for engagement. Members can also meet other Rally users for ongoing support and encouragement. With the right balance of social and digital connectivity, Rally Health creates a modern consumer experience that makes getting healthy personal, relevant and fun. (more…)
Author Interviews, JAMA, Prostate Cancer / 21.02.2015

Karim Chamie MD Department of Urology Ronald Reagan UCLA Medical Center UCLA Medical Center, Santa MonicaMedicalResearch.com Interview with: Karim Chamie MD Department of Urology Ronald Reagan UCLA Medical Center UCLA Medical Center, Santa Monica   Medical Research: What is the background for this study? What are the main findings? Response:  Active surveillance has been shown to be safe and effective. There are multiple longitudinal studies that have demonstrated the safety of active surveillance for men with indolent prostate cancer. In this context, we sought out to determine national practice patterns for localized prostate cancer. Moreover, we wanted to identify patient, tumor, and physician factors that influence treatment decision. What we found was that the vast majority of patients undergo radiation therapy, regardless of patient age and health or severity of tumor. Instead, by far the most significant predictor of whether a patient undergoes radiation therapy is whether they have been referred to a radiation oncologist. On the other hand, surgeons significantly incorporate patient age and health and tumor severity when considering radical prostatectomy (surgery). (more…)
Aging, AHA Journals, Author Interviews, Exercise - Fitness / 20.02.2015

Thomas W. Buford, PhD Assistant Professor, Division of Clinical Research Department of Aging and Geriatric Research, University of Florida College of Medicine Director, Health Promotion Center University of Florida Institute on AgingMedicalResearch.com Interview with: Thomas W. Buford, PhD Assistant Professor, Division of Clinical Research Department of Aging and Geriatric Research, University of Florida College of Medicine Director, Health Promotion Center University of Florida Institute on Aging Medical Research: What is the background for this study? What are the main findings? Dr. Buford: This study was a cross-sectional analysis of data collected from over 1000 older adults upon their entry into the Lifestyle Interventions and Independence for Elders (LIFE) study. Briefly, participants were recruited into the LIFE Study who were over 70 years of age, sedentary, and had mobility limitations. The objective of this study was to examine, at baseline prior to their participation in the study interventions, the association between daily physical activity habits and risk of major cardiovascular events (i.e. heart attack and coronary-related death). The study utilized accelerometers, devices designed to identify and quantify human movement, to measure participant’s daily activity. Predicted risk of cardiovascular events was determined using a risk score established in the Framingham Heart Study. As identified by accelerometry measures, participants spent on average 70% of their waking hours being sedentary. The major finding of the study, however, was that even extremely low-level activity was associated with an improved cardiovascular risk profile. For every 25-30 minutes a participant was sedentary per day, predicted risk was 1 percent higher. Conversely, But activity identified as slightly above sedentary — which could be light housework or slow walking — was associated with higher levels of the more beneficial kind of cholesterol, HDL, in people with no history of heart disease. (more…)
Author Interviews, Diabetes, Exercise - Fitness, Pain Research, Weight Research / 20.02.2015

Dan White PT , ScD, Msc University of DelawareMedicalResearch.com Interview with: Dan White PT , ScD, Msc University of Delaware Medical Research: What is the background for this study? What are the main findings? Dr. White: We know that diet and exercise are beneficial to reduce knee pain, however it is not known whether diet and exercise can actually prevent the development of knee pain in people at high risk.  We found that an intensive program of diet and exercise had a small but statistically significant protective effect with preventing the development of knee pain in overweight and obese people with diabetes. (more…)
Author Interviews, Connective Tissue Disease, Emory, Kidney Disease, Race/Ethnic Diversity / 20.02.2015

Laura Plantinga, PhD Assistant Professor Division of Renal Medicine, Department of Medicine Emory University School of Medicine Atlanta, GA 30322MedicalResearch.com Interview with: Laura Plantinga, PhD Assistant Professor Division of Renal Medicine, Department of Medicine Emory University School of Medicine Atlanta, GA 30322 Medical Research: What is the background for this study? What are the main findings? Dr. Plantinga: Quality of care for end-stage renal disease (ESRD), which is treated with dialysis or kidney transplantation, is a high priority for the U.S. healthcare system, given universal coverage of these services. However, quality of ESRD care remains relatively unexplored in lupus patients, who have multiple providers and may have greater access to care. We found that, overall, nearly three-quarters of U.S. ESRD patients with lupus had pre-ESRD nephrology care and about 20% of lupus patients on dialysis were waitlisted for kidney transplant per year; however, fewer than one-quarter of those who started on dialysis had a permanent vascular access in place, which is associated with better outcomes than a temporary catheter. Furthermore, patients who were black or Hispanic were nearly a third less likely to have pre-ESRD care and were also less likely to be placed on the kidney transplant waitlist in the first year of dialysis than white patients. Having Medicaid or no insurance at the start of ESRD were both associated with lower likelihood of quality ESRD care by all measures, despite universal Medicare coverage after the start of ESRD. While there was geographic variation in quality of ESRD care, patterns were not consistent across quality measures. (more…)
Author Interviews, Pediatrics, Pediatrics / 20.02.2015

Katherine M. Keyes, Ph.D. Assistant Professor of Epidemiology Columbia University Mailman School of Public Health New York, NY 10032MedicalResearch.com Interview with: Katherine M. Keyes, Ph.D. Assistant Professor of Epidemiology Columbia University Mailman School of Public Health New York, NY 10032 Medical Research: What is the background for this study? What are the main findings? Dr. Keyes: The Monitoring the Future study is an annually conducted survey of 8th, 10th, and 12th grade high school students in the United States, covering a wide range of adolescent health behaviors. The same questions on adolescent sleep were queried every year since 1991, allowing us to examine historical trends in the amount of sleep adolescents report. We found that there have been substantial decreases in the proportion of adolescents who report 7 or more hours of sleep on a regular basis, across all age groups and across all demographic groups. In the most recent years, after age 15, less than half of adolescents report regularly getting 7 or more hours of sleep every night. Given the importance of sleep in both the short and the long term for adolescent health, these findings suggest substantial public health concern. (more…)
Author Interviews, Diabetes, Ophthalmology, UCLA / 20.02.2015

Rohit Varma, MD, MPH Professor and Chair, Department of Ophthalmology USC Eye Institute, Keck School of Medicine University of Southern California, Los Angeles, CaliforniaMedicalResearch.com Interview with: Rohit Varma, MD, MPH Professor and Chair, Department of Ophthalmology USC Eye Institute, Keck School of Medicine University of Southern California, Los Angeles, California Medical Research: What is the background for this study? What are the main findings? Dr. Varma: The Centers for Disease Control and Prevention estimates that 4.4% of adults with diabetes aged 40 and older have advanced diabetic retinopathy that may result in severe vision loss. Clinical trials have shown that intravitreal injections of anti-VEGFs, such as ranibizumab, can reduce visual impairment and even in some cases improve visual acuity outcomes in patients with diabetic macular edema. We developed a model, based on data from the RIDE and RISE clinical trials, to estimate the impact of ranibizumab treatment on the number of cases of vision loss and blindness avoided in non-Hispanic white and Hispanic persons with diabetic macular edema in the United States.Results from the model suggest that, compared with no treatment, every-4-week ranibizumab 0.3 mg reduces legal blindness between 58%-88% and reduces vision impairment between 36%-53% over 2 years in this population. (more…)
Author Interviews, Genetic Research, JAMA / 20.02.2015

Dr. Peter Forster PhD Fellow of Murray Edwards College and McDonald Institute at the University of CambridgeMedicalResearch.com Interview with: Dr. Peter Forster PhD Fellow of Murray Edwards College and McDonald Institute at the University of Cambridge   Medical Research: What is the background for this study? What are the main findings?   Dr. Forster: As a result of our paternity testing work at the Institute for Forensic Genetics in Munster (Germany), we have accumulated a pool of over 24,000 parents and their children, of whom we know for certain that they are biologically related. Occasionally we observe a new mutation in these children, which must have come either from the sperm or the egg of one of the parents. As we analyse highly variable microsatellite DNA (a repetitive type of DNA, also know as STR DNA, which stands for "short tandem repeat" DNA), we can fairly easily find out whether the mutation has come from the mother or the father. It turns out that the fathers contribute 6-7 times more mutations to the children than the mothers do. This has long been known. What is new is that we have observed that the male and female teenagers at puberty do NOT set out with the same low mutation load, but instead, the teenage boys already have a sixfold higher mutation load in their sperm than the girls in their oocytes. (more…)
Author Interviews, BMJ, Nutrition, OBGYNE, Sugar / 20.02.2015

Ekaterina Maslova PhD Doctor of Science in Nutrition and Epidemiology Center for Fetal Programming Copenhagen, DenmarkMedicalResearch.com Interview with: Ekaterina Maslova PhD Doctor of Science in Nutrition and Epidemiology Center for Fetal Programming Copenhagen, Denmark Medical Research: What is the background for this study? What are the main findings? Response: From prior studies we know that excessive gestational weight gain (GWG) in pregnancy is associated with complications for both the mother and the child, including gestational diabetes, hypertension, and high birth weight. Understanding the factors that determine gestational weight gain would allow for interventions early on to improve pregnancy outcomes. Dietary intake has been found to influence gestational weight gain in other studies, but evidence is conflicting and still quite limited. In non-pregnant populations a high-protein diet was shown to decrease weight and improve weight maintenance. We therefore hypothesized that a similar relation may exist for gestational weight gain in pregnant women. In this study we had data on dietary intake of more than 45,000 Danish women who were pregnant between 1996 and 2002. We examined the relation between their intake of protein and carbohydrates and the rate of gestational weight gain (in grams per week). We found that women who consumed a high protein-to-carbohydrate (PC) ratio gained less gestational weight gain compared to women with a lower PC ratio in their diet. The results was stronger in women who started their pregnancy already overweight compared to normal weight women. Since a high PC ratio may result from either a high protein intake or low carbohydrate intake, we decided to focus on a component of carbohydrates that may increase gestational weight gain: added sugar. We found that pregnant women with higher intake of sugar gained more weight in pregnancy compared to those who consumed less added sugar. This averaged out to about 1.4 kg (or 7%) higher weight gain across the entire pregnancy. (more…)
Author Interviews, Diabetes, Heart Disease, Toxin Research / 20.02.2015

Katherine A James, PhD, MSPH, MSCE Colorado School of Public Health University of Colorado Denver, Aurora, ColoradoMedicalResearch.com Interview with: Katherine A James, PhD, MSPH, MSCE Colorado School of Public Health University of Colorado Denver, Aurora, Colorado Medical Research: What is the background for this study? What are the main findings? Dr. James: Exposure to inorganic arsenic in drinking water has been associated with several chronic diseases including cardiovascular disease and diabetes mellitus in areas with high levels of exposure.  Our study is one of the first to show association with cardiovascular disease and diabetes mellitus in a low-moderately exposed population. Our results show that for every 15 micrograms per liter of inorganic arsenic in drinking water the risk for CHD disease increased 38% and for diabetes it increases 27%. (more…)
Author Interviews, BMJ, Cancer Research / 20.02.2015

Dr Cristina Renzi Department of Epidemiology and Public Health, University College London, Health Behaviour Research Centre, London, UKMedicalResearch.com Interview with: Dr Cristina Renzi Department of Epidemiology and Public Health, University College London, Health Behaviour Research Centre, London, UK MedicalResearch: What is the background for this study? What are the main findings? Dr. Renzi: Only a minority of symptomatic individuals undergoing cancer investigations are diagnosed with cancer and more than 80% receive an 'all-clear' or non-cancer diagnosis (here called a 'false alarm'). This makes it important to consider the possible unintended consequences of a false alarm. Several studies have shown that investigations for a suspected cancer can have negative psychological effects, even for individuals ultimately diagnosed with a benign condition. In addition, an association between false alarms and subsequent delayed diagnosis has been reported for various cancers, with both patients and healthcare providers contributing to delays. Our review published by BMJ Open focused on 19 research papers which reported information on false alarms and subsequent symptom attribution or help-seeking. By integrating the available evidence from qualitative, quantitative and mixed methods studies this review allowed us to identify areas that need to be addressed in order to reduce the risk of delayed help-seeking after a previous false alarm. In particular, over-reassurance and under-support of patients can be an unintended consequence of a false alarm leading to delays in help-seeking, even years later, if patients notice possible symptoms of the disease again. The review, funded by Cancer Research UK, looked only at adult patients who had a false alarm after raising concerns about their symptoms; the effect of a false alarm might be different in patients who are investigated for suspected cancer following cancer screening. (more…)
Author Interviews, Education, Pediatrics / 20.02.2015

Julia Jaekel PhD Department of Developmental Psychology Ruhr-University Bochum in GermanyMedicalResearch.com Interview with: Julia Jaekel PhD Department of Developmental Psychology Ruhr-University Bochum in Germany   Medical Research: What is the background for this study? What are the main findings? Dr. Jaekel: Recent reports suggest that delayed school entry (DSE) may be beneficial for children with developmental delays. However, studies of the effects of DSE are inconclusive. Our study investigated the effects of delayed school entry versus age-appropriate entry (ASE) in a large sample after minimizing selection bias and accounting for confounding effects of preschool knowledge. We found that delayed school entry has no effect on Year 1 teacher ratings of academic performance. In contrast, DSE children’s standardized mean test scores of mathematics, reading, writing and attention at 8 years of age were lower than ASE children’s mean scores. (more…)
Author Interviews, Brain Injury, Neurology, Parkinson's / 20.02.2015

MedicalResearch.com Interview with: Line Kenborg, MSc, PhD Survivorship Unit Danish Cancer Society Research Center Copenhagen Medical Research: What is the background for this study? What are the main findings? Response: The hypothesis that head injuries increase the risk for Parkinson disease has been examined in many studies during the past decades, but the findings have been highly inconsistent. We have previously examined the hypothesis in a study based on information on head injuries and Parkinson disease from the Danish National Hospital Registry. In this study, we found a positive association between a hospital contact for a head injury in middle or late adulthood and a diagnosis of Parkinson disease. The reported association, however, was almost entirely due to injuries that occurred during the months preceding the first hospital contact for Parkinson disease. Because we used information from registries, we lacked detailed diagnostic information to distinguish Parkinson disease from other types of parkinsonism, and we had no information on milder head injuries and head injuries in early life. So we wanted to study whether head injuries throughout life increased the risk for Parkinson disease in the largest interview-based case-control study to date including patients with a verified diagnosis of Parkinson disease. The main finding of our study is that we do not find any association between head injuries and Parkinson disease. (more…)