AACR, Author Interviews, Cancer Research / 17.04.2018

MedicalResearch.com Interview with: Mark E. Hatley, M.D., Ph.D. Assistant Member Molecular Oncology Division, Department of Oncology St. Jude Children's Research Hospital Memphis, TN 38105 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma occurring in children. Tumors appear histologically and genetically as undifferentiated skeletal muscle and are thus thought to solely originate from early skeletal muscle cells. However, tumors occur throughout the body, including sites devoid of skeletal muscle. In addition, tumor location is a key feature of staging and 40% of patients develop RMS in the head and neck. Interestingly, head and neck muscle development is distinct from the development of trunk and limb muscle. Previously we described a model of rhabdomyosarcoma which occurred specifically in the head and neck and originated from non-muscle cells. In this study we investigated how normal development programs are hijacked to drive rhabdomyosarcoma location. We demonstrated that RMS can originate from immature blood vessel cells that lie in between muscle fibers specifically in the head and neck. During development, these cells are hijacked, and become reprogrammed into rhabdomyosarcoma rather than mature endothelial cells. These RMS cells express factors important in head and neck muscle development. Our findings highlight that cell of origin contributes to RMS location and may explain why a high proportion of RMS occurs in the head and neck.  (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA, Primary Care / 16.04.2018

MedicalResearch.com Interview with: “Doctors” by Tele Jane is licensed under CC BY 2.0Doug Einstadter, MD, MPH Center for Health Care Research and Policy MetroHealth System and Case Western Reserve University  MedicalResearch.com: What is the background for this study?   Response: Despite the recognized importance of blood pressure (BP) control for those with hypertension, based on national surveys only 54% of patients with hypertension seen in primary care have their BP controlled to less than 140/90 mm Hg. Blood pressure measurement error is a major cause of poor BP control. Reducing measurement error has the potential to avoid overtreatment, including side effects from medications which would be intensified or started due to a falsely elevated blood pressure. One way to reduce measurement error is to repeat the BP measurement during an office visit. The American Heart Association recommends repeating a blood pressure at the same clinic visit with at least 1 minute separating BP readings, but due to time constraints or lack of evidence for the value of repeat measurement, busy primary care practices often measure BP only once. Repeating the BP at the same office visit when the initial blood pressure measurement is high has the potential to improve clinical decision-making regarding BP treatment. Several studies have described the effect of a repeat BP measurement in the inpatient setting, but there are little data available to characterize the effect of repeating blood pressure measurement in an outpatient primary care setting. (more…)
Author Interviews, Cancer Research, JAMA / 16.04.2018

MedicalResearch.com Interview with: Lindor Qunaj BSc MD'19 Medical student, Warren Alpert Medical School of Brown University Brown Center for Biomedical Informatics Providence, Rhode Island MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study was motivated by growing concerns that incomplete or delayed release of clinical trial data may put patients at risk of harm or suboptimal treatment and slow the pace of biomedical innovation. Especially in a field as rapidly evolving as oncology, complete and timely dissemination of clinical trial results is critical to the advancement of both patient care and scientific discovery. In an analysis of press releases from eight large pharmaceutical companies, we found that the median delay from presumed availability of Phase 3 trial data to peer-reviewed publication or public posting of results was 300 days. Studies reporting positive findings were published more rapidly than those with negative results. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, JAMA, Stroke / 16.04.2018

MedicalResearch.com Interview with: Dr. Joshua Goldstein MD, PhD J. Philip Kistler Stroke Research Center Division of Neurocritical Care and Emergency Neurology, Department of Neurology MGH Harvard Medical School, Boston Department of Emergency Medicine Massachusetts General Hospital for the Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 (ATACH-2) and the Neurological Emergencies Treatment Trials (NETT) Network Investigators   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: It’s hard to know how aggressively to lower blood pressure in acute intracerebral hemorrhage (ICH).  Randomized controlled trials have been conflicting. We thought that we could use the presence of severe small vessel disease (SVD) - manifested by microbleeds seen on brain magnetic resonance imaging (MRI) – to guide treatment decisions.  On the one hand, those with severe SVD may be most vulnerable to continued bleeding, and specifically need more intensive blood pressure lowering.  On the other hand, if they have impaired regulation of cerebral blood flow, they might be harmed by rapid drops in blood pressure, and maybe we have to be more careful with them. To answer this, we performed a subgroup analysis of the multi-centre ATACH-2 clinical trial of intensive blood pressure lowering. This was the first study to assess the effect of randomized acute stroke treatment on patients with more severe SVD, manifested by microbleeds.  We found that no matter what your small vessel disease burden on MRI, you’ll respond the same to early blood pressure management. (more…)
Author Interviews, Infections, Nature, NIH, PLoS, Rheumatology / 16.04.2018

MedicalResearch.com Interview with: John B. Harley, MD, PhD Professor and Director David Glass Endowed Chair Center for Autoimmune Genomics and Etiology (CAGE) Department of Pediatrics University of Cincinnati Cincinnati Children’s Hospital Medical Center Cincinnati, Ohio 45229 MedicalResearch.com: What is the background for this study? Response: Previous work has shown that Epstein-Barr virus infection is associated with systemic lupus erythematosus and studies of the origins of the autoimmune response have also suggested that the autoimmunity of this disease may originate with the immune response against this virus. In the meantime, many investigators have been studying the genetics of lupus over the past 25 years. They have found about 100 convincing genes that alter the risk of developing lupus. (more…)
Author Interviews, Breast Cancer, JNCI, UT Southwestern / 16.04.2018

MedicalResearch.com Interview with: Yingfei Wang, Ph.D. and Weibo Luo, Ph.D. Department of Pathology UT Southwestern Medical Center Dallas TX 75390 MedicalResearch.com: What is the background for this study? Response: Breast cancer is the most commonly diagnosed cancer in women. Tumor metastasis is frequently found in breast cancer patients and causes more than 90% of cancer death. There is currently no cure for this deadly disease. We have known that breast tumor is not supplied with sufficient oxygen (a phenomenon known as hypoxia), which makes breast cancer cells more aggressive and may be responsible for tumor recurrence, metastasis, and therapy resistance. Hypoxia-inducible factor (HIF) is a master regulator frequently detected in the hypoxic regions and switches on many oncogenes needed for breast cancer cells to grow and spread around the body. The role of HIF in gene regulation is precisely controlled and shutting down of HIF’s activity would be a promising strategy for the treatment of metastatic breast cancer. (more…)
Author Interviews, Pediatrics, Pulmonary Disease / 15.04.2018

MedicalResearch.com Interview with: Gustavo Nino, M.D. Children’s National Health System pulmonologist Study senior autho MedicalResearch.com: What is the background for this study? Response: The epidemiology of respiratory disorders is largely influenced by the individual’s sex resulting in overall higher risk for males than females, particularly during early life. Hormonal, anatomical and behavioral differences are postulated to play a role, but these sex-based respiratory differences are already present at birth, suggesting a strong genetic component. However, the genetic differences in the airways of males and females during early life have been remarkably understudied and are largely unknown. (more…)
Author Interviews, Mental Health Research, Pediatrics, Primary Care / 15.04.2018

MedicalResearch.com Interview with: Anna Scandinaro Medical student Penn State College of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Dr. Usman Hameed, a child and adolescent psychiatrist, and Dr. Dellasega wrote a previous paper called "What is irritability?" which examined the idea and concept of what irritability in school aged children can encompass. After considering possible definitions of irritability, we wanted to see how the concept manifested in clinical practice, especially with the controversy around the new diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) in the DSM 5. The main findings of this study are that primary care providers (PCP)​identified a need for more training and education in how to assess irritability in pediatric and adolescent populations. In contrast, the child and adolescent psychiatrists we interviewed thought more triage from PCPs who care for school aged children with irritability would be helpful.  (more…)
Author Interviews, Depression, Eating Disorders, JAMA, Mental Health Research, Pediatrics / 13.04.2018

MedicalResearch.com Interview with: Tracy Vaillancourt, Ph.D. Full Professor and Canada Research Chair Children’s Mental Health and Violence Prevention Counselling Psychology, Faculty of Education School of Psychology, Faculty of Social Sciences University of Ottawa MedicalResearch.com: What is the background for this study? Response: Although there have been a few studies that have looked at the relation between being bullied and disordered eating, most studies have looked at it from the perspective of does being bullied lead to disordered eating and does depressive symptoms mediate (i.e., explain) the link. We wanted to look more closely at how bullying, disordered eating, and depression were related over time among teenagers by examining all possible pathways. Another novel aspect of our study was the focus on disordered eating behaviour only (e.g., vomiting, using diet pills, binge eating). Most previous work has examined behaviour and thoughts together, but because disordered eating thoughts are so common (termed normative discontent; e.g., fear of fat, dissatisfaction with body shape or size), particularly among girls and women, we wanted to focus on behaviour, which is more problematic in terms of physical and psychiatric health. (more…)
Author Interviews, Colon Cancer, Supplements / 13.04.2018

MedicalResearch.com Interview with: Nathalie Scheers PhD Asst. Professor Chalmers University of Technology Dept of Biology and Biological Engineering Food and Nutrition Science Göteborg, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many different forms of iron supplements are used to treat iron deficiency symptoms or as phosphate binders in patients with renal disease. two of these iron supplements, the chelates ferric citrate and ferric EDTA have been observed to drive colon cancer in mice. In the newly published study in Oncotarget, we are reporting our work on how these iron compounds differ compared to the simple salt ferrous sulphate, which is another common iron supplement. The main finding of this study was that ferric citrate and ferric EDTA promoted the cancer biomarker amphiregulin which in turn activated the MAP kinase ERK in gut epithelial cancer cells. There were no such effects in ferrous sulphate-treated cells.  (more…)
Author Interviews, Hepatitis - Liver Disease, Microbiome, Nutrition, Weight Research / 13.04.2018

MedicalResearch.com Interview with: “Turkish Food” by Garry Knight is licensed under CC BY 2.0Jasmohan S. Bajaj, M.D. Associate Professor Department of Internal Medicine Division of Gastroenterology Virginia Commonwealth University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Altered gut microbiota composition can occur due to diseases and due to changes in the dietary practices. The interaction between these two and their linkage with clinical outcomes in liver diseases, such as cirrhosis is not clear from an international standpoint. In this study we enrolled healthy subjects, and patients with cirrhosis who were either early or advanced in their process from USA and Turkey. We found that the Turkish subjects, who followed a Middle-eastern diet rich in vegetables and fermented milk products, had high microbial diversity, which was in turn associated with lower hospitalizations over 3 months. There was also an additional beneficial effect of coffee and tea intake. This protection persisted even when the clinical factors were accounted for. (more…)
Author Interviews, Sleep Disorders / 12.04.2018

MedicalResearch.com Interview with: “Sleep” by Spencer Smith is licensed under CC BY 2.0Kristen L. Knutson, PhD Associate Professor Center for Circadian and Sleep Medicine Department of Neurology Northwestern University Feinberg School of Medicine Chicago, IL  60611​ MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has shown that “night owls” (people who prefer the evening) have higher rates of diseases such as diabetes or high blood pressure.  We wanted to determine whether mortality risk was also higher in night owls. We used data from the UK Biobank of almost a half million people who were asked whether they were morning or evening types. We found that the night owls had a 10% increased risk of dying over a 6 ½ year period compared to the morning types, even after taking into account existing health problems. (more…)
Author Interviews, Microbiome, Nutrition, Sugar, Weight Research / 12.04.2018

MedicalResearch.com Interview with: Eugene B. Chang, MD Martin Boyer Professor of Medicine Knapp Center for Biomedical Discovery University of Chicago Chicago, IL  60637 and Kristina Martinez-Guryn, Ph.D., R.D.
Assistant Professor 
Biomedical Sciences Program
Midwestern University
Downers Grove IL MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Martinez-Guryn: The original goal of this study was to understand why mice devoid of all microorganisms (germ free mice) are protected from diet-induced obesity. We demonstrate that these mice display severely impaired lipid absorption even when fed a high fat diet. Dr. Chang: We found that many of the processes of dietary lipid digestion and absorption are dependent on and modulated by the gut microbiome which itself responds to dietary cues to adjust the small intestine’s ability and capacity to handle dietary lipids appropriately. This interplay is important for general health, but the findings are also relevant to conditions of overnutrition (obesity, metabolic syndrome) and undernutrition (starvation, environmental enteropathy).  In conditions of overnutrition, high fat, simple sugar, low fiber foods typical of western diets promote small intestinal microbes (which have been largely neglected by the scientific community) that promote fat digestion and absorption. This increases our capacity to assimilate dietary fats which can contribute to the overnutrition problem.  In conditions of undernutrition, these types of gut microbes are lost or minimally represented.  Thus, when nutritional repletion is started, the gut’s ability to upregulate its capacity for dietary lipid digestion and absorption is compromised. (more…)
Author Interviews, Heart Disease, JACC, Outcomes & Safety, Surgical Research, University of Michigan / 12.04.2018

MedicalResearch.com Interview with: Donald Likosky, Ph.D., M.S. Associate Professor Head of the Section of Health Services Research and Quality Department of Cardiac Surgery. University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Michigan was one of several states to expand Medicaid. Current evaluations of the Michigan Medicaid expansion program have noted increases in primary care services and health risk assessments, but less work has evaluated its role within a specialty service line. There has been concern among some that Medicaid patients, who have traditionally lacked access to preventive services, may be at high risk for poor clinical outcomes if provided increased access to cardiovascular interventions. Using data from two physician-led quality collaboratives, we evaluated the volume and outcomes of percutaneous coronary interventions and coronary artery bypass grafting 24mos before and 24mos after expansion. We noted large-scale increased access to both percutaneous coronary interventions (44.5% increase) and coronary artery bypass grafting (103.8% increase) among patients with Medicaid insurance. There was a decrease in access for patients with private insurance in both cohorts. Nonetheless, outcomes (clinical and resource utilization) were not adversely impacted by expansion.  (more…)
Author Interviews, Endocrinology, Mental Health Research, OBGYNE / 12.04.2018

MedicalResearch.com Interview with: Aled Rees, MD, PhD Neuroscience and Mental Health Research Institute Cardiff University School of Medicine, Health Park Cardiff United Kingdom MedicalResearch.com: What is the background for this study?   Response: PCOS is a common condition, affecting 5-10% of women globally, in which elevated male hormone levels can cause a range of distressing and life-limiting symptoms, including reduced fertility, irregular periods, excessive facial and body hair, and acne. Previous studies have suggested a link between PCOS and poor mental health in women but the studies were small and did not adequately take other factors that can affect mental health into consideration. In addition, high levels of testosterone during pregnancy have been reported to increase the risk of neurodevelopmental disorders, such as ADHD and autism, in children. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Epilepsy / 12.04.2018

MedicalResearch.com Interview with: Britta Haenisch, PhD Pharmacoepidemiology in Neurodegenerative Disorders German Center for Neurodegenerative Diseases, DZNE  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Antiepileptic drugs (AEDs) have been shown to affect cognition by suppressing neuronal excitability and increasing inhibitory neurotransmission. Previous studies suggested that AEDs may be associated with cognitive adverse effects. Therefore, we evaluated the association between AED use and incident dementia and Alzheimer’s disease (AD). We utilized large longitudinal datasets from Finnish health registers and from German health insurance data. The case-control analyses was adjusted for several potential confounders like comorbidities and polypharmacy. The inclusion of a lag time between . Antiepileptic drugs use and dementia diagnosis allowed minimization of protopathic bias. Our study provides an association between regular prescription of  antiepileptic drugs with known cognitive adverse effects and the occurrence of dementia and AD in patients aged 65 years and older.  (more…)
Author Interviews, JAMA, Mental Health Research, OBGYNE, Pediatrics / 11.04.2018

MedicalResearch.com Interview with: Jiook Cha, PhD Assistant Professor Division of Child and Adolescent Psychiatry Columbia University Medical Center New York, NY 10032 MedicalResearch.com: What did we already know about the connection between maternal SSRI use during pregnancy and infant brain development, and how do the current study findings add to our understanding? What’s new/surprising here and why does it matter for mothers and babies? Response: Prior studies have shown mixed results in terms of the associations between maternal SRI use during pregnancy and offspring’s brain and cognitive development. Neurobiological studies with animal models suggest that SSRI use perturbs serotonin signaling and that this has important effects on cognitive development (a study conducted an author of this paper, Jay Gingrich, MD, PhD: Ansorge et al., 2004, Science). The human literature has been more mixed in terms of the associations of prenatal exposure to SSRI with brain and cognitive development. In our study, we used neonatal brain imaging because this is a direct, non-invasive method to test associations between SSRI use and brain development at an early developmental stage, limiting the effects of the post-natal environment. In our study, we had two different control groups, that is, a non-depressed SSRI-free group (healthy controls), and depressed but SSRI-free (SSRI controls) group. Also, in our study we used rigorous imaging analytics that significantly improve the quantitative nature of MR-derived signals from the brain structure using two of the nation’s fastest supercomputers (Argonne National Laboratory and Texas Advanced Computing Center) and allows robust reconstruction of brain’s grey and white matter structure in the infants’ brains. We report a significant association of prenatal exposure to SSRI with a volume increases within many brain areas, including the amygdala and insula cortex, and an increase in white matter connection strength between the amygdala and insular cortex. We were surprised by the magnitude of the effects (or the statistical effect size), compared with other brain imaging studies in psychiatry with children or adults’ brains. Importantly, it should be noted that our estimates of brain structure are still experimental and for research-purpose only. This means that our data need to be replicated and rigorously tested against confounders in order to make a firm conclusion. While our study suggests a “potential” association between prenatal exposure to SSRI and a change in fetal or infant brain development, we still need more research.  tracts_in_the_brain (more…)
Author Interviews, Infections, Lipids / 11.04.2018

MedicalResearch.com Interview with: Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry Herlev and Gentofte Hospital Copenhagen University Hospital, Denmark  MedicalResearch.com: What is the background for this study? Response: For decades research into the role and function of high-density lipoprotein (HDL) has revolved around the believe that HDL protects against atherosclerotic cardiovascular disease. However, results from large genetic studies and from large randomized clinical trials with HDL cholesterol elevating drugs have all indicated that there is no causal association between HDL cholesterol and risk of atherosclerotic cardiovascular disease. Given the hitherto strong focus on cardiovascular disease, little is known about the possible role of HDL in other aspects of human health and disease. Preclinical evidence has indicated that HDL might be of importance for normal function of the immune system and susceptibility to infectious disease, but it had never previously been investigated if levels of HDL cholesterol is associated with the risk of infectious disease in individuals from the general population. In the present study we tested this hypothesis in more than 100.000 Danes from the population at large. (more…)
Author Interviews, Global Health, Infections, Pediatrics / 10.04.2018

MedicalResearch.com Interview with: Georgies Mgode PhD Sokoine University of Agriculture Pest Management Centre African Centre of Excellence for Innovative Rodent Pest Management and Biosensor Technology Development Morogoro, Tanzania MedicalResearch.com: What is the background for this study? Response: The background of this study is the APOPO and Sokoine University of Agriculture together with NIMR and NTLP interest to explore a cheap, reliable and sustainable means of addressing TB problem in high-burden countries with limited access to advanced sensitive tests. This refers to countries where to-date TB diagnosis is mainly by microscopy that is less sensitive leaving majority of patients undetected. We were driven to explore how these rats can contribute to diagnosis of TB in children that is known to be difficult and rats are known to have a better and advanced sense of smell. According to WHO " an estimated 1 million children became ill with TB and 250 000 children died of TB in 2016 and the actual burden of TB in children is likely higher given the challenge in diagnosing childhood TB.  (more…)
Author Interviews, Epilepsy, JAMA / 10.04.2018

MedicalResearch.com Interview with: Dr Hayley Gorton PhD MPharm MRPharmS FHEA Research Associate Centre for Pharmacoepidemiology and Drug Safety Research Division of Pharmacy & Optometry| Faculty of Biology, Medicine & Health University of Manchester MedicalResearch.com: What is the background for this study? What are the main findings? Response: It is already known that people with epilepsy are at a higher risk of death than those without epilepsy but we didn’t know much about the risks of different types of death. Unnatural death (mainly accident and suicide) accounts for a very small number of all deaths but, compared to people without epilepsy, people with epilepsy are three times more likely to die by accident and twice as likely to die by suicide. Within these broad categories, persons with epilepsy are five times more likely to die specifically by accidental poisoning with medication, and three times more likely to die by intentionally poisoning themselves with medication. Opioid painkillers and medicines for mental illness were the ones most commonly used in poisoning deaths among people with epilepsy and those without epilepsy. Antiepileptic drugs were taken relatively infrequently-they were involved in about 10% of poisoning deaths in people with epilepsy.  (more…)
Author Interviews, Cancer Research, Cost of Health Care, JAMA, Pharmaceutical Companies / 09.04.2018

MedicalResearch.com Interview with: Aaron Mitchell, MD Division of Hematology/Oncology, Department of Medicine, Lineberger Comprehensive Cancer Center The Cecil G. Sheps Center for Health Services Research The University of North Carolina at Chapel Hill MedicalResearch.com: What is the background for this study? What are the main findings? Response: Financial relationships between physicians and the pharmaceutical industry are very common. However, we are just beginning to figure out whether these relationships may lead to potentially concerning changes in physician behavior - whether physicians tend to prescribe more of the drugs made by a company that has given them money. We decided to ask whether oncologists who receive money from drugmakers are more likely to use the cancer drugs made by companies that have given them money in the past. In studying two specific groups of cancer drugs, one for kidney cancer and one for chronic myeloid leukemia (CML), we found that oncologists who had received payments such as meals, consulting fees, travel & lodging expenses from the manufacturer of one of these drugs tended to use that drug more. When looking at oncologists who received payments for research, we found increased prescribing among the kidney cancer drugs but not the CML drugs. (more…)
Author Interviews, Infections, Orthopedics, Surgical Research / 09.04.2018

MedicalResearch.com Interview with: Dr Setor Kunutsor PhD Research Fellow Musculoskeletal Research Unit Bristol Medical School MedicalResearch.com: What is the background for this study? Response: Hip replacement is a very common operation that is effective at providing pain relief and improving mobility. Infection is a fortunately infrequent but devastating complication that can occur following joint replacement. Currently, two main types of surgical procedures are used in treating these infections – one-stage and two-stage revision strategies. In the two-stage procedure, the existing artificial joint is removed in one operation and the patient is treated for several months with antibiotics. A new joint is then inserted in a second operation. In the one-stage procedure, the artificial joint is removed along with all infected tissue and a new one inserted in the same operation. The two-stage procedure has been in use for decades and was regarded as the most effective treatment. There has been an increase in the use of the one-stage procedure as it has also been claimed to be very effective at treating infection. There has been a lot of controversy among orthopaedic surgeons as to which is the best way to treat infected hip replacements. Several studies have been conducted on the topic, but the findings have been inconsistent. Some claim the two-stage to be more effective and others claim the one-stage procedure is. Currently the majority of studies claim the two-stage is better; but no study has been conducted that compares these procedures head-to-head to decide if one is better or if they achieve the same results. Due to the lack of evidence, some surgeons are reluctant to use the one-stage strategy. There was therefore a need to compare the effectiveness of the two surgical strategies using an appropriate study design. We conducted a study which involved collecting and bringing all previous data together under one umbrella. The process is known as “Individual Participant Data meta-analysis”. It involved communicating with surgeons in different countries all over the world and inviting them to contribute data. We called the name of the group “The Global Infection Orthopaedic Management (INFORM) Collaboration”. (more…)
Author Interviews, JAMA, Mental Health Research, OBGYNE, Pediatrics / 09.04.2018

MedicalResearch.com Interview with: Claudia I. Lugo-Candelas, PhD Postdoctoral Research Fellow Columbia University Medical Center/ New York State Psychiatric Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have seen, in the last decade, an increase in the amount of mothers being prescribed SSRIs during pregnancy. While we know that untreated prenatal maternal depression has adverse consequences for both the mother and child, it’s not really clear what, if any, are the consequences of prenatal SSRI exposure on infant’s brain development. There have been some studies finding increased depression and anxiety in children prenatally exposed to SSRIs, but not all studies find these associations. We thus looked at 2-4 week old infants’ brains, using neuroimaging.  We found increased gray matter volume within the amygdala and insula, and increased white matter connectivity between these two structures in infants prenatally exposed to SSRIs. Of note, the statistical significance and the size of the effects we detected are quite large, even greater than the brain changes that we usually observe in our studies of children and adults with psychiatric disorders. Further, because these structures are involved in emotion processing, and alterations in volume and connectivity are sometimes seen in clinical populations, or in people at risk for anxiety, it important to learn more about what these volume and connectivity differences could mean for these infants. (more…)
ALS, Alzheimer's - Dementia, Author Interviews, JAMA / 09.04.2018

MedicalResearch.com Interview with: Celeste Karch, PhD Assistant Professor of Psychiatry Molecular mechanisms underlying tauopathies Washington University School of Medicine St Louis MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nearly half of all patients with amyotrophic lateral sclerosis (ALS), a fatal neuromuscular disorder, develop cognitive problems that affect memory and thinking. Why a disease that primarily affects movement also disrupts thinking has been unclear. Our findings suggest that genetic connections between the two disorders may explain why they share some of the same features and suggest that some drugs developed to treat ALS also may work against frontotemporal dementia and vice versa. We used a statistical method in almost 125,000 individuals with ALS, frontotemporal dementia (FTD), progressive supranuclear palsy, corticobasal degeneration, Alzheimer’s disease and Parkinson’s disease to determine whether there are common genetic variants that increase risk for multiple neurodegenerative diseases. We found that common variants near the MAPT gene, which makes the tau protein, increases risk for ALS. MAPT has previously had been associated with diseases including frontotemporal dementia and Alzheimer’s disease. But the gene hadn’t been linked to ALS. We also identified variations in a second gene, BNIP1, which normally plays an important role in protecting against cell death, increased the risk of both ALS and frontotemporal dementia. ImportantlyBNIP1 mRNA levels were altered in people who had ALS and in patients with frontotemporal dementia, suggesting the BNIP1 may be a potential therapeutic target for both disorders. (more…)
Author Interviews, Gastrointestinal Disease, Pain Research / 09.04.2018

MedicalResearch.com Interview with: Dr. Joseph Pergolizzi MD Senior Partner and Director of Research Naples Anesthesia and Pain Associates Naples, Florida MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There are roughly 100 million Americans living with chronic pain and many battle debilitating side effects because of their pain medication, including Painstipation otherwise known as opioid-induced constipation (OIC.) In fact, OIC is the most common side effect with approximately 40-80 percent of patients on chronic opioid therapy experiencing it. To better understand this community, the Painstipation survey, conducted by Salix Pharmaceuticals in partnership with the U.S. Pain Foundation, surveyed 441 U.S. adults with chronic pain who were on opioid therapy and suffering from OIC. It gave great insight into this community as it found:
  • More than half (51 percent) of chronic pain patients have been suffering from opioid-induced constipation  for three years or longer
  • Most patients (73 percent) agree that one of the biggest challenges of having OIC is that medications don’t work quickly enough to relieve pain associated with OIC.
  • 53 percent of patients say they want relief for OIC in under four hours
  • Only half of patients surveyed (73 percent) surveyed said they were informed by their doctors that taking opioid medications might result in constipation before they began taking them
  • 77 percent of respondents reported suffering from OIC for at least one year
  • When asked, roughly one-third (32 percent) of patients reported that their doctor does not talk to them specifically about potential adverse drug-to-drug interactions (DDI) of their current prescription and/or over-the-counter medications.
(more…)
Author Interviews, Cancer Research, Lung Cancer, PNAS / 08.04.2018

MedicalResearch.com Interview with: Nada Kalaany, PhD Harvard Medical School Boston Children's Hospital Boston, MA 02115 MedicalResearch.com: What is the background for this study? Response: ​ Non-small cell lung cancer (NSCLC) is the predominant form of lung cancer and the leading cause of cancer death in the US and worldwide. Over a quarter of NSCLC harbors activating mutations in the KRAS oncogene, which despite decades of attempts, has proven to be very difficult to target. KRAS has previously been demonstrated to directly bind to and activate the pro-proliferative kinase PI3K, which is typically activated by insulin/insulin-like growth factor1 (IGF1) signaling. KRAS-PI3K binding is required for KRAS-driven lung cancer formation and progression. However, whether this interaction is sufficient for lung tumor formation and whether additional input is required from insulin/IGF1 signaling, has remained largely controversial. (more…)
Author Interviews, Emergency Care, Opiods / 08.04.2018

MedicalResearch.com Interview with: Frank Scheuermeyer MD MHSc Clinical Associate Professor Department of Emergency Medicine St Paul’s Hospital and the University of British Columbia  MedicalResearch.com: What is the background for this study? Response: Mortality from the opioid epidemic is dramatically increasing and a main culprit appears to be illicit fentanyl. Current research states that patients with presumed fentanyl overdoses are at high risk of deterioration and death, and require prolonged emergency department stays or hospital admission to ensure a safe outcome. Our inner-city hospital adopted a protocol initially developed for patients with heroin overdose, modified it to account for the greater potency of fentanyl, and studied 1009 consecutive patients who arrived with an overdose. (more…)
Author Interviews, JAMA, Mental Health Research / 07.04.2018

MedicalResearch.com Interview with: Dr. Aideen Maguire Centre of Excellence for Public Health Queen's University Belfast Institute of Clinical Sciences B Royal Hospitals Site, Belfast MedicalResearch.com: What is the background for this study?   Response: Consanguineous Marriage is the marriage between second or first cousins. Although not common practice in the Western world approximately 1 in 10 children worldwide are born to consanguineous parents. It is legal in all countries worldwide except the United States of America, North Korea and China. Cousin-marriage is associated with an increased risk of autosomal recessive genetic disorders in offspring but the association between cousin-marriage and the mental health of offspring has not been extensively studied. MedicalResearch.com: What are the main findings? Response: Children of consanguineous parents are over 3 times more likley to be in receipt of medications for common mood disorders (antidepressant and/or anxioltyic medication) compared to children of non-related parents and over twice as likley to be in receipt of antipsychotic medication compared to children of non-related parents.  (more…)
Author Interviews, Bone Density, Geriatrics, Nutrition / 06.04.2018

MedicalResearch.com Interview with: “bought a passive-aggressive amount of milk” by Paul Downey is licensed under CC BY 2.0Shivani Sahni, PhD Assistant Professor of Medicine, Harvard Medical School Director, Nutrition Program Associate Scientist, Musculoskeletal Research Institute for Aging Research, Hebrew SeniorLife, Boston  MA  02131-1097 MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that higher milk intake is associated with higher bone mineral density. In one of our previous studies, we reported that higher dairy food intake was protective against bone loss especially among older adults who used vitamin D supplements. Older adults are at high risk of vitamin D deficiency because recommended intakes are difficult to achieve without fortified foods (such as dairy) or supplements. Vitamin D stimulates calcium absorption, which is beneficial for building bones. However, it is unclear if the effect of vitamin D on calcium absorption is substantial enough to translate into beneficial effects on bone. Therefore, the current study determined the association of dairy food intake with bone health. We further examined whether these associations would be modified by vitamin D status. (more…)