Does Alcohol Really Protect Against Heart Disease? Evidence Not Clear Cut

MedicalResearch.com Interview with:

Dr. Jinhui Zhao PhD Scientist, Centre for Addictions Research of BC University of Victoria

Dr. Jinhui Zhao

Dr. Jinhui Zhao PhD
Scientist, Centre for Addictions Research of BC
University of Victoria

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:  There are now many studies questioning the validity of the theory that moderate alcohol consumption protects against heart disease. We provided an up to date and comprehensive review of the evidence from ‘cohort’ studies i.e. those that assess health risk behaviours of people then follow them up for a number of years to see what characteristics predict death from a particular condition. We wished to test the theory that the appearance of health benefits in relation to heart disease is due to biases that accumulate and become more severe when cohorts are recruited at older ages (e.g. over 55 years). We found evidence to support this hypothesis. Moderate drinkers recruited before 55 years of age did not show any evidence of reduced risk of heart disease even when followed up into old age. Moderate drinkers from the older cohorts, however, did appear to have significant benefits – a finding we attribute to selection biases that accumulate across the life-course.

Several published meta-analyses showed inconsistent findings about how alcohol consumption affects the risk of coronary heart disease (CHD). Most systematic reviews find associations between low-volume alcohol consumption and reduced CHD risk, while some also find increased CHD risk for higher levels of consumption (Maclure 1993, Corrao, Rubbiati et al. 2000, Corrao, Bagnardi et al. 2004, Ronksley, Brien et al. 2011, Roerecke and Rehm 2012). More recent evidence has accumulated to suggest that the case for cardio-protection may be less straightforward. The association of alcohol consumption with CHD may be confounded or modified by other factors such as age and sex and / or biased by those factors which have not been investigated or controlled for in these previously published studies.

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Gene Dosage at 22q11.2 Helps Determine Schizophrenia vs Autism Brain Differences

MedicalResearch.com Interview with:

Carrie Bearden, Ph.D. Professor, Departments of Psychiatry and Biobehavioral Sciences and Psychology Semel Institute for Neuroscience and Human Behavior University of California, Los Angeles

Dr. Bearden

Carrie Bearden, Ph.D.
Professor, Departments of Psychiatry and Biobehavioral Sciences and Psychology
Semel Institute for Neuroscience and Human Behavior
University of California, Los Angeles

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: A 22q11.2 deletion confers the highest known genetic risk for schizophrenia, but a duplication in the same region is strongly associated with autism and is less common in schizophrenia cases than in the general population.

Thus, we became interested in trying to understand whether there were differences in brain development that might predispose to one condition vs. the other.

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Directly Observed Therapy Linked To Lower Mortality In Multi-Drug Resistant TB

MedicalResearch.com Interview with:
Dr. Jorge Salinas MD
Epidemic intelligence service officer
Division of Tuberculosis Elimination
Centers for Disease Control and Prevention 

MedicalResearch.com: What is the background for this study?

Response: Because multidrug-resistant TB (MDR TB) treatment regimens are less effective, more complex, and are more likely to have side effects that are difficult to tolerate than regimens for drug-susceptible TB, patients with MDR TB are at a higher risk of dying. Directly observed therapy (a therapy by which patients meet with a healthcare worker at a regularly scheduled time and place so the healthcare worker can observe the patient taking their TB medication) is recommended to treat all forms of TB disease, including MDR TB.

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Most Health Care Personnel Not Getting Tdap Vaccination

MedicalResearch.com Interview with:
Anup Srivastav, DVM, MPVM, PhD

National Center for Immunization and Respiratory Diseases (NCIRD)
Centers for Disease Control and Prevention
Atlanta GA

MedicalResearch.com: What is the background for this study?

Response: Healthcare personnel (HCP) are at risk for being exposed to pertussis (whooping cough) and spreading the disease to patients in their work settings. CDC recommends tetanus, diphtheria, acellular pertussis (Tdap) vaccination for healthcare personnel to reduce their risk of getting the disease and spreading it to patients. This is the first report of Tdap vaccination coverage among healthcare personnel by occupational setting.

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Frequent Marijuana Use Linked To Increased Risk of Severe Periodontal Disease

MedicalResearch.com Interview with:

Jaffer A Shariff DDS MPH cert.DPH Periodontal Resident | Research Scientist Division of Periodontics, Columbia University College of Dental Medicine New York

Dr. Shariff

Jaffer A Shariff DDS MPH cert.DPH
Periodontal Resident | Research Scientist
Division of Periodontics,
Columbia University College of Dental Medicine
New York

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Marijuana use for both medical and recreational purposes has become increasingly common in recent years; it is the most commonly used recreational drug in the United States. Subsequent increase in its legalization among countries including the United States for recreational purposes, poses an emergent oral and periodontal health concerns.

Our study revealed that frequent recreational marijuana users exhibited deeper periodontal probing depths, clinical attachment loss and higher odds of having severe periodontal disease than the non-frequent users, even after controlling for other risk factors linked to gum disease, such as cigarette smoking.

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Adolescents Admitted For Self Harm At Risk For Further Self Harming Behavior

MedicalResearch.com Interview with:

Dr Annie Herbert, PhD Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare University College London London  UK

Dr. Herbert

Dr Annie Herbert, PhD
Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare
University College London
London  UK 

MedicalResearch.com: What is the background for this study?

Response: 1 in 25 adolescents (i.e. one in every classroom) will be admitted to hospital as an emergency with injuries related self-harm, drug or alcohol misuse, or violence. Currently, the guidelines for how these adolescents are managed differ greatly depending on the type of injury they come in with (whether through self-harm, drug or alcohol misuse, or violence).

MedicalResearch.com: What are the main findings?

Response: In our study, we found that adolescents admitted with any of these injuries were at an increased risk of suicide and of drug or alcohol related death in the ten years after leaving hospital, compared to other admitted adolescents.While the overall risk is relatively low—for example, 2–3 girls out of 1000 and 7 boys out of 1000 who are admitted as an emergency to hospital with drug or alcohol related injuries die from suicide within 10 years—the rates are 5–6 times higher than among adolescents admitted to hospital following an accident.

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Could a Strep Throat Increase Risk of OCD?

MedicalResearch.com Interview with:
Sonja Orlovska MD, PhD student

Mental Health Centre Copenhagen
Denmark

MedicalResearch.com: What is the background for this study?

Response: This Danish register-based study is the largest study so far investigating the hypothesis PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) which describes a possible link between streptococcal throat infection and the subsequent development of OCD and tic disorders in children. PANDAS is in thread with research in mental health in recent years, suggesting that infections and immune activation might increase the risk of mental disorders.

MedicalResearch.com: What are the main findings?

Response: Out of the 1,1 million individuals <18 years of age born in the study period, we found that the 349,982 individuals tested positive for a streptococcal throat infection by their GP had an increased risk of mental disorders by 18% and the risk of specifically OCD and tic disorders was increased with respectively 51% and 35%, compared to individuals who had never been tested. This seems to confirm PANDAS which speaks in favor of a specific link between strep throat and the development of OCD and tic disorders. However, we also found that non-streptococcal throat infection increased the risk of mental disorders, even though the risk of OCD and all mental disorders was larger after a strep throat. The study was performed at the Mental Health Centre Copenhagen together with Senior researcher Michael Eriksen Benros.

MedicalResearch.com: What should readers take away from your report?

Response: Our results indicate that the brain might be affected by the immunological activation caused by a streptococcal infection possibly due to streptococcal antibodies cross-reacting with brain tissue causing psychiatric symptoms which is the theory of PANDAS. However, it seems as if the immunological response caused by other types of throat infections might also have a damaging effect in some individuals. Nevertheless, it cannot be ruled out that the results to some extent might be driven by a medical care-seeking behavior in some parents bringing their child to the GP more often in spite of only few symptoms of throat infection leading to testing for strep throat and also more frequent examination and diagnosis by a psychiatrist.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Even though our study supports some elements of the PANDAS hypothesis, more research is needed to fully confirm PANDAS. The research field would benefit from larger clinical studies following children with PANDAS over a longer period of time with frequent follow-ups in order to establish if streptococcal throat infections cause and worsen neuropsychiatric symptoms of OCD and tic disorders.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Orlovska S, Vestergaard CH, Bech BH, Nordentoft M, Vestergaard M, Benros ME. Association of Streptococcal Throat Infection With Mental DisordersTesting Key Aspects of the PANDAS Hypothesis in a Nationwide Study. JAMA Psychiatry. Published online May 24, 2017. doi:10.1001/jamapsychiatry.2017.0995

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

Finnish-Style Baby Box Reduced Parent-Baby Bed Sharing

MedicalResearch.com Interview with:

Megan Heere, MD Assistant Professor of Clinical Pediatrics Lewis Katz School of Medicine at Temple University Medical Director Temple University Hospital Well Baby Nursery Temple Pediatric Care Philadelphia, PA 19140

Dr. Heere

Megan Heere, MD
Assistant Professor of Clinical Pediatrics
Lewis Katz School of Medicine at Temple University
Medical Director
Temple University Hospital Well Baby Nursery
Temple Pediatric Care
Philadelphia, PA 19140

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Bed-sharing, the unsafe practice in which parents sleep in the same bed as their babies, is associated with sleep-related deaths in infants, including sudden infant death syndrome (SIDS) and accidental suffocation and strangulation in bed. No studies have examined the effect of a Finnish-style baby box on infant sleep environment. Face-to-face postpartum education about safe infant sleep, combined with the distribution of a baby box, which is a cardboard bassinet, reduced the rates of bed-sharing during babies’ first 8 days of life.

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Modified Hospital Elder Life Program Reduces Post-Op Delirium and Length of Stay

MedicalResearch.com Interview with:
Cheryl Chia-Hui Chen, RN, DNSc

Vice Dean for Student Affairs
Professor of Nursing
National Taiwan University
Nurse Supervisor at National Taiwan University Hospital
Taipei, Taiwan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Older patients undergoing abdominal surgery often experience preventable delirium, which greatly influences their postoperative recovery and hospital length of stay. The modified Hospital Elder Life Program (mHELP) utilizes nurses to reduce postoperative delirium and LOS among older patients undergoing abdominal surgery for resection of malignant tumor. The mHELP consisted of 3 protocols: oral and nutritional assistance, early mobilization, and orienting communication, researchers say.

Researchers at the National Taiwan University Hospital randomly assigned 377 patients undergoing abdominal surgery for a malignant tumor to an intervention (n = 197) or usual care (n = 180).

Postoperative delirium occurred in 6.6 percent of mHELP participants vs 15.1 percent of control individuals (odds of delirium reduced by 56 percent). Intervention group participants received the mHELP for a median of 7 days, and they had a median LOS that was two days shorter (12 vs 14 days).

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Injectable Cabotegravir Holds Promise as HIV Prevention Stategy

MedicalResearch.com Interview with:

Martin Markowitz MD Clinical Director and Staff Investigator Aaron Diamond AIDS Research Center Aaron Diamond Professor at The Rockefeller University

Dr. Markowitz

Martin Markowitz MD
Clinical Director and Staff Investigator
Aaron Diamond AIDS Research Center
Aaron Diamond Professor at The Rockefeller University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Cabotegravir ((CAB) is an inhibitor of HIV-1 integrase and is amenable to formulation in both oral and long acting injectable forms. In preclinical studies injectable CAB protected against low dose intrarectal challenge using an HIV-like virus in the rhesus macaque model.

These results support the clinical development of CAB as prevention. This study was a first attempt to establish a dosing regimen and evaluate safety and acceptability of intramuscular injections of CAB. The study was a placebo controlled blinded study of approximately 120 subjects with a 5:1 randomization active/placebo. Subjects received 800mg CAB given as 2 2mL injections or placebo every 12 weeks for 3 injections after a 4 week safety lead in of oral therapy. Safety acceptability and PK were assessed.

The main findings were that injections were associated with injection site reactions in the vast majority of participants that were mild to moderate and of short duration. Only 4 subjects who entered the injection phase discontinued due to injection intolerance. There were no additional safety signals and the participants considered the injections acceptable when asked to complete questionnaires. PK analysis found that despite modeling that suggested that the 800mg q 12 week dose would be adequate, this was not the case. More rapid uptake and release from the depot resulted in lower than anticipated drug levels at trough. Alternate dosing regimens are under study.

Another finding is that there were participants (14%) who had detectable drug in plasma detected at 52 weeks after last injection suggesting the presence of a tail in some individuals.

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STEM activities do not seem to encourage students to make STEM subject choices for AS/A levels

MedicalResearch.com Interview with:

Dr-Pallavi-Amitava-Banerjee.jpg

Dr. Banerjee

Pallavi Amitava Banerjee, PhD, FRS
Lecturer, Graduate School of Education
St Luke’s Campus
University of Exeter 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Several educational programs are being run to increase an awareness and understanding of STEM generally and more specifically to encourage young people to take up STEM learning trajectories.

A longitudinal study was conducted where nearly 60,000 year 7 students were followed up through secondary school. Every year these students took part in several hands on activities, ambassador led events, school STEM trips throughout each academic year from the beginning of year 7 till they took GCSEs.

Two main educational outcomes were considered –
a) GCSE attainment in science and math and
b) continued post-16 STEM participation (AS- and A-levels).

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Metformin Reverses Some Autism Symptoms In Animal Model

MedicalResearch.com Interview with:
Ilse Gantois, PhD

Research Associate
Dr. Nahum Sonenberg’s laboratory
Department of Biochemistry
McGill University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Fragile X syndrome (FXS) is a neurodevelopmental disorder characterized by cognitive impairment and affects 1 in 4000 males and 1 in 6000 females. About 60% of persons with Fragile X also have autism spectrum disorder. FXS is caused by absence of Fragile X protein (FMRP), which results in hyperactivation of ERK (extracellular signal-regulated kinase) and mTORC1 (mechanistic target of rapamycin complex 1) signaling. We show that treatment with metformin, the most widely used FDA-approved antidiabetic drug, suppresses translation by inhibiting the ERK pathway, and alleviates a variety of behavioural deficits, including impaired social interaction and excessive grooming. In addition, metformin also reversed defects in dendritic spine morphogenesis and synaptic transmission.
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