Author Interviews
06 Apr Deliberate Self-harm Associated With Violent Criminality
Posted at 19:23h
in Accidents & Violence, Author Interviews, JAMA, Karolinski Institute, Mental Health Research
MedicalResearch.com Interview with:
[caption id="attachment_33749" align="alignleft" width="133"]
Hanna Sahlin[/caption]
Hanna Sahlin
MSc, Lic psychologist, Lic psychotherapist
Specialist in clinical psychology
PhD-student
Departement of Clinical Neuroscience
Karolinska Institutet
National Self-harm project
Centre for Psychiatry Research, CPF
Stockholm, Sweden
What is the background for this study? What are the main findings?
Response: This study is the result of wanting to find a more conclusive answer to whether individuals who engage in non-fatal deliberate self-harm are more prone to aggression towards others. There has long been a debate on whether aggression to oneself and aggression towards others co-occur, but the studies that have been conducted thus far have been on smaller samples or with clinical or forensic cohorts. Also, the studies have had great variability regarding the definition of both “deliberate self-harm” and “violence”. Thus, it has been difficult to establish an ”overall” effect size for this association, or to draw firmer conclusions on how and if this association plays out in the general population.
We had the opportunity to study this association in several large nationwide population-based registries including all Swedish citizens, and with high specificity regarding the ingoing variables of interest – i.e., non-fatal deliberate self-harm (as registered in the National Patient Register) and violent crime convictions (as registered in the National Crime Register).
We found a five times increased crude risk (hazard) of being convicted of a violent crime if one had received self-harm associated clinical care, and vice-versa, that there was an equally increased risk of self-harm if one had been convicted of a violent crime. After controlling for relevant psychiatric comorbidities and socio-economic status, an almost doubled risk of violent crime conviction remained among self-harming men and women compared to individuals not exposed to self-harm. It is important to notice that our study did not find any evidence suggesting that self-harm behaviours cause violent criminality. Therefore, we conclude that the engagement in violence towards oneself and towards others share an underlying vulnerability to impulsive and aggressive behaviours.
06 Apr Model of RAF Inhibitor Action Provides Roadmap For Resistant Colon and Thyroid Cancer Treatment
MedicalResearch.com Interview with: [caption id="attachment_33719" align="alignleft" width="191"]
Dr. Poulikakos[/caption]
Poulikos I. Poulikakos, PhD
Assistant Professor
Department of Oncological Sciences
Department of Dermatology
The Tisch Cancer Institute
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Mutations in the oncoprotein kinase BRAF are found in about 8% of human tumors, including more than 50% of melanomas. Small molecule RAF inhibitors prolonged survival of melanoma patients with mutant-BRAF tumors, but resistance limits their effectiveness. Further, RAF inhibitors showed only modest efficacy in patients with colorectal and thyroid mutant-BRAF tumors. Previous studies have suggested that the complex biochemical mechanisms of action of RAF inhibitors account for both sensitivity and major mechanisms of resistance to these drugs. Recently, a number of next generation RAF inhibitors have entered preclinical or clinical development, but the most appropriate clinical context for their use remained elusive.
06 Apr Pediatric Death Fall Worldwide, But Still Disproportionately Affect Poorer Countries
MedicalResearch.com Interview with: Dr. Nicholas Kassebaum, MD Assistant Professor Institute for Health Metrics and Evaluation University of Washington MedicalResearch.com: What is the background for this study? Response: Reducing deaths of young children has been an international priority over the past few decades, and much progress has been made in this regard. Comprehensive and timely measurement of death and disease burden among children and adolescents is essential for improving the health of young people. Analyzing the latest estimates from the Global Burden of Disease (GBD), the current study quantifies and describes levels and trends of mortality and disease burden among children and adolescents under the age of 19 from 1990 to 2015.06 Apr Maternal Obesity Linked To Increased Risk of Epilepsy in Offspring
Posted at 11:29h
in Author Interviews, Epilepsy, JAMA, Karolinski Institute, OBGYNE, Pediatrics, Weight Research
MedicalResearch.com Interview with:
Neda Razaz-Vandyke, PhD, MPH
Postdoctoral Fellow
Reproductive Epidemiology Unit
Karolinska Institutet
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is a growing concern about long-term neurological effects of prenatal exposure to maternal overweight and obesity.
The etiology of epilepsy is poorly understood and in more than 60% of cases no definitive cause can be determined. We found that maternal overweight and obesity increased the risks of childhood epilepsy in a dose-response pattern.
06 Apr Effect of Centralization on Health Disparities in Lung and Bladder Cancer Surgery
MedicalResearch.com Interview with: [caption id="attachment_33534" align="alignleft" width="177"]
Dr. Taioli[/caption]
Emanuela Taioli MD PhD
Professor, Population Health Science and Policy, and Thoracic Surgery
Director, Institute for Translational Epidemiology
Director, Center for the Study of Thoracic Diseases Outcome
Director, Division of Social Epidemiology
Icahn Medical Institute,
New York, NY 10029
MedicalResearch.com: What is the background for this study?
Response: Extensive literature documenting the relationship between hospital volume and clinical outcomes has resulted in the centralization of cancer care advocating patients to seek cancer surgical procedures at high-volume (HV) hospitals. Lung resection and cystectomy have been specifically recommended for centralization, but improvements in outcomes are not shared equally among racial groups. It has also been reported that black patients more commonly undergo surgery at low-volume and lower-quality hospitals, despite living in close proximity to higher quality hospitals.
We investigated the effects of centralization on HV hospital utilization and surgical outcomes for lung (n = 28,047 White; n = 2,638 Black) and bladder (n = 7,593 White; n = 567 Black) cancer patients over a 15 year time span (1997-2011) in New York State. We hypothesized that centralization has improved utilization of HV hospitals and outcomes for both black and white patients, but significant disparities remain between black and white patients.
06 Apr Early Low-Dose Hydrocortisone Therapy in Extremely Preterm Neonates Not Linked To Poor Neurodevelopmental Outcomes
MedicalResearch.com Interview with: [caption id="attachment_33576" align="alignleft" width="151"]
Prof. Baud[/caption]
Prof. Olivier Baud MD
Chef de Service, Réanimation et Pédiatrie Néonatales
Team leader, INSERM U1141
Université Paris-Diderot, Sorbonne Paris Cité
Département Hospitalo-Universitaire "PROTECT"
Hôpital Robert Debré, Paris, France
MedicalResearch.com: What is the background for this study?
Response: Preterm birth is frequently associated with perinatal inflammation, a major risk factor for bronchopulmonary dysplasia (BPD). Because glucocorticoids alleviate systemic inflammation, they have been proposed as a therapeutic option in very preterm infants. Early dexamethasone therapy led to short-term benefits but was associated with cerebral palsy and other adverse neurodevelopmental events. Early treatment with low-dose hydrocortisone has been reported to improve short-term outcomes in extremely preterm infants. However, its safety remains to be assessed with regard to the long-term neurodevelopmental outcomes.
06 Apr Large Teaching Hospitals Face Greater Risk of Data Breaches
MedicalResearch.com Interview with: [caption id="attachment_33589" align="alignleft" width="125"]
Dr. Ge Bai[/caption]
Ge Bai, PhD, CPA
Assistant Professor
The Johns Hopkins Carey Business School
Washington, DC 20036
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We examined the hospital data breaches between 2009 and 2016 and found that larger hospitals and hospitals that have a major teaching mission have a higher risk of data breaches.
06 Apr White Matter Trajectories Diverge In Children After Traumatic Brain Injury
MedicalResearch.com Interview with: [caption id="attachment_33705" align="alignleft" width="178"]
Emily Dennis[/caption]
Emily Dennis PhD
Postdoctoral Scholar
Imaging Genetics Center
Mark and Mary Stevens Neuroimaging and Informatics Institute
USC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that there is heterogeneity in outcome post-traumatic brain injury (TBI), but we generally think of this as a continuous variable - with most patients falling in the middle and only a few at the extremes in terms of recovery process and outcome.
Our main finding was that interhemispheric transfer time (IHTT - the time it takes for information to move from one hemisphere of the brain to the other) identified 2 subgroups of TBI patients - those with slow IHTT and those with normal IHTT. These two groups show differences in cognitive function and brain structure, with the IHTT slow group showing structural disruptions that become progressively worse while the IHTT normal group seems to be recovering from the injury.
05 Apr Affordable Care Act Linked To Marked Increase in Surgery for Thyroid Cancer
MedicalResearch.com Interview with: [caption id="attachment_33698" align="alignleft" width="160"]
Dr. Benjamin James[/caption]
Benjamin James, MD MS
Assistant Professor of Surgery
Adjunct Assistant Professor of Otolaryngology
Section of Endocrine Surgery
IU Division of General Surgery
Indiana University Hospital
Indianapolis, IN 46202
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Over the few decades, there has been a substantial increase in the incidence of thyroid cancer. It is the fastest growing cancer and a recent study in JAMA found that the mortality rate has been rising.
In 2006, Massachusetts passed healthcare reform, which expanded Medicaid, created new subsidized insurance programs for those ineligible for Medicaid and extended young adults eligibility on parental plans until the age of 26.
The aim of our study was to evaluate the impact this has had on the treatment of thyroid cancer. To address this question, we used the Hospital Cost and Utilization Project State Inpatient Databases for Massachusetts, New Jersey, New York, and Florida, which included a cohort of 56,581 inpatient admissions from 2001 to 2011. We then compared these states before and after the healthcare reform in Massachusetts to evaluate the effect the healthcare reform had on the treatment of thyroid cancer.
05 Apr IQuity Developing RNA-Based Disease Activity Test for Multiple Sclerosis
MedicalResearch.com Interview with: [caption id="attachment_33692" align="alignleft" width="200"]
Dr. Chase Spurlock[/caption]
Dr. Chase Spurlock, Ph.D.
Executive Officer at IQuity, Inc
Nashville, Tennessee
IQuity is working to further develop RNA technologies that can be used to diagnose and treat Multiple Sclerosis. IQuity hopes to develop a ‘disease activity test’, which would help physicians determine when a patient is likely to relapse so that treatments can be timed for best effect.
MedicalResearch.com: What is the background for IQuity? What are its goals and mission?
Response: IQuity, Inc. is a biotechnology company that focuses on the research and development of innovative specialty diagnostic technology, specifically for autoimmune diseases. Our research has shown that autoimmune patients have distinct RNA expression patterns in their blood, and we have figured out how to leverage machine learning methods to analyze these RNA expression patterns and test for the presence of diseases like multiple sclerosis, IBS/IBD (Crohn’s and ulcerative colitis) and fibromyalgia. We collected patient samples from around the globe to match their RNA profiles against healthy and sick patient profiles we identified through our previous research. These tests led to the development of IQIsolate, our technology that informs the suite of tests which, when used even at the earliest onset of symptoms, can give providers information to rule in or rule out a suspected autoimmune disease with more than 90% accuracy.
Our mission is to relentlessly pursue innovation in specialized diagnostic and analytic technology, identifying complicated autoimmune and autoimmune-related diseases at the earliest signs of symptoms. We strive to enable providers to diagnose early and treat sooner in the disease progression to improve long-term outcomes, lower the overall cost of lifelong autoimmune diseases and minimize the uncertainty and fear patients experience during prolonged diagnosis periods.
05 Apr Antibiotics in Pregnancy Increase Children’s Risk of Otitis Media and Ventilation Tubes
MedicalResearch.com Interview with: Hans Bisgaard, MD, DMSc Professor of Pediatrics The Faculty of Health Sciences University of Copenhagen Copenhagen University Hospital, Gentofte Copenhagen, Denmark MedicalResearch.com: What is the background for this study? Response: The consumption of antibiotics is increasing worldwide. Antibiotics alter the maternal bacterial colonization and by vertical transmission this can affect the offspring. An unfavorable microbiome may increase the disease propensity of the offspring. Otitis media is one of the most common infections in early childhood. We hypothesized that antibiotic consumption in pregnancy can increase the children’s risk of otitis media.05 Apr Exposure to BPA Substitute, BPS, Multiplies Breast Cancer Cells
[caption id="attachment_33686" align="alignleft" width="124"]
Dr. Sumi Dinda[/caption]
MedicalResearch.com Interview with:
Sumi Dinda, PhD, NRP, IC.
Associate Professor
Biomedical Diagnostic and Therapeutic Sciences,
School of Health Sciences and
Adjunct Associate Professor
Department of Biological Sciences
School of Health Sciences
Oakland University
Rochester, MI 48309.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Bisphenol-S (BPS), a substitute for bisphenol-A (BPA), has been suggested to be an endocrine disrupting compound interfering with normal hormonal activity. This bisphenol analogue is found in plastic substitutes, paper currency, and most products marked “BPA free.” Endocrine disrupting compounds interfere with the normal hormonal activity in the body.
Bisphenols, specifically, disrupt the proper functioning of estrogen receptors, such as ERα causing interference with the normal activity of the hormone estrogen. Studies suggest BPS induces ERα pathways via its estrogen-mimicking properties in the body causing increased cell proliferation resulting in increased breast cancer risk. Despite the hope of a safer substitute, studies have shown that BPS exhibits similar estrogenic activity compared to its analogue BPA, due to their structural commonalities.
BRCA1 is a commonly mutated gene in breast cancer; therefore, it is also important to study the effects of BPS on the expression of this protein. The potency of the endocrine disrupting abilities of BPS compared to BPA could show whether BPS is a suitable alternative to BPA in many everyday products.
The results of this study may contribute to the understanding of the relationship between ERα, BRCA1 expression and Bisphenol-S in breast cancer treatment and prevention.
05 Apr Doxycycline May Mute Painful Memories Associated With PTSD
MedicalResearch.com Interview with: Dominik R Bach, PhD, MD University of Zurich MedicalResearch.com: What is the background for this study? What are the main findings? Response: Posttraumatic stress disorder (PTSD) can occur after a psychological trauma such as physical violence, abuse, or natural disaster. It is characterised by increased arousal, flashbacks, and nightmares that reflect memories of the trauma. Current therapies include talking therapy, but it is costly and does not work in everybody. This is why we were looking for ways of reducing aversive memories with a drug. In the current study, we found that the antibiotic doxycycline impairs the formation of negative memories in healthy volunteers. To form memories, the brain needs to strengthen connections between neurons. It has recently emerged that for strengthening such connections particular proteins are required that sit between nerve cells, so-called MMPs. They are involved in many disorders outside the brain, such as certain cancers and heart disease. This is how we already know that doxycycline suppresses the activity of MMPs. Since doxycycline is relatively safe and readily accessible, our research was relatively straightforward. 76 healthy volunteers - half women, half men - came to the laboratory and received either placebo (a sugar pill) or 200 mg doxycycline. They then took part in a computer test in which one screen color was often followed by a mildly painful electric shock and another color was not. A week later, volunteers came back to the lab. They were shown the colors again , this time followed by a loud sound but never by shocks. The loud sounds made people blink their eyes - a reflexive response to sudden threat. This eye blink response was measured. Volunteers who had initially been under placebo had stronger eye blink after the color that predicted electric shock than after the other color. This "fear response" is a sensitive measure for memory of negative associations. Strikingly, the fear response was 60% lower in participants who had initially taken doxycycline.05 Apr Pyrethroid Pesticides Linked To Earlier Puberty in Boys
MedicalResearch.com Interview with: [caption id="attachment_33680" align="alignleft" width="140"]
Dr. Jing Liu[/caption]
Jing Liu, Ph.D.
Associate Professor
College of Environmental & Resource Sciences
Zhejiang University
Hangzhou, China
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In addition to consistent observations of earlier pubertal onset in female since late 19th century, acceleration in male pubertal development also has been reported in more recent studies. Improved nutrition, health and living conditions may contribute to the secular trend towards an earlier pubertal onset. However, the potential role of environmental agents, specifically endocrine-disrupting chemicals (EDCs), also has been emphasized.
Pyrethroids are among the currently used pesticide classes placed on the list of the US Environmental Protection Agency (EPA) as potential EDCs. Pyrethroids are one of the top 10 classes of pesticides and account for greater than 30% of global insecticide usage. Increased human exposure to pyrethroids is thought to occur mainly via residues in diets and indoor residential use. The metabolites of pyrethroids have been widely identified in urine samples of adults, children and adolescents worldwide and the detection rate is usually more than 60% in human populations.
Here, we recognize pyrethroids as a new environmental contributor to the observed secular trend toward earlier male sexual maturity. For the first time to our knowledge, this work reveal a significant and positive association between pyrethroids exposure and gonadotropins levels in 463 Chinese boys, in which a 10% increase in 3-PBA (a common urinary metabolite of pyrethroids) is associated with more than 2% increase in both LH and FSH. Boys with increased urinary levels of 3-PBA have a significantly increased risk of earlier pubertal development, in which the odds of being in an advanced testicular volume and genitalia stage are increase by 113% and 268%, respectively.
Because it is difficult to test the direct causality of environmental risk factors in humans, we further sought to identify in animals how pyrethroids alter the timing of puberty. Postnatal exposure to a widely used pyrethroid pesticide, cypermethrin, can accelerate pubertal timing and induce circulating levels of gonadotropins and testosterone in male mice. Our findings reveal the activation of voltage-gated calcium channels pathway in pituitary gonadotropes and testicular Leydig cells as a newly discovered mechanism of pyrethroid-induced early pubertal development in the male.
05 Apr When Choosing A Mate, Women Choose Looks Over Personality
MedicalResearch.com Interview with: [caption id="attachment_33676" align="alignleft" width="161"]
Dr. Fugère[/caption]
Madeleine A. Fugère, Ph.D.
Professor of Psychology
Eastern CT State University
Willimantic, Connecticut
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous research has shown that both daughters and their parents rate many traits as more important than physical attractiveness in a potential mate (for daughters), including traits such as respectfulness, honesty, and trustworthiness. Previous research also shows that women rate physical attractiveness as more important in a mate for themselves than parents do in a mate for their daughters.
In our research project, we experimentally manipulated the physical attractiveness of male targets (using photographs) and we experimentally manipulated the traits associated with each male target. The trait profiles included the “respectful” trait profile which consisted of the traits respectful, honest, and trustworthy, the “friendly” trait profile which included the traits friendly, dependable, and mature, and the “pleasing” trait profile which contained the traits pleasing disposition, ambitious, and intelligent.
We found that both women and their mothers were strongly influenced by the physical attractiveness of the men and preferred the attractive and moderately attractive targets. Both women and their mothers rated the attractive and moderately attractive men most favorably, especially when they were paired with the most positive trait profile (the “respectful” trait profile).
However, the unattractive man was never rated more positively than his more attractive counterparts even when he possessed the most favorable trait profile.
05 Apr Tridimensional Visualization and Analysis of Early Human Development
MedicalResearch.com Interview with: [caption id="attachment_33668" align="alignleft" width="125"]
Dr. Chedotal[/caption]
Alain Chedotal, PhD
Group Leader, Institut de la Vision (Inserm/UPMC/CNRS), Paris and
[caption id="attachment_33669" align="alignleft" width="125"]
Dr. Berlemont[/caption]
Sylvain Berlemont, PhD
CEO & Founder of Keen Eye Technologies, Incubateur Institut de la Vision, Paris
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: What was known about human embryo development was based on histological techniques developed at the beginning of the twentieth century and no significant progress had been made for about fifty years. A few years ago our team found a method allowing to perform immunostaining on whole-mouse embryos and adult mouse brains. Complete 3D images of the intact samples could be obtained after they were cleared with solvents and imaged with a light sheet microscope.
In this new study we have adapted this method to human embryos during the first trimester of gestation. We provide for the first time high-resolution 3D images of the developing peripheral nervous, muscular, vascular, cardiopulmonary, and urogenital systems. We found evidence for important in differences in the embryonic pattern of nerve branches between the right and left hands. We also present evidence for a differential vascularization of the male and female genital tracts concomitant with sex determination.
04 Apr Insufficient Evidence To Screen Asymptomatic People For Celiac Disease
MedicalResearch.com Interview with: [caption id="attachment_30723" align="alignleft" width="200"]
Dr. Ann Kurth[/caption]
Dr. Ann Kurth, Task Force member
Dean of the Yale School of Nursing
Adjunct professor
New York University College of Nursing and the College of Global Public Health.
MedicalResearch.com: What is the background for this study?
Response: Celiac disease, an immune disorder where people should not eat food with gluten, is fairly prevalent. When people with celiac disease eat foods containing gluten, which is found in wheat, rye and barley, their body responds by inflaming or destroying villi—the tiny, fingerlike projections on the inner lining of the small intestine–which prevents the body from absorbing the necessary nutrients from food.
04 Apr End-of-Life Care Transition Patterns of Medicare Beneficiaries
MedicalResearch.com Interview with: Shi-Yi Wang MD, PhD. Department of Chronic Disease Epidemiology Yale School of Public Health New Haven, CT MedicalResearch.com: What is the background for this study? What are the main findings? Response: Care at the end of life is often fragmented and poorly coordinated across different health providers. Multiple transitions in care settings can be burdensome to patients and their families as well as costly to society. Despite these concerns about care transitions in the end of life, we lack contemporary data on the number, timing, and overall pattern of healthcare transitions in the last 6 months of life. This study adds to the extant literature by understanding transition trajectories, national variation of the transitions, and factors associated with transitions. We found that more than 80% of Medicare fee-for-service decedents had at least one health care transition and approximately one-third had ≥ 4 transitions in the last 6 months of life. We produced Sankey diagrams to visualize the sequences of healthcare transitions. The most frequent transition pattern involving at least four transitions: home-hospital-home (or skilled nursing facility)-hospital-healthcare setting other than hospital. There was substantial geographic variation in healthcare transitions in the United States. We found that several factors were associated with a significantly increased risk of having multiple transitions, including female gender, blacks, residence in lower income areas, presence of heart disease or kidney disease.04 Apr Effects of ICD Shock and Anti-Tachycardia Pacing on Anxiety and Quality of Life
MedicalResearch.com Interview with: Alessandro Paoletti Perini, MD, PhD and Valentina Kutyifa MD, PhD University of Rochester Medical Center Heart Research Follow-Up Program Rochester, New York, 14642 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The present study is a pre-specified sub-study of the Multicenter Automatic Defibrillator Implantation Trial – Reduce Inappropriate Therapy (MADIT-RIT), which was published on the New England Journal of Medicine in 2012. The main trial showed that innovative ICD programming was associated with reduction in inappropriate ICD therapy and mortality. In the present investigation we focused on the detrimental effects that ICD firings, either appropriate or inappropriate, may have on patients’ psychological well-being. We observed that multiple appropriate and inappropriate shocks are associated with increased levels of ICD-related anxiety, a specific kind of psychological disorder which affects patients implanted with an ICD. Multiple appropriate ATP were also proved associated with higher anxiety, although not as much as shocks. On the other hand, we did not find a significant association with anxiety for multiple inappropriate ATP.04 Apr One Drop | Mobile APP Leads To Improved A1c in Diabetes
MedicalResearch.com Interview with: Chandra Y. Osborn, PhD, MPH VP, Health & Behavioral Informatics One Drop Informed Data Systems, Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are over 1,500 mobile apps for people with diabetes, but minimal evidence on their benefit. The One Drop | Mobile app launched in April 2015. Users manually and automatically track their blood glucose and self-care activities via One Drop's | Chrome glucose meter, other Bluetooth-enabled meters, CGMs or other health apps. Users leverage One Drop’s food library, medication scheduler, automatic activity tracking, educational content, recipes, health tips, user polls, and peer support (‘likes’, stickers, and data sharing), and can set blood glucose, medication, carbohydrate intake, and activity goals, receive data-driven insights to draw connections between their behaviors, goals, and blood glucose readings. They can also self-report and track their hemoglobin A1c (A1c) and weight. In July 2016, we queried data on ~50,000 people using One Drop | Mobile. In March 2017, we queried data on >160,000 users. Only users who had entered an A1c value when they started using the app, and entered a second A1c at least 60 days apart, but no more than 365 days apart, were included. In July 2016, people with diabetes using One Drop | Mobile reported a nearly 0.7% reduction in A1c during 2-12 months of using One Drop. In March 2017, users reported a 1.0% reduction in A1c for the same timeframe. A more recent diabetes diagnosis and using One Drop to track self-care activities was associated with more A1c improvement.04 Apr Some Retirees Begin Risky Alcohol Consumption
MedicalResearch.com Interview with: Jaana Halonen, Docent and Senior Researcher Finnish Institute of Occupational Health MedicalResearch.com: What is the background for this study? Response: Retirement is a significant life transition when substantial changes in daily life are experienced as retirees adapt to life without work. After retirement people have more leisure time and more opportunities for different activities, and less stress. These changes are positive, but retirement can also lead to reduced social control and loss of social contacts and therefore be perceived as a stressful life transition. Both the positive and negative aspects related to changes in leisure time, stress, and social networks around retirement may affect drinking behaviours. However, little is known about how risky alcohol consumption changes around the retirement transition. Thus, in our study we wanted to examine how and for whom risky drinking changes around the time of retirement. To do that we followed up public sector workers with questionnaires before and after their old-age retirement.04 Apr Regular Marijuana Use is Costly Healthwise, Especially When Started As Teenager
MedicalResearch.com Interview with: [caption id="attachment_33647" align="alignleft" width="200"]
Dr. McIntosh[/caption]
James McIntosh PhD
Economics Department
Concordia University
Montreal, Quebec, Canada.
MedicalResearch.com: What is the background for this study
Response: Marijuana is about to become legal in Canada. Consequently, an analysis of its effects on users is a high priority. This issue has been explored by Canadian researchers to some extent but there are gaps in what is known about the effects of using marijuana. Most of the Canadian studies focus on youth or adolescent use. This is clearly important but adult use is as well. Establishing the link between early usage and the effects of use over an individual’s lifetime was a major objective of the study.
04 Apr Vagus Nerve Stimulation Improved Treatment-Resistant Depression
MedicalResearch.com Interview with: [caption id="attachment_33642" align="alignleft" width="185"]
Dr. Aaronson[/caption]
Scott T. Aaronson, M.D
Psychiatrist, The Retreat at Sheppard Pratt
Director of Clinical Research
Sheppard Pratt Health System
Baltimore, MD
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study is the largest ever conducted on patients with severe, chronic depression, a group typically ignored by clinical research in psychiatry. We looked at individuals who, on average, had received 8 unsuccessful treatment interventions in the past. These individuals were split into two groups and examined over five years. One group was given proven anti-depressant treatments (medications, psychotherapy, and/or electroconvulsive therapy (ECT)), and one group was given both anti-depressant treatments and VNS Therapy—an implantable, pacemaker-like device that stimulates the vagus nerve, which regulates mood in the brain.
• The study found that 67.9% of the VNS therapy group responded to treatment, compared to 40.9% of patients receiving treatment as usual. Importantly, the VNS therapy group reported responses earlier in treatment, and responses were sustained longer than those receiving treatment as usual.
• VNS therapy improved treatment effect in individuals whether they had unipolar or bipolar disorder, and whether or not they had responded to ECT in the past.
04 Apr PAP May Provide New Therapeutic Target For Bone Metastatic Prostate Cancer
MedicalResearch.com Interview with [caption id="attachment_33638" align="alignleft" width="130"]
Dr. Alice Levine[/caption]
Dr. Alice Levine MD
Professor, Medicine, Endocrinology, Diabetes and Bone Disease
Associate Professsor ,Oncological Sciences
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Prostate cancer (PCa) bone metastases are a major cause of morbidity and mortality. This cancer is unique in its tendency to produce osteoblastic (OB) bone metastases, which affects 90% of men with PCa bone metastases, compared to others that produce osteolytic bone metastases. Currently, there are no existing therapies that specifically target the OB phase and no effective therapies for PCa bone metastases that prolong survival. We have identified a secretory protein that promotes the development PCa osteoblastic bone metastases, Prostatic acid phosphatase (PAP). Prostatic epithelial cells produce PAP. The physiologic function of PAP is unknown. It was the first human tumor marker ever described. Patients with PCa bone metastases demonstrated high levels of PAP. PAP is expressed by PCa cells in OB metastases and increases OB growth, differentiation, and bone mineralization.
04 Apr Donor Sex and Size Important to Kidney Transplant Success
MedicalResearch.com Interview with: Amanda Miller, MD, FRCPC Dalhousie University Transplant Nephrology MedicalResearch.com: What is the background for this study? What are the main findings? Response: Earlier studies have shown that there may be a higher risk of kidney transplant failure if a kidney donor is smaller than their recipient. This may be due to increased strain on the relatively smaller transplanted kidney. Very few studies have investigated outcomes associated with donor and recipient weight mismatch measured directly by differences in body weight however. There is also a suggestion that sex mismatch between kidney donor and recipient may lead to worse outcomes post-transplant, however results from earlier studies have been controversial and conflicting. The combined effect of weight and sex matching/mismatching between kidney donor and recipient (two very important and physiologically relevant factors) has not been rigorously studied previously. Thus, the aim of this study was to determine if receiving a kidney transplant from a smaller donor of the opposite sex would impact transplant outcomes. Accounting for other transplant variables, we demonstrated that if a kidney transplant recipient is more than 30 kg (66 pounds) heavier than the donor there is a 28% increased risk of the transplant failing compared to equally weighted donors and recipients. If the kidney is from a smaller donor of the opposite sex, the risk of transplant failure is further increased to 35% for a male receiving a kidney from a female donor, and 50% for a female receiving a kidney from a male donor. This risk is high and is similar to that when a recipient receives a kidney transplant from a donor who has diabetes; a known risk factor for kidney failure in the non-transplant population.04 Apr Omega-3 Fatty Acid Supplementation Improves Luteal Function in Obese Women
MedicalResearch.com Interview with: [caption id="attachment_33632" align="alignleft" width="133"]
Dr. Polotsky[/caption]
Alex J. Polotsky, MD
Associate Professor of Obstetrics and Gynecology
University of Colorado Denver
Practice homepage
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It has been well established that profound dietary changes occurred over the past 100 years. The type and amount of fat consumed has changed quite a bit over the course of 20th century. Intake of omega-3 polyunsaturated fatty acids (PUFAs), previously consumed in large quantities by humans from vegetable and fish sources, has dropped significantly. The typical Western diet (sometimes also called the typical American diet) provides an omega-6 to omega-3 fatty acid ratio of as high as 25:1, which is quite different from what it used to up until about the 19th century (believed to be about 1:1 ratio).
In animal studies, diets enriched with omega-3 PUFA enhance early embryonic development and boost progesterone secretion. Obesity is well known to be associated with decreased progesterone production in women (even if a obese woman ovulates). The reasons for this are not clear. Obesity is also a state of low-grade chronic inflammation. Omega-3 fatty acids are well known to have anti-inflammatory properties.
We sought to test whether dietary supplementation with omega-3 PUFA favorably affects reproductive hormones in women and whether this effect includes normalization of progesterone production in obesity.
All women in the study tolerated supplementation well, and had significantly decreased their omega-6 to omega-3 ratios (they were normalized much closer to a 1:1 ratio). Omega-3 supplementation resulted in a trend for increased progesterone in obese women, thus enhancing ovulatory function. A 16 to 22 percent increase was observed. Additionally, the supplementation resulted in reduced systemic inflammation.
04 Apr Study Finds Statin Use Not Associated With Breast Cancer Prognosis
MedicalResearch.com Interview with: [caption id="attachment_33622" align="alignleft" width="134"]
Dr. Leiter[/caption]
Amanda Leiter, MD MSCR
Medical Resident, Internal Medicine
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Black women are more likely than White women to have breast cancer with poor prognostic features, which cannot be completely explained by differences in screening, treatment and established risk factors for breast cancer mortality. Black women have higher rates of obesity, insulin resistance and dyslipidemia when compared to White women. Prior studies have shown a decreased risk of breast cancer recurrence and improved survival with statin use.
As statins have an association with decreased breast cancer recurrence and potentially improved survival, disparities in statin use between Black and White women with breast cancer are important to investigate. We aimed to elucidate whether or not statin use differs between Black and White women with breast cancer and if racial disparities in breast cancer can be partially explained by differences in statin use.
03 Apr Suicide Risk Increased in Cancer Patients
MedicalResearch.com Interview with: [caption id="attachment_33625" align="alignleft" width="152"]
Dr. Calati[/caption]
Raffaella Calati, Psy.D., Ph.D.
University of Montpellier
INSERM U 1061: Neuropsychiatry: Epidemiological and Clinical Research
Department of Emergency Psychiatry and Post Acute Care
Lapeyronie Hospital, Centre Hospitalier Universitaire
Montpellier, France
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A number of previous original studies investigated suicidal thoughts and behaviours in cancer patients, finding them to be higher than those in the general population. However, to our knowledge, we performed the first meta-analysis on this link, pooling all the published data to calculate the size of this increased risk.
Our main finding is an increased suicide risk in patients with cancer compared to individuals without it.
It should be underlined that the analyses presented are the first stage in our work, since at the moment we are analyzing a higher number of studies and we are planning to control for confounders, not considered in our first analyses. This means that the exact strength of this association will be more precisely known.
02 Apr Economic Evaluation of a Home-Based Age-Related Macular Degeneration Monitoring System
Posted at 13:17h
in Author Interviews, Cost of Health Care, JAMA, Macular Degeneration, Ophthalmology, Telemedicine
MedicalResearch.com Interview with:
John Wittenborn
Senior research scientist
NORC's Public Health Analytics
University of Chicago
MedicalResearch.com: What is the background for this study? What are the main findings?
Response:The emergence of anti-VEGF treatment for wet-form AMD (choroidal neovascularization) has had a dramatic impact on preserving vision for many Americans. However, community-based studies show that most patients are not diagnosed with wet-form AMD until they have already lost a significant, and largely unrecoverable amount of their vision. Early detection of wet-form AMD is key to effective treatment and the preservation of vision. The ForeseeHome telemonitoring technology provides patients with a means to check their own eyes on a daily basis to detect the earliest signs of vision loss from wet-form AMD.
This is a novel technology that has the potential to improve visual health outcomes for AMD patients. A prior clinical trial (the AREDS-2 HOME study) demonstrated that this technology can detect wet-form AMD earlier, and with less vision loss than standard care alone. However, that is exactly where that study ended as it reported no cost information nor follow-up. Since the end of this study, the device has been cleared by the FDA and approved for reimbursement by Medicare for certain higher risk patients, but no study has yet considered the long-term implications of adoption of this technology.
In our analysis, we use a computer simulation model to essentially estimate what will come next, after patients realize earlier detection of wet-form AMD by utilizing home monitoring. Basically, we follow simulated patients from the time they begin monitoring for the rest of their lives, recording the likely impacts of home monitoring on patients’ long term outcomes including visual status, costs and quality of life.
We find that home telemonitoring among the population indicated for reimbursement by Medicare would cost $35,663 per quality adjusted life year (QALY) gained. Medicare would expect to incur $1,312 in net budgetary costs over 10 years for each patient who initiates monitoring. However, Medicare patients may expect to achieve lifetime net savings when accounting for the chance of avoided vision loss and its associated costs later in life.