Author Interviews, Cognitive Issues, Radiology / 08.10.2014

Sven Haller, M.D. University of Geneva in Geneva, Switzerland. MedicalResearch.com Interview with: Sven Haller, M.D. University of Geneva in Geneva, Switzerland. Medical Research: What are the main findings of the study? Dr. Haller: The main finding is that some elderly individuals with intact cognitive function at baseline already have visible alterations of the brain perfusion measured in Arterial Spin Labeling (ASL)  MRI, which is similar to patients with mild cognitive impairment (MCI). This elderly individual may initially maintain intact cognitive functions due to the activation of their cognitive reserve, yet eventually the cognitive reserve is exhausted and those individuals develop subtle cognitive decline at follow-up 18 months later. Consequently, Arterial Spin Labeling MRI may predict the very earliest form of cognitive decline. (more…)
Author Interviews, Nutrition / 08.10.2014

Dr. Wenjun Li PhD Associate Professor of Medicine (Biostatistics) University of Massachusetts Medical School of Medicine University of Massachusetts Medical SchoolMedicalResearch.com Interview with: Dr. Wenjun Li PhD Associate Professor of Medicine (Biostatistics) University of Massachusetts Medical School of Medicine University of Massachusetts Medical School Medical Research: What are the main findings of the study? Dr. Li:  The study discovered that the effectiveness of dietary interventions is significantly influenced by the presence of a supportive community nutrition environment. (more…)
Stroke / 07.10.2014

dr_john-falconerMedicalResearch.com Interview with: John Falconer MD FRCPC Neurologist, Kelowna General Hospital; Clinical Associate Professor of Neurology, University of British Columbia Medical Research: What are the main findings of this study? Dr. Falconer: This study set out to investigate the possible benefits of having a physician with a proprietorial interest (Pro-MD) in a stroke unit, tightly combined with a multidisciplinary inter-professional team, and including the family and the patient in as essential members for the management of a stroke patient. This also involved the introduction of a geographic located Acute Stroke Unit. We compared Acute Bed Days used by patients from the five months before to five months after this system was put in place. Our main end point was number of days in acute hospital care before and after, but we also informally tracked patient and caregiver satisfaction and staff morale. The Proprietary Physician, or Pro-M Drefers to a physician who has a “proprietorial” interest in a hospital unit or ward. In other words, I was working at this unit in a wholistic sense, trying not only to manage patients as best they can, but also interested in the patient flow and family-patient communications. We found that patient bed days were reduced by approximately 25% overall, while at the same time, patient and family satisfaction was improved, and staff morale increased. Initially, we had supposed that patients and their family would be more satisfied, but we were surprised at the reduction in Acute Bed Days that resulted. (more…)
Author Interviews, Breast Cancer / 07.10.2014

Professor Xiaodong Zhang Professor of Macromolecular Structure and Function Department of Medicine Imperial College, London, UKMedicalResearch.com Interview with: Professor Xiaodong Zhang Professor of Macromolecular Structure and Function Department of Medicine Imperial College, London, UK Medical Research: What are the main findings of the study? Prof. Zhang: Since its discovery 20 years ago, the BRCA2 gene and its protein product, BRCA2, have been under intensive investigations. The importance of the BRCA2 protein lies in the central roles it plays in the most faithful DNA damage repair pathway. Mutations in BRCA2 thus can cause defects in this repair pathway, making the repair inefficient or forcing cells to use alternative repair methods that are prone to mistakes, all of which contribute to mutations in the genomic DNA, thus increase the risk of cancer development. Our study aims to understand how BRCA2 works through studying its 3-dimensional structures and its interactions with other key partners in the repair pathway. Our study provides first 3-dimensional views of BRCA2 and BRCA2-RAD51 and reveals that BRCA2 molecules exist as pairs and a BRCA2 pair recruit two sets of RAD51 molecules arranged in opposite orientations. Our study also shows a single stranded DNA binds across the BRCA2 dimer and that BRCA2 increases the frequency of RAD51 filament formation events, presumably to increase the efficiency of establishing a longer filament required for searching for matching strands of DNA in intact sister chromatin. Our results thus not only define the precise roles of BRCA2 in helping RAD51 filament formation, but how it helps RAD51 loading onto single stranded DNA. (more…)
Author Interviews, Heart Disease, Hospital Readmissions / 07.10.2014

Elizabeth Blanchard Hills, BSN MSJ President, Informed Health SolutionsMedicalResearch.com Interview with: Elizabeth Blanchard Hills, BSN MSJ President, Informed Health Solutions Medical Research: What is your role? Response: My name is Elizabeth Blanchard Hills, BSN, MSJ.  My company, Informed Health Solutions, currently has the privilege of “transitioning” Dr. Smith’s work into clinical practice.  We have been conducting an on-going pilot project with the University of Kansas Hospital since November 2013, and our results are corroborating the results of Dr. Smith’s randomized clinical trial.  We have renamed SMAC-HF; it is now called CareConnext. Medical Research: What are the main findings of the study?  Response: That we could, in fact, significantly lower hospital readmissions among heart failure patients. (more…)
Author Interviews, Prostate Cancer, Testosterone / 07.10.2014

Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology, College of Medicine University of Illinois at Chicago Chicago, IL 60612MedicalResearch.com Interview with:  Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology, College of Medicine University of Illinois at Chicago Chicago, IL 60612 Medical Research: What are the main findings of the study? Dr. Bosland: The two main findings are : (1) that long-term, low-dose testosterone treatment induces prostate cancer in rats (none occurred in control rats) and increases the number of rats with malignant tumors at any site in the body compared to control rats, and (2) that in rats treated long-term with testosterone after a single prostate-targeted chemical carcinogen treatment a high incidence of prostate cancer is induced, even at a very low testosterone dose. (more…)
AHA Journals, Author Interviews, Heart Disease / 07.10.2014

Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, The Leon H. Charney Division of Cardiology, Associate Professor of Medicine, New York University School of MedicineMedicalReseach.com Interview with: Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, The Leon H. Charney Division of Cardiology, Associate Professor of Medicine, New York University School of Medicine New York, NY 10016. Medical Research: What are the main findings of the study? Dr. Bangalore: Using data from the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial, we found that β-blocker use in patients with prior myocardial infarction but no heart failure was associated with a lower composite cardiovascular outcome, driven mainly by lower risk of recurrent myocardial infarction with no difference in mortality. However, in patients without prior myocardial infarction there was no benefit of β-blocker use with a suggestion of increase in stroke risk. (more…)
Author Interviews, CMAJ, Diabetes, Thyroid Disease / 07.10.2014

MedicalResearch.com Interview with: Jean-Pascal Fournier, MD, PhD Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada and Laurent Azoulay, PhD Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Department of Oncology, McGill University, Montreal, Quebec, Canada Medical Research: What are the main findings of the study? Response: Patients with type II diabetes and treated hypothyroidism showed a 55% increased risk for low levels of thyroid stimulating hormone (TSH) (below 0.4 mIU/L) when initiating metformin, compared with those initiating sulfonylurea (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.09–2.20). In contrast, this effect of metformin was not observed in euthyroid patients, with an adjusted HR for low TSH of 0.97(95% CI 0.69–1.36). (more…)
Alzheimer's - Dementia, Author Interviews, Neurology / 07.10.2014

Lena Johansson, PhD, MSc, RN Institute of Neuroscience and Physiology Department of Psychiatry and Neurochemistry Sahlgrenska Academy at Gothenburg UniversityMedicalResearch.com Interview with: Lena Johansson, PhD, MSc, RN Institute of Neuroscience and Physiology Department of Psychiatry and Neurochemistry Sahlgrenska Academy at Gothenburg University Medical Research: What are the main findings of the study? Dr. Johansson: We found that a higher degree of neuroticism in midlife was associated with increased risk of Alzheimer’s disease over 38 years. On the 24 point scale, the risk increased with 4% per each step. Women who score high on the neuroticism scale were more likely to experience feelings such as anxiety, nervousness, worry, and irritability, and they were more moodiness and stress-prone. The association between neuroticism and Alzheimer’s disease diminished after adjusting for longstanding perceived distress symptoms, which suggest that the associations was at least partly depended on long-standing distress symptoms. When the two personality dimensions were combined, women with high neuroticism/low extraversion had a double risk of Alzheimer’s disease compared to those with low neuroticism/high extraversion. (more…)
AHA Journals, Author Interviews, Stroke / 07.10.2014

Vijaya Sundararajan, MD, MPH, FACP Associate Professor Head, Health Outcomes Group, Head, Biostatistics Hub Research Advisor, Centre for Palliative Care Department of Medicine Eastern Hill Academic Centre Melbourne Medical School Faculty of Medicine, Dentistry and Health Sciences University of MelbourneMedicalResearch.com Interview with: Vijaya Sundararajan, MD, MPH, FACP Associate Professor Head, Health Outcomes Group, Head, Biostatistics Hub Research Advisor, Centre for Palliative Care Department of Medicine Eastern Hill Academic Centre Melbourne Medical School Faculty of Medicine, Dentistry and Health Sciences University of Melbourne Medical Research: What are the main findings of this study? Dr. Sundararajan: The main findings of the study are that over the last 10 years, there has been a measurable decline in people having a stroke 3 months after a new mini stroke (TIA); a mini stroke is also known as a ‘warning sign for stroke’. There has also been an overall decline in of the proportion of people having these mini strokes in the Australian State of Victoria (population 5.6million). These trends probably reflect improved primary and secondary prevention efforts for the last decade. These improvements are likely to include increased use of preventive medications and surgery for carotid artery narrowing in people identified as being at high risk of having a stroke, as well as improved behaviors (e.g. reducing smoking, improving diets, uptake of physical activity, among others). The most important aspect of our results is many fewer strokes occur when people with a TIA are managed in a hospital with a stroke unit (up to 6%).  Even when the patient’s TIA is managed in an Emergency Department and the patient released without admission, if the hospital has a stroke unit, these patients appear to have better outcomes. This likely reflects the cohesion and organization of the stroke unit in implementing the necessary tests and treatments promptly, and setting up the infrastructure to follow patients up. (more…)
Author Interviews, General Medicine, Pediatrics, Sexual Health / 07.10.2014

Jeff R. Temple, PhD Associate Professor and Psychologist Director, Behavioral Health and Research Department of Ob/Gyn UTMB Health Galveston, TX 77555-0587MedicalResearch.com Interview with: Jeff R. Temple, PhD Associate Professor and Psychologist Director, Behavioral Health and Research Department of Ob/Gyn UTMB Health Galveston, TX 77555-0587 Medical Research: What are the main findings of the study? Dr. Temple: Through previous research, we know that teen sexting is related to actual sexual behaviors, but we did not have any information on the temporal link between these two behaviors. In short, we found that teens who sexted had 32% higher odds of being sexually active over the next year relative to youth who did not sext – this was even after controlling for history of prior sexual behavior, ethnicity, gender, and age. We also found that active sexting (actually sending a naked picture to another teen) mediated the relationship between passive sexting (asking for or being asked for a sext) and sexual behaviors. In other words, while sending a sext was predictive of subsequent sexual behavior, asking for/being asked for a sext was only associated with sexual behavior through its relationship with active sexting. (more…)
Author Interviews, Coffee, Kidney Stones / 06.10.2014

Pietro Manuel Ferraro, MD PhD Candidate Division of Nephrology Catholic University of the Sacred Heart Rome ItalyMedicalResearch.com Interview with: Pietro Manuel Ferraro, MD PhD Candidate Division of Nephrology Catholic University of the Sacred Heart Rome Italy Medical Research: What are the main findings of the study? Dr. Ferraro: We analyzed the association between caffeine intake and the risk of developing kidney stones in three large cohorts of U.S. health professionals. The 217,883 participants included did not have any history of kidney stones when follow-up began. During 20 years of follow-up, 4,982 of them developed a kidney stone. In all three cohorts, participants with higher intakes of caffeine had a reduced risk of developing kidney stones. Intake of caffeine from sources other than coffee was also associated with reduced risk of kidney stones. Among 6,033 participants with 24-hour urine data, intake of caffeine was associated with higher excretion of calcium but also higher urine volume and lower likelihood of calcium and uric acid stone formation. (more…)
Author Interviews, Dermatology / 06.10.2014

Conor L. Evans, PhD Assistant Professor Harvard Medical School Wellman Center for Photomedicine Massachusetts General Hospital Affiliate Faculty, Harvard University Biophysics Program Charlestown, MAMedicalResearch.com Interview with: Conor L. Evans, PhD Assistant Professor Harvard Medical School Wellman Center for Photomedicine Massachusetts General Hospital Affiliate Faculty, Harvard University Biophysics Program Charlestown, MA Medical Research: What are the main findings of the study? Dr. Evans: The main finding of this research is that topically applied rapid-drying wound dressings containing optical sensors for oxygen can be used to quantify skin oxygenation status in a way that reflects the viability of the underlying tissue, and therefore has the potential to aid in the clinical care for patients with burns, grafts and various other skin conditions. (more…)
Author Interviews, Melanoma, NYU / 06.10.2014

David Polsky, MD, PhD Alfred W. Kopf, MD, professor of Dermatologic Oncology Ronald O. Perelman Department of Dermatology NYU Langone Medical CenterMedicalResearch.com Interview with: David Polsky, MD, PhD Alfred W. Kopf, MD, professor of Dermatologic Oncology Ronald O. Perelman Department of Dermatology NYU Langone Medical Center Medical Research: What are the main findings of the study? Dr. Polsky: We utilized a multi-disciplinary approach including an analysis of socioeconomic factors to elucidate the evolution of attitudes and behaviors maximizing personal ultraviolet light exposure during the 20th century in the United States.  We then compared melanoma incidence rates from national cancer registries to estimated skin exposure and found that they rose in parallel. Though causation cannot be made in an analysis such as this one, this paper describes a historical context for the changing attitudes promoting increased UV exposure, and the rising incidence of melanoma throughout the past century.  It also provides a framework in which to consider public health and education measures that may ultimately help reverse melanoma incidence trends. (more…)
Author Interviews, Exercise - Fitness, Karolinski Institute, Ophthalmology / 04.10.2014

MedicalResearch.com Interview with: Jinjin Zheng Selin, MSc Unit of Nutritional Epidemiology Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden Medical Research: What are the main findings of the study? Response: Our results suggest that higher levels of total physical activity, especially in the long-term, as well as specific types of physical activity including walking/bicycling and work/occupational activity, may be associated with decreased risk of age-related cataract among middle-aged and elderly women and men. On the other side, high levels of leisure time inactivity may be associated with increased risk of cataract. (more…)
Alcohol, Author Interviews, BMJ / 04.10.2014

Professor Tina Kold Jensen MD Professor, Department of Environmental Medicine Research leader, Odense Child CohortMedicalResearch.com: Interview with: Professor Tina Kold Jensen MD Professor, Department of Environmental Medicine Research leader, Odense Child Cohort Medical Research: What are the main findings of the study? Prof. Jensen: Our study suggests that even modest habitual alcohol consumption of more than 5 units per week had adverse effects on semen quality although most pronounced effects were seen in men who consumed more than 25 units per week. Alcohol consumption was also linked to changes in testosterone and SHBG levels. (more…)
Author Interviews, Dermatology / 03.10.2014

MedicalResearch.com: Interview Invitation Robert Dellavalle, MD, PhD, MSPH Chief, Dermatology Service Denver VA Medical Center Denver, CO 80220 Co-Authors: Lindsay Boyers and Chante Karimkhani Medical Research: What are the main findings of the study? Answer: This cross-sectional study of Global Burden of Disease 2010 results, investigated the rates of death from ten conditions with skin manifestations.  There were statistically significant mortality differences in developed countries compared to developing countries.  Developing countries had greater rates of death for all conditions except melanoma and basal and squamous cell carcinomas.  The greatest death rates in developing countries were due to measles, syphilis, and varicella.  Conversely, developed countries had greater rates of death of melanoma and basal and squamous cell carcinomas. (more…)
Author Interviews, Cannabis, Surgical Research / 03.10.2014

David Plurad, MD Los Angeles Biomedical Research In MedicalResearch.com Interview with: David Plurad, MD Los Angeles Biomedical Research Institute. Medical Research: What are the main findings of the study? Based on a survey of patients with traumatic brain injuries, a group of Los Angeles Biomedical Research Institute researchers found those who tested positive for tetrahydrocannabinol (THC), the active ingredient in marijuana, were more likely to survive than those who tested negative for the illicit substance. We surveyed 446 patients who were admitted to a major urban hospital with traumatic brain injuries between Jan. 1, 2010, and Dec. 31, 2012, who were also tested for the presence of THC in their urine. We found 82 of the patients had THC in their system. Of those, 2.4% died. Of the remaining patients who didn't have THC in their system, 11.5% died. While most - but not all - the deaths in the study can be attributed to the traumatic brain injury itself, it appears that both groups were similarly injured. The similarities in the injuries between the two groups led to the conclusion that testing positive for THC in the system is associated with a decreased mortality in adult patients who have sustained traumatic brain injuries. (more…)
Author Interviews, JAMA, Surgical Research, University of Pittsburgh, Weight Research / 03.10.2014

Anita P. Courcoulas M.D., M.P.H., F.A.C.S Professor of Surgery Director, Minimally Invasive Bariatric & General Surgery University of Pittsburgh Medical Center MedicalResearch.com Interview with:  Anita P. Courcoulas M.D., M.P.H., F.A.C.S Professor of Surgery Director, Minimally Invasive Bariatric & General Surgery University of Pittsburgh Medical Center Medical Research: What are the main findings of the study? Dr. Courcoulas: This paper was not a study but a summary of findings from a multidisciplinary workshop (and not a consensus panel) convened in May 2013 by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute. The goal of the workshop was to summarize the current state of knowledge of bariatric surgery, review research findings on the long-term outcomes of bariatric surgery, and establish priorities for future research. (more…)
Author Interviews, NEJM, OBGYNE / 03.10.2014

Dr. Jeff Peipert MD, PhD Institute for Public Health Robert J. Terry Professor, Department of Obstetrics & Gynecology, School of Medicine Washington University in St. LouisMedicalResearch.com Interview with: Dr. Jeff Peipert MD, PhD Institute for Public Health Robert J. Terry Professor, Department of Obstetrics & Gynecology, School of Medicine Washington University in St. Louis Medical Research: What are the main findings of this study? Dr. Peipert: In the Contraceptive CHOICE Project, over 70% of teenage girls and women who were provided no-cost contraception and were educated about the effectiveness and benefits of long-acting reversible contraceptive (LARC) methods selected the intrauterine device (IUD) or contraceptive implant.  This group of over 1400 young women aged 15-19 years had rates of pregnancy, birth, and abortion that were far below national rates for sexually experienced teens. (more…)
Alcohol, Author Interviews, BMJ, HPV, Sexual Health / 03.10.2014

Matthew B. Schabath, Ph.D Assistant Member, Department of Cancer Epidemiology Moffitt Cancer Center Tampa, Florida MedicalResearch.com: Interview with: Matthew B. Schabath, Ph.D Assistant Member, Department of Cancer Epidemiology Moffitt Cancer Center Tampa, Florida   Medical Research: What are the main findings of the study? Dr. Schabath: Overall, the results from these analyses demonstrated that men who consumed the highest amounts of alcohol were associated with an increased risk for genital human papillomavirus (HPV) infections. (more…)
Author Interviews, Pediatrics / 03.10.2014

Sara Sammallahti, MA Institute of Behavioral Sciences University of Helsinki, Finland. MedicalResearch.com Interview, Sara Sammallahti, MA Institute of Behavioral Sciences University of Helsinki, Finland.   Medical Research: What are the main findings of the study? Answer: Not only did we find that faster growth right after preterm birth is associated with better neurocognitive abilities - we also showed that these effects persist into adulthood, that they are seen across a wide spectrum of abilities, and that head growth very early on seems especially relevant in predicting long-term outcomes. These associations were found when we examined 103 young adults who were born prematurely and with very low birth weight (under 1500 grams). (more…)
Author Interviews, Diabetes, Lancet / 03.10.2014

Dr Nita Forouhi Lead Scientist and Programme Leader MRC Epidemiology Unit University of Cambridge School of Clinical MedicineMedicalResearch.com Interview with: Dr Nita Forouhi, MRCP, PhD, FFPHM Lead Scientist and Programme Leader MRC Programme Leader and Consultant Public Health Physician MRC Epidemiology Unit University of Cambridge School of Clinical Medicine Cambridge Biomedical Campus Cambridge, UK Medical Research: What are the main findings of the study? Dr. Forouhi: This large study found that low blood concentrations of 25-hydroxyvitamin D [25(OH)D], a clinical indicator of vitamin D status, were associated with an increased risk of type 2 diabetes, but this did not appear to be a cause-effect relationship. To investigate these associations, we did two things. We first did a systematic review and meta-analysis across 22 published studies and confirmed that there was a strong inverse relation between vitamin D levels and the risk of future new-onset type 2 diabetes among people who did not initially have diabetes. We then used a genetic approach, called Mendelian randomisation, which allows us to test a cause-effect relationship, and found that genetically lower vitamin D levels were not related to risk of type 2 diabetes. This means that we were able to distinguish between association and causation, and concluded that the vitamin D levels did not have a causal link with type 2 diabetes. (more…)
Author Interviews, Heart Disease, JACC, Mediterranean Diet, Omega-3 Fatty Acids / 03.10.2014

MedicalResearch.com Interview with: Dr. Anil Nigam MD MSc FRCPC Director, Research Program in Preventive Cardiology at ÉPIC Centre Montreal Heart Institute Associate Professor, Department of Medicine at Université de MontréalMedicalResearch.com Interview with: Dr. Anil Nigam MD MSc FRCPC Director, Research Program in Preventive Cardiology at ÉPIC Centre Montreal Heart Institute Associate Professor, Department of Medicine at Université de Montréal Medical Research: What are the main findings of the study? Dr. Nigam: The main finding is that high-dose fish oil rich in marine omega-3 fatty acids did not reduce recurrence of atrial fibrillation in individuals with paroxysmal or persistent atrial fibrillation not receiving conventional anti-arrhythmic therapy. (more…)
General Medicine / 03.10.2014

MedicalResearch.com Interview with: Kathrin S. Utz, PhD Department of Neurology University of Erlangen-Nuremberg Erlangen, German Medical Research: What are the main findings of the study? Dr. Utz: A transient ischemic attack is caused when there is a temporary disruption in the blood supply to a person’s brain. It causes the person to experience symptoms, similar to those of a stroke, such as speech and visual disturbance and numbness or weakness in the arms and legs. A transient ischemic attack is only temporary and people make a full physical recovery from it. We found, however, that a TIA is not without cost. Specifically, we found that such persons are at a greater risk of going on to develop the psychiatric condition known as posttraumatic stress disorder (PTSD). We found 1 in 3 patients develop it. PTSD, which is perhaps better known as a problem found in survivors of war zones and natural, can develop when a person experiences a frightening event that poses a serious threat. It leads the person to experience symptoms such as worry, nightmares, flashbacks and social isolation. We found that TIA patients who develop PTSD are also more likely to suffer from depression and anxiety symptoms. Taken together these symptoms pose a significant psychological burden for the affected patients and it therefore comes as no surprise that we also found TIA patients with PTSD have a measurably lower sense of quality of life than TIA patients who do not develop PTSD. We could also identify some potential risk-factors for the development of PTSD following a TIA. Younger patients and patients who overestimate their future stroke risk are more likely to develop PTSD. Also important in this context are the strategies that patients typically adopt to deal with stressful situations. Those patients who use certain types of coping strategies, such as denying the problem, blaming themselves for any difficulties or turning to drugs for comfort, face a greater risk of developing PTSD after TIA. (more…)
Author Interviews, Lancet, Lipids / 02.10.2014

MedicalResearch.com Interview with: Dr. Raul Santos Unidade Clínica de Lipides InCor-HCFMUSP Sao Paulo, Brazil. Medical Research: What are the main findings of the study? Dr. Santos: Evolocumab 420 mg injected subcutaneously every 4 weeks reduced LDL-C by 31% on average, in relation to placebo, in Homozygous familial hypercholesterolemia patients that were using maximally tolerated lipid lowering therapy but not on lipid apheresis regimen. Patients were separated according to the type of LDL receptor mutation, those with at least one allele codifyng a defective mutation on the LDL receptor (residual receptor activity 2-25%) had on average a 41% reduction on LDL-cholesterol. The 2 patients  homozygotes with alleles that codify a null mutation )receptor activity < 2%), did not respond to treatment. This was expected since PCSK9 inhibitors need a functional LDL receptor do work. Basically they increase the expression of the receptor that facilitates the clearance from plasma of circulating LDL particles. In those patients with defective LDL receptor  mutations there was 24% reduction of lipoprotein(a) concentrations, an extra risk factor for cardiovascular disease in familial hypercholesterolemia patients. (more…)
Author Interviews, Orthopedics / 02.10.2014

Dr. Bruce Beynnon McClure Professor of Musculoskeletal Research Dept Orthopedics and Rehabilitation University of Vermont College of Medicine Burlington, VT 05405-0084MedicalResearch.com Interview with: Dr. Bruce Beynnon McClure Professor of Musculoskeletal Research Dept Orthopedics and Rehabilitation University of Vermont College of Medicine Burlington, VT 05405-0084 Medical Research: What are the main findings of the study? Dr. Beynnon: The anterior cruciate ligament (ACL) is an important stabilizer of the joint, and the study investigated how geometry of this ligament and surrounding bone is related to non-contact injury of this ligament. Specifically, the study focused on MRI-based measurements of the size of the ACL, measured as its volume, and the size of the femoral intercondylar notch, or the small space located in the center of the femur in which the ACL resides. Our study revealed that a decrease in the volume of the ACL and a decrease in the size of the intercondylar notch were associated with an increased risk of suffering a non-contact ACL injury in athletes. This finding may be explained by the fact that a smaller ligament is associated with a decrease in its biomechanical properties, such as a smaller ultimate failure load. An alternative explanation is that a decreased femoral intercondylar notch size could result in a greater tendency for the ACL to impinge against the walls of the femoral notch during high demand activities, and increase the risk of injury. The investigation was a longitudinal study with a nested case-control analysis of young, healthy high school and college athletes. The investigation was rigorously designed to control for age, sex, and participation on the same sports team. This enabled us to determine which combination of geometric parameters of the ACL and adjacent bony structures influence risk of suffering a first time non-contact ACL injury. (more…)
Author Interviews, General Medicine, Lancet, Lipids / 02.10.2014

Professor F. J. Raal FRCP, FRCPC, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism Faculty of Health Sciences, University of the Witwatersrand Johannesburg Hospital Johannesburg South AfricaMedicalResearch.com Interview with: Professor F. J. Raal FRCP, FRCPC, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism Faculty of Health Sciences, University of the Witwatersrand Johannesburg Hospital Johannesburg South Africa Medical Research: What are the main findings of the study? Dr. Raal: Heterozygous familial hypercholesterolaemia (HeFH)  is one of the most common inherited disorder in man affects between 1:250 to 1:300 persons worldwide. Thus, there are likely more than 3 million patients with heterozygous familial hypercholesterolaemia in the United States and Europe alone. The RUTHERFORD-2 study was a large world-wide multinational study  of the use of the PCSK9-inhibitor, evolocumab, in over 300 patients with heterozygous familial hypercholesterolaemia (HeFH). Evolocumab administered either 140 mg biweekly or 420 mg monthly as a subcutaneous injection, much like an insulin injection, was well tolerated with minimal side effects,  and markedly reduced levels of LDL cholesterol or “bad cholesterol”  by over 60% compared to placebo. (more…)
Author Interviews, Cancer Research, JNCI, Lung Cancer, UT Southwestern / 02.10.2014

Dr. David Gerber MD Associate Professor of Internal Medicine Division of Hematology and Oncology Harold C. Simmons Cancer Center at UT Southwestern Medical CenterMedicalResearch.com Interview with: Dr. David Gerber MD Associate Professor of Internal Medicine Division of Hematology and Oncology Harold C. Simmons Cancer Center at UT Southwestern Medical Center Medical Research: What are the main findings of the study? Dr. Gerber: Fewer than 3% of adult cancer patients in the United States are enrolled in clinical trials.  Increasingly numerous and stringent eligibility criteria are a major factor limiting participation in clinical trials.  We examined the longstanding and widespread practice of excluding patients with prior cancer from oncology clinical trials.  This policy presumably reflects concerns that a prior cancer would interfere with the conduct, outcomes, or interpretation of a clinical trial, although there is no clear evidence supporting that assumption. We examined more than 50 National Cancer Institute (NCI)-sponsored lung cancer clinical trials.  We found that 80% excluded patients with prior cancers.  This exclusion criterion was applied broadly, including to more than two-thirds of trials with non-survival endpoints.  We then examined national Surveillance Epidemiology and End Results (SEER)-Medicare linked data to estimate the proportion of patients who would be excluded from these trials due to prior cancer.  We found that up to 18% of potential patients are excluded for this reason alone.  In large phase 3 clinical trials, that corresponds to more than 200 patients. (more…)
Author Interviews, Heart Disease, Mediterranean Diet, Nutrition / 02.10.2014

Jyrki Virtanen, PhD Adjunct Professor of Nutritional Epidemiology University of Eastern Finland Kuopio, FinlandFor MedicalResearch.com Jyrki Virtanen, PhD Adjunct Professor of Nutritional Epidemiology University of Eastern Finland Kuopio, Finland Medical Research: What are the main findings of the study? Dr. Virtanen: The main finding was that saturated fat intake was not an independent risk factor for Coronary Heart Disease even in a population with relatively high average saturated fat intake, like in this population with middle-aged and older men from Eastern Finland. In other words, intake of carbohydrates in place of saturated fat was not associated with lower risk, not even when the quality of carbohydrates was taken into account. Only when polyunsaturated fat replaced saturated fat in the diet, was the risk of Coronary Heart Disease, especially Coronary Heart Disease mortality, lower. In fact, also replacing trans fat or carbohydrates with polyunsaturated fat was associated with lower risk. The associations were similar with both n-6 and n-3 polyunsaturated fatty acids. Trans fat intake was not associated with the Coronary Heart Disease risk, but that is most likely explained by the low intake of trans fat in Finland already in mid-1980s. We also investigated the associations of the fatty acid intake with carotid artery atherosclerosis, and the results were generally similar to the findings with incident Coronary Heart Disease events. (more…)