Asthma, Author Interviews, CDC, Occupational Health, Pulmonary Disease / 28.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37228" align="alignleft" width="125"]Katelynn Dodd MPH Respiratory Health Division National Institute for Occupational Safety and Health Centers for Disease Control and Prevention Morgantown WV 26505 Katelynn Dodd[/caption] Katelynn Dodd MPH Respiratory Health Division National Institute for Occupational Safety and Health Centers for Disease Control and Prevention Morgantown WV 26505 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adults with asthma are at increased risk for pneumococcal infection. Adults with asthma who get pneumococcal pneumonia are at risk for additional complications including asthma exacerbation and invasive pneumococcal disease. Our results indicated that adults with work-related asthma were more likely to have received a pneumococcal vaccine than adults with non-work-related asthma—54 percent compared to 35 percent respectively; however, pneumococcal vaccination coverage among all adults with asthma, work-related or not, who have ever been employed in this study falls short of achieving the coverage public health experts recommend. Among adults with work-related asthma, pneumococcal vaccine coverage was lowest among Hispanics (36 percent), those without health insurance (39 percent), and adults aged 18 to 44 years (42 percent).
Author Interviews, Columbia, Heart Disease, Orthopedics / 28.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37221" align="alignleft" width="125"]Dr. Mathew Maurer, Medical Director The Hypertrophic Cardiomyopathy Center NewYork-Presbyterian/Columbia University Medical Center. Dr. Maurer[/caption] Dr. Mathew Maurer, Medical Director The Hypertrophic Cardiomyopathy Center NewYork-Presbyterian/Columbia University Medical Center. MedicalResearch.com: What is the background for this study? Response: Transthryretin cardiac amyloidosis (TTR-CA) is an underdiagnosed type of cardiomyopathy in which TTR (transthyretin, also known as prealbumin), a protein that forms amyloid fibrils, deposits in the heart. The deposits cause thickening of the ventricular wall and diastolic as well as systolic dysfunction. It is usually discovered around age 75 and presents more commonly in men than in women. With advances in non-invasive diagnostic modalities and growing awareness, TTR-CA is being diagnosed increasingly more frequently. Additionally, there are several emerging treatments that are under active investigation. Most of these therapies prevent disease progression and don’t address the amyloid already deposited in the heart. Accordingly, it is imperative that we diagnose TTR-CA before patients develop significant amyloid heart disease. However, this presents a great challenge since there are few known clinical predictors that might alert even the most astute physician that a patient is at such risk. With identification of predictors that may appropriately raise the index of clinical suspicion, clinicians may begin to pick up more subtle (and perhaps not yet clinically significant) forms of TTR-CA and initiate treatment before significant damage occurs. The few known clinical predictors of TTR-CA include bilateral carpal tunnel syndrome and lumbar spinal stenosis, and numerous studies found TTR on biopsies and autopsies of other musculoskeletal sites, particularly in hip and knee joints. (Just last week, and also discussed here on MedicalResearch.com, biceps tendon rupture was also shown to occur more frequently in TTR-CA!) We suspected that patients who ultimately develop TTR-CA may first develop clinically significant hip and knee disease, enough to even warrant a hip (THA) or knee (TKA) replacement.
Author Interviews, Dermatology, JAMA, Surgical Research / 28.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37225" align="alignleft" width="125"]P. Daniel Ward, MD, MS, FACS Facial Plastic Surgeon WardMD Form Medical SpaAdjunct Associate Professor, University of Utah School of Medicine Salt Lake City, Utah 84121 Dr. Ward[/caption] P. Daniel Ward, MD, MS, FACS Facial Plastic Surgeon WardMD Form Medical SpaAdjunct Associate Professor, University of Utah School of Medicine Salt Lake City, Utah 84121 MedicalResearch.com: What is the background for this study? What are the main findings? Response: As a facial plastic surgeon with an interest in finding treatments for patients with facial paralysis, we are always looking for ways to improve the care that our patients receive. One of those treatments is to treat the effects of abnormal and asymmetric facial motion with botulinum, which decreases the deformity that results from facial nerve disorders by decreasing muscular hyperactivity. This study was based on the fact that there are three commercially available types of botulinum available for treatment of the face. There have been studies that have compared the different types of botulinum for cosmetic purposes, but there have not been any studies that specifically looked to see if there were any differences between the different types of botulinum when used for treatment of facial nerve disorders. The main finding of the study is that the three different types of botulinum are essentially equivalent with the exception being that one type of botulinum, incobotulinum toxin, was slightly less effective than the other two types of botulinum at the 4-week follow up point. Of note, all three types were equivalent at all other time points.
Allergies, Author Interviews, Dermatology, JAMA, Pediatrics / 28.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37216" align="alignleft" width="250"]Hives-Urticaria Wikipedia image Hives-Urticaria
Wikipedia image[/caption] Elena Netchiporouk, MD, FRCPC, MSc Dermatology Resident - PGY5 and Dr. Moshe Ben-Shoshan, MD, FRCPC, MSc McGill University MedicalResearch.com: What is the background for this study? Response: We have followed a pediatric cohort of 139 patients with chronic urticaria (CU) (hives) between 2013 and 2015 in a single tertiary care center and assessed the comorbidities, the rate of resolution and determined predictors of resolution.
Author Interviews, Cancer Research, Cannabis / 27.09.2017

MedicalResearch.com Interview with: [caption id="attachment_18486" align="alignleft" width="200"]Dr. Italia V. Rolle, PhD and Dr. Tim McAfee, MD Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion CDC Marijuana plant (Cannabis sativa)[/caption] Jiries Meehan-Atrash Department of Chemistry, Portland State University Portland, Oregon MedicalResearch.com: What is the background for this study? What are the main findings? Response: The need for this study stems from the rising popularity of cannabis, and specifically the fact that many consumers are under the belief that vaporizing extracts thereof is safer than smoking. While this may in fact have some truth to it, it is clear that we must assess the safety of vaporization a route of administration. The main findings are that vaporizing terpenes under dabbing conditions generates some levels of methacrolein (a noxious irritant) at all temperatures that are hot enough to vaporize cannabinoids, but significant levels arise at higher temperatures that are more commonly used. To do this, you'll need to make sure your dab rig is in excellent condition. At the highest temperature used by consumers, significant levels of benzene arise, a compound that is a potent carcinogen and should be avoided at all costs.
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, Nutrition / 27.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37208" align="alignleft" width="125"]Seth A. Berkowitz, MD, MPH Division of General Internal Medicine Diabetes Population Health Unit Harvard Medical School Massachusetts General Hospital, Boston Dr. Berkowitz[/caption] Seth A. Berkowitz, MD, MPH Division of General Internal Medicine Diabetes Population Health Unit Harvard Medical School Massachusetts General Hospital, Boston MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is ever growing pressure to contain healthcare costs in the US. Increasingly, attention is turning to programs that address social determinants of health--that is, those factors which affect health but lie outside the realm of clinical medicine. Prior research has highlighted food insecurity as having a clear association with poor health and higher healthcare costs. SNAP is the nation's largest program to combat food insecurity. However, we did not know whether SNAP participation would be associated with any difference in healthcare costs, compared with eligible non-participants. This study found that participating in SNAP was associated with approximately $1400 lower healthcare expenditures per year in low-income adults.
Author Interviews, Mayo Clinic, Weight Research / 27.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37204" align="alignleft" width="125"]Dr. W. Stephen Brimijoin PhD Department of Molecular Pharmacology and Experimental Therapeutics Mayo Clinic, Rochester, MN 55905 Dr. Brimijoin[/caption] Dr. W. Stephen Brimijoin PhD Department of Molecular Pharmacology and Experimental Therapeutics Mayo Clinic, Rochester, MN 55905 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study was: 1) Ordinary C57 black mice readily become obese when given unrestricted access to high-fat mouse chow. 2) If the obese mice are put on a forced calorie restricted diet they will regain their previous normal healthy weight.  However, if they are given unrestricted access to their previous “normal” low-fat mouse chow, they will rebound into obesity.  This effect can be seen as a model of human obesity and the difficulties that formerly obese men and women face in maintaining healthy body mass gained after dieting. 3) The literature on obesity provided reason to believe that this self-defeating behavioral cycle involves ghrelin, the so-called “hunger hormone.” 4) We had recently shown that the plasma enzyme called “butyrylcholinesterase” was a key regulator of active ghrelin. Therefore, it seemed plausible that raising enzyme levels would reduce ghrelin and, in turn, would blunt food craving.
Author Interviews, Gender Differences, Psychological Science / 27.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37200" align="alignleft" width="102"]Patti J. Fisher, Ph.D. Associate Professor in Consumer Studies AHRM Department Virginia Tech Dr. Fisher[/caption] Patti J. Fisher, Ph.D. Associate Professor in Consumer Studies AHRM Department Virginia Tech MedicalResearch.com: What is the background for this study? Response: Risk tolerance is one of the most important factors contributing to wealth accumulation and retirement. It is important to understand why women are less risk tolerant so that financial planners can better serve their needs because women, on average, live longer than men and often need more retirement savings.
Author Interviews, Autism, Genetic Research, JAMA / 27.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37175" align="alignleft" width="114"]Sven Sandin, PhD Assistant Professor Department of Psychiatry Icahn School of Medicine at Mount Sinai New York, NY 10029 D. Sandin[/caption] Sven Sandin, PhD Assistant Professor Department of Psychiatry Icahn School of Medicine at Mount Sinai New York, NY 10029  MedicalResearch.com: What is the background for this study? What are the main findings? Response: In 2014, we estimated the heritability of autism to be approximately 50%. Motivating us then was the lack of studies in autism heritability using population based and the findings from a twin-study in California finding the heritability to be substantially lower than the 80-90% estimated in previous studies. Since then continued efforts working with the questions on heritability and environmental factors for autism we found differences between different methods and different samples. When we went back to our previous data we found the heritability of autism to be higher than previously estimated. We found that our previous result was due to a methodological artifact where the adjustment for differences in follow-up used in that manuscript underestimated the heritability. Using methods used in other heritability studies the heritability is now estimated to 84%. Importantly, as previously concluded, there is no support for any ‘shared environmental factors’ in the etiology of autism, e.g. environmental factors shared between two siblings.
Author Interviews, Prostate Cancer, Radiation Therapy / 26.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37181" align="alignleft" width="108"]Dr. Shuang George Zhao, MD House Officer, Radiation Oncology University Hospital Ann Arbor, MI 48109-5010 Dr. Zhao[/caption] Dr. Shuang George Zhao, MD House Officer, Radiation Oncology University Hospital Ann Arbor, MI 48109 MedicalResearch.com: What is the background for this study? Response: Targeting cancer through the immune system has been a longstanding goal of cancer research, and with recent advances in immunotherapy, it is now a reality. However, the role of immunotherapy in prostate cancer is still being defined. Sipuleucel-T was the first FDA approved immunotherapy in prostate cancer, and is a personalized cellular therapy that has been shown to prolong survival in patients with metastatic prostate cancer. On the other hand, two recent phase III randomized trials looking at ipilimumab, a CTLA-4 checkpoint inhibitor in metastatic prostate cancer have both been negative for their primary endpoint of OS. Interestingly, there was a PSA response, suggesting that there may be some therapeutic effect in a subset of patients. Therefore, understanding the immune infiltrate is likely critical to selecting patients and therapeutic strategies utilizing the immune system. Unfortunately, it is difficult and laborious to histologically assess immune infiltrate directly. Therefore, we used existing high throughput transcriptomic data with new computational methods in order to more fully characterize the immune landscape of localized prostate cancer.
Accidents & Violence, Author Interviews, Emergency Care / 26.09.2017

MedicalResearch.com Interview with: [caption id="attachment_34914" align="alignleft" width="145"]Gary Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH Dr. Smith[/caption] Gary Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH MedicalResearch.com: What is the background for this study? Response: Previous studies have documented the frequency and characteristics of stair-related injuries among children and older adults. Numerous studies have examined gait characteristics of different age groups and their relationship to falls. In addition, it is estimated that the direct medical and indirect costs of non-fatal stair-related injuries are $92 billion annually in the US. The current study investigates the epidemiological characteristics of stair-related injuries among all ages using a nationally representative sample over a multi-year period. Our study also expands upon prior research on this topic to investigate the mechanisms of stair-related injuries and examine trends.
Anesthesiology, Author Interviews, JAMA, Pediatrics, Pulmonary Disease / 26.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37063" align="alignleft" width="125"]Shabih U. Hasan, MD, DCH, FRCPC Professor and Staff Neonatologist, Alberta Health Services Department of Pediatrics, Cumming School of Medicine University of Calgary Dr. Hasan[/caption] Shabih U. Hasan, MD, DCH, FRCPC Professor and Staff Neonatologist, Alberta Health Services Department of Pediatrics, Cumming School of Medicine University of Calgary MedicalResearch.com: What is the background for this study? Response: Approximately 8% of all infants are born prematurely (preterm birth <37 weeks postmenstrual age). Preterm infants have many challenges including establishment of adequate pulmonary gas exchange. Due to not yet fully developed lungs, preterm infants require respiratory support consisting of respirators and other forms of non-invasive ventilation modalities and supplemental oxygen.  Bronchopulmonary dysplasia (BPD) is the commonest morbidity among very low birth weight infants as 40% of survivors at postmenstrual age <30 weeks develop BPD. This is a serious condition as it can lead to short- and long-term pulmonary complications, increased hospital visits and neurodevelopmental impairment. BPD is defined where preterm infants require respiratory support and/or supplemental oxygen at 36 weeks postmenstrual age. A number of therapeutic and non-therapeutic modalities have been used to prevent BPD including inhaled nitric oxide (iNO).  In 2006, the NO CLD trial demonstrated that iNO prevented BPD (Relative benefit 1.81; CI 1.27-2.59, P = 0.006) if used according to the NO CLD Protocol (Ballard et al., New England Journal of Medicine, 355:343-353, 2006). Our study (NEWNO; Newborns treated with Nitric Oxide) was designed to replicate the NO CLD study.
Author Interviews, Pain Research / 24.09.2017

MedicalResearch.com Interview with: Mark A. Lumley, Ph.D. Distinguished Professor and Director of Clinical Psychology Training Department of Psychology Wayne State University Detroit, Michigan  48202 and Howard Schubiner, M.D Founder and Director Mind-Body Medicine Center Providence-Providence Park Hospitak Warren, MI 48092  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Fibromyalgia is a condition that afflicts many people with chronic pain and other symptoms, which are often severe. There is no clear evidence of tissue damage or other peripheral causes of the symptoms, and experts agree that the pain is real, and its primary source is the brain. Medications for fibromyalgia have limited effectiveness, so psychological and behavioral therapies are core to treatment. Research documents a strong relationship between emotions and pain, and many patients with FM struggle with negative emotions related to difficult life circumstances, such as trauma, abuse, or relationship conflicts. Ironically, most psychological therapies for FM do not address these problems, but rather teach people how to manage their symptoms. Emerging research, however, demonstrates that therapies that help patients engage rather than avoid their difficult emotional experiences improve both psychological and physical symptoms, including pain. Therefore, we developed an emotion-focused therapy, which we call Emotional Awareness and Expression Therapy (EAET), and compared it to both an active education-based control condition and to the leading psychological intervention for fibromyalgia, cognitive-behavior therapy (CBT). The EAET condition was substantially better on multiple outcomes that the control condition 6 months after treatment. Importantly, although EAET did not differ from CBT on many outcomes, EAET was superior than CBT on reducing widespread and in the percentage of individuals achieving substantial pain reduction (that is, at least 50% pain reduction from baseline).
Author Interviews, Breast Cancer / 23.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37125" align="alignleft" width="125"]Rebekah Nagler PhD Assistant professor Hubbard School of Journalism and Mass Communication University of Minnesota Dr. Nagler[/caption] Rebekah Nagler PhD Assistant professor Hubbard School of Journalism and Mass Communication University of Minnesota  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Both the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) have stated that women in their 40s--or, in the case of ACS, women ages 40-44--should have the choice to decide when they want to start screening for breast cancer. These organizations recommend that women in this age group weigh the benefits and risks of mammography screening, with the goal of making an informed decision about when to start screening. Yet recent research has shown that women are more aware of the benefits of mammography screening than the harms, including overdiagnosis and overtreatment (doi:10.1001/jamainternmed.2017.2247). We therefore wondered whether women actually have the information they need to make informed screening decisions. In a population-based sample of 429 U.S. women ages 35-55, we found that awareness of breast cancer overdiagnosis (16.5%) and overtreatment (18.0%) was low. Moreover, we found that most women did not find statements about these harms to be believable and persuasive.
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Orthopedics / 22.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37118" align="alignleft" width="125"]Avinainder Singh, M.B.B.S. Research Fellow Cardiovascular Medicine Brigham & Women's Hospital Harvard Medical School Boston, MA Dr. Singh[/caption] Avinainder Singh, M.B.B.S. Research Fellow Cardiovascular Medicine Brigham & Women's Hospital Harvard Medical School Boston, MA MedicalResearch.com: What is the background for this study? Response: Amyloidosis due to aberrant folding of proteins. These misfolded proteins can deposit in various parts of the body and lead to organ dysfunction. The two most common types of amyloidosis affecting the heart include transthyretin and light chain amyloidosis. Transthyretin is a protein produced by the liver which supports the transport of thyroxine and retinol. Wild-type transthyretin amyloidosis (ATTRwt, previously known as senile amyloidosis) occurs due to deposition of misfolded fibrils derived from transthyretin and primarily affects elderly men. Once considered a rare disease, it is now reported to be responsible for nearly 13% of heart failure with preserved ejected fraction and increased wall thickness. Rupture of the biceps tendon is a rare occurrence in the general population (<1 per 1000). We noticed a ruptured biceps tendon in several patients with wild-type transthyretin amyloidosis and performed this study to further evaluate this finding in a group of patients with wild-type transthyretin amyloidosis and in a control group of age-matched patients with non-amyloid heart failure.
Aging, Author Interviews, Exercise - Fitness / 22.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37094" align="alignleft" width="80"]Dr. Daniel Aggio, PhD UCL Department of Primary Care and Population Health UCL Medical School University College London PA Research Group London, UK Dr. Aggio[/caption] Dr. Daniel Aggio, PhD UCL Department of Primary Care and Population Health UCL Medical School University College London PA Research Group London, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Maintaining a physically active lifestyle into old age is associated with optimal health benefits. While we know that levels of physical activity in youth predict physical activity levels in adulthood, how physical activity in midlife predicts physical activity in old age is not as well understood. It is also unclear how different types of physical activity predict physical activity in later life. Using data from the British Regional Heart Study, an ongoing prospective cohort study involving men recruited between 1978 and 1980, we assessed how physical activity tracks over 20 years from midlife to old age. The study of over 3400 men showed that being active in midlife more than doubled the odds of being active 20 years later. Interestingly, sport participation in midlife predicted physical activity in old age more strongly than other types of physical activity, such as walking and recreational activity. The odds of being active in old age were even stronger for those men who took up sport from a younger age prior to midlife. Sport was the most stable activity across the follow up, with just under half of men reporting playing sport at least occasionally at each survey. However, walking was the least stable; the proportion of men who reported high levels of walking rose from just under 27% at the start of the study to 62% at the 20 year survey, possibly because retirement might free up more time.
Author Interviews, Pediatrics / 22.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37082" align="alignleft" width="125"]Maureen Pirog PhD Rudy Professor of Policy Analysis School of Public and Environmental Affairs Indiana University Dr. Pirog[/caption] Maureen Pirog PhD Rudy Professor of Policy Analysis School of Public and Environmental Affairs Indiana University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We analyzed parenthood, education and income statistics over a long time span from two groups of about 10,000 people -- those born in 1962-64 and those born in 1980-82.
  • Teen fathers and mothers came increasingly from single-mother families with disadvantaged backgrounds.
  • The proportion of teen mothers or fathers living with their partners didn't change, but far fewer were married.
  • The birth rates to teenage girls across the two groups didn't change, but the reported rate of teenage fatherhood increased, a seemingly contradictory conclusion. For example, 1.7 percent of the men in the older group were fathers by the time they were 17, while in the younger group, nearly double that number were dads. About 8 percent of the 17-year-old females in both groups were mothers.
Author Interviews, Education, Karolinski Institute, Pediatrics, Psychological Science / 22.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37074" align="alignleft" width="125"]Malin Bergström PhD Center for Health Equity Studies Karolinska Institutet   Dr. Bergstrom[/caption] Malin Bergström PhD Center for Health Equity Studies Karolinska Institutet   MedicalResearch.com: What is the background for this study? Response: The increase in children who move between their parent's homes after a divorce is one of the major changes in children's life circumstances during the last decade. Spending equal amounts of time in both parents' homes means that these children move fifty times a year. Child experts have claimed this to be stressful and potentially harmful to children's attachment relations to their mothers. Especially for children this young the practice of joint physical custody has been questioned.
Author Interviews, Gender Differences, Genetic Research, Sexual Health / 22.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37070" align="alignleft" width="90"]Steven Arnocky PhD Faculty of Arts & Science-Psychology Nipissing University Canada Dr. Arnocky[/caption] Steven Arnocky PhD Faculty of Arts & Science-Psychology Nipissing University Canada  MedicalResearch.com: What is the background for this study? What are the main findings? Response:  - Previous research has linked the facial width-to-height ratio to a number of testosterone-mediated traits, primarily in men, such as aggression and achievement drive. Some research has also linked FWHR to testosterone directly, although this research is less consistent. If testosterone is linked to cranio-facial development then we hypothesized that facial masculinization should therefore correlate with other testosterone-linked traits. In both men and women, there is good evidence that testosterone increases sexual motivation. In two samples of young-adults from two Canadian cities, we found that  facial width-to-height ratio predicted sex-drive, regardless of whether participants were male or female. In the second study (the larger of the two) we also found that FWHR predicted a more unrestricted sociosexual orientation, in other words, attitudes and behavior consistent with more pluralistic mating, as well as more intended infidelity.
Alzheimer's - Dementia, Author Interviews, Infections, Neurology, Parkinson's / 22.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37066" align="alignleft" width="300"] Under a magnification of 900X, this hematoxylin and eosin-stained (H&E) photomicrograph of a brain tissue specimen revealed a case of neurotoxoplasmosis in a patient who had also been diagnosed with multiple myeloma. Note the Toxoplasma gondii tissue cyst, within which bradyzoites could be seen developing. CDC Image[/caption] Rima McLeod, M.D., F.A.C.P, F.I.D.S.A Professor of Ophthalmology and Visual Sciences,Pediatrics (Infectious Diseases), and The College, Director, Toxoplasmosis Center, Senior Fellow,Institute of Genomics, Genetics and Systems Biology, Member, Commitees on Immunology, and Molecular Medicine and Pathogenesis, Member Global Health Center, Affiliate CHeSS; Attending Physician, Chicago Medicine, The University of Chicago MedicalResearch.com: What is the background for this study? * One third of humans are infected lifelong with the brain-dwelling, protozoan parasite, Toxoplasma gondii. * Approximately fifteen million of these have congenital toxoplasmosis. * The parasite interconverts between slow-growing, encysted bradyzoites and rapid-growing tachyzoites. * In mice, T. gondii creates a chronic intra-neuronal infection and an inflammatory process. * Mice with acute and chronic infection have alterations in neurotransmitters, memory, seizures, and neurobehavior. * Some epidemiologic-serologic studies show associations between seropositivity for T. gondii and human neurologic diseases, for example, Parkinson’s and Alzheimer’s diseases. * Although neurobehavioral disease is associated with seropositivity, causality is unproven. * Serologic studies of humans with diverse genetics are not optimal to detect strong associations or directionality. * Epidemiologic associations also do not reveal parasite-modulated gene networks in human brain that could provide insights into how to cure and prevent resultant diseases. * We need integrative approaches to examine relationships between brain parasitism and other brain diseases, to provide a foundation to identify key pathways and molecules for drug and vaccine design * To address these problems, we considered two central questions: (i) If chronic brain parasitism associates with other neurologic diseases, what are they? And (ii) Which macromolecular networks are modulated by the parasite in human brain that lead to neuropathology which could underpin and facilitate design of treatments? * We hypothesized that a systems approach integrating multiple levels of host parasite interactions might resolve these questions. * To better understand what this parasite does to human brains, we performed a comprehensive systems analysis of the infected brain. 
Author Interviews, ENT, Surgical Research / 22.09.2017

MedicalResearch.com Interview with: [caption id="attachment_36885" align="alignleft" width="114"]Brett A. Miles, DDS MD FACS Associate Professor of Otolaryngology Head and Neck Surgery Co-Chief Division Head and Neck Oncology Fellowship Director Head and Neck Oncologic and Microvascular Reconstructive Surgery Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York, NY 10029 Dr. Miles[/caption] Brett A. Miles, DDS MD FACS Associate Professor of Otolaryngology Head and Neck Surgery Co-Chief Division Head and Neck Oncology Fellowship Director Head and Neck Oncologic and Microvascular Reconstructive Surgery Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York, NY 10029  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The ideal core temperature for patients undergoing prolonged major head and neck surgery remains unknown. Previous data indicates the low temperatures may increase the risk of developing postoperative complications such as tissue loss, hematomas, or surgical infections.(1) Other studies have indicated that high temperatures may also influence outcomes and lead to increased complications such as bleeding.(2) This study was a study of 519 patients who underwent major head and neck surgery at the Mount Sinai Hospital, New York, New York. The study looked at the core temperature of the patients during prolonged surgery for head and neck cancer in order to identify the optimal temperature range for these patients to prevent complications. The study found that higher intraoperative temperatures were associated with worse outcomes in terms of tissue loss, wound complications, and infection. Our study suggests an optimal temperature range of 35.3C-37.6C. If patients were above or below that range for a significant period of time, their complications increased. Therefore maintaining this temperature range (mild hypothermia) may improve flap outcomes in this population.
Author Interviews, Weight Research / 20.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37059" align="alignleft" width="125"]Professor Nuala Byrne PhD Head of School | Health Sciences Faculty of Health University of Tasmania Prof. Byrne[/caption] Professor Nuala Byrne PhD Head of School | Health Sciences Faculty of Health University of Tasmania  MedicalResearch.com: What is the background for this study? Response: Calorie restriction (or cutting back on the energy we are eating) triggers powerful compensatory responses by our body’s metabolism - we might think of it as a “Famine Reaction”. Our body weight is regulated by a series of nervous system and hormone networks that act together to make sure we have enough energy to sustain life. When we eat more energy than our body needs to meet our daily metabolic requirements (positive energy balance), we are designed to store that excess energy; and we are very good at storing. We store this energy in the fat cells (adipocytes) as an emergency reserve for when we hit hard-times when food availability is scarce. The problem in today’s society is that most of us have a constant availability of energy-dense food; making it more common to be in energy excess. When we have less calories being consumed than what we need to fuel all the body’s metabolic processes (negative energy balance), we convert the stored fat into usable energy, and consequently lose weight. While our body does sense the positive energy balance, it is designed to be more sensitive to gauging when we are in a negative energy balance. Our body senses the change in energy intake and the decreasing fat stores, and brings out the artillery to defend our energy stores - this is the Famine Reaction. Our body is constantly changing our physiology in response to challenges to the status quo; the body works constantly to keep the oxygen concentration in the blood at an optimal level, to keep a constant and optimal body temperature, and a constant and optimal amount of sugar in the blood. Our body’s regulatory systems also work hard to defend our energy stores if it senses we are continually in negative energy-balance (i.e., dieting). One major metabolic compensatory as part of the “Famine Reaction” is a decrease in the body’s resting metabolic rate (energy expended while at rest to maintain the basic functioning of our major organs). Given that resting metabolic rate is determined largely by body size and composition, it is expected to decrease with weight loss. However, during dieting, resting metabolic rate has been reported to decrease to a greater extent than that expected from changes in body composition, a phenomenon termed ‘adaptive thermogenesis’. This leads to markedly reduced efficiency of weight loss.
Author Interviews, Diabetes, NEJM, Surgical Research, Weight Research / 20.09.2017

MedicalResearch.com Interview with: Ted Adams PhD Adjunct Professor, Internal Medicine Adjunct Associate Professor, Nutrition & Integrative Physiology The University of Utah  MedicalResearch.com: Why did you decide to conduct this study? Response: The primary aim of the study was to determine the clinical outcomes in patients who underwent gastric bypass surgery. As NIDDK/NIH continued to fund the study, the aim was extended to determining the durability) long-term outcomes) of gastric bypass surgery when compared to non-surgical, severely obese patients.
Author Interviews, Infections, JAMA, OBGYNE, Surgical Research, Weight Research / 20.09.2017

MedicalResearch.com Interview with: [caption id="attachment_36995" align="alignleft" width="116"]Dr. Carri R. Warshak, MD Associate Professor of Obstetrics & Gynecology University of  Cincinnati Dr. Warshak[/caption] Dr. Carri R. Warshak, MD Associate Professor of Obstetrics & Gynecology University of  Cincinnati MedicalResearch.com: What is the background for this study? Response: Cesarean deliveries are the most common major surgical procedure performed in the United States.  A common complication of cesarean section is wound infections that can include infections in the skin and incision site, or infections in the uterus itself after delivery.  These complications can lead to prolonged hospitalization after delivery for antibiotics and even further surgery in severe infections.  Often these wound complications lead to delayed healing, wound opening which can sometimes take several weeks to heal. Studies have demonstrated as many as 12% of women experience a surgical site infection after delivery. Obesity is a strong risk factor for increased surgical site infections.  Increasing maternal weight increases the risk of wound complications, with a two to five fold increase in risk, making surgical site infections and common and concerning complication of cesarean delivery in obese women.
Author Interviews, Cognitive Issues, Mental Health Research / 20.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37050" align="alignleft" width="110"]Amitai Abramovitch, PhD Assistant Professor Department of Psychology Texas State University Dr. Abramovitch[/caption] Amitai Abramovitch, PhD Assistant Professor Department of Psychology Texas State University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obsessive-Compulsive Disorder (OCD) is associated with moderate degree of underperformance on several cognitive tests such as processing speed, and some higher order functions such as planning and inhibition. While this does not constitute a clinically meaningful impairment on these functions, we set out to explore the prevailing myth that OCD is associated with above-average intelligence. This myth, that was propagated by Sigmund Freud 115 years ago and is still surprisingly all too prevalent -  was never tested empirically. The notion of above average intelligence in OCD didn’t make sense to us given that IQ tests are comprised of subtests that assess cognitive function. To test this, we collected all the available data ever published in the scientific literature regarding IQ in OCD versus control samples, and conducted a meta-analysis. Our results show that OCD is not associated with higher IQ than average. In fact we found a slightly lowered IQ in OCD compared to controls, although IQ scores for OCD samples were in the average range. The total IQ score (Full Scale IQ) is comprised of two subscales, namely Verbal IQ, and Performance IQ. Our results show that reduced Full Scale IQ stems primarily from lowered Performance IQ, a scale that is comprised of a number of timed tests. In other words, as opposed to Verbal IQ tests, test scores on Performance IQ subtests rely heavily on performance within a specific time frame, and not only on performance accuracy. Thus, our findings suggest that reduced processing speed found in OCD could lead to reduced Performance IQ, and subsequently lead to lowered Full Scale IQ, and may not be indicative of specific cognitive deficits. This finding suggests that IQ tests administered to individuals diagnosed with OCD may result in a biased Full Scale IQ scores that does not accurately reflect their full intellectual potential.
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Technology / 20.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37046" align="alignleft" width="120"]MedicalResearch.com Interview with: Muthiah Vaduganathan, MD, MPH Brigham and Women’s Hospital Heart & Vascular Center and Harvard Medical School Boston, Massachusetts Dr. Vaduganathan[/caption] Muthiah Vaduganathan, MD, MPH Brigham and Women’s Hospital Heart & Vascular Center and Harvard Medical School Boston, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: The CardioMEMS™ HF System (Abbott, Sylmar, CA) is a commercially-available, wireless hemodynamic monitor that can be permanently implanted in the pulmonary artery (PA) to permit real-time, remote monitoring of PA pressures to enhance clinical decision-making in patients with heart failure (HF). Based on a favorable safety profile and the results of the CHAMPION trial, the US Food and Drug Administration (FDA) approved the device in May 2014. Since FDA approval, the device is being implanted in older patients with greater comorbidities compared with those enrolled in CHAMPION. Limited safety data are available after market introduction in this higher-risk pool.
Author Interviews, BMJ, Ophthalmology / 19.09.2017

[caption id="attachment_37040" align="alignleft" width="250"]Helgi Halldórsson from Reykjavík, Iceland Wikipedia image A man aiming an N-Strike Stampede ECS
Wikipedia image[/caption] MedicalResearch.com Interview with: Dr. Mukhtar Bizrah Accident & Emergency Department, Moorfields Eye Hospita NHS Foundation Trust London, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: We noticed a number of patients presenting to the accident and emergency department at our hospital following 'Nerf gun' injuries. We decided to perform this study because an online literature search revealed that currently there was no published work on this topic. It was worth doing because it is a public health issue. A number of doctors in A&E commented that they have seen a number of patients present with Nerf gun injuries. I personally saw a patient which an inflamed eye and damage to the iris following a 'Nerf gun' injury. We decided to write about three patients with bleeding in the eye (hyphema) because most journals have a cap on the number of patients in a case series. Also, bleeding in the eye following trauma is known to be associated with serious ocular injury and long term repercussions.
Author Interviews, JAMA, Leukemia, Transplantation / 19.09.2017

MedicalResearch.com Interview with: Huisheng Ai, MD, Director Department of Hematology and Transplantation, Affiliated Hospital of the Academy  of Military Medical Sciences, Beijing, China  MedicalResearch.com: Which of these results did you find most interesting or surprising? Response: First, we must stress that microtransplant dramatically improved the outcome of older patients with AML. As we know, older AML patients often possess unfavorable prognostic factors, organ dysfunction, and slow post-chemotherapy hematopoietic recovery. Therefore, the general treatment outcome is unsatisfactory even though the incidence is increasing by age with low complete remission (CR) rates (34% to 65%) and poor short-term survival (Two years overall survival was about 11% to 25%). This study involved cases from multiple centers of China, USA and Spain, and found that microtransplant could not only significantly improve complete remission rate in older AML patients among all age groups from 60 to 85, but also improve 1-year and 2-year overall survival and disease free survival especially in patients aged 60 to 75. Second, microtransplant completely overcomes the restriction of HLA typing. The donor could be the patient’s haploidentical family member, or unrelated and fully mismatched one. The incidence of graft-versus-host disease (GVHD) was only 1.1%, even if no any GVHD prevention was given. Other treatment related complications and mortality were also decreased. These results are much better than those of traditional chemotherapy, myeloablative and non-myeloablative transplant, which provides a more safe and effective treatment choice. We are looking forward to seeing the revision of NCCN guideline for older AML to make microtransplant benefit more older patients.
Author Interviews, Endocrinology, JAMA / 19.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37034" align="alignleft" width="119"]Arjola Bano, MD, MSc, DSc Researcher in the Departments of Internal Medicine and Epidemiology, Erasmus Medical Center, Rotterdam the Netherlands Dr. Bano[/caption] Arjola Bano, MD, MSc, DSc Researcher in the Departments of Internal Medicine and Epidemiology, Erasmus Medical Center, Rotterdam the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Thyroid function is clinically defined by the measurements of serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels. So far, abnormal TSH and FT4 levels as well as variations within the normal range have been linked to an increased risk of cardiovascular disease and death. However, it remains unclear whether there are differences in life span and years of life lived with and without cardiovascular disease, within the reference range of thyroid function. To investigate this, we performed a prospective study among 7785 middle-aged and elderly people with normal thyroid function. Participants were part of the Rotterdam Study, 65 years on average and 52% females. In our statistical analyses, we accounted for sociodemographic and cardiovascular risk factors. Over a median follow-up of 8.1 years, 789 incident cardiovascular deaths and 1357 deaths occurred. Analyses were performed separately among men and women. Our study found differences in life expectancy within the reference range of thyroid function. At the age of 50 years, people with low-normal thyroid function lived up to 3.5 years longer than those with high-normal thyroid function. Also, people with low-normal thyroid function lived a longer life without cardiovascular disease than those with high-normal thyroid function.
Author Interviews, Diabetes, Geriatrics, Primary Care / 19.09.2017

MedicalResearch.com Interview with: [caption id="attachment_37029" align="alignleft" width="117"]Matthew L. Maciejewski, PhD Professor in Medicine Division of General Internal Medicine, Department of Medicine Center for Health Services Research Primary Care Durham VA Medical Center Duke University Dr. Maciejewski[/caption] Matthew L. Maciejewski, PhD Professor in Medicine Division of General Internal Medicine, Department of Medicine Center for Health Services Research Primary Care Durham VA Medical Center Duke University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Treating diabetes requires balancing the risks of long-term harm from under-treatment with the short-term and long-term harm from potential over-treatment. Randomized trials have shown that the benefits of aggressive glycemic control only begin after at least 8 years of treatment. Yet, the harms of aggressive glycemic control –  hypoglycemia, cardiovascular events, cognitive impairment, fractures, and death – can happen at any time. In some older people, “deintensification” of diabetes treatment may be the safer route, because of the risks that come with too-low blood sugar. The American Geriatrics Society (AGS) specifically states that medications other than metformin should be avoided when an older patient’s hemoglobin A1c is less than 7.5%, because the risks of hypoglycemia are larger and the potential benefits of treatment are smaller for older adults with diabetes.  Most attention in prior work has focused on undertreatment of diabetes and there has been only limited investigation of patient characteristics associated with overtreatment of diabetes or severe hypoglycemia. Since the elderly are therefore at greatest risk of overtreatment and Medicare is the primary source of care of the elderly, we examined rates of overtreatment and deintensification of therapy for Medicare beneficiaries, and whether there were any disparities in these rates.  We found that almost 11 percent of Medicare participants with diabetes had very low blood sugar levels that suggested they were being over-treated. But only 14 percent of these patients had a reduction in blood sugar medication refills in the next six months.